THERE were four of them staring at the flood-damaged ceiling: her father, her brother-in-law, her uncle, and the hotel manager. They were at a loss. Florence Nightingale, who had been complaining for weeks about the gurgling water-tank above her bedroom at the Burlington Hotel, finally lost her temper. Had the manager called in the plumbers? No. Had he removed the tank as he claimed to have done? No.
Later, she recorded her feelings in a private note: “I have had a larger responsibility of human life than ever man or woman before. And I attribute my success to this: I NEVER GAVE OR TOOK AN EXCUSE. Yes, I do see the difference between me and other men. When a disaster happens, I act — and they make excuses.”
That was 1860. She was 40 years old, and, although regularly bedridden with a viral infection now believed by many to have been brucellosis, she was, in other respects, at the peak of her powers.
To achieve what she had already done, and would continue to do — for the soldiers at Scutari during the Crimean War; for the health of the British and Indian armies, and, later, the Indian population in general, on behalf of whom she lobbied for better sanitation and living conditions; in the provision of professional training for hospital and district nurses; and in the establishment of specialist midwifery nurses — she had to turn herself into a single-minded, manipulative, softly spoken autocrat.
In the masculine world of medicine, the army, and politics, she would have got nowhere by being gentle and kind.
As a young woman, Miss Nightingale had been sociable, funny, lively, attractive, highly intelligent, well-connected, and not without suitors. She made a name for herself in society. “You might have become a Duchess, had you played your cards better,” wrote Benjamin Jowett, Master of Balliol, who many years later proposed to her. His was not the only offer to be declined.
She was born into a county family accustomed to mixing rich living with high thinking. In company, she was often reserved, watchful, amused, tactfully concealing her thoughts about her fellow guests until she could share them later with her confidants. She did not miss the comic detail. Lady Ashburton, she wrote to her sister, had appeared at a dinner party wearing “a raspberry tart of diamonds on her head which was worth seeing”.
When appropriate, she could display her considerable knowledge, as when she discussed theology with Chevalier Bunsen, the Prussian Ambassador and a biblical scholar; he called her “my favourite and admired Miss Nightingale”.
By her friends she was known for her gift of mimicry and her larky humour. When invited with friends to lunch at Oxford by Canon Buckland, the famous geologist and naturalist, she persuaded her host to allow a three-month-old bear cub from his menagerie to join them at table.
It was a huge joke when the creature grabbed the butter, and the learned cleric, carried away by the high spirits of his young guest, donned a cap and gown to deliver a rebuke.
But it was not enough. The round of social entertainment palled. There were long spells at their two country residences. “What have I done this fortnight?” she wrote in July 1846, aged 26. “I have read the Daughter at Home to Father and two chapters of Mackintosh; a volume of Sybil to Mamma. Learnt seven tunes by heart. Written various letters. Ridden with Papa. Paid eight visits. Done company. And that is all.” She was “bored to desperation”.
From an early age, Miss Nightingale believed that God had called her to his service, but he had not made clear to her what that service should be. She unburdened herself to her “journal” — a mass of notes on random bits of paper — and accused herself of frivolity and vanity. “All I do is done to win admiration,” she wrote. She made herself ill with uncertainty and guilt.
“When one thinks there are hundreds and thousands of people suffering,” she wrote to a confidante, “when one sees in every cottage some trouble which defies sympathy — and there is all the world putting on its shoes and stockings every morning all the same.”
Visiting the cottages near Lea Hurst, one of the two Nightingale country houses, she wrote: “My mind is absorbed with the idea of the sufferings of man. . . All the people I see are eaten up with care or poverty or disease.”
She began to bring basic medical attention to some of the sick and elderly. “Rubbed Mrs Spence for the second time. I am such a creeping worm that if I have anything of the kind to do, I can do without marriage or intellect or social intercourse or any of the things that people sigh after . . . it satisfies my soul. It saves my soul from destruction. I want nothing else, my heart is filled. I am at home.”
Now, at last, it had become clear to her that her vocation was to nurse, and to train nurses. But her decision, in the 1840s, to enrol at Salisbury Infirmary met with outraged opposition by her family. They forbade her to do it, although later she managed some training as a nurse with the Lutheran religious community at Kaiserswerth am Rhein, which she first encountered in 1850.
To understand her parents’ reaction to the idea of their daughter’s becoming a nurse, one must know that the occupation of nursing was at that time nearly as notorious as that of prostitution. The squalor of the hospitals was such that, in Miss Nightingale’s own words, “it was preferred that nurses should be women who had lost their character.”
“Nurses are drunkards,” declared the senior physician of a large London hospital in 1851, and, at the time, most people would have agreed.
