Architecture: A monument to cancer care

A cancer victim's legacy is helping build new centres that support patients facing the terrors of the Big C. By Nonie Niesewand

Maggie Keswick Jencks wrote a blueprint for holistic healing and the built environment as she lay in London's Royal Marsden hospital before she died. This is her introduction: "A diagnosis of cancer hits you like a punch in the stomach. Other diseases may be just as life-threatening, but most patients know nothing about them. Everyone, however, knows that cancer means pain, horrible treatments and - though it's no longer quite the unmentionable Big C of 25 years ago - early death."

View from the Front Line is an account of the quest that Maggie and her husband Charles Jencks, the architecture critic and author, made so that other cancer patients would be better informed about their chances of survival, and to improve their quality of life. Her observations on the failure of NHS hospitals to provide care, as opposed to cure, constitute a blueprint for the way architects can help. She really did believe buildings can affect people.

She put her own money into building the first Maggie's Cancer Caring Centre with the architect Richard Murphy, near the Edinburgh Western General hospital in 1996; it opened 12 months after her death. Neither hospice nor hospital, the day centre is for people to find a bit of space, and find out more about self-help. Any service offered there will be approved by the professional advisory board and it will be complementary to orthodox medical treatment. Empowerment is what Maggie Jencks called it.

Now the second Maggie's Centre, designed by her old friend Frank Gehry, will turn Dundee into a sort of Lourdes. Architectural pilgrims will come to see Gehry's first building in Britain, but the messages it sends out to every hospital about the need for a decent environment to confront illness are a major draw.

Dr Alastair Munro, an oncologist at Dundee's Ninewells, says 9,000 to 10,000 patients are treated for cancer at the university hospital each year - yet there are only 3.5 doctors for them. "Cancer is the process of the loss of control of cell division. If we can kill the cell, the patient gets better. But this leaves a vacuum. A space needs to be filled... Architecture is about space that needs to be filled. Buildings can be therapeutic.

"We can't address the pastoral problems. We're Third World in the treatment of cancer patients. Sure, Dundee has one of the best concentrations of people doing the basic biology of the disease. But we don't take account of the patient. To be honest, we have been too close to a cure, and have forgotten about the care. There is an urgent need for more centres like this to help in getting advice and keeping up spirits."

At 48, Maggie Keswick Jencks underwent a mastectomy. Five years later the cancer had spread to her liver, bone and marrow. When she asked: "How long have I got?" she got the reply: "Two to three months on average." She was then told: "I'm so sorry, dear, but could we move you to the corridor? We have so many patients waiting."

"Waiting could finish you off" is a title tucked into her exploration of the right diet, exercise, meditation, therapy, and support for family and friends in a comfortable, calm environment. The NHS is obsessed with cutting waiting time, but "waiting time in itself is not bad," she observes. It is the circumstances in which you have to wait that count.

She gives a check list of what increases anxiety while diminishing the confidence of the patient. Overhead light, often harsh neon; interior spaces with no views of trees or the sky outside; miserable seating against the walls in a corridor, partitioned toilets without a proper door in a frame; no hand basin in each private lavatory to wipe away tears; no mirror for getting ready to face the world outside again, no herbal tea or coffee, no books for those who want to learn about their disease; no TV or video that could show information tapes or, just as important, comedies. In Anatomy of an Illness Norman Cousins observes that laughter is not only an escape, it also relaxes the patient, leading to less pain and better sleep.

With very little money this could change in NHS hospitals. The NHS Trust wants to site Maggie's Centres close to oncology wards at all major UK cancer treatment hospitals. But how to fund them? The Maggie's Centre is an Edinburgh charity to which she left money. The Dundee project is built through the generosity of Anne Gloag, founder of Stagecoach - helped by Frank Gehry waiving his fees. Charles Jencks is already worrying about cutting the corners of Frank's design to save money. "Quantity surveyors will tell you corners are expensive. But Frank is good at low budgets: this has got to be a challenge for him. It's the water he swims in."

Following major surgery in January this year, Jim Clapperton learnt that he had an inoperable pancreatic cancer. His wife discovered a pamphlet for the Maggie's Centre and took it home. As Jim descended into what he describes as a "spiral of despair and complete hopelessness" his wife drove him to the Centre. They were taken aback by the bright, colourful, airy and modern appearance of the building and the welcome they were given. The centre has support groups, private counselling, access to the Internet to provide updated global information, a library, a rest-room, and a kitchen for nutritional advice. Four months later, Jim Clapperton still has fortnightly appointments for relaxation which he finds "extremely beneficial". Now he and his wife are off to Alaska to see the whales.

