Illness and culture: Maggie's Centres.

As new treatments and diagnostic methods are developed, oncology commands an increasingly wide range of technologies and effective procedures. Yet, in the background is the necessity to deal with an equally complex array of psychosocial problems and lifechanging issues that affect patients with cancer. These problems include, to name only a few, self-image issues caused by hair loss or weight changes, the frustrating lack of mental and physical energy, the forcing of major change in lifestyle habits after a cancer diagnosis, and the necessity to spend time in healthcare spaces (1–3 ). The story of Maggie Keswick Jencks—a writer, gardener, and designer who died in 1995—as related by her husband, architectural critic and author Charles Jencks, illustrates all these problems and adds a unique inspirational dimension (4 ). Having to deal with cancer in conventional hospital surroundings inspired Maggie Jencks to conceive, with others, the idea of creating a space where people could deal with these problems in comfort. The idea was to create a small support center that would be available to people affected by cancer. Although such a center would be located close to a hospital, it would be planned and furnished according to noninstitutional aesthetics, thereby adding a measure of informality to the surroundings. This concept was the beginning of the story of Maggie’s Centres in Britain. The first Centre, opened in 1994, was built by Richard Murphy Architects on the grounds of the Western General Hospital in Edinburgh. Since then, 16 centers either have opened or are in different stages of planning (4 ). “The Maggies” are small, carefully designed buildings, usually close to the hospitals, and are open to people affected by cancer. They are dropping-in places that offer support both for those with cancer and for the persons caring for them. Charles Jencks has been credited with introducing the term “postmodernism,” which he has nicely reclassified in the introduction to his recent book. The Story of Post-Modernism: Five Decades of the Ironic, Iconic and Critical in Architecture is remarkable for its insights into the nature and the “life” of buildings as architectural forms (5 ). As for the Maggie’s Centres, Jencks sees them as hybrid buildings: A Maggie’s Centre is, he writes, “like a house which is not a home, a collective hospital which is not an institution, a church which is not religious, and an art gallery which is not a museum.” There is a domesticity about the space, and many interiors are centered around a kitchen, a place where people come and make tea (4 ). Another unique characteristic of the Centres is that a number of world-renowned architects have participated in their design. The Maggie’s Centre in Dundee, Scotland, which opened in 2003 (Fig. 1), is by American architect Frank Gehry (1929 –) (6 ). Gehry was born in Toronto and set up his first practice in Los Angeles in 1962. In 2002, he founded his current firm, Gehry Partners LLP. His early designs were unconventional, like his own house in Santa Monica, where he controversially transformed the look of a traditional suburban house with an unusual combination of raw industrial materials. The essence of Gehry’s later work is advanced computer-aided design that liberates architectural form to create free-form buildings with varying planes and levels, with curving outlines and billowing shapes. In 1989, he received the prestigious Pritzker Architecture Prize. His bestknown building is the Guggenheim Museum in Bilbao, Spain, built between 1993 and 1997 (7 ). Guggenheim Bilbao became a world-class tourist attraction and placed the town firmly on the international scene. The phenomenon in which an exceptional building dramatically changes the character of an urban location has since become known as “the Bilbao effect.” Compared with the Guggenheim, his Maggie’s Dundee is almost sparse. Here Gehry gave the building a sort of calm combined with warmth, rather than flamboyance. The Centre overlooks the River Tay and sits on the grounds of the university hospital (8 ). Its form includes a small tower with a single window, a metal roof that is both wavy and angular, and a simple timber-framed terrace. The interior is dominated by beams and timber structures. The Maggie’s Centres create an interface with institutionalized healthcare—a kind of buffer surroundCollege of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK. * Address correspondence to the author at: Department of Biochemistry, Gartnavel General Hospital, Glasgow G12 0YN, UK. Fax 44-141-211-3452; e-mail [email protected]. Science in the Arts