Skaggs, who was a student in Mann’s first class in 1966, chose to change the focus of his specialty from housing to health care design because of his teacher’s influence. The design complexities of the projects, that when completed properly, improve staff efficiency and provide healing environments that nurture and restore patients and their families, impressed him. Skaggs rose through the ranks to become chairman and CEO of HKS Architects, Inc., with headquarters in Dallas.
“George is a very caring human being wishing for every one of his students to succeed. He is a professor who follows his students’ progress after they graduate, and in many cases, he helped get them placed into the firms where they are employed,” Skaggs said. “As a result, the ‘flag’ of Texas A&M healthcare architecture has been carried around the world.”
Since Skaggs joined HKS, the firm has designed more than 1,100 unique projects representing approximately 70,000 beds and 120 million square feet of healing space, and those projects have earned more than 130 design awards.
The “teaching firm” method
Skaggs said that from the beginning, Mann’s teaching style was to involve students in the design of real-life projects, working with health care and landscape architects, medical staff, engineers and contractors.
In 1973, Skaggs and Mann decided to informally create a “teaching firm,” resembling a teaching hospital in medical education, which leverages the symbiotic relationship between education provided at Texas A&M and work conducted by HKS, now consisting of 18 U.S. offices and 6 offices abroad. Since then, Mann’s architecture students have worked on real rather than hypothetical design projects through partnerships with HKS.
Today, there are 11 additional award-winning firms that, as members of the Health Industry Advisory Council, support health care facility research and design at Texas A&M: Bates & Associates, Ballinger, CallisonRTKL, Earl Swensson Associates, Inc., FKP Architects, Inc., HDR Architects, Inc., Page, Stantec, EYP Health, Taiwan Yonglin Healthcare Foundation and Horizon Healthcare Consulting and Management, Inc.
“In my mind, what is most important in George’s teaching is the student’s exposure to real-world problems with an emphasis on careful research of the problem before moving to the solution,” Skaggs said. “There are many other classes where students can learn the design process, but they need this exposure as well.”
The “teaching firm” approach to education has resulted in exposing more than a thousand students to the design of various general and specialty hospitals, ambulatory care facilities and other health-related projects throughout the U.S. and abroad, Skaggs said.
Ellis said that Mann celebrates the team, professional and human aspects of architecture rather than strictly focusing on design and theory. Understanding this holistic approach to design and knowing the language of health care architecture gives Mann’s students a jump-start early in their careers, he said.
“In large part, function rules over form in the design of health care facilities, especially in the U.S., because of the complexity of the codes, rules and parameters,” Ellis said. “But as architects, we know that an incredible design can influence the health of the patient experiencing the space. Access to nature, natural light and beauty can reduce stress in patients and impact the healing process.”
Castorina also learned from Mann that architecture involves more than drawing buildings, though he learned the intricacies of that, too. Mann, he said, emphasizes, “bringing the right people to the table.” He is the “master of connectivity” because he focuses as much on navigating the profession as he does on teaching his craft, Castorina said.
Mann connects his students with professionals while they are still in school; he teaches them how to communicate and how to market themselves; and he encourages them to attend national conventions of health care architects.
“He taught networking more than 30 years ago when no other professor whom I knew did—he was ahead of his time,” Castorina said. “I’ve gotten to travel the world, do all kinds of projects, meet all kinds of people and learn a lot, and I have to give George credit for that, for giving me the knowledge of how to network and work with people, which is a skill I still use today.”
For many years, Castorina has recruited students from schools across the country to work in his architecture firms.
“There’s a great energy and sense of humility from the students at A&M,” he said. “It’s very pronounced, and I don’t mean, ‘Oh I’m not good enough,’ because humility is not thinking less of yourself, it’s thinking of yourself less.”
Texas A&M Architecture’s Main Mann
Healing around the world
From the state-of-the-art design of M.D. Anderson Cancer Center in Houston where cancer patients from around the world travel for groundbreaking treatments, to the design and conversion of a McDonnell Douglas DC-10 airplane into a flying eye hospital that delivers otherwise inaccessible care to developing countries, Mann and his students have spent the last 50 years creating innovative spaces for healing. Their health care facilities are located in North America, South America, Europe, Asia and Africa.
