Cicely Saunders: letting people at the end of life finish with dignity

In the winter of 1948, in a late-stage cancer ward in a London hospital, a young nurse was caring for a Polish-Jewish refugee.

His name was David Tasma, in his thirties, in the final stage of cancer, with not much time left. The ward was full of people coming and going; doctors were busy saving the patients who might still be saved, nurses handed out pills and took temperatures on a schedule, and no one really sat down to ask him: are you in pain? Are you afraid? Is there anything you still want to say?

The nurse was Cicely Saunders. She sat by David's bed for months.

In someone's last days, what is needed most is not more machines. It is someone willing to sit down and hold their hand.

David became the turning point of her life. Before he died he left her a sum of money and said: Cicely, this is not for you. It is for the thing you are going to do.

That "thing" barely existed in medicine at the time.

In the middle of the 20th century, hospitals treated dying as a failure. The doctor had not saved the patient. The family did not want to talk about it. The patient was put in a small room at the end of the hall. Painkillers were given "as needed" — only when the pain became unbearable. No one treated "leaving well" as a real medical task.

Cicely made up her mind to change it. At thirty-nine she went back to medical school, qualified as a doctor, and then spent another fifteen years fundraising, writing applications, one by one, until she opened a small hospital on the edge of London — St Christopher's Hospice.

That was 1967.

This hospital was like no other of its time. The goal was not "cure" — it could not cure. The goal was: let the patient not be in pain, not be alone, and remain, in their last days, a person who is treated as a person.

Doctors gave painkillers on a schedule, not waiting for the patient to beg. Nurses sat by the bed and listened to their life story. Chaplains, social workers, volunteers came together to help them finish the last things on their list — meeting an old comrade once more, writing a letter to a grandchild, or simply sitting in the garden in the sun.

Medicine cannot stop death, but it can change what death looks like.

Out of this small hospital on the edge of London, Cicely developed the whole approach that came to be called hospice. Over the following decades, that method spread from that small building to the whole world. Today, in Britain, America, Japan, China, countless hospices and palliative wards can trace their origins back to that small house in 1967.

She lived to eighty-seven. Before she died in 2005, she moved into the St Christopher's she had founded. In her own last days, she was cared for by nurses she herself had trained, using methods she herself had invented. She told the people around her: you see, this thing really works.

She often said: "You matter because you are you. You matter to the last moment of your life." That line is now on the wall of hospices around the world.

Real charity is not how much money you give to living people. It is how well the people who are about to leave are treated, at the end.