Honoured People in Palliative Care around the World

Cicely Mary Strode Saunders 1918-2005 [Новость добавлена - 04.04.2009]

That follows is a copy of the tribute given by Dr Robert Twycross, Emeritus Clinical Reader in Palliative Medicine, Oxford, at Cicely Saunders' Memorial service, held in Westminster Abbey, London on 8th March 2006.

 

 

 

Dame Cicely Saunders

She said:
‘You matter because you are you,
and you matter to the end of your life.
We will do all we can not only to help you die peacefully,
but also to live until you die.’

I first met Cicely in 1963 in Bristol at a Student Christian Movement Conference. I was a medical student; she a qualified doctor. It was truly a ‘fate-full’ meeting because it determined the direction of my medical career. Things would have been very different for me if I’d never met Cicely. I owe her a great debt of gratitude for what she did for me then, for later appointing me as Research Fellow in Therapeutics, and for her continued support ever since. A small part of repaying my debt is the opportunity to honour her here today.

Cicely said, ‘I did not found hospice; hospice found me.’ But, no matter what she said, the obituaries were unanimous: Cicely Saunders was the Founder of the modern hospice movement, of palliative care:
   ‘She transformed the way we look at death and dying.’
   ‘She transformed the care and treatment of the terminally ill.’

Cicely the person

So what was Cicely like as a person? It is said that she was an awkward misfit at school. However, as a student nurse at St Thomas’ Hospital, she was the popular girl, and was very happy. She felt she’d ‘come home’. But, even so, she had to fight a natural shyness, and her student ward reports were not all good. But, that was long ago. More recently, one visitor described her surprise on meeting Cicely:
‘I expected someone gentle, and was struck by her dynamism and force of character. This was clearly someone who had battled.’
And on hearing that someone had observed a look of love and steel in her picture in the National Portrait Gallery, Cicely is reputed to have said:
‘Love and steel, how kind. Anyone doing hospice work will need plenty of both.’
Yes, Cicely certainly possessed both love and steel – compassion and determination.

How else could she have coped as a student nurse with chronic back pain?
Coped with the need to start all over again as a Social Work student?
Coped with the need to go to Medical School because only as a doctor would she be listened to by doctors?

Then, in the early 1960s, she suffered a series of bruising bereavements. Cicely was definitely ‘a wounded physician’, who was thus enabled to sympathise with and support the patients and families who came under her care.

St Christopher’s Hospice

The opening of St Christopher’s Hospice in 1967 was a major milestone in Cicely’s life. It was almost 20 years after she had first decided to build a special Home for people with terminal illness. People like David Tasma, a dying Polish émigré, who in 1948 had left Cicely £500 so that ‘I can be a window in your Home’.

To describe the difference St Christopher’s Hospice has made, and continues to make, to thousands of patients and families, let me quote - necessarily briefly - from a letter written in 1972 by a grateful relative:
Dear Dr Saunders
I would like to write to you and attempt to express something of the gratitude and admiration that I feel for St. Christopher’s. In saying this I realise that St Christopher’s is not just a building, but a way of living – an attitude towards people, their life and their death – that is so remarkable. During those weeks which I spent with my father, and with you, it did seem very remarkable that the vision of one person, who had responded to a need, could be caught and sustained by so many others; so that the vision became a reality and the reality perpetuates itself creatively.

Cicely the professional

Cicely was a tireless ambassador for the cause, and others – too many to name - joined her in the task. The cause was greatly helped in the 1980s when the World Health Organisation introduced its Cancer Control Programme, which emphasised both pain relief and palliative care.

Cicely was an inspirational teacher. Her teaching model of ‘total pain’ took people, almost without effort, from a narrow physical outlook to a holistic approach in which the unit of care is the family. Cicely disparaged ‘tender loving care’; she championed ‘efficient loving care’ in which attention to detail is the constant watchword.

In the 1960s, Cicely prepared a 4-page handout for her lectures. Now, as befits a full-blown medical specialty, the handout has been superseded by the 1244 pages of the multi-authored Oxford Textbook of Palliative Medicine, and by numerous other books. But whether just 4 pages or 1244, the core message remains the same: ‘You matter because you are you’.

Cicely’s autobiography

Many of us have read Cicely’s biography. I wonder how many have read Cicely’s autobiography? It is a slender volume entitled Watch with me, and contains 5 reflective articles written and delivered over a span of 40 years. The last talk, Consider Him, is dated 2003. In little over 10 pages, Cicely recounts the salient points on her pilgrimage through life, and tells again the constant inspiration of her faith. She quotes from a book by one of her favourite theologians:
‘The crucified Jesus is the only accurate picture of God that the world has ever seen, and the hands that hold us in existence are pierced with unimaginable nails’.
She believed that, and I believe that. Indeed, it is clear from her writings, and from her diaries, that her faith was a major, possibly the major, force in her life which sustained her through thick and thin. To ignore this would be to ignore a major source of her resilience and dedication.

In summary

Cicely was a friend, colleague, mentor, teacher or carer to hundreds, indeed to thousands.
Cicely was an inspiration to thousands, indeed to hundreds of thousands of nurses, doctors, and other health professionals in Britain and elsewhere.
Cicely didn’t just talk the talk,
she walked the walk.
She stayed the course, and in doing so she changed the world,
and is changing it still.
Although physically she has left us, her vision lives on.

To honour Cicely, we too must not just talk the talk,
but, like her, we must walk the walk,
and stay the course, and continue the task of changing the world.
Fear of death is instinctive,
so the task is unending.
For each new generation, the same battles to fight and to win.

May it please God to allow Cicely’s mantle to fall on us collectively as we honour her as the founder of the modern hospice, as the founder of palliative care – and also as the one who was found by hospice.

With kind permission of Dr Robert Twycross

 The original article see at http://www.eolc-observatory.net/history/cicely.htm