“If you could have dinner with a person who has died, who would it be?” My reply to this popular icebreaker is always – Dame Cicely Saunders, founder of the modern hospice movement.
In every photo I have seen of Cicely Saunders, she looks like the church lady from Saturday Night Live. But while Cicely Saunders was a respectable Christian woman, she was also a total badass. Even though I only know her through interviews, lectures, and writings – she is one of my most influential mentors.
Cicely Sauders was born June 22, 1918 to a wealthy family in London. She grew up in a home that was characterized by tension and she did not fit in well at school. As a teenager her father once told her, “The problem with your feelings is that they need so much relieving.” (This quote is definitely best read with a British accent, and it sums up my teenage experience as well.) Cicely describes herself as floundering when she entered college at the age of 20. Not knowing what she wanted to do, she began studying politics, philosophy, and economics at Oxford University and figured she’d likely become a politician’s secretary.
However, despite the displeasure of her family and tutors, in 1940 she transferred to Nightingale Training School and became a wartime nurse. Cicely went on to care for wounded and dying soldiers before basic pharmaceuticals, like penicillin, were widely used and operation days were “a nightmare of vomiting patients”. Four years later a back injury forced her out of nursing. She then endured an invasive spine surgery, and returned to Oxford to complete her university studies. She graduated as a medical social worker, but in the evenings she continued to serve as a volunteer nurse at a small hospital that cared for the terminally ill.
Cicely Saunders early experiences in health care ignited her passion for advancing medicine, preserving patients’ dignity, and caring for the whole person (not just a diagnosis) at end of life. She began speaking out against the disinterest of the medical community in caring well for dying people and advocated for research to advance options for pain management. As her voice for dying patients grew stronger, she was told by a surgeon, “Because there’s so much more to be learned about pain and you’ll only be frustrated if you don’t do it properly. They won’t listen to you unless you’re a doctor.” So, in 1951 – at the age of 33 – Cicely Saunders enrolled in medical school. Seven years later, she became a doctor.
I have read a lot about Cicely Saunders and I haven’t found anything that speaks to her personal experience as an unmarried woman in medical school in the 1950s, but I imagine that there were significant gender barriers and social norms that she overcame. And so, for all of these reasons, when I see photos of Cicely Saunders warm face, I think to myself, “Total badass.”
Cicely did not grow up in a religious family. She found her lifework, as well as her path to faith through people. She was greatly influenced by C.S. Lewis, who was a professor of English literature at Oxford when she was a student. Cicely was mesmerized by his conversations with renowned theologians and philosophers. And she was inspired by his example that lay people could speak with knowledge and authority on topics beyond their realm of expertise, as well as integrate fields of study into their work that were outside of their scope of practice.
Because of this Cicely Saunders vision for the modern day hospice was not just rooted in her medical training. She integrated teachings from Julian of Norwich, Teilhard de Chardin, Viktor Frankl, and C.S. Lewis, with her personal experiences as a nurse and as a medical social worker, and her medical knowledge as a doctor to design our current hospice model. Cicely Saunders pioneered a medical practice that cares for the whole person rather than a diagnosis because she regarded the fields of psychology, theology, and philosophy as necessary as medicine for understanding the human body. Because one’s bodily existence is inseparable from one’s heart, mind, and soul.
Throughout her iconic career, Cecily Saunders was always learning from her patients. She trusted them and often looked to them for guidance.
“What our patients have been teaching us has much to say about ordinary living.” – Cicely Saunders, 1974
It was deep conversations with David Tasma, a lonely Polish man from the Warsaw Ghetto with advanced cancer whom Cicely befriended in 1947, that planted the seeds that grew into the modern hospice model. Together they dreamed about a medical specialty that could care well for the dying. Prior to his death David gave Cicely £500, with the encouragement “I will be a window in your home.” It was the first donation Cicely received towards her dream of opening a modern care facility for the terminally ill.
After many years of fundraising, planning, and education, Saint Christopher’s Hospice opened its doors in South London in 1967. Cicely often said, “It took me 19 years to build the Home around the window.” Her thoughtfully constructed care home for the dying was named after the patron saint of travelers because life itself is a journey, and we continue living our story until the moment of our last breath. The brilliance of Cicely Saunders hospice model is her presumption that dying people are still living and medicine should never give up on bringing aid to the living even when a disease is incurable. Because there is much that can be done to help people live as well as possible in the final months or days of their journey by managing pain, preserving dignity, and facilitating peace.
