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Florence Nightingale: Avenging Angel

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Florence Nightingale: Avenging Angel
By Hugh Small. (London & New York: Palgrave Macmillan, 1999. Pg 234.) ISBN: 0-3122-2699-3

Reviewed by Rochelle Caviness, November 20, 2001

"When the newspapers began to report the disastrous state of the British hospital at Scutari, and to praise the superior female nursing provided by the nuns in the French hospitals. "Why have we no Sisters of Charity?" cried The Times plaintively... If it could be shown that a party of English nurses could survive contact with a horde of soldiers in the filed, then the horrors of a London teaching hospital and its dissolute medical students would no longer prevent the introduction of intelligent women into an environment where they could be taught to be of real use." (Pg. 22)
Florence Nightingale, the Lady with the Lamp, gained fame during the Crimean War for leading a team of British nurses who administered to the wounded soldiers at the Scutari Barrack Hospital. Most of Nightingale's biographies have concentrated solely on this period of her life. Hugh Small in Florence Nightingale: Avenging Angel takes an entirely different tack, describing Nightingale's entire life, and her the numerous contributions she made in the fields of public health, army reform, and social reform.

Nightingale was born in 1820, and she died in 1910. Her father provided her with a thorough education, and Nightingale was fluent in several languages. Born into an aristocratic family, Nightingale felt that her talents would be wasted if she kept to the prescribed role of a Victorian lady, that of wife and mother. She set her sights on nursing as an outlet for her talents, but her family was against her pursuing such a public role. She was so determined to become a nurse that she tried to convert to Catholicism for the expressed purposes of establishing a convent of nursing sisters, with herself as the Mother Superior. She failed in this endeavor, but she did eventually decide to go into nursing, no matter what her family thought.

In 1853, Nightingale became the superintendent of a charity hospital, a job which she held for a year. The training she received managing this hospital made her an ideal candidate to lead a group of nurses to the Crimea. This book chronicles Nightingale's early history, how she developed her calling to become a nurse, and the political connections she made that caused her to be chosen to lead the nursing mission to the Crimea. In detailing Nightingales work during the war, Small also details the events surrounding the Crimean war, including the political situation in Britain that helped to make the war such a fiasco.

Nightingale was 34 years old when she set out for the East, and her sojourn there lasted only a year. Yet it is this year for which most of her fame was derived, this, despite the fact that her hospital had an appalling death rate. The cause, as she learned after the war, was primarily due to poor sanitary conditions, something that was not unique to Nightingale's hospital. Poor sanitary conditions and incompetence were rampant throughout the military, a fact which is perhaps best illustrated by the fact that 16,000 soldiers died from various diseases during the war, compared to only 4,100 who died either on the battle field or from wounds received during the fighting (pg 91). Little did Nightingale know, at the time, that she was killing more men than she was saving. This was primarily due to a disregard of basic sanitary and hygiene measures, the importance of which was just beginning to become apparent at the time of the war.

Small spends only a quarter of the book on Nightingale's early life and time in the Crimea. Most of the book concerns the events that occurred after the war, including the governmental conspiracy to cover-up the mismanagement of the entire war, and the unnecessary, appalling death rate among the soldiers. Small also covers Nightingale's mental breakdown, which was due in part to the guilt she felt over so many needless deaths, and her 10-year stint as a bedridden invalid. But most important, he chronicles her relentless efforts to reform the military and the public health systems.

Nightingale was a strong-willed, intelligent woman who never stopped learning. She was also an individual who was willing to admit, at least to herself, when she had made a mistake. She was also a woman who was willing to manipulate history so that she was viewed the way she wanted her life to be remembered. As Small points out, Nightingale created many of the myths that surround her own life. For example, when she wanted to excise certain aspects of her own history, she destroyed many of her own letters, and also requested that others destroy specific letters that she wrote to them. A testament to the respect that her contemporaries had for her is apparent by the fact that most of the people she contacted destroyed the letters, as she requested. Others simply returned all her letters, to her, so that she could do with them as she wished.

Throughout, Small provides a comprehensive look at Nightingale's work by not only referencing her own letters, but also those of others who knew or came into contact with her. He also consulted military records and other, often overlooked resources, to reconstruct Nightingale's life to the fullest possible extent. Included in the book is a detail list of references that Small consulted, as well as endnotes. In this revolutionary biography of Florence Nightingale, Small presents the reader with an unblemished view of exactly who Florence Nightingale was, what motivated her, and the effect of her activities both in making nursing a mainstream and acceptable occupation for middle and upper class women, for helping to institute academic nursing training, and the impact that she had on public health. He highlights some her most important works and explores many of the myths that surrounded her life, all the while providing an engaging and extremely readable biography of a remarkable woman.

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