While providing open space on an urban site was difficult and expensive, some hospital designers did manage to leave unbuilt space on their sites, usually as a courtyard, a lawn or garden. Open space could also be a portion of the site left vacant for future expansion of the hospital building. The use of open space within a hospital site, however, was highly controlled—it was a fresh air reservoir, for quiet therapeutic influence, not a park for active movement.
This became clear in Harlem in 1910, when the directors of Harlem Hospital erected an iron fence along the main walk. Only one building of a larger planned facility had been completed; this left a sizeable area of the site open. There was also a wide setback around the front of the building, to provide fresh air and sunlight to the rooms. The unbuilt area had been turned into grassy lawns, which was a rarity in the poorest, most densely populated areas of the city, and the neighborhood children had taken to using the hospital’s grassy yard as a play area. The doctors, staff, and directors deemed the noise and bustle of the play to be detrimental to the patients’ recuperation. That there were cultural and moral forces at work was also clear, as the neighborhood children were largely ethnic and racial minorities, while the doctors, staff and directors were far more likely to be white. The directors erected the fence to protect the patients, but also in the interests of maintaining order and control. The fence served as a clear physical reminder of the lines of social and cultural separation in the city.
The fence was reported in Bellevue and Allied, AR for 1910, p. 25; photo from Bellevue and Allied, AR for 1911, facing p. 36.