This post by Kate Binnie reports on a groundbreaking approach to creating space for reflection and conversation about respiratory ill health at the Chelsea Flower Show.
In communities disproportionately affected by deprivation and respiratory ill health, the legacy of mining and heavy industry, smoking-related disease, air pollution and occupational exposures (dust, chemicals) is compounded by healthcare inequalities and the inverse care law, whereby resources are often least available in areas of greatest need. For millions of people living with chronic lung conditions, the resulting breathlessness limits everyday life, undermining physical, psychological, social, financial and spiritual wellbeing.
Yet
breathlessness remains remarkably difficult to talk about. People living with
lung conditions often struggle to communicate their experience, while health
professionals may lack the time, confidence or psychosocial resources to treat
it as more than a lungs-and-brain "problem." Miranda Fricker
describes this as hermeneutical
injustice: "a significant area of experience obscured from
understanding owing to prejudicial flaws in shared resources for social
interpretation." In other words, when something cannot be communicated, it
may be rendered invisible.
This is a
phenomenon that my
PhD research explored. Among the 50 patients and professionals I
interviewed, experiences of shared understanding — what Hutchinson has called ‘Breathing Space’ were rare and challenging for all concerned within
systems of care that do not provide the space and time to explore the
breathless person's social, cultural and personal history. From a critical
realist perspective, my analysis indicated not only gaps in interpersonal
communication and at service level (epistemic injustices in themselves), but that
these gaps are generated and sustained by deeper and persistent social,
cultural and material conditions – what Alderson calls ’hostile
absences’.
The
Asthma + Lung UK Breathing Space garden, which has just won a silver medal
at RHS Chelsea Flower Show 2026, emerged as a creative response to these
experiences of restriction and absence. Drawing on findings from my research into
how mind-body interventions help people living with lung conditions, the garden
sought to embody their antonyms: space and presence.
Designed by
my partner Angus Thompson in collaboration with patients and staff at
the Breathing Space lung
rehabilitation centre in Rotherham — where the garden is currently being
rehomed — the garden is grounded in a
simple idea: when we create even
momentary conditions of safety and calm, the body can naturally find its own
way back to easier breathing.
Inspired by
the Japanese concepts of ma and yohaku no bi (the beauty of empty
space and time), Angus translated empirically grounded ideas from my research
into a design that reframes emptiness as possibility: a calm, green space in which space, choiceful
movement, reflection and connection become possible.
For us, the design team, the
most striking aspect of the Chelsea garden was the conversations it made
possible with hundreds (if not thousands, as 160,000 people visited the show
this year) of visitors. One of our volunteers handing out leaflets for Asthma + Lung UK reflected:
There
were people living with asthma, relatives of miners, and so many from
Rotherham, Sheffield and the surrounding communities. The garden seemed to
create an atmosphere of trust that encouraged people, especially men, to open
up and share deeply personal experiences. I honestly couldn't believe how
willing people were to connect and talk.
Design features such as the
oxygen cylinders supporting the Breathing Space platform, the 6:4 breathing
rhythm reflected in the fencing, the carbon-capture concrete, and the calming
effect of the planting acted as unexpected conversation starters. Visitors
frequently responded by sharing personal and family experiences of lung
disease, loss, caring, hope, meaning and recovery. Respiratory professionals
were equally enthusiastic, welcoming the rare visibility afforded to their
often underfunded speciality and asking when they, too, might have a Breathing
Space garden at their own hospital.
This matters because hermeneutical injustice is not only a problem of individual communication and epistemic asymmetry between patients and professionals in the clinical setting, but a problem of collective understanding which limits the potential of everyone concerned with lung disease. When experiences remain difficult to articulate, societies, institutions and healthcare cultures struggle to recognise, respond or make space for them. We were delighted that for one week at Chelsea, a carefully designed garden could become a site of shared interpretation in which conversations about breathing, breathlessness, recovery and hope could be expressed and understood in new ways.
The garden is now relocated at the Breathing Space lung rehabilitation centre in Rotherham, where many of the ideas that shaped its design emerged through conversations with patients, families and staff. The garden is now under the ownership of the local community and is beginning a new life beyond Chelsea.
Acknowledgements
The garden
was funded by Project Giving Back https://www.givingback.org.uk
for Asthma + Lung UK https://www.asthmaandlung.org.uk
Designed
by Angus Thompson https://www.angusthompsondesign.com
and built by Dan Flynn.
Sculpture
by Oliver Barratt https://www.oliverbarratt.co.uk
Rotherham
Breathing Space https://www.therotherhamft.nhs.uk/patients-and-visitors/our-sites/breathing-space
Author bio
Kate is an
HCPC registered music therapist with 20 years’ clinical experience in
palliative care, based in Oxford. In 2016, she completed an MSc
in palliative care from King’s College London funded by the Samuel Sebba
Scholarship. Kate is also a qualified yoga and mindfulness teacher
and works with people with chronic and life-limiting conditions and their
families into bereavement. She delivers training workshops for
clinicians at www.sobelleducation.org.uk, and she is a guest lecturer on the MSc in Palliative Care at KCL and on the UK’s first
PG training in Psycho-spiritual care at Oxford Brookes
University. After 5 years as senior research associate on the
Wellcome-funded Life of Breath project, Kate is now in
the final year of her part-time PhD at the Wolfson Centre for Palliative Care
Research at the Hull York Medical School funded by UKRI (i3) exploring the
relationship between emotion regulation and breathlessness in advanced
disease.
