Sisters in Mercy

More than 80 years ago, the British historian Lytton Strachey (1880-1932) made a name for himself by writing short biographies that debunked their subjects, but did so with elegance and wit. He combined the style of a minor Evelyn Waugh with the slant of a demolition expert like Robert Caro, whose studies of Robert Moses and Lyndon B. Johnson seem to have been carried on in the merry mood of a hanging judge.

Strachey’s best-known book, Eminent Victorians (1918), is a quartet of brilliant portraits of four famous people whose personalities intrigued him even as he was put off by their insistence on taking religion and moral principles seriously. In a brief preface he assigned them bland labels that give readers no hint of what to expect. Henry Edward Manning (1808-92), an Anglican convert who became Cardinal archbishop of Westminster, is identified simply as an ecclesiastic; Thomas Arnold (1795-1842), the legendary headmaster of Rugby, as an educational authority and General Charles George Gordon (1835-85), an eccentric soldier killed in the Sudan, as a man of adventure.

None of these designations is much help, but the phrase for Florence Nightingale (1820-1910), the only woman in the group, is the most opaque. She is described as a woman of action, which is like calling Joan of Arc an innovator. True, but not enlightening.

In the second half of the 19th century, Florence Nightingale was, after Queen Victoria, the most famous woman in the United Kingdom and perhaps in the world. When she was in her mid-30’s, the Crimean War made her a national heroine. For the next 50 years, she was a wealthy and reclusive semi-invalid, whose enormous prestige made her a powerhouse for social and political reform.

After 1857 she rarely left what she called my little cell. For the last 45 of her 90 years this was in fact a handsome townhouse not far from Hyde Park in London. Ample resources provided by her family guaranteed that she lived very comfortably, attended by a cook, several maids and a coachman. Not the style of a Dorothy Day or a Mother Teresa. But unlike them and most social reformers, Florence Nightingale actually managed to change for the better some harmful social structures.

The Crimean War, which made Nightingale a legend, is pretty much a blank page for most Americans, so a digression may be useful here. That was a conflict more pointlessly wasteful of human life than even most wars are. It began in 1854 in the Crimea, a peninsula extending into the Black Sea on Russia’s southern frontier. Some 300 miles across that sea was the capital of the Turks’ Ottoman Empire, the city then still known as Constantinople that is today’s Istanbul.

The belligerents naturally ascribed lofty motives to themselves, but they really fought to decide which of the European powers would control the eastern Mediterranean. Tsar Nicholas I had mobilized troops to back up his demand that he be allowed to look after the welfare of the Orthodox Christians living in what was left of the Ottoman Empire. The Ottoman sultan in Constantinople resisted this claim. To make sure their own routes to the Far East were kept open, France and Great Britain sided with the Turks and sent regiments to the Crimea where the battles took place.

After about a year and a half of fighting, the tsar asked for peace terms in February 1856 and the war ended a month later. By that time, each side had lost approximately 250,000 men. Military operations had been so badly mismanaged that many of these deaths were due to sub-zero weather, along with sickness and a lack of supplies and medical resources.

Florence Nightingale once noted that among the British troops, 73 percent in eight regiments died from disease alonefrom typhus, cholera or dysentery. She saw all that death and misery close up because she supervised the first women ever to serve as nurses in a British military hospital. In October 1854, she led 38 of these women, all of them volunteers, to nurse the wounded who had been evacuated from the Crimea to Scutari, which was, to use Strachey’s term, a suburb just across the Bosporous from Constantinople.

In Scutari, the wounded were housed in a wretched barracks that had been converted to a hospital more likely to kill than to cure. In November 1854, Nightingale wrote to a physician friend of hers in London: We have now four miles of bedsand not 18 inches apart.

Amid this stinking squalor, the poised and indomitable Miss Nightingale went about organizing everything from the kitchens to the sanitary arrangements to the medical care. That was to be, however, her last extensive experience of hands-on nursing. When she returned to England in 1856, she began working behind the scenes as the generalissimo of a corps of high-minded reformers who followed her directionsor were sharply rebuked when they didn’t. She succeeded partly because of her intelligence and forceful personality and partly because as a member of a rich and well-positioned family she had direct lines of communication for a quarter-century with leaders of British government from prime ministers on down.

One of her first campaigns was for the overhauling of the army’s medical services. After that, although she never visited India, she prodded the British government into setting up programs for improving sanitary conditions in its own barracks there, and then in the Indian villages.

