Pod Insights Short History Of... Florence Nightingale About this episode Pre-order our new book: Short History of Ancient Rome
Revered as a heroine, and mythologised as ‘the Lady with the Lamp’, Florence Nightingale has gone down in history as the founder of modern nursing. She battled ill-health and the prejudices of her age to leave an indelible mark on the world, and yet her memory is laden with misconception and half-truths.
So, how did Florence Nightingale, the superintendent of a hellish incubator of disease in the Crimean War, become synonymous with kindness and compassion? Why was she one of the most celebrated figures of her age? And what did she achieve after illness cut short her nursing career?
This is a Short History Of Florence Nightingale.
A Noiser Production, hosted by John Hopkins. With thanks to Hannah Amos, the Collections Manager at the Florence Nightingale Museum in London.
Written by Edward White | Produced by Kate Simants | Assistant Producer: Nicole Edmunds | Production Assistant: Chris McDonald | Exec produced by Katrina Hughes | Sound supervisor: Tom Pink | Sound design by Oliver Sanders | Assembly edit by Dorry Macaulay, Rob Plummer | Compositions by Oliver Baines, Dorry Macaulay, Tom Pink | Mix & mastering: Cody Reynolds-Shaw | Fact check by Sean Coleman
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1:01 Speaker 02 It's early evening on the 9th of November, 1854.
1:07 Speaker 02 West of the Bosporus, in what is now Istanbul, a mule trudges its way down an undulating path.
1:15 Speaker 02 Strapped to its back is a young man. His face is pale and drawn. His clothes flecked with blood. His head hanging limply, chin on his chest. He barely has the strength to breathe.
1:30 Speaker 02 He is not traveling alone. Behind him are dozens of others, bobbing listlessly on wagons and pack animals.
1:41 Speaker 02 This caravan of the wounded are all British casualties of the Battle of Inkerman, a victory over Russian forces in the Crimean War, but one that has come at a cost. For the past three days, injured soldiers have made this agonizing journey in desperate search of life-saving care.
2:01 Speaker 02 At long last, their destination is in sight: an army barracks that has been converted into a hospital.
2:08 Speaker 02 Theoretically, this is their place of refuge. Yet this Scutari barracks hospital has an unwelcome reputation as somewhere where even the healthy can end up dead.
2:23 Speaker 02 At the entrance, the vehicles come to a halt.
2:27 Speaker 02 Wardlies hurry out, and the young soldier is hauled onto a stretcher, carried inside, and placed on a bed.
2:36 Speaker 02 Lifting his head, he sees a woman approaching. Wearing a simple black dress, her hair functionally short, she strides purposefully towards the new patients. Either side of her are rows of beds, crammed just eighteen inches apart. In each one is a soldier, desperately ill or dreadfully injured.
2:58 Speaker 02 The woman is the new superintendent, a woman by the name of Florence Nightingale.
3:04 Speaker 02 She has been charged with bringing order to this place. Less a refuge of healing, more a dank, overloaded cesspit, reeking of filth and death.
3:15 Speaker 02 In the few days she's been here, she's battled the hospital hierarchy to make all manner of changes. Starting by clearing away the mounds of feces that splatter the floors.
3:28 Speaker 02 They're short of everything here, from mattresses to bedpans. And today, chaos has descended. Hundreds of men are arriving from the battlefield.
3:38 Speaker 02 Nightingale and her nurses do the best they can with paltry resources. But the volume of patient is overwhelming, and this is just the beginning.
3:48 Speaker 02 As the day goes on, wave after wave arrive at the hospital door, six hundred by nightfall, and there'll be even more tomorrow.
3:57 Speaker 02 Soon the wards will be clogged with the mutilated and the traumatized.
4:03 Speaker 02 Later that evening, in the pitch dark, Miss Nightingale walks through the packed rooms. Her path illuminated by the dim light of a single lantern, she checks on each man in turn. Some will not make it to morning, but it's not just the battlefield injuries that will kill them. It's the invisible germs that surge their way around this horribly overcrowded building.
4:27 Speaker 02 Right now, Miss Nightingale knows nothing about that, believing instead that the deaths are caused by medical incompetence, poor diet, noxious odors. Pretty much anything other than the true cause. For all her obvious brilliance and determination, she is doing little to prevent the deaths of thousands in her care. Her hospital is a death trap.
5:01 Speaker 02 Revered as a heroine, mythologized as "the lady with the lamp", Florence Nightingale has gone down in history as the founder of modern nursing.
5:12 Speaker 02 Fortified by an indefatigable self-belief, she battled ill health and the prejudices of her age to leave an indelible mark on the world. Yet her memory remains laden with misconception and half-truths.
