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THE ARCHITECTURE OF HOPE focuses on an exciting building project that has been underway since the mid-1990s - new cancer caring centres that offer a fresh approach to both architecture and health. Named after Maggie Keswick and co-founded with her husband, the writer and landscape designer Charles Jencks, these centres aim to be situated at all the major British hospitals that treat cancer.

Already sixteen have been completed, with at least seven more the pipeline. Starting in Scotland, where the first were built, they have implications well beyond their modest size and origins. Complementary to NHS hospitals, they present a face that is welcoming, risk-taking, aesthetic and life-affirming; and with their commitment to the other arts, including landscape, they bring in the full panoply of constructive means.

Maggie's Centres are a new mixed building type for healing that have different roots in the past. As Jencks and Heathcote show, this hybrid quality is a response to the condition of cancer; its myriad causes and bewildering number of possible therapies. The 'architecture of hope' is this new emergent hybrid genre, consisting of various metaphors that correspond in kind to the many different types of cancer and their various treatments.

The Centres have been designed by celebrity architects, including Richard Murphy, Page and Park, Frank Gehry, Zaha Hadid, Richard Rogers, Richard MacCormac, the late Kisho Kurokawa, Piers Gough, Wilkinson Eyre and Rem Koolhaas. Additional Centres are being planned by Norman Foster & Partners, Thomas Heatherwick and Steven Holl.

The Centres are committed first to helping cancer sufferers help themselves, to inspiring carers to care more, and secondly to architecture. It is the arts and building, important allies in the perennial struggle with cancer, that lead to the 'architecture of hope'. As people walk into a centre after a diagnosis, or enervating treatment, often disoriented and lacking in self-confidence, they enter another world which acknowledges their importance and a basic condition that may become prevalent: living with cancer and not losing hope.

This is a new edition of The Architecture of Hope, first published in 2010, but now completely updated and redesigned with new material throughout, and additional essays about the role of art at Maggie's and about the gardens and landscaping. There is also a new section showcasing the way architecture students have responded to the Maggie's brief.

