11/07/2025
Thank you Florence Wald.
In 1974, a nurse opened a place where people came not to get better, but to die well.
It was revolutionary.
Today, millions of Americans have access to hospice care because of her.
This is the story of how kindness became medicine.
Florence Wald was the Dean of Yale School of Nursing in the early 1960s—one of the most prestigious positions a nurse could hold. She'd achieved everything her profession offered: respect, influence, a platform to shape the future of nursing education.
But something troubled her deeply.
She'd spent years in hospitals watching patients die—and watching how poorly American medicine handled death. Patients with terminal illnesses were subjected to aggressive treatments long after they offered any hope. They died in sterile hospital rooms, separated from families, surrounded by machines and strangers, treated until the very end as medical cases rather than human beings.
The medical establishment measured success by survival rates and cure percentages. If you couldn't cure someone, medicine often seemed to lose interest.
Florence kept returning to a question: What about the patients we can't cure? Don't they deserve excellent care too?
In 1963, she attended a lecture at Yale by Dr. Cicely Saunders, a British physician who was developing a radical new approach to caring for the dying. Saunders talked about "total pain"—the idea that people at the end of life suffered not just physically, but emotionally, spiritually, and socially.
She described a different model of care: one that focused on comfort rather than cure, on quality of life rather than quantity, on supporting the whole person—and their family—through the dying process.
Florence was transfixed. This was what had been missing.
In 1967, Dr. Saunders opened St. Christopher's Hospice in London—the first modern hospice, built on principles of pain management, emotional support, and dignity in dying. Florence immediately arranged to visit.
What she saw changed everything.
At St. Christopher's, patients weren't hooked to endless machines. They weren't subjected to futile treatments. Instead, they received expert pain management, emotional counseling, spiritual support. Their families were included in care. Children could visit. Pets were welcome. The environment was warm, homelike.
Patients there didn't just die—they lived until they died. They told stories. They laughed with family. They found peace and meaning in their final weeks or months.
Florence returned to America with a mission: to bring this model of care to the United States.
But the obstacles were enormous.
American medicine was focused on fighting death, not accepting it. Hospitals measured success by discharges and survival rates. Insurance didn't cover "comfort care"—it covered treatments, procedures, cures. The entire system was built around the assumption that medicine's job was to save lives, not to make death bearable.
Florence faced skepticism from colleagues: Why would we give up on patients? Isn't hospice care just giving up?
She faced financial challenges: Who will pay for care that doesn't lead to cure?
She faced cultural resistance: Americans don't want to talk about death. They want hope.
But Florence understood something others missed: Hope doesn't always mean cure. Sometimes hope means comfort. Sometimes it means dignity. Sometimes it means dying surrounded by love instead of machines.
In 1966, Florence made a decision that shocked the medical establishment: she resigned as Dean of Yale School of Nursing—walking away from prestige and security—to pursue hospice work full-time.
She assembled a team: a chaplain, a surgeon, a pediatrician, fellow nurses. Together, they studied dying patients' needs. They interviewed families. They researched pain management techniques. They developed a model adapted for American healthcare.
And in 1974, they opened Connecticut Hospice in Branford, Connecticut—the first hospice in the United States.
It wasn't a hospital. It didn't look clinical or institutional. It was designed to feel like home—with comfortable rooms, natural light, space for families to gather, gardens where patients could sit.
The care philosophy was revolutionary:
• Pain management: Aggressive use of medication to ensure comfort, without fear of addiction in terminal patients
• Family involvement: Families weren't visitors—they were partners in care
• Emotional and spiritual support: Chaplains, counselors, and social workers were as important as nurses
• Patient autonomy: Patients decided their care goals, not doctors
• Quality over quantity: The goal wasn't more days—it was better days
When the first patients arrived, something remarkable happened.
People who had been suffering—physically and emotionally—found relief. Families who had felt helpless watching their loved ones decline found ways to help, to connect, to say goodbye with intention. Patients who had felt like burdens discovered they could still have meaningful moments with family.
Death didn't become less sad. But it became less frightening, less lonely, less inhumane.
The model worked.
News spread. Other communities wanted hospices. Healthcare professionals visited Connecticut to learn. Within a decade, hospices were opening across America—in hospitals, nursing homes, and eventually as home-based services.
By 1982, Congress added a hospice benefit to Medicare, making hospice care accessible to millions of elderly Americans. By the 1990s, hospice had become a standard part of American healthcare.
Today, over 1.5 million Americans receive hospice care each year. The National Hospice and Palliative Care Organization estimates that hospice programs exist in virtually every community in the United States.
Florence Wald didn't invent the concept—that credit belongs to Cicely Saunders. But she brought it to America, adapted it, fought for it, and proved it could work within the American healthcare system.
She transformed how a nation thinks about death and dying.
Florence continued her work long after Connecticut Hospice opened. She advocated for prison hospice programs—believing even incarcerated people deserved dignified deaths. She researched care for people with AIDS during the crisis of the 1980s. She pushed for better palliative care education in medical schools.
In 1998, she received the National Medal of Science—not for discovering a cure or inventing a technology, but for changing how we care for the dying.
Florence Wald died on November 8, 2008, at age 91. Appropriately, she died at home, receiving hospice care—the model of care she'd spent her life bringing to America.
Her legacy lives in every hospice nurse who holds a patient's hand. In every family who gets to say goodbye at home instead of in a hospital. In every patient who dies without pain, surrounded by love, with dignity intact.
She proved that some breakthroughs aren't about technology or speed.
They're about recognizing that medicine is not only about adding days to life, but adding life to days.
That comfort is medical care. That dying well is as important as living well. That the last chapter of life deserves the same attention, compassion, and excellence as the first.
Florence Wald looked at how America treated its dying and said: We can do better.
Then she spent her life proving it.
Not with new drugs or surgical techniques.
But with something medicine had forgotten:
Kindness. Dignity. Presence.
The revolutionary idea that caring for someone means honoring them—even, and especially, at the end.
