The architecture of hope: Maggie's Centre, Oldham
Places that make life better by design
In the corridor of an NHS hospital in Edinburgh a big idea was born. It would change the type of care given and support received for anyone affected by cancer.
Maggie Keswick Jencks was given three months to live and then asked politely by the nurse if she would wait in the corridor as other patients needed to be seen. Being thrust into miserable surroundings directly after learning traumatic and life-changing news led her to devote her final months to inverting the experience of cancer patients and their families.
Maggie believed that a physical space can positively impact the emotional wellbeing of humans - even when your world has been turned upside down. She envisioned a space where people view themselves differently as individuals under unusually difficult circumstances, not as cancer victims. A space with as much natural light as possible, with views out onto nature and the sky. A space that would feel safe and welcoming. A space that raises spirits and restores humanity.
The centre would help visitors to find their own best way of coping with the disease. There was to be no ‘right way’. A Maggie’s Centre would provide free practical, emotional and social support to people with cancer and their family and friends. This would range from a cup of tea you could make yourself in a friendly kitchen to attending weekly support groups led by a clinical psychologist.
In November 1996, the first Maggie’s Centre opened in Edinburgh and Maggie’s dream become a reality. There are now 20 Maggie’s Centres in the UK which receive over 200,000 visitors per year. Most of them have been built in the grounds of hospitals with cancer departments, and by some of the most internationally renowned and prestigious architects.
This is not architecture for architecture’s sake. These are places that are making people’s lives better by design.
Elevated in the elements is Maggie’s Oldham. Standing on stilts above a tree garden, overlooking the Pennines and engineered in a pioneering hardwood, it’s no surprise that the building is often referred to as a treehouse. Designed and built by London-based architects dRMM in 2017, Oldham is one of the newest Maggie’s centres.
The brief for building a Maggie’s Centre asks a lot of its architects. They are challenged with making the space do as much work as the people who work there. This means that the preliminary planning stages are crucial.
When approaching the design for Maggie's Oldham, dRMM ensured they kept five key factors in mind:
- Human connection
- Overcoming fear
- Access to information
These factors are variable and make coping easier in the hardest of circumstances - like battling cancer. Every single design decision made by dRMM had one or more of these factors in mind. The design of the whole is intended to maximise the human capacity for positivity.
On 8 October 2018, nothing was wrong with Christine. There had never been anything wrong with her, she was fighting fit. And then on 9 October her life changed beyond recognition. At 66, Christine was diagnosed with multiple myeloma, a blood cancer. Within a week she was on strong chemotherapy and had a transplant just a few months later. From the very start of her treatment, Christine starting coming to Maggie’s for relaxation classes.
“It’s very unconscious but you just feel at home. It’s my home from home. It’s not something you can put into words. It’s just a feeling. The whole building feels like that.”
The first time Christine walked into Maggie’s she met another woman who had the same rare form of blood cancer that she had just been diagnosed with.
“I came here and made lots of friends, it’s been my saviour. That’s the key I think. Suddenly you’re in the world of cancer which I’d never been in before. It was a strange world to enter. You’re all in it together here. You don’t meet that outside.”
“Walking through the door to places, I often wanted the floor to swallow me up. But here, people will greet you as you come in.”
Christine rarely talks or even thinks about cancer when she comes to Maggie’s. She still goes to the relaxation classes, turning up an hour early and staying the same amount of time afterwards to have a cup of tea with all the friends she’s made since coming. They chat across the kitchen island, a large and beautiful plank of walnut, with the cork panelled kitchen cupboard doors absorbing sound and softening the acoustic of the centre. No matter how much they have to catch up on, there is a tranquility to the buzz.
“This has given me another circle of friends. I look on it on the positive side and think I wouldn’t have known these people before. Getting my cancer is a bonus!”
“Unfortunately my cancer’s incurable so I’m always going to be in the world of cancer. I can’t turn the clock back, you just have to make the most of it. And being here is part of making the most of it. I go to the hospital for a reason and come here for pleasure.”
“When the building was going up I said to myself, ‘that is such a lovely, beautiful building I’d really like to work there’. I visualised myself working here!”
And Salma’s experience couldn’t be more suited to working at Maggie’s. She runs the relaxation classes once a week, having worked for over 10 years in complementary therapies and stress management in various sections of oncology.
“When you walk in that tree is just amazing, especially through all the seasons. It’s beautiful, it’s there as you open the door and it invites you in further. Some call it the tree of life. I just feel it gives people hope, and a place where people understand. I can stand there for 10 minutes and it just blows me away, even before you get to the rest of the building.”
Salma’s classes involve progressive muscle relaxation, relaxing the body first before the mind can follow. And the tree even plays a role in these. She’s spent hour-long sessions just talking about the tree of Maggie’s. The tree marks the centrepiece of the building as you enter. There is a large, asymmetrical glass hole in which a huge silver birch grows. The connection to the outside, to nature and the sky is undeniably present.
“The building has done half of the job for me before I’ve even done the relaxation.”
By the window overlooking the Pennines, a large curtain can be drawn along a looped track acting as a divider, creating a room within a room. Designed by Dutch artist Petra Blaisse in a yellow mossy fabric on one side and a shiny silver on the other, the curtain creates an enclosed and intimate space where the classes take place.
“It’s almost therapy just pushing the curtain. We argue over who’s going to open and close it! It really enhances my sessions. The clever windows allow the light to flow in at an equal amount. It gives such a lovely ambiance of light and darkness, it feels cosy and comfortable, almost like a human feeling.”
