After decades of gaining strength as a movement, the battle lines have been drawn again, with a significant structure in peril. The Medical Center of Louisiana at New Orleans, popularly known as Charity Hospital, a looming Art Moderne presence in the Deep South, battered by Hurricane Katrina but apparently structurally intact, now faces a more insidious foe—abandonment—together with the demolition of more than 120 structures in a nearby neighborhood currently listed on the National Register of Historic Places. But not without a fight.
 
The contemporary drama pits big money ($2 billion in much-needed investment for New Orleans to become a 21st-century medical Mecca) and power (the Veterans Administration and the Louisiana Office of Facility Planning and Control) against a hard-hit community, organizing and finding its voice after the hurricane, asking to be heard. No one denies that the city needs the capital investment, or that a medical campus would benefit the larger city and state economy. As in many preservation arguments, however, the value and relevance of an existing property lies at the core of the debate, in this case the 1-million-square-foot hospital designed by Weiss, Dreyfous, & Seiferth and built from 1937 to 1939. Should it be retained or jettisoned? Is any sort of compromise scheme possible?
 
Today, architects on both sides of the divide are playing a central role at Charity once again. The Foundation for Historical Louisiana partnered with the National Trust for Historic Preservation in commissioning a $600,000 evaluation of the core property by the firm RMJM, which maintains an active practice in both historic preservation and health care (with local architects Waggonner & Ball, and structural engineers Robert Silman Associates, among others). A respected national firm, NBBJ, and local partners have been employed by state authorities responsible for planning entirely new facilities for Charity and the VA on another 70-block campus—located in midtown, and farther away from the central business district—carved, in part, from an existing neighborhood.
 
“I cannot imagine a more important case for historic preservation,” states Jack Davis, a New Orleanian and member of the board of trustees of the National Trust for Historic Preservation. He cites the RMJM study that shows how transforming the existing structure makes sense economically, reducing costs by $283 million dollars compared to the current plan; saves time (two years, by renovating an unoccupied structure); and keeps New Orleans’s urban core intact while delivering the sought-after, contemporary medical complex.
 
But Louisiana officials in charge of the proceedings aren’t convinced. In a letter to the state legislature, Jerry Jones, an architect and assistant commissioner of the state’s Office of Facility Planning and Control, wrote that building a hospital that does not equal the programmatic goals set for the new campus “does not make long-term sense.” Jones and others argue that renovating Charity would provide comparatively inadequate parking and ambulatory-care space. It would also preclude flexibility in future building and expansion of the medical center. Ultimately, the state legislature will decide if the plans for the alternate site—and the continued neglect of Charity—proceed as previously planned.
 
Given the iconic stature of the hospital (founded in 1736) in the history of health care, the building’s importance in the Louisiana landscape, and the ramifications of demolishing houses currently listed as “contributing” on the National Register—as well as the immediate need for medical care—the outcome matters for the city’s, the state’s, and the region’s future. An outside arbiter, such as a university, might bring clarity and credibility to the issues, though in this case, most of New Orleans’s prodigious educational establishment has a vested interest in the outcome.
 
The Charity dilemma, still unresolved as of this writing, illustrates how preservation has evolved into a vital and necessary discussion in contemporary urban environments. It also demonstrates how, in a French phrase familiar in New Orleans, “Plus ça change, plus c’est la même chose” (“The more things change, the more they remain the same,” for non-French speakers). For centuries, the links to our past and the past’s relationship to our present have provoked heated argument, even passion, which can sometimes galvanize a community and on occasion occlude its vision. The term preservation, and the discipline and movement that accompany it, has shifted with time: Today’s preservationist occupies a different landscape than our grandmother’s.