Word of the Moment

Word of the Moment

word of the moment

To Comfort Always. A history of palliative medicine since the nineteenth century
David Clark

Oxford Medical Histories

Professor Clark provided a fascinating glimpse at the longer history of hospice care. He spoke of the “seven ages” of hospice care under the themes of Awakening, Charism, Indifference, Uncertainty, Formation, Recognition and Challenges. He explored the foundations of the modern hospice movement which was led by women and largely religiously inspired. Exploring the role of pioneering women who led the development of homes to care for the dying.

Clark suggests that dying people were hidden away and excluded from the growing medical institutions where death was regarded as failure and the increasing medicalisation of death. There is recognition of Cicely Saunders’ concept of “total pain” in developing holistic care and the gradual development of hospice care becoming recognised as a specialism.

“Clark’s history of palliative care feels relevant as the story moves to describing the ‘Brompton Cocktail’, the concept of “total pain”, the introduction of syringe drivers and the growth in both research and service models, it feels inevitable that specialty recognition would be achieved and in fact be essential in ensuring acceptance within the wider medical profession. The pace of development and global spread of palliative medicine and hospice care as described by Clark is amazing.

As readers, we are introduced to Allan Kellehear, Atul Gawande and Dr Eduardo Bruera. These new pioneers are challenging the profession’s thinking as it once again attempts to battle the social challenges and to grow its place in mainstream medicine.

These important lessons in our history that remind us about the true holistic nature of our care so well described by Marx, Munk and Cicely Saunders which both embrace the role and influence of medicine whilst guarding against medicalisation. The book reminds us that in our history hospice leaders were pioneers, lobbying, influencing, researching and innovating – all whilst managing their emerging charities. In many ways, the challenges we face today are no different but are at scale and require the pioneering focus and spirit worthy of our predecessors.

“To Comfort Always” takes us on a wonderful journey of palliative care history and looking forward to the future.

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