Material Marvels: The bended brain clinic

Materials World magazine
1 May 2018

Only in Las Vegas, USA, could you get a brain clinic that has an alter ego as an events venue, the Lou Ruvo Clinic for Brain Health. Ines Nastali investigates the materials used to build the hospital with a twist.

Away from the 24-hour amusement show that is the Las Vegas’s Strip, USA, serious research into memory disorders is being done at the Cleveland Clinic’s Lou Ruvo Centre for Brain Health. The aim to cure diseases, such as Alzheimer’s, doesn’t mean that the building, which houses the centre, isn’t a gamble, though.

Architect Frank Gehry is known for his deconstructive building styles, as seen in the Guggenheim Museum in Bilbao, Spain, or the Luis Vuitton Foundation museum in Paris, France, and he is also the mind behind the Cleveland clinic’s extravagant stainless steel design. 

Get them on board 

It took a bit of convincing to get Gehry to agree to design a building in Las Vegas as he feared it could become part of yet another theme park. But Larry Ruvo, a philanthropist, got him to agree.

Ruvo is the founder of fundraising campaign Keep Memory Alive, board member and fundraising chairman for charities Alzheimer’s Research and the Las Vegas Alzheimer’s Association, and also part of the Nevada Tourism Alliance and the counsel for a Better Nevada. After seeing his father suffer from Alzheimer’s, he wanted to do more to help cure the disease and planned to build a research clinic that would focus on memory loss. This personal aspect also impressed Gehry. He has been a member of the board for a Huntington’s disease foundation for decades and after Ruvo agreed to make the disease that kills brain cells one of the future clinic’s research areas, he was on board. 

‘First they said Frank Gehry would never build in Las Vegas. Then they said the medical powerhouses wouldn’t take Vegas seriously. They told him he could never recruit world class doctors,’ Ruvo’s wife Camille remembers in a Las Vegas Sun documentary about the clinic, adding that when her husband decided to build the centre in Las Vegas, a city located miles away from the country’s renowned medical hubs, he was met with sceptics at every turn.

Gehry met with then mayor of Las Vegas, Oscar Goodman, who recalls the meeting in the documentary. ‘He picked up a piece of paper and he actually twisted it and threw it and when it landed, he said, this is how it’s going to look.’

In the end, Ruvo managed to not only get the architect to join the project, but also the Cleveland Clinic, headquartered in Ohio, USA, to operate the Lou Ruvo Centre for Brain Health in 2009, two years after the building works started. The following year, world-renowned Alzheimer’s specialist Jeffrey Cummings, MD, ScD, was hired as director. 

Build an identity

But before all this happened, Gehry planned a £50m project for a building that would, in addition to housing the clinic and research centre, feature an events space that can be rented to raise funds in for the Keep Memories Alive foundation as well as serve as its headquarters. 

With the architect not wanting to be associated with the amusement park that the desert city is, but to inspire world-leading research, he opted for a building that would cause enough attention to attract medical professionals, serve as a marketing tool and at the same time, wouldn’t give patients the typical feel of being in a hospital.

The two hemispheres

Gehry designed a building made of two parts, marked by contrasting design, allowing a nod to the two cerebral hemispheres of the brain. ‘The complex is split into two distinct wings, representing the logical and creative aspects of brain function,’ WSP, the structural engineering company commissioned to deliver the project, states. ‘To the north, a stack of splayed rectangular boxes, clad in white stucco render with glazed recesses, forms the logical four-storey medical clinic, containing patient facilities, neuroimaging suites and research space. To the south, an undulating stainless steel and glass structure – reflecting creative thought – houses a large atrium, allowing the centre to double as a revenue-generating events facility.’ 

The materials used to build the two wings also differ. ‘The medical wing has a steel frame and composite concrete and metal deck floors, while a distinctive curved steel trellis cantilevers off its south side, marking the transition between two halves of the complex,’ WSP states. ‘The events centre, meanwhile, comprises a laser-cut prefabricated structural steel shell punctured by 199 windows that flood the space with natural light. Supplemented only by two internal steel columns that pick up the loads from the different roof lines, the unique structure is largely self-supporting, making possible the column-free atrium inside.’ 