Castorina’s first professional project, a 24-story hospital just outside Hong Kong, remains one of his favorite designs after more than 30 years in the business. His latest project is the $480 million second phase of the UT Southwestern Medical Center in Dallas. He was lead designer of the $800 million first phase while an employee of CallisonRTKL Architecture.
Former Texas A&M student John Castorina, national director of health care and partner in the Dallas office of Hoefer Wysocki Architecture, is leading the expansion of the UT Southwestern Medical Center in Dallas.
“This is the only medical institution with five Nobel laureates, so I’m privileged to even work with these guys,” Castorina said. “You deal with the most educated people in the world in this profession, and not only do you have to know your business, you have to understand theirs.”
Being a thought leader in health care architecture means studying all the time to stay abreast of an always-changing medical industry.
“That internal quest for knowledge is essential, and there’s a lot to learn,” Castorina said. “I’ve been doing this for 33 years now, and on a good day, if I know 10 to 15 percent of what’s happening in health care, I feel pretty good about myself – it’s just that vast.”
Southern Ellis, former Texas A&M student and associate with HKS Architects in Dallas, consulting with Songambele Hospital staff about the multi-phase construction project in the east African village of Nkololo, Tanzania.
Designing for different worlds
In the developed world, the focus of health care design is on improving the quality and effectiveness of the facilities, while in undeveloped countries, the focus is simply on providing access to facilities, Ellis said.
“Mann always lectured about the international side of architecture before it was cool, about global banking and connecting internationally,” Ellis said.
Mann connected Ellis with Father Paul Fagan, a Catholic missionary priest, to design a rural hospital in the remote east African village of Nkololo, Tanzania, for his thesis project. Father Paul read about Mann’s work online and contacted him in hopes of securing an architect willing to donate services to his project.
“This project reaches beyond architecture,” Ellis said. “It gets into global, community and public health.”
Ellis traveled to Tanzania to meet with Father Paul and the doctors and nurses who would eventually staff the hospital in Nkololo. Through the fundraising efforts of Roads to Life Tanzania, Inc., a non-profit established by Father Paul, Ellis was able to design and build several buildings, including a surgical suite, an inpatient ward, a laboratory, a mother-child health clinic and an infectious disease clinic, in phases over the last seven years.
The Songambele Hospital in the east African village of Nkololo, Tanzania, which is being designed and built in phases by Southern Ellis, an associate with HKS Architects in Dallas, began as a thesis project when he was an architecture student at Texas A&M.
“Before, people had to travel an hour on the back of a motorcycle to reach the closest medical facility if an emergency C-section was needed, and lots of times, they didn’t make it there, and they lost the baby,” Ellis said.
The lab facility allows the locals to perform blood transfusions, which helps to combat malaria, one of the biggest health issues in the region. And the infectious disease clinic, which concentrates primarily on AIDS, has attracted an international partner, Doctors With Africa, a non-profit organization that has furnished a full-time Italian doctor who is providing medical, counseling and training services for one year.
“Fundraising is one of the biggest challenges,” Ellis said. “Convincing people on this side of the world that something is very important on the other side of the world is difficult.”
The shortage of medical personnel in the developing world required Ellis and his colleagues to design the facilities in ways that maximize the staff to treat the most number of patients and build housing to attract staff from larger cities to the remote village. They also realized in their deliberations that the construction process could serve as a catalyst for community development.
The team developed a trade school to train locals in construction techniques, such as welding, masonry, carpentry and operation of heavy machinery, which they can use to transform their communities long after the medical buildings are complete, Ellis said.
The substantial phases that remain include another inpatient ward, a private ward and a nursing school for locals that can build sustainability into the staffing process.
George Mann poses in a shop during a visit to the Shanghai office of HKS Architects. During this trip, he and a couple of his former Aggie architecture students found the apartment where his family had lived after fleeing the Nazis.
Coming full circle
Several years ago, Mann visited the Shanghai office of HKS, which was led at the time by his former student Alex Ling, and Ellis was working there, too. Using a return address that Mann had found on a letter his father had mailed from China to his uncle in Austria many years earlier, the three of them traveled up and down a road trying to locate the apartment where Mann had lived, and nearly died, when he was a child. They eventually found the old building and gained access to a former neighbor’s apartment. The residents remembered the Jewish family that had once lived next door.
“This was one of those moments with Mann outside of the studio,” Ellis said. “His eyes teared up, and it was an awesome moment to share with this incredible mentor in my life.”
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