How Maggie’s Centre in Fife transforms the environment for cancer patients
In this extract from Who Built Scotland, a Historic Environment Scotland book, Kathleen Jamie looks at the Maggie’s Centre in Fife
In her 1995 essay A View From The Front Line Maggie Jencks bravely recounts being told, five years after apparently successful treatment, that her breast cancer had returned and had spread to her liver, bone and bone marrow. She would have just months left to live. She was in her early 50s, with teenage children. The doctor meant well, but it was a busy clinic. Having been given the news, she was asked to go sit in the corridor.
In the event, ‘extremely powerful chemotherapy’ granted her 18 months of remission, during which she wrote her account and laid down her vision for cancer care. She speaks about diet, and supplements and nonwestern approaches, of the need to engage with one’s treatment, not be passive. The daughter of a Scottish merchant family, Maggie had grown up in Hong Kong and was familiar with Chinese medicine. “Yoga, Qigong and guided relaxation all helped me during my treatment,” she writes. But chiefly, and here began the movement that would bear her name, ‘no patient should be asked to sit in a corridor … immediately after hearing they have three or four months left to live’.
Even unwell, she must have been energetic and persuasive. Soon, she had convinced the Western General Hospital in Edinburgh that what they needed was a cancer care centre, where ‘thoughtful lighting, a view out to trees, birds and sky, and chairs and sofas arranged in various groupings could be an opportunity for patients to relax and talk, away from home cares.’
That first centre opened a year after her death in 1995, at the age of 54. In the two decades since, Maggie’s husband Charles Jencks has striven to open many more Maggie’s Centres. There are eight now in Scotland and more appearing across the UK and abroad. The Maggie’s Centres raise their own funds – it is not NHS money – and build at the invitation of the NHS, usually where there are oncology departments. Charles Jencks was and is a landscape architect and architecture critic. He and Maggie counted amongst their friends many now-famous architects. Maggie herself had the blueprint. After her death, Charles had the clout, contacts and vocabulary to take the project forwards.
The Fife Maggie’s Centre has had to find space in the congested site of the Victoria Hospital, and in the bewilderment of signs and destinations, you might not notice it if you weren’t looking for it. It’s rather like something in a fairy story, a little building which only becomes visible when you need it, and even then it’s not as you might expect a ‘caring’ centre to be. The single-storey building has a dark, angular, mineral look, like folded sandpaper. It’s not what you’d call touchy-feely. The walls are pierced with triangular windows that look as though they’d admit no light. If you find your own way there, or are nudged toward it by clinicians or friends, you must enter by a long, dark, walledin ramp… The entrance passageway is deliberately dramatic. It tells you that you are leaving one space, and one state of mind – the huge hospital, buses, car parks, corridors, and language you barely understand – and entering another kind of space. The wall protecting the entrance looks and feels gritty but it guides and protects the traveller and announces an arriv- al. It’s like the embrace of a benign but powerful witch.
The dark hard slanting walls may discomfit some, but people who find their way into the Maggie’s Centre are not perturbed. You have to be brave when you have cancer, or are caring for someone who has cancer; entering a strange building is the least of it. If you’re courageous enough to approach the building you are rewarded. “Its apparent aggression is all bluster,” said critic Edwin Heathcote. Crucially, you have to enter the building to know that after the dark passageway, there comes the transformation of light. Inside, the darkness is banished and the space is openplan, but with turns and curves like a seashell.
There are pink sofas and creamy rugs, plants and artworks. On a shelf stand a row of playful animal sculptures by Eduardo Paolozzi. The walls are white, but soft white, not clinical. The triangular, deep-set windows offer no view of the hospital or car parks, rather they admit changing spangles of sunlight.
The real surprise is a whole long wall of glass, shielded and unseen from the entrance passage, which opens onto trees, almost at canopy level, meeting with the leaves and birds. Beyond the window, accessed by sliding doors, a balcony runs the whole length of the building.
Mostly, Maggie Jencks’s vision was about enabling people to be active in their own care, and the Maggie’s Centres seek an architecture that enables this. The professional staff run drop-in support sessions all day, and plan a weekly programme of meditation sessions and confidence-building sessions – helping you face the
You have to enter the building to know that after the dark passageway, there comes the transformationoflight
world when you feel rubbish and your hair falls out – and sessions on the financial repercussions of cancer, and sessions especially for youngsters. The centres are intended as places to go when the stress of cancer, its treatments and aftermath can get on top of you.
I asked one of the centre staff if she felt uplifted herself, coming to work, if it is indeed a building which cares for the carers. Before, she told me, she’d done the same kind of counselling and support work in the corner of a library and I was reminded at once of Maggie Jencks being asked to go and sit in the corridor. Out of sight. Corners and corridors. The Maggie’s Centre motto is ‘people with cancer need places like these’.
“Yes,” the nurse said. “It still has the ‘wow’ factor. I feel I can do my work here. But I do have centre-envy! The new Lanarkshire one is fantastic.”
One wonders if each Maggie’s designer is upping the ante, just a little. The Fife centre was the work of the late Zaha Hadid, the Iraqiborn British architect who became the first woman to win the Royal Gold Medal from the Royal Institute of British Architects, twice won the Stirling Prize, and was made a Dame in 2012. Hadid died suddenly in 2016, leaving some of her major projects uncompleted, so her Londonbased practice continues in her name… Maggie’s Fife, small and intimate, was Hadid’s first permanent structure in the UK and with her passing becomes more noteworthy. The present centre director, Alison Allan, knows the building now needs some attention; the surrounding trees are lovely but green resin or algae is staining the building’s dark facade, and there are one or two other issues which mean that Zaha Hadid’s office has to be approached before work can be undertaken... It makes you wonder, if a Maggie’s architect goes on to become a ‘starchitect’ will they inevitably forget their more humble commissions? What will become of the buildings, if the original architect has passed on and the personal connection with the Jencks family is lost?
It’s the question of care, again. How to care for the unique buildings which care for the carers who care for the sufferers? It ought to be a cycle of virtue, and it needs to be achieved if the buildings are to function as metaphors, where peeling paint or a weather-stain or a bit of breakage takes on great symbolic weight. ● An extract from Who Built Scotland: A History of the Nation in Twentyfive Buildings (Historic Environment Scotland, £20 hbk), out now.