So there we were, walking down the Via Cavour in Rome, when to the left, we saw perhaps the most famous, and certainly oldest, building profile in the world: the Colosseum. Rome has much to offer in displaying 2,700 years of history but, for my money, the most dramatic and mysterious is this ancient sports arena.

I should explain that I’m blessed with a wife who covers international medical meetings as an online journalist; she allows me to tag along as the vacationing spouse. Fortunately, we both were able to tour the fabled interior of the Colosseum, something we yearned to do after circumventing the looming structure during our first night in Rome.

And we both went in with some serious misconceptions.

In a nutshell, we thought that the Colosseum was well over 2,000 years old and had served to entertain Julius Caesar and his cronies, if not his predecessors. And we thought that the remains we saw were indeed of the original structure. They are, but not to the extent we imagined. There are no obvious “seats” inside, only remnants of the piers that supported them. And what was with the floor of the Colosseum—a rabbit warren of tiny cells and narrow passageways that could scarcely accommodate a bout of tiddly winks, much less gladiatorial combat?

An excellent book we purchased on the site, titled appropriately enough The Colosseum, by scholars Keith Hopkins and Mary Beard (Profile Books, London, 2005, 2006), provided many of the answers (or, as the scholars emphasize, as best as could be determined after nearly two millennia). The basic facts: the Colosseum was built in 72 A.D. by the Emperor Vespasian. It has gone though earthquakes, fires, and centuries of use as a travertine quarry for Roman construction projects. It has been patched up numerous times over the centuries, including as recently as the 20th century. The “floor” we saw was actually a basement beneath the arena floor, now gone with the ages, and was used to house animals, gladiators, and machinery for Roman “special effects”—as in “How did that lion get there?”

More to the point here, the book offers a brief discussion of the architectural planning that went into the structure. It shows the decisions and the trade-offs that went into making a workable building. For example, the length-to-width ratio of the arena is a familiar looking 5:3; the exterior was sized to accommodate 80 identical arches which, in keeping the seating area constant, meant having to reduce the arena size somewhat; the voussoirs of the arches were nearly identical, but the vertical supports, as well as the stairways, varied substantially in dimension, probably due to the varying quality of the travertine used. Archaeologists have also discovered an intricate and sophisticated drainage system underneath the arena, as well as a massive concrete and rubble foundation ranging from about 15 to 45 feet thick, center-to-perimeter, with 10-foot thick retaining walls—a foundation indeed for the ages.

No one is quite sure who the architects were. Today’s architects, though, might well ruminate on the builder’s art that went into such a structure. In this day and age of healthcare design, a 100-year hospital is deemed an outstanding achievement. True, today’s technologies and materials are vastly different, with different purposes. But it is humbling to think what can be achieved by designers and builders working at the state of the art of their given eras. HD

Richard L. Peck, Editor-in-Chief


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Healthcare Design 2008 October;8(10):6