Modern medicine has amassed a powerful armoury of weapons in its battle against cancer. These involve high-tech machines, complex chemotherapy regimens and strongly radioactive substances. But perhaps something far simpler could help to make a vital difference in determining people’s survival rates: caring environments that are in touch with Mother Nature.
That is the philosophy behind a new approach to cancer care being pioneered by Maggie’s Centres, a charity that is harnessing the skills of some of the world’s best architects to build centres offering support and respite that combine homely, natural atmospheres with innovative design. Next Saturday the organisation is opening its latest centre in Inverness to the public as part of National Architecture Week.
There are now four Maggie’s Centres in Scotland, with ten more being developed in the rest of the UK, including a London headquarters designed by the award-winning architect Richard Rogers. Other architects include Frank Gehry, Zaha Hadid and Daniel Libeskind.
The BBC broadcaster Kirsty Wark, a patron of the charity, has been involved with Maggie’s Centres from its early days. Other celebrity backers inlude J. K. Rowling and Bob Geldof. Wark, who has family experience of cancer, was inspired by its first unit in Edinburgh. “It is such a restful space with dignity and privacy, where people can feel cocooned from what is happening to them. They can sit in peace and cry, or do whatever they want to do. The environment brings a sense of positiveness.
“My father had lung cancer and I know numerous other people who have had cancer. The problem is that often the medical care is excellent, but the clinicians are hard-pressed and the facilities neglected. Many people’s first brush with treatment is in an old Victorian hospital. I have seen corridors full of women waiting for the results of their mammograms. It’s not the staff’s fault, but it is a distressing place to be.”
The original Maggie was Maggie Keswick Jencks, a highly respected landscape gardener who died from cancer in July 1995. Her treatment in hospital inspired her to develop better, friendlier ways of care. She had undergone a mastectomy and had been clear of the disease for five years when, in 1993, her consultant told her that she might have only four months to live. He then asked her if she would make space for other patients by sitting in the corridor.
“No patient should be asked, no matter how kindly and how overworked the hospital staff, to sit in a corridor without further inquiry, immediately after hearing that they have an estimated three to four months to live,” she wrote in her patient-information booklet, A View from the Front Line.
In fact, she lived for 18 months — time that she used to visit progressive cancer-care centres in America and to develop a blueprint for the first Maggie’s, in a former stable in the grounds of Edinburgh’s Western General Hospital. She died with the plans on her bed. Her fundamental wish was that patients could have easily accessible, friendly and harmonious support in beautiful surroundings. Maggie’s Centres must all be sited in hospital grounds and be free to everyone, she said. They should offer advice on nutrition, fitness and stress management and, most of all, give emotional support.
A year after Maggie died, that first centre was completed; a place filled with light and space, cosy corners and sitting rooms where patients and families are offered advice, therapy, psychology and support. It might be next to an NHS hospital, but it looks aeons away. The care services have been developed by a team led by Laura Lee, who was Maggie’s cancer nurse and now is the organisation’s driving force.
Six years later, in 2002, Glasgow got its own Maggie’s, in the old gatehouse at Glasgow University. Wark opened the champagne to honour the local fundraisers who had turned the plans into reality. “People need somewhere to be peaceful. That’s what Maggie’s offers,” she says. “The Glasgow unit is a prime example. Men in west Scotland can often have difficulty discussing their feelings, but more men than ever are coming through the doors. It’ s attractive to them; modern, light and non-intimidating.”
How do they persuade great architects to help? It doesn’t take much, says Wark. “It’s a refreshing challenge for architects, who normally do grand projects, to work in such small spaces. I think the architects bring an amazing modesty to each project.”
The secret to the Maggie’s design ethos is nature, says David Page, of Page & Park architects, who has designed two of Maggie’s centres: the Glasgow gatehouse and the Inverness, unit, which welcomed its first clients this month. “Both buildings are in urban environments but we have ensured that they focus on an area of green space,” he says. “There is an innate desire in us all to integrate with nature and the outside world; for example, by having balconies and large windows in our homes. That relationship to landscape should be even more important when building for health. If you put people in brick boxes with fluorescent light, you deny their healthy relationship with nature — that reassuring sense of sunlight, moisture, clouds, the changing patterns of night and day.”
Maggie’s at Inverness has been designed around the theme of mitosis, the division of cells in a healthy body, which is reflected in eye-catching building designs and by the healing garden, designed by Charles Jencks, the distinguished American-born architectural historian and writer who was Maggie’s husband and co-founder of the charity. He argues that, given the right research, the centres should be able to prove that they increase cancer patients’ lifespans. “
Several studies show the positive results of such environments, but they have not been from a large enough sample to convince sceptics,” he says. There is another crucial aspect to good building, he adds: “Good architecture says to the professional team, ‘We care, and to show it we have spent extra attention and money on you. Inspiration matters and can change things. Don’t give up’.”
Maggie’s Centre at Inverness will be open to the public next Saturday; www.maggiescentres.co.uk For more information on National Architecture Week, June 17-26, www.architectureweek.org.uk
Finding a cure in rooms with a view
The NHS, with its Victorian piles and 1960s’ brick boxes, is hardly built to commune with nature, but a growing body of research is encouraging the service to harness the healing power of beautiful environments.
Moving pictures Patients in Dorset County Hospital’s cancer isolation rooms, whose windows look out on to dull hospital buildings, can now enjoy live pictures beamed to their widescreen TVs from a local beauty spot, the lake at Kingston Maurward. Alex Coulter, the hospital’s arts co-ordinator, says: “We hope that a live view of nature will allow patients to experience the real world, and that this will increase their feeling of wellbeing and quality of life.”
Field work In the Middle Ages, horticulture was used to ease mental illness and city doctors used to prescribe sickly patients trips to the countryside. Florence Nightingale once declared: “The effect in sickness of beautiful objects is hardly at all appreciated. People say the effect is all in the mind. It is no such thing. The effect is on the body, too.”
Science and gardens In 1984 a nine-year trial by Dr Roger Ulrich showed that surgery patients at Pennsylvania Hospital recovered more quickly, needed less medication and suffered fewer complications if they had a view of trees from their bed, rather than a brick wall. When healing gardens, greenhouses, atriums and plants were put into nursing homes in Texas, there were 57 per cent fewer bedsores and a 60 per cent reduction in behavioural problems. Now NHS Estates, the health service’s building arm, has recruited Ulrich to help to design new hospitals.
Musical notes The researcher, Dr Rosalia Staricoff, says her study of 425 patients at London’s Chelsea and Westminster Hospital shows that live music in an antenatal clinic significantly increases signs of wellbeing in foetal heartbeats. Another of her studies at the hospital found that patients receiving chemotherapy while surrounded by paintings had a third less depression.
Birth pains A study of 700 women published this week by the National Childbirth Trust says that more than a quarter of women feel that NHS delivery rooms that look starkly clinical rather than homely make it more difficult for them to cope with labour.
