Feeling architecture in literature: Listening to illness narratives for a design that feels better

By Uğurgül Tunç, Koç University

Can we feel architecture? Can the built environment make us feel a certain way? If yes, can we talk about architecture not only in terms of its visual qualities but also for its sensory aspects beyond the obvious haptic, olfactory and auditory? The detailed descriptions of sensory/spatial experiences conveyed in first-person narrative in Peyami Safa’s Dokuzuncu Hariciye Koğuşu (Ninth Surgical Ward), a semi-autobiographical coming-of-age story set in Istanbul in the mid-1910s, attempt to do just that by describing architecture in terms of emotions it provokes. The novel begins with a multiple-page sensory portrayal of a hospital corridor complete with the sounds, smells and emotions that are associated with this space, creating a mental image in the reader’s mind.

The creaking of an unseen door towards the deep ends of the corridor. Footsteps rubbing against tarpaulin. A foaming white coat taking flight and disappearing in the distance, and a not entirely comprehensible hospital smell consisting of iodine, ether, oil, bodily fluids and the like.

[…Those who wait] look at the door of the examination room with hope.

And the door of the examination room opens. A white-coated burly man points at one of them and calls that child in a loud voice.

The sick child is puzzled between the ending of the torturous wait and the beginning of the fear of entering that room as they walk in while leaning on their father’s arms; simultaneously the smell of heated medication and rotten blood exits the room gently creeping out the sentient nasal passages of those who wait, and like a colourless whitewash it gets plastered onto the highest walls of the long corridor without being seen.[1]

The novel’s protagonist is an introverted teenager afflicted with bone tuberculosis who is all too familiar with the sounds, smells and other sensory experiences filling hospital spaces as experienced by him; he knows what they are harbingers of. During his frequent hospital visits he befriends a physician named Mithat. On a quest to find a way to regain his health without losing his leg, the narrator even goes to the Imperial School of Medicine where he is given a tour of the premises complete with an overwhelming stop at the anatomy lab. There he recounts a scene from Shakespeare’s Hamlet during his encounter with the cadavers. The protagonist is taken aback by the way a doctor oddly describes these human beings as ‘fresh’ cadavers. This encounter causes a shift in his future sensory experiences, particularly those of taste, and he becomes unable to eat meat, something which doctors say he needs to do to heal.  

The novel is an illness narrative written by Peyami Safa six decades before Arthur Frank put forward the concept of chaos, restitution and quest narratives of illness,[2] and far earlier than the popularization of Narrative Medicine by Rita Charon[3]. It provides examples of different types of healthcare professionals; the considerate ones and those who lack entirely a sensitivity to patients. Set in the late Ottoman era, but published in 1930, seven years following the proclamation of the Turkish Republic, the novel, perhaps unintentionally, becomes a commentary on the intersectionality of health and disease, and their relationship to Ottoman imperial architecture. The protagonist’s particular relationship with the city’s architecture goes beyond the hospital walls. He identifies with the ageing wooden houses lining Istanbul’s back alleys which, much like him, need regular ‘surgery’ just to remain standing. He resides with his mother in one such humble dwelling and claims that all houses of this kind empower him as he searches for his own house among them; he concludes that they all feel like his own home (see for example, figure 1). 

Photo taken by Konrad Lembcke, of Kasnakçılar Sokak, Hoca Gıyasettin, Fatih, Istanbul, Turkey
Figure 1: Konrad Lembcke, ‘Kasnakçılar Sokak, Hoca Gıyasettin, Fatih, Istanbul, Turkey’ (January 2021), Flickr.

In a section titled ‘What the sofa[4] tells me’, the protagonist reads an unoccupied room in his family home to understand his mother’s emotions. He describes the sofa as follows:

This sofa is like an old person’s face: The entire soul of our house, its sorrows and joys are seen there, the events of every single day add a stain, a line, a wrinkle, and sometimes a sign only visible to us on the ceiling, the walls, the floor. This sofa is alive: It moves and changes with us, it gets cluttered and tidied up with us, it sleeps and awakens with us; this sofa is like a third face among us, and it even smiles and cries at times.

This sofa has four corners: The front door in the middle, two windows on both sides. A minder[5] next to the window. Dining table next to the minder. Two chairs next to the table. One sits, eats and entertains guests on this sofa.

My motionless pause every time I enter here is to take a look at this face which shows me to myself.

