Dame Cicely Saunders
DBE, Order of Merit, FRCN
Dame Cicely Saunders, a Fellow of the Royal College of Nursing, died on 14 July, aged 87, in St Christopher's Hospice, the ground-breaking London hospice she founded in 1967.
St Christopher's was undeniably Britain's first modern hospice for the dying, and has since become the model for organisations throughout Britain and in 95 countries round the world. Indeed, through her inspirational leadership and enlightened approach to palliative care, Dame Cicely is universally recognised as the founder of the worldwide hospice movement.
Cicely Saunders was born in Barnet on 22 June 1918, into a prosperous but unhappy family. Shy and awkward, she was sent to Roedean School when she was 10 and it was there, she said, that she developed a life-long affinity with outsiders. She also had a troublesome back and, although she had wanted to be a nurse, she went instead to Oxford, where she read politics, philosophy and economics.
When war broke out she enrolled, despite her parents' objections, as a student nurse at St Thomas's Hospital, London. She was considered an outstanding nurse in all respects, but after an operation failed to alleviate her back pain, her surgeon advised her to quit. She then trained as a social worker, or what was quaintly called a "lady almoner", gaining the Diploma in Public and Social Administration and qualifying in 1947.
Finding her vocation
As an almoner, working at Archway Hospital in 1948, she cared for a dying Polish Jewish émigré called David Tasma, with whom she developed an intense spiritual relationship. He had few friends and no family, and the only consolation for him was the loving care she gave him.
To realise their shared vision of establishing a place where dying people could live out their final days in peace and dignity, he left her £500 - all he had and a lot of money in those days - although it would be almost 20 years before her dream found substance in St Christopher's Hospice at Sydenham in southeast London.
Following Tasma's death she continued as an almoner but worked as a volunteer sister at St Luke's Hospital, a home for the dying in Bayswater. Convinced that doctors were deserting the dying, but knowing that people would not pay attention to her as a nurse, she applied and was accepted, aged 33, as a medical student at St Thomas's Hospital.
"Constant pain needs constant control"
After qualifying, she obtained a research scholarship at St Mary's Hospital, Paddington, and studied pain management in terminal illness. She also began working with the nuns at St Joseph's Hospice to help them improve their standard of care.
At a time when patients were normally made to wait until their pain was unbearable before receiving relief, she introduced the "constant pain needs constant control" system she had developed at St Luke's. She also recognised that reducing fear and anxiety reduced their physical pain as well, a revolutionary concept in those days. She said, famously, that there was no such thing as intractable pain, though she had met intractable doctors.
Newly qualified, Dr Saunders now devoted herself to founding a hospice. In late 1959 she drew up a proposal outing the structure and named it after St Christopher, patron saint of travellers. It would take another eight years of tireless planning, writing, fund raising and rallying support before the first patient was admitted in 1967.
Many years ago, asked about the prospect of her own death, she said she would hope for a sudden death but would prefer to die - as she has done - with a cancer that gave due notice and allowed the time to reflect on life and to put one's practical and spiritual affairs in order.
As she said: "You matter because you are you, and you matter to the last moment of your life."
May she rest in peace.