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10 1 Setting the Stage Saunders “just opened the door to me,” Wald recalled. Saunders “solved the problem that both the faculty and the students were having in the hospital, seeing patients, particularly cancer patients, being treated with curative treatment, and where it was very obviously not curing the disease,but the suffering was so great. . . .They couldn’t get the doctors to tell them what was . . . the outlook for them, or to consider a variety of ways of treating the situation.”1 Saunders traced her interest in end-­ of-­ life care to her work with a Jewish immigrant from the Warsaw ghetto who was dying in a London hospital. She then gained additional experience caring for terminally ill people at two other London facilities: St. Luke’s Hospital and St.Joseph’s Hospice.By 1963 when Saunders traveled throughout the United States, she had developed a new method of pain control and begun planning St. Christopher’s, the hospice she established in London four years later. In talk after talk, she chastised doctors who concluded there was “nothing more to be done” for patients desperately needing pain relief and spiritual and emotional solace. At Yale she received a standing ovation. Although Wald, then dean of the nursing school, was not in the audience, she heard about it from a colleague and soon established a close relationship with Saunders.Throughout the rest of her life, Wald referred to Saunders as her primary mentor.2 Born in New York City in 1917, Wald noted that she learned to value social justice as a child. Her father was a banker and Setting the Stage 11 her mother a secretary. Although neither attended college, she described them as “very vigorously self-­ educated.”They also “were very liberal in their thinking.”Her father subscribed to The Nation, and both parents registered as Socialists and championed Norman Thomas. Her mother volunteered at a health care clinic serving poor people.3 Religion, however, had no place in the family. Although her father was Christian by background and her mother Jewish, Wald stated that both were “free thinkers, and really never depended on religion as their spiritual resource throughout their life,even through death.”Wald’s father complained that the churches took too much money from people.4 He appears to have had a special antipathy toward Catholicism, the religion of half the participants in Wald’s study. Her father led the family on Sunday morning walks and “as we passed the Catholic church when the congregants were saying Hail Marys, he would shake his walking cane at the church and shout ‘Papist pap for the masses.’”5 Throughout her life, Wald railed against the harm caused by organized religion.6 According to her daughter Shari Vogler, however, Wald’s husband was born into an orthodox Jewish family. When they married,they agreed to bring up their children as Jewish.They belonged to a conservative synagogue and celebrated the High Holidays and Passover.7 Wald graduated from Mount Holyoke in 1938 and the Yale School of Nursing in 1941. Her first job was at Henry Street Nurses Settlement, established by Lillian Wald in New York’s Lower East Side. (Although Florence liked people to associate her with Lillian Wald, they were not related.) By the time Lillian Wald retired in 1933, the nursing service had cared for 100,000 patients,many of whom were immigrant and poor.8 Florence Wald was disappointed to find it had changed dramatically when she arrived in 1942. As she told an interviewer, “it was not really helping the impoverished or the disadvantaged” but was “just nursing. It didn’t have its social component.”9 She left in 1944 to enter the U.S. Army Signal Corps and then worked as a research assistant in two medical facilities. In 1953, she joined the nursing staff at New York’s Babies Hospital. Founded in 1887 by two physicians who Fig. 1. Florence Schorske Wald (Credit: Yale University, Harvey Cushing/John Hay Whitney Medical Library) Setting the Stage 13 were sisters, Babies Hospital served children younger than three. During the 1920s, it was affiliated with Columbia-­ Presbyterian Hospital.10 At Babies Hospital,Wald began to join an interest in psychiatry to her long-­ standing commitment to social justice. In that period, psychiatry increasingly meant Freudian psychoanalysis. As a past president of the American Psychiatric Association noted, “By 1960, almost every major psychiatry position in the country was occupied by a psychoanalyst,” and “the psychoanalytic...

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