THE Great Lesson Dame Sicily Saunders Teaches about Hospice Ministry

. It was at a conference entitled "Empathy, Altruism and Agape: Perspective on Love in Science and Religion – A Research Symposium," she gave the evening dinner talk, entitled "Why I Can Never Retire." She pointed out that while she was 83 years of age, she still goes into St. Christopher’s hospice in London every morning and changes bedpans for an hour with the nurses before spending at least several hours sitting on the ends of beds and listening attentively to dying individuals as they might wish to speak of their lives and situation. She said that attentive listening is a form of love, and it makes people feel that their lives are significant, even if there is just a short while left before they pass on. Dame Cicely always included chaplains and pastoral care on her hospice teams, and that became the model worldwide as she trained all the leaders of the modern hospice movement. She stated with some emotion that while “In the nursing and social work text books they talk about me as the woman who founded hospice, they talk about what I did, but not why I did it. I did it for God and to help dying people to be absorbed in God’s love.” Dame Cicely often spoke of compassion. What does “compassion” add to “care”? It adds an element of stronger affective response and deeper awareness of the concrete reality of the patient’s “illness” experience. Bernard Lown, MD, one of the greatest cardiologists of our time, the inventor of the defibrillator, and recipient of the Nobel Peace Prize for founding and developing International Physicians for the Prevention of Nuclear War, wrote a classic book entitled The Lost Art of Healing: Practicing Compassion in Medicine (Houghton Mifflin, 1996, Ballantine Books, 1999). It is a powerful statement about how compassionate care, often in the form of attentive listening, creates a “healing relationship” with patients that improves diagnostic clarity, patient outcomes, patient adherence with treatment, and brings immense gratification to the professional as well. It also makes healthcare systems successful. In our system of hospice care, each of us is personally responsible to nurture a culture of compassionate care in which: • patients will not experience humiliating insensitivities or rudeness, but rather compassion, respect, hospitality and attentive listening; • interactions with patients are uniformly recognized as having the significance of any other important clinical intervention; • physicians, nurses and all staff will find patient care more gratifying and meaningful; and, • benevolent and respectful interactions between members of the healthcare team will be understood as establishing the secure base from which the compassionate care of patients unfolds. There is a beautiful passage in the book of Isaiah, chapter 35, verse 1, “The desert shall rejoice and blossom like a rose.” Let your work be guided by this idea. Patients and families experience many deserts, burning deserts, scorching deserts that leave them empty of meaning, empty of content, empty of substance. Help them to sing Hallelujah in a new key, and to be witnesses to the transforming power of love. When you are in the desert, plant a rose… a rose of peace, a rose of reconciliation, a rose of faith, hope and love. And the desert will blossom. You, as a clinician, will blossom, patients will blossom, whole hospitals and facilities and homes will blossom. And as the Psalm reads, “Those who refresh others will themselves be refreshed.” Never forget that the affirmation of the patient’s significance is profoundly important in times of severe illness. In the words of E.E. Cummings: “We do not believe in ourselves until someone reveals that something deep inside us is valuable, worth listening to, worthy of our trust, sacred to our touch.”