She founded and organized a nursing school and wrote in Notes on Nursing (1860) a little book that became a best-seller and is still in print. She was involved in the effort to reform the British workhouses that Dickens indicted in Oliver Twist. She compiled masses of statistical data and wrote analytic reports for the organization of health care at home and in the colonies. In her drawing room, she received big-wigs from around the world and carried on a network of correspondence.

Even in her old age, as Strachey said, When hospitals were to be built, when schemes of sanitary reform were in agitation, when wars broke out, she was still the adviser of all Europe. Compared with Florence Nightingale’s ability to rattle and influence the system, Hillary Clinton seems so far to have been hardly more effective than the wife of a village mayor opening the annual flower show.

Nowadays, however, although most adult Americans know the name of Florence Nightingale, they do not know much more about her. They are vaguely aware that she had something to do with the reform of nursing, but they don’t know that she recommended that the sick be cared for at home rather than be sent to a hospital to grow worse.

If they are senior citizensmake that very seniorthey may also remember from their school days that Longfellow described Florence Nightingale in some rather leaden verses as a lady with a lamp passing through the wards of a military hospital as through the glimmering gloom. (The young wounded men in the Scutari barracks were the ones who first gave the lady that title, and they didn’t mean it as poetry. After eight in the evening when orderlies took over from the female nurses, Miss Nightingale allowed no woman but herself to patrol the wards.)

Yet if Florence Nightingale has faded from the popular imagination, she continues to attract the attention of scholars. In fact, in a first-rate essay-review in the March 8 issue of The New York Review of Books, Helen Epstein, an expert on public health, notes what she calls a revival of Nightingale studies.

Among fairly recent books on Florence Nightingale are two from American women with distinguished professional careers of their own. Both were published in 1999. One is a full-scale biography by Barbara Montgomery Dossey, Florence Nightingale: Mystic, Visionary, Healer. The other is Mary C. Sullivan’s The Friendship of Florence Nightingale and Mary Clare Moore. This is a scrupulously edited collection of Nightingale’s correspondence with a Sister of Mercy who accompanied her to the Crimea. Their friendship continued after they returned to England and ended only when the nun, the Irish-born Mary Clare Moore, died in London in 1874 at the age of 60.

Ms. Dossey’s book, a handsomely produced over-size volume, is highly readable although too hefty to be conveniently balanced by subway riders. It not only provides a full-length and sympathetic portrait of Florence Nightingale, but with the help of 250 illustrations, many of them photographs, it vividly evokes the upper-class world of 19th-century England. That high-Victorian universe teemed with persons and events that Barbara Dossey identifies for grateful U.S. readers who have no idea who Palmerston was, much less when he served as prime minister, or where the port of Balaklava is, much less what went on there in October 1854. (It was the site that month of the battle that Tennyson described in The Charge of the Light Brigade.)

Mary C. Sullivan’s monograph enlarges a detail from the broad canvas and surrounds the letters it reprints with a most satisfying historical commentary that says a great deal not only about Florence Nightingale but also about the Roman Catholic Church in Great Britain at that time.

Despite their differences in scope, these two books have an important strength in common. They both pay instructive attention to Florence Nightingale’s rather heterodox Christian faithto the religious beliefs that powerfully energized her life but were dismissed by Lytton Strachey with ironic amusement.

There is also a certain likeness between the two authors, as one can see from a capsule summary of their careers. Each has a particular reason for an interest in Florence Nightingale and special qualifications for following up that interest. Barbara Dossey is not only a nurse herself, but also a pioneer in what is called holistic nursing. Mary Sullivan is not only a Sister of Mercy herself, but also a professor of language and literature. It is neither too cute nor too strained to say that these two writers share with Florence Nightingale and Mary Clare Moore a dedication to works of mercy, corporal or spiritual. The four are, so to say, sisters in mercy.

Barbara Dossey received a B.S. in nursing from Baylor University in 1965 and a master’s degree from Texas Women’s University 10 years later. Nowadays she and her husband, Larry Dossey, a physician, live in Santa Fe, N.M. As writers, lecturers and editors they are leaders in the promotion of alternative therapies in the care of the sick.

In Attending to Holistic Care, an article they contributed to the August 1998 issue of the American Journal of Nursing, the Dosseys argued briskly and persuasively that physicians and nurses should not concentrate exclusively on the body, the sick organs, and the deranged biochemistry of their patients. They should follow Florence Nightingale’s example and also take account of the psychological and spiritual dimensions of these patients’ lives.

The National Institutes of Health’s Office of Alternative Medicine says this consideration of the whole person, including physical, mental, emotional, and spiritual aspects, is what is meant by the holistic approach. As Ms. Dossey describes it, that approach sounds like the considerate and perceptive care that patients would like to think all good nurses practice. I want to emphasize, she has said, that holistic nursing is not a speciality in nursing, as I so often hear, but is the essence of nursing....

