Page last updated at 11:13 GMT, Tuesday, 11 May 2010 12:13 UK

The lady without the lamp

Scene from the Crimea, by Jerry Barrett

By Tom Geoghegan
BBC News Magazine

She is the epitome of the caring, attentive nurse, but a new exhibition reveals Florence Nightingale was among the first victims of the media's thirst for creating celebrities.

The legend of Florence Nightingale was born on the morning of 24 February, 1855, when the Illustrated London News published a picture of a woman gliding through a hospital ward of stricken soldiers, holding a lamp.

In a war that had sparked only negative headlines about the terrible conditions and the agony of injured troops, here was an image of angelic compassion that struck a national chord.

The picture, taken from an artist's engraving and based on reports of Nightingale's work at the Crimean War, was reproduced in the Times and suddenly Florencemania gripped the country.

London Illustrated News, Feb 1855
The picture that started the legend

There was an outpouring of public adulation the like of which had never been seen before. The appetite for her image was insatiable and an industry sprung up producing statuettes, figurines from the Staffordshire potteries and posters, all by artists who had never seen her but imagined - in an idealised way - her features.

Her portrait was seen on lace mats and even on paper bags, and songs and poems recounted her efforts in tending for the sick and the dying.

She was the first mega-celebrity, says Caroline Worthington, director of the Florence Nightingale Museum, which opens this week after major redevelopment, in the centenary year of her death.

"Her sister Parthenope [got] obsessed with Florence's story," says Ms Worthington, who notes that she "fanned the flames of the media" by passing them on to newspapers.

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"Soldiers were also writing to their wives, saying they kissed her shadow and that's how the image of the lady with the lamp was born."

When Florence arrived back in the UK in August 1856, she slipped back into the country rather as a celebrity would in modern times, deploying a pseudonym - Miss Smith - to duck under the media's radar. It meant she travelled to her home in Derbyshire without drawing attention.

"Queen Victoria and Prince Albert were very keen and asked her to come to Balmoral. Albert gave her a jewel he had designed for her. Florence was charmed by them and sought a Royal Commission to explore what had happened in the Crimea."

Calling from God

This kind of empowerment was a far cry from her frustrated upbringing in Victorian upper-class society, which she described as a "gilded cage".

She desperately wanted an education and independence, rather than marriage, and her prodigious intellect, love of maths and obsession with cataloguing her shells and coins marked her out as unconventional.

When 16, she felt a calling from God to nursing, which provoked horror from her parents, because it was in those days a profession more akin to a domestic servant. But she trained in Germany and as anger mounted over Times newspaper reports about the suffering of British soldiers fighting in the Crimean War, she was sent to Scutari in Turkey to head a 38-strong team of female nurses.

Born 1820 in Florence, Italy
Grew up in Hampshire
Sent to Crimea in 1854
Returned to the UK in 1856
In 1860, she established the Nightingale School for nurses at St Thomas' Hospital in London
Published Notes on Nursing in same year, a philosophy still used today
Died in 1910, aged 90

In letters home, she described the appalling conditions, with soldiers writhing in agony in the wards. Four times as many were perishing from infection and disease as were dying in battle, and the death rate in Nightingale's hospital was higher than in others until the Sanitary Commission arrived and flushed out the sewers upon which the hospital was built.

She instilled military-style discipline in her nurses, with a uniform and a strict curfew. She took on tasks that went beyond her duty, but cemented her popularity with the soldiers by writing letters of condolence to relatives and setting up a banking system so soldiers could send money home.

"I can't imagine going to a warzone now, in the 21st Century, let alone a woman whose dad was a millionaire, from upper class society, upping sticks and going off," says Ms Worthington. "It took immense courage."

But her fortitude in the Crimea quickly turned to vulnerability at home.

For the period after the war, and much of her subsequent life, she suffered terribly from what is thought to be chronic brucellosis - a disease more common in livestock, which causes weakness and intermittent fever in humans. She was also depressed, confined to her bed for the most part of five decades. She worked in isolation, only seeing one person at a time.

Athena the owl, stuffed
Her pet owl Athena, stuffed
Medicine chest she took to war
Brooch designed by Prince Albert
Lamp, which bears little resemblance to the one she is so often depicted holding
The Florence Nightingale Museum is at St Thomas' Hospital, London

"The irony is that she's famous for two years of work but she had a good 50 years beyond that which was more significant."

She established nursing as a profession for everyone, she adds, and her work on hospital design was followed across the world.

Using public money donated in her honour, she set up the Nightingale School for nurses, based in St Thomas' Hospital in London. And in 1860 her Notes on Nursing became a bestseller, advising ordinary women on how to care for relatives.

Her nursing philosophy was one based on cleanliness, warmth, fresh air and a good diet. It was sensible, if a little eccentric. A woman who rustles her skirts, she once wrote, is a "horror of a patient".

She used her fame to campaign for reforms in many areas of health, often using statistics to drive her arguments. In all, she wrote 200 books, pamphlets and articles, and more than 14,000 letters. But her celebrity status always troubled her.

"She hated the legend because it obscured what she was trying to do," says biographer Mark Bostridge.

Florence Nightingale
Nightingale lived until she was 90

"The Lady of the Lamp is not something she attached much importance to, because although she went round the wards at night, she wasn't primarily a nurse. She was administering the experiment of introducing female nurses to the military sphere, the sphere of war. So she would have thought the Lady of the Lamp image as misleading."

Nightingale was probably the first non-royal to be the object of such extraordinary adulation, says Mr Bostridge, author of Florence Nightingale: The Woman and the Legend. But she hated the fame and thought all the things swept up in it, like the lamp and her pet owl Athena, were trivial.

