Can architecture improve health?

The Guardian

Dundee, Scotland:

When Maggie Keswick Jencks died from cancer in July 1995, plans for the conversion of a former stable at Western General hospital in the Scottish capital, Edinburgh, lay on the bed with her. Drawn up by the Scottish architect Richard Murphy, these were designs for the first of the Maggie’s Centres that opened in November 1996.

Patrons of Maggie’s Centres include Gehry, the sculptor Sir Eduardo Paolozzi, Harry Potter author JK Rowling, and British television presenters Jon Snow and Kirsty Wark. Maggie’s husband was Charles Jencks, the distinguished American-born architectural historian and writer; they met while Maggie was studying at the Architectural Association in London. Both were close friends of Gehry and of the architects who have been commissioned to design seven more Maggie’s Centres in Scotland and England.

At 47, Maggie was diagnosed with breast cancer. Like many people, she found hospitals disturbing, not least because of their design. Maggie wanted to confront not just the disease gnawing away at her body -- what could she learn from it, what therapies were available, what sort of diet should she adopt, what sort of exercise regime - but what appeared to be the lack of truly caring cancer care clinics in Britain.

In 1993, after a mastectomy and a five-year remission, Maggie was diagnosed with cancer of the bone, bone marrow and liver. “How long have we got?’’ she asked a local consultant, thinking of her family. “The average is three to four months,’’ he replied, adding: “I’m so sorry, dear, but could we move you to the corridor? We have so many patients waiting.’’

“No patient,’’ wrote Maggie in her warm and inspiring booklet, ‘A View from the Front Line’ (1995; revised 2003), written for fellow cancer patients, “should be asked, no matter how kindly and how overworked the hospital staff, to sit in a corridor without further inquiry, immediately after hearing they have an estimated three to four months to live.” Most hospital environments say to the patient, in effect: ‘How you feel is unimportant. You are not of value. Fit in with us, not us with you’.’’

“Medical treatment,” says Laura Lee, former oncology nurse and chief executive of Maggie’s Centres, “is only part of the solution if you are affected by cancer. What is crucially important to well-being, as Maggie learned, is your attitude to that treatment and the confidence that you can carry on with your life. This might sound pretty obvious, yet where can you find somewhere to go and talk, to learn and have people to listen to you and care for you? Almost nowhere. That’s why Maggie came up with the idea of Maggie’s Centres before she died: beautiful, relaxed day-care centres -- homely, clubby, friendly and in the best new buildings by some of the world’s most imaginative architects.

And who could be frightened by a Frank Gehry building? Cartoon-like, they can make the most distressed visitor smile. The Dundee building waves hello to visitors with its funny crinkle-crankle roof echoing the rippling Tay behind and below it. Inside, it is warm and chummy, with a dash of Hollywood in the glamorous Busby Berkeley stair that whirls up from the ground floor.

Maggie, for all her informed discussion of medicines and therapies, and no matter how hard the going, remembered to laugh, smile and enjoy life as best she could. If she was going to die prematurely, she wanted, she said, to die well. She found the idea of going on a sugar-free and fatless diet, for example, something of a joke. “Had someone told me to follow such a diet, I would have been appalled. (Life with such miserable meals! You must be joking!) I am not a natural vegetarian. I adore meat - roast lamb for Sunday lunch is my idea of caviar with trumpets; roast beef with Yorkshire pudding makes my heart sing,’’ she said. She learned, though, so much about cancer (including what to eat, and ways to care for carers and sufferers) that her Maggie’s Centres had very nearly got off the drawing board by the time she died. The centres, says Laura Lee, “turn around three key concerns: relaxation and stress reduction, emotional support, and information. We’re friendly, and even funny, and we don’t turn people away. We don’t boss patients about or their friends and families. What we’re not, though, is an alternative therapy treatment centre working completely outside conventional medicine.’’