The Architecture of Hope Maggie's Cancer Caring Centres

by Jencks, Charles; Heathcote, Edwin

• ISBN13: 9780711225978
• ISBN10: 0711225974
• Edition: 1st
• Format: Hardcover
• Copyright: 2010-03-23
• Publisher: Frances Lincoln

Summary

THE ARCHITECTURE OF HOPE focuses on an exciting building project that has been underway since the mid-1990s - new cancer caring centres that offer a fresh approach to both architecture and health. Named after Maggie Keswick and co-founded with her husband, the writer and landscape designer Charles Jencks, these centres aim to be situated at all the major British hospitals that treat cancer. Already six have been completed and six more are in the pipeline. Starting in Scotland, where the first were built, they have implications well beyond their modest size and origins. Complementary to NHS hospitals, they present a face that is welcoming, risk-taking, aesthetic and life-affirming; and with their commitment to the other arts, including landscape, they bring in the full panoply of constructive means. Maggie's Centres are a new mixed building type for healing that have different roots in the past. As Jencks and Heathcote show, this hybrid quality is a response to the condition of cancer; its myriad causes and bewildering number of possible therapies. The 'architecture of hope' is this new emergent hybrid genre, consisting of various metaphors that correspond in kind to the many different types of cancer and their various treatments. The Centres have been designed by well known architects Richard Murphy, Page and Park, Frank Gehry, Zaha Hadid and Richard Rogers. Further projects underway include buildings by Richard MacCormac, the late Kisho Kurokawa, Piers Gough, Wilkinson Eyre and Rem Koolhaas. The centres are committed first to helping cancer sufferers help themselves, to inspiring carers to care more, and secondly to architecture. It is the arts and building, important allies in the perennial struggle with cancer, that lead to the 'architecture of hope'. As people walk into a centre after a diagnosis, or enervating treatment, often disoriented and lacking in self-confidence, they enter another world which acknowledges their importance and a basic condition that may become prevalent: living with cancer and not losing hope.

Excerpts

THE ARCHITECTURE OF HOPE

Charles Jencks





The typical situation with cancer?

Maggie Centres, cancer caring centres now growing apace in Britain, arose from the experience of my late wife Maggie Keswick. They came from her struggle in fighting cancer over many years. By 2008 there were six Maggie Centres up and running and five in the pipeline, a completely unexpected situation. When Maggie and I had the original idea in 1993, we had contemplated only one small room with a big window looking out onto a green space, nothing like eleven buildings and a whole programme of cancer support.



Maggie was first diagnosed with what she called 'the dreaded disease' in 1988 and, after undergoing a mastectomy and radio therapy, she considered herself cured. Thus when the affliction returned five years later she mistook the symptoms for an old back ache, one that felt very much like those of her youth. She then followed the zigzag path that many do when they have intermittent pain, the wrong information and a misdiagnosis. For five months she went to one back doctor after another, one visit for an MRI scan that was misread, several appointments with her own doctor who told her what she wanted to hear (that she was alright) and then, in a traumatic meeting in June 1993, she was finally told the truth. The breast cancer had spread to her liver - that was the pain - and her bones. This prognosis was delivered in a Scottish Surgery in the town of Dumfries near where we lived. We went in to see the oncologist who regularly came from Edinburgh, a pleasant doctor who like those in the National Health Service was hard working, and with little spare time on his hands. She later recounted the experience in a home movie made for her mother, and her wry irony sums up a situation that was to recur. It crystallized our thoughts:



"Charlie and I went to Dumfries and the doctor there said,' I think you ought to see the doctor who comes every week from Edinburgh'…so we waited in this awful interior space with neon lights and sad people sitting exhausted on these chairs…and the nurse said, Could you come in?' And then we saw this doctor from Edinburgh, and we said, 'Well, how long, how long have I got?' And he said, 'Do you really want to know?' And we said, 'Yes we really want to know.' And he said, 'Two to three months.' And we said, 'Oh -!' And then the nurse came up, 'I'm very sorry dear, but we'll have to move you out into the corridor, we have so many people waiting.' So we sat on these two chairs in the [windowless] corridor trying to deal with this business, having two to three months to live. And as we sat there various nurses who I knew came up and said, very cheerfully, 'Hello, dear how are you?' 'Well,' managing a laugh, 'I'm fine.'"



She smiled at this ludicrous situation. Most revealing in her account was the plural usage. She and I and our two children were in it together. Cancer patients always need someone close by to help them negotiate the very difficult terrain, someone to "care" for the myriad problems as they arise. As families with cancer know, it is an enveloping situation that affects all areas of life: how do you break the news to loved ones, how do you get a loan, where to buy a wig when chemotherapy kicks it, and how to face death. These are the kinds of social and psychological situations that come with cancer, often drag on for months and are very good reasons for having a cancer caring centre beside every major hospital.



But there was not one next to the Western General Hospital in Edinburgh, the place where Maggie was to fight her cancer and go for weekly chemotherapy treatments for the next eight weeks. Instead, we encountered a new version of that ludicrous situation. On every visit to recharge her chemo-drip we had to wait in this windowless box and avert our eyes from the other possible victims on death row, sitting opposite, just six feet away. All one could do was hide behind a well-worn copy of Hello!, another version of penitential cheer and 'have a nice day.' The weekly visit to this cramped cell became associated in Maggie's mind with the affliction and the chemotherapy. This was Architectural Aversion Therapy banged in by celebrity-tat, and it formed our resolve. As Maggie was later to write in A View from the Front Line -



…waiting in itself is not so bad - it's the circumstances in which you have to wait that count. Overhead (sometimes even neon) lighting, interior spaces with no views out and miserable seating against the walls all contribute to extreme mental and physical enervation. Patients who arrive relatively hopeful soon start to wilt.



She goes on to mention the need for a private area, 'an old-fashioned ladies' room - not a partitioned toilet in a row,' which 'supplies privacy for crying, water for washing the face, and a mirror for getting ready to deal with the world outside again.' Such facilities would seem fairly obvious for a place where one confronts life and death issues, and indeed they are becoming more common near cancer wards. But the issue is deeper than an old-fashioned ladies' room, as I have heard on several occasions from patients who have used Maggie Centres. They have told me, with considerable emotion welling-up close to tears, that the Centre provided a place for them to go - away from their family, their business, the hospital - and have good cry.



The ambiance of Maggies, the calm dignity, the sympathetic attitude of the carers in this environment, all made the difference in their fight with cancer. Their gratitude was palpable. Maggies gave them a place to confront their myriad problems one at a time, and share such experience with others so afflicted. The special kind of architecture was humorous and thoughtful, provoking but informal, contemplative and risk-taking. It allowed them a self-transformation over time from someone in a state of crying shock to a clear-eyed acceptance of their plight. It encouraged the kind of transformation, as I will explain, that Maggie herself went through.