A place among the pines asks: What are we healing from?

The Paimio Sanatorium is often considered architect-designer Alvar Aalto’s most important creation, though just as much credit should be granted to his wife and closest colleague, Aino Aalto. Together, the Aaltos shaped a holistic vision of architecture, design, and healing, nestled amongst pine trees, about an hour and a half by car from Helsinki towards Turku.

Originally built as a place of healing for tuberculosis patients, and having stood empty for years, plans are underway to repurpose the premises – with some former patient rooms already renovated for eager visitors, accompanied by a restaurant and various events, especially in the summertime. Much remains to be utilised. With the aforementioned malady fading into history, a new question arises: What are we healing from now?

Designed by Aino and Alvar Aalto in 1929 and completed in 1933 as a landmark of functionalist architecture, the sanatorium represents a radical synthesis of architecture and nature, focusing on the healing properties of design and its relationship with the human body. A cutting-edge medical facility in its time, the sanatorium evolved over the decades into a general hospital before being decommissioned in the mid-2010s.

In 2020, the Paimio Sanatorium Foundation was established to preserve and extend the Aaltos' progressive vision in the form of a hub for regeneration, reflection, and future-forward solutions. With an unintentional nod to the history of the premises, the first years of the sanatorium’s new era were marked by another illness concerning air particles and breathing. During the recent pandemic, events were sparse but renovations proceeded, and studies for new purposes needed to be reconfigured. In 2023, the sanatorium celebrated its 90th anniversary – and a new chapter began.

“Right now we are in a very good situation. It’s extremely tricky to do something in a temporary environment when we know that things will be done very differently in the future,” says Mirkku Kullberg, CEO of the Paimio Sanatorium Foundation. 

“We want the sanatorium’s new use to match the original purpose as closely as possible. While tuberculosis is no longer a threat, many people need a place of personal restoration. In the old days, sanatoriums were places of rest away from the metropolitan bustle. Tuberculosis was not only an illness of the poor; it affected everyone.”   

Renovations of the patient rooms, as well as staff quarters across the lawn, began with the idea of preserving as much of the original as possible while welcoming new life. Resting on the past with dreams of tomorrow.

“We can’t renovate something into a museum. A central point of this restoration is to explore new purposes. Use is the best mode of preservation – this cannot be a passive building. Of course, the site is an architectural masterpiece, but its function is more important. We should not push the boundaries to any extremes. I follow ‘wow-architecture’ with interest but personally find it a strange concept,” says Kullberg.

In mid-May, two busloads of Paimio-curious travellers hopped on board in Helsinki to spend an afternoon and evening at the sanatorium to welcome the summer, hear the latest developments, and visit the summer’s art exhibition spread out over several curious nooks and crannies. I expected to spend these hours in a tight-knit brigade, but once we heard the opening remarks by the Foundation’s team and exhibition curators, everyone seemed to disappear into thin air in smaller batches, myself included. Perhaps that’s what the Paimio Sanatorium does best: invites one to follow their own path and do what they need to do. Some examined the patient rooms, some explored the art at the bunker building, and some reclined on the rooftop’s loungers to take in the air in solitude.

I spent a long moment on the nature path around the main house where artist Josefina Nelimarkka had installed “atmospheric poetics” to accompany a meditative walk amongst the pines. These texts were laser-cut onto see-through and mirror plates left to linger in the air, reflecting trees and clouds and always changing according to the weather – and perhaps one’s inner climate.

“Whenever we breathe, we share something with the forest – and in this same process, we become part of the whole sanatorium,” Nelimarkka says. “The body-based experience and breathing are essential in ‘Atmospheric Un/knowing’. Air is a shared space. I wanted to create the path in a way that one’s own walk and the meditative experience it forms serve to expand perception, suggesting a different relationship with the forest. The forest is the most essential feature of the sanatorium, at least for me. It feels profound to walk the same paths as the patients once did, and it’s hard to comprehend without having that physical experience. The forest has been there much longer than any of these buildings.”

Heading back to the buses, I shared some chats with fellow travellers. Someone recommended lying on a spike mat at bedtime to help with deeper sleep. Another wished that the sanatorium would offer symbolic pine needle burials as a rebirth ritual. I found myself wondering what the world’s most advanced depression rehab could look and feel like in Paimio. The first anatomical theatre was built in Padua in 1595 to explore and share how the human body looks and functions. What could be a way to dissect the human body and mind to understand how the damnations of our time – excessive scrolling, loss of body and community, crumbling ecosystems and social democracies, war crimes and genocide – affect us? And how then to stitch oneself back together, find each other as humans, and do our best to develop new societies based on justice and wellbeing?

The Paimio Sanatorium is expecting a busy flow of curious summertime visitors, along with the residency programme’s first artists ready to enter the premises. Some will come for the design, some for the pines, some for the art, or an event. The current role of the Foundation seems to resemble that of the former chief physicians: keeping an eye on activities and patients, seeing what works, designing new cures. “We need to create wellbeing and joy. It’s essential to focus on activities. So, more a cooking school than a restaurant. Functional living rooms, merging hotel hospitality with a campus, reading a book for a week, maybe reactivating the greenhouses. We also want to stay active in inviting the local communities in and around Paimio to join us,” Mirkku Kullberg envisions.

Upcoming major events include the now yearly Spirit of Paimio conference taking place again in October as an open and inclusive “platform for thinking, learning, and doing”, which leans on the Aaltos’ legacy of future-making. The sanatorium likes to remind us that “we didn’t just inherit a masterpiece. We inherited a masterclass in designing our shared future.” Kullberg would like to see the Spirit summit as the Davos of the Nordics.  

Ensuring a healthy future for the sanatorium currently means that business intelligence calculations need to be constantly crunched to answer the following question: How to cover the costs yet offer something for everyone? Along with architecture, nature, design, and healing practices, money inevitably becomes part of the overall equation. The Aaltos based their designs very much on the idea of enhancing the everyday for everyone, not just design aficionados. A sanatorium of the 2020s needs to be accessible.

While again asking the crucial question of what we need to heal from, another intertwined question unfolds when catching the full view from the rooftop:

What do the pine trees need to keep standing?

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