Salma often sees a transition in the people that have come to her classes, whether it’s visual or verbal.
“It’s often like seeing a different person compared to when they walked in. The building does two things. It gives pleasure and it also allows people to be human again. It reminds them of who they as people are rather than just somebody that has cancer.
It gives people back what cancer may have taken from them. It’s ab empowering them.”
After three surgeries Steve was physically devastated. In early January 2018, he was diagnosed with bladder cancer. He had gone from being extremely active, playing basketball regularly at the age of 54, to hardly being able to put one foot in front of the other. He was in a fog.
“The active me just vanished. One of the things I remember being genuinely frightened of was that I might never get back to that. I might always be this person that I didn’t recognise.
The fear manifested itself emotionally and physically.”
“I’d seen this treehouse building and wondered what it was. I thought it can't be anything to do with the hospital because it’s so different. It’s natural isn't it. It's almost like being in a forest. We all identify with nature don’t we, even if it’s subconsciously.”
The building is made entirely from hardwood cross laminated timber - a pioneering invention developed by dRMM and American Hardwood Export Council (AHEC). Made from living materials in their raw state, Maggie’s is a healthy form of building. The exterior is made from thermally modified American tulipwood cladding and has a similar wooden interior. It’s not lacquered or chemically treated, creating a natural and organic environment - counteracting the experiences that are often synonymous with cancer.
“I walked through the door and it was almost like an epiphany. I just thought what a beautiful place. I needed to be here. You’ve gotta get that fear out in some way. Maggie’s became an antidote for me when I desperately needed it.”
The plan of the building is incredibly open, allowing visitors to see views of the garden designed by landscape artist Rupert Muldoon to the south, the horizon to the north, and the sky above. There is the curtain for division and some smaller rooms for privacy, but in the spirit of ‘there’s nothing to be afraid of behind closed doors’, they are generally left open.
“It’s the open-plan building. The energy just flows in here, doesn’t it. There’s no block to the energy. Maybe that’s what helps people to feel different, and ultimately normal. I definitely didn't feel normal when I walked through these doors but I feel normal now.”
Steve is making a good recovery after having his bladder removed and chemotherapy. He’s back to playing basketball.
“I genuinely feel that if I hadn’t have found this place I’m certain my recovery would have been different. This place will always mean something to me for the rest of my life. It’s magical really. It’s hard to put into words but there’s a chemistry about this place and it just worked for me. And I know I’m not the only one that feels this way.”
Working for nearly 20 years as a colorectal specialist nurse, Trish had been incredibly focused on how to look after the physical health of those dealing with cancer. Now, as the new Centre Head of Maggie’s Oldham, looking after the psychological is her priority.
“On the clinical side, there's no time to take into account the cancer diagnosis itself and the psychological aspects of that because everything is so rushed. It was just pressure pressure pressure and scurrying all the time.
I wanted more time to speak to people about their concerns. There is no time limit on the support that is given here. The people that come in are not patients, they’re visitors.”
In Maggie’s centres there are no signs on doors, no name badges or uniforms, no clocks, no notes taken during meetings. All of the factors that reinforce the institutional design of hospitals are reversed at Maggie’s. Visitors are put back on an equal footing.
“We just rely on what people tell us. We don't know what’s wrong with them when they walk through that door. And they might not tell us. Only by talking and unpicking things can you find out whether they’re a carer, or whether they have cancer themselves.”
Trish likes to sit by the fireplace facing towards the door. The curved glass atrium in the centre of the building means she can see everything that’s going on in the centre from one spot.
“I can always see the door. I can see people that are coming in. The hardest thing is walking through the door.”
The curve of the glass centrepiece is also designed to greet visitors as they enter. You can take your time, look around, and either gravitate towards the kitchen on your left or the views on your right. It empowers people to make the choice for themselves.
“A lot of people that come here are very vulnerable, and you need to let them know that it’s okay how they’re feeling. An environment like this puts them at ease. You see their shoulders drop as soon as they come in as they feel the space. It’s comfortable, like a home from home.”
Access to information
Things have been getting progressively worse for Kim’s mum. She’s 81 and has breast cancer, as well as a tumour that wasn’t initially spotted. Doctors are struggling to give her chemotherapy because of her anaemia. Kim’s mum has been to Maggie’s on the odd occasion, but it’s Kim that is the regular visitor.
“Knowing that the information is here when you’re ready and want it has been so important. Knowing that you’ve got people to ask or just take it yourself.”
Since coming to Maggie’s, Kim’s family have been able to access some carer's allowance which has been a huge support to them. “They’re thrilled to bits. They wouldn't have bothered or known if they hadn't come. And my mum wouldn't have even entertained applying for a blue badge.”
A discrete and unimposing library nook greets you to your right as you enter the centre. There are leaflets and brochures, covering the practicalities of dealing with cancer.
“A lot of people don’t like to ask, do they? Especially if they’re not well. The first time I came I looked through a book but I wouldn't dream of seeing if there was someone to talk to. I'd rather have the information and then decide what I'd like to do.”
The space allows visitors and their families find out information in a way that suits them, whether it’s through accessing the information in solitude or talking to the staff or volunteers. When they are ready to talk, the building’s openness and expansive views over the horizon provide a sense of calm in which to consume the information - and a valid excuse for avoiding direct eye-contact.
“The one thing I haven't used Maggie’s for yet is speaking about my mum being ill. There are times that I feel I would like to speak to somebody but I can’t face up to it. But if something happened, I would feel really comfortable.”
Discover the Maggie's Centres of the UK
Maggie's Centre, Oldham
Maggie's Centre, Oldham