Most medical schools are fit only for cadavers. Diller Scofidio and Renfro has injected a sense of life into the typology with a tower of morphing, cascading spaces. The college of Physicians and Surgeons, a graduate school for Columbia University Medical Centre, is a magnet for musically inclined students, in part because of a piano allegedly donated by Rachmaninoff. The Vagelos Centre, as both Diller and project director Anthony Saby note, reflects discussions with faculty, students and the unusually hands on donor, the surgeon and biochemist P Roy Vagelos, an alumnus who headed the pharmaceutical firm Merck. Its footprint – 12,500 sqf at the base floor plate, tapering to 6,000 sqf with setbacks in the tower – is narrow enough that some staff were initially sceptical about the site’s suitability. But the firms’ stacking strategy turns this constraint into a positive feature, emphasising vertical circulation and social interaction in place of large, inefficient floor plates and long corridors. Labelled ‘New York’s zaniest new building’ by the real estate webzine The Real Deal, Vagelos strikes an arresting profile of fritted glass and white glass fibre reinforced concrete. Zaniness is not the point. The display of diverse cantilevers, ramps, stairways and terraces makes Vagelos the architerctural equivalent of the 1960/s anatomical toys Visible Man and Visible Woman: grotesque only initially, then perceptible as highly purposeful, almost literalising the phrase ‘organic architecture’. ‘We figure this is a building for at least 50 years,’ says Columbia University cardiologist and medical education expert Ronald Drusin.