Bedside Manners 11: Back to Health

Florence Nightingale set out to change the course of nursing as the world knew it… and ended up getting more than she ever bargained for. 

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Episode Transcript

Speaker 1 (00:05):
The tempers of the citizens of Marblehead, Massachusetts, were about
to boil over. By the seventeen seventies, the town was
home to five thousand people, making it one of the
largest and richest fishing ports in the colonies, but a
stark economic divide had appeared between those who owned fishing
boats and those who worked on them. Things only got
worse after a fisherman's wife fell ill after washing his clothes.

(00:29):
At the time, some thought that she had been poisoned,
but after the rest of the household started to show
the same symptoms, folks started to fearfully whisper about the
potential real cause, smallpox, and soon more rumors spread, as
did the infection. The town officials move quickly, creating an
inspection committee and limiting the movement to from and around

(00:50):
the town. Houses where disease appeared were guarded, and those
who got sick were taken away for quarantine, and, in
a fit of truly paranoid behavior, all dogs in town
were ordered to be killed for fear that they might
be responsible for spreading the disease. The first five people
to succumb to smallpox were buried across the harbor on

(01:10):
a spit of land known as Marblehead Neck, but soon
there were too many to be safely and efficiently transported.
Town officials were looking for answers. Decades earlier, a smallpox
inoculation had been developed. It was proposed that a private
inoculation hospital could be built on nearby cat Island. There,
people would be inoculated and remain during their infectious post

(01:33):
inoculation quarantine period. And while this seemed to be a
promising solution, in reality it was far from perfect. The
price of treatment was often beyond the reach of many
in the colonies, including most of these fishermen and their families.
Protection was so close and yet so far. The proposal
for this hospital made the working class majority of Marblehead uneasy.

(01:56):
For those who couldn't afford services, the chances that they
would accidentally contray the disease from hospital clients and die
seemed very high. Town hall meetings went back and forth.
The building started, then it stopped, it then started again,
and disregarding the wishes of a community at large, the
hospital finally opened its doors on October sixteenth of seventeen

(02:16):
seventy three, and staff welcomed in several hundred patients who
would all stay there for thirty days. These first patients
were mostly wealthy outsiders and treated their stay as a vacation,
contrary to their directives to remain inside for their contagious period.
They could be seen sunning and boating and playing lawn
games outside. For the humble townsfolk who lived and worked

(02:38):
the cold waters in rocky coastline of Marblehead, it was
all too much. By the time the third batch of
paying clients was inoculated on December fifteenth, tensions in town
had reached a boiling point, and when that group of
patients was discharged back into town, fury erupted. On January
twelfth of seventeen seventy four, a hospital boat was set
on fire in the harbor Whek. Later, four folks were

(03:01):
caught stealing bedclothes from the hospital, potentially an act of
sabotage by intentional contamination of their town, for which the
hospital would be blamed and ideally shut down. They were
soon tarred and feathered as punishment, but that didn't do
much to quell the tensions. Two weeks later, on January
twenty eighth, another group of men rode out to the
hospital and set it on fire. The town watched it

(03:23):
burn to the ground. Everything was destroyed, and no sooner
had the smoldering ceased did the perpetrators get caught. But
their supporters were many, and all were deeply enthusiastic, marching
the few miles down to Salem and demanding their release.
The jailer was overpowered and the sheriff gave up, letting
the men go free. Though their enemy was a common one,

(03:44):
the town split apart. Eventually, Marblehead's sickness and rupture would heal,
and the story would become swept under the tides of history.
Humans have always been at war with disease, although it's
only been in the past one hundred years or so
that we've had a better understanding of how it all works.
For as long as our bodies have been battlegrounds, there

(04:05):
have been those on the front lines working to win
the war. I'm Aaron Mankie, and welcome to bedside, manners.
For as long as we've occupied bodies, we've needed to

(04:26):
heal them. We move through this life hoping to live
well and free from pain, but obstacles are inevitable. We're
all going to get some bumps and bruises and maybe
things that are far worse along the way, and when
that happens, we look to people who know how to
take care of us. Historically, healing traditions have been passed
from person to person, generation to generation through things like families, communities,

