Florence Nightingale invented the modern nursing profession and changed the course of public
health forever.
But she spent much of her own life sickly and reclusive, while also pushing back against
the expectations of her day.
This is her tragic true-life story.
Nightingale was born on May 12, 1820 in Florence, Italy to wealthy British parents.
Her mother Frances was from an elite family of merchants, and her father William Edward
was an affluent landowner.
Nightingale spent most of her childhood in her family's Embley Park estate in Hampshire,
England.
She enjoyed many of the benefits of upper-class life.
She was comfortable, well-traveled, and unlike most girls of the time, she received a rigorous
education.
Her father tutored her in math, science, philosophy, history, and the classics.
But her family also held very rigid, traditional beliefs about the role women were expected
to play in society.
They did not believe women of wealth should work outside the home.
Instead, they should be focused on finding a suitable husband, marrying well, and maintaining
their class standing.
This became a point of contention when, at the age of 16, Nightingale received what she
described as a call from God to become a nurse and minister to the sick.
"Though at the time nursing was not a respected profession, Nightingale felt very called to
become a nurse."
Her family, especially her mother, rejected this idea outright.
Frances had married well, and she expected the same of her daughter.
Nursing was not a suitable profession for a respectable woman, and Florence's family
forbade her from pursuing her call.
Nursing as a formal profession didn't exist until after Nightingale invented it.
In the early 1800s, women who worked as nurses were lower-class and not well-respected.
They were perceived as lazy, disinterested, and generally inept.
It was also believed that they were a little too fond of the bottle and at times even dabbled
in prostitution.
Wealthy, well-educated women, on the other hand, weren't expected to work at all, let
alone in such a lowly position.
But Nightingale rejected these expectations.
Instead, she devoted herself to performing charitable works and learning nursing as best
as she could on her own.
In 1850, she went to Germany to study nursing.
She trained for a little over three months, mastering the basics of patient care and hospital
administration.
In 1853, her father relented to her intentions by giving her a stipend that allowed her to
move to London and accept the position of superintendent at the Institution for Sick
Gentlewomen in Distressed Circumstances.
Nightingale was strong-willed, stubborn, and socially awkward, but she nevertheless received
her fair share of suitors.
As a young woman, she rejected at least two marriage proposals.
Her cousin, Henry Nicholson, offered his hand in 1844, but she turned him down.
The second proposal caused her much more grief.
She met the poet Richard Monckton Milnes in 1842, and he pursued her for seven years.
He proposed to her in 1847, and she took her time thinking it over.
She was very fond of him, and the decision wasn't easy.
According to Nightingale biographer Sir Edward Cook, she was attracted to Milnes and she
believed that she could be satisfied spending her life with him.
Then in 1849, he pressed her for a final answer, and she turned him down one last time.
She believed that marriage would interfere with her calling to help people, ultimately
deciding that she couldn't be satisfied by a life devoted to society and domesticity.
As she put it,
"To be nailed to a continuation and exaggeration of my present life, without hope of another,
would be intolerable to me.
Voluntarily to put it out of my power ever to be able to seize the chance of forming
for myself a true and rich life would seem to me like suicide."
"'You're gonna marry rich, 'cause you're rich, and you're gonna have kids.'
And Florence is like, 'Ugh, I don't think I want that all.'"
Throughout her twenties, Nightingale suffered from frequent bouts of depression.
Her family's constant refusal to support her vocation exacerbated her dark moods.
Her relationship with Richard Milnes was another source of distress.
In 1847, she ended up suffering a mental breakdown.
She went to Rome to recover, where she met the politician Sidney Herbert.
This meeting changed the course of her life.
Herbert became a lifelong friend and ally, and she became one of his most trusted advisers.
But this didn't put an end to Nightingale's periods of unhappiness.
She wrote in 1850,
"In my thirty-first year, I can see nothing desirable but death."
She remained uncertain if she'd made the right decision rejecting Milnes' proposal, writing,
"I know that if I were to see him again, the very thought of doing so quite overcomes me.
I know that, since I refused him, not one day has passed without my thinking of him,
that life is desolate to me to the last degree without his sympathy."
In 1854, Britain went to war with Russia on the Crimean Peninsula, but the British military
lacked the necessary infrastructure to care for their wounded soldiers.
Many men languished in poorly-kept hospitals, dying not only of their injuries but also
of preventable illnesses such as typhoid, dysentery, and cholera.
When news of their poor treatment reached England, public outrage forced Sidney Herbert
to seek out Nightingale's help.
In October 1854, she led a group of 38 volunteer nurses to the city of Scutari to improve the
filthy and overcrowded conditions at Barrack Hospital.
She also dealt with inadequate supplies, overworked and uncooperative staff, and a death rate
of over 40 percent.
Nightingale immediately pushed for a sanitary commission to flush the latrines, clean the
water supply, and improve air flow in the wards.
She was met with resistance, butting heads with commanding officers and uncooperative
male doctors.
But she eventually succeeded.
With improved ventilation and sanitary procedures, the death rates dropped to just 2.2 percent.
In between implementing structural changes, managing her staff of volunteers, and lobbying
the government for funds, Nightingale still found time to administer hands-on care to
her patients.
