"Two figures emerged from the Crimea as heroic, the soldier and the nurse. In each case the transformation in public estimation took place, and in each case the transformation was due to Miss Nightingale. Never again was the British soldier to be ranked is a drunken brute, the scum of the earth. He was now a symbol of courage, loyalty, and endurance, not a disgrace but a source of pride. She taught officers and officials to treat the soldiers as Christian men.
"Never again would the picture of a nurse be a tipsy, promiscuous heritage. Miss Nightingale had stamped the profession of nurse with her own image.... The nurse who emerged from the Crimea, strong and [full of pity], controlled in the face of suffering, unselfseeking, superior to considerations of class or sex, was Miss Nightingale herself. She ended the Crimean war obsessed by a sense of failure. In fact, in the midst of the model and the filth, the agony and the defeats, she had brought about a revolution."
A workmanlike and thorough biography, slow to start. The book really gets traction, however, once Nightingale's experience in the Crimea begins, then becomes again a bit rudderless chronicling the remainder of her unbelievably productive career and life. Not gripping or a page-turner, but a book that takes a patient reader on an interesting journey through the Victorian era, and offers a curious reader a wonderful collection of topics for further exploration (see reading list below).
Notes/Quotes:
* While living in Italy as a youth, Florence was moved by the cause for Italian freedom movement from under Austrian hegemony, and while living in Geneva shortly afterward, she was further struck by a near war between France and Switzerland when Napoleon III came to Geneva to see his dying mother. Florence was also struck by the isolation of England and the English people from these geopolitical crises, simply by virtue of living on an island just off the continent. Reminiscent of a similar isolation of the United States for much of its early history.
* "All I do is done to win admiration." Florence struggles with her calling, with finding her purpose, and berates herself for shallow motivations.
* "Do you think it would be unsuitable and unbecoming for a young English woman to devote herself to works of Charity in hospitals and elsewhere as Catholic sisters do? Do you think it would be a dreadful thing?"
* "My dear miss Florence, it would be unusual, and in England whatever is unusual is thought to be unsuitable; but I say to you 'go forward,' if you have a vocation for that way of life, act up to your inspiration and you will find there is never anything unbecoming or unladylike in doing your duty for the good of others. Choose, go on with it, wherever it may lead you and God be with you."
* Appalling conditions in hospitals of that era, and "low morality" of hospital workers was accepted, and presumed, which is why Florence's family was appalled and scandalized by her desire to become a nurse.
* She rejected multiple suitors, something way out of the norm for the Victorian era, also appalling to her family.
* I have more respect for her battles against her as social norms, as well as her rejection of her family's expectations of a "woman of her station," than anything else.
* Her sister Parthenope, melodramatic, narcissistic, sucking life force and attention from Florence, using her in her control dramas. They have an extremely difficult relationship. It's striking.
* One crystal clear take away from this book is how you have to follow your mission, and you cannot let haters or dreamzappers or even malicious or manipulative family members hold you back. Fuck 'em. You have to follow your mission.
* Her hospital work, her studies, were just a dress rehearsal for the Crimean war, 1854.
* Worth noting that it took 40 years from the English victory over Napoleon at Waterloo, for the English military to revert to incompetent. It only took 20 years for the US military to accomplish the same degradation after World War II. History often rhymes.
* The book clearly changes tone and urgency, and becomes much more readable and enjoyable when we enter the Crimean war era of Florence nightingale's life.
* "This is not a Lady but a real Hospital Nurse... and she has had experience."
* "There is that one person in England that I know of who would be capable of organizing and superintending such a scheme." Family friend Sydney Herbert who at the time was secretary at war for England, directing Florence Nightingale to go to the Crimea to assist British soldiers.
* The potential to change, totally, how nurses were perceived in English society at that time.
* Only 38 decent nursing candidates showed up to join Nightingale to go to the Crimean theater, and they needed 40.
* Also her mother and sister who subverted Florence's nursing goals all along suddenly changed their mind when she received her directives to help soldiers in the Crimean War. Suddenly they decided they wanted to take pride in her commission, and bask in her reflected glow.
* She and her team arrived at Scutari in Turkey, but then are completely cold-shouldered by the military doctors and medical staff at the hospital there. Totally ignored, not used, even seen as a threat! But the arrogant stonewalling of the medical staff collapsed as the entire British army collapsed, as Scutari hospital was totally overwhelmed totally with a massive numbers of wounded. At this point the arrogance of the medical staff in the military melted, and they became grateful for help from Florence Nightingale and her team of nurses.
* Reminiscent of how even highly intelligent doctors often cannot see "where the puck is going to be" when it comes to healthcare decisions, and they constantly find themselves helplessly skating to where the puck is.
* See also embarrassing Victorian-era politicking and religious infighting: people pissed that too many Roman Catholics were among the nurses, and not enough nurses from the Church of England etc., when Florence Nightingale only wanted women who were competent, irrespective of their faith.
* I don't think it's an exaggeration to say that Florence Nightingale completely revolutionized wartime medicine, revolutionize the administering of supplies, and obviously revolutionizing the gathering and analysis of statistical information of wartime casualties and medical outcomes.
* "The troops worshiped her: "'What a comfort it was to see her pass even,' wrote a soldier. 'She would speak to one, and smile to as many more; but she could not do it all you know. We lay there by hundreds; but we could kiss her shadow as it fell and lay our heads on the pillow again, content.'"
* She becomes severely ill with Crimean fever in May 1855 while examining the hospital at Balaclava and attempting to deal with political struggles for control of that hospital. Almost unbelievable the degree of backbiting and subversion she had to face, both among military officers, staff at the hospital, nurses under her authority etc., while at the same time her legend grew back home as soldiers returned to England from the war. It's always darkest before the dawn.