When in 1897 someone asked her for her portrait, to go into the trained nursing section of the diamond jubilee exhibition at Earl's Court, she responded by saying: "Oh the absurdity of the people and the vulgarity!... I won't be made a sign at an exhibition."

Revolutionised hospital design
Reshaped midwifery training
Workhouse reform
Improved health of soldiers
Raised awareness of poor health in India
Notes on Nursing was international bestseller
Nightingale training schools became a model

The concept of fame was different back then, says Ellis Cashmore, a lecturer in celebrity culture.

As the currency of the age, it's now thought of as more desirable than wealth, he says, but in Victorian times it was associated with notorious criminals or vulgar entertainers, so it's no surprise that an educated woman like Nightingale felt like this.

The paradox was, says Mr Bostridge, that she was able to use that mythology to make changes.

"Without that image, she would not have had this enormous power to effect the changes that she wanted to, because the government ministers were aware of the popular mandate she had.

"Although she never made any public appearances or made any public speeches, there was a fear among politicians that she would, that was her power. And as a 19th Century woman, her method of working was very much behind the scenes."

The mythology clouds the historical reality, he says, because few of us know what she actually accomplished in helping to set up a modern public health service.

Below is a selection of your comments.

She did however make a cylinder recording to raise money in 1890 for the Light Brigade Relief Fund. This early recording in the "for charity" genre was marketed in 1935 as a 78rpm record. Bob Geldorf did nothing new. I also believe her "lamp" was a beam of light shining through the red tape and ignorance of the war.
Frances Dewis, Great Baddow, UK

The hospital I work in was originally designed with input from Flo. The original Nightingale wards had lovely high ceilings with windows that are almost the full height of the room so they're light and airy. A nurse could sit at one end and see what was happening in the whole ward. In the modern wings the ceilings are about the same height as a modern house, with sealed windows, and they are muggy and smelly and overheated. Because they are divided into bays it is difficult for staff to keep an eye on patients. I don't think they're an improvement!
Paul Braham, Ringwood UK

There is some suggestion that rather than being depressed, Florence Nightingale may also have suffered from ME (Myalgic encephalomyelitis) which would have made public appearances and the enjoyment of celebrity very difficult.
Peter Parker, Kent, UK

My grandfather, Charles James Sillence, was gamekeeper to the Nightingale family and grandmother used to tell me that Florence used to ride up to their house on the edge of the estate and invite them to tea. She also told me that Florence had been in love with the assistant groomsman but because he was of lower status her father sent him away and allowed Florence to to become a nurse and supplied money for this to be made possible to make up for this. Florence said because of this she would never marry as he was her only true love.
Sandra Noyce, Southampton

Surely one of her biggest contributions to modern life is her use of pie charts to illustrate data from the Crimea.
Otto Williams, Watford

You missed a very important point in Florence's story - the reason she wanted education and independence was that she could not marry the love of her life. In St John's Anglican Church in Elora, Ontario, is the following inscription on a display case: "On display in the Church is a pair of chalices given to its Rector, Reverend John Smithhurst, in 1852, believed to have been presented to him by his long-time love and cousin, Florence Nightingale." According to the story, cousins in love were not spoken about in Victorian society, and John was sent on his way to preach to the citizens of Canada, far away from Florence.
Nigel Johnson, Toronto, Canada

It would be fairer to look at her achievements along with those of her contemporary, Mary Seacole. Trailblazing though Nightingale was, she was not alone.
Steve Morrison, Aberdeen

My mother's guardian Dr Maud Mary Chadburn 1870-1957 who founded the now closed South London Hospital for Women was called in to give an opinion on some ill health that Florence Nightingales was suffering in her old age. Sadly the only thing I now remember being told of this meeting was that she was a rather grumpy old lady.
Peter Lang, Oxford

I myself am a registered nurse and work at Saint Vincent's Hospital Manhattan, remembered mainly for our role in tending to the victims of 9/11. Our hospital and nursing school closed last week after 160 years of service to the community. I would like to think that the nursing model and vision of the Nightingale will be shared to other organizations as the nursing staff seek employment elsewhere. To Florence and the rest of my staff....Thank You!
Ramon Villa-Real, New York, US

We still have an orange (very dried) that she gave to my great grandfather during the Crimean War along with his sword.
Tamsyn, Farnham

She did not seek fame. It came her way, but hindered her work. Hence she avoided it vigorously. This is true selflessness. Her broader vision was service, improvements and betterment that she attained for millions, in Europe and Asia alike. Hats off to the SPIRIT.
Dr Arun Varma, Mumbai, India

F Nightingale is deeply revered in history of Russian field (military) medicine. Her deeds in the Crimean war inspired remarkable surgeon NI Pirogov to encourage patriotic Russian women for nursing wounded solders. Later, NI Pirogov tried to convince the Tsar in reforming backward field medicine. Contrary to what had happened in Britain, the Tsar didn't support him and forced him to internal exile.
Gennady Orlov, Saratov, Russian Federation

Nikolai Pirogov essentially pioneered battlefield medicine, supported by the "Russian Florence Nightingale' Ekaterina Mikhailovna Bakunina. Tirelessly working in spite of the government's impenetrably paralysed bureaucracy, they deserve as much credit as Nightingale and Seacole for saving thousands of lives in what was an unexpectedly vicious and disease-ridden war.
G James, London, England

Thank you to Florence and Mary and all the other women (and men) who set the foundations of our profession across the world. We are proud to do what we do and we do it every 24 hours across the world enduring increasingly difficult constraints on time and resources. Sometimes we risk our lives to do it. We are under the increasing pressure of a litigious culture and yet we appreciate it when the vast majority of patients, relatives and allied health worker colleagues express sincere gratitude for what we do. "To do no harm." Happy Nurses Day to all who serve in our noble and (often) self sacrificing profession.
Phil RN, Newport

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