When McDonald’s invades the hospital

Spend enough time scrolling online, and you’re bound to stumble across a photo of a mega-rest stop in Breezewood, Pennsylvania. It’s a stretch about half a mile long on Route 30, where 3.5 million cars and 1.5 million trucks crawl along each year.

The image — snapped by Edward Burtynsky, an artist who has spent four decades dedicated to “bearing witness to the impact of human industry on the planet” — reads like a parade of corporate logos. You see a Denny’s nestled in the Exxon parking lot, just behind the glowing golden arches of a McDonald’s. A Wal-Mart delivery truck turns sharply toward a Pizza Hut. Or maybe it’s the nearby Quiznos or Perkins. Look closer and the logos multiply: Taco Bell signs rise in the distance, Subway lurks behind a Starbucks. It’s like a game of late-stage capitalism seek-and-find.

As it turns out, there’s a reason for all this sprawl. Breezewood is the awkward handshake between Interstate 70 and the Pennsylvania Turnpike, which almost meet but never quite do. In the 1950s, when I-70 was being built, federal rules forbade using government money to connect a free road directly to a toll road.  As the New York Times explained back in 2017, that law has since been overturned, but to honor it, highway planners created a looping interchange that lets drivers (in theory) avoid the turnpike. From this slow, steady stream of traffic, the mega-rest stop was born.

Once this photo made its way onto the internet, it became a meme of sorts, a symbol of America’s landscape sameness. Typical captions? “You don’t go here, you end up here.” Some geeky urban-planning jokes about “low-density sprawl.” And my personal favorite: “The European mind can’t comprehend this.”

In Breezewood, you can at least blame the corporate overload on the quirks of interstate travel: it’s nowhere and everywhere all at once, the perfect habitat for a Denny’s-Quiznos-Starbucks trifecta. The logos shout for attention, but they’re temporary fixtures — you fill up your tank, grab a coffee and hit the road again.

But what happens when you can’t just drive away? When this sprawling, branded landscape shows up not on some awkward stretch of highway, but in the very cafeteria where you eat lunch every day?

There’s a newer photo making the rounds on Reddit’s r/latestagecapitalism—a snapshot of a high school cafeteria in Texas. On the walls, signs for Sonic, Global Kitchen, The Iron Skillet and Jimmy John’s crowd the space like unwelcome guests.

It’s a little sadder here.

Because what was once confined to liminal spaces like rest stops and airports has crept into every corner of public life, from schools and hospitals to military bases, carving out a built environment that doesn’t just blur regional identity, but actively works against our health.

The experts all agree: it’d be better if these Big Brand fast foods weren’t there. And, according to a recent survey, the majority of Americans do too, saying places like hospitals shouldn’t serve or profit from fast food. Yet somehow, we keep blaming people for being unhealthy while designing a world that makes the unhealthy choice the easiest, most visible — and often the only one.

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One of the most striking things about the Breezewood photo’s endless internet circulation is the chorus of comments it inspires: “That looks just like the rest stop near my hometown,” or “That’s exactly the one I know.” It’s a refrain that speaks to something both comforting and unsettling — a shared landscape of sameness stretching coast to coast.

This ubiquity isn’t happenstance. The cultural critic Umberto Eco long ago described the American roadside not as a place so much as a performance, a carefully staged tableau where every fast-food chain plays its prescribed role: to entice, to captivate and ultimately, to encourage consumption. Breezewood is nothing short of a masterwork in this genre: a sprawling, neon-lit theater of capitalism’s most recognizable icons. And the consolation prize? You can always leave at intermission.

But what has changed — and what feels distinctly more insidious — is the migration of this corporate stagecraft into the very institutions entrusted with our care and education.

Consider the image of the high school cafeteria in Texas. The comments once again form a chorus: “That’s my high school too,” says one. “No, that looks like my local shopping mall,” counters another.

When the school cafeteria starts to look and feel indistinguishable from a mall food court, the set design does more than just shape aesthetics. It scripts behavior. Every sign, every tray, every shiny wrapper nudges students toward quick, packaged options. In a space built for consumption, making an authentic, healthy choice becomes an act of rebellion. And it’s happening more frequently, as an increasing number of schools have slowly started to serve brand-name fast foods in their cafeterias.