* The reader really gets the impression that Nightingale understood the difference between laurels/public approbation and actual productive work done out of the public view. True virtue is practiced out of the public eye.
* She finds an even greater calling calling to reform the treatment of the British private soldier. " She must look after the troops not only when they were ill but when they were well." "I can never forget." She's traumatized by visions and memories of the hospital wards at Scutari hospital.
* The problem was she exposed the murderous incompetence of the British military medical chain of command for murderous incompetence, and afterwards they did whatever they could to resist any of her suggestions for improvements. They were automatically, autonomically opposed to her. Reminds the reader of the story of the reviled Hungarian doctor Ignaz Semmelweis, who vainly tried to convince his peers of the value of handwashing, and was destroyed for it. Again: history rhymes.
* Fortunately she receives backing from Queen Victoria herself, and then teams up with Dr John Sutherland and Dr William Farr, both pioneers in the application of statistics to medicine. They produce a devastating report of mortality among British army soldiers in hospitals.
* She nearly works herself to death multiple times. "To contemplate the work which Miss Nightingale performed for the army produces a sensation of weariness. It is too much. No one person should have driven herself to accomplish all this."
* Her book Notes on Nursing, highly regarded even now. "Habits of hygiene now taken for granted were then startling innovations."
* In esse or in posse: in actuality or in potential (this is a new one for me)
* All the senior administrators and governmental officials got deathly ill or died right when the British Army reforms were about to be put into place. Sydney Herbert died, Florence Nightingale was herself bedridden for many months, Arthur Clough became so ill he had to move to Greece, Dr. Alexander died of a cerebral hemorrhage, etc.
* The death of Sydney Herbert pretty much kills the potential for any reforms taken after the 1857 Royal Sanitary Commission, many of his initial steps were later undone even. It did begin a period of improvement in the sanitary conditions of British soldiers in the coming decades, however none of it is attributed to Sydney Herbert, and furthermore Florence Nightingale had no actual political power to do anything except through him.
* The government of the Northern American States reached out to her during the American Civil War, and she sent her evidence before the 1857 commission to them.
* A reader can't help but get the impression that all these Victorians spent a lot of time on their fainting couches. See Florence's hyperbolic and emotional letter writing, her commentary about her health, etc. "Exaggeration was the custom of the age."
* "Once there was work to be done, she asked neither for credit nor consideration, only to be allowed to do it."
* Her greatest challenge yet was working on sanitation for the British army in India, which involved raising the entire sanitary standard of the country. She wrote her remarks about India in a book called Observations by Miss Nightingale, the most readable of her writings. The main work on India, a report called The Indian Report, was subverted or suppressed somehow and the original version was altered and embarrassing parts were cut out, the original work was lost. (!!)
* She gets down, she's a perfectionist. "She must have everything, or she declared she had nothing. She refused to consider what had been done, only what had not." She has tremendous attachment to outcome--understandably so, because peoples' lives depended on sanitary conditions--but it causes her to be filled with Victorian rage when the government doesn't execute her plans to the level she would like. Governments come and go in England, and some of them incorporate her and her work more than others.
* See also certain errors/failures deriving from her "paper knowledge" about India (she never went there): for example "wanting to open windows" in soldiers' barracks because it helped health outcomes in England and the Crimea, but she had zero context for the cruel heat of India, and why windows wouldn't/couldn't be opened in barracks during the day in that climate.
* Her health and her mental capacity started to decline by 1869." She was no longer capable of the sustained effort necessary to write a book." 52 years old and an invalid, she decides to move into St Thomas's hospital, not exactly to be a patient, but to live a life of austerity, poverty, and discipline in the general hospital ward. This appalled her friend Benjamin Jowett, who convinced her not to do it.
* She stayed in close touch with all the nurse graduates from her nursing school, placed many of them in positions, wrote many hundreds of letters back and forth with them. By 1887 there were Nightingale School nurses all over the world, working in various hospitals in various positions.
* "There was a great deal of romantic feeling about you 23 years ago when you came home from the Crimea. (I really believe that you might have been a Duchess if you had played your cards better!) And now you work on in silence, and nobody knows how many lives are saved by your nurses and hospitals (you have introduced a new era in nursing): how many thousand soldiers who would have fallen victims to bad air, bad drainage and ventilation, are now alive owing to your forethought and diligence; how many natives of India (they might be counted probably by hundreds of thousands) in this generation and in generations to come have been preserved from famine, oppression and the load of debt by the energy of a sick lady who can scarcely rise from her bed. The world does not know all this, or think about it. But I know it and often think about it, and I want you to, so that in the later years of your course you may see (with a side of sorrow) what a blessed life yours is and has been."
-- Benjamin Jowett, famous Oxford scholar and translator of Greek classics into English, writing to Florence Nightingale in 1879.
* Late in her old age "she was treated with an almost religious deference." She was sheepish, embarrassed even, about all the adulation. Her health began to decline significantly at age 80, her site failed completely and she started to lose her memory. By 1906 she no longer recognized visitors.
To read:
Notes on Nursing by Florence Nightingale
Observations by Miss Nightingale by Florence Nightingale
The Crimean War: A History by Orlando Figes
Santa Philomena (poem) by Longfellow
The Indian Mutiny by John Harris
Gordon At Khartoum by John Buchan
Strenuous Life by Theodore Roosevelt
Garibaldi: Hero of Italian Unification by Christopher Hibbert
History of the Italian Republics in the Middle Ages by Jean-Charles-Leonard Sismondi
History of the Fall of the Roman Empire by Jean-Charles-Leonard Sismondi
The Last Days of the Consulate by Claude Charles Fauriel