Remembering Cicely after 10 years

On 23 June 2015, 120 people gathered at St Christopher’s to remember Dame Cicely Saunders to celebrate her life and many achievements ten years since she died at the hospice she founded.

“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”

Dame Cicely Saunders

Participants came from as far afield as the Shetland Isles and Uganda and ten renowned speakers shared some fascinating recollections of our founder, followed by an update on St Christopher’s current direction delivered by our Joint Chief Executive Shaun O’Leary and Heather Richardson and a thanksgiving service presided over by Spiritual Care Lead Dr Andrew Goodhead and St Christopher’s former Chaplain, Rev Len Lunn.

Speakers who were introduced by hospice trustee Dr Tyrrell Evans and led by Dr Mary Baines included Professor Irene Higginson, Dr Anne Merriman, Dr Colin Murray Parkes, Cicely’s Goddaughter, Rosemary Burch and Drs Tom West and Gill Ford, both of whom trained as doctors alongside Cicely Saunders.   Cicely’s love of music was demonstrated by some fine playing of the Lark Ascending by Damian Falkowski, the violinist and family friend who played at her funeral and that of her husband.

A number of those in the audience have sent us their reflections on Remembering Cicely;

Dr Nigel Sykes, former Medical Director, St Christopher’s

This was a unique gathering to remember a unique person. It was an event that covered a great span in time and also demonstrated the great breadth of Dame Cicely Saunders’ influence. Here were people who had known Cicely as a medical student, had heard her developing ideas about a new and better way to care for dying people and had seen her determination to put those ideas into practice, even if to do so took twenty years (which it did). I found myself sitting alongside two other recently retired hospice medical directors, all feeling rather senior, but the freshly told recollections of Cicely went back to the year of our birth.

From the perspective of a doctor working in palliative care, here, in a way unlikely to be repeated, were gathered the physicians who had worked with Cicely Saunders to build the foundations of the service we now recognise as St Christopher’s: Mary Baines, who set up the home care service, the first in Britain; Tom West, who worked alongside Dame Cicely as the hospice expanded and then succeeded her as Medical Director; Robert Twycross, who laid the foundations of the research that had been a part of the founding vision for St Christopher’s; Gill Ford, who in addition to directing the hospice’s education programme, played an absolutely key role in gaining acceptance of palliative medicine as a specialty, an achievement that has greatly facilitated the spread of palliative care in hospitals and its entry into official policies; Colin Murray Parkes, involved in the St Christopher’s project from even before the hospice opened, whose seminal work on psychological problems in bereavement is known worldwide but who also first showed that hospice care benefitted patients and families not only physically but emotionally too.

The afternoon was not just about how Cicely’s vision brought St Christopher’s into being. It also demonstrated just how far her influence has extended: beyond medicine into nursing and the whole multiprofessional team; beyond professionals, to be a greatly loved figure across her extended family; beyond her own country to be an inspiration to improve the care of the dying in Africa and across the globe; and beyond her own time to inspire through her original example the programmes of research needed in order to bring about continued improvements in palliative care.

Remembering Cicely was a very special event that in both speakers and audience brought together a rarely-assembled collection of people who knew and worked with her. All of them will have had their own memories stirred and, at the same time, learnt something new. Cicely herself should have felt honoured.

Dr Louis Heyse-Moore DM FRCP

Who could ever forget Cicely? I thought, as I sat in the audience listening to Dr Tom West, witty and pithy as ever; begin proceedings by remembering Cicely as a friend. Half an hour earlier I had walked the familiar route to St Christopher’s; but this was not quite the hospice I remembered. There had been change; rooms had morphed, contracted, expanded, moved, improved. Somewhat dizzy, I cautiously entered – to find I had stepped into the past. I met colleagues and friends whom I hadn’t seen for twenty years; it was so moving. And when the rememberings began, it was history relived: a gathering of the friends who had helped Cicely realise her dream.

No, I couldn’t forget Cicely: compassionate, thoughtful, charismatic, scalpel sharp, vulnerable and with the single-minded tenacity you need to be midwife to a worldwide movement. I wondered how she did it. We were told: it was a vocation, literally. God put his hand on her shoulder and asked. Well, no wonder then.

Cicely is rightly famous for her achievements but it was the small stories that touched me most: her personal friendships, the memories of her god-daughter, her early years at medical school, walking in the Scottish Highlands, her love of the poetry of Gerard Manley Hopkins, her attention to detail in the care of her patients. And there was, too, the cost, the times of loneliness and grief: the three Poles she loved and lost.

Of course my own memories surfaced: Cicely leading the Christmas carol crocodile through darkened wards lit only by candles; students from the Yehudi Menuhin school playing Bach Partitas on the wards at her invitation; Cicely in tears in a seminar as she remembered her dead father.

So we came to her dying, the last scene in a long life. I wondered what it was like for the staff of St Christopher’s to look after Cicely during her last illness; such a responsibility and such a privilege. They would have wanted to ensure that she had the best symptom control possible, that they were available to support her during times of fear or sadness, that her last wishes were met. Dr Mary Baines poignantly recalled going with Cicely to her flat to decide on giving away her clothes. One of Cicely’s favourite sayings was ‘Watch with me’, the last service we can offer a dying person. Surely this is just what Cicely’s carers, friends and family did during her last days and hours.

