Before Florence Nightingale, nursing was the domain of religious orders or women too disreputable to be domestic servants. The Crimean war, in 1854, was embarked on blithely by the British government, but the lack of medical provision sent the death rate soaring among the troops. Nightingale, though she struggled to find even 40 women skilled in nursing, seized the opportunity to be at the heart of the action. But this was just the start of decades of arguments about what, precisely, the role of the nurse is. Glorified housemaid or healer? Curer or carer? Manager, dispenser of medicines, administrator, consultant, therapist, angel of mercy?
Like most girls of my generation, I had a nurse’s outfit and read the Sue Barton books by Helen Dore Boylston, about red-headed Sue who embraces hospital discipline, proves brave and competent and finds love with Doctor Bill. Also well-thumbed was Florence Nightingale: A Ladybird Book – a beautiful lady rescues the entire British army by means of a lamp and a crinoline. But the appeal of nursing went far beyond the clothes; it was being part of a team, competent, compassionate, and there at the moment of crisis.
So eventually I wrote The Rose of Sebastopol, inspired by Nightingale’s transformation from bored society miss to pioneer and reformer. While doctors figure large in literature, I don’t think enough has been written about or by nurses, in any genre. But here’s my choice of 10 books; Nightingale might have approved of some, not all.
1. Martin Chuzzlewit by Charles Dickens
Published about a decade before Nightingale shot to prominence, this novel features Mrs Gamp, the drunken opportunist who is present at births, sickbeds and layings out and “has a face for all occasions”. Her idea of night nursing is to drag the pillow from beneath her patient’s head so she can get some sleep. Gamp epitomises the early Victorian disregard for hygiene, washes neither her clothes nor her hands and doesn’t expect her patient to recover except by sheer fluke.
2. Notes on Nursing. What It Is, and What It Is Not by Florence Nightingale
Nightingale is incredulous that no woman is taught even the rudiments of nursing and her handbook fills the gap. Her obsession is with clean air and some of her dictates are hilariously of their time: “A nurse who rustles … is the horror of a patient … The fidget of silk and crinoline … the creaking of stays.” Others are touching in their delicacy: “It is a curious thing to observe how almost all patients lie with their faces turned to the light, exactly as plants.” Nightingale was fierce, witty, demanding, relentless, resourceful and eloquent. To read this book is to hear her voice.
3. Wonderful Adventures of Mrs Seacole in Many Lands by Mary Seacole
This exuberant autobiography was written to raise funds when Seacole returned from the Crimea. She describes herself as “a motherly yellow woman” who was turned down by the War Office and Nightingale’s team despite her proven experience nursing fever-stricken soldiers in Jamaica. Nevertheless, she made her way to the Crimea to set up a hotel and general store. Unlike Nightingale, she ended up on the frontline and provides hair-raising descriptions of nursing wounded soldiers, including a Russian who nearly bit off her finger when she was examining his jaw.
4. Testament of Youth by Vera Brittain
If ever there was a memoir for our times, it is this. Brittain’s passionate account of her pre-war girlhood, love affair, and the brutal discipline of her work as a Voluntary Aid Detachment nurse, first in England then Malta and France during the first world war have an extraordinary resonance. She captures the torment of grief – as she lost fiance, brother and friends – endured while performing punishing duties. Paradoxically, one of the most heart-wrenching chapters describes how Brittain’s parents required her to abandon hospital work and resume her role as daughter of the house.
5. Endell Street by Wendy Moore
A companion read to Vera Brittain, this is an account of a hospital set up and run entirely by women. Moore documents the tenacity of the two suffragette doctors who established the hospital, and the female team who staffed it. Previously unskilled women, some of them inexperienced even in domestic work, toiled relentlessly to nurse wounded men, and victims of the Spanish flu. Yet after the war these women were relegated to poorly paid areas of medicine, and decades later nurses were still treated as recalcitrant parlour maids by their matrons and those who fixed their pay.
6. A Manual for Cleaning Women by Lucia Berlin
These stories are crazily on the edge. The figure of the nurse appears frequently – dispassionate, fond of gossip, worn out. It takes a strong stomach to read Dr HA Moynihan, in which a dental nurse helps her dentist grandfather yank out all his own teeth. And the tragic juxtaposition of two voices in Mijito – a teenage mother and the overworked nurse for whom a bruised baby is one more case on a long list.
7. The Language of Kindness by Christie Watson
This is part narrative, part Watson’s reflection on the profession she loves, from midwifery to laying out a body. Like the other memoirs on this list, it humbles me, because the nurse has seen so much, and displays such compassion, skill and resilience. Watson explores the extraordinary and diverse qualities required of a modern nurse. It would be reassuring if this book, published in 2018, had pointed to a greater valuing of nurses before pandemic struck.
8. In the Midst of Life by Jennifer Worth
By the author of Call the Midwife, this is a series of essays about death – from euthanasia to the requirement of hospitals to resuscitate even frail and dying patients. Some chapters are love stories, others brutally explicit about how, as a society, we often get death wrong. Worth writes with searching authority about a subject she believed we all need to get much better at talking about. She died in 2011, meeting her end with the courage and dignity her book advocates.
9. One Pair of Feet by Monica Dickens
I read this countless times as a girl and was heavily influenced by it to become a writer. Dickens (great-granddaughter of Charles) has a wicked turn of phrase, is a ruthless observer of human foibles and endlessly self-deprecating. She describes life as a trainee nurse in the second world war, the pettiness of the hierarchy, the spartan regime, the junior’s duties as bed-maker and skivvy. Some of her prejudices are disturbingly of their time, but she captures moments of tenderness alongside her slapdash attempts to get done and is sometimes deeply respectful of the skilled women with whom she works.
10. Reasons to Be Cheerful by Nina Stibbe
This novel is so deadpan the laughter caught me by surprise. The heroine, Lizzie, enlists as a dental nurse and describes in exquisite detail aspects of her weird family, dubious friends and sinister employer – a dentist obsessed with joining the Freemasons. I’ve included it here because it’s funny, quirky and beautifully written. An antidote.
The Rose of Sebastopol special edition by Katharine McMahon is published by W&N, with an additional final chapter and new preface.