Klinik Arlesheim is constructing a distinctive new building made of wood. Lukas Schöb, medical director of the clinic, and architect Yaike Dunselman from 9grad architektur spoke with Wolfgang Held.
What does this new building mean for Klinik Arlesheim?
Lukas Schöb: Ever since the decision was made to construct this wooden building, we’ve felt it’s a big step into the clinic’s future. We’re feeling a kind of social tailwind—both from our clinic community and from our external contacts. People often react sensitively or critically to change, but we’re now experiencing a thoroughly constructive atmosphere. There’s a high commitment to this project. Everyone understands why we want and need to take this big step: our existing building is simply too old. The new building is a generational decision for the clinic.
In times when hospitals are under so much economic pressure, that takes courage.
LS: Yes, it does take courage. We find ourselves in a crisis of healthcare policy, where hospital rates are being consciously kept artificially low for political reasons. This recently led to a significant loss of revenue for hospitals and is driving some institutions to bankruptcy. We’re aware of the risks and work every day to remain economically stable.
What wishes are you fulfilling with this construction project?
LS: In the first place, it’s about making it possible for us to continue practicing anthroposophic medicine here. Our existing building is not sustainable according to the current development of regulations. Of course, we’re interested in more than just maintaining our status—there’s a wish for development, a wish for a future. The decision to build a wooden building is in harmony with the clinic’s core values, and that’s probably what’s giving us the tailwind I mentioned. At the same time, I’d like to emphasize that the new building is only an instrument for our work, not the substance of it. The substance is medicine: our commitment to healing based on the anthroposophical picture of the human being. This tool will enable us to better fulfill our demanding task.
This tool will be a wooden building, which is unusual for something this size. What were your reasons for this decision?
Yaike Dunselman: It’s worth dispelling some of the preconceptions about building with wood. It’s often said that wood doesn’t last long—yet the oldest house in Switzerland is a wooden house! Wood is durable when it’s handled and installed correctly. The new building will be constructed using the Wood100 solid-wood construction system. Certified Wood100 is felled during the waning moon and is thereby more durable, weather-resistant, and more resilient than conventional construction timber. Another preconception concerns fire: in the event of a fire, a wooden structure is often safer. A frying pan, for example, has a wooden handle rather than a steel one for a good reason: wood does not conduct as much heat as steel.
LS: The beams remain standing longer in a fire in a wooden building, for example, a farmhouse, than in a reinforced concrete building. Wood resists fire the longest.
YD: Wood is a natural material—and that means that care is part of preserving it. We should learn to treat our planet’s natural materials with attentiveness. This is a forward-looking gesture that creates sustainable quality.
Are you limiting yourself to softwoods such as spruce, pine, or fir?
YD: Yes, for reasons of sustainability, because this wood comes from Switzerland and the Black Forest! In addition, we don’t just use spruce but also beech or oak for the door frames, because this wood is harder. Incidentally, the façade is made of larch, because this wood is especially weather-resistant.
From practical to aesthetic, what artistic challenges does wood present?
YD: It’s about connecting with the natural material and developing an appropriate and vivid design from the material itself. I’ve already completed several projects with wood and find it a wonderful and fruitful starting point for working with natural and vulnerable building materials. Many people today are looking for materials and building components that are indestructible and require no maintenance. But that’s not in keeping with life or our values. Life teaches us that we should develop a consciousness that our environment is vulnerable—and so are we. So, especially in places where life is at stake, such as in a hospital, our work should be shaped and built with and from this vulnerability. Vulnerability and longevity can be combined very well!
LS: Rudolf Steiner also built the therapy center next to the clinic out of wood. We wanted to pick up on its design language without simply copying it. Instead, we wanted to allow it to be an inspiration for us. Anyone who compares the two buildings will easily see this.
What about hygiene with wood? The standards for hospitals are very high.
LS: We have rooms where we seal the wood to ensure seamless hygiene. This applies, for example, to endoscopy rooms, where stomach, intestinal, and lung examinations are performed.
The Widar Clinic in Järna, Sweden, which has now unfortunately closed, had wide wooden floorboards. This created a natural and elegant look. I thought that people would recover more quickly than if they were walking on linoleum flooring. Does the health aspect also play a role when it comes to using wood as a building material?
YD: Healthy building material promotes health. I’m convinced of that. A human being’s perception of wood is something completely different from that of other materials! Add to this the climatic effect of wood. It breathes and is able to absorb and release moisture. The effect of wood on the indoor climate is enormous.
You design architecture for patients. Does that make you a bit of a doctor yourself?
