Sunday20 August 2017

Toh Shimazaki’s eye surgery is sight specific

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A brief to rethink a new eye surgery scheme has resulted in a non-invasive design that grows out of the contours of its secluded West Sussex site

Cedric Price famously maintained a long involvement with East Grinstead. He named the large, all-white room at the top of his office after the West Sussex town and retreated there when he wanted to work undisturbed. Anyone who called for him would be rebuffed by a simple statement of fact: “Mr. Price is unavailable; he is in East Grinstead.”

I told this story to Takero Shimazaki as we travelled down to the (real) East Grinstead to see the building that his practice has recently completed on the edge of the town. As it happens, the question of how an architect might seize control of their time is one with which Shimazaki and his partner, Yuli Toh, are particularly preoccupied. That concern is reflected in the unusual composition of their practice — certainly the only one that I know of which incorporates its own architecture school. Over each of the past four summers Toh Shimazaki has devoted a month to teaching a group of paying students drawn principally from the partners’ native Japan and has recently expanded this operation to include day courses for children. Its dream scenario is that the school might occupy the same space as the studio and run throughout the year. It is a compelling model: the students benefit from exposure to the reality of practice while the studio acquires a stream of talent and also, crucially, an economic base that allows it to be selective about the projects that it undertakes.

Shimazaki explains how he came to appreciate the fundamental importance of taking control of one’s own creative destiny from his former employer, Peter Smithson. Having been introduced to Smithson in the early nineties by Toh — who is married to Alison and Peter’s son, Simon — he spent a year contributing to the obsessive remodelling of Axel Bruchhäuser’s woodland Hexenhaus, a project on which Smithson began working in 1986 and to which he added subsequent phases on an almost yearly basis until his death in 2002.

While retaining a healthy degree of scepticism about the other-worldliness of such a professional outlook, Shimazaki clearly views the level of control that Smithson secured in his last years as a benchmark against which to measure the efficacy of his own practice. The Smithsons’ architectural preoccupations have also proved an abiding influence, particularly their interest in the means by which a building can forge a relationship with the territory that it addresses. That was certainly a principal concern of the celebrated Osh House which Toh Shimazaki completed in 2007 and it is again in evidence in the East Grinstead building, a privately run eye surgery clinic, which at £2.4 million is the largest project that the practice has undertaken to date.

The reception desk is set into a wall of exposed brick.

Credit: Edmund Sumner

The reception desk is set into a wall of exposed brick.

Dubbed the Centre for Sight, the new building has been commissioned by Sheraz Daya, a surgeon who pioneered the use of laser eye correction in the UK and who previously maintained a smaller facility at the nearby Queen Victoria Hospital. Daya has always conducted his initial patient assessments at his office in London’s Harley Street. The East Grinstead facility is therefore conceived solely as a site for treatment. It is used intermittently but intensively — a laser operation can be performed in under 10 minutes, allowing Daya and his staff to attend to as many as 25 patients in the course of a day.

Toh Shimazaki was not the first architect to be invited to look at the project. Daya had already secured planning permission for a scheme designed by another practice but had come to view it as neither large enough nor sufficiently ambitious in architectural terms. His new architect’s challenge was to meet both requirements within a budget that remained unchanged. The key to achieving that lay in a drastic reduction of one of the former scheme’s largest anticipated costs: groundworks. Composed as a freestanding block of a broadly square footprint, the first project had demanded a very expansive level surface be cut into its sloping site. Toh Shimazaki recognised that by reimagining the building as a thin, contour-hugging extrusion. A much less invasive, and therefore costly, incision would be required.

There is a good deal of art underpinning the seeming carelessness


The very beautiful, secluded site lies within the estate of the nearby Hazeldean Farm and was formerly occupied by a barn that, over time, had been augmented by ad-hoc lean-tos. While this was not, in itself, a structure of any architectural aspiration Toh Shimazaki recognised its potential to serve as the conceptual building block of the new scheme. What the practice has built is, in effect, a terrace of eight such barns, each in brick and capped by a zinc roof of a similar asymmetric profile.

Even given the reduced scope of the required groundworks, the limestone cutting that has been exposed along the site’s northern, uphill edge remains an imposing 4m in height. The building’s relationship to this landform is an intimate and fundamental one. While the back half of the terrace is positioned hard against the rock, the front four bays have been allowed to wriggle free. The road by which the scheme is approached takes us past the head of this conga line before delivering us to a visitor car park caught in the cleft between the building and the ridge. The affinity between these two bodies is brought into focus by the location of the front door at the point where they meet.

