My best teacher

14th September 2001 at 01:00
When I told Mr Barrett I wanted to work with the dying, he said 'Go and read medicine. Unless you become a doctor no one will listen to you.' And he was right

I had huge regard for Norman Barrett and held him in awe. He was a thoracic surgeon at St Thomas's Hospital in London and nicknamed "Pasty" because of his red face. He was an absolutely brilliant teacher and I worked closely with him after I was invalided from nursing to become a medical social worker. Mr Barrett asked for a social work report on all patients, which was very unusual in those days (the late 1940s). I taught myself to type and helped with his notes, and when he gave a dinner party for overseas visitors I was invited along.

At the same time I worked as a volunteer at St Luke's Hospital in Bayswater, one of the early homes for the dying, where I saw how effective regular oral morphine doses were, compared to patients having to suffer pain first and then be given morphine.

I persuaded Mr Barrett to go to see what was going on there. When I told him I wanted to return to nursing because I desperately wanted to work with the dying, he said: "Go and read medicine. Unless you become a doctor, no one will listen to you." And he was absolutely right.

It wasn't a suggestion, it was a directive. My father financed me and I spent most of my thirties studying. I'd been educated at Roedean, but I wasn't happy boarding and didn't fit in easily, which gave me sympathy for the disadvantaged. If you are unpopular, as I was, it does teach you to know what it is like to feel rejected - and the dying have been rejected.

I had a degree from Oxford, but I hadn't done science at school, so I planned first to go to a crammer. When Mr Barrett heard about it, he went to see the dean at the medical school at St Thomas's and said: "You've got to take this woman on, she's got an idea." The rest, I suppose, is history. Thanks to Mr Barrett I became a medical student and then I got a clinical research fellowship and spent seven years researching the nature of terminal pain and introducing regular pain control.

Later I'd meet Mr Barrett around the corridors of St Thomas's and he'd always ask how I was getting on. He was a stickler for courtesy, especially towards junior staff. He also had a great sense of humour.

He was a very good writer. He wrote a fascinating paper about cholera and edited the journal, Thorax. I learned from him the importance not just of reading medicine, but of keeping records. He used punch cards so, when I went to work at St Joseph's Hospice in the East End, I put my 1,100 patients' notes on such cards. That's how I was able to produce statistics demonstrating that there was no drug dependence for oral morphine. When I arrived they had no drug charts, no patients' notes, no ward reports.

When I finally founded St Christopher's Hospice I wrote to Mr Barrett to tell him. I also sent him a copy of our first textbook and said: "Thank you so much for what you helped me to do." That was not very long before he died. He was never able to visit the hospice, but he knew it was founded on a sound scientific basis.

Before that no one had ever really looked at the scientific foundations of the end of life care, or hadn't ever thought that it needed that sort of approach. So when Mr Barrett said to me "Go and read medicine" he was really taking a most unusual stance.

Without a doubt, Norman Barrett was the best teacher I ever had and I still keep in touch with his daughter.

Dame Cicely Saunders was talking to Pamela Coleman

THE STORY SO FAR

1918 Born Barnet, north London

1940-44 Nurse at St Thomas's Hospital, London

1945 Gains BA (PPE) from St Anne's College, Oxford

1947-51 Social worker

1951-58 Medical student and clinical research fellow

1959 Publication of Care of the Dying as a series of articles which later becomes a best-selling book

1967 Founds St Christopher's Hospice

1969 onwards Awarded 25 honorary degrees, the first from Yale

1989 Awarded Order of Merit September 17, 2001 Due to be awarded $1 million Hilton Foundation humanitarian prize, New York

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