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A Healing Place

are specially designed to facilitate laparoscopic surgery and other such innovations.

The new outpatient exam rooms, where most care at DHMC is delivered, are different, too. The old rooms are 80 square feet; the new ones are a full 50% bigger at 120 square feet. No obvious visual cues signal this change—but to anyone who has had occasion to squeeze a feisty preschooler, her baby brother, her two anxious parents, a nurse, and a doctor into one of those rooms for an important confab, the adjustment is noticed and appreciated.

Judge is particularly proud of this achievement because those extra square feet, multiplied by the number of exam rooms, is a lot of precious space—and because her firm had sought, unsuccessfully, to build 100-square-foot rooms in the original facility. Prevailing in such struggles, through the exercise of architectural diplomacy, is one of Shepley Bulfinch's signal capabilities.

One final detail deserves mention. It is a very modest improvement from the late-20th-century's DHMC-Lebanon to the early-21st-century's, but it is a source of joy to those who do notice it. For reasons that are self-evident only to engineers, the windows of the original DHMC complex are partially blocked at regular intervals by cross-braces. It turns out that these angled supports are there to protect the building from earthquake damage.

Judge points out that the advent of a technique known as "moment connections" rendered the cross-bracing unnecessary in the new parts of the complex. Moment connections protect a building from so-called "moment forces"—forces that can cause structural members to rotate. It is comforting to know that the Project for Progress buildings will endure, even if the earth literally shakes beneath

In the new and renovated parts of the facility, waiting areas (above) and exam rooms (below right) are more spacious than they were in the original 1991 complex. The Emergency Department is also much larger.

The new Emergency Department is a carefully planned space designed to speed the patient's journey from ambulance bay to inpatient bed. And, not incidentally, to provide comfort and privacy to concerned family members.

them. And it is even more comforting to know that the people who use those buildings—people who often feel emotionally and spiritually shaken—can now view the serene and healing environs of DHMC without obstruction.

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Kreis lives in Grantham, N.H. A former journalist, he is now an attorney who moonlights as an architecture critic for the local daily newspaper, the Valley News, and other publications. He also chairs the Patient-Family Advisory and Advocacy Council of DHMC's Cystic Fibrosis Center. Kreis's wife is Dr. Jennifer Keller, a 2001 graduate of Dartmouth Medical School as well as an alumna of the DHMC anesthesiology residency program. [For more about the author's background, see the video.]

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