Florence Nightingale had a deep distaste for what she called “all that
ministering angel nonsense”, yet that is how she lives on in folk memory,
carrying a lamp and smoothing the pillows of dying soldiers in the Crimea.
It is an image cemented by the trio of monuments in Waterloo Place in
London: statues of Florence and of Sidney Herbert (the Secretary of State
for War who invited her to go to the Crimea) and the Guards’ Memorial, more
commonly known as the Crimea Memorial. As he freely acknowledges, Mark
Bostridge is the latest in a long line of Nightingale biographers from Sir
Edward Cook, author of the first authorized Life in 1913, to have to
struggle with this.
Bostridge has also to contend with the fact that his subject is the only woman
among the targets for iconoclasm in Lytton Strachey’s Eminent Victorians.
Strachey, tongue-in-cheek, proclaimed the first requisite of the historian
to be “ignorance, which simplifies and clarifies, which selects and omits,
with a placid perfection unattainable by the highest art”. Ninety years
later, Bostridge could not, would not, wish to make any such claim. He has
trawled through a multitude of archives to see what can be added to the
materials made available to Cook. His archival work has been complemented by
the preparation, under the general editorship of Professor Lynn McDonald, of
fifteen volumes of Florence Nightingale’s Collected Works, now issuing from
the Wilfrid Laurier University Press, Ontario.
Bostridge, Strachey and Cook are at one in portraying Florence not as
ministering angel but as campaigner, organizer and administrator. Florence’s
sister Parthenope told the novelist Mrs Gaskell that Florence “does not care
for individuals . . . but for the whole race as being God’s creatures” and
Elizabeth Gaskell’s own observation subsequently confirmed that. It was a
view shared by the poet A. H. Clough, married to Florence’s cousin Blanche,
and by Blanche’s mother, Mai Shore Smith, who had interceded with Florence’s
parents in the battle to allow her to study nursing, and who worked beside
her in the Crimea. Both Clough and Mai Shore Smith had direct experience,
too, of Florence’s ruthless capacity to use and exhaust those close to her,
whether family members or friends.
Florence’s work in the Crimea probably did little to reduce the death rate
there; but it did provide her with the experience and the public standing to
embark on a series of campaigns to reorganize army medical care, to begin
the work of creating a nursing profession and to raise standards in and
understanding of public-health issues, in Britain and its Empire. These are
her real achievements. Bostridge gives a scrupulously full and
well-contextualized account of these reforming efforts, while managing not
to lose his reader in the thickets of bureaucratic infighting.
Parthenope Nightingale’s phrase, “God’s creatures”, was no mere convention.
Florence believed she had been directly called by God to work in nursing and
in public health and noted the several occasions on which she believed God
spoke to her directly. She was a devout, if somewhat heterodox Christian,
believing in a God of infinite goodness and wisdom, the author of universal
laws, including the laws of health. There seems more than an echo of her
family’s Unitarian inheritance here, although Bostridge does not acknowledge
this possibility, writing with a degree of detachment from the religious
dimensions of Florence’s thought and the environment in which she had to
work. In the early 1850s, Florence compiled a sixty-five-page pamphlet,
setting out her theological views for the “Artizans of England”. It was
never published in this form; and when she returned to it at the end of the
decade, it grew into something much larger, three volumes entitled
Suggestions for Thought to the Searchers after Truth among the Artizans of
England, six copies of which were privately printed to gather friends’
comments in the summer of 1860. Known among family and friends as Florence’s
“Stuff”, its revision was never completed and general publication has had to
wait for the Collected Works.
Although heterodox, Florence was firmly Protestant in her general religious
stance and associations; and this contributed powerfully to her réclame in
mid-nineteenth-century England. This was a rabidly anti-Catholic society,
with complex and deeply ambivalent attitudes towards those associations,
religious and lay, who so often carried out the work of caring, in
predominantly Catholic societies, whether the nursing of the sick, the
sustenance of the indigent, or the education of the young.
Sinister monks had an established pedigree in English demonology. The rapid
growth of Catholic sisterhoods, both religious and lay, in early
nineteenth-century Europe, promised to add to the cast of characters. By the
middle of the century, however, devout Anglicans were beginning cautiously
to explore the creation of sisterhoods, despite much hostility and freely
flying accusations about secret Roman influences and the break-up of
families. Public outcry about the death rates among soldiers fighting in the
Crimea gave them their opportunity. As Anne Summers has shown in Angels and
Citizens: British women as military nurses 1854–1914 (1988), the sisterhoods
were seeking a public stage on which to prove themselves, and care for Her
Majesty’s troops was the perfect rebuttal to the charge of being
“un-English”. Florence’s commitment to nursing and her expedition to the
Crimea, which included members of Anglican sisterhoods, provided them and
the wider society with an unassailably Protestant icon. The shaping and
burnishing of the icon is admirably delineated in Bostridge’s chapter, “A
Visible March to Heaven”.
