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Views & Reviews Between the Lines

Bringing Nightingale down to size

BMJ 2012; 344 doi: (Published 28 March 2012) Cite this as: BMJ 2012;344:e2317
  1. Theodore Dalrymple, writer and retired doctor

We all love heroes and heroines, but even more so do we enjoy the exposure of their hidden faults. I will not speculate on why this should be so: perhaps it is that, our lives being mediocre, we fear to contemplate unmitigated the heights of human accomplishment.

The greater is the reputation; the more guiltily delicious is the debunking. When I was a child, Florence Nightingale was an untouchable heroine, like Elizabeth Fry. Before her, nurses were Dickens’ Mrs Gamp; after her, they were ministering angels. Soldiers were eternally kissing her shadow as she went by.

One of the great works of historical debunking is F B Smith’s Florence Nightingale: Reputation and Power, published in 1982. Smith, an Australian historian, sometimes makes you laugh out loud (and not because of any witticism of Miss Nightingale’s). You know what you are in for from the first sentence:

Florence Nightingale’s first chance to deploy her talent for manipulation came in August 1853. Within a short space, one learns that the Lady with the Lamp was a consummate liar: Miss Nightingale’s account of her good works at the Middlesex Hospital constitute a memorable example of her powers as a titillating fabulist.

Reflecting on the fact that Nightingale dismissed most of the staff that she herself had chosen at the first institution that she ever ran, The Invalid Gentlewoman’s Institution in Harley Street, Smith says, “The superintendent [does] not seem to have excelled in picking and training staff.” Detailing her unfair criticisms of the committee of that institution, Smith does point out her superiority in one respect: “But none of them matched the force and ingenuity she brought to intrigue.”

This is all good, clean, knockabout fun. Some of Smith’s evidence does show his subject in a lurid light—for example, her taking to task of her great bureaucratic assistant, Sidney Herbert, during his final illness, for not trying hard enough to help her, while she at the time luxuriated in the role of invalid that she was successfully to play for a further 50 years.

As is well known, Miss Nightingale rejected the germ theory of disease, arguing that, if accepted, it would impair her sanitary work. She insisted to the end of her days on dirt and miasma as the cause of disease, rejecting contagion altogether; she opposed smallpox vaccination in India; and she never grasped that the germ theory of disease was actually compatible with sanitary reform.

She was what would now be called a brilliant spin doctor. When Agnes Jones sought admission to the Nightingale School, Florence wrote, “[Her] peculiar character is want of character.” But when Jones died in harness in Liverpool Workhouse, having after all trained at the Nightingale School, Florence turned her for propaganda purposes into a paragon.

Smith chronicles her manipulations, deviousness, evasions, and lies, but he admits that, overall, she did an immense amount of good. His aim is to disabuse us of the romantic idea that people who do good must themselves be good, but let us hope that his readers do not take this as a licence actually to be bad.

His explanation as to why Miss Nightingale did not destroy documentation that was unflattering to her memory is memorable:

Florence Nightingale, like Mr Richard Nixon and his tapes, was so possessed of the habit of deceit and the conviction that the full record would compel posterity to vindicate all her actions, that she could not bring herself to destroy material which had become part of her identity. Having brazened out lies in life she would brazen them out in death.


Cite this as: BMJ 2012;344:e2317

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