By Elizabeth Fee and Mary E. Garofalo
Florence Nightingale was born on May 12, 1820 of wealthy British parents who expected her to do all the things young ladies of her class did: to spend much of her time in the drawing room entertaining her sister or her friends; to take occasional rides in carriages, to visit others; to appear at parties and dinners; and to be occupied with embroidery, playing the piano, and painting—these activities were meant to be “charming” and not taken too seriously.
But Florence was different. She felt a higher calling; she wanted to work, to use her intellect, her skills, and her moral passion, to make a difference in the world. She was bored with the trivial lives that upper class women led; she had her destiny to fulfill. She told her parents that she wanted to be a nurse. They were horrified. “It was as if I had said I wanted to be a kitchen-maid,” she wrote.
At last, after nine years of struggle, Florence’s parents reluctantly allowed her to train as a nurse in Germany. On her return, she accepted a post as Superintendent of the “Establishment for Gentlewomen during Illness,” on Harley Street in London. In 1853, her father gave her five hundred pounds a year, making her financially independent.
One year later, the Crimean War began. In 1854, under the authorization of Sidney Herbert, the Secretary of War, Florence Nightingale brought a team of 38 volunteer nurses to care for the British soldiers fighting in the Crimean War. Nightingale and her nurses arrived at the military hospital in Scutari and found soldiers wounded and dying amid horrifying sanitary conditions. Ten times more soldiers were dying of diseases such as typhus, typhoid, cholera, and dysentery than from battle wounds.
The hospital was dreadful: the soldiers were poorly cared for, medicines and other essentials were in short supply, hygiene was neglected, and infections were rampant. There was no clean linen; the clothes of the soldiers were swarming with bugs, lice, and fleas; the floors, walls, and ceilings were filthy; and rats were hiding under the beds. There were no towels, basins, or soap, and only 14 baths for approximately 2000 soldiers. The death count was the highest of all hospitals in the region. As Nightingale wrote in in a letter in 1855:
“I have seen the men come down through that long long dreadful winter (we received four thousand in seventeen days between Dec 17 /54 & Jan 3 /55) without other covering than a dirty blanket & a pair of old Regimental trousers when the stores were teeming with every kind of warm clothing, living skeletons devoured with vermin, ulcerated, hopeless & helpless & die without ever lifting up their heads 70–80 per diem on the Bosphorus alone up to the 13th Feby when we reached our maximum of mortality.”
Nightingale purchased 200 Turkish towels and provided an enormous supply of clean shirts, plenty of soap, and such necessities as plates, knives, and forks, cups and glasses. She brought food from England, cleaned up the kitchens, and set her nurses to cleaning up the hospital wards and tending to the sick and wounded. The death rate in the hospital fell by two-thirds.
Nightingale’s accomplishments in the Crimea were largely the result of her concern with sanitation and its relation to mortality, as well as her ability to lead, to organize, and to get things done. She fought with those military officers that she considered incompetent; they, in turn, considered her unfeminine and a nuisance. She worked endlessly to care for the soldiers themselves, making her rounds during the night after the medical officers had retired. She thus gained the name, “The Lady with the Lamp.” Nightingale had to write sad letters about the fate of some of the wounded soldiers as in this letter to Mrs. Batch:
My dear Madam,
Your letter was forwarded to me at this place where my Hospital duties at present require me. I have desired that enquiry should be made of Dr. Blackwood, concerning his attendance on your son. He remembers perfectly well, being called in to him in the middle of the night, but when he reached him, he was quite unconscious. He remembers however, hearing that he had been seen previously, earnestly in prayer. He also recollects hearing how much he was valued & beloved.
I beg to remain, dear Madam, with true sympathy for your great loss,
After the war, Nightingale returned to England, became an invalid and remained bed-ridden well into her sixties. From her bed, she produced over two hundred books, pamphlets, and reports, and over twelve thousand letters, mostly related to her work. When Nightingale got out of bed and reentered the world, she poured even more energy into her work. In the final years of her life, she reformed civilian hospitals, reorganized the War Office, founded the Nightingale School for the training of nurses, and brought public health and sanitation to India. After accomplishing an amazing amount, Nightingale died at the age of ninety in 1910.
Elizabeth Fee is Chief Historian in Office of the Associate Director for Library Operations at the National Library of Medicine. Mary E. Garofalo is Research Nurse in the Laboratory of Host Defenses, National Institute of Allergy and Infectious Diseases, National Institutes of Health.