The First Hospices

On Tuesday my father died at Community Hospice House. He'd been diagnosed with bone cancer in the spring and finally entered hospice when it was clear that he had about a week to live. It was my first experience with hospice, and I was struck by the intense level of individualized care provided by the staff. Quite different from hospitals and nursing homes.

What intrigues me is that while modern hospices as we know them originated in the 19th century, the earliest hospices were born around the time of the medieval crusades, catering to sick pilgrims. The Hospitallers treated the sick as if they were kings and queens, not only in the hospices in and around Jerusalem, but particularly in the great hospital near the Church of the Holy Sepulchre. Jonathan Riley-Smith describes the institution as follows:

"This establishment was run on a staggering scale, with almost unimaginable luxury for the time... There were separate beds throughout and in the obstetrical ward there were also little cots for the children born to women pilgrims. The diet of the inmates was lavish by contemporary standards. They were given white bread and on three days a week fresh meat: pork or mutton, or if they could not stomach these, chicken. Four physicians and four surgeons were on the staff, assisted by nine sergeants-at-service in each ward. The spiritual needs of the patients were carefully met. On reception each inmate made confession and received communion; thereafter he or she seems to have been encouraged to receive the Sacrament every Sunday. The expenses of this hospital, serving patients who were probably sleeping in separate beds for the first time in their lives and certainly would never have eaten white bread and meat regularly or have had such close spiritual supervision, must have been enormous." (The Crusades, p 58)

This mirrored the general care offered by hospices during the time of the earliest crusades (c. 1095-1187 CE). While the Hospitallers began assuming military duties by the 1130s, they still retained a focus on caring for the poor and diseased on a level that was, by contemporary standards, rather astounding.

We've come a long enough way that separate beds and white bread may not seem terribly impressive, but our modern hospices continue to outshine other medical facilities in terms of holistic devotion to the patient. It's an irony that these extraordinary institutions of care and compassion were first run by "holy warriors", but as I've said before, the crusades are often unfairly maligned. I'm grateful my father was able to spend his final hours in such a place.