_THE LADY-IN-CHIEF_
The Barrack Hospital--Overwhelming Numbers of Sick and
Wounded--General Disorder--Florence Nightingale’s “Commanding
Genius”--The Lady with the Brain--The Nurses’ Tower--Influence
over Men in Authority.
A perfect woman, nobly planned,
To warn, to comfort and command;
And yet a spirit still and bright,
With something of an angel light.
WORDSWORTH.
The official position which the Government had accorded Miss
Nightingale was Superintendent of the Nursing Staff in the East,
and the title by which she eventually became known was that of
Lady-in-Chief.
Her control extended over the nursing staffs of all the hospitals,
some eight in number, in which our wounded soldiers were placed on
the Bosphorus and the Levantine. The first and chief scene of Miss
Nightingale’s personal ministrations, however, was the great Barrack
Hospital at Scutari, lent to the British Government by the Turkish
authorities. It was beautifully situated on a hill overlooking the
glittering waters of the Bosphorus, and commanded a view of the fair
city of Constantinople, with its castellated walls, marble palaces,
and domes, rising picturesquely on the horizon. No more enchanting
prospect could have been desired than that which met the Lady-in-Chief
when she reached Scutari, the “silver city,” held in such veneration by
the Turks. The town seemed placed in a perfect Garden of Eden, and the
lovely blue of the Eastern sky enhanced the beauty of the scene.
The Barrack Hospital was a fine handsome building, forming an immense
quadrangle with a tower at each corner. An idea of its size may be
gathered from the fact that each side of the quadrangle was nearly a
quarter of a mile long. It was estimated that twelve thousand men could
be exercised in the central court. Galleries and corridors, rising
story above story, surrounded three sides of the building, and, taken
continuously, were four miles in extent. The building and position were
alike good, but the interior of the hospital, as Miss Nightingale soon
discovered, was a scene of filth, pestilence, misery, and disorder
impossible to describe. On either side the endless corridors the
wounded men lay closely packed together without the commonest decencies
or necessaries of life.
After being disembarked at the ferry below the hospital from the
vessels which brought them from the battlefields of the Crimea, the
wounded men either walked or were dragged or carried up the hill to the
hospital. Surgical, fever, and even cholera cases came along the road
together in one long stream of suffering humanity.
[Illustration: THE BARRACK HOSPITAL AT SCUTARI.]
Several days had elapsed since the men left the battlefield, and the
majority had not had their wounds dressed or their fractured limbs set.
The agony and misery of the poor fellows in this untended and often
starving state can be well imagined. And how their hearts sank when
they at length reached the hospital, where at least they expected food
and comfort. Alas! there was little provision of any kind for the
sufferers. Nolan, in his history of the campaign, says that in these
early months of the war “there were no vessels for water or utensils
of any kind; no soap, towels, or cloths, no hospital clothes; the men
lying in their uniforms, stiff with gore and covered with filth to a
degree and of a kind no one could write about; their persons covered
with vermin, which crawled about the floors and walls of the dreadful
den of dirt, pestilence, and death to which they were consigned.
“Medical assistance would naturally be expected by the invalid as soon
as he found himself in a place of shelter, but many lay waiting for
their turn until death anticipated the doctor. The medical men toiled
with unwearied assiduity, but their numbers were inadequate to the
work.” Invalids were set to take care of invalids and the dying nursed
the dying.
It was a heart-breaking experience for the Lady-in-Chief when she made
her first round of the wards at Scutari. The beds were reeking with
infection and the “sheets,” she relates, “were of canvas, and so coarse
that the wounded men begged to be left in their blankets. It was indeed
impossible to put men in such a state of emaciation into those sheets.
There was no bedroom furniture of _any_ kind, and only empty beer or
wine bottles for candlesticks.”
In addition to the miseries entailed by overcrowding, the men lying on
the floors of the corridors were tormented by vermin and their limbs
attacked by rats as they lay helpless in their pain.
The immediate surroundings of the hospital were a hotbed of pestilence;
Miss Nightingale counted six dogs lying under the windows in a state of
decomposition. Add to this that in this vast caravanserai of wounded,
sick, and dying men there was no proper provision for washing, no
kitchens, culinary conveniences, or cooks suitable for hospital needs,
and no sanitation, and some conception may be formed of the Augean
stable which the Lady-in-Chief and her nurses had to cleanse, and the
chaos out of which order was to be brought.