(04:48):
and continents. We have long looked to healers throughout human history.
The healer held a special place in the heart of
the community. Historically, they used natural materials available to them.
Flora and fauna were used to create decoctions and selves,
tinctures and teas. Spiritual and manual therapies came into play too.
They were considered good and wise, the bearers of tradition

(05:11):
and culture, and we know that these positions were often
held by women. Myths and legends from across the world
often center women at the heart of life and death.
To create, to destroy, and in the case of our
story today, to repair. It was a revered and mighty power,
and one that came to be feared by those who
wanted some power of their own. As Western Europe colonized

(05:33):
the globe, they took aim to vilify traditions that weren't
their own. They had to find ways to justify their
ruthless and violent expansion. Accounts of these places were frequently
distorted and diminished in their quest for extermination. These included
how a place healed its people and the community's reverence
for those doing this work. Women and what they knew

(05:55):
were seen as threats to the conquering powers, but the
danger for healers didn't remain abroad. Back home, women started
to be targeted by their own officials, neighbors, and even
family members. The Malleus Maleficarum, a title that literally means
the Hammer of the Witches, was written in the mid
fourteen hundreds by a German Catholic clergyman named Heinrich Kramer.

(06:17):
He set out to record everything that he thought he
and other scholars knew about demonology. What he accomplished instead
was to set off the deadliest witch hunt in the
history of the world. In his book, he suggested that
a charge of sorcery should be equivalent to the legal
charge of heresy and to be executed as such. He

(06:37):
laid out different ways to extract confessions from the accused
using torture. For example, he spoke of the clear and
present danger of witchcraft and gave the public ways to
sniff out a witch in their midst. According to his book,
there were three different classes of witches, those who harm,
those who can harm and heal, and those who can
only heal. The link was cemented and the results were deadly.

(07:02):
Scores of people across Europe were accused and executed for
witchcraft during the fifteenth to seventeenth centuries. Sources very wildly,
but scholars today believe between fifty thousand and eighty thousand
people were killed, and yes, while men did die, they
were less frequently the victims of religious and social scrutiny.
Even still, healing traditions lived on even under the threat

(07:24):
of death. The keepers of this knowledge continued to pass
down their traditions and to work with their community, even
if now their practices were inextricably linked with malevolent, ungodly forces.
As centuries on European doctrine moved away from the home
and degree granting physicians colleges were created. Healing became less
about traditional knowledge and more about leveraging wealth and social

(07:47):
connections to gain acceptance into medical schools, which function similarly
to social clubs. In fact, many of these newly minted
physicians would go an entire career without so much as
touching a human body. SEMy physicians went to great lengths
to distinguish themselves from country doctors and folk healers. They
dismissed traditional healing practices, even if their own, such as leeching, bleeding,

(08:10):
and treating patients with any number of poisonous compounds, were
barbaric at best and deadly at worst. Women, of course,
were long left out of these opportunities to professionalize alongside men.
In the early twentieth century, though, a socially sanctioned avenue
for care appeared for women who could pay for the privilege.
They could go to nursing school and earn their degrees

(08:33):
and stripes. Far from holding a place of reverence, though,
it was thought that women who entered into this field
into the workforce were desperate and impoverished. Nursing was far
from being viewed as an honorable vocation. But that is
until one woman came along and changed the tide of
public opinion. Florence Nightingale was born in Florence, Italy, on

(09:01):
May twelfth of eighteen twenty. She inherited a British family
of wealth and status, as well as their liberal humanitarian
outlook on the world. Her grandfather was an abolitionist who
sat in the House of Commons, while her father, William,
had fought for parliament reform and other various social causes.
As a child, Florence and her sister Francis received a

(09:22):
fine education. They studied everything from history and literature to
math and philosophy. At a young age, it was clear
that Florence possessed a mind that saw the world through
gathering data. She loved charts and graphs, filling notebooks with
notes and numbers, and collecting informational pamphlets. Through the course
of her family's European travels, Florence had hope for her future,

(09:44):
and in February of eighteen thirty seven, she had a vision.
That was when she believed she had received a revelation
from God. In her telling, Florence was directed to live
her life in service to others. She began paying visits
to the sick and the infirm and learned of care work,
but to be a nurse at this moment was seen
as grunt work, the vocation of women with lower social standing.

