August 2022 saw the premiere of my play Cicely and David at the Edinburgh Fringe Festival. It tells the story of a Polish migrant, David Tasma, who is dying from cancer in post-war London, estranged from home and family. A brief, intense relationship with his social worker, Cicely Saunders, helps him to find some resolution to what he feels has been a worthless life. In the process, an idea is born that later becomes the world’s first modern hospice, founded by Cicely Saunders in 1967 and soon to become a beacon for end of life care improvement around the world.
The play comes in the wake of some 20 years of scholarly interest on my part in the life, work and legacy of Cicely Saunders. She continues to be regarded as the founder of the hospice movement and a key architect in the widely recognised specialty of palliative care. As an academic I wrote her biography, published an edition of her letters, and two collections of her varied writings, and also authored numerous specialised journal articles about her.
Despite all this, I still felt there might be other ways to communicate her contribution, and with it the wider message of hospice and palliative care. So in 2021, I embarked on writing a play about her and some of her formative influences: Cicely and David.
I hope you will find interest in the play and I take this opportunity to thank the many people, and especially my friend Dr Jo Hockley, who have all helped Cicely and David to come into being.
What you’ll find here
On these pages there are links to more detailed articles about how the play was developed in collaboration with staff and students at Queen Margaret University and also in workshops at Wallace Hall School, Thornhill and with members of the Dumfries Musical Theatre. There is information about past and future performances and about a film made at the premiere. You can also find out how to access the playscript if you are considering a production of the play.
Cicely and David can work at a number of levels. It can be effective in a lightly prepared reading, or it can be developed into a full production with elaborate design and staging. It can be used purely as a piece of theatre. Or it can serve as a platform for public engagement, professional development and group discussion.
News and upcoming events
I am currently in discussion with several hospice organisations in the UK and internationally, where plans are being made for screenings of the play. Details will be posted here as soon as they are available. In addition, the Italian translation of the play has been completed recently.
Following a ‘taster’ performance of Scene 1 at a conference of the Scottish Partnership for Palliative Care in May 2022, Cicely and David was first performed in full by the Pennyland Players on 16-20 August at the 2022 Edinburgh Fringe festival. One of the performances was filmed and is available for screening.
The cast – Older Cicely (Serena Park) , Paul (Michael Johnston), Younger Cicely (Tegan Smith/Caladh Walker), David (Jaimie Busuttil), Woozle (Arlene Mckay)
Stagehands/Front of House – Theo Nicholson, Lulu Perren, Joy and Michael Nicholson, Sally Hockley
Our sponsors – Dr Fiona Graham, Gilbert Archer, James and Antoinette Galbraith, Scottish Partnership for Palliative Care, St Columba’s Hospice, Marie Curie, Irish Hospice Foundation, St Christopher’s Hospice, Highland Hospice, Cicely Saunders International, Marie Curie, Queen Margaret University, Edinburgh, Hospices of Hope.
Interview with David Clark about the play, in May 2023 Newsletter of International Association for Hospice and Palliative Care (scroll down from the link).
Performances, screenings and events since summer 2022
28th September 2022: At an evening event organised by Highland Hospice, in Inverness, Scotland a ‘taster’ from the play was read by two drama students at the University of the Highlands and Islands. After an inspiring opening talk by best-selling author Dr Kathryn Mannix, on ‘Tender Conversations’, Juliet Kelly and John Moar read scene 1 from the play to excellent effect. The scene is itself a conversation of great tenderness between the ageing Cicely and a newly bereaved father. Following thunderous, sustained applause and cheers from the capacity audience, there was much praise for the performances and several enquiries about further opportunities to see the play. Huge thanks to Juliet and John.
Juliet Kelly and John Moar
30th September 2022: An online presentation by David Clark to members of the European Society of Narrative Medicine and Health Humanities. David outlined his collaboration with Cicely Saunders in the last 10 years of her life (2005-2010), along with the projects and publications that emerged from it. He went on to explain how the idea for the play had been formed and the creative process involved in working with university and school students as well as with amateur actors, to develop the script. A film clip of two scenes from the play was also shown. More details of the Society can be found here: https://www.medicinanarrativa.eu/eunames
15th November 2022 As part of a two week programme of activities to launch a new palliative care service in Schleswig, Germany, Dr Georg Bolig hosted a screening of the play (its global premiere!) in the Helios Klinikum (University Hospital of the Universities of Kiel and Lübeck). Dr Bollig wrote:
“When I first heard about the play written by [David Clark] I thought that it would be good work with a sound historic and scientific basis. After I have seen it I have to say: it is brilliant! Congratulations you did a marvellous job!
