Florence Nightingale

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It's early evening on the 9th of November 1854.

West of the Bosphorus, in what is now Istanbul, a mule trudges its way down an undulating path.

Strapped to its back is a young man.

His face is pale and drawn, his clothes flecked with blood.

His head hanging limply, chin on his chest.

He barely has the strength to breathe.

He is not traveling alone.

Behind him are dozens of others, bobbing listlessly on wagons and pack animals.

This caravan of the wounded are all British casualties of the Battle of Inkerman, a victory over Russian forces in the Crimean War, but one that has come at a cost.

For the past three days, injured soldiers have made this agonizing journey in desperate search of life-saving care.

At long last, their destination is in sight, an army barracks that has been converted into a hospital.

Theoretically, this is their place of refuge.

Yet this Gutare Barracks Hospital has an unwelcome reputation, as somewhere where even the healthy can end up dead.

At the entrance, the vehicles come to a halt.

Orderlies hurry out, and the young soldier is hauled onto onto a stretcher, carried inside and placed on a bed.

Lifting his head, he sees a woman approaching.

Wearing a simple black dress, her hair functionally short, she strides purposefully towards the new patients.

Either side of her are rows of beds crammed just 18 inches apart.

In each one is a soldier.

desperately ill or dreadfully injured.

The woman is the new superintendent, a woman by the name of Florence Nightingale.

She has been charged with bringing order to this place.

Less a refuge of healing, more a dank, overloaded cesspit, reeking of filth and death.

In the few days she's been here, she's battled the hospital hierarchy to make all manner of changes, starting by clearing away the mounds of feces that splatter the floors.

They're short of everything here, from mattresses to bedpans.

And today, chaos has descended.

Hundreds of men are arriving from the battlefield.

Nightingale and her nurses do the best they can with paltry resources.

But the volume of patients is overwhelming, and this is just the beginning.

As the day goes on, wave after wave arrive at the hospital door, 600 by nightfall, and there'll be even more tomorrow.

Soon the wards will be clogged with the mutilated and the traumatized.

Later that evening, in the pitch dark, Miss Nightingale walks through the packed rooms.

Her path illuminated by the dim light of a single lantern, she checks on each man in turn.

Some will not make it to morning, but it's not just the battlefield injuries that will kill them.

It's the invisible germs that surge their way around this horribly overcrowded building.

Right now, Miss Nightingale knows nothing about that, believing instead that the deaths are caused by medical incompetence, poor diet, noxious odors,

pretty much anything other than the true cause.

For all her obvious brilliance and determination, she is doing little to prevent the deaths of thousands in her care.

Her hospital is a death trap.

Revered as a heroine, mythologized as the lady with the lamp, Florence Nightingale has gone down in history as the founder of modern nursing.

Fortified by an indefatigable self-belief, she battled ill health and the prejudices of her age to leave an indelible mark on the world.

Yet her memory remains laden with misconception and half-truths.

So how how did Florence Nightingale, the superintendent of a hellish incubator of disease in the Crimean War, become synonymous with kindness and compassion?

Why was she one of the most celebrated figures of her age?

And what did she achieve in the long decades of her life after illness cut short her nursing career?

I'm John Hopkins from the Noiser Network.

This is a short history of Florence Nightingale.

Florence Nightingale is named after the city in which she is born on the 12th of May 1820.

Her English parents, William and Fanny, are in Italy as part of an extended honeymoon.

Florence is the couple's second child.

Their first was born a year earlier in Naples, a girl they called Parthenope.

William is the heir to a considerable fortune, inherited from his great-uncle, a wealthy industrialist, while his wife is the daughter of a crusading MP whose causes include the abolition of slavery and freedom of religion.

In 1821, the young family moves back to England, splitting their time between two beautiful homes.

Hannah Amos is the collections manager of the Florence Nightingale Museum in London.

One of the properties that William Nightingale had inherited, Leigh Hurst up in Derbyshire, was to be their main family home and they would spend most of their summers in this large house with lots of lovelies surrounding the countryside.

They also purchased a second house, Enble Park, down in Hampshire, which became their winter home.

The girls would have had a very happy childhood.