The building takes its place very comfortably alongside the vernacular brick structures with high clay roofs that we pass on the way up the drive. The distribution of its massing ensures that much of its bulk is disguised, while the dominance of its roof offers a vivid connection with the indigenous forms. Its material palette, while more various than that of its neighbours, operates within a similarly tight chromatic range. Two firings of the same local brick are employed, the darker, overfired one forming a plinth; external joinery is in dark-stained sapele; while the stridency of the zinc has been moderated through the specification of a red mineral pigment.

The interiors are designed to project a feeling of depth.

Credit: Edmund Sumner

The interiors are designed to project a feeling of depth.

As terraces go, this is a pretty unruly one. If we consult the plan we can see that none of the eight units are the same width, and each is ever-so-slightly misaligned with its neighbours. On closer inspection it becomes apparent that there is a good deal of art underpinning the seeming carelessness: the extent by which the external walls step in and out is precisely gauged to allow a downpipe to be recessed into each narrow flank. The architect has worried away at the section to similar effect. The roofs bob incrementally up and down and describe, over the course of the building’s length, a stilted rise and fall — a gesture that finds its echo in the variable datum sketched out by the dark brick plinth.

What purpose does all this formal agitation serve? It is surely significant that this is a building with few windows, a condition enforced by its very significant cooling requirements. The busy articulation of its massing can therefore be understood as a means of rescuing the project from the shed-like expression that could otherwise have been its fate.

It is also, however, a way of rooting the building in its site. The lineage of Smithson projects that — to use their own term — “ride the landscape” suggests itself as a precedent: the 1956 Close Houses, the Paolozzi Studio House of 1959 and the “squashed crocodile” that was their magisterial 1965 scheme for the British Embassy in Brasilia. Each is a long, narrow volume that appears to have been draped over its sloping site, the rise and fall of the ground translating into a roofline of corresponding restlessness.

Its architecture is one of gentleness and pliancy — qualities health buildings all too rarely reflect


Where the Centre for Sight differs from those models, however, is that much of the elevational modulation is a cheeky fiction. Look, for instance, at the north elevation. What we assume we are seeing is a single-storey building that climbs, mid-way along its length, on to higher ground.

In fact, this is a building that begins as a single-storey structure and then adds an extra floor of office space at the back — the confusion resulting from the obscuring effect of the limestone cutting.

Actually, the ground that the building sits on is essentially level. Certainly the ground floor is carried through at a constant grade — a product of the client’s concern to ensure the most efficient flow of patients, staff and surgical materials. At first glance, the plan appears to have a rather maze-like quality. Circulation is often doubled up, either to provide separate routes for patients and staff or to keep surgical waste apart from the clean areas. All this, however, serves to ensure that the patient’s “front of house” experience is as untroubled as possible. The location of the entrance in the middle of the plan allows the pre-operation assessment area and the theatre space to be placed to either side of the waiting room. It is this space that most closely corresponds to the aesthetic of the exterior. It rises to the underside of the roof, revealing a quasi-gable wall of exposed brick within which the reception desk has been recessed.

The encompassing fabric has a palpable depth. The reveals of the skylights extend for the better part of a metre, reflecting the substantial quantity of servicing — nobody wants to catch a whiff of toasted cornea — that it has been necessary to accommodate within the roof void. Elsewhere the depth is of a more perceptual nature. Glass doors and internal windows admit partial views to the territories beyond, while the light entering through the external windows is filtered by sapele louvres mounted on the outside wall.

Each unit is a different width

Each unit is a different width and slightly misalighned with its neighbours

The clinical requirements borne by the other public spaces have inevitably restricted their architectural expression, but care is everywhere evident. The bespoke bronze signage system and bronze-effect ironmongery are certainly not the kind of details one encounters in a standard NHS facility. Mediating between such intimate encounters and the scale of the wider topography is ultimately the building’s principal concern. Its architecture is one of gentleness and pliancy — qualities that health buildings all too rarely reflect but which must surely have a transformative impact on patient wellbeing.

Original print headline - Sight specific

Project team

Architect Toh Shimazaki Architecture, Client Centre for Sight, Structural engineer Fluid Structures, Services engineer Max Fordham, Quantity surveyorBonfield, Contractor John C Lillywhite, CDM Coordinator Stace Health & Safety


Readers' comments (2)

  • Grows out of the contours of its secluded West Sussex site? In what way? Want to see growth out of contours look up Enric Miralles. Nasty brick, nasty roof, nasty tarmac. What happened?II would have expected much much better from Toh Shimazaki.

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  • Although it is fantastic to see a medical building evolving from the norm, I cant help but think this looks pretty nasty as a piece. OK they've got some designer chairs in the waiting area but come on... it looks like a suburban style flats conversion from the late 80's. very nasty in my opinion, kinda soul-less, from the pictures that is. Kinda hard to make brick, gorgeous wood and white walls look this bad. Just goes to show that good materials don't necessarily guarantee a great creation...

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