It is not altogether surprising that the doctors and hospital
authorities did not immediately welcome the very unique band of sisters
who had come to their assistance. These already overwrought gentlemen
were disposed to think that the ladies would prove a greater hindrance
than help. In those days it was regarded as unavoidable that a soldier
should suffer, and humanitarian attempts to lessen the sufferings were
considered sentimental and effeminate.
Possibly some of the younger medical men thought that the rats which
infested the hospital would prove the needed scare to the newly arrived
nurses. Of course it was held that the most strong-minded women would
fly at the approach of a mouse: what therefore would be the effect
of a rat? But this idea was dispelled when it was known that the
Lady-in-Chief had fearlessly dislodged a rat from above the bed of one
of the nurses with an umbrella. The sheds where the sisters sorted the
stores were over-run with the pests. “Our home rats,” said one of them,
“would run if you ‘hushed’ them; but you might ‘hush’ away, and the
Scutari rats would not take the least notice.”
Only twenty-four hours after the arrival of Miss Nightingale at Scutari
the wounded from the battle of Inkerman began to arrive in appalling
numbers, and soon every inch of room in the General and in the Barrack
Hospitals was filled with sufferers. Many of the men had indeed no
other resting-place than the muddy ground outside. The Lady-in-Chief
had had no time to initiate reform, collect stores, or get any plans
for the relief of the patients into working order before this fearful
avalanche of wounded soldiery came upon her.
[Illustration: BOULOGNE FISHERWOMEN CARRYING THE LUGGAGE OF MISS
NIGHTINGALE AND HER NURSES.
[_To face p. 128._
]
It was the testing moment of her life. Had Florence Nightingale failed
at this crisis in personal endurance, or in power to inspire her
subordinates with a like courage, her mission would have sunk into
a benevolent futility. She and her nurses might have run hither and
thither smoothing pillows, administering gruel, and doing other kind
and womanly service, but grateful as that would be to the poor
fellows in their extreme misery, it would not have remedied the root
of the evil. The Lady-in-Chief had to look beyond the present moment,
though not neglectful of its demands, to the more important future,
and institute a system of nursing reform which should make such scenes
as she now witnessed impossible. It was her ability to do this which
lifted Florence Nightingale into such a supreme position.
The attention and praises bestowed on her during the Crimean period
roused a little jealousy and resentment in some quarters. Other women
engaged in nursing the sick soldiers possibly thought that they had
made equal personal sacrifices with Miss Nightingale--some indeed gave
their life in the cause. Others again, returning to a life of seclusion
after toiling through the arduous nursing of the campaign, might
perhaps have felt some injustice that one name alone rang through the
land, while others who also had borne the heat and burden of the day
remained unhonoured and unsung. No one would wish to exempt from due
praise even the humblest of that “Angel Band” who worked with Florence
Nightingale and still less would she, but in every great cause there is
the initiating genius who stands in solitary grandeur above the rank
and file of followers.
Such was the Lady-in-Chief: she came to Scutari as something far more
even than an efficient nurse. She brought the organising and governing
faculty and the brain power of which the officials in charge seemed
bereft. Delicate, high-bred, and retiring in nature as Miss Nightingale
was, she possessed the subtle quality which gave her command over
others, that undefinable something which broke down the opposition of
the most conservative obstructionist when he came under her personal
influence. She was unfettered by precedent or red tape, and brought to
her task a clear idea of the administrative mechanism which was needed
to afford due care and provision for the prostrate soldiery.
Her woman’s nature was roused to indignation at the sight of suffering
which she could only regard as the result of unbending and unthinking
routine, and she brought her quick intuitions and agile brain to
remedy the evil. When men were dying daily by the score for the want
of suitable nourishment, she declined to listen to under officials
who feared to disobey regulations by opening stores without the usual
order, and took the responsibility of having the packages undone. The
Lady-in-Chief was herself a strict disciplinarian, or she would never
have brought order out of chaos, but she had humanity enough to know
when the iron rule might be relaxed in the interests of those under
her care. Her common sense, her spirit of unselfish devotion, and her
strong, though gentle, persuasiveness gradually overcame the prejudice
of the constituted authorities against the new element introduced into
hospital work.
Mr. Sidney Herbert in his letter to the Principal Medical Officer at
Scutari (Dr. Menzies) announcing the coming of the nurses, had enjoined
him “to receive with attention and deference the counsels of the
Lady-in-Chief.” Great as was the power which the unflinching support
of this distinguished man gave her, it was secondary to the influence
which she attained by the force of her own character. The late Dean
Stanley, who was not a man to misuse the English language, described
Miss Nightingale’s faculty as “commanding genius.”