They had lots and lots of cousins on her mother's side.

She actually had, I think it's eight siblings.

William invests his time in providing his daughters with a rich, full education, unusual for girls of the era.

Young Florence proves to be an excellent pupil.

She has a quick, inquiring mind with a particular strength for mathematics.

Outside the classroom, she develops a passion for the natural world, collecting shells and flowers, and grasping any opportunity to care for a new pet.

When a maid discovers a nest of baby mice in a mattress, Florence attempts to hand-rear them, feeding them drops of milk and warming them by the fire.

But despite the Nightingale sisters' education and interests, as upper-middle-class girls, their future paths are narrow.

The main expectation that their family would have had for both of the daughters would have been to get married, had their own children, and run their own household, and basically continued the family lines.

Clarence decided, I think, quite an early age that this life probably wasn't going to be for her.

In 1836, at the age of 16, she experiences the first stirrings of a vocation, when influenza tears through the bucolic community surrounding the Nightingale's Grand Hampshire home.

Nineteen members of the household fall ill, including 15 of the family's servants.

Florence steps up to the plate.

She cares for the sick, rising before dawn, busying herself with tasks throughout the house.

The following year, a teenage Princess Victoria ascends to the throne, and Florence comes to believe that God has a special plan for her too.

Influenced by the writings of the American preacher Jacob Abbott, she aspires to a life devoted to practical, selfless acts of charity.

She has her first calling from God at the age of 16.

She doesn't quite know what this calling is at the time, but she knows it's service to other people.

From now on, Nightingale's worldly ambition is inseparable from a sense of religious devotion.

Slowly, the form of her calling takes shape.

Aged 25, she devises a plan to train in nursing at the Salisbury Infirmary, not far from Embley Park.

In her mind, nursing is a form of pure Christian service, a selfless devotion to those in need.

Florence has her heart set on it.

Her parents are less enthusiastic.

They are absolutely horrified.

Nursing at the time is not a profession as we know it today.

It has actually a very bad reputation.

In sort of popular media, there is the Charles Dickens character, Mrs.

Gamp, who is a nurse in Martin Chuzzlewit,

and she is often drunk.

She doesn't care for her patients in any way.

She doesn't really care about nursing at all.

And this caricature of nurses becomes sort of the main image of nursing within the population of Britain.

So the idea that this well-educated young lady wants to go into this is absolutely horrifying to her parents.

They outright refuse to let her do any work, full stop really.

Even the idea that she wants to work is pretty bad to them.

And so, for the next two years, she moulders in her parents' home.

She rejects an eligible suitor, fearing that marriage will terminate her vocation.

But there is still no clear path to fulfilling her ambitions.

Though she reads voraciously about the latest social reform work, her life is empty and uneventful.

and she sinks into bouts of depression and despair.

At various points, she confides to her diary that she would rather die than live a life so stagnant and pointless.

It's only when friends of the family, Selena and Charles Bracebridge, offer to take her traveling across Europe and Egypt that her spirits lift.

I always like to think that her parents made a bit of a mistake in this area.

They thought they were sending her off to forget about this whole scheme of nursing.

But in fact, these family friends, the Bracebridges, are very liberal, they're very free-thinking, and they actually support Nightingale's idea of working and nursing.

So all the time they're traveling, Nightingale is able to visit all the local hospitals and convents and places providing health care.

Her parents finally relent.

They allow their daughter, now 30 years old, to train as a nurse at a hospital run by an order of religious women in Kaiserwerth in Germany.

It is an immensely fruitful experience.

She learns a great deal about nursing and her sense of mission is fortified.

Three years later in 1853, she is appointed superintendent of a hospital in London for so-called gentle women.

Caring for socially respectable ladies is all well and good, but what she really wants is to nurse where it is really needed.

It just so happens that around this time, an outbreak of cholera is raging in the disreputable London district of Soho, affecting some of the poorest people in the city.

Hundreds fall ill and die, and Nightingale briefly volunteers at the Middlesex Hospital, where many of the victims are sent.

A lot of the patients there were considered fallen women, so this would have been very, very different to the women she had been working with at Harley Street, and she would have come across some extremely extremely ill patients.

