The Life of Florence Nightingale, vol. 1 of 2

by Sir Edward Tyas Cook

II

There was another sphere in which Miss Nightingale came to the rescue of the sick and wounded from the blunders of official administration. She clothed them, 50,000 shirts in all having been issued from her store. The history of this private clothing department is curious. The regulations of the War Office assumed that every soldier brought with him into hospital an adequate kit, and it was no part of the Purveyor's duty to supply such a thing as a shirt. But three of the four generals of division in the Crimea had decided not to disembark the men's knapsacks. Sebastopol, it was confidently expected, would fall in a few days' time, and the men were to march light. In most cases they never saw their knapsacks again.[120] Hence the sick and wounded who arrived at Scutari immediately after the Battle of the Alma were destitute of all clothing except what was on their persons, and that was in many cases fit only for the furnace. No regulation existed whereby, if the soldier had for military reasons been deprived of his kit, the deficiency could be made good. The supply of a change of linen for the sick and wounded while in hospital, and of clean shirts to wear when invalided home or returned to the front, was perhaps a better allocation of benevolent funds than a supply of altar-cloths for a new church at Pera. At any rate Miss Nightingale thought so; and thus she and her coadjutors were in some measure the clothiers as well as the purveyors of the wounded soldiers.

III

Miss Nightingale assumed responsibility on one occasion as a builder, and this was at the time the usurpation which was most condemned in some quarters and the most commended in others. Some wards in the Barrack Hospital were in so dilapidated a condition as to be unfit for the reception of patients. The Commander-in-Chief had warned the hospital authorities that additional sick and wounded might shortly be upon their hands. The uninhabited wards might by prompt expenditure be made capable of accommodating 800 cases. The expenditure, however, would be considerable, and no one seemed willing to incur it without superior authority. Miss Nightingale stepped into the breach. With the concurrence of Dr. McGrigor, a senior medical officer of the hospital, she represented the urgency of the case to Lady Stratford de Redcliffe. The Ambassador had been empowered, as we have seen, to incur expenditure; and his wife, as she had given Miss Nightingale to understand, was the authorized intermediary between the Ambassador and the authorities of the hospitals. Lady Stratford saw the urgent necessity of the work, and Mr. Gordon, the chief of the engineering staff, was instructed to put it immediately in hand. The workmen, 125 in number, presently struck, whereupon Miss Nightingale, on her own authority, succeeded in engaging 200 other workmen, and the work was rapidly completed. Lord Stratford subsequently disclaimed any responsibility,[121] and Miss Nightingale paid the bill out of her own private resources. The War Department, when the affair came to their knowledge, approved her action, and reimbursed her. This instance of “the Nightingale power” made a great impression, and she herself regarded it as the most beneficent thing she did in the East. The fame of the affair was noised abroad, and reached the British camp at Balaclava, where our unfailing friend, Colonel Sterling, heard of it with hot indignation. Miss Nightingale, he wrote, “coolly draws a cheque. Is this the way to manage the finances of a great nation? Vox populi? A divine afflatus. Priestess, Miss N. Magnetic impetus drawing cash out of my pocket!” In normal times it would certainly not be the way to manage the finances of a great nation. And even in times of emergency the way which would of course have occurred to any well-regulated slave of routine was that Miss Nightingale should have spoken to some officer on the spot, that he should have represented the case to the Director-General of the Army Medical Department in London, that the Director-General should have moved the Horse Guards, and the Horse Guards the Ordnance, that the Ordnance should then have approached the Treasury, and that after process of minuting and countersigning, the work should in due course have been officially ordered. But meanwhile Lord Raglan's wounded would have arrived at the hospital, and there would have been no wards ready to receive them. As it was, “the wards were ready,” as Miss Nightingale reported to Mr. Herbert (Dec. 21), “to receive 500 men on the 19th from the ships Ripon and Golden Fleece. They were received in the wards by Dr. McGrigor and myself, and were generally in the last stage of exhaustion. I supplied all the utensils, including knives and forks, spoons, cans, towels, etc., clearing our quarters of these.”