(10:06):
Women of Florence's class and upbringing were bound by ideals
of domesticity, the grime and grudge of hospital wards were
wholly unsuitable for their delicate constitutions. For many in her
peer group, they were expected to marry, well, have children,
and stay home. This was the height of the good life,
or so she was told. Florence, though, didn't want to

(10:28):
be put in this box. She fought against the conventions
of her station, even turning down a marriage proposal. So
she set out to become a nurse and publicly declared
her intent to do so. She began to travel, spending
time with different hospitals, healers, and teachers to learn about
the craft. She journeyed throughout Europe, studying both hospital systems

(10:49):
and patient care, and as her experience grew, so too
did her network of professional contacts, establishing a long list
of personal champions as a well bred englishwoman, though the
latter would become indispensable to affecting systematic change. Her parents, though,
were appalled at her career choice. By eighteen fifty she
had enrolled in nursing school in Germany. Despite their protests.

(11:12):
By eighteen fifty three, her father relented. He would allow
Florence to do as she wished, and even afforded her
an allowance to do it. His blessing and financial commitment
to Florence came at a pivotal moment.

Speaker 2 (11:24):
You see.

Speaker 1 (11:24):
In eighteen fifty three, the Crimean War began. After months
of escalating tension, Russia and the Ottoman Empire went to
war and soon brought their allies into the fray. Back
in England, the day to day realities of the war
were broadcast in a new novel way. An underwater cable
from Crimea to England allowed news to reach in the
span of a few hours. It was one of the

(11:45):
first wars to be documented extensively by journalists. The British
general public saw what was happening. The death toll was
high and the barracks were filthy. The troop's care was
being mismanaged, as evidenced by ever climbing mortality rates. In
eighteen fifty four, Florence received another message. This time it
wasn't to call for God, but a letter from England's

(12:06):
Secretary of War asking her to assemble a team of
nurses and head to the front lines in Turkey. Wounded
British soldiers were dying in the field hospitals, and they
wanted her help. By mid October, she committed herself to
the project. Within a week, she had assembled a team
of thirty eight nurses and left for the front. On
November fourth, they arrived at Scutari, the British Army barracks

(12:29):
in Istanbul. They had been allocated to the British Army
for the duration of the war and had been converted
into a temporary military hospital. The main British camp was
across the Black Sea, almost three hundred and fifty miles
away in Crimea. They quickly got to work alongside medical officers,
assessing the situation and attending to the wounded. The medical

(12:50):
men originally didn't want the women there and felt undermined
by their presence, but they also needed the help. What
Florence and her team saw at the barracks was utter
square piles of sewage on the floor, in claustrophobic wards,
men's weeping, gangerous wounds, filled with maggots, foul smelling, soiled
bed linens and bandages, and rotting food. This moment would

(13:12):
be approving ground for her. Everything that she had been
studying for had been leading her to this, so she
turned to face it with grace and ferocity. The changes
to the barracks were swift. Florence and her team brought
muscle and money. Soon new life was breathed into the space.

(13:33):
New windows were installed, floors were refinished, and large bath
tubs were brought in and kept fresh and warm for
tired men. Fresh linens were always made available, and there
were finally enough beds. But conditions weren't sparkling. They were
far better than before. Some of Florence's handpick nurses left,
but more continued to arrive. For the soldiers, the kindly

(13:54):
faces of these women were a welcome sight. There was
finally enough care to go around. The ounce of Florence
and her team began appearing in newspapers back in England.
Coverage was effusive and poetic, painting her to be both
a savior and saint on the front lines. Through these stories,
the public's opinion about the field of nursing began to shift.

(14:15):
You can think about Florence as something of an influencer.
She took something decidedly uncool and made it admirable. Nursing
was no longer seen as simple menial labor. It was
something valorous. She brought respectability to the women who were
already doing the work, and for wealthy women cloistered at
home due to society's expectations of them, nursing proved to

(14:36):
be a socially acceptable vehicle for escape. The papers wrote
about the Lady with the Lamp, a specter that feels
almost mythological in its design. It was reported that Florence
worked upwards of twenty hours a day, but relieved all
of her nurses at eight p m. She would make
nightly rounds her oil lamp, moving slowly and steadily through
the barracks, a welcome sight for all who lingered there.