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Introduction: The Potion of Hope by Charles Jencks The Architecture of Hope is the story of cancer caring centres and how they have grown in Britain and elsewhere to become a new kind of institution. Located next to a large hospital, each Maggie's Centre is a personal, designed place that encourages self-help. The buildings look at the same time striking yet familiar, and their hybrid functional nature has great implications for mass-health today. Each Centre is like a house that is not a home, an existentialist church that is non-denominational, a hospital that is a non-institution, and a place of art that is a non-museum.  The idea started off, modestly, in 1994, when my late wife Maggie Jencks and I thought of converting a room at the end of a hospital corridor in Edinburgh into one small haven for cancer patients, with a view on to nature, where one could sit peacefully between bouts of noxious therapy. In twenty years it has grown into more than twenty buildings with gardens, and a developed programme of caring activities that help cancer patients help themselves. Maggie would have been amazed at this extraordinary growth, because we only planned one building before she died in 1995; but she did have an inkling of the future, since she wrote a general blueprint for caring centres. What explains their runaway growth, and success?   Five factors that helped us grow The reasons for the progress of Maggie's as an institution can be debated, and given various priorities, but they would surely include the following five factors.  First, and most basic, is the widespread need for cancer caring centres around the world, in an epoch when the 'disease' affects one in three and rising. In addition, many more people are living longer with cancer than ever before. Thus we are part of a global movement, and the demand for carers will grow insatiably. This also will be true of other major chronic maladies, such as heart disease, dementia, diabetes, strokes and obesity. So the lesson of such caring centres extends well beyond cancer. Simply put, large hospitals - and the many people who are living over ninety years - cannot do without them. Maggie's Centres have thrived because of this deep, global need.  A second reason for our intense development is the commitment of a varied Board of Directors - all the volunteers - and a dedicated staff, who are even more varied in make-up. A variety of motives and skills is the key. Teams of different types of people, when they have a common goal, make a charity work well. This is because it takes so many different parts of a personality to carry out all the necessary roles: to care for patients, to raise money, to do the legal work, to decide what values are worth supporting, to smile when you are angry, to smooth ruffled feathers, to fight cancer and to care about caring.  The architecture of hope, I will be arguing, is a necessary hybrid: many particular things and precise functions that must work for exact problems, not just one big thing. If we take care of the carers, and they take care of the patients, then a virtuous circle of hope is created. Credit is due to our committed staff and Cancer Support Specialists (CSS), our many Local Boards and Centre Heads, those who work in each Centre and make it work.  Our Centre Heads are especially important, for they are the first person you often meet when you walk in the door, and they oversee the weekly programme (which is shown below as the Tree of Options, in the first chapter, page xxx). Our CEO, Laura Lee, has steered our development for twenty years with the Professional Advisory Board (PAB), while our first three Chairmen - Sir David Landale, Derek Dougles and Nigel Cazer - have taken a small Scottish team and transformed it into an international network. I could go on, but even this small selection brings out the point. The particular strength of Maggie's comes from its many and different characters who work together.  And this brings me to a third reason, to Maggie herself, who wrote the Blueprint that continues to inspire us, and which we extend as we get bigger. Of course, she, and the experience she went through, which is touched on below, is a very important reason why many continue to remain dedicated to the Centres, such as her close friends Marcia Blakenham and her oncology nurse, Laura Lee. We do not speak about our great affection for Maggie, because it goes without saying here, and because words cannot capture it. But their absence should be understood, and felt, as the motive behind so many of us, a continuous source of strength for our development.  There is another very satisfying reason our organization has prospered, the fourth I would like to highlight, again for personal reasons. This is the positive role played by the architectural profession. Architects, like any group, are competitive and collegial, but with us it seems that each successive Centre has set the bar a little higher. Their performance - and I speak as a (self-interested) critic - has been extraordinarily high.  Furthermore, they have made sacrifices. Many have given their services for little or nothing, many have made ten or more study models of our tiny commission, and many have helped to raise money or have given talks or sold drawings for us. Why this commitment? Why have many architectural schools set a Maggie's Centre as a student design problem? The reader will find hints of an answer below, shown in the section devoted to Centres that we were offered for free, as it were, to posterity. I call this the 'Utopian-Realist Tradition', because this duality brings out a perennial motive of architects. Their idealism, their intention to create a better society through pragmatic action, has driven the profession since the time Vitruvius described this motive in the first century BC.  Perhaps architects have been attracted to us because we are committed to architecture, but there is a deeper reason. In the age of shopping, as Rem Koolhaas has dubbed our time, a cancer caring centre is a challenging commission, one that deals with death and the passion to live - that is, the pressing question of hope in our title. Since hope, I will be arguing, is multi-form and comes in specific packages, it must also produce a compound building. The architecture of hope is thus necessarily a hybrid, a theme of many of the chapters in this book, including Angie Butterfield's essay on our gardens.  