I think this would have probably been quite eye-opening for her and just a whole different environment.

As cholera does its worst in London, the British Army enters a world-changing conflict on the eastern reaches of Europe.

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In the Crimean Peninsula, Britain and France have joined forces with the Ottoman Empire against Russian territorial expansion.

For Britain, securing its route to India is of paramount importance.

Thanks to the recent invention of the telegraph, reports of the conflict are shuttled back to Britain with unprecedented speed and frequency.

Never before has a foreign war received such in-depth coverage, and it's far from glowing.

The British public learns of the incompetence, inefficiency, and corruption that is blighting the war effort.

Moreover, it is revealed that thousands of soldiers are enduring the most awful conditions.

Huge numbers are dying, most not in combat, but from inadequate medical attention.

With political pressure mounting, Sidney Herbert, Secretary at War, is looking for ways to allay public fury.

He knows just the person.

Florence Nightingale, a friend whom he first met when she was undertaking her transformative tour of Europe.

With Herbert's enthusiastic backing, Nightingale is selected to manage the barrack hospital at Skutare in Turkey.

Although it's 300 miles from the front lines, this is where swathes of British soldiers are sent to recuperate.

But all too often, the opposite seems to happen.

Nightingale won't be going alone.

Beneath her will be a team of hand-picked nurses.

The initial 38 that were put together, these would have all come together through adverts in the newspapers at the time.

They were a mixture of nurses from the hospitals across the country, and there were a small number of nuns mixed in with this as well.

Across history, we see that convents and monasteries and buildings associated with the church often provide a lot of health care in the community rather than hospitals.

Hospitals wouldn't have been anything like we know today.

So nuns often were the sort of primary nurses in a lot of environments.

The mission generates a lot of attention.

In particular, the story of Miss Nightingale, a respectable lady of impeccable virtue doing her patriotic duty, captures the public imagination.

In the autumn of 1854, Nightingale's nurses are all in place and ready to go.

The job before them is crucial for the credibility of the government, the health of the soldiers, and the reputation of of nursing.

It is late afternoon on the 26th of October 1854.

Beneath a cobalt blue sky, a young woman stands on the docks in the French city of Marseille.

Rebecca Lawfield is one of the team of 38 nurses selected for the Nightingale mission.

Her journey began six days ago when she and the rest of the delegation departed London by train.

It was an inauspicious start.

One of the nurses arrived at the station drunk and had to be sent home.

Now, Lawfield and her colleagues are preparing for the final leg of their voyage across the Mediterranean Sea to Turkey.

For her, as for many of Nightingale's nurses, simply traveling to Turkey is a once-in-a-lifetime experience.

Yet, she has been warned of what to expect of the Skutari hospital.

She knows this will be no holiday.

A voice shouts instructions.

It's time to leave.

Lawfield adjusts her hat and makes her way up the gangplank.

Their vessel is a steam packet, a male ship named Vectus.

Ahead of her is Florence Nightingale, confident, organized, driven.

For the last couple of days, Lawfield and the others have observed her buzz around, making last-minute preparations and dealing with all manner of people.

She seems to be a true force of nature.

With its passengers all aboard, the Vectus is ready to depart.

Lawfield watches Marseille recede as the ship pushes out into the clear water.

But the journey is far from tranquil.

Built for speed and nimbleness, the Vectus careens on the waves, and after a while, some of the women are struggling with seasickness.

Gripping a handrail, Lawfield descends a steep stairway down to the cabins.

Below deck, the air is thick and fetid.

She hitches her skirt to save it from the water that sloshes on the floor.

As the boat rocks, Lawfield inches her way into a cabin where she finds Florence Nightingale groaning on a stiff, narrow bed.

She may be building a reputation for fortitude, but she clearly has no stomach for the open seas.

For days, Nightingale confines herself to her cot.

When she attempts to eat, she's too nauseous to keep anything down.

Above deck, the wind picks up.

As the Vectus passes the Greek islands, it pitches high into the air.

Lawfield holds her breath.

For a dreadful moment, it seems the ship is about to keel over.