Although there are already plenty of books about Florence Nightingale, Ms. Dossey thought there was room for another. This would be a book giving adequate attention to the religious convictions that shaped Florence’s ideal of the nursing vocation and made her a forerunner of the holistic nursing concept.

Mary C. Sullivan also appreciates Florence Nightingale’s spirituality, and she too has something distinctive to add to the Nightingale story. She is an accomplished scholar who entered the Rochester, N.Y., regional community of the Sisters of Mercy in 1950. After teaching for some years at both elementary and high school levels, she did graduate studies at the University of Notre Dame. In 1960 she received her doctorate with a dissertation on aspects of Joseph Conrad’s style.

Since then she has had one of those careers that can be said to have broken a mold and, however it is described, could hardly have been imagined for sisters before the Second Vatican Council. In 1969 she joined the faculty of the Rochester Institute of Technology, a private, nondenominational school that offers its 15,000 students some 200 majors in engineering, technical and business fields. Mary Sullivan is currently a professor of language and literature in the institute’s College of Liberal Arts, which provides a seasoning of the humanities for those thousands of young men and women. She served as dean of this college from 1977 to 1987 and chaired R.I.T.’s academic senate from 1996 to 1999.

In writing a commentary for the Nightingale-Moore correspondence, Mary Sullivan chose, she says, not to use such titles as Sister and not to call sisters by their surnames only. That may be a hint to reviewers, and she herself will be referred to here either as Professor Sullivan or by her full name.

With her background, Mary Sullivan is ideally equipped to examine the letters she has so skillfully edited. Like all the great Victorians, Florence Nightingale was a prodigious letter writer. Some commentators have thought that her chronic illness was either a product of neurosis or a pretext designed to ward off inopportune visitors. Barbara Dossey is loyally convinced that during the Crimean War Florence did in fact contract a fever that periodically prostrated her for the rest of her life. Whatever the case, she maintained her crusades and contacts through a torrent of letters from her little cell. All my business is writing, she said in 1865.

About 14,000 of her letters have survived. Some have been published; the rest remain in archives. The 52 letters that Professor Sullivan has edited are preserved in the archives of a convent of the Sisters of Mercy in a London neighborhood called Bermondsey. This house, opened in 1839, was the first establishment of the Sisters of Mercy in England.

Forty-seven of these letters were addressed to Mother Mary Clare Moore, the first superior at Bermondsey. She and Florence Nightingale were first brought together in the autumn of 1854. One-third of Britain’s troops in the Crimea, or about 10,000, were Irish Catholics. For this reason Bishop Thomas Grant of Southwark suggested to the secretary of war, Sidney Herbert (1810-1861), one of Florence’s great supporters, that some Roman Catholic sisters be included among the volunteers who were being recruited by Miss Nightingale for nursing service.

So it happened that 10 of that first group of 38 who sailed from England to Scutari were sisters. Five of these, and easily the most experienced, were from the Mercy convent in Bermondsey, with Mary Clare Moore at their head. Two months later, 15 Sisters of Mercy from Ireland also joined the volunteers.

Generally speaking, Florence Nightingale thought better of men than of women, because men were more sympathetic to her work and more of a help. But for Mary Clare Moore, whom she always addressed as Dearest Revd. Mother, she had only praise.

This was not because she was indulgent toward nuns. During the months in the Crimea, she often skirmished with the superior of the sisters from Ireland, Mother Mary Francis Bridgeman, whom Florence referred to on occasion as Reverend Mother Brickbat.

Mother Mary Clare, however, was a colleague, not an adversary. To one of her great friends and pen pals, Benjamin Jowett (1817-1893), the Oxford Greek scholar and liberal Anglican clergyman, Florence wrote in 1862:

The most religious mind I ever knew was that of a R. Catholic Revd. Mother who was so good as to go out with me to the Crimea. After we came home I found her one day cleaning out a gutter with her own hands. I know she did it on no theory. I think she had much better employed a man to do it, but that is what I mean by a true idea of religious life, and she the only R. Catholic too I have ever known who never tried to convert me.

Not that Reverend Mother could have expected success if she had tried. Florence Nightingale was brought up as an Anglican, and Barbara Dossey says she never seriously considered leaving the Church of England. On the other hand, as Ms. Dossey also notes, Florence was disenchanted with the church because she thought it neglected the poor.

