Indian Journal of Palliative Care
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Year : 2004  |  Volume : 10  |  Issue : 1  |  Page : 24-26

'Watch with me': Essays by Cicely Saunders

Consultant in Radiation Oncology and Palliative Care, Christian Medical College, Vellore, India

Correspondence Address:
Reena George
Consultant in Radiation Oncology and Palliative Care, Christian Medical College, Vellore
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Source of Support: None, Conflict of Interest: None

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How to cite this article:
George R. 'Watch with me': Essays by Cicely Saunders. Indian J Palliat Care 2004;10:24-6

How to cite this URL:
George R. 'Watch with me': Essays by Cicely Saunders. Indian J Palliat Care [serial online] 2004 [cited 2021 Jan 27];10:24-6. Available from:

This book provides a fascinating insight into mind and motivation of the founder of the modern hospice movement. It is a collection of five essays written by Cicely Saunders over a forty-year period. David Clark's foreword describes the context in which these pieces were first written, provides an outline of Cicely Saunders's life, and invites us to think about the biographical and spiritual influences that shaped her.

Cicely Saunders was born in 1918. She started her university education in Oxford in 1938, but interrupted her degree to train as a nurse during the Second World War. A back injury forced her to discontinue nursing and she later qualified as a medical social worker. It was in this role, in 1947 that she met David Tasma, a Polish refugee with advanced cancer. Through their friendship and their discussions Cicely Saunders's vocation began to find shape. David Tasma left her with a challenge to self-giving 'I only want what is in your mind and in your heart' [1] and 500 pounds 'to be a window in your home'. [1] It was to be another nineteen years before St Christopher's opened.

During the intervening years Cicely Saunders equipped herself for her task. She worked as a volunteer nurse in a home for the dying and then in 1951, at the age of 33 started medical school. She tried to learn from her patients and to draw together those who would work with her. A painful encounter was to 'add authenticity to this search'[2] Antoni Michniewicz was a sixty- year old Polish widower admitted for terminal care in St Joseph's Hospice. Cicely Saunders and he fell deeply in love. He died three and a half weeks later. The pain of this bereavement was to last several years. There are only brief allusions to this experience in the first essay which was written within a few years of his death. A moving account of the relationship is found in the last chapter, 'Consider Him' written in 2003.

Interspersed through the book are phrases that encapsulate what Cicely Saunders wanted to do, 'To found a Home to meet the needs of symptom control and individual recognition at the end of life'[1] and how 'with the diligence of the mind and the vulnerability of the heart.'[3]

But perhaps most fundamental to Dame Cicely herself was the why of her vocation. She says at the outset, 'The most important foundation stone' for St Christopher's were the words 'Watch with me'[4] - (Christ's plea in the garden of Gethsemane on the lonely night before his crucifixion). These words resonate through all five essays and Dame Cicely reminds us that 'surely to watch with me could not have meant to take away or explain or understand…it simply meant be there.'[5] Her work to her, therefore, means a 'Coming together …above all with the creative suffering of God' [5] because 'death becomes a place where we trust God to preserve our relationship with Him and others.' [5]

Cicely Saunders accepts that many palliative care workers may not have a similar religious motivation for their work. It would still be true to say that the why remains important - be that in finding meaning in the poignancy of the present, or in the quiet hope of newness in the hereafter. 'To face death is to face life and to come to terms with one is to learn much about the other.'[6] And palliative care workers 'In doing so … have found themselves receivers rather than givers, gaining new strengths and insights from those they set out to help'[6] These themes of spirituality, meaning and mutual self giving run through the book.

Dame Cicely writes about the many patients whom she counts among her key teachers, 'When our own knowing Him seems so pathetically overwhelmed by lesser concerns, again and again we find inspiration in coming back to our patients.'[7]

She also offers us memorable descriptions of the physical, spiritual and psychosocial aspects of care:

'The sacraments of the cup of cold water and the feet washing'[8]

'Really looking (at the patient), … learning what this kind of pain is like, what these symptoms are like, and from this knowledge finding out how best to relieve them.'[9]

'We do not know why God allows this, but we do know what He will share it; and as He does so He will redeem and transform it.'[10]

'How to be silent, how to listen and how just to be there. As we learn this we will also learn that the real work is not ours at all.'[6]

The fourth chapter, 'A Personal Therapeutic Journey' provides the pharmacological angle to this palliative care history. We are told about the challenges of medical treatment in the 1940s and the subsequent arrival of antibiotics and other wonder drugs. Dame Cicely describes show she learned about the regular administration of oral morphine is St Luke's Hospital, London and then applied this in St Joseph's Hospice and St Christopher's. There is mention of the Brompton Cocktail and Robert Twycross's research into the efficacy of diamorphine versus morphine. With reference to research Cicely says 'Whatever happens it will still matter that we go on listening and that we continue our questioning.[11] Her own most lasting contribution to health care was the concept of total pain:

'…a complex of physical , emotional , social and spiritual elements. The whole experience for a patient includes anxiety, depression and fear; concern for the family who will become bereaved; and often the need to find some meaning in the situation, some deeper reality in which to trust.'[12]

The publishers are to be congratulated for selecting these important writings and making them available to a larger audience. The book will be a valuable addition to medical and general libraries; and a unique source of inspiration and information for any one interested in palliative care.

 » References Top

1.Saunders, C, Watch with Me, Mortal Press, Sheffield, 2003, p 40  Back to cited text no. 1    
2.Ibid p 43  Back to cited text no. 2    
3.Ibid p 41  Back to cited text no. 3    
4.Ibid p 1   Back to cited text no. 4    
5.Ibid p 48  Back to cited text no. 5    
6.Ibid p 28   Back to cited text no. 6    
7.Ibid p 10   Back to cited text no. 7    
8.Ibid p 39  Back to cited text no. 8    
9.Ibid p 2   Back to cited text no. 9    
10.Ibid p 15   Back to cited text no. 10    
11.Ibid p 35  Back to cited text no. 11    
12.Ibid p 34  Back to cited text no. 12    


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