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Maggie’s Centre, Nottingham City Hospital, by CZWG Architects

CZWG’s provocative Maggie’s Centre, with Paul Smith interiors, will challenge purists and charm the public, writes Christine Murray. Photography by Martine Hamilton Knight

The indignity of cancer is something I am familiar with: my sister died of breast cancer aged 36.

Her diagnosis was followed by denial, hers and mine, because she was 31, vibrant, successful, healthy, athletic, a non-smoker and most thoroughly alive. How she would have fared had the cancer been left untreated is unthinkable, but as it was caught early on, it seemed like it was the cure that made her sick; a rigorous course of treatment that nevertheless failed to save her.

The cruelty of cancer lies in understanding it. Cancer isn’t really a disease per se – in most cases it isn’t something you cause, or catch. It’s mutiny. The body has turned on itself. The language of war is apt here: this is a world of rogue cells and free radicals, tumours like terrorist training camps, healthy systems misappropriated, hijacked, gone AWOL.

Like the process of aging, cancer feels like a betrayal. Your body has decided, without your permission, to overthrow you. Despite advances, medical treatment is a blunt instrument, often indiscriminate and unsophisticated, like carpet bombing. Collateral damage is inevitable: your hair, your wellbeing, your health. I once asked an oncologist why my sister got sick, and he said it was just bad luck. Cancer is unpredictable, unpreventable, inexplicable, and also, not fair.

The Maggie’s Centre has stepped into the space after diagnosis, effectively assisting patients as they fumble between the five stages of grief that follow any shock (denial, anger, bargaining, depression and acceptance). Founded by Maggie and Charles Jencks in 1995, after Maggie’s battle with cancer inspired the idea, each Maggie’s unique architect-designed surroundings in a sense nurture that precious denial (the merciful feeling that everything will be fine), while their informative material and sympathetic counsellors nudge you towards acceptance (everything may not be fine, but that, in itself, is fine). All this is humanely accomplished over a nice cup of tea, and not in the fluorescent-lit nightmare of a hospital corridor. 

The Maggie’s Centre brief also provides for other stages of grief: a variety of crying rooms, including private loos with locks on the door, counselling rooms and uplifting, comforting spaces. The only stage not provided for is anger – how I would love to see a Maggie’s with a punching bag in the basement, a sound-proof screaming room, or at least a lap pool for some angry swimming. I’m sure many a visitor would benefit from a safe space for venting the undignified anger which accompanies diagnosis, although that wouldn’t embody the ‘keep calm and carry on’ mantra which underpins the Maggie’s ethos.

The emerging typology of the Maggie’s Centre has dignified the grieving of one’s lost health, mainly through the introduction of domestic tropes, especially the kitchen and the hearth. And in this, Piers Gough’s Maggie’s Centre in Nottingham makes no exception.

Gough’s commission came after a fortuitous dinner party with personal friend Frank Gehry and Marcia Blakenham, vice-chair of the board at Maggie’s. ‘Frank said to Marcia, “Oh, you should ask Piers to do a Maggie’s,” and they all gulped. Very sweetly, a short while after that, I got the call,’ says Gough. The practice has another sympathetic connection – Charles Jencks was Gough’s tutor at the AA, and when he was still a student, asked Gough to design a jacuzzi for his and Maggie’s home. ‘I decided it should be an upside-down room, where you sit in the dome, and the floor is the ceiling. So then Charles got out his slide collection of domes from around the world and put them in the projector upside-down. I remember Maggie opened the door and just shook her head, laughing at us. She was so lovely, and very indulgent.’

Designed without fee by his practice CZWG Architects, and furnished and decorated by Nottingham-born star designer Paul Smith, Gough’s Maggie’s Centre is a green oval supergraphic perched on a sloping site at Nottingham City Hospital, nestled in the trees beside the BDP-designed breast centre and adjacent to one of the entrances to the hospital campus.

Gough chose the awkward site because it was unlikely to be useful in any future hospital expansion plans, while also offering a strong presence on the street. The building was conceived as a treehouse, and was originally designed in timber, the shape inspired by the Chinese moon gate (Maggie studied Chinese gardens) and the overlapping corners by the criss-crossed edges of American log cabins. It was Maggie’s chief executive Laura Lee, Blakenham and Jencks who pushed for the ceramic-tile facade, confessing that they had been hoping for something like CZWG’s lavatory in Westbourne Grove, also clad in green ceramic tile. Timber has been retained for the pedestrian bridge to the entrance and the balconies.

If Maggie’s Centres can be loosely divided into the wilfully iconic and the wilfully domestic, CZWG has followed Zaha Hadid’s Maggie’s Fife and Gehry’s Maggie’s Dundee in creating a striking object, as opposed to Page\Park’s design in Glasgow or Richard MacCormac’s in Cheltenham. But while the outside is playful, Postmodern and irreverent, inside Gough’s overlapping ovals is a perfectly square plan, and perhaps the most traditional arrangement of all Maggie’s Centres: a house, with public spaces below and private, bedroom-like spaces above. The aesthetic of Smith’s design reinforces the innate domesticity of the layout, with pastel walls, plush multi-coloured furnishings, a Shaker kitchen and all the trappings of a spread from Elle Decor.

Staggered over two half-levels and an upper floor, with a podium for services only below, the plan of the building is easily intuited from the entrance hall. From here, you can see down the half-level into the kitchen, with the sitting room/library to your right, office to your left, and stairs to the upper level opposite. Counselling rooms, the IT workstations and a yoga studio are upstairs, where the building takes advantage of its position among mature trees, placing branches and leaves within touching distance of the 90-degree-openable windows. The lower (ground) floor acts as a store for summer furniture and contains an insulated tank for rainwater harvesting, an air-source heat pump and fans which allow the basement to be used as the plenum.