This scripted consumption isn’t limited to schools; it extends to places where care and wellness are meant to come first. Hospitals, for example, occupy a curious middle ground between health and habit — and a recent survey highlights the uneasy contradiction that lingers beneath the surface.

In a July 2025 survey conducted by the Physicians Committee for Responsible Medicine and Morning Consult, 85% of 2,202 American adults agreed that fast food (including staples like cheeseburgers, fried chicken and pizza) does little to promote good health.

That skepticism extended specifically to hospitals. Fifty-two percent of survey respondents said fast food should not be sold there. Even more: 57% said hospitals shouldn’t profit from it

For what it’s worth, a previous report surveyed medical students across the country, asking them to weigh in on a telling question: “Is it acceptable for fast-food restaurants to be in hospitals?” About 57% of students said no — a majority, but not an overwhelming consensus.

And yet, the reality on the ground tells a different story. Across 146 medical and osteopathic schools, only 45 reported that their affiliated hospitals did not serve any fast food at all. The others have chains like Starbucks, Subway, Chick-fil-A, Au Bon Pain and even McDonald’s lining the halls.

In many cases, both the chains and the institutions themselves profit from these deals, turning cafeterias and lobbies into a quiet engine of revenue.

I was reminded of a similar gap between ideal and practice while listening to the podcast “MOPs and MOEs” last year, after seeing a report in Military Times. On the show, Marine Corps Sgt. Maj. Troy E. Black, the senior enlisted advisor to Joint Chiefs of Staff Chairman Gen. CQ Brown, didn’t mince words: “If you want to reduce obesity, serve different types of food at the chow hall. Remove immediately all fast-food restaurants from all installments.”

Dining halls on-base sign contracts with the Defense Department, giving them stricter nutritional standards, but, as Black notes, “it doesn’t compete with a cheeseburger” when there are fast-food outlets steps away. Many bases host Arby’s, Dairy Queen, Burger King, KFC, McDonald’s, Panda Express and more — all marketed as amenities.

Yet the results are stark. An October 2023 report from the American Security Project found nearly 70% of service members are overweight or obese. Defense Department data shows the obesity rate has more than doubled in the past decade, from 10 to 21%.

We tell ourselves the same story in spaces meant to safeguard health and readiness. Of course, students should eat well. Patients should recover in environments that model good nutrition. Soldiers should be fit, even as the world around them nudges toward the cheapest, easiest choice.

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So how did we end up here? Dutch architect and theorist Rem Koolhaas might have part of the answer.

Two decades ago, he coined the term Junkspace to describe the leftover architecture of modernity, the stuff that piles up when the main event is “progress.” Fast-food restaurants were prime specimens: the junk food of architecture. “Junkspace is what remains after modernization has run its course,” Koolhaas wrote. “Continuity is the essence of Junkspace; it exploits any invention that enables expansion.”

In other words, Junkspace isn’t just about ugly buildings or bad lighting. It’s about the way spaces designed for profit strip away context, scale and care, leaving behind something frictionless and eerily familiar. Once you know to look for it, spotting Junkspace almost becomes a game — you can find it anywhere, even in the rooms where we’re supposed to be healthiest.

In a hospital corridor lined with Subway ads, in a school cafeteria plastered with Sonic logos, in the shadow of a Burger King on-base. The settings change, but the choreography stays the same. You’re funneled toward the brightest signs, cheapest calories, most familiar flavors. Hospitals, schools and bases aren’t just adopting the aesthetic of the food court; they inherit its commercial logic.

At the same time, we chastise people for being unhealthy while building — or at least tolerating — a world where unhealthy options aren’t just available; they’re the default.

So what can be done? The first step is to notice when the spaces in our own communities start sliding into Junkspace. The second is to say something. Even as the Secretary of Health and Human Services courts fast-food companies that run on beef tallow and Bitcoin, we can tell our local hospitals and schools: we don’t want them to become rest stops of bad decisions. Let Breezewood be Breezewood.

We shouldn’t have to live there.