5:29 Speaker 02 So how did Florence Nightingale, the superintendent of a hellish incubator of disease in the Crimean War, become synonymous with kindness and compassion? Why was she one of the most celebrated figures of her age? And what did she achieve in the long decades of her life after illness cut short her nursing career? I'm John Hopkins. From the Noiser Network, this is A Short History of Florence Nightingale.
6:04 Speaker 02 Florence Nightingale is named after the city in which she is born, on the 12th of May, 1820. Her English parents, William and Fanny, are in Italy as part of an extended honeymoon. Florence is the couple's second child. Their first was born a year earlier, in Naples. A girl they called "Parthenope". William is the heir to a considerable fortune, inherited from his great-uncle, a wealthy industrialist, while his wife is the daughter of a crusading MP whose causes include the abolition of slavery and freedom of religion. In 1821, the young family moves back to England, splitting their time between two beautiful homes. Hannah Amos is the collections manager at the Florence Nightingale Museum in London.
6:51 Speaker 03 One of the properties that William Nightingale had inherited, Lee Hurst up in Derbyshire, was to be their main family home. And they would spend most of their summers in this large house with lots of lovelies surrounding countryside. They also purchased a second house, Embly Park down in Hampshire, which became their winter home. The girls would have had a very happy childhood. They had lots and lots of cousins on her mother's side. She actually had, I think it's eight siblings.
7:25 Speaker 02 William invests his time in providing his daughters with a rich, full education, unusual for girls of the era. Young Florence proves to be an excellent pupil. She has a quick, inquiring mind with a particular strength for mathematics.
7:41 Speaker 02 Outside the classroom, she develops a passion for the natural world, collecting shells and flowers, and grasping any opportunity to care for a new pet. When a maid discovers a nest of baby mice in a mattress, Florence attempts to hand-reer them, feeding them drops of milk and warming them by the fire. But despite the Nightingale sisters' education and interests, as upper-middle-class girls, their future paths are narrow.
8:09 Speaker 03 The main expectation that their family would have had for both of the daughters would have been to get married, had their own children, and run their own household, and basically continued the family lines. Florence decided, I think, quite an early age, that this life probably wasn't going to be for her.
8:33 Speaker 02 In 1836, at the age of 16, she experiences the first stirrings of a vocation, when influenza tears through the bucolic community surrounding the Nightingale's grand Hampshire home. Nineteen members of the household fall ill, including 15 of the family's servants. Florence steps up to the plate. She cares for the sick, rising before dawn, busying herself with tasks throughout the house.
9:02 Speaker 02 The following year, a teenage Princess Victoria ascends to the throne, and Florence comes to believe that God has a special plan for her too. Influenced by the writings of the American preacher Jacob Abbott, she aspires to a life devoted to practical, selfless acts of charity.
9:20 Speaker 03 She has her first calling from God at the age of 16. She doesn't quite know what this calling is at the time, but she knows it's service to other people.
9:31 Speaker 02 From now on, Nightingale's worldly ambition is inseparable from a sense of religious devotion.
9:42 Speaker 02 Slowly, the form of her calling takes shape. Age 25, she devises a plan to train in nursing at the Salisbury Infirmary, not far from Embly Park. In her mind, nursing is a form of pure Christian service, a selfless devotion to those in need.
10:01 Speaker 02 Florence has her heart set on it. Her parents are less enthusiastic.
10:07 Speaker 03 They are absolutely horrified. Nursing at the time is not a profession as we know it today. It has actually a very bad reputation. In popular media, there is the Charles Dickens character Mrs. Gamp, who is a nurse in Martin Chuzzlewit. And she is often drunk. She doesn't care for her patients in any way. She doesn't really care about nursing at all. And this caricature of nurses becomes the main image of nursing within the population of Britain. So the idea that this well-educated young lady
10:49 Speaker 03 wants to go into this is absolutely horrifying to her parents. They outright refuse to let her do any work, full stop, really. Even the idea that she wants to work is pretty bad to them.
11:03 Speaker 02 And so, for the next two years, she molders in her parents' home. She rejects an eligible suitor, fearing that marriage will terminate her vocation. But there is still no clear path to fulfilling her ambitions. Though she reads voraciously about the latest social reform work, her life is empty and uneventful. And she sinks into bouts of depression and despair. At various points, she confides to her diary that she would rather die than live a life so stagnant and pointless.
11:37 Speaker 02 It's only when friends of the family, Selina and Charles Bracebridge, offer to take her travelling across Europe and Egypt, that her spirits lift.
