St Christopher's hospice, which was founded in 1967 by Dame Cicely Saunders, who has died aged 87, is a beacon for the supposedly terminally ill and their families. Situated in the London suburb of Sydenham, it led to the founding of hospices around the world employing her principles.
By using drugs scientifically to manage pain, and by allowing relatives to spend a great deal of time with her patients, Saunders altered the bleak concept of death for thousands of people. To her, dying was part of life; her creed was Living Before Dying. She became almost a folk hero after the journalist Victor Zorza and his wife wrote A Way To Die: Living To The End (1980), a moving, persuasive book about their daughter's death in a hospice.
Saunders was born in Barnet, north London. She was the eldest child of an affluent estate agent, and a classic example of how early unhappiness and unease can be converted into a positive force. Her parents' marriage was extremely unhappy, and her mother was a remote and cold woman. Saunders was to emerge as a strong character, more interested in other people's problems than her own self-pity.
She would have preferred as her mother her unmarried Aunt Daisy, into whose care she was given at the age of one, only for her to be snatched back later, through jealousy of Daisy's influence. Her mother was seen as inadequate and uncaring by her husband and children. It was Cicely, in 1945, who informed her that her marriage was over, and that she must move out.
Educated at Roedean, from 1932 to 1937, Saunders did not get into Oxford University at her first attempt. But she persisted, and after cramming, in 1938 began reading politics, philosophy and economics at St Anne's College. But then the second world war broke out, and she abandoned PPE in favour of training as a state registered nurse at St Thomas' hospital, London, qualifying in 1944.
She loved tending the sick, but back trouble forced her to change direction again just after she qualified. She went back to St Anne's College in 1944, taking a BA in 1945, qualifying as a medical social worker in 1947 and becoming a lady almoner at St Thomas's hospital.
Saunders had also abandoned agnosticism. While training for social work, she holidayed with some Christians, went through a conversion and was soon attending Bible-reading groups and prayer meetings. Then, in 1948, she encountered the first of three significant relationships with men that were to enrich her life, as well as give her emotional pain. All were with Poles, two of whom were within sight of death.
One of the terminally ill patients she nursed was David Tasma, a Polish-Jewish refugee who, having escaped from the Warsaw ghetto, had worked as a waiter. She fell in love with him, and he left her his wordly wealth of £500 to be "a window in your home". That act, which helped germinate the idea that became St Christopher's is remembered by a plain sheet of glass in the entrance to the hospice.
In the late 1940s, Saunders began working part-time at St Luke's Home for the Dying Poor in Bayswater, and it was partly this which, in 1951, led her to begin study at St Thomas's to be a doctor. She qualified in 1957. A year later, she began working at the Roman Catholic St Joseph's hospice in Hackney, east London, where she was to stay for seven years, and researched pain control.
It was while there that she met a second Pole, Antoni Michniewicz, a patient with whom she fell in love. His death, in 1960, coincided with the death of Saunders's father, and another friend, and put her into what she later called a state of "pathological grieving". But she had already decided to set up her own hospice, focused on cancer patients, and said that Michniewicz's death had shown her that "as the body becomes weaker, so the spirit becomes stronger".
What followed was accomplished at a time when euthanasia was sometimes thought of as the only kind answer for those dying of cancer and other painful conditions. The early 1960s was a time of fundraising, work on the site began in 1965 and, two years later, St Christopher's opened, despite the resistance of sections of the medical establishment.
Saunders claimed that after 11 years of thinking about the project, she had drawn up a comprehensive blueprint and sought finance after reading Psalm 37: "Commit thy way unto the Lord; trust also in him; and he shall bring it to pass."
It was seen as the first hospice to bring together teaching and clinical research, pain and symptom control, and compassionate care. It was a place where patients could garden, write, talk - and get their hair done. There was always, Saunders would emphasise, so much more to be done, and she did it, as its medical director from 1967, and then, from 1985, as its chairman, a post she occupied until 2000, when she became president.
Religion always played a part at St Christopher's, though it was never forced on patients or staff: neither were necessarily Christian. The object was always as much secular as religious: to convince patients and their relatives and friends that they were not alone; that, despite their terminal condition, they still had value as human beings - and that sometimes even conditions thought by the medical profession to be rapidly terminal could have a remission. A significant percentage of patients who were not expected to leave St Christopher's alive, in fact, did so.
On the other hand, Saunders ridiculed some of the medical profession for not giving large doses of pain-killing drugs on the grounds that they might become addictive. If the patient were dying anyway, what did it matter? Nor did she believe that drug doses big enough to remove pain entirely would necessarily cause the patient to develop such a tolerance to the drug that it would become ineffective.
Saunders had been helped, too, from the 1960s, by her love for a third Pole, the painter Professor Marian Bohusz-Szyszko. Passing a gallery in 1963, she saw in the window a painting, a sombre blue Crucifixion Of Christ. She went in and bought another painting by the same artist, Christ Calming The Waters. She was so moved by it that she wrote to him, and he wrote back. He was 18 years older than her, but she fell in love with him and covered the walls of St Christopher's, where he came to live and paint, with his pictures. They married in 1980.
The recipient of many honorary fellowships and doctorates, in Britain and abroad, Saunders's books included Care Of The Dying (1960); the co-editing of The Management Of Terminal Disease (1978), Hospice: The Living Idea (1981) and Watch With Me (2003).
Saunders died at St Christopher's, which has trained more than 50,000 students, spreading palliative care programmes to more than 120 countries. Her husband died in 1995.
· Cicely Mary Strode Saunders, nurse and hospice pioneer, born June 22 1918; died July 14 2005
