The Life of Florence Nightingale Volume I Part 12

CHAPTER I

THE CALL

(October 1854)

Not for delectations sweet, Not the cushion and the slipper, not the peaceful and the studious, Not the riches safe and palling, not for us the tame enjoyment, Pioneers! O pioneers!

WALT WHITMAN.

On September 20 the Battle of the Alma was fought, and the country, as Greville noted, was "in a fever of excitement." The disembarkation of the allied British and French forces for the invasion of the Crimea had begun on the 14th. Their advance was not resisted until they reached the bank of the Alma, where the Russian commander was awaiting attack, in so strong a position that he was confident of victory. In less than three hours the allied troops had driven the enemy from every part of the ground. Lord Raglan, the Commander of the Forces, congratulated the troops on "the brilliant success that attended their unrivalled efforts in the battle, on which occasion they carried a most formidable position, defended by large ma.s.ses of Russian infantry, and a most powerful and numerous artillery." The river which the Russian commander had hoped to make the grave of the invaders became famous in the annals of British valour:--

Thou, on England's banners blazoned with the famous fields of old, Shalt, where other fields are winning, wave above the brave and bold; And our sons unborn shall nerve them for some great deed to be done, By that twentieth of September, when the Alma's heights were won.

O thou river! dear for ever to the gallant, to the free, Alma! roll thy waters proudly, proudly roll them to the sea!

Nearly forty years had pa.s.sed since the British army had been engaged in European warfare. The Battle of the Alma, though it disclosed little tactical skill, and though it was not followed up as it might have been, had at any rate shown the desperate courage of the British soldier. The note of exultation which inspired the verses of Archbishop Trench expressed the popular mood.

Presently there was a change. The number of killed and wounded was very large; but though many homes were thrown into mourning, it was felt, in the words of the official bulletin, that such a victory "could not be achieved without a considerable sacrifice." The country did not at the time grudge the sacrifice; but Lord Raglan's dispatch was followed by another. The Crimean War was the first in which the "Special Correspondent" played a conspicuous part, and the dispatches sent to the _Times_ by Mr. William Howard Russell availed even to overthrow a Ministry. In the _Times_ of October 9, attention was drawn to the futility of the nursing arrangements on the British side. The old pensioners, who had been sent out for such service, were "not of the slightest use"; the soldiers had to "attend upon each other." On the 12th a long letter from "Our Special Correspondent," dated "Constantinople, September 30," ended with the following pa.s.sage:--

It is with feelings of surprise and anger that the public will learn that no sufficient preparations have been made for the proper care of the wounded. Not only are there not sufficient surgeons--that, it might be urged, was unavoidable; not only are there no dressers and nurses--that might be a defect of system for which no one is to blame; but what will be said when it is known that there is not even linen to make bandages for the wounded? The greatest commiseration prevails for the sufferings of the unhappy inmates of Scutari, and every family is giving sheets and old garments to supply their wants. But why could not this clearly foreseen want have been supplied? Can it be said that the Battle of the Alma has been an event to take the world by surprise? Has not the expedition to the Crimea been the talk of the last four months?

And when the Turks gave up to our use the vast barracks to form a hospital and depot, was it not on the ground that the loss of the English troops was sure to be considerable when engaged in so dangerous an enterprise? And yet, after the troops have been six months in the country, there is no preparation for the commonest surgical operations! Not only are the men kept, in some cases, for a week without the hand of a medical man coming near their wounds; not only are they left to expire in agony, unheeded and shaken off, though catching desperately at the surgeon whenever he makes his rounds through the fetid ship; but now, when they are placed in the s.p.a.cious building, where we were led to believe that everything was ready which could ease their pain or facilitate their recovery, it is found that the commonest appliances of a workhouse sick-ward are wanting, and that the men must die through the medical staff of the British army having forgotten that old rags are necessary for the dressing of wounds. If Parliament were sitting, some notice would probably be taken of these facts, which are notorious and have excited much concern; as it is, it rests with the Government to make inquiries into the conduct of those who have so greatly neglected their duty.