IV

In all these things Miss Nightingale may be warmly commended, but the officials need not be too hotly condemned. They were but doing their duty, as they had learnt it; and for the rest, it was the system, or want of system, that was at fault. Just as in London there was no co-ordination among the Departments, so at Scutari there was no unity of action, and no clear personal responsibility. “It is a current joke here,” wrote Miss Nightingale from Scutari, “to offer a prize for the discovery of any one willing to take responsibility.” It was never awarded, for Miss Nightingale herself was, I suppose, “barred.” In writing to Mr. Herbert, she called many of the officials at Scutari by very hard names, but in other letters she admitted that the ultimate fault lay elsewhere. “The grand administrative evil,” she said (Dec. 10), “emanates from home—in the existence of a number of departments here, each with its centrifugal and independent action, uncounteracted by any centripetal attraction, viz. a central authority capable of supervising and compelling combined effort for each object at each particular time.” Mr. Herbert might write, but the officials would not act. The force of custom was too strong. Miss Nightingale showed the Purveyor a letter from the Minister. “This is the first time,” he said, “I have had it in writing that I was not to spare expense. I never knew that I might not be thrown overboard.” “Your name,” she had told Mr. Herbert (Nov. 25), “is continually used as a bug-bear. They make a deity of cheapness, and the Secretary at War stands as synonymous here with Jupiter Tonans, whose shafts end only in a brutum fulmen. The cheese-paring system, which sounds unmusical in British ears, is here identified with you by the officers who carry it out. It is in vain to tell the Purveyors that they will get no kudos by this at home.”

It should not be supposed, however, that Miss Nightingale was a spurner of rules, and a despiser of discipline, routine, and subordination. The very reverse is the case. Her whole career makes it probable, the character of her mind suggests it, and the administration of the funds placed at her disposal, with which the present chapter has mainly been concerned, proves it. If she shocked and staggered some official minds by her daring innovations, it was her strictness and insistence upon rules and regulations that was most criticized in unofficial quarters. She explained the matter very clearly in her final Statement to Subscribers. She had been placed by the Government in two positions of trust, each independent of the other. She had been appointed superintendent of the nursing establishment; and she further had received authority, as almoner of the “Free Gifts” (as the Royal Bounty was called), to apply them, and any other gifts derived from private sources, in the War Hospitals. In the second of these capacities, she could, if she had chosen, have administered her stores solely at her personal discretion, and have delegated a like discretion to other superintendents, sisters, or nurses appointed by her. But, except in a few special cases, which it were superfluous to enumerate, she rejected the liberty of personal discretion, and administered her funds only upon the requisition of medical officers. (She lays repeated stress on this fact, but I daresay that she herself was often the originating source of the requisitions. We have seen that in Harley Street she had learnt the art of managing overworked doctors.) Her statement of the reasons which governed her action is characteristic of her good sense. The exercise of personal discretion alone would have been the easier course; but the objections to it were “the abrogation of ordinary rule; the impossibility of preventing irregular issues, or at least of disproving the charge, and the unfitness of a large proportion of the women, who efficiently discharge the duty of the Nurses, to be the judges of the wants of soldiers and distribution of supplies to them; and, farther, the abuse which some would undoubtedly make of the power. To those to whom the charge of dishonesty would not apply, religious partiality either would, or, what in matters of this kind is only less mischievous, would be believed to, apply.” Next, there was the danger of patients being given other food than what the medical officers ordered. “It is needless to state to any sensible person, even without hospital experience, the manifold dangers of issuing to Nurses, whether ‘Ladies, Sisters, or Nurses,’ stores or facilities for procuring stores, to be distributed at their own discretion through the Wards. It is to be remembered that the employment of women in Army Hospitals is recent, that many experienced and able Surgeons are opposed to it, that, among these, some are honestly, and some are unscrupulously prone to find objections to it, and to exaggerate mischiefs arising from it; that the Surgeon can, to a considerable extent, allow the Nurse to be useful, or force her to be comparatively useless, in his Wards; that the War Hospitals are a bad field for investing the Nurse with powers and offices which she never exercises in Civil Hospitals. On these grounds, as strict an adherence to existing rules as was possible appeared to be the only course.… Miss Nightingale exacted and she rendered adherence to rules to a large extent, and she strictly reverted to them when any emergency, during which, at the instance of authorities, she had departed from them, had ceased. A position such as hers necessarily exposes the holder to attacks from different quarters upon opposite grounds. While previously existing authorities are disposed to complain of all novel expenditure as lavish, and tending to the relaxation of discipline by over-indulgence, others, who feel themselves checked or restrained by regulations in the distribution of comforts according to their ideas of benevolence, will naturally object to the obstruction, in their view unnecessarily, interposed to the current of public liberality. While the experience of all who have conducted the operations of any extensive charity proves that the application of the ordinary axioms of business is the only road to success, it also sufficiently shows that such application is surely attended by no small measure of unpopularity.”[122]