We read in the thrilling accounts of the period how the Lady-in-Chief
went her rounds at night, passing along the endless corridors and
through the hospital wards carrying a little lamp, the gleam of which
lighted her progress of mercy and love. Dying men turned on their
pillows to bless her shadow as it passed. In far-away New England the
idea of “The Lady with the Lamp” inspired the muse of Longfellow:--
A Lady with a Lamp shall stand
In the great history of the land,
A noble type of good
Heroic womanhood;
and it has remained the most beautiful and popular title bestowed upon
Florence Nightingale, but at the risk of appearing modern and prosaic
we venture to re-christen our heroine “The Lady with the Brain.”
When Miss Nightingale began her work, her energies were concentrated
on the Barrack Hospital already described, and on the General Hospital
at Scutari, which was a little farther removed. The other British
hospitals in the East also came under her supervision, but Scutari
claimed at first her undivided personal attention. Attached to her
staff were the thirty-eight trained nurses who had accompanied her,
the Rev. Sidney Osborne, the chaplain, and her friends, Mr. and Mrs.
Bracebridge of Atherstone Hall. Mrs. Bracebridge was to act as overseer
of the housekeeping department. A most valuable helper also was Mr.
Stafford, a young man of family who had left the drawing-rooms of
Mayfair to go to Scutari and “fag” for the Lady-in-Chief. He wrote
letters, went on missions of inquiry, and did anything and everything
which a handy and gallant gentleman could do to make himself useful to
a lady whom he felt honoured to serve.
Taken collectively, this little group may be termed the “party of
reform” who were installed at Scutari at the beginning of the winter
of 1854. Lady Stratford de Redcliffe, the wife of our Ambassador at
Constantinople, and her “beauteous guest,” Lady George Paget, were also
most helpful in sending little comforts for the wounded officers, but
it was said of Miss Nightingale that she “thought only of the men.” The
common soldier was undoubtedly her chief concern.
[Illustration: THE LADY-IN-CHIEF IN HER QUARTERS AT THE BARRACK
HOSPITAL.]
The Lady-in-Chief and her staff had their quarters in a tower at
one of the corners of the hospital, and the busy life which went on
there from day to day is thus described by the Rev. Sidney Osborne.
“Entering the door leading into the Sisters’ Tower,” he writes, “you
at once find yourself a spectator of a busy and interesting scene.
There is a large room with two or three doors opening from it on one
side; on the other, one door opening into an apartment in which many of
the nurses and sisters slept, and had, I believe, their meals. In the
centre was a large kitchen table: bustling about this might be seen the
high-priestess of the room, Mrs. C----. Often as I have had occasion
to pass through this room I do not recollect ever finding her absent
from it or unoccupied. At this table she received the various matters
from the kitchen and stores of the sisterhood, which attendant sisters
or nurses were ever ready to take to the sick in any and every part of
these gigantic hospitals. It was a curious scene, and a close study
of it afforded a practical lesson in the working of true common-sense
benevolence.
“The floor on one side of the room was loaded with packages of all
kinds--stores of things for the internal and external consumption
of the patients; bales of shirts, socks, slippers, dressing-gowns,
flannel, heaps of every sort of article likely to be of use in
affording comfort and securing cleanliness.... It was one feature of
a bold attempt upon the part of extraneous benevolence to supply the
deficiencies of the various departments which as a matter of course
should have supplied all these things.
“In an adjoining room were held those councils over which Miss
Nightingale so ably presided, at which were discussed the measures
necessary to meet the daily-varying exigencies of the hospital. From
hence were given the orders which regulated the female staff working
under this most gifted head. This, too, was the office from which were
sent those many letters to the Government, to friends and supporters
at home, telling such awful tales of the sufferings of the sick and
wounded, their utter want of so many necessaries.”
We have in this description a glimpse into the beginning of the
Lady-in-Chief’s organising work. In the sisters’ quarters she was from
the first undisputed head, and by degrees the order and method which
she established there affected every other part of the hospital.