YD: No, that won’t make me a doctor! But I’ve tried to connect with the issues of healing and to see the new building through the eyes of our collaborators in order to get a feel for what’s being done here. What works here? How can the building embrace and support that? Here, we find that what’s important is warmth and love, so wood is the material of choice. Material, soul, and spiritual reasons all come together in choosing wood as the building material.
LS: Above all else, the functionality of a modern hospital is paramount. It must be technically sound and approved by the authorities—this alone is a challenge.
How did you integrate all the technical aspects and practical requirements?
YD: We solved this problem as a team with our numerous specialist engineers. The new hospital building is indeed a functional structure—there’s no denying that. Everything is consistently geared toward the practical everyday life of a hospital, and of course, it contains a great deal of technology. Nevertheless, this technology should remain as invisible as possible to patients.
What do you like most about the building? As an architect, you see the whole, but is there a special spot that makes your heart beat faster?
YD: Yes. At the beginning, we held a workshop and asked our collaborators, “What do you want? What is your vision, your dream? What significance should the new clinic have for you and for our patients?” I found the responses very interesting and beautiful, resulting in some striking and significant images. Following these images is what makes my heart beat! One was especially clear: a strong consciousness of the path the patient is taking. This gave rise to the question: What is the artistic principle of health? I believe there are several, but one is that there is always a balance between polar processes. We breathe in, we breathe out—we’re never one-sided; inner space, inhalation, outer space, exhalation, interest in the world. Health means balance and openness, whereas illness often shows itself as one-sidedness, a purely body-oriented pattern. I have tried to translate this principle into my own contemporary and modern design language. The guiding images for this were the images of path, warmth, breathing, heart, and sheath.
LS: This led us and our collaborators to the elements that now define the building. There’s a cascade of light in the center: light falls from the very top into the inner courtyards.
What about the lighting? Today, we have a great need for light, but at the same time, a clinic also needs to provide a sense of home, protection, and introspection.
YD: That’s an interesting question. As a Dutchman, I like large windows and lots of light. Where is the limit? How much can you tolerate? It’s always a question of balance, as with wood. How much wood is good? It needs to be complemented by other materials.
LS: A new building gives us the opportunity to rethink all the questions that are architecturally relevant to healing. For example, when patients are lying in bed, how should the view of the door be shaped? This is a matter of the need for protection. We have addressed such issues in a collegial manner—in this case, in particular, with the nursing staff. When it comes to topics such as rhythm, proportions, or creative design explorations, I’m very happy to have Yaike at our side. He understands our fundamental concerns and implements them professionally into architecture. It’s remarkable that anthroposophy creates a common basis of understanding here, connecting such different professional groups. Likewise, the long-standing, excellent collaboration with the Swiss architectural firm BSS-Architekten is worth mentioning. It’s no walk in the park—but we’re in a good phase of this cooperation.
YD: This means that the idea of collaboration was central from the outset.
LS: It means that nothing was actually planned, but instead arose from a process, from meetings. It sounds simple, but it actually means a great deal: the building was created through a collaboration.
Organic architecture from the inside, too?
YD: Yes, in the process—and yes, as a fundamental gesture.
I’ve heard that Rudolf Steiner always wanted to paint wood. Today, we prefer natural wood. How do you handle this?
YD: For me, it’s always a question: Was Steiner really so, or did he go through his own developments? Times have changed. I’ve found that Rudolf Steiner was always incredibly of-the-times—and we should see that as a challenge. We don’t have to paint wood today just because that’s how it was done a hundred years ago. We live in a different time, in which there’s a strong need for clarity and nature. One can call it materialism, but we can also see it as a longing for authenticity, for truth—for direct contact with the material or for the material itself to have an effect. Color comes into the building, yes, but it is restrained and not dominant.
What are the reactions to the new building? What kind of response has there been from the anthroposophical community, the surrounding area, and the association of clinics?
LS: Our previous project, the Schmetterling project, sparked debate and polarization. Now we’re experiencing the opposite: overwhelmingly positive reactions. Criticism mainly concerns the threefolding of the building with regard to the roof—but this is a regulatory requirement. There is a lot of momentum, both from the general public and from the architectural community, and great interest in the project.
One hundred meters from your new building, the municipality of Arlesheim built its new community center, Setzwerk—a steel structure. How does that resonate?
YD: I find it contrasting and exciting: a metal edifice, the former Weleda building, and then our wooden construction—three worlds side by side.
When building, there are always surprises. What surprises caught you off guard?
LS: For me, it’s always astonishing to see plans implemented in reality—it surprises me every time. But I like to be surprised when plans become reality. I was surprised by the size. Four floors underground! I already knew that something big was being built, but seeing it built always astounds me.
