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A blueprint for cancer-caring centres around the world
A State of Mind
To Space and Back
- Eye on Design
The first Maggie’s Centre
A cancer diagnosis provokes an existential crisis and a welter of difficult emotions including anxiety, fear, fragility and disconnection. Writer Natalie Goldberg’s memoir about experiencing cancer, Let the Whole Thundering World Come Down (2018), conveyed her struggle to come to terms with the intense reality of her own impermanence and to manage to be in love with her life even when life had brought illness and a fear of dying. The opening of the first Maggie’s Centre was a response to the need of facing this challenge.
The concept of the Maggie’s Cancer Caring Centres created a blueprint to respond to the need for cancer caring centres around the world at a time when the disease affected one in three or more people. The founder, the late Maggie Keswick Jencks, was inspired by a vision of a warm and welcoming place, a sanctuary where you could become an informed participant in your treatment. The Centres have powerfully shifted expectations of the design of remedial spaces to have the best possible emotional impact on those who come.
The first Maggie’s Centre, designed by Richard Murphy OBE, opened in Edinburgh on the grounds of the Western General Hospital, two years before the Maggie’s Cancer Caring Centres Trust was established in 1998 to enable the self-funding of each Centre, which needs to be its own ambassador in the local community. The site meant a lot to Jencks as it was where she was diagnosed and went for her final treatment before she died in 1995. She and her husband Charles Jencks wanted to achieve the curative value of a well-designed building as widely as possible.
Spatial qualities conducive to healing
The qualities Maggie desired inform the written brief to all architects for their Maggie’s Centre commissions. A quiet and safe domestic atmosphere – the antithesis of clinical institutions. A central kitchen hub for relaxation and for meetings, including a library, space for programmes of yoga, beauty care and other courses, individually tailored. ‘We want Maggie’s to shelter you but to be open to the outside world, to encourage you to look out’. A spatial concept responding to the local context but also bold and self-confident, reflecting the individual personalities of each architect selected. A landscaped path as a breathing space for visitors so as they near the front door they can shed some of the stress of the hospital atmosphere.
Observing changes in hospitals in the Netherlands, the USA and Japan, Charles Jencks speculated some time ago that the medical centre would ‘naturally evolve towards more human and variegated building types…like a hotel, or small village with a shrine’. At the West London Centre (Rogers Stirk Harbour, 2008), ‘a quiet place set apart’ as Charles Jencks describes it, are small courtyards next to private consultation rooms, opening onto nature, and one large multi-functional room with sliding doors. All the centres have a space like this, to ‘allow the imagination to play on future possibilities, to go beyond the immediate cancer, and to step outside oneself, risking failure…possible places of inward transformation’.
The point of the hybrid, therapeutic quality is to inspire hope by making the most of light, colour, texture, form and landscaping, to create a unique spatiality and presence conveying joy and zest as well as calm. ‘We ask our landscape designers and our architects to work closely together from the beginning of a project’. Many of the centres are spiral or pinwheel—Edinburgh, for example—a hybrid of both in form, or doughnut-shaped, such as OMA’s centre at Gartnavel in Glasgow (2010). At Maggie’s at Barts Hospital in London, designed by Steven Holl Architects (landscaping by Darren Hawkes), which opened in December 2017, the homely kitchen hub is a double height space, with Holl’s Okalux double layered glazing discretely diffusing the natural light. This gives character to the colours of the artistic strips of vinyl positioned horizontally across their panes, loosely suggesting musical notes. Its open plan nature, free of signage, feels enveloping and soothing.
Paving the way for more humane hospitals
Since the late 90s Maggie’s Chief Executive Laura Lee has worked with one of the founding trustees Marcia Blakenham to expand the network of 22 centres across the UK. Before making new commissions they take time to get to know the work of different practitioners and to consider who would best work for a particular site and its conditions. Three more centres will open by the end of 2019: a Thomas Heatherwick building for Maggie’s Yorkshire; one by Ab Rogers at the Royal Marsden Hospital in Sutton; and another by Dow Jones Architects in Wales. Amanda Levete’s building for Southampton broke ground on 4 February. The team is fundraising to bring Maggie’s to Northampton, Taunton (architect Alison Brooks), Coventry and North London.
More centres are opening internationally: the Kálida Sant Pau Centre in Barcelona, designed by Benedetta Tagliabue (EMBT Architects), will open at the San Pau Hospital complex in May 2019. A centre by Herzog & de Meuron is planned for Oslo, and so is the first Dutch centre, in Groningen, to be designed by Marlies Rohmer.
“While hospitals are mostly clinical in feel, the popularity of the Maggie’s Centre network demonstrates how highly these institutions regard the need to have a welcoming refuge of this kind in their grounds.”
While hospitals are mostly clinical in feel, the popularity of the Maggie’s Centre network demonstrates how highly these institutions regard the need to have a welcoming refuge of this kind in their grounds, with architects making sure they adapt their concepts to the local climate.
For example, the Kálida Sant Pau Centre in Barcelona is a garden pavilion enjoying access to the fine Catalan weather, one for which the boundaries between interior and exterior space are blurred, with an open and flexible sequence of gardens and courtyards on the lower floor. As with all the other centres, a programme of evidence-based support strengthening physical and emotional wellbeing will be provided, and the centre is connected to the Oncology Department of the hospital by an imaginatively designed paved area.
The commissioning team knows it is asking a lot. ‘What we are looking for in our architects and our designers is an imagination and thoughtfulness which looks beyond the normal boundaries of function…what will not vary is the requirement to build a beautiful, small, humane building which raises your spirits when you walk into it’.
Main image: Maggie’s Glasgow Gartnavel, set on a small hill on the grounds of the Gartnavel General Hospital in Glasgow, Scotland. Designed by OMA with landscaping by Lily Jencks. The connected ring of single storey Miesian pavilions has a sequence of glazed and solid walls and is nestled in woodland planting that also animates the central courtyard. Photo © Philippe Rualt