11:46 Speaker 03 I always like to think that her parents made a bit of a mistake in this area. They thought they were sending her off to forget about this whole scheme of nursing. But in fact, these family friends, the Bracebridges, are very liberal, they're very free-thinking, and they actually support Nightingale's idea of working and nursing. So, all the time they're travelling, Nightingale's able to visit all the local hospitals and convents and places providing healthcare.
12:16 Speaker 02 Her parents finally relent. They allow their daughter, now thirty years old, to train as a nurse at a hospital run by an order of religious women in Kaiserwerth in Germany.
12:30 Speaker 02 It is an immensely fruitful experience. She learns a great deal about nursing, and her sense of mission is fortified. Three years later, in 1853, she is appointed superintendent of a hospital in London for so-called gentlewomen.
12:48 Speaker 02 Caring for socially respectable ladies is all well and good, but what she really wants is to nurse where it is really needed.
12:57 Speaker 02 It just so happens that around this time, an outbreak of cholera is raging in the disreputable London district of Soho, affecting some of the poorest people in the city.
13:08 Speaker 02 Hundreds fall ill and die, and Nightingale briefly volunteers at the Middlesex Hospital, where many of the victims are sent.
13:17 Speaker 03 A lot of the patients there were considered fallen women, so this would have been very, very different to the women she'd been working with at Harley Street. And she would have come across some extremely ill patients. And I think this would have probably been quite an opening for her and just a whole different environment.
13:39 Speaker 02 As cholera does its worst in London, the British Army enters a world-changing conflict on the eastern reaches of Europe.
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14:53 Speaker 02 In the Crimean Peninsula, Britain and France have joined forces with the Ottoman Empire against Russian territorial expansion. For Britain, securing its route to India is of paramount importance.
15:07 Speaker 02 Thanks to the recent invention of the telegraph, reports of the conflict are shuttled back to Britain with unprecedented speed and frequency. Never before has a foreign war received such in-depth coverage. And it's far from glowing.
15:24 Speaker 02 The British public learns of the incompetence, inefficiency, and corruption that is blighting the war effort. Moreover, it is revealed that thousands of soldiers are enduring the most awful conditions. Huge numbers are dying, most not in combat, but from inadequate medical attention.
15:47 Speaker 02 With political pressure mounting, Sidney Herbert, secretary at war, is looking for ways to allay public fury. He knows just the person: Florence Nightingale, a friend whom he first met when she was undertaking her transformative tour of Europe. With Herbert's enthusiastic backing, Nightingale is selected to manage the Barrack Hospital at Scutari in Turkey. Although it's 300 miles from the front lines, this is where swathes of British soldiers are sent to recuperate. But all too often, the opposite seems to happen.
16:26 Speaker 02 Nightingale won't be going alone. Beneath her will be a team of hand-picked nurses.
16:33 Speaker 03 The initial 38 that were put together, these would have all come together through adverts in the newspapers at the time. They were a mixture of nurses from the hospitals across the country. And there were a small number of nuns mixed in with this as well. Across history, we see that convents and monasteries and buildings associated with the church often provide a lot of healthcare in the community rather than hospitals. Hospitals wouldn't have been anything like we know today. So, nuns often were the primary nurses in a lot of environments.
17:14 Speaker 02 The mission generates a lot of attention. In particular, the story of Miss Nightingale, a respectable lady of impeccable virtue doing her patriotic duty, captures the public imagination.
17:30 Speaker 02 In the autumn of 1854, Nightingale's nurses are all in place and ready to go. The job before them is crucial: for the credibility of the government, the health of the soldiers, and the reputation of nursing.
17:50 Speaker 02 It is late afternoon on the 26th of October 1854.
17:55 Speaker 02 Beneath a cobalt-blue sky, a young woman stands on the docks in the French city of Marseille.
18:04 Speaker 02 Rebecca Lawfield is one of the team of thirty-eight nurses selected for the Nightingale mission. Her journey began six days ago, when she and the rest of the delegation departed London by train. It was an inauspicious start: one of the nurses arrived at the station drunk and had to be sent home. Now, Lawfield and her colleagues are preparing for the final leg of their voyage across the Mediterranean Sea to Turkey. For her, as for many of Nightingale's nurses, simply traveling to Turkey is a once-in-a-lifetime experience. Yet, she has been warned of what to expect at the Skutari Hospital. She knows this will be no holiday.
18:49 Speaker 02 A voice shouts instructions: "It's time to leave." Lawfield adjusts her hat and makes her way up the gangplank. Their vessel is a steam packet, a male ship named Vectus. Ahead of her is Florence Nightingale: confident, organized, driven.
19:08 Speaker 02 For the last couple of days, Lawfield and the others have observed her buzz around, making last-minute preparations and dealing with all manner of people. She seems to be a true force of nature.