On the following day a further letter from the "Special Correspondent"

was published. "It is impossible," he wrote, "for any one to see the melancholy sights of the last few days without feelings of surprise and indignation at the deficiencies of our medical system. The manner in which the sick and wounded are treated is worthy only of the savages of Dahomey.... The worn-out pensioners who were brought as an ambulance corps are totally useless, and not only are surgeons not to be had, but there are no dressers or nurses to carry out the surgeon's directions, and to attend on the sick during the intervals between his visits. Here the French are greatly our superiors. Their medical arrangements are extremely good, their surgeons more numerous, and they have also the help of the Sisters of Charity, who have accompanied the expedition in incredible numbers.[69] These devoted women are excellent nurses." These scathing attacks changed the mood of the country. There was still exultation in victory, and still readiness to pay its price; but the "Special Correspondent's" charges of neglect towards the sick and wounded raised a feeling of bitter resentment--of resentment against the authorities, but also of pity for the victims. The _Times_ accompanied the "Special Correspondent's" letter on October 12 by a leading article, making appeal to its readers, who were sitting comfortably at home, to bestir themselves, and render such help as might be possible to the soldiers in the East. A letter was published next day from Sir Robert Peel, who had enclosed 200 to start a fund for supplying the sick and wounded with comforts. Other contributions were quickly forthcoming, and on October 14 a letter was published asking: "Why have we no Sisters of Charity? There are numbers of able-bodied and tender-hearted English women who would joyfully and with alacrity go out to devote themselves to nursing the sick and wounded, if they could be a.s.sociated for that purpose, and placed under proper protection."

[69] For the actual number, see below, p. 149.

II

There were those among the ladies of England who had not waited to be stung into action by such appeals. On the first news of the failure of the British nursing arrangements, they had asked themselves whether they might not help, not merely by money, but by personal service. One of the first to move was Lady Maria Forester. She must have read and marked the letter in the _Times_ on October 9, for already by October 11 she had placed herself in communication with Miss Nightingale, offering money to send out some trained nurses. "I was so anxious something should be done," she said to Lady Verney, "that I would have gone myself, only I knew that I should not have been the slightest use." Happily the minds of those who could be of the greatest use were moving in the same direction. If a party of women nurses were to be sent out to the East with any prospect of success, there were two persons in England whose co-operation was essential, and by fortunate chance they were personal friends.

One was Mr. Sidney Herbert, the Secretary _at_ War. The preposition which I have placed in italics must be noted. The reader would not thank me for entering at length into all the intricacies of War Office organization, disorganization, and reorganization, which went on during the Crimean War, and have continued to our own day. But this much it is necessary to remember, that in 1854 there was a Secretary _for_ War (the Duke of Newcastle) and a Secretary _at_ War (Mr. Sidney Herbert). The curious part of the arrangement was that the Secretary _at_ War had nothing to do with war, as such; he was, technically, only a financial and accounting official. But Mr. Sidney Herbert, in the emergency created by the Crimean War, stepped courageously beyond the strict bounds of his office. He had already shown himself by many beneficent measures of practical reform to be the Soldiers' Friend. He was deeply interested, as we have heard (p. 80), in the care of the sick. He knew how over-worked was his colleague, the Duke of Newcastle, and in this matter of hospitals he a.s.sumed the position of volunteer delegate of the Secretary of State. "I wish," wrote Mr. Gladstone to Monckton Milnes (Oct. 15, 1855), "that some one of the thousand who in prose justly celebrate Miss Nightingale would say a single word for the man of 'routine' who devised and projected her going."[70] Lord Stanmore has said not a word, but a volume, in that sense; what was truly admirable was "the man of routine's" bold departure from routine. The employment of female nurses in the army was in this country entirely novel. It would probably excite some jealousy in the medical profession; it was sure to be criticized by the military men. The Cabinet had much else to think of. The Duke of Newcastle had more on his hands than any one human being could properly accomplish. Mr. Herbert, from his influence in the Cabinet, from his winning manner and general popularity, was the man to carry through the new departure. He had pondered long over the problems of nursing, both in military hospitals and in civil life. He could see no reason why a task, which in civil life was entrusted almost exclusively to women, should in the case of military hospitals be confined to men. The French Government had sent out fifty Sisters of Mercy. Mr. Herbert could see no reason why England should not do something of a like kind. He determined to make the experiment.