Mercifully, everything stays the right way up.

The Vectus continues its horrid journey.

After several days of this punishment, the waters calm.

On the 4th of November, Nightingale finally emerges from her berth and joins Lawfield on the deck just as the great city of Constantinople appears on the horizon.

But as they draw closer, the view could barely be less impressive.

Thick drizzle obscures the city's fabled charm.

When Nightingale eventually disembarks the Vectus, she is immensely relieved to be treading on solid, dry land again.

Even so, she knows that what's waiting for her, just three miles away at the Scutari Hospital, is going to be a lot worse than anything the Mediterranean can throw at her.

When Lawfield, Nightingale, and the other nurses nurses arrive at the Scutari Barracks Hospital, things are, if anything, worse than feared.

The conditions were absolutely atrocious.

There would have been people just everywhere.

It would have been noisy, smelly, probably dark.

The air wouldn't have been flowing through the buildings.

It was nothing like Florence could have ever imagined.

In her efforts to improve conditions, Nightingale comes into direct and frequent conflict with the male military establishment.

She's basically not allowed to nurse or interact with any of the soldiers initially.

It's a male-dominated space.

They've never had any women working alongside them.

So their initial reaction is to be, well, we don't need you here, but everything's fine.

So she sets about cleaning the rooms that the soldiers are living in.

sets up proper kitchens.

This means that, you know, there's clean bedding and clean clothing for the soldiers.

They're getting proper nutritious meals.

So later on, when her and her nurses are allowed to eventually start interacting with soldiers and actually providing that care, all of that basic stuff is in place.

Nightingale is still finding her feet when Skutari receives a flood of desperate new patients.

On the 9th of November, 600 casualties from the Battle of Inkerman arrive.

Over subsequent days, they're joined by many hundreds more.

Soon, the corridors in Skutari are crammed with almost 2,000 patients, but approximately two dozen of them die each day.

In fact, across that winter, more than 4,000 men in Nightingale's care don't make it.

About 90% of these deaths result from illnesses such as typhus and cholera.

But throughout this bleakest of seasons, she does what she can for her soldiers.

In an attempt to lessen fear and trauma, she erects screens around around the poor men who are subjected to amputations.

The saving grace is that chloroform is available, even though there isn't a single operating table in the hospital.

The soldiers appreciate her efforts.

In attending to their comfort and well-being, she offers them something they've never received before.

She makes them feel cared for.

Under Miss Nightingale's supervision, these men are human beings whose lives matter instead of cannon fodder left to rot in a foreign field.

Soon, news of Nightingale's impact extends beyond Scutare, with stories of her efforts finding their way into British newspapers and magazines.

In February 1855, a famous illustration of her is published, in which she is shown walking from bed to bed in the dead of night, checking on each wounded soldier.

She holds a so-called genie lamp to light her way.

The flame acts as a metaphor, a glimmer of hope in these darkest of times.

And even though the lantern she uses is in reality of a different design, the image sticks.

A legend is born.

Florence Nightingale will forevermore be the lady with the lamp.

The lady with the lamp is first mentioned by a soldier in a letter home to his family, and this gets sent off to one of the newspapers in London.

The public become fascinated by this almost enigmatic woman who's gone out.

They don't really know who she is.

She just kind of appears.

No one has seen her.

The illustrators doing the illustrations for the newspapers, they're in London, so they don't really know what she actually looks like, so her real likeness doesn't get out for a long, long time.

The mystery fuels her mythology.

In Britain, Nightingale becomes a huge celebrity.

Lines of unofficial merchandise are launched, and her first name sees a spike of popularity with baby girls named in her honor.

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Back in Scutari, Nightingale has undoubtedly made her patients more comfortable and her hospital more organized.

Yet mortality rates remain stubbornly high.

A government commission is set up to investigate.

What it finds is nightmarish.

The sewer beneath the hospital building is horribly clogged.

A dead horse is festering in the water supply, which is also contaminated by leaking latrines.

The notion that such hazards could be the cause of disease is not straightforwardly obvious to Florence Nightingale.

She, like so many others at this time, adheres to what's called the miasma theory, which holds that disease is caused by bad smells and dirty air.

