For its fortieth anniversary and the opening of the new hospital, Policlinico San Donato IRCCS — a leading center for heart and large vessel diseases in adults and children — commissioned a photographic volume documenting the transformation of the facility. Coordinated by the agency Image Building with art direction by Marina Del Cinque, the project captures the evolution from a care facility to a highly specialized hospital, integrating research, teaching, and clinical practice. The work spans the entire hospital ecosystem — from architecture to operating rooms, wards, laboratories, and academic spaces — creating a clear and coherent visual narrative of the institution’s complexity. Working in a fully operational hospital required rigor and adaptability: access to operating rooms during procedures, coordination with medical teams, strict respect for patient privacy, and management of demanding technical constraints. In this context, the photography adapted to the hospital, not the other way around. The result is an organic visual archive, conceived not only for the editorial volume but also for institutional and corporate communication, capable of translating a highly specialized environment into a readable and strategic narrative that highlights the structural, technological, and organizational choices defining the institution’s identity.