While she was battling with red-tapism in order to get access to stores
which lay unpacked in the vicinity of a hospital filled with poorly
fed, badly clothed, and suffering men because nobody seemed to know who
had the right to dispense them, sympathetic friends were keeping the
store in the Sisters’ Tower replenished. But it was impossible to keep
pace with the needs. The published letters sent home by the nursing
staff at this period all contain requests for invalid requisites
and clothing. The wounded were dying in scores for want of a little
stimulant to rouse their exhausted systems when they first arrived at
the hospitals, and men lying in clothing stiff with gore could not even
procure a change of garment. As the cold increased, the frost-bitten
patients, arriving from the trenches before Sebastopol, had not even
the luxury of a warm shirt. One of the nurses writing home said:
“Whenever a man opens his mouth with ‘Please, ma’am, I want to speak to
you,’ my heart sinks within me, for I feel sure it will end in flannel
shirts.”
The task of the Lady-in-Chief was to bring benevolent as well as
neglectful chaos into order. She had to inquire into the things most
urgently needed and advise her friends in England. All this was
unexpected work, for it will be remembered that Mr. Sidney Herbert, in
the letter inviting Miss Nightingale to go to Scutari, had dwelt on the
fact, as he believed it, that the hospitals were supplied with every
necessary. “Medical stores,” he had said, “had been sent out by the ton
weight.”
Alas! through mismanagement, these stores had been rotting on the shore
at Varna, instead of reaching Scutari, and much that had arrived was
packed beneath heavy ammunition and difficult to get at. The loss of
the _Prince_, laden with supplies, was a culminating disaster which
occurred on November 14th, about two weeks after Miss Nightingale’s
arrival.
The reticence of the hospital authorities prevented the true state of
affairs from reaching the British public. Indeed, the whole Service,
from commandant to orderly, conspired to say “All right,” when all was
wrong. One of the sisters has described how this policy worked in the
wards. An orderly officer took the rounds of the wards every night, to
see that all was in order. He was of course expected by the orderlies,
and the moment he raised the latch he received the word, “All right,
your honour,” and passed on. This was hospital inspection!
In excuse for the officers who were thus easily put off, it may be said
that the wards were filled with pestilence, and the air so polluted by
cholera and fever patients that it seemed courting death to enter.
For that reason orderlies already on the sick list were set to act
as nurses, and they often drank the brandy which it was their duty
to administer to the patients, in order to keep up their spirits,
or “drown their grief,” as they preferred to put it. Men in this
condition became very callous. Those stricken with cholera had their
sufferings terribly enhanced by the dread of being buried alive, and
used to beseech the orderlies not to send them to the dead-house until
quite sure that they had breathed their last. Utter collapse was the
last stage of Asiatic cholera, and the orderlies took little pains
to ascertain when the exact moment of dissolution came; consequently
numbers of still living men were hurried to the dead-house. One does
not wish to hold up to blame and execration the seeming inhumanity of
the orderlies. They were set to do work for which they were untrained
and often physically unfit, and were also demoralised by the shocking
condition of the wards. It was the system rather than individuals which
was to blame.
Into these insanitary, filthy, and pestilential wards came the
Lady-in-Chief, and she did not say “All right.” It was useless for
officialdom to “pooh-pooh”: she, fortunately, had Government authority.
What her quick eye saw was communicated to the Commander-in-Chief, Lord
Raglan, and to Mr. Sidney Herbert at the War Office, and brought in due
course the needed instructions for reform.
Not the least quality of the Lady-in-Chief was her influence over
men in authority. She was not dictatorial, she was not aggressive,
but she possessed the judgment which inspired confidence and the
knowledge which compelled respectful attention. Her letters to the War
Minister at home, and to Lord Raglan, the General in the field, were
models of clear and concise documents, devoid of grumbling, rancour,
or fidgety complaints, but they contained some appalling facts.
Unerringly she laid her finger on the loose joints of the commissariat
and hospital administration. By the enlightening aid of her letters
from Scutari the Home Government was enabled to pierce the haze which
surrounded the official accounts from the Bosphorus, and gradually the
hospital management was put on a footing which harmonised with the
Lady-in-Chief’s recommendations.
Lord William Paulet, who succeeded Major Sillery as Military Commandant
at Scutari shortly after Miss Nightingale’s arrival, soon learned
to place entire confidence in her judgment. “You will find her most
valuable, ... her counsels are admirable suggestions,” wrote the War
Minister to the new Commandant and Lord William proved the truth of
the statement. Lord Raglan in one of his dispatches to the Duke of
Newcastle said, “Lord William [Paulet] like Brown [Sir George Brown]
speaks loudly in praise of Miss Nightingale,” adding that he was
confident that she had “done great good.” As the weeks passed by, Lord
Raglan grew to consider the Lady-in-Chief a most efficient auxiliary
“general.”