The tenderness of timber

All photos Alex de Rijke unless otherwise stated

Designed with care, dRMM's Maggies Oldham is turning the cancer centre network towards natural materials. Along with their groundbreaking use of hardwood CLT in the body of the building, cork screens, oak door handles and uncut birch railings, all feature to remake the Maggies template.

Of the many recent CLT projects completed in Britain in the last twelve months, the Oldham Maggie's Cancer Care Centre speaks to a sensibility that encompasses the poetic and a sensitivity and relationship to nature, which almost all other recent CLT buildings decked out in engineered timber, seem complete unaware of - despite their use of the latest wonder wood.

The small, delicately balanced timber box, sits on slender steel columns at the western edge of the Royal Oldham Hospital, between Oldham proper, and the sprawling outskirts of Manchester.  Like many Maggie buildings, a small site has been found near the main hospital which, while helping with accessibility, also ensures that comparisons between the two approaches are difficult to ignore. At Oldham this is particularly pronounced, as dRMM have made a point of emphasising natural materials both inside the building and externally. Nature plays a leading role in the building’s undercroft landscaping, and scooped out of the site, the ground below the building has been given over to a stony garden designed by Rupert Muldoon. A thin young birch tree has been planted at the garden’s centre, its silver trunk rising up through an opening cut into the middle of the building like a symbol. From within, the tree’s leaf canopy quivers and bends in the summer breeze on the other side of transparent glazing.

Photo Tony Barwell
Way in to the Royal Oldham Hospital - Photo Open Source

Externally, the dark hued CLT cladding looks like a particularly organic corrugated metal; while inside, the same hardwood CLT runs the lengths of walls and ceiling, a benign backdrop to this refuge whose brief is to help and sustain people diagnosed with cancer. Visitors enter either by climbing a wood stepped staircase between garden and the railing lined balcony, or through a more conventional doorway on the centre’s south side. Once inside, a bright yellow floor runs the course of the main room, slipping round the freeform curving glass centre to the far end of the building. Here, an expansive window placed above the line of the hospitals boundary wall, looks down across the nearby bungalow estate, towards the Pennine hills.

Garden approach from the main hospital
Stonewall cantilever
and eastward window-scape

Petra Blaisse’s InsideOutside curtain space

Light is a presence in the building. Flooding in through the window-scape at one end, and also illuminating the absent centre, the tree’s branches reaching for the sky and close enough to touch just the other side of the glass, are suggestive of rebirth. The transparent glazed container form reminded me, at least, of an Aaltoesque Iittalla vase, an echo of the humane modernism of the Finnish master, and a possible reference to the vase’s actual designer, Aalto’s first wife Aino Moriso, who worked on the Paimio Sanatorium and died early, after a three year battle with cancer.

This sensitivity extends across the materials palette, whether the hardwood CLT walls and ceiling strips which complement and calm the yellow floors, or the various features and detailing throughout the building. A narrow sculpted wood burning stove climbs from the floor next to the far window, its black flue pipe continuing through the ceiling, while a long, hanging – and yellow – curtain, sits to one side, designed by Petra Blaisse, the Dutch interiors (and exterior) designer, with her company InsideOutside, a further suggestive touch continuing the ‘absent present/inside out’ motif. Described as ‘useful art’, the curtain can run the length of its ceiling railing, creating a fold around private space for the inevitable difficult personal and traumatic meetings. This, after all, is a place where many people have to come to terms with the immensity of their own death.

Maggie Keswick Jencks (Photo Maggies)

That is at the heart, for those who don’t know about their origins, of what the Maggies Centre’s are about. Maggie Keswick Jencks was the interior designer wife of the post-modern architect theorist Charles Jencks, and the original inspiration for the network of centres. In summer 1993, while undergoing treatment for her own cancer, the upset of trying to find the temporarily re-housed oncology department within the sprawling Edinburgh General Hospital for one critical appointment, made, not completely surprisingly, a profound impression on the Jencks’. Their experience seeded an idea which, in the years since, has grown and grown. Namely to use the professional skills and expertise of architects, to design centres focused on the human element of providing comforting and therapeutic places and surroundings. Where empathic design could hold and support people experiencing what were traumatic life experiences and, indeed for a substantial minority, the finality of a terminal condition. (For an extensive healthcare design overview circa 2007, including a focus on the Maggies’ buildings, see FDR 7’s Design With Care themed section.)