It has a fundamental impact on Nightingale's work at Scutare, in which she tries to rid the place of its rank odours.

Her idea was wrong, but what she was doing was right.

So cleaning up and trying to get some fresh air in.

During COVID, we were told to keep our windows open.

She was doing all of that.

She was making sure that everyone was washing their hands.

So while she didn't have quite the right theory, she did do all of the right things.

However, as Nightingale doesn't subscribe to the novel theory of contagion, it leads her to overlook certain crucial factors, such as the risks of overcrowding and of disease being transmitted in water.

It's only once these issues are addressed that the death rate at Skutari begins to fall.

which it does rapidly in the spring of 1855.

Nightingale's attention now turns to hospitals on the front line in Crimea, where British soldiers are also languishing.

On the journey across the beautiful expanse of the Black Sea, she experiences the effects of her growing fame.

Passengers crowd the decks of nearby boats to get a glimpse of the lady with the lamp, cheering and applauding as she sails past.

She is conveyed around the war zone in a horse-drawn carriage, depictions of which soon fill newspapers in Britain and elsewhere.

Joining her on this expedition is another lauded celebrity, Alexis Sawyer, a French chef and restaurateur who has built a gastronomic empire in London.

Between them, they plan to transform the diets of ailing soldiers.

But before they can set to work, disaster strikes.

On the 12th of May, the day after Nightingale turns 35, she suddenly collapses.

On one of her visits out to the Crimean Peninsula, she picked up what was then called Crimean fever.

Today, this is thought to be something called brucellosis, which is a bacterial infection picked up from infected meat and sometimes unpasteurized milk.

So, she obviously ate or drunk something out there that caused her to become very ill.

There was a point where they actually thought she was going to die out there, and I think everyone was preparing for the worst.

After several days her condition improves.

Begrudgingly she returns to Skutari to convalesce.

But even here she refuses to rest.

From her sickbed, Nightingale draws up plans to help improve the well-being of British soldiers, encouraging them away from drink and idleness.

She helps to open a cafe for recuperating servicemen, organizes lectures and activities, and arranges for them to receive newspapers and books.

She also uses her time to write to the families of of soldiers in her care and those who have recently died.

But the Nightingale touch is not appreciated by everyone.

Her tussles with the men in charge of Scutari continue.

There are also tensions among the nurses in her charge.

Several are dismissed for ill-discipline and incompetence.

Others are reprimanded for falling short of Nightingale's notoriously high expectations.

I think she was quite difficult to work under.

She had very precise and exact ways of working.

And if someone wasn't up to her standards, that's it.

They were on their way home.

She did clash quite a lot with some of the nurses.

A lot of them were absolutely devoted to her, but we see that through nursing, that you know, there's all these kind of standards and procedures that you have to follow.

But a lot of them weren't used to having that strong leadership.

After a year at Scutari, she is disappointed by the various obstacles she still faces.

Christ was betrayed by one, she complains in one of her many writings.

But my cause has been betrayed by everyone.

Evidence, perhaps, of a certain inflexibility and a tendency to dramatize her own circumstances.

Yet for all the difficulties, Nightingale has achieved her objectives of turning Scutari into a well-run hospital.

By the war's end in early 1856, a year and a half after her arrival, its death rate is comparable to that of any hospital in one of England's big industrialized cities.

Florence Nightingale couldn't be held in higher esteem, with the public donating huge sums of money to support her work.

Among the people, her reputation is almost that of a secular saint.

As far as they are concerned, She is responsible for saving the lives of countless brave British soldiers.

Despite the appalling casualty rate, the Crimean War turns out to be a sizable victory for British forces.

By the summer of 1856, Nightingale is ready to return home.

Yet she goes out of her way to avoid anything resembling a hero's welcome.

Traveling to England incognito under the alias of Miss Smith, She makes it all the way to a railway station in Derbyshire without being recognised.

Once she alights the train, she takes her bags and walks a mile and a half across the fields, turning up at her parents' house unannounced.

Adjusting to life back home is testing.

Over the last two and a half years, Nightingale has had life-changing experiences.