And I looked: Two pillows on top of each other above the minder (This means my mother felt a bit sick and laid down here). Next to the table a chair that has been pulled in front of the shelf (This means my mother took a bottle of medication from the top shelf). Ah… et voilà, a bottle on the table: Kordiyal[6] (This means my mother has been troubled by some affliction). A damp, wrinkled handkerchief on the seat (This means my mother has cried).[7]

The novel demonstrates a wide range of architectural typologies in the Ottoman capital including the majestic köşk[8], of a wealthy relative, an Ottoman Pasha[9], who takes the teenager in to live with his family with the hopes that better living conditions might improve his overall health (see for example, figure 2). The köşk, situated in the Erenköy district of Istanbul’s Anatolian side, appears as a space of contradictions. It makes him feel out of place as a poor boy in a rich household. Unlike the humble and run-down wooden houses of the city, he cannot read the köşk accurately. The majestic mansion is presented almost as a sanatorium, a space for healing where the protagonist is expected to get better. Yet, he feels conflicted about it. One day he decides to cut his ties with the köşk, the next he feels that it brings him joy and admits that he must have misread it previously. He later changes his mind.

Figure 2: Ealinggirl1954, Mansion of Ottoman statesman Ragip Pasha in Caddebostan, Istanbul (10 March 2022), Wikimedia Commons

The narrator, at the time the story was being written, realises that he was in love with the Pasha’s daughter, Nüzhet. As he recalls those days, he questions whether as a teenager he might have misinterpreted the intimacy between the young girl and his younger self. The protagonist struggles to read both the köşk and the people who live in it; his struggle to understand that environment continues even as an adult while he composes his illness narrative. During his stay in the köşk he engages in self destructive actions, such as not using the crutches which are required for his recovery. He is also to remain away from stressful situations as per his doctors’ orders, one of the main reasons for his stay at the köşk. Usually calm and reserved, he even loses his temper for the first time in this space as he becomes confrontational with a fashionable guest, a physician named Ragıp, who intends to ask Nüzhet’s hand in marriage. The protagonist loses his temper and his sense of self in the köşk. He becomes an agitated and suspicious person who is not afraid of disrespectful behaviour, such as confronting his hosts and their guests about how out of touch they are with ordinary people. One of the central chapters of the book is even titled ‘I am changing’. In recent years this type of spatial paradox, experienced when one enters into spaces where one does not necessarily belong to or identify with, has been explored in Bong Joon-ho’s Parasite (2019)—a movie about a poor family turning into criminals under the spell of the architecture of a luxurious house they find themselves inhabiting.    

The protagonist of Dokuzuncu Hariciye Koğuşu returns to his family home with his mother a few days following his accidental overhearing of a conversation between Nüzhet and her mother regarding the protagonist’s illness, in which Nüzhet’s mother warns her not to get too close to the teenager since his disease might be contagious. The protagonist’s physical condition deteriorates immediately following his departure from the köşk. He is subsequently hospitalized and the possibility of losing his leg becomes ever more real. The physicians at the hospital talk to each other using medical terms, and at times speak French when they want to conceal conversations about whether to amputate the teenager’s leg. Yet even when delivered in a foreign language he understands everything clearly in the hospital, contrary to the circumstances in the köşk where he struggled to recognize even his own emotions and behaviour. In the end, his leg is saved after a long painful stay at the hospital’s ninth surgical ward and several surgeries. After his recovery, and just before being discharged, he learns that Nüzhet is to marry Ragıp in a matter of days. He also receives the news that the Pasha, Nüzhet’s father, is in poor health without much chance of survival, and that he would like the recently healed teenager to pay him a visit at the köşk one last time. 

This semi-autobiographical novel closes with a section titled ‘Notes’, consisting of some random-sounding excerpts from the protagonist’s (or perhaps Safa, the author’s) own diary. Each is written with open quotations:

“I am leaving the hospital tomorrow.

“I fear living outside the hospital.

“I got so used to pain and submission that if I abandon those, I will feel a void as if a part of my soul has been amputated; if I don’t abandon them, how will I ever live without rebelling?

“If only I could write a novel to be read in hospitals one day and inserted these notes of mine in it…[10]

The last entry in the section is dated October 5, 1915, and reads:

“I am leaving the hospital in five minutes. Final note. Others will wail in this room. I understand them all too well already in advance. Inside the gown, which I take off and throw on the bed, will eternally be the same human being: the patient.[11]

Dokuzuncu Hariciye Koğuşu, is based on the author’s memories as a sick teenager. The protagonist is sent to an environment that is assumed to have the ideal sensory qualities and he is expected to find solace there. However, his condition deteriorates. The afflicted teenager finds himself in an unfamiliar environment, out of place, and additionally he becomes inflicted with unfulfilled romantic desires. However, the teenager feels at peace and safe in seemingly less comfortable environments, such as the wooden houses in the back alleys of the Ottoman capital. He feels less confused and more at home in the hospital space, which could be confusing to some.