The audience in our hospital was a mixture of doctors, nurses and hospice volunteers. The feedback from them was that the play was educational, but also moving. The people appreciated the subtitles very much.
After the film we had a lively discussion lasting more than an hour where we discussed Cicely’s history, the impact of palliative care and the different themes from the field that are addressed in the movie. Thank you very much for the opportunity to show the movie and your kind support!
Some colleagues suggested translating the subtitles into German. If you are interested to do so I could assist you to look for funding and manpower”.
15th November 2022: At the conclusion of a webinar hosted by the Cicely Saunders Society, two extracts from the film of the play were shown and notice given that the Society is planning a ‘one day festival of Cicely Saunders’ for a date to be confirmed in summer 2023. The festival will include a full screening of the film. More details in due course from the Society.
18th November 2022: We had the honour to host an online screening of the full ‘Cicely & David’ play followed by an open discussion with David Clark and Jo Hockley. The screening took place as part of the 3rd Annual Symposium for the Arts in Palliative Care which was co-organised by St Columba’s Hospice Care and Queen Margaret University in Edinburgh and which focussed on the theme of Re-imagining Creativity and Care. This was the third annual event of its kind, bringing together arts therapists, socially engaged artists and other professionals from the wider palliative care field internationally.
The story of Cicely and David offered a wonderful opening to the symposium. Through an insightful, personal and informative account of the early beginnings of Cicely Saunders’ work and her relationship to the Polish patient, David Tasma, delegates gained some insights regarding the roots of the modern hospice movement. As David became a window in Cicely’s home, delegates were invited to consider who is the window in their own ‘homes’. Who are the individuals that have played a formative role in their own work? What stories have shaped their own professional identities and continue to drive their passion?
Such questions and insights fuelled wider discussions throughout the symposium as we considered the need for re-imagining creativity and care in the field. In these discussions, authenticity emerged as a key driver in the stories we grow about our work with people and their communities. Cicely’s curiosity and readiness to take risks, challenge conventions and push beyond existing boundaries were useful reminders that can drive our contemporary efforts in palliative care. This includes an expansion of our engagements with loss, change and grief within the wider society where a Western death-denying culture still prevails.
8th December 2022 An online screening of the play took place with members of the End of Life Studies Group, School of Interdisciplinary Studies, University of Glasgow. Participants included staff and postgraduate students. The discussion ranged over issues such as: which characters were real or imagined, how backstories were constructed, the role of the imaginary character Paul, as ‘everyman’ in the play, the potential for further creative works to celebrate and explore the life and legacy of Cicely Saunders, and the possibilities of producing a full screenplay and ‘movie’ of Cicely and David. Members of the group undertook to plan a shared reading of the playscript in 2023.
One participant, Miranda Cinchy, a PhD candidate in the University of Glasgow School of Interdisciplinary Studies, kindly offered the following reflection:
“I came to Cicely and David with very little knowledge of Cicely Saunders and the hospice movement. It can be difficult to tell a story such as this without being didactic, but the character of Paul and his opening conversation with the older Cicely enabled details to flow naturally. Having these characters present on stage while scenes from the earlier years were acted out successfully conveyed the sense of flashback and ensured that the hospice (where Cicely and Paul had met) remained a central motif throughout. I found the play very interesting and unexpectedly moving; the live music was affective, and there was real sense of the attachment between Cicely and David through their conversations and those between Cicely and her gently admonishing friend Woozle. I would have liked to learn more about Marian, Cicely’s husband, who was tantalisingly mentioned early in the play, but understand that the relationship of Cicely and David took centre stage, and one of the big successes of Cicely and David was creating a both fascinating and succinct portrayal of a life’s work.”
January/February 2023 Members of the team at Hospices of Hope have been exploring how they can use the film in support of their work in the UK and their partner countries in Eastern Europe. Here are some of the team members’ reactions to their first viewing :
“Not having known very much about Dame Cicely Saunders previously, I found the play to be moving, educational and comforting. The actors were great, as was the music played throughout”
“I really enjoyed the way the play was set out, with Dame Cicely looking back at her life and the reasons she started her important work. I learnt a lot and found it quite emotional at times”
“The play was a great reminder of how one person can make a big difference – even if they don’t believe they can! It was very touching and gave a great insight into the life of Dame Cicely Saunders and David.”