Accessibility is given pride of place with the lift positioned alongside the stair, although annexing it to a corner would have created a more striking welcome (a generous stair would have allowed light from the building’s top-light to penetrate the entrance hall, inviting exploration upstairs). However, the position of the double-entry lift is ideal for its functionality: wheelchair users can enter frontwards on any floor and exit facing the right way.

Making the details fit for purpose in this way, more than the expression of a singular vision, is something Gough believes in. The lack of a relationship between the Maggie’s facade and interior is also part of Gough’s design ethos, and the disconnect is jarring, though apparently intentionally so. Speaking at a panel discussion on Postmodernism at the RIBA in October, Gough asserted to an audience of enthusiastic students that he didn’t see why the inside of a building should relate to its exterior. ‘Buildings should celebrate being alive, and contradictions are part of the joy that architecture can bring.’ 

‘Postmodernism is not about being rational or organised,’ he added. ‘A building has to be useful, not look useful.’ At the lecture, Gough described architecture as a ‘vehicle to show your humanity’ and said ‘buildings should be about feeling, not theory’. After he spoke, a few students broke into spontaneous applause, one saying, ‘This is so refreshing. All our tutors talk about is sustainability and authenticity. Are you saying we don’t have to listen to them?’ There was a palpable sense that Maggie’s Nottingham is the kind of building students are waiting for. It seems a generation gap is widening, and that a debate about architectural taste is brewing.

The unfussiness of CZWG’s approach results in a feeling of serendipity when this building works – and overall, it does work. The playful joli-laid aesthetic of the facade is joyful, while the interior has a reassuring feel to it. The ‘house’ approach is comforting and instantly recognisable. Although it is a small building, the multi-storey layout makes it feel as though there is somewhere to go, suggesting visitors will be able to wander about, or at least in, around and up.

Maggie’s Centres are funded by donations, and construction doesn’t start until two years’ running costs, in addition to the build cost, is raised. As such, Gough said he was cost-conscious, and felt uncomfortable making this an ‘expensive’ building, because any save on the build could be put to use elsewhere. As a result, this is not a lavish Maggie’s Centre (it cost half as much as OMA’s), but one with an aesthetic and plan the public will intuitively understand, and likely love.

Client’s view

The Maggie’s Centre buildings spark curiosity. The designs aim to be inviting and encouraging, appealing to everyone to come through the door and explore. When people walk into a centre, they instantly find an open, homely kitchen, where the kettle is always on the boil. There is no reception desk or formal place to sign in, however Maggie’s always have cancer professionals available to greet visitors, making them feel they have come to the right place.

We help people to untangle the complicated information they receive from the hospital, as well as providing a high level of psychological, practical and emotional support. With the kettle on, many people start talking and unwinding without even realising. The centres are designed to offer both private and public spaces, so that it is equally easy to place yourself among the buzz and chat of the centre, or to find a safe and quiet spot just for you.

On average, each visitor returns seven times. Cancer support specialists gain much insight from that first conversation, where they carefully assess the needs of individuals and families, and recommend which classes and groups would be of most benefit, as well as which specialised staff they could gain support from meeting. Several courses run for six weeks, while weekly support groups are ongoing.

Many friendships are formed over the kitchen table or within groups. Our male-to-female ratio in 2010 was 27 per cent men to 73 per cent women, and we aim to balance this in the coming years.

Laura Lee, chief executive, Maggie’s Cancer Caring Centres

Credits

Start on site November 2010
Contract duration 11 months
Gross internal floor area 360m2
Form of contract Traditional
Total cost £1.45 million
Cost per square metre £4,027
Client Maggie’s Cancer Caring Centres
Architect CZWG
Interior design Paul Smith (Interiors)
Structural engineer AKTII
M&E consultant KJ Tait
Quantity surveyor / project manager Turner & Townsend
Landscape architect Envert Studio
Main contractor Bowmer and Kirkland Building Services
CDM co-ordinator PFB Construction Management Services
Approved building inspector MLM Building Control
Estimated annual CO2 emissions 22.5kg/m2/yr

Structural engineer’s view

Maggie’s Centre Trust was founded to provide support and create a peaceful environment for all those dealing with the trauma of cancer.

The mischievously shaped Nottingham Maggie’s Centre will be an oasis of tranquillity amongst the bustling Nottingham City Hospital, providing a welcoming and relaxing sanctuary.

The structural system comprises hybrid steel and timber superstructure above a reinforced concrete pedestal rotated at 45o to the superstructure.

The pedestals foot print is be pulled back as far as possible and away from the roots of the adjacent trees which form a key part of the context of the building.

These concentric rotated axes and small footprint create large over-hangs which disguise the pedestal’s presence and create floating appearance.

Fabricated steel beams aligned and concealed within the intersecting ovals transfer the superstructure loads to the concrete pedestal. This steel deck also provides a stable platform from which to build with a minimum of temporary works.

The doubly curved roof and walls consist of a light steel skeleton in filled with straight timber members. This system provided a simple convention and fast construction method to created an otherwise complex shape.

The timber members are faced with a timber ply skin to create structural diaphragms in the vertical and horizontal and curved roof planes which stiffen the steel frame against wind, loads and out of balance loads created by the slight asymmetry of the steel frame. This hybrid construction provides a very efficient structural solution.

The foundations had to be closely coordinated with the adjacent trees which are such a key part to the context of the building.
Gerry O’Brien, AKTII

Maggie’s Centre, Nottingham City Hospital, by CZWG Architects, steel superstructure

Maggie’s Centre, Nottingham City Hospital, by CZWG Architects, steel superstructure

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