Literature often presents us with the paradox of healing environments not feeling quite right for the occupants. Charlotte Perkins Gilman’s short story ‘The Yellow Wallpaper’ (1892) provides another example of an unfamiliar space that compounds the afflictions of its disease-stricken occupant. The protagonist of Gilman’s story is a woman suffering from postpartum depression and she is taken to a country mansion by her physician husband. Rather than getting better as expected, the woman’s condition deteriorates as she becomes obsessed with the yellow wallpaper covering the walls of her room in the mansion. Much like the relationship between the köşk and the protagonist in Dokuzuncu Hariciye Koğuşu, Gilman’s protagonist keeps changing her mind about whether she likes the yellow wallpaper or not – and ultimately, she finds herself consumed by it.  

Following her analysis of two illness narratives, John Diamond’s C: Because Cowards get Cancer Too (1998) and Matilda Tristram’s Probably Nothing: A Diary of Not-Your-Average Nine Months (2014), Victoria Bates concludes that place is of relational nature and that ‘a person’s relationship to their illness and recovery is also part of the relational making of space and place’.[12] In her analysis, Bates also emphasises how the two author-protagonists of these illness narratives relate to their surroundings changes in each stage of the illness as they go through different forms of human/non-human relationality.[13] The changing attitudes of protagonists towards space and place in works of literature such as Dokuzuncu Hariciye Koğuşu and ‘The Yellow Wallpaper’ confirm Bates’ ideas and strengthen her argument that demographic and cultural factors as well as temporal changes need to be explored further in order to better contextualise the embodied and affective aspects of place-making and the senses in healthcare environments.[14]

Roger Ulrich’s ground-breaking 1984 article ‘View Through a Window May Influence Recovery from Surgery’ popularized the idea that the built environment could be altered to create better human experiences. Evidence-based design initiatives and institutions such as the Academy of Neuroscience for Architecture (ANFA) look for ways to identify which emotions are triggered by certain design elements. However, such attempts overlook the unique nature of emotions and the impossibility of formulating universal definitions for different emotions. As demonstrated by studies like ‘A Sense of Place: Exploring nature and wellbeing through the non-visual senses’[15], for a sensory design element to contribute to wellbeing it needs to be personalised for each individual or modifiable/controllable by the user.[16] This study focusing on auditory design concluded that memory plays an important role in how individuals relate to sound; while trying to explore which sounds were more soothing or more comforting than others, researchers realised that the meaning of ‘soothing’ or ‘comforting’ differed from person to person.[17] Similarly, with the research I am conducting on birth narratives in my project titled ‘Birth as a Sensory Experience’ we aim to understand how we can improve hospital spaces where labour and delivery take place, our findings illustrate that it is the flexibility factor that makes the whole difference simply because what feels better or more comfortable will always differ from person to person. A room that provides its users with sufficient agency to modify its features is often preferred because ‘comfort’, after all, is a subjective phenomenon, and it is not possible to formulate a universal description of what feels comfortable.  

In Dokuzuncu Hariciye Koğuşu, familiarity formed by an accumulation of memories brings with it a certain sense of belonging and comfort to the protagonist. Both Safa’s Dokuzuncu Hariciye Koğuşu and Gilman’s ‘The Yellow Wallpaper’ demonstrate that the meaning of a ‘healing environment’ changes from person to person. Does this mean that the mission to design buildings which make people feel better is futile? Maybe not entirely. Perhaps for a space to become a healing place, its design needs to be considerate of the uniqueness of its occupants’ feelings rather than aiming to formulate one-size-fits-all design ideas based on the assumption that emotions are universal.

Some of the notes in Dokuzuncu Hariciye Koğuşu’s final section read: 

“Those who have never experienced a major disease can never claim to understand everything.

“No two people can be as close to each other as two patients.

“Those who are not afflicted with a disease will understand so little of us![18]

Perhaps illness narratives like Safa’s Dokuzuncu Hariciye Koğuşu can help us understand more of the nuances of being a patient and inspire architects to leave some of the sensory design decisions to the patients. Flexibility, it seems, is a key ingredient for an architecture that does not inhibit its occupants’ agency as it lets them add their individual touches to the space. According to geographer Tim Cresswell, built spaces become places when people attach meaning to them.[19] An architecture that lets people turn spaces into their own meaningful places – whether it be a majestic köşk, a humble wooden dwelling or even a surgical ward – is possible.