“Cicely and David’s story is very inspiring and moving – I am glad to have seen the play as I had not appreciated the history behind the hospice care movement. It was very well written, informative and enjoyable to watch.”
10 March 2023 saw the start of a new cycle of training at St. Joseph’s Home, in Celje, Slovenia. The ‘Powers of Weakness’ programme is designed for anyone in the workplace who deals with the seriously ill and dying. The first meeting involved reflections on the importance of spirituality in palliative care using the Cicely Saunders’ book Watch with Me. In October 2023, six months after the introductory meeting, a film of the play ‘Cicely and David’ will be presented to participants who wish to deepen their approach. For more information, email irena.svabkavcic@gmail.com and see: https://www.jozef.si/domov/publikacije/
19 April 2023 Screening of the film of the play to an invited audience, at St Christopher’s Hospice, London, to mark the completion of the hospice’s oral history project and associated exhibition.
‘I wanted to let you know what a triumph your play was when we showed the film of it at St Christophers last evening.
It was profoundly moving and people loved the story, the sensitivity of its production and its theatricality. There is much more specific feedback we can provide but I just wanted to say thank you for the opportunity to show it and for the opportunity it afforded last night and in the future to connect with the history of St Christopher’s and its foundations alongside the story of Cicely and David’.
Heather Richardson, Director of Academic Learning and Action at St Christopher’s
Heather continues:
Some of the feedback that I thought was particularly strong includes the insights provided by the film regarding:
The youth of Cicely in her work with David Tasma and the formation of her ideas
The length of the time it took her to create the ideas for St Christopher’s and its opening
Her tenacity – evident in the acting of both the young and older Cicely
In addition people commented on:
The sensitivity with which the relationship was handled by the actors and in the script. Its depth and value was clearly articulated
The power of the shifts in time perspectives, starting in the mid-2000s; then back to 1947/8, then forward to the mid-1990s
The value of seeing her reflect on the importance of the relationship in the final part of the play where she speaks at the conference
Everyone here wants to see it again and ensure others involved in St Christopher’s sees it as well
We will keep you in the picture on all of this
But congratulations and thanks in the meantime
20 April 2023 Hospices of Hope screening of the play, open to the public.
We had a lovely evening screening the play, with many commenting on how moving it was and how much they learnt about Dame Cicely’s life. It really helps to understand the context of the start of the hospice movement whilst capturing everyone’s attention with the story.
Jess McKechnie, Donor Relations Manager, Hospices of Hope
4 May 2023 A screening of the play for students and staff at Queen Margaret University, Edinburgh took place as part of Dying Matters Awareness Week
Dr Erna Haraldsdottir writes: ‘About 40 people, mostly students in nursing, drama and occupational therapy, came to a showing of the film “Cicely and David” at Queen Margaret University (QMU) on 4th May 2023. Four of the cast/directors/crew were there alongside Jo Hockley (producer) to discuss aspects about palliative and end of life care, which stimulated a lively and honest conversation with people telling their own moving stories after the film. Students found the play “extremely moving” and “very real”. It was evident how the film was enlightening in terms of what are the needs of those who are dying: “I realise now often dying people just need comforting”; “I was struck by the focus on what matters; it is not just time … it’s about the quality of time”; “I am wondering about ‘secret grief’ that staff may suffer when caring for dying people” It was also striking how real the story was to the audience and some felt a strong emotional connection with David Tasma himself ….. “did Professor Clark ever find out what happened to his family?”’