Initially thwarted in her wish to nurse, she was compelled to stay at home, complying as best she could, and as cheerfully as she might, with the expectations of her parents and sister. Apart from her social duties, she was put in charge of the still-room, the pantry, and the linen room. Not at all a Cinderella, much more the chatelaine.
After a hard day’s work in the still-room in charge of preserving and bottling fruit, she wrote to her cousin, Hilary Bonham-Carter, about “supervising fifty-six jam pots with the eye of an artist”. She drew up “green lists, brown lists, red lists”. “I am up to my chin in linen, glass and china,” she wrote at Christmas 1846.
The lists survive in the Verney Nightingale archive: notebooks recording in meticulous detail the large collection of silver, china, and glass, and noting the damages, losses, repairs, and replacements.
IT WAS this attention to detail, combined with her formidable organisational skills, which accounted for her achievement during the Crimean War (1854-56). At the British military hospital in Scutari, Turkey, the chatelaine became the quartermaster. It was not what she went out to do, but there was no one to do it.
Within the first two months, she had ordered 6000 shirts, 2000 pairs of socks, 500 pairs of underpants, and a proportionate amount of nightcaps, slippers, plates, tin cups, forks, and spoons. To do this, she had to cut through the military red tape. Her access to the Times fund (£30,000), and her acquaintanceship with the Secretary of War, Sidney Herbert, made that possible.
She had to overcome hostility from the military and medical staff at every level. One example suffices: on the wards, in the absence of any effective sanitation (the lavatories were broken), there stood large open wooden tubs. Because the orderlies had refused to empty them, they overflowed, and in some wards the floors were covered with excrement and urine.
To compel the orderlies to empty the tubs she stood quietly beside each one, sometimes for up to an hour, neither scolding nor raising her voice, until she got her way.
Getting her way was, as the Government soon discovered, what she always did. She succeeded because she made sure she knew the facts, and then, having mastered the subject, she pulled every string she could.
IN LATER years, when she was gathering information for the Royal Commission on the Health of the Indian Army, she wrote to 200 military stations, and to every senior military and medical officer whom she knew in the subcontinent, or to whom she could get an introduction. It was said that her knowledge of India was so great that every viceroy visited her before taking up his post.
And previously, when she had been preparing the report of the Royal Commission on the Health of the British Army, she printed 2000 copies of a pamphlet she had written, “Mortality in the British Army”. In it, she presented the statistics by use of graphic charts — the first time, it is thought, that anyone had used that device in a formal report. Later, she became the first woman to be elected to the Royal Statistical Society, and to be awarded the Freedom of the City of London.
She sent the pamphlets to the Queen, the Commander-in-Chief of the Army, and every member of both Houses of Parliament. Enclosed with each copy she wrote a personal letter implying that the recipient was being given privileged information. “This is for your own reading,” she wrote to one; and, to another: “Please do not leave this about.”
To Mr Herbert she explained: “It is always more gratifying to people to have a thing they think other people have not.”
She knew how to exploit her fame, although she claimed to despise it. She rarely appeared in public. After her return from Turkey, her chronic ill-health meant that for years she hardly went out — although this did not affect her reforming agenda, or prevent her writing more than 200 books and pamphlets that were influential in the field of nursing, and hospital planning and organisation, which are still respected today.
THE world came to her, but, as Gladstone discovered when he was turned away, it was as well to make an appointment. On one occasion, she was advised to take the cure at Malvern. Her journey became a royal progress. At her departure, by train, the stationmaster and his staff stood bare-headed as veterans of the Crimea carried her chair through a hushed crowd to the waiting carriage.
Benjamin Jowett was right: Miss Nightingale might well have married a duke and become a great society hostess. She chose to play her cards differently, however. To achieve what she believed was her purpose in life, she gave up much. Friendship and love — she had been passionate in both — were put aside. Atalanta’s golden apples, she called them.
“Dearest,” she wrote in valediction to one of her closest friends, “it is well that we should not see too much of each other. Farewell, my beloved one.” And, in a private note, she wrote: “O God, no more love. No more marriage, O God.”
She was a young woman when she wrote those words. Years later, the novelist Elizabeth Gaskell wrote of her: “She has no friends and wants none. She stands alone. . . Her powers are astonishing.”
Miss Nightingale died on 13 August 1910, and, as her family had turned down an offer of burial at Westminster Abbey, she was buried in the graveyard at St Margaret’s, East Wellow, in Hampshire.
Achievements of Florence Nightingale
• awarded the Royal Red Cross by Queen Victoria, in 1883
• first woman to be awarded the Order of Merit, in 1907
• established a School of Midwifery at King’s College Hospital, a model for the country, which today is the Florence Nightingale School of Nursing and Midwifery
• inspired the founding of the International Red Cross, which still awards a Florence Nightingale Medal
• International Nurses Day celebrated around the world on 12 May, her birthday
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