As Damian Falkowski played ‘The Lark Ascending’ by Vaughan Williams, chosen by Cicely for her funeral, and a beautiful metaphor for the journey of the soul to Paradise, I reflected, too, on the grief of all who worked at St Christopher’s at the loss of its founder and their inspiration.

Stephen Spender wrote of ‘The names of those who in their lives fought for life… And left the vivid air signed with their honour.’ A good epitaph I think.

Ref: Spender, S. I Think Continually of Those in: J.B. Foreman (ed.) Collins Albatross Book of Verse. London: Collins, 1960: 621.

Dr David Oliver, Consultant in Palliative Medicine, Wisdom Hospice, Rochester and Honorary Reader
University of Kent

Listening to the talks about Dame Cicely brought back so many memories.  I first came to St Christopher’s as a student on my elective in 1978 and spent a month working on the wards as an auxiliary and having the opportunity to see everyone at work.  Six years later I was back as registrar!

I have so many good memories of my two years at the hospice.  The team was so welcoming and I had the wonderful opportunity to work closely with Mary Baines and Tom West, both showing the various aspects of care and medicine for patients and families, both in the hospice and at home. The Grand Rounds were always a time of anxiety as the registrar would be expected to present a patient with complex needs and we were always concerned as to the reaction of Dr Saunders. However, I can remember that after all the discussion, she would bring a clarity and reality to the deliberations, focussing clearly on the patient and family.

When I had moved to be consultant at the Wisdom Hospice in Rochester I would return at times for Grand Rounds, where we could bring our issues. On one occasion I discussed a man who was refusing to leave his house, but his symptoms were getting worse.  There was discussion about the need for blood tests and investigations to elucidate the cause of these symptoms but at the end, Dr Saunders pointed out that if he was determined to stay at home, all we could do was treat according to our best judgement and investigations were never going to be a viable option.

I was also brought back to 1985 when several speakers talked of “the sherry”.  As a registrar on call on Sundays we were “summoned” to Dr Saunders’ office for a glass of sherry before lunch. After a busy morning seeing patients and families a large sherry was certainly a challenge – and trying to remain sober and upright when leaving her office a further challenge!

Dame Cicely was always very supportive and when we were expecting our second child during my first year at the hospice she provided books for my wife to read, as she was in Kings’ College Hospital for several weeks during a difficult pregnancy.  When Tom was born she sent him, not the parents! a card.  It was of a rainbow and inside was written “may you find your crock of gold”.

It was a privilege to be at St Christopher’s and work alongside Dame Cicely, who had such an impact on the care of the dying and modern medicine.

Richard Scheffer

Two words stand out from the recent day to remember the contribution of Dame Cicely: vision and leadership.

No-one who encountered Dame Cicely, no matter how peripherally, could not remember both her vision and her leadership. It was these qualities that time and again those reminding of us of their memories of Dame Cicely recalled – as a scientist, as a doctor, as “the boss”, but also as a friend, as a godmother, as an inspiration.   And woven into the day was a constant reminder of another important quality – that of Dame Cicely’s spirituality, her personal search for meaning and her expression of that through her faith.

I met Dame Cicely as a medical student in South Africa and, like all those present at this day of remembering, had being captured by her vision and excited by her leadership. We were a broad group that she influenced: nurses, doctors, social workers, chaplains, volunteers. All gathered to remember the woman and her remarkable effect, not just on our lives, but the countless numbers that each of us had cared for over our careers.

It is rare to be invited to a time of reflection on one’s career and although the day was focussed on Dame Cicely, inevitably, being back at St. Christopher’s, it became a time of reflection and remembering of one’s own experience of learning from such a charismatic person, together with great people, who shared their skills and experience with us so freely and generously. It was not always an easy nor a pleasant experience. Learning to be with, and support, those who are dying and their loved ones, while retaining ones personal equilibrium is painful at times. Everyone present had a story of how Dame Cicely had cared for and supported them through a difficult experience.

Each person I spoke to at the end of the day seemed to have had a similar experience to mine. I had remembered not just the difficulties of learning and growing but especially the excitement of the experience of excellence of care at St Christopher’s benefitting from Dame Cicely’s vision and leadership.

A truly remarkable day. Thank you.

Dr Fiona Randall

‘Although entitled ‘Remembering Cicely’, what impressed me most was that it was a day of giving thanks for her and all that she achieved, both directly and through the people she inspired by personal contact.

It was good to hear the different ways in which people knew her, each with their very personal insights into her character and great strengths. I recall how good it was to be together, especially at St Christopher’s, with so many old friends. It was great to see Mary, Tom and others who taught us so much. It was also moving to be among that group of us for whom palliative medicine became a possible medical career simply because of the work of Dame Cicely. Many of us were the first generation of doctors who pursued ‘palliative medicine’ as a first choice of medical career, even though there was no such specialty when we went to St Christopher’s to learn.

So what I will remember most from a personal perspective is a sense I felt, in the thanksgiving service on that day, of great thankfulness for what Dame Cicely gave me – the ability to follow a truly fulfilling medical career in the care of the dying, a career which used all of my ‘talents’ and energies, whilst rewarding so greatly at a human level. I also felt some sadness because of the thought that that group of people will probably not gather again, and it is likely that I will not see many of them again, since so many of us have retired.

Someone recently asked me if there is a ‘memorial’ to Dame Cicely. I explained that a physical memorial is not needed, for the real and living memorial is the work of the great many people she inspired, which work has changed patient care so very much for the better. And so many of those people gathered at St Christopher’s this June to remember, be thankful, and to celebrate together.’

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