She's witnessed horrifying trauma, been stricken with terrible illness, and of course, become a hugely celebrated public figure.

Nightingale actually really didn't like the public perception of her and her fame.

After the war, she basically goes into hiding for a good few years.

At one point, the carriage she'd used during the war was brought back to the UK and it was paraded around Southampton.

And the carriage almost becomes a bit of a symbol of her and it's used in various different locations across the country.

And I think she says something like that Russian cart hangs around my neck.

And she eventually gets one of her footmen to basically go and take it away and hides it away at one of her houses.

But though she's now safely back in the quiet of her old family home, Nightingale cannot shake the traumatic experience of Scutare.

She struggles to sleep, unable to escape the memories of the horrors she's witnessed.

She has no appetite.

At night she feels anxious.

During the days she stares blankly out of the window.

In a private note she writes, Oh, my poor men who endure so patiently, I feel I have been such a bad mother mother to you.

But soon, an invitation arrives that brightens her mood.

It is the 21st of September, 1856,

a damp autumn morning in the Scottish Highlands, where, thanks to a recent deluge, the nearby River Dee has burst its banks.

Deep in ancient woodland, a coach squelches its way along a narrow path, its wheels throwing up great globules of mud into the air.

Inside the vehicle, Florence Nightingale sits pensively.

She's en route to a very important meeting.

Presently, the dense forest thins out and a grand building comes into view like something from a fairy tale, a castle.

festooned with turrets and towers.

But this is no medieval fortress.

It's Balmoral, a newly built country bolthole for none other than Queen Victoria and her husband, Prince Albert.

During the war, the Queen was captivated by reports of Nightingale's work.

She even sent a gift of a beautiful red brooch in thanks for her service to the nation, along with a letter of support, which Nightingale shared with the soldiers at Scutare.

Now, Victoria is honoring Nightingale with a private audience.

It's a rare privilege, and an opportunity to ask the monarch to back reform of medical care in the armed forces.

At the castle entrance, Nightingale descends the coach.

Although there is no grand welcoming committee, her arrival is marked by a solitary bagpiper, as is customary.

Nightingale is shown into a drawing room like a parody of a highland hunting lodge.

Everywhere there are thistles and antlers, and each available surface is swathed in tartan.

Before long, Her Majesty appears at the door.

Half a dozen little dogs scamper around her ankles as she comes in to greet her guest, who lowers herself into a deep curtsy.

They settle on tartan-covered sofas, facing each other, the Queen at a slight angle to accommodate the swell of her pregnant belly.

But though Nightingale is here to advance her cause, the conversation is stilted.

The two women are almost identical in age, yet they differ in so many ways.

Victoria expecting her ninth child, the epitome of 19th century domesticity, the mother of a nation.

Nightingale, a woman who has rejected convention in search of a different life.

After a few minutes, Victoria's husband Albert strides into the room and the atmosphere changes.

He and Nightingale are peas in a pod, businesslike and serious.

As tea is delivered, they discuss facts and figures, systems and procedures.

Nightingale presses her case for a royal commission to examine the causes of deaths in the Crimean War.

She also tells the Queen how dearly the soldiers at Scutari valued the words of support she sent them.

Victoria is visibly moved by this.

She prides herself on having a deep emotional connection with her people.

While the Queen has no authority to launch the official investigation that Nightingale seeks, she pledges her support.

It seems her influence is enough to tip the balance.

Soon after Nightingale returns from Balmoral, the Royal Commission is up and running.

It's now that the post-Crimea stage of Nightingale's career begins in earnest.

With a £500 annual allowance from her father, she moves into a suite at the Burlington Hotel in London, which will be her HQ for the next several years.

Her immediate concern is her own investigation into medical care in the armed forces, one intended to complement the Royal Commission.

To this end, she teams up with eminent experts, including the statistician William Farr.

And while Nightingale is no longer a working nurse, the legend of the lady with a lamp persists.

In 1857, the American poet Henry Longfellow publishes a poem in The Atlantic magazine.

It is a gushing paean to Nightingale the Nurse, whom he describes as a noble type of good, heroic womanhood.