She saw the value of rules, and respected them, sometimes even when they were ridiculous. On a cold night in January 1856, she was by the bedside of a dying patient; whose feet she found to be stone cold. She requested an orderly to fetch a hot-water bottle immediately. He refused, on the ground that his instructions were to do nothing for a patient without directions from a medical officer. Miss Nightingale stood corrected, and trudged off to find a doctor and make requisition for the bottle in due form. On a night in the following month, there was an unusually cold east wind, with a heavy snowfall. The patients in the ward attended by a civilian doctor were exposed to the wind and complained bitterly of the cold, but the regulation supply of fuel had given out. As the Government store was closed, Miss Nightingale waived the rule about applying first to the Purveyor, and gave the doctor fuel from her private stores. Next day the civilian doctor requisitioned in due form for an extra supply of fuel. He was refused. He carried his case to the Inspector-General. That official pleaded that he could not depart from the regulations which allowed only a certain quantity of wood for each stove. But, urged the civilian, exceptional cold calls for an extra allowance. Possibly, replied the Inspector-General with exemplary gravity, but “a Board must first sit” upon the question. The civilian smiled good-humouredly, and begged the great man to supply the wood first, and let the Board sit upon it when the weather was milder. The Inspector-General consented. These little incidents[123] throw a flood of light upon the difficulties through which Miss Nightingale had to thread her way. She was a firm believer in rules; but she was one of those able administrators who have the sense to know, and the courage to act upon the knowledge, that rules sometimes exist only to be broken.

And this was precisely the kind of initiative that the state of things in the hospitals at Scutari demanded. Miss Nightingale's adherence to rules may have brought unpopularity upon her from some of her subordinates or subscribers; but her departure from rules, on due cause of emergency, and her cutting of knots—perhaps even her breaking open of consignments—brought from her official superior, Mr. Sidney Herbert, nothing but commendation and support. One sees this sometimes in his letters to herself, sometimes in those which he addressed to others, and which reflect the impression made upon him by her vigour and resource. “Pray recollect,” he wrote to the senior medical officer (Dec. 1, 1854), “in your demands upon us here, whether for more men, more comforts, or more necessaries, that there is no question of pounds, shillings and pence in such matters, but that whatever can be got must be got.” And to the Purveyor-General he wrote: “This is not a moment for sticking at forms, but for facilitating the rapid and easy transaction of business. There is much mischief done to the public service by the stickling for precedence and dignity between departments.” Thus he wrote to many others also; but he confessed to Mr. Bracebridge that he had “small hopes of these men. I have been writing in this sense before, and in vain; but I trust there is some improvement. They are so saturated with the cheese-paring economy of forty years' peace, that there is no getting them to act up to a great occasion.”[124] Miss Nightingale's initiative alone saved the situation.

I have in this chapter separated various illustrations of that initiative from others which, in the preceding chapter, were attributed to “the woman's insight.” But perhaps the separation, though convenient, is imaginary, and all the cases of Miss Nightingale's administrative energy are ascribable to the same cause. Such was Mr. Kinglake's opinion; yet I have always suspected that the exceeding prominence given by him to the woman's touch in Miss Nightingale's work may in part have been caused by a desire to heighten the contrasts, and to barb with deadlier point his brilliant satire upon incompetence in official places. Let those who believe that it is possible to make a sharp delimitation between the “masculine” and the “feminine mind” settle this matter as they may. It seems to me that as there are old women of both sexes, so in both sexes there are men of business. My object in this chapter has been to show that Miss Nightingale brought to bear upon the task which confronted her at Scutari those high powers of the administrative mind, be they masculine or feminine, which, in moments of emergency, are capable of resource, initiative, decision.

CHAPTER VI
THE REFORMER

We have made Miss Nightingale's acquaintance, and are delighted and very much struck by her great gentleness and simplicity, and wonderful, clear, and comprehensive head. I wish we had her at the War Office.—Queen Victoria (Letter to the Duke of Cambridge, 1856).

“When one reads such twaddling nonsense,” wrote Dr. Hall in November 1855 from the Crimea to Dr. Andrew Smith in London, “as that uttered by Mr. Bracebridge, and which was so much lauded in the Times because the garrulous old gentleman talked about Miss Nightingale putting hospitals, containing three or four thousand patients, in order in a couple of days by means of the Times funds, one cannot suppress a feeling of contempt for the man who indulges in such exaggerations, and pity for the ignorant multitude who are deluded by these fairy tales.”[125] The contempt and pity of the Inspector-General of the hospitals in the East were not unmixed, I think we may surmise, with a good deal of anger, which, we may also surmise, was shared by his friend, the Director-General of the Medical Department in London. Such feelings were in the course of human nature, and the exaggeration in the statements cited by Dr. Hall is palpable. Miss Nightingale was not a magician. It would be an idle fairy tale to represent that by her exertions, either in a couple of days, or a couple of months, she effected a complete transformation scene. And it would be unfair to attribute solely to Miss Nightingale the gradual improvements which, though largely due to her initiative and resource (as described in preceding chapters), were in fact the result of the exertions of many persons both at home and in the East. “I have an unbounded admiration of Miss Nightingale's qualifications,” said a deputy medical inspector, “and of the manner she applies them, but I see dozens of things placed to her credit which I happen to know she had nothing to do with.”[126] Such was doubtless the case. Yet though in one sense Dr. Hall was perfectly right, in another he was profoundly wrong. Neither he, however, nor any of the other medical men who shared his views, need be blamed for their misapprehension. The facts of the case can only be fully understood now that access is obtainable to the private correspondence of Miss Nightingale and other actors in the drama.

