Creatively resolving a narrow, sloping site atop Marquam Hill, the new OHSU Kohler Pavilion addresses the expanding regional need for patient care capacity at the existing hospital. Offering commanding views of the city, Mount Hood, and the Willamette River from both patient beds and healing gardens, this expansion includes a 9-story, 350,000 sf flexible tower containing 26 ICU beds, 60 flexible med-surge beds, 8 new OR’s, Radiation Therapy, the Center for Women’s Health clinic, and several garden view terraces above a 450-car concealed parking structure and relocated roadway. A vital circulation hub interconnecting public access, patient care, teaching facilities, research zones of the OHSU campus, and future buildings, the project weaves Pacific Northwestern architectural metaphors of forest, mountain, city, and history into a simple, elegant landmark, symbolic of state-of-the-art healthcare.