What Drove Florence Nightingale was Rage.
Was it her frocks that first attracted me? At the age of six, frizzy-haired and dressed in polyester, I was given the Ladybird book of Florence Nightingale and gazed for hours at her image: a beautiful lady in a tight-waisted gown, white cap and apron holds aloft a lamp whilst wounded men in tidy beds look on adoringly. To me she was the Virgin Mary, fairy-tale princess and head girl all rolled into one.
Years later, inspired to write a novel, The Rose of Sebastopol, based on her life, I dug deep and travelled far in search of her. And discovered that what drove the real Florence Nightingale was rage. The moment when she escorted a party of ill-trained women to work in an army hospital was the turning point in her life. She was Winston Churchill, Greta Thunberg or Captain Tom…. Cometh the hour…
Now on the 200th anniversary of her birth, with a new special edition of my novel just out, more than ever I want to celebrate who she really was, what we can learn from her and why her pioneering spirit lives on today…
Her first momentous battles were with her family. On their prolonged honeymoon her parents produced baby Parthenope (the Greek name for Naples), then, just over a year later, on 12th May 1820, Florence was born – again named after her birth-place. At first glance Nightingale’s childhood seems pretty charmed. The family had two country estates funded by a lucrative lead-smelting business and a busy social life amidst a vast extended family and well-connected friends. Florence was educated at home by her father, especially in mathematics, and had jaunts to Paris, Athens and Egypt.
Otherwise, all day long she was at the beck and call of her mother and sister, who expected her to fritter away hours on needlecraft, piano and endless chatter. She raged against lack of privacy, moral purpose or any direction other than marriage – and called it a form of starvation. To have no food for our heads, no food for our hearts, no food for our activity, is that nothing?
The one activity that did fulfil her was nursing. Sickly Parthenope gave her plenty of practice, as did the poor villagers on her father’s estate. The terrible irony is that some of them might have been actually poisoned by lead in the water – a by-product of the lead smelting upon which the Nightingale fortune was founded. But when Florence dreamed up the idea of training in a local infirmary her family and friends were flabbergasted; she might just as well have suggested a career in prostitution. To them, the nurse was either a female relative who was ‘naturally’ supposed to know how to minister to the sick, or the type of low-born woman who worked in one of the nation’s filthy hospitals, too drunk or lazy to be a housemaid
Florence further enraged her family by turning down at least three suitors. Richard Monckton-Milnes proposed on such a regular basis that it became a habit for him to turn up for dinner, propose, get rejected and then ride home. Nightingale dubbed him her ‘poetic parcel’. Loaded with cash and friends, he seemed destined for greatness but his greatest claim to fame was his ability to spot and sponsor talent – he wrote the first biography of the poet John Keats. But as well as refined tastes, Richard had a coarser side. Had Florence married him it’s mind-boggling to imagine how, as Lady M. Milnes, she would have reacted when introduced to his extensive library of erotica. Rather poignantly, when he at last gave up asking she was distraught. Perhaps her description of marriage as a form of suicide had been the final straw.
By the age of thirty-three Nightingale thought she’d achieved nothing. She couldn’t know that her years of frustration had poised her for the great adventure of her life. Despite agonising self-doubt she had developed a steely sense of purpose, was an expert at resistance, had impeccable connections, and a powerful talent with the pen. What’s more, she’d wangled a couple of weeks observing in a German nursing institution. The stage was set.
First, the prelude. When the post of superintendent of a home for distressed gentlewomen was offered she accepted, despite family protest. The home’s committee of high-born ladies had no idea what they’d taken on. Miss Nightingale interested herself in everything from the cost of jam to dirty chair covers.
A year later, Britain declared war on Russia. In March 1854, 30,000 troops set sail for the Crimean Peninsular, spirits high, blissfully unaware that nobody had bothered to plan ahead. Within three months 1,000 troops were dead with cholera – and not a shot had been fired. The weather was so fine the men were instructed to leave warm clothes in the ships and within days they were struck by icy winds. And when the first battle was fought nobody knew what to do with the wounded. A rudimentary hospital had been established in an old barracks in Scutari, in Turkey (near Istanbul), but it was a week’s voyage from the Crimea, where the battles were fought.
A newspaper correspondent wrote: Not only are men kept… for a week without the hand of a medical man coming near the wounds ….but now, when they are placed in a spacious building where we were led to believe that everything was ready that could ease their pain or facilitate their recovery, it is found that the commonest appliance for a workhouse sick-ward are wanting…
Worse still, the papers compared the British arrangements to those of the French who were assisted by Sisters of Charity….these devoted women are excellent nurses….