The Frank Gehry building stands in an ancient woodland on the brow of a hill overlooking the river Tay. It is a small work and Gehry has shown great sensitivity and attention to detail. The scale model on view at the Soane Museum, as part of the current case study on Gehry, shows small block planning - the model will be transferred to the Dundee Contemporary Arts gallery when the show closes on 19 June.

Just 150 yards away from Maggie's new centre is a bridge, also designed by Gehry, across a shallow man-made lake on the site, important because it is a boggy area and the bridge across the water to the Ninewells oncology wards for treatment carries both a physical and emotional need.

Keeping mind and body on the same track is important. Fred Stephens is the local project architect. A sheaf of drawings accompanying the model shows how Gehry begins with a drawing of such force that it spins around the page like a cosmic Big Bang. The next stage is the model, simplistic in appearance but deadly accurate in ascribing function to the cluster of small boxes, "really understandable to me who can't follow plans and elevations", says Laura Lee, director of Maggie's Centre in Edinburgh.

The final stage is wrapping these functional forms into a collage with a membrane. At Bilbao's Guggenheim it was curvaceous, tensile titanium. Who knows how this building will end up? Only Frank Gehry. What you see at this stage is not necessarily what you will get. A series of imploding bricks and blocks is designed to show us simply that he tackled the function of the brief.

Planned on a domestic scale, at 200 square metres, it has an entrance with a coat and brolly space; a sitting-room extension with information and library area, video access, an outside view, and a hearth. There may be a fish tank - Maggie Keswick liked them. The kitchen has a table for 12 and a central island for cooking demos, as diet is important.

There's a larger relaxation room for 12 lying down, two smaller counselling rooms with a fire, and two small soundproofed therapy rooms. Lavatories have wash basins and mirrors and no gaps under the doors. There is a small space to lie down, and a garden, as well as parking for visitors.

The brief to Frank Gehry must have pained him a little. He was her best friend, after all. "We want the building to make you feel - as Maggie made you feel when you had spent time with her - more buoyant, more optimistic, that life was more interesting than it seemed before. Ambitious, but possible?"

The Taj Mahal is the famous love story written in marble. Time and tourists have picked away over four centuries at the lapis lazuli but the spirit remains. But it still is a tomb. Meanwhile, another love story is being written in Dundee by Charles Jencks, in the name of his late wife.

Suggested Topics
Arts and Entertainment
Jamie Dornan as Christian Grey in the first-look Fifty Shades of Grey movie still

film
Arts and Entertainment
Sue Perkins and Mel Giedroyc, centre, are up for Best Female TV Comic for their presenting quips on The Great British Bake Off

TV
Arts and Entertainment
Martin Freeman as Lester Nygaard in the TV adaptation of 'Fargo'

TV
Arts and Entertainment
A scene from Shakespeare in Love at the Noel Coward Theatre
theatreReview: Shakespeare in Love has moments of sheer stage poetry mixed with effervescent fun
PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
Arts and Entertainment
<p><strong>2008</strong></p>
<p>Troubled actor Robert Downey Jr cements his comeback from drug problems by bagging the lead role in Iron Man. Two further films follow</p>

film
Arts and Entertainment

theatre
Arts and Entertainment
Tycoons' text: Warren Buffett and Bill Gates both cite John Brookes' 'Business Adventures' as their favourite book

books
Arts and Entertainment
Panic! In The Disco's Brendon Urie performs on stage

music
Arts and Entertainment

film
Arts and Entertainment
Keira Knightley and Benedict Cumberbatch star in the Alan Turing biopic The Imitation Game

film
Arts and Entertainment

TV
Arts and Entertainment
Radio 4's Today programme host Evan Davis has been announced as the new face of Newsnight

TV
Arts and Entertainment
Pharrell Williams performing on the Main Stage at the Wireless Festival in Finsbury Park, north London

music
Arts and Entertainment
Carrie Mathison returns to the field in the fourth season of Showtime's Homeland