‘After the premiere of Cicely and David in Edinburgh, the ATLANTES research group, led by Dr. Centeno at the University of Navarra, Spain, saw the potential of the play to transmit the message of palliative care. For this reason, it was decided to bring the work closer to the Spanish context. A professional literary translation was made and the group revised the terms used in palliative medicine in Spain. (It is important that the communication is effective and unambiguous, so that the reality of palliative care is conveyed correctly.) On Friday 12 May, we met at the Castillo de Arazuri (Pamplona, Spain) with the aim of enhancing the social bonds of the team and deepening the meaning of their work in palliative care. During the day, a dramatised reading of the play took place. Two doctors, a nurse and two PhD students played the characters of Cicely (older and younger), David Tasma, Woozle and Paul. We did a simple staging, divided into three spaces: a static one for the older Cicely and Paul, who during scenes 2-8 remained on one side of the stage contemplating Cicely’s story; a second space for the encounters between the friends (Woozle and the younger Cicely) and a third, larger and more comfortable one for the hospital moments with the younger Cicely and David. Before starting, we handed out a brochure with the text of the play, so that all the members of the team could follow the script easily. The text was bilingual Spanish-English, to make it easier for non-Spanish speakers to read. We devised a reflective activity to be carried out after the play. We planned the following questions:
Reflect on the relationship between the characters and the emotions they convey; how does the story portray the challenges and decisions faced by patients, families and professionals?
Key themes such as dignity, relief of suffering, quality of life, decision-making, emotional support and the importance of companionship are identified in the play. How do these relate to your understanding and experience of palliative care?
About the palliative care message, what is the message intended to convey to the audience? How did it make you feel or what did it make you think?
However, the questions weren’t necessary, the play was very moving in its own right. There were moments of laughter, but also moments of great emotion among our colleagues. At the end of the play we shared our emotions freely in small groups. There was laughter, tears and also some hugs.
Cicely and David is certainly worth spending some time with. The play has helped us to reflect on the meaning of palliative care. Let the play be, in a way, ‘a window in our home’.
15-17th May 2023: A screening of the play took place at the annual conference of the Association of Hospice and Palliative Care Chaplains, at the Hayes Conference Centre, Swanwick, Derbyshire. In preparation for the event, John Wonnacott writes: ‘A number of palliative care chaplains watched Cicely and David, a filmed version of the stage play and it sparked a number of reactions. First and foremost as a historic piece it was fascinating to step into the shoes of Cicely Saunders both in her younger days and also as she reflected on her life. It was moving to be reminded of the journey that she had been on both in terms of the physical landmarks such as the Archway Hospital and the hurdles that she had faced in those early days of blazing the trail for hospice care. Her persistence and perseverance were illuminating and inspiring. There were aspects of her spiritual care too that were strong reminders of the core of person centred palliative care and also watching it gave space to reflect on how things have changed in terms of boundaries and practice. We also were reminded of how important Cicely Saunders’ own faith was to her. The poem at the end was very powerful too. We felt it was a very useful piece enabling those within the palliative care field and beyond to reflect on the roots of palliative care and be spurred on to explore further what palliative care could look like in the 21st Century’.
September 2023: Work has begun on an Italian translation of the playscript and is being undertaken by Francesca Bracco in collaboration with Dr Jo Hockley (pictured). Francesca is a member of L’Associazione di Promozione Sociale “Sul sentiero di Cicely – Per le Cure Palliative APS which is dedicated to promoting the life and work of Cicely Saunders in Italy. Jo produced the first performances of the play in Edinburgh. Professional translator Holly Beattie is also giving advice on the process. For more information, contact francesca.bracco@gmail.com
11th October 2023: Jewish Care and North London Hospice organised a screening of the play, followed by a Q&A discussion about the wider meaning of palliative and hospice care. The discussion was chaired by Dr Adrian Tookman, retired Medical Director Marie Curie & Co-Chair EOL Care Partners Think Tank. The organisers, Paula Plaskow and Hannah Newton reported:
‘We held the film in the auditorium at the Maurice and Vivienne Wohl campus in Golders Green, London. Refreshments were offered from 2.30pm as people arrived and the film started at 3.00pm, leaving about an hour for the Q&A session.
Dr Tookman’s style was relaxed and informative as he responded to questions from attendees. An additional advantage was that during his career, he had the privilege of meeting Dame Cicely, and this added to the awareness of the event. 35 people had initially signed up on Eventbrite, but on the afternoon, just 16 people attended from varied health and social care occupations: A GP, Clinical Nurse Specialists, researchers, social workers, marketing, and community development colleagues. However, the lower number of attendees seemed to enhance the intimacy of the atmosphere, and we were not aware of the time flying past due to the quality of the conversations. The film stimulated the following conversation examples: How to support a family spiritually. Ensure we see the ‘whole’ person. (Dr Tookman spoke about ‘Total Pain’). The impact of faith visits with a patient and the family. How to have a presence (spiritually) with a person at EOL. How clinical care is an art as well as a science. How EOL care is often ignored in care homes. The importance of working with difference skill sets/professions. Orthodox faith and EOL. People are living longer now with enhanced medical technology. Recognising ‘everyone is involved’ from clinical, housekeeping and catering. Start a simple conversation to lead into something deeper.
