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Abigail Clary (M.ARCH. ’97) has spent decades designing every kind of health care space, attempting to make them more patient-friendly and efficient. One should know this to grasp the immense frustration and helplessness she felt when her father died.

“My dad knew who we were on the last day of his life. He smiled at me and blew a kiss to my mom, and then he died alone in his room in the middle of the night,” Clary told her audience at a TEDx Chicago talk in 2024, “and we will never know what happened.”

The crowd was silent enough to hear a pin drop.

“I thought if anybody knows this system, it’s me. And I couldn’t have been more wrong—I was totally helpless,” continued Clary, an architect who assisted in the design of numerous health care centers across the Midwest. Those projects include University of Chicago Cancer Center and the renowned Chicago rehabilitative research institution called the Shirley Ryan Ability Lab, of which she was the primary architect.

In 2022, her father, suffering from primary progressive aphasia, had lost the ability to speak for himself or understand language. After a seizure he was taken to a local hospital, but was sent home after limited treatment and soon suffered a damaging fall.  

Clary tried to get him into multiple specialized care facilities, but was met with a slate of technicalities. A clinician was needed for a referral. He wasn’t yet in hospice. A vacant case management position prohibited intakes.  

“We fell into this black hole where there was nowhere for us to go within the health care system,” Clary says.

Clary’s mother, recognizing that her husband couldn’t communicate, asked to sleep with him in his room. No, hospital workers told her—that was only allowed for those in hospice. He died alone in his room that night. The family was informed in a grieving room that seemed built for discomfort and indifference: no windows, mismatched furniture, and a stack of supplies stashed in one corner.

Clary is now attempting to transform the pain of that evening—and everything that led up to it—into substantive change.

“In health care architecture, we historically have focused on function and efficiency. However, this can make for experiences that are impersonal, lonely, and frightening,” she says. “But it doesn’t need to be that way. We can change institutional care to something that is inspiring and inclusive and allows you to have dignity in life and death.  

“If my dad had had a place like that, he would not have died alone.”

**

Clary remembers getting a phone call after making a pitch to design the Shirley Ryan Ability Lab’s new home facility in Chicago. It was from the lab’s CEO and CFO. They liked her, but had one big concern: She was only 38, and had never handled a project of that size on her own.

“I told her I wasn’t interested in failing, and this was personal for me,” Clary says. “It wasn’t my expertise; it was my authenticity.”

She got the project.  

Despite any concerns about her age, Clary had no small amount of experience under her belt. Within a year of graduating from ������ƵAPP, she’d taken a job at Loebl Schlossman & Hackl, working primarily on health care renovation projects such as Gottleib Memorial Hospital in Melrose Park, ������ƵAPP, and Resurrection Medical Center in Chicago.  

After 13 years, she moved to an even larger firm. At HDR Inc., she was the health care principal in Chicago, pursuing and leading all the firm’s Midwest projects. As a “seller-doer,” she was not only finding work but also leading it.

While in school, Clary admits she didn’t excel at designing projects from scratch. But on the job she discovered a true talent for materializing her clients’ visions—particularly those that had yet to be fully realized.

“Sometimes [clients] don’t know what their vision is. I can help pull out what they’re trying to solve through conversations,” Clary says.

David Grandy, the national vice president for delivery system innovation at Kaiser Permanente, says Clary “is clear in communicating her depth of expertise in ways that are disarming—particularly to other experts. Which is to say, she deeply understands the perspectives of physicians, business leaders, and technologists, and she can help them connect to others.  

“She is passionate about impact, and that passion for impact is infectious.”

But as Clary’s expertise in envisioning health care spaces grew, she learned to question clients’ initial asks—particularly if she sensed that they were based simply on how projects had been done for the past 20 years.

Such “old-school” thinking places heavy emphasis on the bottom-line efficiency of facility employees, without thinking of the very human effects on patients and health care staff, and their lasting experiences and impressions, Clary says.

“For a long time, health systems were thinking of efficiency and seeing that as a success, because the patients weren’t there for very long. They were thinking of efficiency, not emotion,” Clary says.

Today, as CannonDesign’s first-ever executive director of health for all, Clary builds teams of not just architects, but interior designers, strategists, process engineers, smart-building consultants, and a plethora of other professionals. Her deep design process often includes surveys and interviews with everyone from nurses to administrators to prospective patients.

"Our definition of design is much broader than architecture,” she says. One of Clary’s current major projects is the University of Chicago’s new cancer hospital in Chicago’s Hyde Park neighborhood.

Fresh ideas include allowing cancer patients control over their room—letting them set their personal space’s temperature, sound levels, and lighting—to reduce anxiety and allow agency in a scary environment. Also, sending “check-in” wristbands to patients at home, enabling a less demanding and abrasive screening and security process when they arrive at a hospital, including personalized greetings and “invisible” bag checks.

“People with cancer arrive at these care facilities essentially blind: They can’t see or hear because they have so much anxiety. If they have that wristband, they don’t have to worry about getting through security, and they already know where they’re going,” Clary says.

Yet Clary’s designs hardly ignore employees. She notes that nurses—who often witness grievous injuries or death—have historically been expected to deal with their trauma in breakrooms or bathrooms. Her designs include adding a “cocoon” in health care facilities: a group of rooms where nurses can “take a breath,” with relaxing ambient sound, color, and lighting.

“She thinks about impact holistically. While facility design is a way to make an impact, she understands that the facility is a strategic asset,” says Grandy.

Clary adds, “I want to change the world of health care however I can do it. Through the built environment, the experiences within it, you name it. My father ended up dying alone. It was so undignified. When I think of patient experience, I think of that, and I don’t want it to happen again.”