'What have I got to do to say thank you and to serve?' These words, spoken by Cicely Saunders, led to the founding of St Christopher's Hospice 50 years ago.It is generally accepted that this was the beginning of the modern hospice and palliative care movement.
Cicely had gone up to Oxford to read politics, philosophy and economics. The war started and she felt it was wrong to be studying books when there was practical work to do. So, much to the displeasure of her parents and college principal, she left Oxford. She enrolled at St Thomas's Hospital and started her nursing training there in 1940. She loved the work and felt that she had found her vocation. However, her long-standing back trouble worsened and she was told that she couldn't continue nursing. But she wanted to remain close to patients so she retrained as a medical social worker.
In the summer of 1945, Cicely chose to go on holiday with a group of Christian friends. She had previously called herself an atheist but circumstances in the family and in her own life led her to seek a living faith. She had started reading, especially CS Lewis,and in the company of her friends, she came to accept she should come to God 'just as I am'. She said later that 'God turned me round and it was all right. It was for all the world like suddenly finding the wind at your back instead of battling against it all the time'. This was the experience which led Cicely to ask God to show her his purpose for her life. She waited two years for the answer when she met the young man who was to change her life. David Tasma was a Polish Jew who had escaped from the Warsaw ghetto and was working in London as a waiter. All his family had perished in the Holocaust. Cicely became his only friend and they talked a great deal about his needs which were not being met. His physical pain was poorly controlled with intermittent injections of analgesics. He was desperately lonely and dying after what he felt was a useless and unfulfilled life. He had been brought up a Jew but no longer knew if he believed in God.
Cicely later described the total pain experienced by the dying consisting of 'physical, emotional, social and spiritual pain'. She learnt this at David's bedside. It was as they talked that there came to them both a vision of a better way to care for the Davids of the future. And when he died, he left Cicely all the money he had,£500, with the words 'I will be a window in your home'.
During the next two years, Cicely sought to test her vocation by spending time with dying patients, but this did not satisfy her. She discussed her calling with the surgeon she worked for. 'Go and read medicine', he said. 'It is the doctors who desert the dying'. Cicely was by now 33 and had not studied science at school but she was accepted at St Thomas's for 1st MB.
I joined her for the clinical course in 1954 and we came to know each other well as we were members of the hospital Christian Union. Remarkably, no fewer than five of us became hospice doctors at a time when there were almost no hospice doctors in the world.
After qualifying and house jobs, Cicely knew that she needed to understand more about pain control in the terminally ill. So she obtained a scholarship to do research in this field and worked with the patients at St Joseph's Hospice. Her work showed that, with regular giving of analgesics, the widespread fear of addiction was unfounded.
On 24 June 1959, Cicely was reading Daily Light, a collection of Bible texts. That day she read: 'Commit thy way unto the Lord and he shall bring it to pass'. She knew with complete certainty that this was the time to do something practical about the vision that had motivated her for eleven years. She gathered around her a group of people who advised her, raised funds and prayed. In 1961 she launched the charity and started looking for a site. This was found in Sydenham, the money came in and the hospice with 54 beds was opened by Princess Alexandra on 24 July 1967. David's window was in a prominent place.
During these 50 years there has been an enormous increase in interest around end of life care. When I joined Cicely in 1968, she gave me a double-sided sheet of A4 saying that this was the symptom control I needed to know! This has grown into the Oxford Textbook of Palliative Medicine and much more. A great deal of research has been undertaken including comparing analgesics,studying clinical and psychosocial problems and service delivery.The movement has spread worldwide. There are now 200 hospices in this country and 16,000 units worldwide, including many in poorer countries.
Most people in this country will, by now, have some acquaintance with hospice and palliative care. Unfortunately, few seem to know the story behind them and that they came about because of the calling of God to an individual, Cicely Saunders.