3 November 2023: A screening of the film of Cicely and David, with Spanish sub-titles, took place on day three of the 11th Argentina Congress of Palliative Care – in Cordoba. The film was given a special slot in the programme and was introduced by Dr Gabriel Goldraij, Jefe del Programa de Atención Domiciliaria y Cuidados Paliativos, Hospital Privado Universitario de Córdoba. Gabriel has kindly written this reflection on the play (see below) which he gave by way of introduction to the film at the conference. Thank you Gabriel!
Dr Gabriel Goldraij introduces the film of Cicely and David to the conference audience in Cordoba.
“Good afternoon, everyone, welcome to this activity. In a few minutes we are going to start the projection of the film.
I am going to read a few words as a presentation of this.
David Clark, the screenwriter of this play that we are going to see, is an academic and sociologist. I have read an article by him. It was interesting for me. Browsing the web, I learned that he has written a play about Cicely’s encounter with David Tasma, a patient Cicely met in 1947. This is a film of that experience.
I don’t know David Clark personally, but as he is from the palliative care community, surely, we will be able to talk, I tell myself. He lives in Scotland. I write to him, and he responds kindly. He sends me the movie. We watch it with my colleagues at my house on a Wednesday after work. It doesn’t cost us. We can rest and have a good time and continue talking about palliative care. The idea arose to share it at the congress, and we got to work on that.
I heard about Cicely’s and David Tasma meeting in 2005 at the Pallium course. There was a photo of them. Gustavo said: “David. He will be someone important in palliative care”. The relationship between him and Cicely seemed to be a kind of founding myth of this movement.
David is someone who arrives with a strange, foreign name. He lives in east London. Immigrant place. The wind that runs from west to east causes the Thames to carry a nauseating smell to that part of the city, devaluing it. David Tasma doesn’t seem calm, but at least in London there are no ghettos. There is loneliness, foreignness, and bellyache. I thought a lot about David Tasma. What is a young Polish man doing in London in 1947? My grandfather was also a young man fleeing Poland. Only he took the ship to South America. Maybe he was David’s brother. The dates match.
Cicely, another world. Upper-class secular family from London, which she somewhat contradicts by becoming religious. She studies literature, she is very tall, very young. Idealistic. She smiles frankly in the photos. She along with David is creating a kind of DNA for palliative care. A different clinic with the one that is close to dying. Far from the uniformity of the ward, attentive care for the life history of the other. Today, 70 years later, we discover ourselves in a line of thought. Cicely smiles with the confidence that she knows something, when the others say that they find it strange that she can die without suffering. She smiles with satisfaction when a mourner says that in the last weeks of his wife’s life they they spent beautiful moments together. Death is not an end for Cicely, but neither is it a space of martyrdom.
David Tasma brings up what Primo Levi calls survivor’s guilt. He survived and didn’t deserve it. Cicely listens: Total pain. David speaks. A pleasant field opens for both. Someone who risks telling their story and someone intelligent who knows how to listen and heal with words.
A question appears among her colleagues: What is the correct professional distance? Cicely experiences crossing borders even though she is warned of the risks she runs. It is possible to find meaning in suffering to reformulate it and alleviate its weight. Illness and sickness are different concepts. So, we cannot talk to the patient as if we were the book. You must find the words. In her practice, the correct professional distance becomes fraternal solidarity with the frail. The dialogue also has blocks, forced silences. How do two people meet: how can they. Even the purest encounters are a battlefield. Cicely and David open this game where she is involved, where she has taken a liking to him and where David Tasma, in the words of John Berger, can begin to put together the fragments that migration and illness have dispersed“.
Gabriel Goldraij (November 2023)
14 November 2023: A screening of Cicely and David took place prior to the annual symposium of the International Collaborative for Best Care of the Dying Person, taking place in Rotterdam, the Netherlands. The audience comprised about 20 members of the iLIVE project
‘Beautiful performance. Deeply moving. Well balanced in information and emotions. A real monument for those great and inspiring persons’.