But the poetic gloss of her public reputation obscures the woman beneath it and the reality of her contribution to the world.

I think one of the biggest misconceptions we have about her is actually thinking of her as a nurse.

And I know a lot of people won't be too happy with that.

A lot of nurses won't really like that.

But her nursing career started in 1853 and was pretty much over by the end of 1856.

Really, to me, she is a reformer.

She's a statistician, she's campaigner.

And even when she was nursing, she was more in a management role.

Superintendent was her title both at Harley Street and across the war.

And yes, she was a nurse.

I'm not denying she was a nurse, but she was so much more.

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In the summer of 1857, Nightingale's mother and sister come to stay with her at the Burlington Hotel.

But the extreme absorption in her work concerns her mother, who takes her to task for laboring over her papers into the small hours.

A few days later, Nightingale collapses.

Doctors tell her it's frayed nerves.

A modern perspective might suggest that it's another attack of brucellosis.

For the next 11 years, Nightingale barely leaves home.

She moves, if at all, from her bed to the sofa, and back again, and endures frequent bouts of excruciating spinal pain.

Inevitably, her suffering takes a toll on her.

Family and friends report that she is querulous, irritable, and short-tempered.

A rare upside of her condition is that it helps her to regulate the time she is able to give to others, including her family.

This might help to explain how this lengthy period of ill health and seclusion is perhaps the most productive of Nightingale's life.

A lot of the letters that we have in our collection are of her making appointments with people.

She very much didn't want people to turn up at her house uninvited.

She very strictly made appointments.

She was very strong-willed, had her own way of doing things, and knew what she wanted and where she wanted to get to.

With the help of William Farr, Nightingale continues to dig into the facts surrounding military hospitals.

The numbers that they uncover are astounding.

Of the 18,000 British deaths in Crimea, 16,000 were due to illness, not injury.

To her horror, Nightingale learns that the wards of Scutare were one of the most lethal theaters of the entire conflict.

The conclusions are inescapable.

It was the reduction in overcrowding, the flushing of the sewer, and the cleaning of the water supply that was the key to saving lives at Scutare.

not the battery of changes the Nightingale nurses had implemented.

Moreover, Nightingale learns that mortality rates for soldiers in army hospitals in Britain are also staggeringly high, and poor sanitation is the chief cause.

The Royal Commission delivers its findings in February 1858.

Around the same time, Nightingale sends the report she has been working on to 2,000 public figures.

It's a mammoth work, hundreds of pages of detailed analysis and extraordinary revelation.

And it's relayed in an arresting, utterly novel way.

This report was for MPs, but she knew they weren't going to read 800 pages worth of just text.

So she creates these diagrams.

They're really easy ways to present the data without having to read all of the stuff around it.

Her Coxcomb diagram, for example, is her most famous and that shows the mortality rates at the British Army hospitals.

And it's an early form of pie chart.

And this diagram really shows that it was the disease that the soldiers were picking up in the hospital which was the biggest cause of death within the hospitals.

In coming years, sweeping reform takes place within the military along the lines she suggests.

Higher standards of hygiene and sanitation are introduced.

An army medical school is founded to improve the quality of care.

At home and abroad, the health of British soldiers is transformed.

The compilation of her report is a personal turning point for Nightingale, too, the beginning of the end for her adherence to the miasma theory.

Some also speculate that the findings leave her with overwhelming guilt over the thousands of deaths she now realizes she might have prevented.

What's certain is that from this time forth, Nightingale makes remarkable efforts to improve public health in numerous ways.

In 1859, she publishes Notes on Hospitals.

The book outlines her thoughts on hospital architecture and design, all dictated by the need for ventilation and spacing, the lack of which had proved so deadly at Scutari.

The following year, another volume, Notes on Nursing, is an immediate bestseller.

in which Nightingale distills the rudiments of nursing in the home.

Around the same time, she launches launches the Florence Nightingale Training School, attached to St.

Thomas's Hospital in London.

All the while, as she works from the confines of her own home, she recognizes the unavoidable fact that without her exceptional privilege, none of this would have been possible.

Indeed, the issue of poverty is often at the forefront of her work.

Wealth inequalities in Victorian Britain are enormous.

