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Still, death is a relentless presence and that can take a toll on the staff. Dame Cicely has helped create a system of team support, with doctors, nurses and social workers watching one another for signs of stress. "Sharing of grief is absolutely essential," says Psychiatrist Parkes. That goes for Dame Cicely as well. In her 21 years at St. Christopher's, more than 13,000 people have died, including her mother. "If death doesn't get to you, I doubt you should be in it," she admits, and in the past, she has consulted a psychiatrist for problems she experienced in recovering from a bereavement. But former Matron Helen Willans insists that since Dame Cicely was married for the first time eight years ago, "she has been a much happier person." She shows immense tenderness to her husband, bringing him to the hospice every day from their home nearby to paint in an upstairs studio. His pictures adorn nearly every wall in St. Christopher's, a blaze of colorful Crucifixions and abstracts that, she says, "are icons of life."
To her staff over the years, she has been known to be somewhat less tender: often brusque and occasionally imperious. Dr. Anthony Smith, who trained at St. Christopher's and is now medical director of a hospice north of London, recalls that an interview with Dame Cicely was "like going to the headmaster's study." Others complain that she has been slow to adapt to new needs, particularly the admission of AIDS patients. "She simply wouldn't allow an AIDS patient to breathe on St. Christopher's," says one observer. Her views have changed, but she still insists that any AIDS patients admitted must also be suffering from cancer. In fact, one such patient was admitted to the hospice's home-care program. Says Saunders: "Hospice didn't set out to look after everyone in the world who was dying of everything."
The other aspect of her personality, the humorous, tender side, is reflected not only in the devotion of her staff but also in the lively, casual air of St. Christopher's. Visitors, even small children, are admitted at all hours. Dogs stroll around, visiting their sick owners. Some patients sip whiskey with their visitors. "It's like a five-star hotel," says an elderly patient. More, perhaps, it is a throwback to the early days of the century, when care from birth to death was normally delivered at home. As Matron Duffield observes, "A hospital would insist on a strict diet for a dying diabetic patient. We serve chocolate cake." Saunders calls it creating an ambience of safety. "We make it possible to face the unsafety of death."
She has never lost her sense that death "is an outrage" for those left behind. "It's an outrage when a young father or mother dies, leaving two kids, or two old people who have spent 50 years together are parted." She is sustained by her belief that "this isn't the end, and parting isn't forever." For those who take a more secular view of death, there are very practical reasons for the hospice philosophy. "We must not lose the chance," she says, "of making good on a great deal of untidiness in our lives, or of making time to pack our bags and say, 'Sorry, goodbye and thank you.' " There are many in the world today who, after watching death come calmly and peacefully to relatives, have good reason to say thank you to Dame Cicely.