‘Very touching and inspirational to know better the beginning of hospices and palliative care’
‘We all enjoyed the play and it prompted long and interesting discussions, with input from those that worked with Cicely, noting Cicely as effectively the first (singlehanded) Multi Disciplinary Team. Recommended’
Comments from audience members
17 November 2023: a screening of the play, with Slovenian subtitles, took place at St Joseph House, Celje, Slovenia. The session was introduced by Dr Irena Švab Kavčič. David Clark joined the group by Zoom and his talk and the subsequent discussion were translated by Marjana Bernot. The seminar was organised in cooperation with the Slovenian Association for Palliative and Hospice Care (SZPHO). For more details, see: https://www.jozef.si/david-in-cicely/
“As part of the “Strength of Helplessness” training program, we completed the first module, entitled “Palliative care – searching for depth”. We are grateful that David Clark, biographer of Cicely Saunders talked to us about the path that led to the creation of the play ‘Cicely and David’. Watching the film of the play, we saw how Saunders’ meeting with David Tasma presents the fundamental postulates of palliative care. Like the book “Watch with Me”, the play is also multifaceted, important not only for those who encounter the seriously ill and dying, but for everyone who is looking for answers to the questions that come with the various trials of life”.
Irena Švab Kavčič
3 December 2023: A screening of the play took place at the Universidad del Salvador (USAL) in the Faculty of Medicine, Buenos Aires. This free event, was open to students, teachers, and health professionals, and marked the 25th anniversary of the partnership between USAL and the PALLIUM Institute, through which health professionals in Latin America receive certificated training in palliative care. Over 200 people attended in person or remotely and David Clark joined them from Scotland, to introduce the film.
For further information contact Professor Gustavo de Simone: ggds55@gmail.com
8 March 2024: Latin America Congress of Palliative Care, Cartagena, Colombia. The Atlantes Theatre Group staged the first performance of the Spanish version of the play, to huge success and a standing ovation from the audience of around 400 conference participants. Some brief quotes and photographs here, with the possibility of a longer report to come.
‘Thank you David Clark for the very emotional work remembering the beginnings of palliative care! Wonderful representation!!’
‘It was a deep emotional moment as well as an opportunity for learning and reflecting on the origin and vision of palliative/ hospice care’.
‘It reminded us that Cicely was one like us with successes, mistakes, difficulties and joys but she did not lose sight of what she wanted. David understood her, and helped her towards her dream, while she helped him to close his cycle on earth! Thank you, Cicely and David, because of you, we are here doing palliative care!!’
Warm, emotional response to Cicely y David in Cartagena 8th March 2024
Civivox Theatre, Pamplona, Spain: 13th March 2024
A full performance of the play was given by members of the Atlantes Global Observatory for Palliative Care and the Palliative Care Service of the University of Navarra Clinica. A full account of the evening, written by David Clark, who was in the audience, can be found here
Cast
Older Cicely: Ana Larumbe
Paul: Alvaro Montero
Young Cicely: Alicia Hernando-Garreta
David Tasma: Diego Candelmi
Woozle: Ana Paula Salas
Direction and Production
Vilma Tropdoro: Director
Alicia Hernando-Garreta: Co-Director
Production: Carlos Centeno
Technical team: Fernanda Bastos, Cristina Bejar
Music: Albert Recasens
Photo credits:Jorge Miras Pouso and University of Navarra
Reviews of the performances in Cartagena and Pamplona
He sido afortunado de presenciar el estreno de la obra de teatro del profesor David Clark, Cicely y David, soy médico y hago cuidados paliativos desde el 2012, conozco la historia de Cicely Saunder, he leído varias veces el libro Velad Conmigo y lo hago leer a mis alumnos de la asignatura de Medicina Paliativa, año con año les pido un ensayo de uno de los capítulos del libro y me enriquecen muchísimo cuando los leo.
Pensar en que vería la obra me generó mucha expectativa e hizo que pusiera todos mis sentidos desde el inicio y que continuara así hasta el final, fue como un sostener la respiración de forma prolongada o que se paralizara el tiempo mientras veía el desarrollo de la obra.
Me emociono ver la representación de los personajes, diversos sentimientos brotaron en mi al oír a Cicely mayor contando la historia a Paul, esto me recordó las intervenciones de duelo que solemos hacer y ver a Cicely como uno más, como uno de nosotros, me hizo sentir a gusto, y pensar que lo que hacemos, nuestras intervenciones son correctas. Pienso que algunas veces idealizamos a los pioneros de cuidados paliativos y no nos damos cuenta de que son tan “de carne y hueso” como nosotros.
