PORTLAND, Ore. — The Portland Veterans Affairs Medical Center campus sits on a 450-foot-tall basalt-rock hill south of downtown. Marquam Hill, also known as “Pill Hill” due to the amount of medical facilities clustered on its crest, is also crowded with homes, steep slopes and daily commuters (during non-pandemic times).These steep and rocky slopes garnered ridicule for Dr. Kenneth Mackenzie when he initially proposed to build a medical school on Marquam in 1914. According to Oregon Health and Science University’s historical collections, “The land, unusable to the railroad company, came to be known as ‘Mackenzie’s Folly’ in reference to its location on an inaccessible hilltop.”And after more than 100-years of technological changes making access to PVAMC better today, the site still presents problems for modern construction when the U.S. Army Corps of Engineers and VA Portland Health Care System begins structural seismic improvements to three critical buildings on campus.“The most interesting component by far, are the site limitations,” said Bryan McClure, Portland District project manager. “Marquam Hill is a pretty constrained location, with quite a bit of change of topography. We’re taking the entire façade off of the two tall tower buildings and replacing them while maintaining an active, operational hospital campus – that’s not a small effort. The constraints that are up there, I would say are the most unique thing we’re facing.”This partnership between the Corps and VA has been happening across the U.S. as Corps engineers have been helping build, renovate, or retrofit hospitals and other medical facilities. In Portland, the VA Portland staff and Corps staff are planning and designing in phase one of the project. The teams meet frequently and explain the project to various stakeholders.“Whenever we’ve had guests and visitors to come and take a look at the project site, that’s always their first comment is, ‘man, this is not going to be a very easy project site for you guys to pull all of this off,’” said McClure. “There’s just not a lot of space for laydown, there’s not a lot of space for construction parking, there’s not a lot of space for construction trailers and offices.”VA Portland staff understand the complexity of the site – very well.“This seismic project presents a lot of challenges,” said John Dodier, chief of VA Portland Facilities Management Service. “Mitigating any future potential harm to life and property is the goal and we’ll get there; it will just take continued good coordination with all our partners. The long-term safety of our veterans, staff and visitors depends on it.”Construction efforts will also add to the capacity of an existing parking garage and realign the main plaza and transportation corridor. Designers expect that each part of the job will lead to its own complications.“Knowing that it’s already pretty developed, with a lot of buildings and a lot of infrastructure; roads, the concept of trying to get in very large tower cranes and be able to do some of this very large construction effort, in a very tight, constrained location all while trying to minimize the impact to the hospital operations is certainly the biggest challenge that our team has identified,” said McClure.Corps and VAMC staff expect to begin construction in 2023 and anticipate the VA will okay further pieces of the project next summer.