Architects have designed us good buildings that last, which sustain our staff and ethos. They have raised the fighting spirit of many patients, lifting their hearts at a time of desperation. Their brilliance and (sometimes) celebrity status help us raise the millions we need as a charity. Enough said? No; I do not understand why other institutions such as ours do not use good architects, and stand by them. Finally, there is a fifth factor, a reason which is itself a mixture. This is our relation with others and other charities. We have a yin-yang relationship to the NHS, the mega-health service that by its very nature cannot do what we do. We offer the variety of personalized services I have mentioned, those that primary cancer specialists are too busy with their responsibilities to address: from the cosmetic - Where do I buy a wig? - to the psychological - How do I tell the children, or my boss? - to the financial - How do I get a loan, or apply for state benefits? - and so on, and on. Laura Lee describes below some of the 10,000 things you have to think of when you have cancer. It is not just a physical problem but a chronic one. And that is why you need a carer, and a caring framework, for all the five chronic maladies. The NHS is very good when it works, but its bigness makes our smallness look good, and necessary, for dealing with the social realities of cancer. These are some of the reasons we have grown quickly, but steadily, reproducing ourselves. End of the beginning At first we were one small centre in Edinburgh. Then, taking a leap into the dark, we became two with Glasgow. After listening to a paper describing how successful charities often grew so fast they exploded apart, we became three, four and five in Scotland, and then six through to thirteen in England, Wales and Hong Kong, and now twenty and counting . . . one can hear the timebomb ticking.  If you double the size of an animal, you cube its volume and its appetite. If you double an institution, then you cube the money it eats up - and we have to raise it all. Success means that you have to run twice as hard as before to stay in the same place. Our office staff has grown from four in a small room to 150 in an open-plan and connected network. Should we try to grow as fast as the NHS, which has gone from thirty centres when we started to fifty-eight today, and keep pace? Whatever the outcome, we are big enough to know who and what we are. In effect, we are at the end of the beginning stage, and just starting the beginning of a middle period when we have to decide whether to deepen our service or grow further; or do both together. Plan of the book  As the Contents page shows, this book is divided into four basic sections of unequal length. In the first set of essays I describe the way the Centres grew from Maggie's experience with cancer, and how the common orientation of hope (and fear) is built into this reality, and then the architecture that deals with it. Laura Lee sets out our myriad services and describes their meaning and genesis. Edwin Heathcote, the architectural critic, raises an interesting question - what are the historical relations between buildings and health, is there a hidden or lost tradition, starting in Egypt and Greece? Do our Centres relate to this? Richard Cork, the art critic, continues this inquiry showing the historical strengths of art connected to healing, questioning Heathcote as does the anodyne approach that often surrounds suffering in our time. As Pop artists proclaimed, 'We don't want an art that sits on its ass in a museum,' (or a hospital either): a phrase of both Eduardo Paolozzi and Claus Oldenburg, whose work we show (as well as completely different types). Angie Butterfield ends this section and overview with a look at our gardens and landscapes, emphasizing the garden as haven and showing how patients have actually experienced them. The middle two sections of the book show twenty-three Centres, the first built the second planned. They are discussed by Edwin Heathcote, in pithy summaries. In these layouts, some of the gardens are also illustrated by their designers. This is the heart of the book, demonstrating our experiment in a Petri dish - that is, how with basically the same architectural brief twenty-three different solutions have evolved. As opposed to a franchise or a McDonalds or, say, the common layout of a Cistercian church, we respond to the local context, the individual personalities of each creator, and their parti, or concept, or plan idea. Mass-customization is a cliché in the post-modern age, when computer production can vary the form as cheaply and efficiently as it can reproduce exact copies. You could say that these twenty-three different formal types prove the adage of our time: that there is not one way to skin a cat, or one optimal solution or one standard universal answer. After all, there are 250 types of cancer, and five different stages. As in nature, generally the best answer to a problem is purposeful variety.  The third section shows some of those architects led by Charles Page who have designed schemes inspired by Maggie's based on different assumptions. These, and the students whose work at the University of Leuven in Belgium, are discussed by Professor Ann Heylighen, again illustrating the point: from the very same brief, many concepts take off. Obviously, some are superior to others in organization, but all of them are valid as metaphors to highlight, and to generate, a caring centre. We end the book with a scrapbook of photos and analysis, history and events: 'Notes on the Growth of Maggie's'. This section shows how we were created, mentions key aspects of our programme, gives the key dates of openings and buildings, underscores our fundraising and local boards, and gives a flavour of what we are.  The Architecture of Hope is not an official history of Maggie's, but rather a representative sampling of buildings, gardens, art, events and opinion. We have let the architects speak here more than the patients and carers. One reason for this is that we plan another book that gives the subject of healthcare time for research, and the space to tell its important message. Nevertheless, to make a record of some of the many who have helped us, and help the patients help themselves, we have mentioned and shown some of the events - and key people - and to them goes our heartfelt thanks. This new edition of the book is entirely new in several ways. The previous contributors have recast their articles, and new essays have been written by Richard Cork, Angie Butterfield, Charles Page and Anne Heylighen. Katy Mahoud has helped me re-edit the book, as well as gather many of the new photographs. Finally, Michael Brunström has once again not only laid out the entire book, but actually read the text while doing so, thus producing the kind of integrated design and meaning that is, if not unique today, becoming exceptionally rare. On behalf of Maggie's, I extend my thanks to all of them, for being another convivial team, working to exacting standards on an idealistic project, under considerable duress and pressure from me, and never complaining. Charles Jencks, May 2014  Excerpted from The Architecture of Hope: Maggie's Cancer Caring Centres by Charles Jencks All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.

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Charles Jencks is the author of several best-selling books on architecture. He divides his time between lecturing, writing and designing in the USA, in the UK and in Europe.

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