Florence Nightingale also occupied an unassailable social position: she was
unequivocally a lady. In recent writing on gender roles in
nineteenth-century England much has been made of the way in which the work
of caring, seen as peculiarly feminine and initially honed in a domestic,
essentially private setting could be developed and expanded to provide a
route for middle- and upper-class women into the public sphere and even, for
those whose incomes were insufficient to support their status, into paid
employment. At first sight, nursing appears one obvious vehicle for such a
transition. Yet it proved to offer a much more contested, difficult and
long-drawn-out path than either philanthropic activity metamorphosing into
social work or the professionalization of teaching. Nursing training and
employment, both military and civilian, was far slower to get off the ground
than teaching and teacher training; and mortality rates in the Boer War
1899–1902 were dreadfully reminiscent of those in the Crimean War,
suggesting how little had been learned in the intervening decades. The
principal reasons for these difficulties lie in class and status and their
potent interactions with gender, interactions different from those taking
place in philanthropy or in teaching. In philanthropy a lady was by
definition ministering to those below her in the social scale, the poor and
needy. A lady might teach a mixed Sunday or daily elementary class: they too
were her social inferiors. If she taught pupils of her own class they would
be girls or young women – or very little boys under seven. Her forays
outside the home could be constructed so as to offer no challenge to her
social status. A committed or career nurse, however, would find it harder to
select patients by class or gender. She had also to establish a working
relationship with the male doctor responsible for their care, whose social
status might be different from her own. The society of early
nineteenth-century England had coped with these dilemmas by classifying
female nurses as servants. Not all resembled Dickens’s monstrous creation in
Martin Chuzzlewit, Sairey Gamp: they might be superior servants; but they
were women, not ladies.
The battle to establish nursing as a female career path in the period up to
1914 was thus difficult and protracted because it could not escape or evade
difficult junctures in social relations, difficulties which Bostridge
understates. Clashes between Florence and those who opposed her are
presented as primarily clashes of ideas, personalities and political
interests, her aggressive behaviour after her return from the Crimea almost
certainly exacerbated by brucellosis contracted there. Yet these clashes
often also had social dimensions and resonances. Florence Nightingale’s
battle with her family to be allowed to pursue nursing as a vocation,
beginning by studying with the Protestant deaconesses at Kaiserwerth in
Germany, took over ten years. It led her in her private writings, and in the
text eventually published as Cassandra, to portray them and families more
generally as stifling, all-devouring: she railed against “unloving love”. It
isn’t hard to imagine that one strand in the family’s opposition, whether or
not they were able to articulate it, was the fear that she would become
thereby irretrievably déclassée. Fanny Nightingale certainly had a sharply
developed sense of social position and social ambition. It was no accident
that when Fanny and W. E. Nightingale at last began to give way, they
allowed Florence to accept the post of Superintendent of the Establishment
for Gentlewomen during Illness in Harley Street: it must have seemed safe.
If nurses were more likely to be treated as women than as ladies, doctors were
striving hard to become accepted as gentlemen. The middle decades of the
century were a critical period in the fight for professional standing.
Although the creation of the General Medical Council in 1859 marked a
turning point, the status of doctors was still uncertain: readers of
Middlemarch have only to remember the insecurities of Lydgate. And within
the group there were gradations. Army doctors and surgeons came low down the
pecking order. Florence’s social position and connections gave her one kind
of assurance in her dealings with them; at another level it may have jarred
cruelly with some of those on whose territory she was encroaching. At the
end of the 1860s Florence’s protégé, Jane Shaw Stewart, was dismissed from
the post of Superintendent-General of Nurses at the Royal Victoria Hospital,
Netley; her social hauteur was a major element in her downfall. Shaw
Stewart’s successor, Jane Cecelia Deeble, was the widow of an Army surgeon,
who knew her place.
Shaw Stewart’s relations with her nurses at Netley were little happier than
her relations with the doctors. Thorny questions generated by the
interactions of gender, class and status were not confined to relations
between nurses and doctors: they were also to be encountered in relations
between nurses. Florence’s arrival in the Crimea had been noted by Fanny
Duberley, the gossipy officer’s wife who had accompanied her husband to war,
and she wrote home: “The first thing her principal assistant did – was to
elope with a doctor. She will have a nice job to keep the staff in order;
but I dare say some of them, if steady and respectable which no soldier’s
wife out here even dreams of being, may do good. And if she keeps them from
drinking”. The view of nurses as servants, even superior servants, to be
managed by ladies, is vividly conveyed. The parties of nurses who went out
to the Crimea were clearly stratified into ladies and women, the ladies not
prepared to undertake the heaviest physical work in the wards and even
expecting the women to wait on them in their quarters. It is little wonder
that some of the women in the Smyrna group went on strike, commenting that
“they came out as nurses, not to do housework”.
Yet if nursing was going to grow as a female occupation, a career even, it
needed to attract women as well as ladies, people who saw it not simply as a
divine calling but also as an honest, respectable, even honourable way of
earning a living. In facing this, Florence was impaled on a dilemma largely
of her own making. Her unshakeable conviction that nursing represented a
call from God, reinforced perhaps by the blinkers of her own secure social
position and the illness-enforced seclusion of much of her life after the
Crimea, led her fiercely to oppose moves to organize nurses into
associations and to establish a process of registration. The tensions
between ladies and women in nursing persisted to 1914 and beyond.
Cook and Strachey were too close to these tangled knots of class, status and
gender to examine them. Distance might have allowed Mark Bostridge to
attempt some unravelling. His assiduity in the archives has enabled him to
add much colour, nuance and detail to the picture of Florence’s life and
work, particularly for the years before 1854; while the brucellosis
hypothesis helps make sense of the patterns of behaviour and illness which
followed. The bold outlines of her portrait, however, remain those discerned
by Cook in 1913, and Strachey after him in 1918. “Strength of head”, Cook
wrote, “was quite as marked in her as goodness of heart, and she had at
least as much of adroitness as of simplicity.”
Mark Bostridge
FLORENCE NIGHTINGALE
The woman and her legend
648pp. Viking. £25.
978 0 670 87411 8
Gillian Sutherland is Director of Studies and a lecturer in History at
Newnham College, Cambridge. She is the author of Faith, Duty and the Power
of Mind: The Cloughs and their circle 1820–1960, 2006.