Digital help

Where the clinic building meets the steel façade of the events venue, complex calculations to ensure stability of the connections had to be made. ‘The irregular elevation of the clinic’s north façade meant accurate detailing of the steelwork was crucial, while design of the curved trellis had to factor in large lateral seismic and wind forces. Virtually every steel connection had to be individually designed and fabricated,’ WSP says. Digital building information modelling was used to provide an overview of the project’s complex geometry.

‘For each project, we enter all user and technical requirement specifications into a database connected to the various computer aided tools for design, clash detection and quality control. These are combined into a single 3D computer model and shared among stakeholders, including architects and an engineering design team, building contractors, the healthcare provider, and medical staff,’ WSP states.

As design and construction plans progress, having the digital twin of the end product, ‘enables clashes to be detected and fixed before they become problems on the construction site, allowing the team to analyse alternatives, identify issues and solve problems before they occur in real life. This minimises construction re-work, greatly reducing risk and saving time and money,’ WSP states in a project description.

This meticulous approach was necessary as each piece of steel contains between 60 and 100 bolts binding together smaller components. And, with an increasing number of connection points, there is less tolerance for error. 

Engineers therefore allowed an adjustment space of a few centimetres for weather-induced expansion of the entrance of the events centre, which is made of glass and a supporting aluminium grid, as any error would mean a complete disassembly and reconstruction of 544 steel elements and 30,000 screws.

Put it together

Before the stainless steel panels were installed, the building was coated with a layer of black rubber to keep it waterproof. 

All lattice and support panels were made in Germany and assembled on location in the USA. Other components were manufactured in China and shipped to Las Vegas. To ensure that all components were placed in the correct position, a barcode system for each steel piece was used. 

Workers onsite then scanned the modules and confirmed the information with the engineers in Germany. This process meant that each steel piece was examined individually, making adjustments prior to placement easy.

Good view, good sound

Not only the steel panels proved challenging to install. Of the afore mentioned 199 windows, none has the same size. The shape and plane of each are different. Their forms are the result of the computational building- layout, which was determined for each location to optimise conservation of heat or air conditioning.

In addition, Gehry equipped the windows with sensors so that shades roll out automatically when a certain temperature is reached, useful considering that the average high temperature in August is 40°C. 

Most of the windows are accessible by lift for cleaning purposes. It has been recommended to use water that has been processed through reverse osmosis to avoid the creation of spots during the drying process.

Part of the planning process also included optimising acoustics in the events venue. Due to the uniqueness and complexity of the roof and general outline of the building, the acoustics of the room was also modelled.

Throughout the building, an undulating serpentine pumice type sound absorbing material called BASWAphone, that looks like painted plaster panels, which was manufactured in Switzerland, was installed in all concave walls and the ceiling to absorb and guide sound as well as to ensure concert hall acoustics. 

Important insights

The events that take place in the venue fund the research inside the clinic. Nine years after it opened its doors, 70 clinical trials for Alzheimer’s and other brain disease treatments have been conducted. Currently, the centre focuses on researching the effects of repeated head trauma on long term brain health, having identified ageing athletes in contact sports such as retired boxers and mixed martial art fighters, with progressive neurocognitive deficits. ‘Our emphasis is on early identification of neurocognitive decline and prediction of long-term neurological consequences. Why is it that with similar levels of trauma, some individuals are more at risk than others?’ the clinic states. So far, they have learnt that changes in brain volume are not seen until after approximately five years of professional fighting and not all fighters exhibit such changes. 

Under the undulating roof, the scientists will dedicate their time to find a cure for Alzheimer’s. From May 2018 on, a new director Dr Marwan Sabbagh, will join the clinic. He wants to develop a blood test to screen for Alzheimer’s, and a spit test to detect amyloids, a protein found in greater quantities in the saliva of those with Alzheimer’s.

Quick facts

  • 199 windows, none of them equal
  • 18,000 stainless steel tiles, each with unique measurements
  • 875 shades of steel shingles
  • 30,000 steel screws
  • 544 special steel parts were manufactured, with a weight ranging between 900 and 4500kg
  • 65,000 hours of engineering work
  • 910m2 of event space for up to 400 seated and 700 standing attendees