The infamous Poor Law of 1834 restricts financial aid to the poor, forcing many into workhouses.

In these austere places, little better than prisons, paupers are given food and shelter in exchange for gruelling manual labour.

Health in such settings is virtually non-existent.

The workhouses that would have been set up across Britain would have had infirmaries attached to them, but there wouldn't have really been any proper medical provision for them.

It was often up to the sort of most able-bodied women in the workhouse to look after people.

They would never have trained as nurses.

They would have literally just been women who have ended up in the workhouse.

To address the problem, Nightingale works closely with a fellow reformer, William Rathbone.

In 1864, they create the position of a nursing superintendent at a workhouse in Liverpool.

It's the first such appointment anywhere in Britain.

To modern ears, it might sound small.

In the 1860s, it was a quietly radical step.

They set to work on these sort of formal staffing structures for the workhouse infirmaries because they felt the poor in society should have equal access to health care.

This really changes the way people view the workhouse infirmaries.

And

although I couldn't 100% say it has that link to the NHS, I think it really does start off that idea of universal health care for all and ensuring that everyone has equal access to healthcare when they need it.

1887 is Jubilee Year in Britain, the 50th anniversary of Victoria's ascension to the throne.

At the start of her reign, expectations had not been high, but the teenage queen has grown up to become, in many communities at least, a beloved leader, the emblem of an era.

Something similar can be said of Florence Nightingale, now 67 and living in Mayfair in London.

Half a century has passed since she first heard the voice of God calling her to service.

Famed not just for her work in health reforms, to the public, in many ways she is the embodiment of a Victorian feminine ideal, representing compassion, good works, cleanliness and godliness.

To mark the Queen's special anniversary, an exhibition is held in London.

Gathered together are a vast array of artefacts to display the successes of the Victorian era.

A section is devoted to Nightingale, including the carriage that transported her around Crimea, an object that has acquired an almost mystical quality, more religious relic than mere memento.

Much like her queen, Nightingale spends her later years largely hidden from public view.

She also becomes passionately interested in India, though, again, mirroring Victoria herself, she has never set foot there.

As a younger woman, Nightingale had been interested in the welfare of British soldiers in India.

Now, in her old age, she becomes a public supporter for Indian self-governance reforms.

The final years of her life are spent quietly in Mayfair.

Despite her prolonged health problems, she lives until the age of 90, passing away on the 13th of August, 1910.

In the years since her heyday, she is cited as a key influence on all manner of initiatives.

Henri Dunant credits Nightingale as his inspiration for founding the International Red Cross in the 1860s, as well as for his work that leads to the founding of the Geneva Convention.

For much of the late 20th century, she is the only woman other than Elizabeth II to appear on British banknotes.

When the COVID-19 pandemic hits the UK in 2020, the temporary hospitals built to care for those affected are named in her honour.

The life of Florence Nightingale was one of courage, service and devotion, but despite her privilege in a deeply unequal society, it was also marked by struggle, isolation and regret.

Over a century after her death, Her story is as layered with legend and misconception as it was when she still personally tended the sick.

But the core message of Nightingale's life burns as brightly as her lantern once did in those hellish Scutari hospital wards.

Florence Nightingale's biggest legacy is really her reform work in terms of nursing, healthcare, and hospitals.

These really laid the foundations for modern healthcare today.

Nightingale and her lamp became a symbol of hope for people in the Crimean War.

And these people were stuck in an awful situation, and they just needed someone who cared.

And I think for me, human nature hasn't changed in the last 200 odd years.

There are still people today who step outside their comfort zone to really try and help others and to make a difference.

Next time on Short History of, we'll bring you a short history of the Mitford Sisters.

When you think about that time in the 30s running up to the Second World War, I can't tell you how many people have said to me recently how relevant it seems for today.

And we've got a very, very disturbed world with a lot of voters across Europe swinging to the right.

So I think there is a relevance in following their story.

It's just interesting as well as gramorous.

That's next time.

If you can't wait a week until the next episode, you can listen to it right away by subscribing to Noiser Plus.

Head to www.noiser.com forward slash subscriptions for more information.

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