She did many things herself, but she was also the inspirer and instigator of more things which were done by others. She was able of her own initiative to institute considerable reforms; but she was a reformer on a larger scale through the influence which she exercised. Though she was in truth no magician, there were men on the spot who, not being able to understand the secret and sources of her power, seemed to find something uncanny in it. Our good friend, Colonel Sterling, who hated the intrusion of petticoats into a campaign, was very much puzzled. The thing seemed to him “ludicrous,” as we have heard, but he had to admit that “Miss Nightingale queens it with absolute power”; and elsewhere he speaks of “the Nightingale power” as something mysterious and “fabulous.” The secret, however, is simple. “The Nightingale power” was due to causes of which some were inherent in herself and others were adventitious. The inherent strength of her influence lay in the masterful will and practical good sense which gave her dominion over the minds of men. The adventitious sources of her power were that she had both the ear and the confidence of Ministers, and the interest and sympathy of the Court. I have called this accession of influence “adventitious,” but it also accrued to her, in a secondary degree, from the inherent force of her character.

The influence of the Court in strengthening, in speeding up, and sometimes in chiding Ministers, especially in military matters, was, during the reign of Victoria, very great, as all readers of memoirs of the time are aware.[127] And from an early period of Miss Nightingale's mission the Court had expressed a lively interest in it, and had intimated a wish that full consideration should be paid to her experiences and impressions. “Would you tell Mrs. Herbert,” wrote the Queen to Mr. Sidney Herbert (Dec. 6, 1854), “that I beg she would let me see frequently the accounts she receives from Miss Nightingale or Mrs. Bracebridge, as I hear no details of the wounded, though I see so many from officers, etc., about the battlefield, and naturally the former must interest me more than any one. Let Mrs. Herbert also know that I wish Miss Nightingale and the ladies would tell these poor, noble wounded and sick men that no one takes a warmer interest or feels more for their sufferings or admires their courage and heroism more than their Queen. Day and night she thinks of her beloved troops. So does the Prince. Beg Mrs. Herbert to communicate these my words to those ladies, as I know that our sympathy is much valued by these noble fellows.” Upon the receipt of the Queen's message, the chaplain went through the wards reading it to the men, and copies of it were also posted on the walls of the several hospitals. “The men were touched,” Miss Nightingale reported to Mr. Herbert (Dec. 25). “‘It is a very feeling letter,’ they said. ‘She thinks of us’ (said with tears). ‘Each man of us ought to have a copy which we will keep till our dying day.’ ‘To think of her thinking of us,’ said another; ‘I only wish I could go and fight for her again.’” The Queen's message was followed by more substantial proof of Her Majesty's interest, and here again Miss Nightingale was made the intermediary between the throne and the soldiers. Through Mr. Sidney Herbert, the Queen had ascertained from Miss Nightingale the kind of comforts which would be useful to the wounded, and the following letter was sent to her by the Keeper of the Queen's Purse:—

Windsor Castle, December 14 [1854]. Madam—I have received the commands of Her Majesty the Queen to forward by the ship Eagle some packages containing some comforts and useful articles which Her Majesty wishes to be placed in your hands for distribution, as you may think fit, amongst the wounded and sick at Scutari.

Her Majesty has wished to mark by some private contribution from herself her deep personal sympathy for the sufferings of these noble soldiers, and her admiration of the patience and fortitude with which they have suffered both wounds and hardships.

The Queen has directed me to ask you to undertake the distribution and application of these articles, partly because Her Majesty wished you to be made aware that your goodness and self-devotion in giving yourself up to the soothing attendance upon these wounded and sick soldiers had been observed by the Queen with sentiments of the highest approval and admiration; and partly because, as the articles sent did not come within the description of Medical or Government stores, usually furnished, they could not be better entrusted than to one who, by constant personal observation, would form a correct judgment where they would be most usefully employed.

The Queen sent presents of warm scarves and the like to Miss Nightingale's nurses. The position of Almoner of the Free Gifts and the confidence thus shown by the Sovereign greatly extended the prestige of Miss Nightingale, who was already known to command influence with the Government, to have the favour of the Press, and to be the darling of popular opinion. Officials might feel sore, and old fogeys might grumble, but the fact became palpable that “the Nightingale power” had to be reckoned with.