Luego viendo a Cicely con David y recordar que esa relación humana dio origen a los cuidados paliativos modernos fue emocionante y cada palabra, cada frase, que se decían las disfrutaba muchísimo. El vestuario de los personajes, el fondo, las pausas, su papel también bien desempeñado me metía en la época y en las conversaciones.
Redescubrí que la esencia de los cuidados paliativos viene dada por la preocupación genuina de Cicely (nosotros los profesionales) con el pasado, el presente y el futuro de David (los pacientes y sus familiares o cuidadores) tratar de encontrar que el enfermo logre la paz y su curación espiritual, a través del acompañamiento, comunicación asertiva y lenguaje no verbal es lo que Cicely intento con David desde que le conoció. Sintió empatía y compasión con él. David correspondió con generosidad. Y me quede pensando si debemos considerar también a David como pionero de los cuidados paliativos, sobre todo cuando al final de la obra él dice “justo ahora empiezo” Creo que desde el cielo apoyo a Cicely para que las cosas fueran saliendo: atenciones clínicas en el hospice, la educación y la investigación. Recordé a pacientes míos que en sus últimas horas de vida me han dicho “desde el cielo te ayudaré”.
Creo que la obra trasmite muchas cosas para los que nos dedicamos a esta profesión tan magnifica: en el paciente, no importa que te ha traído a los cuidados paliativos seguramente tu historia cambiará para mejor, encontraras sentido a lo que te está pasando. En los profesionales nos muestra que somos frágiles ante el sufrimiento del otro y que podemos ser transformados en esa relación.
Mario López Saca, Palliative Medicine Doctor
I have been fortunate to witness the Spanish premiere of Professor David Clark’s play, Cicely and David. I am a physician specializing in palliative care since 2012, familiar with Cicely Saunders’ story, having read the book Watch with Me several times, and I make my students in Palliative Medicine read it as well. Every year, I ask them to write an essay on one of the book’s chapters, which enriches me greatly when I read them.
The anticipation of seeing the play generated high expectations for me and led me to engage all my senses from the beginning and continue until the end. It was like holding my breath for an extended period or freezing time while watching the play unfold.
I was moved to see the characters’ portrayal; various feelings arose in me as I heard the older Cicely telling the story to Paul. This reminded me of the bereavement interventions we often do, and seeing Cicely as one of us made me feel comfortable, reaffirming that what we do, our interventions, are correct. Sometimes, we idealize the pioneers of palliative care without realizing that they are as human as we are.
Then, seeing Cicely with David and remembering that their human relationship gave rise to modern palliative care was thrilling, and I thoroughly enjoyed every word, every phrase they exchanged. The characters’ costumes, the background, the pauses, and their roles were well executed, immersing me in the era and the conversations.
I rediscovered that the essence of palliative care is given by Cicely’s genuine concern (ours as professionals) for David’s past, present, and future (the patients and their families or caregivers), trying to ensure that the patient achieves peace and spiritual healing through accompaniment, assertive communication, and non-verbal language, which is what Cicely attempted with David from the time she first met him. She felt empathy and compassion for him. David responded generously. And I wondered if we should also consider David as a pioneer of palliative care, especially when at the end of the play, he says, “I am just beginning now.” I believe that from heaven, he supported Cicely in making things happen: clinical care at the hospice, education, and research. I recalled patients of mine who, in their final hours, have said to me, “I will help you from heaven.”
I think the play conveys many things for those of us dedicated to this magnificent profession: in the patient, no matter what brought you to palliative care, surely your story will change for the better, and you will find meaning in what is happening to you. In professionals, it shows that we are fragile in the face of others’ suffering and that we can be transformed in that relationship.
Mario López Saca, Palliative Medicine Doctor, El Salvador
Una esencia del arte es que nos permite sentir. Esto, que es tan propio del ser humano, nos recuerda que estamos vivos. Y eso es lo que la historia de Cicely y David transmitió a través de la hermosa interpretación de sus actores en el reflejo de la obra escrita por David Clark.
