It is not easy to paint human sympathy. It’s a fuzzy abstract of a virtue too often defined by what it’s not — a lack of censure, a putting aside of moral rigour, a slightly shapeless, passionless form of kindness.
But there is nothing passionless about the portrait of Dame Cicely Saunders by Catherine Goodman just unveiled at the National Portrait Gallery: the founder of the British hospice movement gives the viewer her full attention. Her eyes, lasering through thick, old lady spectacles, do not invite confidence, they demand it.
For Dame Cicely, sympathy is a matter of “love and steel”. The phrase was used to describe the new portrait by a friend of the artist and Dame Cicely takes the compliment like a duchess accepting a bouquet. “Love and steel, how kind,” she says, and swiftly passes the tribute on to the people behind her. “Anyone doing hospice work will need plenty of both.”
At 87, confined to a wheelchair with inoperable cancer, Dame Cicely exudes a kind of sleeves-rolled-up efficiency. Her hands, glamorously beringed, habitually grasp each other, as if testing their remaining strength. Her approach to the business of being immortalised in oils was characteristically workmanlike.
“Cicely worked as hard as I did on the portrait,” says Catherine Goodman. “There was a kind of mutual concentration in our sittings which is really very rare when you paint someone. Most of the time they’re quite offended by the direct gaze of the painter, but Cicely really engaged with the whole process.”
“I was going to say you have to concentrate on being yourself,” says Dame Cicely, “but that’s not quite right. You have to concentrate on what is interesting that you’ve done which, presumably, has an effect on your face.”
Henri Matisse maintained that a successful portrait demands “total kinship” between artist and sitter. There is, at least, deep friendship and understanding between Goodman and Dame Cicely, developed over some 22 sittings in Dame Cicely’s home before she moved to St Christopher’s, the hospice she founded in South London. The chatty sessions were a gradual revelation of form and spirit. They were necessarily interrupted by Dame Cicely’s cancer treatment and the artist’s concern for her friend is felt in every brushstroke.
“I have worked a lot, privately, in my drawing and portrait painting, with the disabled — both my mother and sister are disabled — and I am very interested in the whole idea of pain and how it can be redemptive or not,” says Goodman. In the finished portrait there is a lightly dealt but unmistakeable quality of transfiguration which speaks of the deep religious faith shared by artist and sitter. (Goodman is a Catholic, Dame Cicely a “widely based Protestant who does a lot of Catholic reading”.) A pleasant low-rise in a leafy corner of South London, St Christopher’s has been Dame Cicely’s second home for 40 years and she is content that it should be her last home. The light-filled rooms and atmosphere of cheerful calm are a far cry from the conditions she encountered as a young nurse in the terminal wards of wartime hospitals.
“I began training as a ward nurse in 1941 at St Thomas’ Hospital,” she recalls. “Young patients dying of tuberculosis and septicaemia from war wounds begged us to save them, but we had little to offer except devoted nursing.” In wards stretched to capacity by the exigencies of the time, there was literally no room for the dying. Terminal patients followed a grim progression from the public humiliation of “the end bed” to the comfortless isolation of a screened cubicle for their last hours. Even more distressing to Saunders and her nursing colleagues was the way in which patients were expected to “earn their morphine” by exhibiting unmanageable levels of pain.
Invalided out of nursing by a back problem, Saunders completed a war degree in PPE at Oxford and returned to St Thomas’ as a “lady almoner” or medical social worker. In the starched optimism of Aneurin Bevan’s shiny new National Health Service, terminal care was given a low profile. As Saunders puts it: “Dying wasn’t part of the vision.”
It was in 1949, a year after the inception of the NHS, that Saunders met David Tasma, the man who would change not only her life but the lives — and deaths — of so many others. “In the first ward that I took over as a very new medical social worker there was a young Polish Jew with inoperable cancer, who was being kept in hospital until he was ‘well’ enough to be sent back to his digs. But he had nobody — he had come from the Warsaw ghetto — so I followed him up through outpatients and when he collapsed the following January I had him admitted to the Archway hospital in Highgate. I must have visited him about 25 times — he died on January 25 — and we talked and talked. I was already thinking I must do something about the dying, and talking about it; he said he had a bit of money to leave — and that he would like to help set up a home for the dying. ‘I’ll be a window in your home,’ was how he put it.”
Had the Roedean-educated social worker and the refugee fallen in love? “I was very fond of him, yes,” she says, but then adds, “I suppose I must have had a bit of a ‘thing’ about Poles, because I later had another very close relationship with a Polish Catholic, and my husband was a Pole (the artist Marian Bohusz, whom Saunders married, aged 60, in 1980).
Tasma, however, was the emotional wellspring for Saunders’s vocation. “Just before he died, he said to me: ‘Can’t you say something to comfort me?’ So I said the 23rd Psalm, The Lord is My Shepherd. He asked me to go on, so I recited the 121st, The Lord Himself is Thy Keeper, and then I offered to read to him. But he said, ‘No, I only want what is in your heart.’ Those two conversations became a challenge to me — the openness of a window to the world, and the match between heart and mind; everything of the mind — research, teaching, understanding, had to be matched with the vulnerable friendship of the heart. Those for me were the axiomatic hospice principles.”
It took 19 years of fund-raising to build, as Saunders puts it, “a home around Tasma’s window”. First, she re-trained as doctor. In 1967, St Christopher’s was established as the first teaching hospice, and Saunders was rapidly established not just as the pioneer, but the leading authority to this day, on palliative care. In 1989 she received the Order of Merit and three years ago established the Cicely Saunders Foundation, an international research and education body dedicated to the “improving care at the end of life”.
The key to it all, she insists, is in listening to what the dying have to say. She has sat at countless bedsides and every story is different; the patient is the expert on his or her pain, and death, approached with dignity, can be a friend.
Is there a secret, then, to dying well? The answer, it seems, is the judicious use of painkillers and love; whether the love of friends and family or the loving care of professionals. For Dame Cicely, love is not only, as Larkin would have it, what remains of us, but what goes with us on our final journey. “So many people feel guilty that they weren’t there at the last moment,” she says. “My husband did that to me — I’d been with him here at the hospice all day and only just got back the moment after he’d taken his last breath. But I’m sure that’s all right. Because if you love someone, you are there. I think we unconsciously hold on to the dying, but they want to spare us that last moment.”
Does such close acquaintance with death make it easier to face one’s own mortality? “Well,” she replies, “I am facing it. Because I’ve got spreading cancer — even though it’s doing it a bit slowly.”
“Cicely has said that she doesn’t mind dying and how can you not believe her?” says Catherine Goodman. “We’ve talked about the difference between spiritual fear and human fear. I don’t recognise any spiritual fear in Cicely, but there’s a bit of human fear.”
Dame Cicely leans forward, hugely interested in this discussion of her demise. She doesn’t look impatient for death, but she is prepared. She doesn’t look frightened at all.
National Portrait Gallery, St Martin’s Place, London WC2 (020-7306 0055)