[70] _Life of Lord Houghton_, vol. i. p. 521.

He was strengthened in his resolve by the fact that he was intimately acquainted with the character and the powers of the second indispensable person. He knew Miss Florence Nightingale. The preceding Part of this volume has shown by "what circuit first" her life had been one long preparation for precisely such work as was now wanted. She and the Minister had read the dispatch in the _Times_ with equal, if different, interest. To Mr. Herbert it came as a call for something to be done, if the Ministry were to avoid dangerous criticism; and to this motive, which must rightly actuate every Minister, there was added the conscience of a high-minded man, sincerely and eagerly anxious to do all that was possible to improve the treatment of the sick and wounded soldiers. To Miss Nightingale, as she read the dispatch, and the stirring appeal which accompanied it, the words came with something of the force of a call from Above. For nearly ten years of her life she had consciously yearned, and half-consciously for a much larger period, after ample scope in which to exercise her power of organization, and her desire to serve the sick and suffering. During many of those years she had been training herself so as to be ready to use her opportunity when it should occur. And here was the opportunity at hand, in which patriotism confirmed her personal aspirations. "G.o.d's good time" had come.

The minds of the Minister and of Miss Nightingale were kindled together.

They reached the flash-point of action at almost an identical moment.

Private initiative forestalled official overtures only by a few hours.

Working in harmony, they carried the scheme into operation with an unparalleled rapidity.

III

Within two days of the publication of the dispatch from Constantinople, Miss Nightingale and her friends had made their plans. She submitted them to the Minister in the following letter addressed to his wife:--

(_Miss Nightingale to Mrs. Herbert_.) 1 UPPER HARLEY STREET, _October_ 14 [1854]. MY DEAREST--I went to Belgrave Square this morning for the chance of catching you or Mr. Herbert even, had he been in town.

A small private expedition of nurses has been organized for Scutari, and I have been asked to command it. I take myself out and one nurse.

Lady Maria Forester has given 200 to take out three others. We feed and lodge ourselves there, and are to be no expense whatever to the country. Lord Clarendon has been asked by Lord Palmerston to write to Lord Stratford for us, and has consented. Dr. Andrew Smith of the Army Medical Board, whom I have seen, authorizes us, and gives us letters to the Chief Medical Officer at Scutari.

I do not mean to say that I believe the _Times_ accounts, but I do believe that we may be of use to the wounded wretches.

Now to business.

(1) Unless my Ladies' Committee feel that this is a thing which appeals to the sympathies of all, and urge me, rather than barely consent, I cannot honourably break my engagement here. And I write to you as one of my mistresses.

(2) What does Mr. Herbert say to the scheme itself? Does he think it will be objected to by the authorities? Would he give us any advice or letters of recommendation? And are there any stores for the Hospital he would advise us to take out? Dr. Smith says that nothing is needed.

I enclose a letter from E. Do you think it any use to apply to Miss Burdett Coutts?

We start on Tuesday if we go, to catch the Ma.r.s.eilles boat of the 21st for Constantinople, where I leave my nurses, thinking the Medical Staff at Scutari will be more frightened than amused at being bombarded by a parcel of women, and I cross over to Scutari with some one from the Emba.s.sy to present my credentials from Dr.

Smith, and put ourselves at the disposal of the Drs.

(3) Would you or some one of my Committee write to Lady Stratford to say, "This is not a lady but a real Hospital Nurse," of me? "And she has had experience."

My uncle went down this morning to ask my father and mother's consent.

Would there be any use in my applying to the Duke of Newcastle for his authority?

Believe me, dearest, in haste, ever yours, F. NIGHTINGALE.