Famously, Nightingale’s letter offering to lead a party of nurses to the Crimea crossed with Sidney Herbert’s, the secretary of state at war and a close family friend: ‘There is but one person in England… who would be capable of organising and superintending such a scheme…he wrote.
Florence Nightingale’s letters home make sensational reading. She details the horrors she encounters, the deficiencies in the arrangements, the soaring death-rate. ‘We are steeped up to our necks in blood…’
‘These poor fellows have not had a clean shirt nor been washed for two months ….the state in which they arrive ……is literally crawling. .. I have ordered 300 scrubbing brushes….’
She was soon battling with everyone – from the surgeons who clung to their old methods, to those in charge of supplies who blocked Nightingale at every turn, to some of her own nurses who got drunk, too cosy with the soldiers or, worst of all, tried to convert them to Catholicism. And she battled with the government back home. Nobody was spared, including Sidney Herbert, who made the mistake of sending out another party of women, against Nightingale’s wishes:
To have women scampering about the wards of a Military Hosptl all day long, which they would do, did an increased number relax their discipline….would be as improper as absurd.
She knew that if female nurses were to be tolerated in that male world of army medicine their behaviour must be impeccable so she attended to every detail of their lives from petticoats – grey, not white – to insisting that they were never alone on a ward or on the streets. She certainly made sensational enemies – not least amidst some doctors, and a nun she dubbed Mother Brickbat – but she also commanded extraordinary loyalty. Her dedication to the wellbeing of the ‘common’ soldier was unquestionable.
To the public back home, desperate for good news, Nightingale became the iconic figure I had so admired in my Ladybird Book: the Lady with the Lamp. And it’s true she did make nightly ward rounds, and wounded soldiers probably kissed her shadow. But she was actually forging ahead with a far less glamorous legacy; the wholesale reform of military hospitals and army medicine.
When she returned to England the nation was ready with bunting and a huge fund-raising campaign. But Florence arrived unannounced and walked up from the station, emerging on the drive at home as a thin, solitary figure, clad in black. She was to live on for more than fifty years and for most of them she took to her bed.
There are a number of theories about what afflicted Florence Nightingale. During the war she had been stricken with the dreaded Crimean Fever – most likely a form of brucellosis which caused exhaustion, fever and excruciating pain in the spine and joints. Others think it was lead poisoning, thanks to childhood exposure. Or that she suffered from post-traumatic stress after her gruelling work amidst that relentless tide of dying men.
Whatever the cause she now had the perfect excuse to escape family life forever. Nightingale’s work had only just begun. Fascinated by statistics and data, she was horrified to discover that the death rate in her own hospital in Scutari had been higher than in other hospitals on the battlefields. Until then she had not fully understood how infection would spread in a hospital – despite 300 scrubbing brushes – if it was built over a cess pit. What’s more, the stats informed her that the death-rate among soldiers, even in times of peace, was nearly twice that of ordinary civilians. As a campaigner she was up against a ponderous Royal Commission but her name was a powerful weapon. As was her pen. From her sick bed she wrote a torrent of words, Notes on Hospitals, Nursing, Army Medicine, The organisation of the army in India.
Yet she was initially very reluctant to give her name to a new school for nurses. After her experiences in the Crimea she predicted – rightly – there’d be endless arguments about the role of the nurse, how she should be trained, and who should train the trainers. Being Florence, she insisted on the importance of good personal habits (by which she meant punctuality, cleanliness and ‘moral’ discipline), but there was much debate on how far nurses needed to know anatomy as opposed to bed-making. Once committed, Florence enquired into every detail about a probationer’s progress. And was closely involved in designing a new-style hospital, the rebuilt St Thomas’s, that would conform to her ideal of cleanliness and clean air for all patients.
To celebrate the 200th anniversary of Nightingale’s birth, 2020 is designated by the World Health Organisation as The Year of the Nurse, and it’s a devastating irony that now, because of Covid, new temporary hospitals have been erected in her name. I suspect that her views on the current crisis would have made uncomfortable reading. In her lifetime medicine was transformed – not least through the introduction of anaesthetics and the understanding of how germs are spread through dirty water and dirty hands – thus vindicating her obsession with cleanliness, clean air and discipline. Although she might have been shocked at the idea of nurse consultants and academics, she would have applauded our belated recognition that the wellbeing of our nation now relies upon nurses and their key role within the NHS.
She was a brilliantly infuriating, contradictory, indomitable human being. A thorn in the side of anyone who stood in her way. But her vision was as bright as the lamp she carried in those dark wards at night. We have all to be grateful that instead of the drawing room she opted for a faraway army hospital built over a cesspit. And that she rejected the role of dutiful daughter and instead was a marvellous fury who could never rest in a world where sick people died from inadequate care.
A still from Scrapbooks are out of fashion (made in collaboration with Derby Libraries)