Mary Baines is Emeritus Consultant at St Christopher's Hospice.
further reading
Du Boulay S, Rankin M. Cicely Saunders: The Founder of the Modern Hospice Movement. London: SPCK, 2007
Cicely had gone up to Oxford to read politics, philosophy and economics. The war started and she felt it was wrong to be studying books when there was practical work to do. So, much to the displeasure of her parents and college principal, she left Oxford. She enrolled at St Thomas's Hospital and started her nursing training there in 1940. She loved the work and felt that she had found her vocation. However, her long-standing back trouble worsened and she was told that she couldn't continue nursing. But she wanted to remain close to patients so she retrained as a medical social worker.
In the summer of 1945, Cicely chose to go on holiday with a group of Christian friends. She had previously called herself an atheist but circumstances in the family and in her own life led her to seek a living faith. She had started reading, especially CS Lewis,and in the company of her friends, she came to accept she should come to God 'just as I am'. She said later that 'God turned me round and it was all right. It was for all the world like suddenly finding the wind at your back instead of battling against it all the time'. This was the experience which led Cicely to ask God to show her his purpose for her life. She waited two years for the answer when she met the young man who was to change her life. David Tasma was a Polish Jew who had escaped from the Warsaw ghetto and was working in London as a waiter. All his family had perished in the Holocaust. Cicely became his only friend and they talked a great deal about his needs which were not being met. His physical pain was poorly controlled with intermittent injections of analgesics. He was desperately lonely and dying after what he felt was a useless and unfulfilled life. He had been brought up a Jew but no longer knew if he believed in God.
Cicely later described the total pain experienced by the dying consisting of 'physical, emotional, social and spiritual pain'. She learnt this at David's bedside. It was as they talked that there came to them both a vision of a better way to care for the Davids of the future. And when he died, he left Cicely all the money he had,£500, with the words 'I will be a window in your home'.
During the next two years, Cicely sought to test her vocation by spending time with dying patients, but this did not satisfy her. She discussed her calling with the surgeon she worked for. 'Go and read medicine', he said. 'It is the doctors who desert the dying'. Cicely was by now 33 and had not studied science at school but she was accepted at St Thomas's for 1st MB.
I joined her for the clinical course in 1954 and we came to know each other well as we were members of the hospital Christian Union. Remarkably, no fewer than five of us became hospice doctors at a time when there were almost no hospice doctors in the world.
After qualifying and house jobs, Cicely knew that she needed to understand more about pain control in the terminally ill. So she obtained a scholarship to do research in this field and worked with the patients at St Joseph's Hospice. Her work showed that, with regular giving of analgesics, the widespread fear of addiction was unfounded.
On 24 June 1959, Cicely was reading Daily Light, a collection of Bible texts. That day she read: 'Commit thy way unto the Lord and he shall bring it to pass'. She knew with complete certainty that this was the time to do something practical about the vision that had motivated her for eleven years. She gathered around her a group of people who advised her, raised funds and prayed. In 1961 she launched the charity and started looking for a site. This was found in Sydenham, the money came in and the hospice with 54 beds was opened by Princess Alexandra on 24 July 1967. David's window was in a prominent place.
During these 50 years there has been an enormous increase in interest around end of life care. When I joined Cicely in 1968, she gave me a double-sided sheet of A4 saying that this was the symptom control I needed to know! This has grown into the Oxford Textbook of Palliative Medicine and much more. A great deal of research has been undertaken including comparing analgesics,studying clinical and psychosocial problems and service delivery.The movement has spread worldwide. There are now 200 hospices in this country and 16,000 units worldwide, including many in poorer countries.
Most people in this country will, by now, have some acquaintance with hospice and palliative care. Unfortunately, few seem to know the story behind them and that they came about because of the calling of God to an individual, Cicely Saunders.
Mary Baines is Emeritus Consultant at St Christopher's Hospice.
further reading
Du Boulay S, Rankin M. Cicely Saunders: The Founder of the Modern Hospice Movement. London: SPCK, 2007
