Historical Notes; The wisdom of Florence Nightingale

FLORENCE NIGHTINGALE believed that mistakes bring wisdom. If this is the case, she must have been the wisest person in Britain. Her mistake was to support the doctors in claiming, during and after the Crimean War, that 15,000 soldiers had died in her hospitals because the Army had sent "the wrong kind of patient". During her lifetime, most of Victorian Britain knew that she had changed her mind 12 months after the war, and admired her honesty. Since her death her biographers have avoided mentioning her mistake and her correction of it, and in doing so have ignored the defining event of her life.

The soldiers were sent to Nightingale's hospital at Scutari in a dreadful state: starving, scorbutic, and sometimes with their extremities dropping off from frostbite. They were not fatally ill, but their symptoms distracted attention from the typhoid and dysentery which escalated in the hospitals and killed 10 per cent of the Army in one single month. The aristocratic officers treated the common soldier as "the scum of the earth, enlisted for drink", but Nightingale practically worshipped them and refused to treat the officers, while imploring Queen Victoria to allow the men to send their pay home to their families instead of letting them use it to drink themselves to death.

Following the war Lord Palmerston, the Prime Minister and an old family friend, manoeuvred Nightingale into leading a public inquiry into the mistreatment of the common soldier. Palmerston wanted to stop Queen Victoria interfering in military affairs and saw Nightingale as a more democratic "Mother of the Army". Her search to assign blame for the many deaths became obsessive, especially when she discovered statistics showing that the death rate had varied dramatically between hospitals; her own hospital at Scutari was at least twice as bad as any other. She worked dispassionately through a list of suspects including the Army officers, the doctors, and the politicians until finally she concluded that it must have been her own fault because she had failed to notify the Army 300 miles away of how many soldiers were dying in her hospital. The Army had thought the men were convalescing on the beaches, while in reality they were going into a mass grave.

Her discovery very nearly killed her. Not only had she "killed" the dying soldiers who had kissed her shadow, she felt she had betrayed her nurses from whom she had demanded total obedience. They had plotted together to steal food for the dying men and prolong their lives for a few days, and when their schemes failed the nurses were so distressed that the dying patients had to comfort them. Memories like these tortured Nightingale. Still only 37, she abandoned her nursing career and took to her bed for 11 years. She remained a reclusive invalid until she died, working 16 hours a day to save the millions of lives in England that would be needed to pay off her imaginary debt.

But the public, awed by her dreadful experience during the war and her sense of duty, trusted her completely. To destroy this hated reputation as a ministering angel, she leaked copies of a secret government report to her many admirers which included the statistics showing how her hospital at Scutari had killed patients rather than curing them. Surviving leaked copies of this report are now the only source of this data; which has been ignored since her death. The Government hushed up her findings and the public enquiry she led was a sham. And as recently as 1974 the Director- General of the Army Medical Department claimed that hospital conditions had nothing to do with the soldier's deaths!

Hugh Small is the author of `Florence Nightingale: avenging angel', to be published next month (Constable, pounds 18.99)

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