Maggie Gets It: A Place Like Home

We are beyond excited to introduce our little sister, Kerry, as a guest blogger. As the youngest of five girls, Kerry has always shined and held her unique place in our big family; here, she yet again shows off her knowledge and insight as an architect. Our sister Colleen, in particular, would be proud to read Kerry's discussion of how the "built environment" can promote healing and Colleen would appreciate the unique form of care offered to cancer patients by Maggie's Centres in the UK. 

Everyone knows Colleen was a champion of everyone around her, but she was especially protective and supportive of her sisters. When I showed more artistic than athletic promise as a young person, Colleen insisted that I take an art class outside of our basic grade school art program. I don’t remember how old I was or if she was in medical school or her residency at the time, but I do remember her driving me to the weekly class, rushing me from basketball practice at least a couple of times. Colleen barely played me when she coached my 7th grade basketball team, so her believing in my artistic abilities was HUGE. I knew she wouldn’t push me to do something just to be nice. Plus, taking an art class where I knew no one probably prepared me to go to a college where I knew no one, and major in architecture, of which I knew nothing.

So, it is with my background in architecture that I would like to relate to caring for Colleen at the end of her life. The built environment (a term Colleen loved to poke fun at-“What does that even mean Kerry??”) has the potential to either worsen discomfort or improve healing during times of crisis and its aftermath. Over the years we saw a spectrum of treatment facilities, in-patient and outpatient care rooms, hospital lobbies, and cafeterias. After Colleen died our house was transformed by what seemed to be a million bouquets, orchids and ferns, a rose bush and a new tree in the backyard: a physical manifestation of Colleen's reach. The places where we dwell define our dealings with death, almost as much as our intangible memories and feelings.

A recent issue of The Architectural Review is dedicated to death, chronicling crematoriums, chapels, hospitals, memorials, and care centers that deal with end of life experiences. One such exemplar of a place of healing is the Maggie’s Centres. I’ve admired the architecture of these centers for a while, but it wasn’t until caring for Colleen in her last few months that I truly longed for something similar in the US, much less Michigan.

Who is Maggie?

Maggie Keswick Jencks was a writer, landscape designer, cancer patient, and wife of architectural theorist Charles Jencks. In the last few months of her life, she and her husband and cancer nurse outlined their ideas for a cancer care center that could contrast the banal and sterile atmosphere of the hospital where she was being treated. In the Metropolis Magazine article "Living with Cancer" Samuel Medina describes Maggie's feelings: “In such neglected, thoughtless spaces, she wrote, patients like herself were left to 'wilt' under the desiccating glare of fluorescent lights.” 

What is a Maggie’s Centre?

Maggie’s Centres offer free emotional, practical, and social support for cancer patients, as well as their friends and family. The first one opened in Edinburgh, followed by 19 more in various cities across the UK, one in Hong Kong, and a few more planned for the UK and other international cities. Each center is designed by a different architect, resulting in a collection of wildly distinct buildings, yet all adhere to the same prompt. They are located near, but remain separate from, institutional hospitals and treatment centers, and do not replace conventional cancer care.

Simply put by Dezeen's Amy Frearson: “it offers a non-clinical environment where anyone affected by cancer can stop by for advice or support.”

Maggie's Centre, London, UK

Richard Rogers'  design for the West London location has won multiple design awards, most notably the 2009 RIBA Stirling Prize. Rogers Stirk Harbour + Partners in turn donated their winnings back to the cancer care center.

Photo by José Miguel Hernández Hernández

Maggie's Centre West London - Weekly Schedule  

Maggie's Centre West London - Weekly Schedule  

Maggie’s Centres are intentionally informal, residential in scale, and multi-purposed. If you want community, you can be comforted to find a group gardening class, other patients to chat with, yoga, and therapy sessions. If you would like a private place to think, you can find a library, a quiet garden, a cozy reading nook, or a massage. Worried about financials, sleeping, or your nutrition? You can even talk to experts in these fields at Maggie’s Centres. When we were scrambling to find a massage therapist with cancer patient experience, we could have used the resources of Maggie’s Centres. When we simply wanted to get out of the house without dealing with sad or confused looks, we definitely could have used a Maggie’s. 

The most recently completed Maggie’s Centre in Manchester is summed up by its architects, Foster + Partners, this way: “The design of the Manchester centre aims to establish a domestic atmosphere in a garden setting and, appropriately, is first glimpsed at the end of a tree-lined street, a short walk from The Christie Hospital and its leading oncology unit.”

 
 

Architects Have Feelings Too

  • Sir Norman Foster, designer of the Manchester location has said: "I have first-hand experience of the distress of a cancer diagnosis and understand how important Maggie's Centres are as a retreat offering information, sanctuary and support."
  • Frank Gehry, designer of the Dundee and Hong Kong locations, described his pain in designing the first center outside the UK: "I was going through the loss of a daughter while I was designing the center," the architect said. "I think you sort of suck it up and hope to make something that is soothing and respectful and hopeful. There's always hope, it's not a dead end." The Hong Kong center features a garden designed by Maggie's daughter, Lily Jencks. 
  • Maggie’s husband, Charles Jencks, has also emphasized the importance of caregivers: In Steve Rose's Guardian article, Maggie's Centres: can architecture cure cancer?, Jencks states “in a way, the carers are more important than the patients. Because if the carers are cared for, they turn up, they enjoy it and you create this virtuous circle, this mood in a Maggie's Centre which is quite amazing. So architecture helps do that because it looks after the carers." 