Fue inevitable tocar la propia humanidad en el dolor de la pérdida. Desde la desgarradora muerte de un ser querido, la pérdida de la propia vida, la propia historia, la identidad; con la culpa de no haber hecho lo suficiente, de haber perdido el merecimiento y la dignidad.
En esa oscuridad en la que sume el dolor, está ella, Cicely, representando ese faro de luz de los cuidados paliativos que acompaña en el camino. Ella, sin dejar de ser humana, con sus propios miedos, alegrías, aflicciones, aciertos y desaciertos. Desde ahí, un camino de igual a igual, Cicely y David comparten momentos no sólo de dolor, sino también sueños y esperanzas. Y justo cuando parece haber llegado el momento del ocaso, David trasciende a través del sueño de Cicely, habiendo ella trascendido en el vacío de la soledad en él, al final de su vida.
La historia de Cicely y David nos muestra un amor que nace, vive y se alimenta del contacto humano y compasivo cuando acompañamos o nos permitimos ser acompañados. Desde mis ojos, ese amor humano trasciende un sueño y deja un legado que al día de hoy sigue creciendo. Un infinito de gratitud, amor y compasión entre quienes comparten en el camino tomados de la mano.
Como paliativista me fue inevitable verme en las vivencias de Cicely, en aquellos momentos de juventud cuando va iniciando el camino de los cuidados paliativos, en su sensibilidad y entrega al cuidado de alguien que la necesita. Ver con ella, el camino que los cuidados paliativos han recorrido gracias al esfuerzo y trabajo de todos quienes lo han permitido, ha sido valioso e inspirador ya que aún hay mucho camino por recorrer.
Sentir a Cicely tan cercana en su historia y vivencias me ha recordado la importancia de creer en nosotros mismos, de creer en nuestros sueños y sobre todo, de trabajarlos constantemente.
Escuchar el mensaje de los cuidados paliativos, en las citas memorables de Cicely, en aquel escenario y llegando a todo ese público, fue un regocijo. Si el arte permite llevar y difundir conocimiento, definitivamente encontramos una potente fuente de luz para hacer visible los cuidados paliativos con esta hermosa obra de arte.
Carla Zapata, fellow de Cuidados Paliativos, Espana
The essence of art is that it allows us to feel. This, so intrinsic to the human being, reminds us that we are alive. And that is what Cicely and David’s story conveyed through the beautiful portrayal by its actors in the reflection of the work written by David Clark.
It was inevitable to touch upon one’s own humanity in the pain of loss. From the heart-wrenching death of a loved one, the loss of one’s own life, one’s own story, identity; with the guilt of not having done enough, of having lost deservingness and dignity. In that darkness in which pain envelops, there is Cicely, representing that beacon of light of palliative care that accompanies on the journey. She, without ceasing to be human, with her own fears, joys, sorrows, successes, and failures. From there, a path of equals, Cicely and David share moments not only of pain but also dreams and hopes. And just when it seems that the twilight has come, David transcends through Cicely’s dream, having she transcended into the void of loneliness in him, at the end of his life. Cicely and David’s story shows us a love that is born, lives, and feeds on human and compassionate contact when we accompany or allow ourselves to be accompanied. From my perspective, that human love transcends a dream and leaves a legacy that continues to grow to this day. An infinity of gratitude, love, and compassion among those who share the journey hand in hand.
As a palliative care specialist, I couldn’t help but see myself in Cicely’s experiences, in those moments of youth when she is starting the journey of palliative care, in her sensitivity and dedication to caring for someone in need. Seeing with her, the path that palliative care has traveled thanks to the effort and work of all those who have allowed it, has been valuable and inspiring because there is still much road to travel. Feeling Cicely so close in her story and experiences has reminded me of the importance of believing in ourselves, believing in our dreams, and above all, constantly working on them.
Listening to the message of palliative care, in Cicely’s memorable quotes, on that stage and reaching all that audience, was a delight. If art allows us to carry and disseminate knowledge, we definitely find a powerful source of light to make palliative care visible with this beautiful work of art.
Carla Zapata, Palliative Care Fellow, Spain
Accessing the playscript
If you are interested in using the script of Cicely and David (English and Spanish versions) for performance or educational purposes, please contact me at: david.graham.clark53@gmail.com
Accessing a film of the first performance
A film of the performance at Edinburgh 2023, with English subtitles, is available. If you wish toorganise a screening of the film, again, please contact me at: david.graham.clark53@gmail.com
Quotidian 