(15:00):
But even still, men continued to perish. In fact, during
Florence and her team's first winter at Scutari, over four
thousand soldiers died, with a death toll of about forty
two percent. Florence insisted that these deaths could be attributed
to inadequate nutrition and supplies, and pressed for more support
from the government. As the working conditions at Scutari began

(15:20):
to improve, Florence was able to take leave and tour
other hospitals treating other wounded men. But while she was
in Crimea, she fell dangerously ill with a high fever
When she was well enough to travel again, she returned
to Scutari, where she became one of the patients attended
to by her own nursing staff. She recovered and returned
her sick bed to someone else. By March of eighteen

(15:43):
fifty six, peace had come to the region. She stayed
for a few more months, returning home to England in
August of that year. She was welcomed home with open
arms and hailed as a national hero. She had become
an icon during the time she was away, and the
British public wanted to celebrate her, but Florence just wanted
to rest. She had contracted brucellosis on the front, its

(16:05):
lingering flew like effects haunting her attempts to return to
a normal life. Her work, though, wasn't done. Florence had
amassed a huge body of data while she was working
at Scutari and planned to present it to the Royal
Commission on the Health of that Army. When she finally
finished compiling all of her notes, though she realized that
something had gone terribly wrong. She could now more fully

(16:26):
understand what had happened at the barracks. The soldiers hadn't
died due to malnutrition or lack of resources, as she
had originally believed, but from communicable diseases such as typhoid
and dysentery. She concluded that the huge death tolls under
her care were a result of poor sanitation and her
own ignorance about hygiene protocols. Yes, they had cleaner surroundings

(16:48):
than when she arrived, but that hadn't been enough. Florence
knew what she had to do next. She presented her
findings with shame, with vigor, and with a new solution.
She began to campaign for public health and worked to
educate hospitals in her orbit about better sanitation practices. Florence
was determined to write what had gone so wrong. She

(17:09):
now realized that so much of what had killed these
men could have been prevented, and she was determined to
never let it happen again. Florence looked ahead to life
after the war and determined what she wished to do next.

(17:30):
She had become a public figure, a national hero, and
a respected figure in the field of healthcare. Eyes looked
toward her, and she undoubtedly felt the weight of expectation.
Florence published her report and, pulling on her established relationships
within the government helped to open an Army medical college
in eighteen fifty nine, a military hospital in eighteen sixty one,

(17:52):
and a permanent Army Sanitary Commission. In eighteen sixty two,
a national fund in her name was established for the
purpose of founding a training school for nurses. This was
the only recognition of her services that she would publicly accept.
By eighteen sixty the Nightingale School and Home for Nurses
was established. The first class graduated five years later and

(18:13):
they haven't stopped since. The school, now part of King's College, London,
is still around to this very day. Although the infections
that she picked up during the war would become chronic,
she campaigned tirelessly for reform. During the American Civil War,
she was frequently contacted for advice on how to manage
field hospitals. She worked with India's army on their sanitation problems.

(18:35):
She went on to train medics in the Franco Prussian
War and even trained Linda Richards, the first woman who
would become a certified nurse in the United States. Florence
Nightingale died at age ninety on August thirteenth of nineteen
ten in London, and although she was offered a burial
place in Westminster Abbey. Her final resting place is far
more humble. She's buried in a churchyard with a headstone

(18:58):
that simply has her initials and dates of her birth
and death. Her legacy extends beyond her long life, and
her influence has stood the test of time. The character
that was created in the popular wartime press cemented Florence
in the public's imagination. Today, she's remembered most strikingly as
that lady with the lamp, but the bulk of her career,

(19:18):
which covers some of her most important work, took place
in the decades after she returned home from war. Florence
is a picture of civility in a moment that was
far from civilized and proved to be an attractive distraction
from the true nature of the army's complete mismanagement of
the war. And she was also deeply human, far from perfect,

(19:39):
and partial to beliefs that would be controversial today. We
remember the symbol, the icon that is Florence. The real
changes that Florence brought were fueled by flesh and blood humanity,
first by addressing the shortcomings of others, and then by
committing the remainder of her life to rectify hers. Florence
couldn't heal her own chronic illness, nor could she undo

(20:01):
the choices that were made in Scutari, but she did
what she could for decades afterward, and the field of
nursing around the globe has never been the same. Care
work is powerful. It takes a special kind of person
to dig deep into the trenches of human suffering, and

(20:23):
for those folks we are grateful, but we're not quite
done just yet. If you stick around through this brief
sponsor break, my teammate Robin Minister, will tell you one
more story about another healer finding their place in the world.