Perhaps it is better to keep it quite a private thing, and not apply to Gov^t. _qua_ Gov^t.

This letter was posted on Sat.u.r.day. Mr. Herbert had left London to spend Sunday at Bournemouth, and thence, unaware of the communication which was on its way to him from Miss Nightingale, he addressed the following letter to her:--

(_Sidney Herbert to Miss Nightingale._) BOURNEMOUTH, _October_ 15 [1854]. DEAR MISS NIGHTINGALE--You will have seen in the papers that there is a great deficiency of nurses at the Hospital at Scutari.

The other alleged deficiencies, namely of medical men, lint, sheets, etc., must, if they have really ever existed, have been remedied ere this, as the number of medical officers with the army amounted to one to every 95 men in the whole force, being nearly double what we have ever had before, and 30 more surgeons went out 3 weeks ago, and would by this time, therefore, be at Constantinople. A further supply went on Thursday, and a fresh batch sail next week.

As to medical stores, they have been sent out in profusion; lint by the _ton_ weight, 15,000 pairs of sheets, medicine, wine, arrowroot in the same proportion; and the only way of accounting for the deficiency at Scutari, if it exists, is that the ma.s.s of stores went to Varna, and was not sent back when the army left for the Crimea; but four days would have remedied this. In the meanwhile fresh stores are arriving.

But the deficiency of female nurses is undoubted, none but male nurses having ever been admitted to military hospitals.

It would be impossible to carry about a large staff of female nurses with the army in the field. But at Scutari, having now a fixed hospital, no military reason exists against their introduction, and I am confident they might be introduced with great benefit, for hospital orderlies must be very rough hands, and most of them, on such an occasion as this, very inexperienced ones.

I receive numbers of offers from ladies to go out, but they are ladies who have no conception of what an hospital is, nor of the nature of its duties; and they would, when the time came, either recoil from the work or be entirely useless, and consequently--what is worse--entirely in the way. Nor would these ladies probably ever understand the necessity, especially in a military hospital, of strict obedience to rule. Lady M. Forester (Lord Roden's daughter) has made some proposal to Dr. Smith, the head of the Army Medical Department, either to go with or to send out trained nurses. I apprehend she means from Fitzroy Square, John Street, or some such establishment. The Rev. Mr. Hume, once chaplain to the General Hospital at Birmingham (and better known as author of the scheme for transferring the city churches to the suburbs), has offered to go out himself as chaplain with two daughters and twelve nurses. He was in the army seven years, and has been used to hospitals, and I like the tone of his letters very much. I think from both of these offers practical effects may be drawn. But the difficulty of finding nurses who are at all versed in their business is probably not known to Mr. Hume, and Lady M. Forester probably has not tested the willingness of the trained nurses to go, and is incapable of directing or ruling them.

There is but one person in England that I know of who would be capable of organizing and superintending such a scheme; and I have been several times on the point of asking you hypothetically if, supposing the attempt were made, you would undertake to direct it.

The selection of the rank and file of nurses will be very difficult: no one knows it better than yourself. The difficulty of finding women equal to a task, after all, full of horrors, and requiring, besides knowledge and goodwill, great energy and great courage, will be great. The task of ruling them and introducing system among them, great; and not the least will be the difficulty of making the whole work smoothly with the medical and military authorities out there. This it is which makes it so important that the experiment should be carried out by one with a capacity for administration and experience. A number of sentimental enthusiastic ladies turned loose into the Hospital at Scutari would probably, after a few days, be _mises a la porte_ by those whose business they would interrupt, and whose authority they would dispute.

My question simply is, Would you listen to the request to go and superintend the whole thing? You would of course have plenary authority over all the nurses, and I think I could secure you the fullest a.s.sistance and co-operation from the medical staff, and you would also have an unlimited power of drawing on the Government for whatever you thought requisite for the success of your mission. On this part of the subject the details are too many for a letter, and I reserve it for our meeting; for whatever decision you take, I know you will give me every a.s.sistance and advice.