Dame Cicely Saunders, who went to school in Brighton, pioneered the modern hospice movement. On what would have been her 105th birthday, we discover more about the extraordinary woman who revolutionised end-of-life care
Among the well-to-do girls receiving instruction at Roedean, Cicely Mary Strode Saunders cut an imposing figure. At 6ft tall and shy, she was already, at 14, formidably intelligent.
Roedean was not her choice of school, and she was furious at being sent there without being consulted. ‘In a sense, I was an outsider which was good for me in that being unpopular when you are young gives you a feeling for others who feel like they don’t belong,’ she said. Nevertheless, her schooldays in Sussex sowed the seeds for her later accomplishments as the woman who revolutionised care for the dying, the birth of the hospice movement and the importance of palliative care in modern medicine.
For a woman of such impressive accomplishments, she was very humble. She told Thames Television in a 1983 interview that after she left school, ‘I was really floundering a lot.’ After initially being rejected, she went to St Anne’s College, Oxford in 1938 to read philosophy, politics and economics with the vague idea of becoming secretary to an MP.
But when war broke out in 1939, Cicely decided she wanted to be useful and – despite fierce opposition from her family – began her nurse’s training at the Nightingale School at St Thomas’s Hospital in London.
Here, she felt that she had found her calling. ‘Cicely was happy – marvellously happy,’ writes her biographer, Shirley du Bourlay. ‘For the first time she was the popular girl, the one whose opinion was sought, who had friends, who was successful. She slotted into nursing… like a book finding its right place on the shelf.’ It came as a bitter disappointment when an injury to her back ended her nursing career just as she was completing her training in 1944.
Cicely knew by now that being with patients is what made her happy, so she returned to Oxford to finish her studies while also attaining a diploma in Public Health which enabled her to become a medical social worker at St Thomas’.
A seismic encounter followed when she became involved with the care of David Tasma, a 40-year-old Polish-Jewish refugee, who, having escaped from the Warsaw Ghetto, had been working as a waiter in London. David had terminal cancer and was suffering from what Cicely would later describe as ‘total pain’ which included psychological, social, emotional and spiritual distress as well as the physical sensations of illness.
David spent the last months of his life in a busy surgical ward because there wasn’t anywhere else for him to go. Cicely would sit and read to him and told him about her ambition to build a dedicated facility for the dying. When he died, he left her £500 (around £19,000 today) ‘to be a window in your home’. When St Christopher’s Hospice in Sydenham opened in 1967, a large, plain glass window was dedicated to David with a small brass plaque.
By this time, Cicely started volunteering as a nurse at St Luke’s Hospice for the Dying Poor, where she found patients receiving dedicated nursing care and some pain relief, but without the benefit of professional medical guidance.
She wanted to change that but a Harley Street surgeon warned her to do so she would need to train as a doctor herself. ‘It is the doctors who desert the dying,’ he said. Cicely described her medical studies as ‘quite a plod, when you’re in your thirties,’ but she qualified in 1957 and immediately applied for a research grant which allowed her to study pain management of the terminally ill at St Mary’s Hospital in Paddington.
At the same time, she was working St Joseph’s Hospice, Hackney, run by the Roman Catholic Sisters of Charity where she helped the nuns improve their standard of care and introduced a more efficient standard of record-keeping. There, in 1960, she met Antoni Michniewicz, another Polish patient with who she developed a close relationship and whose death, shortly before that of her father Gordon Saunders, ushered in a period of deep mourning.
Nevertheless, Cicely’s considerable energies now focused themselves on campaigning for improved care of the dying. She wrote six well-received articles for the Nursing Times and prepared a thorough proposal for a 60-bed dedicated hospital for the dying which would be called a hospice and would provide care, teaching and research.
While touring the UK and United States she discovered a hitherto-undiscovered talent for fundraising – perhaps inherited from her father, a highly successful estate agent – and built a network of international medics interested in being part of this palliative care revolution.
In 1963, Cicely met a third Polish man, artist Marian Bohusz-Szyszk. She admired his work and bought some of his paintings. As a devout Catholic, long separated from his wife, Marian wasn’t able to marry Cicely until after his wife died in 1975. They married in 1980, the same year Cicely was made a Dame.
Before that she focused on her work. St Christopher’s Hospice had opened in 1967, the first modern hospice in the UK, followed by others including, in 1973, St Barnabas House in Worthing. It had been the brainchild of Dr ‘Gus’ Gusterson, a consultant at Worthing Hospital who had launched the appeal to build the home in March 1968. Cicely had attended the event at Worthing Assembly Hall and told the audience: ‘The work among people in advanced stages of illness is not sad, depressing work – it is incredibly satisfying. What these people want is relief from pain and distress, comfort and compassion. They need longer-term nursing than can be given in a busy general ward.’
At the meeting, Dr Gusterson remarked: ‘I am told this is a bad time to launch an appeal. Everybody is worried about their standards of living. What I am hoping to interest people in is other people’s standards of dying.’
It took Dr Gusterson five years to raise the £183,107 needed to build the hospice on Columbia Drive. Now, 50 years later, St Barnabas House has cared for more than 45,000 patients and their families. In 2011, after years of hard work and fundraising, the hospice moved to a new site on Titnore Road.
In a 1999 interview published in the New York Times, Dame Cicely said: ‘Everybody else says they want to die suddenly, but I say I'd like to die of cancer, because it gives me time to say I'm sorry, and thank you, and goodbye.” She died of breast cancer at St Christopher’s in 2005 aged 87. She remains an inspirational figure in the medical community, and her legacy has improved so many lives – from those in their last days to the people they left behind.
www.stchristophers.org.uk/about/damecicelysaunders
St Barnabas House: www.stbh.org.uk/50-years
Dame Cicely was my inspiration
Rachel King, Head of Clinical Services at St Barnabas House
‘Dame Cicely inspired me to be a palliative care nurse more than 10 years ago. Her ethos, her words, and her determination to provide outstanding palliative care still inspire me every day.
The needs of our patients and their loved ones are ever-changing and increasingly complex and the way we deliver hospice care is evolving with the needs of our community. Our drive to support people to die peacefully – but also to live until that point – remains as strong as ever.
Now I am in a senior leadership position where I can shape and influence hospice care, Dame Cicely's passion to continue to improve, innovate and research continues to inspire me – as did her refusal to accept the status quo.’
