Towards the within: a hospital psychogeography

“Browse a bookstore’s philosophy section and you will find hefty tomes devoted to the analysis of single concepts such as friendship, authenticity, guilt, power, morality, freedom, and evil. Scholars wrestle with the precise meaning of these concepts because they are inherently abstract. Unlike concepts that refer to categories of things that we experience with our sense, these concepts lack a concrete referent existing in the world outside ourselves.”

Landau, Robinson & Meier (2014) The Power of Metaphor: Examining its influence on social life. American Psychological Association: Washington DC, p. 3

Like intestines, UK hospital estates are a characteristic cramming together of a variety of eras, sizes and functions of buildings. Navigation through, along, between and into such an assortment of functional elements is a feat of achievement in and of itself. It calls for a unique culture of wayfinding instruction (by the institution) and active, ambulatory interpretation (by the visitor). What follows is an attempted psychogeographical account of one such navigation.

The hospital’s outer car park is quite a way from the destination, but it is convenient, familiar open space. It lacks that squeezed-in aspect of more proximate, characteristically inserted-feeling, hospital parking sites.

It is a cold, frosty morning. To get to my destination I must navigate the contorted labyrinth of paths, roads and buildings that make up this estate, its vital organs and its interwoven passages and dead-ends.

In leaving the bright, winter sunshine of the car park I must first enter and squeeze through the dark narrow lane that runs between the secure psychiatric ward and a high bank. The windows are bulbous at their base, their protruding metal caging preventing escape of the ward’s content, but allowing moments of controlled ventilation,

Next, I emerge onto a slippery path, set on a gentle (but today perilous-feeling) incline. The passageways have been carefully prepared over night with specialist salts in anticipation of my tentative passage. These surfaces are notably clear-looking and the crystals glisten in the early morning sunlight, reflected and magnified in the adjacent window screens.

Indeed, touring this estate is a constant dialogue with the myriad surfaces, screens and cameras that mediate this journey, by turns offering-up images of far away and (very) close at hand.

I step down into Central Lane. I turn South but soon find myself in a waste storage compound. Here, everything appears to have its place. There are laundry bays, clinical waste bays and a variety of refuse trolleys. But there are no people and no doors through which I think am invited (or permitted) to pass. So, I reverse from this dead end and head North, up the long straight channel of this service lane. To my left the otherwise smooth banking has been recently excavated. Mini-diggers sit abandoned there and fluffy brown earth billows out of the ground. This fibrous outbreak unmasks the two-dimensional appearance of this bank – reminding me that the bank has depth, substance beneath the surface that enables the surface to stay so, stable, taut, smooth and unremarkable-seeming.

Meanwhile to my right I’m passing endless apertures of workshops and stores, their windows and doors acting hour-by-hour as membranes receiving and emitting supplies and services vital to the life of this hospital-organism. And still I have seen no people.

Reaching the end of Central Lane, I’m conscious that I’ve now spent many minutes walking in the opposite direction to my destination. But there have been no opportunities to enter the hospital complex through these walls. So, I feel somewhat relieved when I at last reach a sharp bend, which will finally enable me to turn South. But the bend is awkward, and requires me to contort my body and step out into the road. Here I must suddenly make sense of the road markings that seem to invite me to walk amongst the traffic. The clarity of Central Lane’s singular routing has given way to shapelessness and uncertainly. As a clarification of sorts, a sudden blast of cold, sharp air hits flaccid flesh, causing my face to wince.

Ahead of me a delivery lorry is parked perpendicular to the pavement, jutting out into the road. A yellow box painted onto the road shows me that it undertakes this awkward insertion on a regular basis. Through the evolution of this estate this kink in the route has become normalised, accommodating to the growing-over-time functional needs of the blank building into which it is now a necessary daily attachment. To move forwards I must step blindly out into the opposite carriage, and hoping to find nothing speeding towards me.

Time is now marching on, the deviation of my journey has eaten away at what I had though was adequate journey time. I am now breathing heavily. My heart is starting to pound as anxiety starts to mount. What else lies unexpectedly ahead? How much longer is this going to take? This site’s internal anatomy is not what I was expecting. Things looked more simple on the estate plan that I’d casually glanced at before setting out (and which I now wish I’d studied more intently).

I pick up the pace. I only have 10 minutes left now. I hug the edge of cluster of new buildings which look like the Westward turning point I’m seeking to transpose the required route from the map onto this terrain. (With time now tight I have abandoned my improvisational drift, and I am now surrendered to my phone’s map). But in self-admonishment – noting the mistaken fit between the cluster and the map – I chide myself that “the map is not the territory”.

Hastening towards my destination I finally find the entrance to the cluster of buildings which will deliver me to my destination. Upon entering I am reunited with the realm of people – all moving at notably slower pace than my now running-out-of-time stride. I chide myself again: “be grateful that you can move swiftly still, these folk are not choosing to be slow or uncertain in their movement”.

Once inside a new form of disorientation takes over. I now have to work in three dimensions: to find the right level and direction of travel. I get it wrong at first try and hurtle up, and then back down a flight of stairs. I passed through doors that lead onward to other doors, and pass through rooms within rooms (each seemingly smaller than the last). Generally, I’m passing further and further inside, but occasionally a corridor spits me out into gaps between buildings, a third space of exterior interior (courtyards of sorts).

Then with one further turn I finally reach my destination: Caecum House. And the procedure is completed.

Image Credit:,_Northern_General_Hospital,