Most people have some connection to cancer, including architects. By involving star architects, like Frank Gehry, celebrities like Benedict Cumberbatch, and powerhouses like Camilla the Duchess of Cornwall, Maggie’s Centres have been able to gain support, offer free services, and continue opening new centers in cities across the UK and internationally.

Yet the success of Maggie’s Centres can also be attributed to its sensible (small scale), sensitive (support not limited to a scheduled appointment slot), and inclusive (accessible for everyone affected by cancer) concept that fills a gap in healthcare today. Some hospitals have even “solicited the foundation’s services” that Maggie’s Centres offer, such is the case with the opening of the Glasgow location, near Gartnavel General Hospital. Of the foundation’s past year of visitors, “99% found the support [Maggie’s Centres] offer helpful.” The West London location alone gets almost 100 visitors a day.

What makes this foundation even more unusual is its commitment to designers who help realize these goals. Charles Jencks claims the architecture is “risk taking” because it engages with a very real existential crisis. “To live is a great risk. Cancer patients go through this cycle of desperate fear, of deciding to die,” he says. “But those like Maggie risked to live. That’s the architecture in a way and what architects need to get into their building. And I think they have.” Jencks admits to using the famous architects as a way to gain funding, notice, and continued support. In return, the architects jump at the opportunity to be among the list of top designers, to contribute to this innovation in cancer care, and to grapple with an unusual design challenge. Richard Rogers describes the centres as "in a way monumental, and precious, like a church that isn’t a church, a gallery that is not in a museum, or a house that is not a home." Maggie's Centres are fairly unprecedented in building type, and wrapped up in the program requirements are complicated emotions of fear, mortality, healing, and hope. With these challenges, architects and the Maggie's Centre charity have set up a high risk, high reward cancer care system.   

Consider Design, Consider Space as a Factor in Caregiving

+ What is wrong with the U.S.?

You might be thinking well, lots of things. You might be thinking, this could never happen here! But if they can do it, maybe we can push ourselves to do something similar, at any scale. Take this funny comment about Americans for example, and note Maggie's original goal:

‘To cut a long story short, Maggie and I decided to fight,’ Jencks says. ‘Empowering the patient became our strapline, although Maggie hated it because it’s too American. From her experience came the idea of setting up one little room. It gave her a focus she never had in her life.’

+ Creating a Sense of Home

Each Maggie’s Centre includes a kitchen, and a central dining table, which are often the heart of a home. Creating the feeling of home can be simple, and an important way of healing or providing comfort.

Colleen at Home 

Colleen at Home 

Yet Maggie’s Centres don’t give off a New Age vibe or make reference to Freud’s consulting couch; they are informal, like a home away from home. Jencks coined the term ‘kitchenism’ to describe the communal ambience of the centres, which allows patients and carers to come and go when they wish and simply gather around the kitchen table for a cup of tea in a proper mug, not a hospital-issued plastic cup.
— Cate St Hill, "Piles of Hope- 20 Years of Maggie's Centres"

+ Views of Nature, Natural Light, Fresh Air

It was pretty chilly when Colleen was very sick, and we all remember how crazy we probably looked, propping up chairs by our front door and opening it to get some fresh air and sun. My favorite part of the various Maggie’s Centres is the range of landscape designs and the attention that goes into shaping garden views, providing different ways to experience the outdoors, and considering the effects of natural light. 

Peter Zumthor's Serpentine Pavilion (Not a Maggie's Centre, however rightly located in UK). Photo by Georgi Georgi via Flickr. 

Peter Zumthor's Serpentine Pavilion (Not a Maggie's Centre, however rightly located in UK). Photo by Georgi Georgi via Flickr. 

Peter Zumthor, a favorite architect of mine, has said before “When I like it, you will like it too, because I’m not so special.” It is obvious from each of the 20 Maggie’s Centres that every designer has a distinct style, but design that understands our core vulnerabilities and how to make us feel invited, relaxed, and supported in times of need, is design that can be liked by all. 

Maggie gets it. She understood that while hospitals are vital in treating cancer, a supplemental support system rooted in a physical place is necessary. She understood that caregivers and families need support too. She understood that light and atmosphere are important aspects in healing. Colleen would have loved what Maggie Keswick Jencks has started in the UK with Maggie's Centres, and I only hope they keep growing, right into the US. 


Resources:

"Living with Cancer" by my former classmate, Samuel Medina, for Metropolis Magazine

"Maggie’s Manchester by Foster + Partners: ‘What matters is not to lose that joy of living in the fear of dying" by Gillian Darley, for The Architectural Review  

"Pile of Hope- 20 Years of Maggie's Centres" by Cate St Hill

"A Home from Home: Maggies West London Revisited" by Amanda Birch in The Architect's Journal

A tour of Maggie's Glasgow Location: