Cicely Saunders and ‘Watch with Me’

—At Cicely Saunders’  Memorial Service, which took place in Westminster Abbey in March 2006, Dr Robert Twycross  gave the eulogy. Like others I was surprised to hear him say: ‘Many of us have read Cicely’s biography. I wonder how many have read Cicely’s autobiography? It is a slender volume entitled Watch with Me, and contains five  reflective articles written and delivered over a span of 40 years.— The last piece, Consider Him, is dated 2003. In little over 10 pages, Cicely recounts the salient points on her pilgrimage through life, and tells again the constant inspiration of her faith’. It was a remarkable acknowledgement of the little book and seemed to inspire others to seek it out.

In 2008, the Milan based palliative care physician, Augusto Caraceni , together with colleagues,  produced an Italian edition. The next year, 2009, a Swiss pastor and postgraduate student Martina Holder-Franz translated it into German. Spring of 2011 on a glorious day in Majorca, saw the launch of the Spanish edition, translated by Marisa Martin, Susan Hannam, Carlos Centeno and Enric Benito. Towards the end of 2013 the Portuguese edition was published, translated by Francisco Galrica Neto and with revisions and a preface by Isabel Galrica Neto. There are now plans to bring out an edition in Latin America.  Watch with Me has been widely cited and well reviewed. Reena George, writing in the Indian Journal of Palliative Care described it as ‘a unique source of inspiration and information for anyone interested in palliative care’.  There is every chance that other editions and translations will appear in the future and I am always happy to help with any practical arrangements to that end.

     

Key themes of the book

Running through each of the five chapters of Watch with Me is the relationship between personal biography, the emergence of the spiritual life and a deep concern with the ethics of care.

The eponymous opening chapter is taken from a talk given at the AGM of St Christopher’s Hospice,  in 1965 –  two years before the hospice opened.  It is about foundations – material, practical and above all the foundations of care, taken from words spoken by Christ in the Garden of Gethsemane. It sums up the demands that will lie ahead – and the importance of ‘being there’. The second chapter, from 1974, is about faith and takes its inspiration from patients at the hospice. It also chimes with the mood of the day, quoting Tolkien’s metaphors of quest to demonstrate how, despite the worst adversities, ‘release comes unexpectedly and in the end all are seen to have played a part’. Faith, she says, can be about letting go as well as receiving with open hands.

‘Facing death’, the third chapter, was written for a Catholic journal in the 1980s. It is a reflective piece containing the distillation of decades of personal experience in caring for dying people:  ‘To face death is to face life and to come to terms with one is to learn much about the other’. ‘A personal therapeutic journey (chapter four) is a well known piece that first appeared in the Christmas edition of the British Medical Journal in 1996 and has been much enjoyed. It takes us to the wards of St Thomas’ Hospital in World War Two, to reflections on the armamentarium of the day (including the Brompton Cocktail) and then on to the path breaking concept of ‘total pain’, which she first described whilst working at St Joseph’s Hospice in the early 1960s.

The collection concludes wonderfully with ‘Consider Him’, where Cicely Saunders outlines for readers new and old the elements that make up her modern philosophy of care for those at the end of life – along with its sources, inspirations and dilemmas. She acknowledges that ‘Hospice and palliative care today is carried out by many people who find that religious answers do not speak to them. Nevertheless they give much spiritual help. When I asked our chaplain what was the real foundation for his work, he said simply brokenness‘.  She has traveled a long way in her thinking and beliefs from the beginning of the book where her main concern is to take a biblical text and apply it to the work of the hospice.  The journey is fully revealed in five short chapters and stands as a remarkable testimony to faith and work in the life of one person.

Continuing worth

Watch with Me is now out of print in English and hard-to-come-by second hand copies trade well above their modest initial price. Whether or not one shares its specifically Christian outlook (which I do not) its 50 pages still contain much to inspire those interested in the work of hospice and palliative care around the world today. It is also important as a link to the origins of a modern movement, which could all too easily disengage with its founding vision and ideals. To that extent some have called it essential reading for nurses, doctors and others who are training for work in palliative care. As I have found in writing this post, it also repays re-reading.

If there is interest I could perhaps find some way to put up an open access copy of the original English version.  If you are fortunate enough to have a copy already, take it out over the Easter weekend and explore the rich messages that Watch with Me still has to offer.

David Clark, 15 April 2014