InsideOutside I – Early Maggies Centres Edinburgh and Inverness (Photo's Maggies)

After her diagnosis, Keswick Jencks lived for two further years. However, before she died, the beginnings of the Maggies Centres projects was up and running. The super-well connected couple enrolled some of the best-known architects to design the early Maggies Centres, including Frank Gehry and Zaha Hadid. They also worked with other well-known, if not such internationally luminous starchitect brands, Scottish practices, Richard Murphy and Page & Park. The first completed building, the Edinburgh Maggies Centre, was a conversion sitting next to Edinburgh Royal Infirmary opened in 1996. A decade later, the Hadid designed Maggies Fife was already the fifth Maggies, following a steady roll out across the principal Scottish cities, Glasgow, Inverness (both Page & Park) and Gehry’s small, Maggies Dundee in the early summer 2005. This past June, Maggies Oldham joined an ever-increasing list of centres, the 21st building in the organisations 21st year.

HadidGehry OutsideInside II (photos Maggies)

Those early Scottish projects - with the exception of Hadid’s Fife project – all emphasised wood as a, if not their, core material and a more or less implicit recognition of that material’s ‘extra’ healing qualities. Both Gehry’s Dundee and Page & Park’s Inverness Maggies, were essays in the tenderness of timber. In the intervening decades, the Maggies buildings, with a couple of exceptions, veered away from such a focus. But although wood buildings may have taken a back seat, the Maggies network grew, and gained a name coined by Charles Jenks, ‘the architecture of hope’. Now, with dRMM’s Maggies Oldham, the wood focus is back centre stage. Not only wood, though, for dRMM’s de Rijke the argument about using natural materials in healthcare is much broader. The increasing evidence of cancer in developed countries points toward carcinogenic elements in our food, drink and air, and material components of our built environment.’ he writes in an essay published at the time of Oldham’s opening. dRMM have made an obvious connection, that buildings could express these wider overlapping themes  - natural organic materials complement healthy organic food; the two are exactly the ingredients so missing from both the NHS and so much of public architecture. “I’ve spent time in hospitals so I’m very aware of the inadequacies of hospital environments", he said, on one of Oldham’s opening days. “It’s similar to diet; the same could be said of the buildings, that they’re not healthy. You know, it’s the last place to be if you’re sick. In 2012 I had appendicitis, and what should have been two days turned into two months because I got a hospital infection. So I became extremely evaluative, lying looking not out of a window, but up at a ceiling”, de Rjike says. “It is just like the use of wood in classrooms, which lower heart rates and improve respiratory problems!”

More pictures about food and buildings

The Oldham building, through inter-weaving the natural world outside with natural materials inside, draws Maggies into relatively new terrain for the organisation – natural building materials. The specification isn’t as radical and all-consuming as Architype’s all natural materials Enterprise Centre at the University of East Anglia, but there is enough of a cross section to underline the point. dRMM have specified cork wall screens and oak door handles, while raw uncut birch lines the entrance balcony railing. This is a rather different palette to dRMM’s usual fare of bright, and at times, gaudy, colours. For the studio, Maggies Oldham is unusual; it’s one of the few projects where their eco-sensibility is worn on their sleeves, in contrast to a fair few buildings where both sensibility and CLT is invisible, the other side of the walls.

It is also intensely personal for de Rijke, Through most of the project he nursed his girlfriend, Lucy, who had terminal cancer which towards the end of her life, brought them to Manchester for treatment. She died a few weeks after the centre opened. One of her last acts being to visit the building during the opening.

More pictures about NHS food and buildings

“In wood” de Rijke ends the essay on designing the Maggies centre – using a favourite quote of his, long lifted from Helsinki’s Wood Program director, Pekka Heikennen - “there is hope.” ‘Everybody knows a hospital is no place to get well if you are sick. A waiting room and two-star hotel, arranged around an operating theatre without windows’ is Lucy’s definition. ‘A machine that fixes and creates health problems’ is mine. He notes how Lucy made him aware of ‘the effect of light levels and colour on skin made sensitive from radiotherapy, right down to the details of wood not metal door handles to avoid the neuropathy of fingers made painful by chemotherapy’ revealing a partial source of the oak wood handles. In the essay, de Rijke also folds the project into a larger intention, to reverse the first principles of healthcare design, re-orienting the profession towards designing with natural materials, with timber at the heart. This is bold, and is far easier said than done. What will actually happen is for the future, though de Rijke says he’d be up for larger scale NHS buildings, “I’d love to do a hospital”, he states, though one can’t but help think that this is an unlikely scenario for the NHS in the current climate.  This Maggies, like the vast majority has come from private funds from Mr Oldham's Sir Norman Stoller Foundation; “the right amount” says de Rijke. “Part of the reason why I use wood” he adds, as we stand near the far end window, “is because that there is almost no question that it doesn’t answer about the hope for the planet, let alone people with cancer. It may be very useful informing a very comforting and therapeutic environment in a building, but on the other hand provided we plant two to three, or four times the amount that we’re cutting, then there is hope for the planet.”