19:20 Speaker 02 With its passengers all aboard, the Vectus is ready to depart. Lawfield watches Marseille recede as the ship pushes out into the clear water.
19:31 Speaker 02 But the journey is far from tranquil. Built for speed and nimbleness, the Vectus careens on the waves, and after a while, some of the women are struggling with seasickness. Gripping a handrail, Lawfield descends a steep stairway down to the cabins.
19:49 Speaker 02 Below deck, the air is thick and fetid. She hitches her skirt to save it from the water that sloshes on the floor.
19:58 Speaker 02 As the boat rocks, Lawfield inches her way into a cabin, where she finds Florence Nightingale groaning on a stiff, narrow bed. She may be building a reputation for fortitude, but she clearly has no stomach for the open seas. For days, Nightingale confines herself to her cot. When she attempts to eat, she's too nauseous to keep anything down.
20:22 Speaker 02 Above deck, the wind picks up. As the Vectus passes the Greek islands, it pitches high into the air. Lawfield holds her breath. For a dreadful moment, it seems the ship is about to keel over.
20:40 Speaker 02 Mercifully, everything stays the right way up. The Vectus continues its horrid journey.
20:49 Speaker 02 After several days of this punishment, the waters calm. On the 4th of November, Nightingale finally emerges from her berth and joins Lawfield on the deck, just as the great city of Constantinople appears on the horizon.
21:04 Speaker 02 But as they draw closer, the view could barely be less impressive. Thick drizzle obscures the city's fabled charm.
21:15 Speaker 02 When Nightingale eventually disembarks the Vectus, she is immensely relieved to be treading on solid, dry land again. Even so, she knows that what's waiting for her, just three miles away at the Scutari Hospital, is going to be a lot worse than anything the Mediterranean can throw at her.
21:40 Speaker 02 When Lawfield, Nightingale and the other nurses arrive at the Skutari Barracks Hospital, things are, if anything, worse than feared.
21:50 Speaker 03 The conditions were absolutely atrocious. There would have been people just everywhere, it would have been noisy, smelly, probably dark. The air wouldn't have been flowing through the buildings. It was nothing like Florence could have ever imagined.
22:04 Speaker 02 In her efforts to improve conditions, Nightingale comes into direct and frequent conflict with the male military establishment.
22:13 Speaker 03 She's basically not allowed to nurse or interact with any of the soldiers initially. It's a male-dominated space, they've never had any women working alongside them, so their initial reaction is to be, "We don't need you here, everything's fine." So she sets about cleaning the rooms that the soldiers are living in, sets up proper kitchens, this means, you know, there's clean bedding and clean clothing for the soldiers, they're getting proper nutritious meals. So later on, when her and her nurses are allowed to eventually start interacting with soldiers and actually providing that care, all of that basic stuff is in place.
22:53 Speaker 02 Nightingale is still finding her feet when Skutari receives a flood of desperate new patients. On the 9th of November, 600 casualties from the Battle of Incomen arrive. Over subsequent days, they're joined by many hundreds more. Soon, the corridors in Skutari are crammed with almost 2,000 patients, but approximately two dozen of them die each day.
23:18 Speaker 02 In fact, across that winter, more than 4,000 men in Nightingale's care don't make it. About 90% of these deaths result from illnesses such as typhus and cholera. But throughout this bleakest of seasons, she does what she can for her soldiers.
23:37 Speaker 02 In an attempt to lessen fear and trauma, she erects screens around the poor men who are subjected to amputations. The saving grace is that chloroform is available, even though there isn't a single operating table in the hospital.
23:53 Speaker 02 The soldiers appreciate her efforts. In attending to their comfort and well-being, she offers them something they've never received before. She makes them feel cared for. Under Miss Nightingale's supervision, these men are human beings whose lives matter, instead of cannon fodder, left to rot in a foreign field.
24:16 Speaker 02 Soon, news of Nightingale's impact extends beyond Skutari, with stories of her efforts finding their way into British newspapers and magazines. In February 1855, a famous illustration of her is published, in which she is shown walking from bed to bed in the dead of night, checking on each wounded soldier. She holds a so-called "genie lamp" to light her way. The flame acts as a metaphor, a glimmer of hope in these darkest of times. And even though the lantern she uses is, in reality, of a different design, the image sticks. A legend is born. Florence Nightingale will forevermore be "The Lady with the Lamp".
24:59 Speaker 03 "The Lady with the Lamp" is first mentioned by a soldier in a letter home to his family, and this gets sent off to one of the newspapers in London. The public become fascinated by this almost enigmatic woman who's gone out. They don't really know who she is. She just kind of appears. No one has seen her. The illustrators doing the illustrations for the newspapers there in London, so they don't really know what she actually looks like. So her real likeness doesn't get out for a long, long time.
