CHARLESTON, S.C. - Amid screeching power saws and ringing hammers, hundreds of workers labor on the Medical University of South Carolina's almost $400 million Ashley River Tower - the most expensive hospital project in state history and the first phase of a more than $1 billion medical complex.

About 500 workers are on the job site these days, working to complete, by early next year, the modernistic building of steel and glass resembling a curving sail.

The building, also among the most expensive single public projects ever built in the state, is comprised of a seven-story tower with patient beds and a four-story center for diagnosis and medical operations connected by a light-filled atrium.

The complex is resistant to hurricanes, earthquakes and even infections.

Its windows won't break in winds of 220 miles per hour and the building is 15 feet above grade near Charleston's Ashley River, keeping it largely out of the way of a storm surge.

Gaps engineered into the building allow it to move as much as 16 inches in event of earthquake, said Dennis Frazier, facilities administrator for the hospital.

Inside are separate hallways for moving patients to operating rooms so they are not wheeled down public hallways, reducing the risk of infection. Corian, which many people use for kitchen countertops, has been installed on the walls of the operating rooms allowing for better cleaning and to reduce the threat of infection.

Medical equipment is suspended from booms in the ceilings, meaning less clutter and allowing easy replacement with newer technology. Panels at the ends of the building can be removed allowing large equipment to be brought into the operating rooms.

The new hospital will have 156 beds to treat patients with cardiac and digestive diseases, adding to the approximately 600 beds in nearby MUSC medical facilities.

The plan is to expand the new hospital in phases and eventually replace the existing MUSC Medical Center a few blocks away, originally built in the 1950s.

The investment will easily surpass $1 billion, said MUSC President Dr. Raymond Greenberg. He said the initial plan was to expand over two decades, but recent thinking has been to do it sooner to keep costs down.

"When people look at this hospital, they think it's the Medical University of South Carolina and therefore tax dollars paid for it," he said. "There's not one nickel of tax money."

Greenberg said it was being paid for by revenues from taking care of patients.

When MUSC, which has 600 students and employs about 11,000, first envisioned a new hospital, there was talk of moving from downtown Charleston where the school has been located since it was founded in 1824.

But that would also have meant moving a campus, said Greenberg, who had favored a location in North Charleston.

"What we were talking about as a $1 billion investment in the hospital in 2002 became a $3 billion project replacing everything," he said. "Logistically it was not the smartest strategy."

The hospital building cost about $275 million, but add the cost of medical equipment and infrastructure, including a hospital power plant, the cost approaches $400 million.

Thom Berry of the state Department of Health and Environmental Control said it is thought to be the most expensive hospital ever built in the state, although the agency doesn't specifically track hospitals by cost.

It also ranks among the most expensive single public projects in state history. The $632 million Ravenel Bridge, the most expensive bridge ever in the state, opened two years ago across the nearby Cooper River.

The new hospital is opening at a time of greater demand for treatment of digestive and heart disease, said Dr. Mark DeLegge, a gastroenterologist with the university's Digestive Disease Center.

And, he said, it makes sense to keep such patients in the same place.

"More often than not people will come in with chest pain and frankly, chest pain can feel like heartburn or it can feel like pressure," he said. "That doesn't really help you differentiate whether you're having a heart attack or whether it's from reflux disease."

Cardiologists and gastroenterologists work closely to sort such patients out, he said, and increasingly, patients with such complaints are baby boomers.

"With increased weight of people and our more sedentary lifestyle, there is more heart disease and there is more GI disease," he said. "I see this hospital as filling the needs of the baby boomers exactly."

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