Speaker 2 (20:42):
You could say that Mary was a healer by birthright.
Her mother was a master of folk medicine with those
in Jamaica referred to as a doctress. She'd a practice
based in hygiene and herbs and a working understanding of
tropical diseases and basic surgery. Before she won her freedom
and moved to Kingston, she nursed fellow enslaved people on
a nearby sugar plantation. Mary inherited her mother's wisdom and practices,

(21:06):
and she also had spirit. Her father had been in
the Scottish Army, which gave her a life of more
social mobility than she otherwise might have had. He had
traversed the seas, and this wanderlust is what she inherited
from him. As a teenager, she traveled twice to England
and around the Caribbean. She eventually married and stayed so
for eight years until her husband passed away. She would

(21:26):
go on to live her life as a single woman,
focusing her efforts on designing and pursuing a life she
had only dreamt of as a child. By eighteen fifty,
at the outbreak of a cholera epidemic in Kingston, she
found herself utilizing the healing arts that she had learned
from her mother, and by eighteen fifty two she was
living and working with her brother in Panama and once
again had a chance to serve the sick as the

(21:48):
country was rocked by a cholera outbreak. She traveled to
London the following year and stumbled across a newspaper headline
that would change the course of her life. She learned
about the Crimean War and was termed to travel to
the front and offer her services. She was dismayed though,
when her offers were rejected by British authorities and Florence
Nightingale herself. She decided to pay her own way, though

(22:10):
she was told there were no nursing vacancies and no
need for her services. As to why this happened, well,
it's still debated by scholars today. Some insist that Mary
Suekole wasn't qualified. Others say it was because she didn't
go through the accepted application channels. Others believed it was
outright racism. She was certainly hurt, but she wasn't going
to be dissuaded. Tapping into her other skill set, hospitality

(22:33):
and mercantilism, she made her way to Scutari, where she
opened a restaurant for wounded and sick men. Here they
would find respite for being transported to the hospital for care.
For this work, she was herald as a hero, appearing
in newspapers alongside Florence Nightingale, being called the mother of
the Army and Mother Sekul. Even Florence softened to her
appearance on the battlefront, recognizing her contributions to the care

(22:57):
and morale of the soldiers. When a peace treaty was
finally signed in March thirtieth eighteen fifty six, the troops
began to funnel out. She would be one of the
last to leave Crimea, staying until the last possible moment
to sol off all parts of her business. This endeavor
was unsuccessful and she returned to London penniless. She didn't
fade into obscurity, though, you see. Her reputation grew and

(23:19):
her fans amassed. Countless lives were touched by her care,
and it was now time for her to receive some
in kind. In eighteen fifty seven, forty thousand people attended
a four day fundraising gallet to help her get back
on her feet. Queen Victoria and her family established the
Sea Coal Fund to ensure she live out the rest
of her days in comfort. On the one hundredth anniversary

(23:39):
of the Crimean War, the Jamaican Nurses Association named their
headquarters the Merry Sea Coull House. She was also posthumously
awarded the Jamaican Order of Merit in nineteen ninety one.
Across Upon in England, a painting of her now hangs
in the National Portrait Gallery. She was voted the greatest
Black Britain in a two thousand and four poll. Today,
a statue of her stands at Saint Thomas's Hospital, former

(24:02):
site of the Florence Nightingale School of Nursing and Midwifery.
Nearby is a statue of Florence herself, and while some
mostly staunch defenders of Florence's work and detractors of Mary's,
have been irked by this proximity, what has proven to
be true is that there's room enough in this world
for two heroes, and should we be so lucky to

(24:23):
find more in our.

Speaker 1 (24:24):
Midst Grimm and Mild Presents Bedside Manners was executive produced
by Aaron Manke and narrated by Aaron Manke and Robinminitter.
Writing for this season was provided by Robin Miniter, with
research by Sam Alberty, Taylor Haggerdorn and Robin Miniter. Production
assistants was provided by Josh Thain, Jesse Funk, Alex Williams,

(24:48):
and Matt Frederick. You can learn more about this show,
the Grim and Mild team and all the other podcasts
that we make over at Grimandmild dot com, and as always,
thanks for listen.

Speaker 2 (25:00):
The name