25:31 Speaker 02 The mystery fuels her mythology. In Britain, Nightingale becomes a huge celebrity. Lines of unofficial merchandise are launched, and her first name sees a spike of popularity with baby girls named in her honor.
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26:53 Speaker 02 Back in Skutari, Nightingale has undoubtedly made her patients more comfortable and her hospital more organized. Yet mortality rates remain stubbornly high. A government commission is set up to investigate.
27:07 Speaker 02 What it finds is nightmarish.
27:12 Speaker 02 The sewer beneath the hospital building is horribly clogged. A dead horse is festering in the water supply, which is also contaminated by leaking latrines.
27:24 Speaker 02 The notion that such hazards could be the cause of disease is not straightforwardly obvious to Florence Nightingale. She, like so many others at this time, adheres to what's called the miasma theory, which holds that disease is caused by bad smells and dirty air. It has a fundamental impact on Nightingale's work at Skutari, in which she tries to rid the place of its rank odors.
27:51 Speaker 03 Her idea was wrong, but what she was doing was right. So cleaning up and trying to get some fresh air in. During COVID, we were told, you know, keep our windows open. She was doing all of that. She was making sure that everyone was washing their hands. So while she didn't have quite the right theory, she did do all of the right things.
28:18 Speaker 02 However, as Nightingale doesn't subscribe to the novel theory of contagion, it leads her to overlook certain crucial factors, such as the risks of overcrowding and of disease being transmitted in water. It's only once these issues are addressed that the death rate at Skutari begins to fall, which it does rapidly in the spring of 1855.
28:42 Speaker 02 Nightingale's attention now turns to hospitals on the front line in Crimea, where British soldiers are also languishing. On the journey across the beautiful expanse of the Black Sea, she experiences the effects of her growing fame. Passengers crowd the decks of nearby boats to get a glimpse of the lady with the lamp, cheering and applauding as she sails past.
29:06 Speaker 02 She is conveyed around the war zone in a horse-drawn carriage, depictions of which soon fill newspapers in Britain and elsewhere.
29:15 Speaker 02 Joining her on this expedition is another lorded celebrity, Alexis Sawyer, a French chef and restaurateur who has built a gastronomic empire in London. Between them, they plan to transform the diets of ailing soldiers. But before they can set to work, disaster strikes. On the 12th of May, the day after Nightingale turns 35, she suddenly collapses.
29:40 Speaker 03 On one of her visits out to the Crimean Peninsula, she picked up what was then called Crimean fever. Today, this is thought to be something called brucellosis, which is a bacterial infection picked up from infected meat and sometimes unpasteurized milk. So she obviously ate or drunk something out there that caused her to become very ill. There was a point where they actually thought she was going to die out there, and I think everyone was preparing for the worst.
30:12 Speaker 02 After several days, her condition improves. Begrudgingly, she returns to Skutari to convalesce. But even here, she refuses to rest. From her sick bed, Nightingale draws up plans to help improve the well-being of British soldiers, encouraging them away from drink and idleness. She helps to open a café for recuperating servicemen, organizes lectures and activities, and arranges for them to receive newspapers and books. She also uses her time to write to the families of soldiers in her care and those who have recently died.
30:50 Speaker 02 But the Nightingale touch is not appreciated by everyone. Her tussles with the men in charge of Skutari continue. There are also tensions among the nurses in her charge.
31:02 Speaker 02 Several are dismissed for ill-discipline and incompetence. Others are reprimanded for falling short of Nightingale's notoriously high expectations.
31:13 Speaker 03 I think she was quite difficult to work under. She had very precise and exact ways of working, and if someone wasn't up to her standards, that's it, they were on their way home. She did clash quite a lot with some of the nurses. A lot of them were absolutely devoted to her, but we see that through nursing, that, you know, there's all these kind of standards and procedures that you have to follow, but a lot of them weren't used to having that strong leadership.
31:41 Speaker 02 After a year at Skutari, she is disappointed by the various obstacles she still faces. "Christ was betrayed by one," she complains in one of her many writings. "But my cause has been betrayed by everyone."
31:56 Speaker 02 Evidence, perhaps, of a certain inflexibility and a tendency to dramatize her own circumstances.
32:04 Speaker 02 Yet for all the difficulties, Nightingale has achieved her objectives of turning Scutari into a well-run hospital. By the war's end in early 1856, a year and a half after her arrival, its death rate is comparable to that of any hospital in one of England's big, industrialised cities. Florence Nightingale couldn't be held in higher esteem, with the public donating huge sums of money to support her work. Among the people, her reputation is almost that of a secular saint. As far as they are concerned, she is responsible for saving the lives of countless brave British soldiers.