“I am quite certain that St Christopher’s has to learn to be a place where people do not let you down but instead give the feeling of reassurance and safety that comes from faithfulness. I think from this need especially stems the demand that we should grow into a real community. It is very important that we should be a group of people who have confidence in each other, and that St Christopher’s should be the kind of family and home that can give the welcome and hospitality of a good home, where people are accepted as themselves and can relax in security. It must also be a place where everyone knows that the individual contributions matter and that there is no hierarchy of importance in what gets done.” – Cecily Saunders, 1965
Cicely recognized that pain, agitation, and despair are not only caused by physical injury; they can also be evidence of emotional and spiritual wounds. The source is not always rooted in the physical body, but can be the manifestation of worry for family, broken relationships, unfinished business, and misunderstood theology. Therefore, care for the whole person – being mindful of the needs of the body, heart, mind, and soul – cannot be fully treated by one doctor. Proper care for the dying requires a team of professionals collaborating to achieve the patient’s goals at end of life.
“The whole approach has been based on the understanding that a person is an indivisible entity, a physical and spiritual being. The only proper response to a person is respect; a way of seeing and listening to each one in the whole context of their culture and relationships, thereby giving each his or her intrinsic value.” – Cicely Saunders, 1996
By Cicely’s direction, a dying person’s goals, wishes, and preferences – rather than a doctor’s informed opinion – create the basis for the plan of care. And then the needs of the patient are met by a team of healthcare professionals that includes a doctor, nurse, health aid, social worker, spiritual counselor, volunteers, and bereavement support. (The hospice I work for also includes Music Therapists on our patients care teams. This is a remarkable specialty that utilizes music as a therapeutic intervention to manage physical pain, stimulate memory functions in the brain, and more.)
“The body has a wisdom of its own and if you can manage to say yes to the ending of life almost in the same way you say yes to the other things that happen in life, then it can open up and the strengths and the possibilities of that time can be made more apparent.” – Cicely Saunders, 1983
In addition to redefining medicine for the dying, Cicely pioneered care for the bereaved as well. She worked closely with Elisabeth Kubler-Ross, (renowned psychiatrist and author of “The Five Stages of Grief”). They developed a fond partnership in advancing care for the grieving by collaborating on research, touring through the US to offer joint lectures, and supporting each other’s work. Cicely described herself and Elisabeth as “two blades of a pair of scissors” trailblazing the way for therapeutic bereavement care so that grief could be witnessed and processed openly with the necessary support of the medical and social communities.
“I don’t think you help people in anguish by coming in with easy answers…you come in to listen. And then with listening you often hear the strength that already lies within, and then we help them to see it.” – Cicely Saunders, 1983
In an almost poetic conclusion, Dame Cicely Saunders at the end of her remarkable life, was admitted to Saint Christopher’s Hospice with end stage breast cancer. She died in the care of the home she created on July 14, 2005. She was 87 years old.
“(Through death) we find our way in the freedom of the spirit. This with the challenge of openness from the symbol of (David Tasma’s) window, the match of all the diligence of the mind together with the vulnerability of the heart, these were the founding principles of hospice and palliative care and, I believe, still stand today.” – Cicely Saunders, 2003
Dame Cicely Saunders pioneered the hospice model of care, and Saint Christophers directly paved the way to the specialty of Palliative Care because she truly believed that “you matter because you are you, you matter to the last moment of your life”.
She was recognized for her accomplishments with numerous awards and honors including:
- Member of the Order of Merit
- Dame Commander of the Order of the British Empire
- Fellow of the Royal College of Surgeons
- Fellow of the Royal College of Physicians
- Fellow of the Royal College of Nursing
- Dame of the Order of St Gregory the Great (awarded by the Pope)
- Recipient of the Templeton Prize (the world’s highest-value annual prize awarded to an individual)
- Recipient of the Conrad. N. Hilton Humanitarian Prize (The world’s largest humanitarian award, which she accepted on behalf of St Christopher’s Hospice)
However, the ‘why’ that fueled her renowned work was never about personal recognition. She was motivated by her passion of caring for others and the need to improve systems. She had the ability to see things differently than her contemporaries, and the perseverance to stay committed to the challenging work that brings about change for the common good.
“Time isn’t a matter of length, it’s a matter of depth.” – Cicely Saunders
Like I said in the beginning. Total badass.
NOTE: quotes and details for this post were learned from the following sources. I encourage you to take a closer look to discover the inspiration offered by Cicely Saunders and her remarkable life:
- “Watch With Me” (collection of five lectures by Cicely Saunders)
- “Dame Cicely Saunders, Interview”, Thames Television, 1983
- “2001 Hilton Humanitarian Prize, Dame Cicely Acceptance Speech“
- “The Influence of Philosophy, Theology, and Spirituality in the Work of Dame Cicely Saunders“, recorded conversation between David Clark & Marina Holder-Franz
- “The Significance of Theology in the Life and Work of Cicely Saunders”, lecture by Marina Holder-Franz
- Cicely Saunders, wikipedia