Honoring a “founding mother” of the hospice that was the Mother of Hospice Regattas in 1982, the Hospice Cup.
We are an aging population and in the coming decades end of life issues will be taking on more importance in the health care arena. Dr. Elisabeth Simms, recognized as a “founding mother” of palliative care and hospice, has spent virtually her entire career as a doctor caring for patients who face advanced illness. On October 30, she was recognized as Capital Hospice’s 2010 Passion for Caring Honoree at the organization’s 21st annual gala at the Ritz-Carlton Hotel Tysons Corner.
Simms, the first physician to ever receive this award, helped pioneer hospice care in the U.S., working with Dr. Josefina Magno, who helped establish Hospice of Northern Virginia, now known as Capital Hospice. Magno’s work paved the way for hospice and palliative care within the medical community.
We met with Simms at Katie’s Coffee House near her home in Great Falls. After championing hospice for so long, Simms now finds herself caring for her husband. It’s a situation that is all too familiar to her and she takes her own advice to heart. “Communication between the family and the caregivers is so critical,” she said. “It doesn’t always happen the way you want it to.”
Simms was a schoolgirl in Lynfield, north of Boston, when her father made the decision to leave his career as an engineer to become a minister. “He shared [the reasons] for his decision,” she said. “I have a clear memory of sitting down with him and listening to him explain what he wanted to do.” As an adolescent, she was at a point in her life when she was giving thought to her own future. “He knew it was going to involve financial sacrifice,” she said. Her mother had to go back to work to make up the loss of income. “It was a family project in many ways, but there were never any regrets. It was a positive thing for me and my brother.”
Her father’s decision had an unexpected benefit. As the daughter of a minister, she won a scholarship to Wellesley College. “I started thinking about medical school in high school,” she said, influenced, not only by her father’s decision to give back, but also by many of the doctors she read about—Thomas Dooley, known for his humanitarian efforts in Southeast Asia, and Albert Schweitzer, known for his missionary work in Africa. “These were doctors who were on a mission,” she said.
It didn’t take long for Simms to discover her own mission. At Boston University Medical School, Simms was one of 20 women in a class of 400. She called selecting a medical specialty a “process of elimination.” Knowing she wanted to work with adults, internal medicine became her first choice, signing on to do an elective in gynecology with a doctor she found inspiring. “Gynecological oncology didn’t exist, but all his patients had breast, uterine, or ovarian cancer,” she said. “He was a good mentor and role model. You tuck those experiences away and, as time went on, I became interested in helping seriously ill older adults.”
She graduated from medical school in 1976. Elisabeth Kubler-Ross was continuing to make headlines with her observations on death and dying, while Dr. Cicely Saunders was pioneering the hospice movement in Great Britain. “Big sparks were happening, she said. Closer to home, Simms was encountering end of life situations. “I had the experience of being with people as they died,” she said. In many cases, the family was not permitted to be at their loved one’s bedside and had no role in making critical decisions. Simms recalled thinking: “We can do better than this. This needs to change.”
Change would come, and Simms would play a pivotal role. After medical school, she did a fellowship in oncology at the National Institutes of Health (NIH). Her return to Virginia (her father had become a minister there while she was in college), coincided with Dr. Josefina Magno establishing the Hospice of Northern Virginia. “Somehow I learned that Dr. Josefina Magno was looking for someone to do home visiting,” she said. The two women met at Josefina’s house, talking for two hours while rocking on a porch swing. “She was a captivating person,” Simms said. “I remember calling my husband when I got back to work. My heart was racing. The commitment was made. It just felt right.”
She would begin making home visits to critically ill patients in Loundon County. One encounter stands out in her mind—a woman with breast cancer suffering excruciating pain. Along with a nurse from the county health department, Dr. Simms went to the nearby pharmacy. Fortunately, she found herself on the same wavelength as the pharmacist who had recently attended a conference on pain management. He took out his information, she took out her prescription pad and they made a plan. The nurse returned to the cabin, administering oral morphine to the woman in order to get her pain under control. “Pain can be debilitating,” she said.
Simms became the medical director of the Hospice of Northern Virginia from 1983 through 1988. Now renamed Capital Hospice, it is recognized as one of the top ten largest hospices in the U.S. with more doctors and nurses certified in hospice and palliative care than any hospice organization in the country.
Today, Simms has a thriving medical practice, but also continues to make home visits, something she sees as critical to her work. She believes that everyone should have access to hospice services, no matter their income. Capital Hospice has a Patient Care Fund to help those who might not otherwise be able to afford hospice care.
Simms doesn’t need a crystal ball to know that the demand for palliative care will continue to grow. And through her practice and home visits, she will continue to do all she can to relieve suffering, work with families, and teach other doctors about end of life care. Accepting her award, she observed: “My goal during the early days of palliative care was simply to create relief of suffering. Doctors then would often say, `There is nothing else to be done.’ That’s an awful thing to say to someone. There is always something more to be done from my perspective.”
For more information on services offered by Capital Hospice, visit www.capitalhospice.org, or call 1-800-869-2136.