Florence
Nightingale

Avenging Angel
Hugh Small
(St. Martin's Press)

    Lo, In that hour of misery
    A Lady with a Lamp I see
    Pass through the glimmering gloom
    And flit from room to room.
    And slow, as in a dream of bliss
    The speechless sufferer turns to kiss
    Her shadow as it falls.

n his poem, Longfellow was inspired by the letter from a soldier in Florence Nightingale's hospital in Turkey. The soldier had been injured in Victorian England's Vietnam, the Crimean War, called "the most unnecessary war in modern Europe."

In l854 England sent 20,000 men to stop Russia's expansion into Turkey. It was a disaster. England was in the first powerful rush of the Industrial Revolution. The technology that produced superior, complex manufactured equipment far exceeded the military's ability to deliver all those manufactured parts to the right place, at the right time, in the right order. English soldiers starved, froze, and without the proper equipment, died by the thousands.

Those injured and ill who made it back to the base hospitals faced more horrors. Devastating reports of the treatment and death rates in these institutions led Parliament to send Nightingale and thirty-eight nurses to the military hospital at Scutari, near Constantinople. Her original commission put her in charge of nursing in Turkish hospitals. Later the War Office classified her status as General Superintendent of hospitals outside Turkey as well.

It was a controversial call --- few women braved Victorian society's contempt for women who worked. Only her connections in government and years of advocacy for the nursing career gave her the prestige that allowed this exceptional appointment.

Subsequent investigations show that over 16,000 British soldiers died of sickness, while fewer than 2,600 were killed in battle and 1,800 died of wounds. A disproportionate number of those deaths occurred at Scutari Hospital under Nightingale's superintendency. Unsanitary conditions were shocking: patients were crowded into spaces with little or no ventilation, over f¶tid sewers and polluted wells.

Medical supplies were so limited, and her patients so sick when they arrived, that Nightingale did not investigate the reasons for the excessive fatalities. It was the new science of statistics that revealed to her that she and her medical staff had neglected even the most elementary sanitary precautions, and her patients had paid with their lives. This shattering realization and its attendant guilt led to a ten-year breakdown. Upon her recovery she dedicated the rest of her life to a crusade for hygienic conditions in hospitals.

These disclosures about "the Lady with the Lamp" are embedded in a complex historical matrix. England's immense losses in its first war of the Industrial Age brought down the government and spawned competing commissions and investigations. Florence Nightingale: Avenging Angel posits a complex game in which Nightingale was used to further a purpose which went far beyond reform. This secret agenda prevented Queen Victoria from reŽstablishing royal control over the British army --- for the Minister of War revealed gross incompetence and inaction on the part of the Queen's officers. When these results were debated in Parliament, the army's supply arrangements were brought under Parliament's control. It is likely, however, that Nightingale never knew the part she played in this shadow drama.

Hugh Small's gossipy, scholarly book removes the sugar-coating from Florence Nightingale's image, and finds not a beneficent nurse, but an accomplished administrator. Even during her ten-year illness she maintained a huge correspondence on her favorite subject, and over 12,000 letters remain. She may have been history's most prolific letter writer.

Nightingale had rather unique religious beliefs. Small's light touch with his material shows here:

    Nightingale appeared to identify herself with Christ. Or, it may be more accurate to say that she may have believed that Christ had similar problems to hers.

She had always believed that God talked to her. Her work with Chas. Babbage and his prototype computer crunched the numbers that revealed her errors, and she came to believe that statistics were the voice God telling her what to do.

The author believes that each generation gets the Nightingale it deserves. Since the volume of her personal papers is so huge, biographers can find evidence for any point of view they wish. Thus, The Angel of Mercy gave way to the Emancipated Woman and in a 50's bio, the product of a dysfunctional family. Her reputation has survived each of these alternative versions of her life.

It was hardest, we suspect, to survive her inclusion in the "children's hero stories" category. That designation arouses doubt in even the dullest child --- George Washington with his hatchet, Betsy Ross with her flag, Florence with her lamp. We always knew there was something we weren't being told?

Small's Florence Nightingale is one of the first modern women. She was not "the merciful angel of Scutari whose personal purity silenced the curses in the soldiers' throats and made the surgeons gentle." She was a crusader, an innovator and the prophet of an important social movement. When God spoke to her through Babbage's machine, she spent the rest of her life spreading the word.


--- Cese McGowan


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