-By Katie Weeks , Photography by Robert Benson

Medical facilities aren't necessarily known as the most relaxing places, so patients checking in at Duke Integrative Medicine at Duke University in Durham, N.C., may be in for a bit of a shock on their first visit. Set back from the rest of Duke's medical campus and cradled by pine forests, the 27,000-sq.-ft. center, one of the first new-build facilities to combine traditional medicine with more alternative, holistic practices, is warm, inviting, and decidedly non-clinical. It's also exactly what the client ordered.

"It's not every day a client comes in and wants a new paradigm or something that hasn't been done before," recalls Turan Duda, AIA, partner at Duda Paine. "There are centers where it was a renovation of an existing space, but I was thrilled to start from scratch with a whole new building and a blank slate. How can we design a building that doesn't just speak about the program but also captures the mission of what it's trying to do?"

Stepping back, the designers began by thinking not only about programmatic requirements, but also about experiential elements. "We wanted to think about what it would feel like and how the spaces would unfold," Duda explains. "One of the very first things the client team said was they wanted a warm, nurturing environment. Well, what does that mean architecturally?"

Duda Paine's response to this question is a layered design that embraces the mind, body, and spirit from the start. Forget the automated doors of a large-scale hospital that whip open and thrust a patient straight into a waiting area. At Duke, "the front of the building and its wooden trusses create this semi-circular embrace that welcomes someone into the building in a gracious way, as opposed to the usual experience of, boom, you're in the front door. It's a kinder, gentler way of bringing people into the building," Duda says. Progressing indoors, patients' first interior experience is a rotunda library that opens up to the tree line beyond, and to further emphasize this connection, the designers crafted the rotunda's ceiling with arched wooden trusses that suggest a canopy of tree branches.

From a curved entryway, the building is planned as a series of branches or fingers that reach back into the surrounding woods, each of these culminates in some sort of public space—be it a multipurpose room, nutrition center, or, venturing farther out into the woodlands, an outdoor labyrinth or private meditation rooms. Within the branches are evaluation rooms, treatment rooms, conference and workshop spaces, fitness facilities, showers and changing rooms, and a full kitchen/dining room. The configuration also allowed for the placement of healing gardens and water elements throughout the facility.

Inside, the warm palette of wood, stone, and neutral colors instills a sense of materiality, and large windows in almost every space help blur the line between indoors and out. In fact, the only space without direct views outdoors is a quiet room, where patients can retreat after treatment. Even here, the outdoors are reflected with the use of arched wooden truss work that references the entrance of the facility, as well as a bamboo garden and a water wall. "The rotunda and the quiet room are emblematic of the two important aspects of this facility," Duda explains. "The rotunda is essentially the living room. It's the most public room and aspect of the experience." Conversely, he says, "the quiet room is the most intimate space. It is a far more meditative space. One is about looking out at nature and the other is about looking inward."

Throughout the space, visitors will notice a subtle repetition of circular geometry and segmented arcs. What they may not know on first glance, however, is that these arches are not only a nod to the gothic arches found elsewhere on Duke's campus, but the alignment is also in tune with the golden ratio. What's more, in lining up the golden ratio with the human body, the starting point for each circle or arch coincides with the human heart—which only seems appropriate for a healthcare facility.

who
Project: Duke Integrative Medicine. Architect: Duda Paine Architects; Turan Duda, principal in charge; David Davis, architect/manager; Darren Lathan, staff architect. Project owner: Duke University Medical Center and Health Systems Architect; Gregory Warwick. General contractor: Balfour Beatty Construction US; John Rankin, senior vice president, Raleigh division; Shelly Goodwin, project superintendent, director of operations. Structural engineer: Gardner & McDaniel; Stephen McDaniel. Civil engineer: Haden Stanziale; George Stanziale, principal; Craig Morgan, project manager. Mechanical, electrical, plumbing and fire protection engineers: Newcomb & Boyd Consultant and Engineers; Christopher Rousseau, principal; Jeffrey Linde, project manager; Landscape architect: Hughes, Good, O’Leary & Ryan Planners& Landscape Architects; Robert Hughes, principal; Lauren Standish, project manager. Lighting designer: Cline Bettridge Bernstein Lighting Design; Francesca Bettridge. Green building consultant: the Folsum Group; Richard Price. Kitchen consultant: Daniel Design; Reggie Daniel; Acoustical consultant: Stewart Acoustical Consultants: Noral Stewart. Audio/visual consultant: Kontek Systems; Wes Newman. Photographer: Robert Benson.

what
Glass, interior painting: PPG Industries. Laminate: Nevamar Company. Resilient flooring: ECOsurfaces Commercial Flooring, Gerert Limited, Bonitz Flooring Group. Bamboo wood flooring: Greenwood Products Co. Tile: Appiani Tile, Nemo Tile, Royal Mosa, David Allen Company. Wallcoverings: Phillip Jeffries. Millwork: Cronen Casework, Salisbury Millwork. Drywall: USG. Lighting: Artemide, McGraw Edison LIghting, Cooper Lighting, B-K Lighting, TEKA Illumination, Legion Lighting Company, Linear Lighting, Lumascape USA. Carpet: Fortune Contract. Carpet walk-off mat: Van Dijk Carpet. Toilet partitions: Ampco Products, Hardward Distributors. Dual-flush toilets: Mansfield Plumbing Products. Metal roof and wall panel systems: Metecno Morin. Interior roller shades: MechoShade. Food service: Halton Company, Jacobi-Lewis Company. Glass entrance systems: Oldcastle Glass. Alum clad wood windows: Quaker Windows. Wood doors: Algoma Hardwoods, Hardward Distributors. Metal door frames: Ceco Door Products. Steel doors and frames, wood doors: Hardward Distributors. Door hardware: Rockwood Manufacturing Company, Von Duprin, Markar Architectural Products. Ceiling: Armstrong World Industries. Moveable walls: Modernfold. Storm drainage: N.C. Products. Joint sealants: OSI Sealants, Jacobs Glass Company. Roof membrane: Dow Roofing Systems. Projection screens: Draper, Kontek Systems. Spa/whirlpool: Baja Spas, Candler Pools & Spas. Sauna and steam room: Amerec Sauna and Steam. EIFS system: Dryvit Systems. Fixed ladders: Alaco Ladder Company. Resilient wall base: Roppe Corp. Waterproofing: Joyner Masonry Works. Termite control: Frye Exterminating Company. Masonry, pre-case stone: Joyner Masonry Works. Structural steel, joist, deck, metal fab, stairs: Steel Fab of VA. Blinds and shades: Signature Blinds. Sitework, pavement markings: Patriot Building Company. Electrical: Starr Electric. Fire extinguishers/protection: Sunland Fire Protection. Plumbing: Triangle Mechanical Contractor. Aluminum entrance and storefront, wood windows, unit skylights, glazed aluminum curtainwall: Jacobs Glass Company. Metal framing: Precision Walls. Signage: ASI-Modulex. Acoustical ceiling/wall: Mid-Atlantic Specialties. Metal roof system, flashing, roof accessories: Baker Roofing. Louvers: Newcomb & Company. Painting: Mansion Decorators. Concrete work: Patriot Building Company. Flooring: Bonitz Flooring Group. Controls and instrumentation, energy management systems: Johnson Controls. Exterior plants: ValleyCrest Landscape Development. Interior water feature: Art n’ Motion Design. Heavy timber: Brooks Building Products.

where
Location: Durham, NC. Total floor area; 27,000 sq. ft. No. of floors: 1. Total staff size: 35 FTE.