TV
Arts and Entertainment
Crowds soak up the atmosphere at Latitude Festival

music
Arts and Entertainment
Meyne Wyatt and Caren Pistorus arrive for the AACTA Aawrds in Sydney, Australia

TV
Arts and Entertainment
Rick Astley's original music video for 'Never Gonna Give You Up' has been removed from YouTube

music
Arts and Entertainment
Quentin Blake's 'Artists on the beach'

Artists unveils new exhibition inspired by Hastings beach

art
Arts and Entertainment
MusicFans were left disappointed after technical issues
Arts and Entertainment
'Girl with a Pearl Earring' by Johannes Vermeer, c. 1665
artWhat is it about the period that so enthrals novelists?
Arts and Entertainment
Into the woods: The Merry Wives of Windsor at Petersfield
theatreOpen-air productions are the cue for better box-office receipts, new audiences, more interesting artistic challenges – and a picnic
Arts and Entertainment
James singer Tim Booth
latitude 2014
Arts and Entertainment
Lee says: 'I never, ever set out to offend, but it can be an accidental by-product'
comedy
Arts and Entertainment
tvThe judges were wowed by the actress' individual cooking style
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    Screwing your way to the top? Good for Lana Del Rey for helping kill that myth

    Screwing your way to the top?

    Good for Lana Del Rey for helping kill that myth, says Grace Dent
    Will the young Britons fighting in Syria be allowed to return home and resume their lives?

    Will Britons fighting in Syria be able to resume their lives?

    Tony Blair's Terrorism Act 2006 has made it an offence to take part in military action abroad with a "political, ideological, religious or racial motive"
    Beyoncé poses as Rosie the Riveter, the wartime poster girl who became a feminist pin-up

    Beyoncé poses as Rosie the Riveter

    The wartime poster girl became the ultimate American symbol of female empowerment
    The quest to find the perfect pair of earphones: Are custom, 3D printed earbuds the solution?

    The quest to find the perfect pair of earphones

    Earphones don't fit properly, offer mediocre audio quality and can even be painful. So the quest to design the perfect pair is music to Seth Stevenson's ears
    US Army's shooting star: Lt-Col Steven Cole is the man Hollywood calls when it wants to borrow a tank or check a military uniform

    Meet the US Army's shooting star

    Lt-Col Steven Cole is the man Hollywood calls when it wants to borrow a tank or check a military uniform
    Climate change threatens to make the antarctic fur seal extinct

    Take a good look while you can

    How climate change could wipe out this seal
    Should emergency hospital weddings be made easier for the terminally ill?

    Farewell, my lovely

    Should emergency hospital weddings be made easier?
    Man Booker Prize 2014 longlist: Crowdfunded novel nominated for first time

    Crowdfunded novel nominated for Booker Prize

    Paul Kingsnorth's 'The Wake' is in contention for the prestigious award
    Vladimir Putin employs a full-time food taster to ensure his meals aren't poisoned

    Vladimir Putin employs a full-time food taster

    John Walsh salutes those brave souls who have, throughout history, put their knives on the line
    Tour de France effect brings Hollywood blockbusters to Yorkshire

    Tour de France effect brings Hollywood blockbusters to Yorkshire

    A $25m thriller starring Sam Worthington to be made in God's Own Country
    Will The Minerva Project - the first 'elite' American university to be launched in a century - change the face of higher learning?

    Will The Minerva Project change the face of higher learning?

    The university has no lecture halls, no debating societies, no sports teams and no fraternities. Instead, the 33 students who have made the cut at Minerva, will travel the world and change the face of higher learning
    The 10 best pedicure products

    Feet treat: 10 best pedicure products

    Bags packed and all prepped for holidays, but feet in a state? Get them flip-flop-ready with our pick of the items for a DIY treatment
    Commonwealth Games 2014: Great Scots! Planes and pipers welcome in Glasgow's Games

    Commonwealth Games 2014

    Great Scots! Planes and pipers welcome in Glasgow's Games
    Jack Pitt-Brooke: Manchester City and Patrick Vieira make the right stand on racism

    Jack Pitt-Brooke

    Manchester City and Patrick Vieira make the right stand on racism
    How Terry Newton tragedy made iron men seek help to tackle their psychological demons

    How Newton tragedy made iron men seek help to tackle their psychological demons

    Over a hundred rugby league players have contacted clinic to deal with mental challenges of game