[1] Peyami Safa, Dokuzuncu Hariciye Koğuşu (Istanbul: Suhûlet Kitabevi, 1937), pp.7-9. trans. Uğurgül Tunç

[2] Arthur Frank, The Wounded Storyteller: Body, Illness, and Ethics (Chicago, IL: The University of Chicago Press, 1995).

[3] For further information, refer to Rita Charon, Narrative Medicine: Honoring the Stories of Illness (New York, NY: Oxford University Press, 2006) and Rita Charon et al., The Principles and Practice of Narrative Medicine (New York, NY: Oxford University Press, 2016).Even though the field is considered new, illness narratives in art, literature, and non-fiction have been in existence for many centuries as in the second-century Greek orator Aelius Aristides’ telling of his experiences at the Asklepieion of Pergamon or the fourth-century Chinese calligrapher Wang Xizhi’s correspondences detailing his health problems.

[4] Also known as ‘hayat’ (literally meaning ‘life’). A shared space in the Ottoman/Turkish house which allows circulation between rooms and other sections of the house. For floorplans of the traditional Turkish house, see Sedad Hakkı Eldem, Türk Evi Plan Tipleri [Types of Plans of the Turkish House] (Istanbul: Pulhan Matbaası, 1954).

[5] A type of cushioned seating unit placed directly on the floor in Turkish houses.

[6] A type of medication.

[7] Peyami Safa, Dokuzuncu Hariciye Koğuşu (Istanbul: Suhûlet Kitabevi, 1937), p. 16. Translation by Uğurgül Tunç.

[8] A type of large Ottoman mansion.

[9] Ottoman title indicating social rank and nobility.

[10] Peyami Safa, Dokuzuncu Hariciye Koğuşu (Istanbul: Suhûlet Kitabevi, 1937), pp. 111–12. Translation by Uğurgül Tunç

[11] Ibid, p. 112. Translation by Uğurgül Tunç.

[12] Victoria Bates, ‘Sensing space and making place: The hospital and therapeutic landscapes in two cancer narratives’, Medical Humanities 45.1 (2019): 10–20.

[13] Ibid.

[14] Ibid. See also the work of Rob Boddice on biocultural historicism. Rob Boddice, ‘The Cultural Brain as Historical Artifact’, in Culture, Mind, and Brain: Emerging Concepts, Models, and Applications, ed. by L.J. Kirmayer, C.M. Worthman, S. Kitayama, R. Lemelson and C.A. Cummnings (Cambridge: Cambridge University Press, 2020), pp. 367–74.

[15] A UK-based research study jointly funded by the Arts and Humanities Research Council (AHRC) and the Engineering and Physical Sciences Research Council (EPSRC). Researchers: Victoria Bates, Clare Hickman, Helen Manchester, Jonathan Prior, Stephanie Singer.

[16] Victoria Bates et al., ‘Beyond landscape’s visible realm: Recorded sound, nature, and wellbeing’, Health and Place 61 (2020).

[17] Ibid.

[18] Peyami Safa, Dokuzuncu Hariciye Koğuşu (Istanbul: Suhûlet Kitabevi, 1937), pp. 111–12. Translation by Uğurgül Tunç

[19] Tim Cresswell, Place: An Introduction (Malden, MA: Blackwell Publishing, 2004).

This post is part of the ‘Building with Feeling’ series of blog posts.

Uğurgül Tunç (Koç University) is a PhD candidate at Koç University. She received her BA from McGill University and MA from Istanbul Technical University. She also holds post-graduate certificates in Biomedical Ethics and Narrative Medicine from Harvard Medical School and Columbia University Vagelos College of Physicians and Surgeons. Her research interests include the history and architecture of healthcare spaces, sensory studies, and curatorial studies. She is currently writing her dissertation on the history and architecture of healthcare spaces in the late Ottoman and early Turkish Republican eras. With her “Birth as a Sensory Experience” project, Tunç aims to improve the sensescapes of antenatal wards and delivery rooms. She is also a member of the “Sensing Spaces of Healthcare” working group supported by the UK Research and Innovation Future Leaders Fellowship. Tunç is a contributor to the Infectious Diseases and Clinical Microbiology journal and the UK Institute of Historical Research series “Archives of Global History”. Funding for her research is provided by the Vehbi Koç Foundation and the American Research Institute in Turkey. 

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