Tulipwood – prolific and popular on the Eastern side of North America
(Open Source)
Maggie Keswick Jencks (Photo Maggies)

It is the wood that makes a particularly indelible impression inside the long room. Again using the new hardwood, Tulipwood, or American Tulip Poplar, which de Rijke and dRMM have been experimenting with over the last half dozen years, here at Maggies Oldham, it is being applied structurally to a complete building for the first time. After a series of experiments – see the Andrew Lawrence piece here - in which the studio worked with the American Hardwood Export Council (AHEC) and Arup to develop the material so it could be used in a full-scale building, this is the result.

 “I think tulipwood is a really beautiful material” de Rijke says, touching the finely grained timber, after I’ve asked him why he likes the material he’s been involved with for the past half dozen years so much. “For me, it’s more beautiful than the knotty pine you generally get on softwood CLT…. I think that the fineness of the grade and the contrast, that’s what I like… the fact that you get dark, here, and it gives it a certain life and rhythm. As a species it grows straight and tall and, so unusually for a hard wood, it is fast growing and is very plentiful as well, which makes it sustainable  … There’s a plethora in the US, although it didn’t fare so well, I’m told in Europe, after the Ice Age.”

“In the States though, they don’t treat it so seriously. It’s not a respected timber, and is used on skirting boards and architraves, because it is fine grain so you can profile it. I really relish the opportunity to try and do a Midas touch on it and turn it into something special. And the reason it’s special is that it’s lighter and stronger than softwood CLT. Wall thicknesses can, critically, be lighter, so foundations can be more economic.“

Tulipwood in detail - Photo Jon Cardwell, AHEC
Corrugated - Photo Jon Cardwell, AHEC

Technically, the centre’s southern face is comprised of a double wall, with two offices, toilets and other facilities sandwiched between the two curving walls, helping carry the load. As an AHEC sponsored project the tulipwood comprise in all 27.6m3 of lumber from deepest Middle Tennessee. Prior to finally arriving on site, the material had made a roundabout journey, container shipped across the Atlantic to Aichach, Southern Germany. In Aichach - known in CLT circles as the Bavarian town where the first CLT buildings were built – it is tested, graded and prepared by the Austrian timber transnational, Züblin and once ready, loaded onto an artic and sent on its way, bound for Oldham.                  

with CLT walls (Photo’s FCBStudios)
Bath’s Dyson Centre for Neonatal Care 

A normal travel itinerary in the world of industrial timber logistics, Maggies Oldham reflects a relative cautious advocacy of natural materials within a sustainability agenda, which, if compared to the more radical materials advocates, hugs closer to the centre ground. But in hospitals and healthcare design, Maggies Oldham is a radical departure. Laura Lee, Keswick-Jencks’ nurse and now the Maggies Centres chief executive observes how “each project is a fresh application you learn something from everything you do.” For the NHS mainstream to specify wood inside many parts of its infrastructure is riddled with the complications of health risks, and the need for super-hygienic surfaces. Any move to introduce natural materials would make the environment that patients, staff and visitors stay and work in, that much less sterile and clinical. As far as CLT is concerned, to date there has been hardly any use within the NHS; the only example I know of, is FCB Studio designed Neonatal Unit within the Royal United Hospital in Bath.

For its part, Oldham is an inspirational meeting space between what sustainable design theorist, Jonathan Chapman, calls ‘emotionally durable design’ and the architecture of hope. As a visitor, I felt that the building expressed the design ethos at the heart of dRMM, sensitive and careful in its concerns, while taking the next step in its introduction of natural materials and the place of nature at the centre of the project. Though de Rijke has endured a hellish time, it isn’t difficult to imagine that given the opportunity he could well build on Maggies Oldham, and come to contribute significantly to the transformation of the NHS design ethos, and the future of its built estate, small and large. A NHS embracing natural materials; that is something to behold! It is also for the future. In the meantime Oldham is a refuge and a beacon, highlighting the hope wood expresses, a physical embodiment of the tenderness of timber. OL

This piece was supported by AHEC’s funding of this Unstructured edition.

Photo Tony Barwell