32:43 Speaker 02 Despite the appalling casualty rate, the Crimean War turns out to be a sizeable victory for British forces. By the summer of 1856, Nightingale is ready to return home. Yet, she goes out of her way to avoid anything resembling a hero's welcome.
33:00 Speaker 02 Travelling to England incognito under the alias of Miss Smith, she makes it all the way to a railway station in Derbyshire without being recognised.
33:10 Speaker 02 Once she alights the train, she takes her bags and walks a mile and a half across the fields, turning up at her parents' house unannounced.
33:19 Speaker 02 Adjusting to life back home is testing. Over the last two and a half years, Nightingale has had life-changing experiences. She's witnessed horrifying trauma, been stricken with terrible illness, and of course, become a hugely celebrated public figure.
33:34 Speaker 03 Nightingale actually really didn't like the public perception of her and her fame. After the war, she basically goes into hiding for a good few years. At one point, the carriage she'd used during the war was brought back to the UK and it was paraded round Southampton. And the carriage almost becomes a bit of a symbol of her and it's used in various different locations across the country. And I think she says something like, "That Russian cart hangs around my neck." And she eventually gets one of her footmen to basically go and take it away and hide it away at one of her houses.
34:15 Speaker 02 But though she's now safely back in the quiet of her old family home, Nightingale cannot shake the traumatic experience of Skutari. She struggles to sleep, unable to escape the memories of the horrors she's witnessed. She has no appetite. At night, she feels anxious; during the days, she stares blankly out of the window.
34:35 Speaker 02 In a private note, she writes: "Oh, my poor men who endure so patiently. I feel I have been such a bad mother to you."
34:44 Speaker 02 But soon, an invitation arrives that brightens her mood.
34:57 Speaker 02 It is the 21st of September, 1856. A damp autumn morning in the Scottish Highlands, where, thanks to a recent deluge, the nearby River Dee has burst its banks.
35:09 Speaker 02 Deep in ancient woodland, a coach squelches its way along a narrow path, its wheels throwing up great globules of mud into the air. Inside the vehicle, Florence Nightingale sits pensively. She's en route to a very important meeting.
35:28 Speaker 02 Presently, the dense forest thins out, and a grand building comes into view like something from a fairy tale: a castle, festooned with turrets and towers.
35:39 Speaker 02 But this is no medieval fortress. It's Balmoral, a newly-built country bolt hole for none other than Queen Victoria and her husband, Prince Albert.
35:51 Speaker 02 During the war, the Queen was captivated by reports of Nightingale's work. She even sent a gift of a beautiful red brooch in thanks for her service to the nation, along with a letter of support, which Nightingale shared with the soldiers at Skutari. Now, Victoria is honoring Nightingale with a private audience. It's a rare privilege, and an opportunity to ask the monarch to back reform of medical care in the armed forces.
36:21 Speaker 02 At the castle entrance, Nightingale descends the coach.
36:26 Speaker 02 Although there is no grand welcoming committee, her arrival is marked by a solitary bagpiper, as is customary.
36:34 Speaker 02 Nightingale is shown into a drawing room like a parody of a Highland hunting lodge. Everywhere there are thistles and antlers, and each available surface is swathed in tartan. Before long, Her Majesty appears at the door. Half a dozen little dogs scamper around her ankles as she comes in to greet her guest, who lowers herself into a deep curtsey.
36:58 Speaker 02 They settle on tartan-covered sofas, facing each other, the Queen at a slight angle to accommodate the swell of her pregnant belly.
37:07 Speaker 02 But though Nightingale is here to advance her cause, the conversation is stilted. The two women are almost identical in age, yet they differ in so many ways. Victoria, expecting her ninth child, the epitome of 19th-century domesticity, the mother of a nation. Nightingale, a woman who has rejected convention in search of a different life.
37:31 Speaker 02 After a few minutes, Victoria's husband Albert strides into the room, and the atmosphere changes.
37:38 Speaker 02 He and Nightingale are peas in a pod, businesslike and serious. As tea is delivered, they discuss facts and figures, systems and procedures. Nightingale presses her case for a royal commission to examine the causes of deaths in the Crimean War. She also tells the Queen how dearly the soldiers at Scutari valued the words of support she sent them. Victoria is visibly moved by this. She prides herself on having a deep, emotional connection with her people.
38:20 Speaker 02 While the Queen has no authority to launch the official investigation that Nightingale seeks, she pledges her support. It seems her influence is enough to tip the balance. Soon after Nightingale returns from Balmoral, the Royal Commission is up and running.
