Return to site

Dungeons, Casinos, and the Airless Office vs The Architecture of Hope

Maggie's Centers

broken image

I recently had the distinct displeasure of being in a hospital and an emergency room in Michigan. The architecture of the ER reminded me of a combination dungeon and casino. It was difficult to know what time of the day it was. No light. No air. No cell phone service. Machines blinked and beeped around us. The rooms barely had privacy with curtains raggedly pulled askew. The beds were torture devices. The nurses in a little fishbowl in the center. Beige. Grey. Antithetical to any kind of healthy psychology. Instead, all I wanted to do was run.

The hospital room was not much better but at least it had a window. You could see a field and trees. Although there was no fresh air (are they afraid I’ll jump?) there was least some way of being a part of a greater world. I could see the cars and birds go by. There was a famous study done in 1984 where they studied patients with a view of a brick wall and patients with a view of nature. (

“Records on recovery after cholecystectomy of patients in a suburban Pennsylvania hospital between 1972 and 1981 were examined to determine whether assignment to a room with a window view of a natural setting might have restorative influences. Twenty-three surgical patients assigned to rooms with windows looking out on a natural scene had shorter postoperative hospital stays, received fewer negative evaluative comments in nurses' notes, and took fewer potent analgesics than 23 matched patients in similar rooms with windows facing a brick building wall”.

If something so simple as a tree can help people heal so why is it so common to see that brick wall?

I have just returned from The International Society for Evolution, Ecology and Cancer Conference 2019 in London. As a precursor to the main event, we toured some fantastic places. Perhaps one of the best was the Maggie Center attached to Barts Medical and Dentistry School. This beautiful, light filled building designed by Steven Holl is one of many buildings designed for cancer patients and their families. It was a dream of Maggie Keswick and her architect husband Charles Jencks. They experienced firsthand the inhumane qualities of the medical system. After receiving terrible news about Maggie’s cancer, they found themselves sitting in a windowless hospital hallway as nurses cheerfully sailed by with glib questions such as “How are you doing, dear?”

The juxtaposition of the needs of a human versus the innate inhumanness of a large medical system propelled them to create these centers that are serene and calming; centers formed round the warmth of a kitchen and the hope that can come from community. Charles Jencks wrote a wonderful book about these centers called “The Architecture of Hope”. Many of these centers (there are over twenty now) are designed by word class architects. Frank Gehry, Zaha Hadid, Rem Koolhaas among many others. These buildings are works of art. Designed with empathy, sympathy, and insight, they resonate with the capacity of humans to care for each other. You can feel it the minute you enter. You are not alone.

For more information, check out