09/23. ROOM ICU 500.00. LAB AUTO BLOOD CT 1402101. 17.00...
09/24. ROOM ICU 500.00. LAB SALICYLATE 1401050. 40.00....
09/25. ROOM ICU 500.00. LAB ACT PAR THROM 1404001. 27.00…
09/26. ROOM ICU 500.00. LAB CHEM-8 1401111. 31.00…
09/27. ROOM ICU 500.00. OPER OP RM 150 1001005. 520.00… 1
Published by David Hellerstein, M.D. in the March 1984 issue of Harper's Magazine, “The Slow, Costly Death of Mrs. K__” describes a woman's illness through an annotated medical bill. An excruciatingly exhaustive list of dates, treatments, and charges, the closely packed figures of the invoice tabulate the costs of care from a woman’s twenty-five-day hospital stay. This data set produces in precise detail the summation of tests, medicine, equipment, labor, and space for Mrs. K__’s care, adding up to a final bill for $47,311.20 on October 18th, the day of her death.
What do we think of when we imagine the architectures of health and hospice? In Mrs. K__’s bill, the only reference to her environment is the daily charge of $500.00 for her ICU room. Punctuating the endless list of blood tests, tissue cultures, x-rays, equipment rentals, and dosages, the repetition of the room charge produces “the low affect that accompanies the perception of minor differences against a backdrop of the generic”2. The dull affect of the list—a deadpan aesthetic that reflects Mrs. K__’s “slow and costly death” in the words of Dr. Hellerstein—embodies the spatial and temporal alienation of modern healthcare, abstracting the actual lived experience of illness, loss, and grief. While architectures of health often reproduce this abstraction, characterized by hushed waiting rooms, generic labyrinths of overly conditioned corridors, and curtained grids of beds bristling with tubes and equipment, what other forms of spatial practice can re-inscribe care into this mystifying flow of bodies, medicine, and capital? Rather than obscuring the invisible infrastructure of costs, assessments, and risks in medicine, how can architecture overcome the dull dread of hospital bills, invoices, administrative overhead, and insurance claims to produce a new interface with our spaces for care?
About the author BIO MISSING