QI The Book of the Dead

an actual swiller-out of bedpans or bandager of wounds, these nocturnal walks are what gave rise to her legend among the troops and the public back home.
    Her first few months at Scutari were disastrous. Death-rates at the hospital soared and even nurses and doctors succumbed to disease. The death-rate only began to drop when the sewerage system had been overhauled and the source of infection was removed. Nightingale didn’t make this connection herself until the war had ended. She returned to London in 1856 a heroine and, despite being traumatised and ill, threw all her energy behind getting a Royal Commission on army health established. She met Queen Victoria and Prince Albert to press her case. Afterwards the queen remarked, ‘What a head! If only we could have her at the War Office.’ Her efforts paid off and Sidney Herbert was appointed to chair the Commission.
    In 1858 Florence submitted her evidence to the Commission in the form of an 830-page report, Notes on Matters Affecting the Health, Efficiency, and Hospital Administration of the British Army . Appended to it was what she called her ‘coxcomb’ of statistical diagrams, devised with the help of William Farr, head of the General Registry Office. This included her famous ‘polar area diagram’, a kind of pie chart which has since become a standard of statistical graphics. What the figures and diagrams showed came as a profound shock. During the first awful winter of the war, soldiers had been three times more likely to die in Scutari than they had been in the basic field hospitals at the front. What had killed most of the soldiers in the Crimea wasn’t their wounds, but infections caused by poor sanitary conditions on the wards. Scutari, as one historian put it, was more of a death campthan a hospital. Florence was mortified. If she had overhauled the sewerage and general hygiene sooner, thousands of soldiers’ lives might have been saved. All the hand-holding and ward-walking had been beside the point. In an agony of trepidation she put forward her report, fully expecting ‘the Lady of the Lamp’ to be exposed as a fraud: ‘The lamp shows me only my utter shipwreck.’ The report was never published. Although its conclusions framed British policy on hospital hygiene and nursing practice for generations to come, the government decided that to present the full weight of the evidence would be too damaging to national morale. This was too late to save Florence. The stress of preparing the figures, the weight of personal blame she felt, and the symptoms of her worsening brucellosis led to a physical collapse and she came close to death. At the age of thirty-seven she took to her bed and never really emerged again.
    Nonetheless, her fame and her influence grew steadily. From her bed in Mayfair, insulated from the disruptions of her family, she directed the course of health, hygiene and sanitation all over the world. A public collection in her name raised £45,000 and was used to set up the Nightingale School of Nursing at St Thomas’s Hospital in London. She became the first woman to be made a Fellow of the Royal Statistical Society (her experience in Scutari had taught her that ‘statistics were the measure of God’s purpose’). In 1860 she published Notes on Nursing: What It Is, and What It Is Not , a book that made her ‘fresh air and cleanliness’ gospel available to everyone. Although she rarely ventured out, she corresponded with many of the most famous people of her time, including Mrs Gaskell, General Gordon (of Khartoum), William Gladstone and Harriet Beecher Stowe. As far as romantic entanglements went, the closest she came to that was a long andwitty correspondence with Benjamin Jowett, the Master of Balliol College in Oxford, who became her spiritual confessor, encouraging her to write the last in her now tall pile of unpublished books, Notes from Devotional Authors of the Middle Ages , a history of mysticism. He called her ‘Florence the First, Empress of Scavengers, Queen of Nurses, Reverend Mother Superior of the British Army, Governess of the Governor of India’. She responded with: ‘Maid of all dirty work rather, or, the Nuisances Removal Act, that’s me.’ As Lytton Strachey remarked, ‘She remained an invalid, but an invalid of a curious character – an invalid who was too weak to walk downstairs and who worked far harder than most Cabinet Ministers.’
    Against all odds, Florence Nightingale outlived the misery of