Florence Nightingale: The Making of an Icon

Florence Nightingale’s enduring fame is concentrated in an image: a Victorian gentlewoman of serene countenance, seen at night in a crowded hospital ward filled with desperately ill and wounded men, holding aloft a solitary lamp as she brings succor to the poor souls around her. Probably the most famous nurse in history, her reputation then and now centers on the preservation of this moment, which crystallized in the first newspaper accounts of her undoubtedly heroic service tending to British casualties during the Crimean War of the 1850s.

Students of history have learned to cock a skeptical eyebrow at such tableaux; we are primed to uncover the stage direction behind the scene, and to be disillusioned in turn. The title of Mark Bostridge’s rigorously researched biography Florence Nightingale: The Making of an Icon hints at that sort of purpose — a pulling back of the veil to reveal the machinery behind a media-ready moment. But readers who expect a debunking will instead discover something much more valuable, for Bostridge portrays a personality that conquered nearly every challenge it encountered, and a woman whose breadth of accomplishment extends far beyond the vigil over the beds of soldiers.

It was, however, that service from which all else flowed — her work as the leader of a detachment of civilian nurses under the hastily improvised imprimatur of an English government that was desperately trying to deal with an emerging scandal provoked by the army’s utter lack of preparation for the high rate of Crimean war casualties. The nightmarish conditions of the main combat hospital, located in Scutari, in Turkey, provided the stage for Nightingale’s entry into history. At 34, she had only a year’s experience as superintendant of a new Establishment for Gentlewomen During Illness, but her lifelong interest in nursing had driven her to seek out training and experience available to few in England at that time. A family connection with Sidney Herbert, the secretary of war, matched her desire to go to Scutari with the government’s need to be seen doing something to address the crisis.

It’s hard to believe that Herbert or anyone in London had any idea how lucky a choice they’d made. Nightingale’s presence proved transformative — though it is hard to pinpoint, even armed with the detailed chronicle that Bostridge provides, the moment at which her role at Scutari underwent a metamorphosis. At some point she stopped being the leader of a small group of female nurses (who could not even enter the wards to tend the wounded without the invitation of one of the doctors) and emerged as what Lytton Strachey characterized as essentially the “administrative chief” of the entire facility. It may have begun at the moment of her arrival: one account notes that among her first actions was “to take a piece of chalk & number all the beds throughout the hospital.”

This action is characteristic — Nightingale not only lavished personal energy upon the sick and wounded; more vitally, she struggled to bring what we’d understand as a modern conception of public health principles to bear in an atmosphere defined by the army’s mulish resistance to change. Historically treated as a quasi-criminal rabble by their gentlemen-officer superiors, British soldiers were provided with few supplies in hospital other than what they brought on their backs. Outraged by official resistance and incompetence, Nightingale focused her resources (and her political connections) on solving problems of supply and organization. Addressing the deadly hygiene issues in the hospital was an even greater challenge (walls literally crawled, and the drains were blocked with the corpses of animals), which took an agony of time to meet effectively.

In a war that lacked triumphs (this is the war of “The Charge of the Light Brigade,” a cavalry action both gallant and pointless) Nightingale’s ability to snatch something approaching a victory from the ashes, enhanced by her highly visible self-sacrifice, was galvanizing to the English public; the newspapers painted her as the new model of Victorian womanhood. Soon an adoring nation was purchasing instant biographies, cheap artists’ renderings, and even statuettes.

“Florence,” Bostridge notes, “had no patience with her legend, or with anyone seeking to promote it.” That didn’t mean she didn’t know how to wield it as a weapon: convinced the War Office was dragging its feet, she warned Herbert, “hree months from this day I publish my experience of the Crimea campaign?unless there has been a fair and tangible pledge by that time for reform.” Now chronically ill (Bostridge draws upon recent research to suggest a recurring case of brucellosis, a bacterial disease contracted from contaminated cheese), Nightingale became a sofa-bound report- and letter-writing machine — arguing, goading, pleading, coaxing, and threatening Herbert and others into putting her ideas into practice. Multiple books, like the invaluable Notes on Nursing, followed. From the overhaul of army medicine and hospital architecture and, in later years, a full-scale attack on exploitative land management in India, Nightingale set her sights on larger and larger targets.

Perhaps the most revelatory aspect of Bostridge’s study is his account of how Nightingale made her way to such a position of indirect but very real power. The product of a family which had for generations been prominent in evangelical Dissenting circles, Nightingale received a wide-ranging and liberal education. By 16, she had “the rudiments of chemistry, geography, physics and astronomy” and was also studying mathematics, grammar, philosophy and a wide range of history. She could speak French and Italian, and as a teenager her Greek and Latin were good enough that she was translating Homer and Socrates. Exposure to the emerging science of statistics gave her the tools to later grapple with public health questions on a grand scale. And, as Bostridge masterfully demonstrates, the philosophical and theological legacy of her grandfather — a prominent abolitionist and fervent advocate of social reform — permeated her upbringing.

But however central her family was in giving her the tools to achieve her ambitions, the almost paradoxical fact is that, from early on, Nightingale held the conviction that life as the daughter of an upper-class family was in essence a prison. Her early ambitions were to care for the sick in practical terms and to work for moral and religious improvement in the neglected profession of nursing. These goals were constantly hemmed in by the demands of her mother and sister, who expected Florence to take her place in the pageantry of upper-class feminine life. And though she was neither a killjoy (she loved travel and the opera) nor immune to the temptations of married life (after a proposal, she meditated in her diary on her “passional nature”, which would, she thought, be fulfilled in her husband), she was always keenly aware of the limits a conventional life would impose on her. A quasi-autobiographical work titled Cassandra testifies to her bitterness over having to make this choice. But once she did, she never seems to have looked back.

As Bostridge reveals more and more of the shape of the icon, we find her still — perhaps even more — admirable, formidable, inspiring, and heroic but not particularly likable. Although she commanded almost limitless devotion from a circle of family and friends, she was implacable in her professional feuds; in letters about those who got in her way, she could be scathing. Perhaps the most illuminating truth this study unveils is neither Nightingale’s capacity for outrage nor her powerful charisma, but her resolute empiricism. Throughout her life Nightingale let one after another of her preconceived ideas fall away in favor of what she saw before her, without the least tremor in her core convictions. Focused on the morality of nurses as a young reformer, she later trained her energy on more practical issues of hygiene and became a passionate advocate of the sanitarian movement. Dismissive of germ theory in her early years, by the end of her career she urged nurses to practice antisepsis. Throughout the book, her voracious hunger for better information on the world is palpable. Mark Bostridge has given us a biography that, in its diligence, its painstaking search after nothing but the truth, does most noble justice to its subject, whose goal was always to bring light into the darkness.