She wandered the wards at night, a lamp in hand, earning herself the nickname "The Lady
with the Lamp."
"She garnered a reputation as a reformer and an advocate for public health."
On one of Nightingale's excursions to the Crimean Peninsula, she came down with a case
of Crimean Fever, also known as brucellosis.
This is a highly contagious bacterial infection that she most likely contracted by coming
into contact with contaminated animal products.
Weakened by her illness and slow to recover, she was forced to leave the Crimean Peninsula.
However, rather than return home to England, Nightingale went back to Scutari, where she
remained until the end of the war in 1856.
The military hospitals in Turkey closed that spring, and she finally returned home to England
in August of that year.
She never fully recovered from brucellosis, and the ill effects of the disease lingered
for the rest of her life.
News of Nightingale's work in Scutari eventually reached the press, and she became a media
sensation in England.
Her dramatic reduction of mortality rates and improvement of hospital conditions earned
her recognition and praise, while the image of her as the lady with the lamp stuck in
people's minds.
A portrait in the Illustrated London News, published in February 1855, depicted her tending
to rows of sick patients, holding a lamp to light her way.
Her iconic image was reproduced on keepsakes.
The public loved her, with some people even sending her fan mail.
When Nightingale finally returned to Derbyshire in 1856, she was lauded as a hero of the war
effort, but all the attention made her uncomfortable.
Exhausted and battling the effects of Crimean Fever, she shied away from the spotlight.
She preferred to stay in her home, doing most of her important work away from the public
eye.
Nightingale's intelligence and ambition were unmatched, and her work revolutionized health
care institutions.
Her books, Notes on Hospitals and Notes on Nursing: What It Is and What It Is Not, detailed
the proper ways to run a sanitary hospital and administer care to the sick.
This led to nursing becoming a respectable profession held to strict standards of care.
Nightingale was also a brilliant statistician, using graphs and pie charts to display her
reports.
She used her findings to lobby the government to improve public health, particularly in
rural India.
She advocated for improved sanitation, helped establish an improved drainage system that
reduced the spread of fatal diseases, and supported efforts to relieve famine and poverty.
Yet despite all that she accomplished, she still had to deal with the limitations of
being a woman.
Although her social standing commanded some respect, she still lacked any real authority
to implement her ideas.
Thus, to bring her ideas into reality, she was reliant on male allies, notably politically
influential figures like Sidney Herbert and John Sutherland, while she worked in the background.
But the limitations she faced only drove her to work harder.
She held herself and other women to high standards.
She often criticized her own gender for falling short, admonishing those who only tried to
be men and thereby succeeded only in being third-rate men.
In 2008, Nightingale biographer Mark Bostridge put forth the theory that she suffered from
spondylitis, a chronic inflammatory spinal disease for which there was no cure.
The disease causes back and joint pain, swelling, and stiffness.
Over time, the bones of the spine can fuse together and new ones can form, causing immobility.
The onset of the disease most likely started when Nightingale was in her 40s, and continued
to worsen with age.
With little effective treatment available for the condition, the pain often forced her
to remain in bed for weeks at a time.
Although there are rumors that she took bromide to lessen her libido, Bostridge's research
shows that she actually took the bromide to ease her spondylitis symptoms.
According to Bostridge, spondylitis is what kept Nightingale bedridden during the 1860s
when she was in her forties.
As he put it,
"Somebody once said that posterity has done Florence Nightingale a great disservice by
saying she wasn't suffering from an organic disease.
She was."
It's well-known that Nightingale suffered from multiple physical illnesses in her life.
But some modern psychiatrists speculate that it's also possible that she had serious mental
ailments as well.
According to Dr. Katherine Wisner, an expert of mood disorders in women, it's possible
that Nightingale actually suffered from untreated bipolar disorder throughout her life.
She had well-documented bouts of depressive episodes in her teens and twenties, and the
divine calling she claimed to have received from God could be explained by hearing voices.
Both of these symptoms can be indicators of bipolar disorder.
In her adult life, Nightingale had documented mood swings that her physical ailments alone
might not fully account for.
She was intensely ambitious and productive, writing prolifically and working tirelessly
from her home.
But her life was punctuated by bouts of seclusion, fatigue, listlessness, and depression.
According to Dr. Wisner,
"Illness alone does not account for her severe mood swings, or the fact that she could be
so incredibly productive and so sick at the same time."
Nightingale never married and had no children.
Her work was her legacy.
At the end of her life, she became even more reclusive, although she did receive two great
honors for her achievements shortly before her death.
In 1904, she was given the title of Lady of Grace of the Order of St. John of Jerusalem,
and in 1907, she became the first woman to be granted the Order of Merit.
Nightingale's obituary in The Guardian reported her death at the age of 90 from heart failure
in 1910.
Because of her many accomplishments, she was eligible for a state funeral and burial at
Westminster Abbey, though her will specified that her service be a reserved affair.
In keeping with her final wishes, her family declined the offer of the state funeral.
Instead, her memorial was held at St. Paul's Cathedral in London.
"So, Florence Nightingale was responsible for pioneering an industry and giving women
a job and a purpose."
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