38:39 Speaker 02 It's now that the post-Crimia stage of Nightingale's career begins in earnest. With a £500 annual allowance from her father, she moves into a suite at the Burlington Hotel in London, which will be her HQ for the next several years. Her immediate concern is her own investigation into medical care in the armed forces, one intended to complement the Royal Commission.
39:03 Speaker 02 To this end, she teams up with eminent experts, including the statistician William Farr. And while Nightingale is no longer a working nurse, the legend of "The Lady with the Lamp" persists.
39:17 Speaker 02 In 1857, the American poet Henry Longfellow publishes a poem in The Atlantic magazine. It is a gushing pion to Nightingale the nurse, whom he describes as "a noble type of good, heroic womanhood."
39:34 Speaker 02 But the poetic gloss of her public reputation obscures the woman beneath it and the reality of her contribution to the world.
39:43 Speaker 03 I think one of the biggest misconceptions we have about her is actually thinking of her as a nurse. And I know a lot of people won't be too happy with that. A lot of nurses won't really like that. But her nursing career started in 1853 and was pretty much over by the end of 1856. Really, to me, she is a reformer. She's a statistician, she's a campaigner. And even when she was nursing, she was more in a management role. Superintendent was her title, both at Harley Street and across the war. And, yes, she was a nurse. I'm not denying that she was a nurse. But she was so much more.
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41:30 Speaker 02 In the summer of 1857, Nightingale's mother and sister come to stay with her at the Burlington Hotel. But the extreme absorption in her work concerns her mother, who takes her to task for laboring over her papers into the small hours. A few days later, Nightingale collapses.
41:51 Speaker 02 Doctors tell her it's frayed nerves. A modern perspective might suggest that it's another attack of brucellosis. For the next 11 years, Nightingale barely leaves home. She moves, if at all, from her bed to the sofa and back again, and endures frequent bouts of excruciating spinal pain.
42:13 Speaker 02 Inevitably, her suffering takes a toll on her. Family and friends report that she is querulous, irritable, and short-tempered.
42:24 Speaker 02 A rare upside of her condition is that it helps her to regulate the time she is able to give to others, including her family. This might help to explain how this lengthy period of ill health and seclusion is perhaps the most productive of Nightingale's life.
42:40 Speaker 03 A lot of the letters that we have in our collection are of her making appointments with people. She very much didn't want people to turn up at her house uninvited. She very strictly made appointments. She was very strong-willed, had her own way of doing things, and knew what she wanted and where she wanted to get to.
43:01 Speaker 02 With the help of William Farr, Nightingale continues to dig into the facts surrounding military hospitals. The numbers that they uncover are astounding. Of the 18,000 British deaths in Crimea, 16,000 were due to illness, not injury. To her horror, Nightingale learns that the wards of Skutari were one of the most lethal theatres of the entire conflict.
43:26 Speaker 02 The conclusions are inescapable. It was the reduction in overcrowding, the flushing of the sewer, and the cleaning of the water supply that was the key to saving lives at Skutari, not the battery of changes the Nightingale nurses had implemented. Moreover, Nightingale learns that mortality rates for soldiers in army hospitals in Britain are also staggeringly high, and poor sanitation is the chief cause.
43:56 Speaker 02 The Royal Commission delivers its findings in February 1858. Around the same time, Nightingale sends the report she has been working on to 2,000 public figures. It's a mammoth work, hundreds of pages of detailed analysis and extraordinary revelation, and it's relayed in an arresting, utterly novel way.
44:17 Speaker 03 This report was for MPs, but she knew they weren't going to read 800 pages worth of just text. So she creates these diagrams. They're really easy ways to present the data without having to read all of this stuff around it. Her Coxcomb diagram, for example, is her most famous, and that shows the mortality rates at the British Army hospitals. And it's an early form of pie chart. And this diagram really shows that it was the disease that the soldiers were picking up in the hospital which was the biggest cause of death within the hospitals.
44:57 Speaker 02 In coming years, sweeping reform takes place within the military along the lines she suggests. Higher standards of hygiene and sanitation are introduced. An army medical school is founded to improve the quality of care. At home and abroad, the health of British soldiers is transformed.
45:19 Speaker 02 The compilation of her report is a personal turning point for Nightingale too. The beginning of the end for her adherence to the miasma theory. Some also speculate that the findings leave her with overwhelming guilt over the thousands of deaths she now realises she might have prevented. What's certain is that from this time forth, Nightingale makes remarkable efforts to improve public health in numerous ways. In 1859, she publishes Notes on Hospitals. The book outlines her thoughts on hospital architecture and design, all dictated by the need for ventilation and spacing, the lack of which had proved so deadly its quittari.
