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Dame Cicely Saunders OM DBE: founder of the hospice system.

Mary was born into a well-to-do family in Barnet, Hertfordshire in 1918; the last year of the First World War. In 1938 she became a student at Oxford University, but left in 1941 to enter St. Thomas' Hospital, in wartime London, as a probationer nurse--a 'Nightingale'. This was the era of the six day week for nurses, and night duty was a three month spell of 12 nights on duty and two nights off. Interspersed with all this was attendance at lectures and studying for the SRN.

Back trouble ended her nursing career in 1944. Saunders returned to Oxford, completed her degree, had a laminectomy and then returned to St. Thomas' as a lady almoner, as the medical social worker was called in those days. Her parents divorced and Saunders, an agnostic until then, converted to evangelical Christianity.

In 1948, Saunders began to work once or twice a week, in her spare time, at St. Luke's Hospital, one of the few in this country that provided terminal care for patients with advanced cancer. It had 48 beds. The nuns did not stick to strict protocol; a modified 'Brompton cocktail' was administered every four hours by mouth then, if necessary, by injection. Hyoscine was given for terminal restlessness.

Cicely Saunders decided that she needed to be medically qualified to continue her work; she realised that, in those days, professional people would not listen to a nurse or an almoner. She therefore entered St. Thomas' medical school in 1951, at the age of 33, and qualified MB, BS in 1957. She was now 39 and set to work in earnest.


By now there was a considerable increase in available drugs; steroids, antidepressants and chlorpromazine, and nerve blocks for pain were being developed.

From 1958 until 1965, at St. Joseph's Hospital, she developed the technique of 'total patient care' and coined the term 'total pain'. This involved not only relief of symptoms--pain, nausea etc,--but also the psychological, social and spiritual problems of the patient and the family. She learned important lessons from clinical trials--diamorphine had no advantage over morphine and, most importantly, that the administration of morphine in regular dosage before the pain appeared led to an actual reduction in the total daily dosage of the drug and to more effective pain control.

In 1967, she was able to open St. Christopher's Hospital in London, (named after the patron saint of travellers), the first modern hospice for terminal care, where patient care, teaching and research could be combined. It provided care for the whole patient and the family. She said to the patient 'You matter because you are you and you matter till the last moment of your life'.

The hospice is now world-famous; a centre for the training of doctors, nurses and other health care professionals from all over the world. In the 1960's Saunders made many trips overseas, especially to the USA, lecturing and teaching. The US Hope movement was founded in 1971. There are currently about 8,000 hospices world-wide, in 100 countries.

Honours poured upon her. In 1965 she was appointed OBE (Officer of the British Empire) and in 1979 this was advanced to a DBE and she became Dame Cicely. Finally, in 1989, she received the rare accolade from the Queen, of the CM, (Order of Merit). In 2001 Dame Cicely received the largest award for contributions to humanity, the Conrad Hilton Prize, worth 700,000 [pounds sterling], on behalf of St. Christopher's.

At the age of 71, Dame Cicely married a Polish artist, Marian Bohusz-Szysko, aged 79 and in poor health. He lived, painted and died at St. Christopher's and his paintings decorate its walls.

She herself developed cancer and died at St. Christopher's in 2005 at the age of 87; truly a remarkable woman in healthcare.

Provenance and Peer review: Commissioned by the Editor; Peer reviewed


Photograph reproduced with the kind permission of Cicely Saunders International Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ.

Professor Harold Ellis


Emeritus Professor of Surgery, University of London; Department of Anatomy, Guy's Hospital, London

by Professor Harold Ellis

Correspondence address: Department of Anatomy, University of London, Guy's Campus, London, SE1 1UL.
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Author:Ellis, Harold
Publication:Journal of Perioperative Practice
Geographic Code:4EUUK
Date:Jul 1, 2009
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