YD: What Lukas mentioned, that we have the wind at our backs in this project, comes as a bit of a surprise to me. It’s a large and complicated project that many people are working on. We’re also still under a lot of pressure when it comes to costs. But so far, everything is running quite smoothly.
Building also means learning as you go. What changes and corrections did you have to make along the way?
LS: The healthcare sector is developing so rapidly—when I look at the clinic today and look back ten or twenty years ago, we’re at a completely different point. The building’s not finished yet, but at the same time, we already have to look to the future: we know that within a few years, up to forty percent of the space in a hospital will be used differently than originally planned. This was also the case in the current, now old, building: there were many changes in the function and use of the rooms. For example, a room for speech therapy later became an office and ultimately a lounge. Changes in life and work situations require constant architectural adaptation.
YD: We were guided by this consciousness when designing the building. That’s why no serious mistakes were made.
Where have you invested, especially in quality?
LS: With moon wood. Wood100 is more expensive than conventional wood, but it was worth it to us. It’s air-dried for two years, which is unique. And it’s completely chemical-free, which was important to us. We focus on the highest quality, especially in the patient rooms—for example, by using clay plaster on the walls.
LS: Yes, where the real mystery of healing takes place, there is also a kernel of consciousness. We built a model one-to-one patient room to experience how it works—with real materials.
YD: We rotated the beds and arranged and moved chairs around in it to see what works best, looks best, and fits together in the best harmony. Especially when something is made to last, we shouldn’t spare expense.
Once the project is complete, it will probably not be finished, because the health and therapeutic issues will only begin to become apparent in practice. Wouldn’t it be good to have research centers to investigate these issues further?
LS: We do have several research centers, but the research focuses on other things. One simply has to draw boundaries. Now it’s our turn to plan the move. Then we’ll have to put all the processes we’ve thought through into practice. When visitors come and say, “Oh, building the new facility must be a lot of work for you!” I like to reply, “The construction is only the preparation; the real challenge is to constantly rethink anthroposophic medicine and to always be on top of the ‘social reconstruction’ that such a clinic requires.”
Building is a process of incarnation, which is perhaps why conflicts often arise when someone builds. Building is a test for the social and societal organism—did you experience that?
LS: We’re consciously facing this challenge without knowing exactly how it will all proceed in all its details. The good collaboration during the construction phase and the fact that all the collaborators are involved gives me confidence.
What is the significance of the construction project for you personally, Lukas?
LS: I’ve been working as a doctor at the hospital here for 24 years now. I’m very pleased to be able to help shape this transition into and with the new building.
The construction is also a commitment to Arlesheim.
LS: Yes. However, if you ask someone who thinks purely from a financial perspective whether a hospital should be built on a building site for single-family homes, the answer is usually, “Better somewhere else, where the building land is cheaper.” We, on the other hand, have made a conscious decision to say “yes” to this location—also in consciousness of its history. This is the birthplace of anthroposophic medicine. With the new therapeutic laboratory, we’ve also made an explicit commitment to anthroposophic remedies. These are things that are extremely important for the future.
When is the opening planned?
LS: In just under two years. But first, the existing building has to be demolished. The old and new hospitals are so close together that we can’t open the new one while the old one is still standing, even though we will already be working in the new building. The inauguration will be a big celebration.
Klinik Arlesheim
Klinik Arlesheim is the leading anthroposophic clinic in Switzerland. For over one hundred years, conventional medicine has been successfully complemented with anthroposophic medicine. In addition to medical diagnostics and treatment, the clinic offers individualized therapies and personalized care. The name Klinik Arlesheim was created in 2014 from the merger of the former Ita Wegman Clinic and the Lukas Clinic. The clinic has a capacity for around 90 inpatients in the fields of oncology, internal medicine, and psychiatry. In addition, the clinic offers an oncology day clinic, outpatient services such as general and specialist medical care, and 24/7 emergency care. The clinic is the first in the canton of Basel-Landschaft to offer “Hospital at Home,” a hospital-equivalent care service at home. Medicines are manufactured to the highest quality standards in the clinic’s own therapeutic laboratory. The clinic is on the hospital list of the canton of Basel-Landschaft and fulfills cantonal service mandates for inpatient offerings in oncology, internal medicine, and psychiatry.
More Klinik Arlesheim
Translation Joshua Kelberman
Title image Klinik Arlesheim. Photo: Stijn Poelstra
With the Goetheanum building in the background, I wonder why there is not more of an organic element in the architecture, of a time element in the walls, or from wall to wall.