46:01 Speaker 02 The following year, another volume, Notes on Nursing, is an immediate bestseller, in which Nightingale distills the rudiments of nursing in the home. Around the same time, she launches the Florence Nightingale Training School, attached to St Thomas's Hospital in London. All the while, as she works from the confines of her own home, she recognises the unavoidable fact that without her exceptional privilege, none of this would have been possible. Indeed, the issue of poverty is often at the forefront of her work.
46:36 Speaker 02 Wealth inequalities in Victorian Britain are enormous. The infamous Poor Law of 1834 restricts financial aid to the poor, forcing many into workhouses.
46:49 Speaker 02 In these austere places, little better than prisons, paupers are given food and shelter in exchange for gruelling manual labour.
46:58 Speaker 02 Health in such settings is virtually non-existent.
47:02 Speaker 03 The workhouses that would have been set up across Britain would have had infirmaries attached to them, but there wouldn't have really been any proper medical provision for them. It was often up to the most able-bodied women in the workhouse to look after people. They would never have trained as nurses. They would have literally just been women who have ended up in the workhouse.
47:27 Speaker 02 To address the problem, Nightingale works closely with a fellow reformer, William Rathbone. In 1864, they create the position of a nursing superintendent at a workhouse in Liverpool. It's the first such appointment anywhere in Britain.
47:43 Speaker 02 To modern ears, it might sound small. In the 1860s, it was a quietly radical step.
47:50 Speaker 03 They start to work on these formal staffing structures for the workhouse infirmaries because they felt the poor in society should have equal access to healthcare. This really changes the way people view the workhouse infirmaries and although I can 100% say it has that link to the NHS, I think it really does start off that idea of universal healthcare for all and ensuring that everyone has equal access to healthcare when they need it.
48:22 Speaker 02 1887 is Jubilee Year in Britain, the 50th anniversary of Victoria's ascension to the throne.
48:30 Speaker 02 At the start of her reign, expectations had not been high, but the teenage queen has grown up to become, in many communities at least, a beloved leader, the emblem of an era. Something similar can be said of Florence Nightingale, now sixty-seven and living in Mayfair in London. Half a century has passed since she first heard the voice of God calling her to service. Famed not just for her work in health reforms, to the public, in many ways, she is the embodiment of a Victorian feminine ideal, representing compassion, good works, cleanliness, and godliness.
49:08 Speaker 02 To mark the Queen's special anniversary, an exhibition is held in London. Gathered together are a vast array of artefacts to display the successes of the Victorian era. A section is devoted to Nightingale, including the carriage that transported her around Crimea, an object that is acquired an almost mystical quality, more religious relic than mere memento.
49:36 Speaker 02 Much like her Queen, Nightingale spends her later years largely hidden from public view. She also becomes passionately interested in India, though, again mirroring Victoria herself, she has never set foot there. As a younger woman, Nightingale had been interested in the welfare of British soldiers in India. Now, in her old age, she becomes a public supporter for Indian self-governance reforms.
50:02 Speaker 02 The final years of her life are spent quietly in Mayfair. Despite her prolonged health problems, she lives until the age of ninety, passing away on the thirteenth of August, 1910.
50:14 Speaker 02 In the years since her heyday, she is cited as a key influence on all manner of initiatives. Henri Dounant credits Nightingale as his inspiration for founding the International Red Cross in the 1860s, as well as for his work that leads to the founding of the Geneva Convention. For much of the late 20th century, she is the only woman other than Elizabeth II to appear on British banknotes. When the Covid-19 pandemic hits the UK in 2020, the temporary hospitals built to care for those affected are named in her honour.
50:51 Speaker 02 The life of Florence Nightingale was one of courage, service and devotion. But despite her privilege in a deeply unequal society, it was also marked by struggle, isolation and regret. Over a century after her death, her story is as layered with legend and misconception as it was when she still personally tended the sick. But the core message of Nightingale's life burns as brightly as her lantern once did in those hellish, scutare hospital wards.
51:23 Speaker 03 Florence Nightingale's biggest legacy is really her reform work in terms of nursing, healthcare and hospitals. These really laid the foundations for modern healthcare today. Nightingale and her lamp became a symbol of hope for people in the Crimean War. And these people were stuck in an awful situation and they just needed someone who cared. And I think, for me, the human nature hasn't changed in the last 200-odd years. There are still people today who step outside their comfort zone to really try and help others and to make a difference.
52:10 Speaker 02 Next time on Short History of, we'll bring you a short history of the Mitford sisters.
52:16 Speaker 05 When you think about that time in the 30s, running up to the Second World War, I can't tell you how many people had said to me recently how relevant it seems for today. And we've got a very, very disturbed world with a lot of voters across Europe swinging to the right. So I think there is a relevance in following their story. It's just interesting, as well as glamorous.
52:40 Speaker 02 That's next time.
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