The architecture of health with Dame Laura Lee MBE

Anyone who has spent time anxiously waiting in a tired, old and drab NHS hospital corridor, a windowless treatment room or even in a harshly-lit onsite café could be forgiven for thinking that the physical building has no role to play in the treatment of ill health that goes on within it. And yet we do not need to go too far back in time to revisit the beautifully light and airy sanatoriums, or the 19th-century mental asylums that were designed with staggered wings and extensive landscaping to see that there was a time when the building, the actual physical environment, was viewed as being absolutely central to the medical treatments within.

At Maggie’s, the architecture of a building is central to their philosophy - everyone’s home for cancer care! As a charity whose mission is to provide free cancer support and information in centres across the UK, they are passionate about the importance that good design plays in wellbeing. Each centre is based on an NHS hospital site, and are built in partnership with the clinical cancer teams within the hospital who see, and want to support, the need for broader, holistic and far reaching cancer care strategies that go beyond that which the NHS can offer.

Maggie Keswick Jencks was a garden designer, writer and artist, and was married to Charles Jencks, an American cultural theorist, landscape designer and architectural historian. They were in Scotland in 1993 when Maggie, at the age of fifty two, was told that the cancer from which she had recovered five years earlier had returned, and was terminal. Maggie was given this news by an overworked doctor, one we all might recognise if we’ve spent time within our wonderful, yet historically hugely under-funded hospitals, and was left to process the enormity of it in a windowless corridor. It is absolutely telling that despite the shock of the news they’d been given Maggie and Charles found themselves talking about the ‘need for somewhere ‘better’ for people with cancer to go, outside of but nearby to the hospital’, and so the idea behind the Maggie’s was born.

Dame Laura Lee DBE

My background is nursing and I was a clinical nurse specialist, Maggie was my patient. She came to our hospital with advanced breast cancer having been told she had three months to live. And I gave her her chemotherapy, and was part of her clinical team. Maggie’s grew out of her experience of being treated on the NHS. Whilst the NHS was fantastic in aspects of what it did, there was stuff missing for her in terms of going through her cancer experience, which led her to have the idea for Maggie’s.

DAME LAURA LEE DBE, the Chief Executive of Maggie’s has been an integral part of Maggie’s since the very beginning.

Maggie fought hard to stay well, and went on to live for another eighteen months, precious time in which she and Charles designed the blueprint for the centres together, and also enlisted the help of some of their friends including some of the architects who’d go on to help design the centres. Maggie felt strongly that what was important was that she, that we, should “not to lose the joy of living in the fear of dying.” She believed strongly that beyond the medical treatment for cancer that the NHS offered, there needed to be a holistic approach to providing support, understanding and indeed space to those living with cancer. That the centres which provided this needed to be beautiful, thoughtful buildings with welcoming outdoor spaces that offer a home from home, spaces that are designed to feel nothing like a hospital.

Maggie’s Southampton © AL_A

Maggie’s Edinburgh © 2019 Philip Durrant

There’s a kitchen table, a cup of tea and that sense of community, that sense of not being alone.

The first Maggie’s opened in Edinburgh in 1996, and although there are now a number of centres, including overseas, they each feel connected. Each centre is designed with the original blueprint as its starting point, and although each centre is unique and sits comfortably within the landscape in which it lives they all share an underlying feeling. They are designed to be "calm, friendly and welcoming places, full of light and warmth, offering glimpses and views of the nature that surrounds them." Each centre has a table situated at the heart of the building, so that when you walk into Maggie’s, ‘there’s a kitchen table, a cup of tea and a sense of community, that sense of not being alone.’ The carefully curated and always thoughtful centres also offer spaces to find privacy as well as places to come together as a group.

Maggie’s Edinburgh © 2019 Philip Durrant

Maggie’s centres are open for people to just drop-in and no referral is needed. For Laura and her team the ability to welcome, to support and to accompany individuals and their families or loved ones as they are on their cancer journey is what sets Maggie’s apart, and it is at the centre of the way in which each Maggie’s is structured. This ethos is a reflection of the reason Laura chose to become a cancer nurse.

"While I was going through my cancer and through my nursing training I spent some of my placements in cancer wards. My first job as a staff nurse was working in a cancer ward and I think what I particularly was drawn to was the capacity to have, and to build, a relationship with the person and the family, which is very different from working on a surgical unit where people come in for their operation before leaving, and then you don’t see them again. That’s one of the things that I value about what our centres are able to do, is to build long term, meaningful relationships."

Put simply, Maggie’s centres are a true reflection of what can be achieved when there is a meaningful conversation between architecture and health, between primary and secondary care.

Take a listen

You can listen to Dame Laura Lee’s full interview with Ilmarie Braun, Same but Different Project Manager on our podcast, Rarity Life Heard.