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Journey through Stanford’s hidden pneumatic tube system

Marcus Picou, lead maintenance engineer, oversees the entire pneumatic tube system.


Buried deep in Stanford Hospital is a network that’s a little more Jules Verne than Silicon Valley.

Four miles of pneumatic tubes run in between the floors and ceilings of the hospital. It’s a suction-powered superhighway to move objects around the vast medical campus.

A pneumatic tube system is a network of metal tubes that uses compressed air to transport items in capsules. You might have seen a smaller version of this delivering checks and cash at the drive-thru of your local bank branch.

Stanford’s system is one of the biggest and most efficient pneumatic tube networks in the country — it has a 99 percent success rate, and delivers about 7,000 capsules per day.


A series of tubes


Marcus Picou, lead maintenance engineer, oversees the entire system.


“The clinicians, or the nurse or the phlebotomist, whoever. They’ll draw the blood from the patient and stick it in this capsule,” Picou said. “The object of this is to get it to the clinical labs so they can do their analysis for the blood.”

So blood samples, medications, small medical devices, and everything in between goes into the capsules. Breakable items get folded into a plastic air pillow inside the capsule. The plastic six-inch capsule itself is pretty heavy, weighing in around 3.5 pounds with a fiber band around it to help it slip through the tube system with ease.



"I don't know why you would want to do that though. Only because I've seen some urine spills in here I've had to clean, so I'm like — you're sending your lunch through this — like, OK?" —Stanford Hospitals Lead Maintenance Engineer Marcus Picou

And in a place where high tech reigns supreme, Stanford Hospital uses this slightly old-school, quirky system to get all small, transferable hospital goods from point A to point B — because the internet still can’t do everything.


A trip to the engine room


If you worked here, you’d put a capsule in a robotic-looking basket arm and send it on its way by pressing a number on a keypad. It would then get suctioned up at 30 miles an hour, 45 feet into the air, all the way to the engine room on the roof.



The engine room is the heart of the system, and it’s surrounded by metal tubes, with capsules whizzing by. A super-strong fan powers all of it. It doesn’t look like much, just a large metal box with tubes coming in and out, with an exhaust pipe.

After being sucked up to the roof, each capsule gets pushed back down into the bowels of the hospital, where it shoots out in a different location.

All blood samples land in a nondescript cubby in the wall, and roll down a carpeted shoot. Phlebotomists check labels and perform whatever test the doctor has ordered on the capsule’s contents.

Phlebotomist Susan Cabalbag uses the pneumatic tubes every day.

“It’s pretty cool, it’s neat that you don’t have to walk all the way to the other side of the hospital to drop something off,” she said, though she added that after being around it for so long, it isn’t that strange to her anymore.


Lost capsules


Picou said the tube system saves Stanford’s hospital workers hours of travel time.

"If you didn’t have the system, you’d have to have somebody walk that blood or whatever to the lab, or medication to the pharmacy, walk it up to the patient,” Picou said. ”So you’d have to hand deliver. With this it eliminates that.”

Stanford’s pneumatic network has a near-perfect success rate. But capsules still get lost sometimes. And when that happens, Picou has to go find it.

“I do a mad dash and try to find it and I’ll go get it myself,” he said. “And I’ll deliver it myself.”

He averages about seven miles a day just making sure the system is running smoothly.

The whole thing has a steampunk feel to it. This technology is straight out of the 1890s, when pneumatic tubes were cutting edge — and were first used to deliver mail.

In several East Coast cities, metal canisters of letters zoomed under streets to people’s homes. But it was costly and inefficient, so it never quite caught on.

The idea stuck around though. More than a century later, Elon Musk is into pneumatics. You may have heard of Hyperloop, his proposal to transport people in a large, vacuum-sealed tubes from San Francisco to Los Angeles in under an hour.

And pneumatic tubes are still being built in hospitals around the country.

Leander Robinson is the former chief engineer at Stanford Hospital. He helped install its tube system in 1991. What makes Stanford’s system different from others, he says, is its success rate.

“The care that the maintenance team puts into the system makes it perform at a higher efficiency rating than other facilities,” Robinson said. “Timing is everything.”


Let's ... not do lunch


The system costs Stanford millions of dollars to install and maintain. And they’re still expanding it into newer buildings.

Right now, the honor of the largest tube system goes to the Mayo Clinic in Rochester, Minnesota. But when Stanford is done expanding, it may be a serious contender.

“I’ve seen other hospitals, they don’t send blood or any biologicals whatsoever because of the fear of breakage, the fear of it becoming lost,” he said. “At Stanford, we sent everything, we send blood, urine, stool.”

Bodily fluids, chemotherapy drugs ... and lunch!

“I’ve seen somebody do that one time,” Picou said, shaking his head. “Obviously it doesn’t happen every day...I don’t know why you would want to do that though. Only because I’ve seen some urine spills in here I’ve had to clean, so I’m like you’re sending your lunch through this … Like OK?”

At least you know there’s a 99 percent chance your lunch will arrive when and where you need it.