In any case, whether or not she was a potential convert, Florence always thought for herself, and until she was very old her mind was never idling in neutral. Ms. Dossey tracks very fully that mind’s twofold journeyin the pursuit of learning and in a search for union with God.

Florence’s father was a gentleman of leisure who had inherited great wealth. The Dossey book has photographs of the family’s two main housestheir winter residence, a massive pile set within a 4,000-acre estate called Embley Park, and a summer home only slightly less grand in Derbyshire. From these commodious bases there were frequent trips to London and the continent.

Like all upper-class women of her day, Florence Nightingale was educated at home, but her father supplemented the governesses’ lessons by teaching her Latin and Greek. In later years she would, on her own initiative and with vast enthusiasm, study mathematics, statistics and theology. She also made and had privately published copious anthologies of the ideas she had gathered and developed from these studies. She hoped Britain’s unchurched working classes would find these volumes nourishing, but they preferred less strenuous uses of what leisure they had.

Florence Nightingale’s zest for learning was, however, only part of her inner life. In an account of herself that she wrote when she was 31, she said: God has always led me of Himself...the first idea I can recollect when I was a child was a desire to nurse the sick...I thought God had called me to serve Him in that way.

Her parents naturally thought otherwise. The disheveled and drunken Sairy Gamp of Dickens’s Martin Chuzzlewitt was a pretty accurate image of nurses in the England of the 1840’s. But Florence knew that was not the only possible type. She wanted, she said, to devote herself to works of charity in hospitals and elsewhere as Catholic sisters do.

She began by caring for the sick in her own extended family. Then in 1851 she spent three months studying nursing at an admirable German hospital, the Institute of Deaconesses at Kaiserwerth on the Rhine. She also observed a hospital run by the Sisters of Charity in Paris.

In August 1853 she took up her first full-time nursing position when she became in London the superintendent of what was grandly called the Institution for the Care of Sick Gentlewomen. A little more than a year later she was off to the Crimea. When she returned to England in 1856 she began those projects for social reform that would make her the adviser of all Europeand parts of the Americas too.

No doubt, most of her letters dealt with these projects. For 20 years, she wrote almost daily to a certain Dr. John Sutherland who had headed a commission on sanitation that went to Scutari in 1855. Ms. Dossey and Professor Sullivan reprint in whole or in part letters of quite another sortletters in which Florence Nightingale’s comments on her conversation with God are sent up like bursts of light.

Barbara Dossey quotes an early letter that is particularly striking. In September 1846, when Florence was looking around for some way of developing nursing skills, she wrote to her aunt, Hannah Nicolson: I never pray for anything temporal...but when each morning comes, I kneel down before the Rising Sun, & only say, Behold the handmaid of the Lordgive me this day my work to dono, not my work, but thine.

Three years later, she refused a marriage proposal from Richard Mockton Miles, a wealthy and cultivated suitor who had been hanging around for seven years. Marriage to him, she coolly observed in some notes made only for herself, would satisfy the intellectual and passionate side of her nature, but not the moral and active side. God, she added, has clearly marked out some to be single women as He has others to be wives, and has organized them accordingly for their vocation.

During a trip to Greece in 1850, she consolidated her understanding of her vocation by making on May 12, her 30th birthday, some promises that she considered to be vows of obedience and celibacy.

Ms. Dossey doesn’t explain how Florence interpreted this vow of obedience. She may only have meant that she would fulfill whatever she thought to be God’s will for her. That, at least, was what she aimed to do. In a letter she wrote to Mother Clare Moore on Christmas Eve 1863, she recalled that St. Catherine of Siena had not lived to see the reformation of the papacy that she wanted; And I shall not see the reformation of the Army. But I can truly say that, whatever I have known our Lord to desire of me, I have never refused Him (knowingly) anything.

Florence Nightingale asked that many of her letters to Mother Clare be burned. (They may have contained too much snappy criticism of politicians and some bishops.) She in turn, burned many of Mother Clare’s letters, but only after treasuring them for a while. On Dec. 15, 1863, she tells Mother Clare that she is visiting her brother-in-law but has with her all your dear letters. And you cannot think how much they have encouraged me. They are almost the only earthly encouragement I have.

In fact, their exchanges encouraged them both, for, as Mary Sullivan points out, Florence’s friendship and solicitude were an enduring support in Clare Moore’s religious life.

The letters preserved in the Bermondsey convent and reprinted in Professor Sullivan’s admirable book are a cozy blend of down-to-earth chat and musings on higher things. A single short note may touch both keys. Writing a few lines on Jan. 20, 1864, Florence says she is sending six bottles of Port wine to speed the recovery of a Mercy sister who has had typhus. She regrets that she hasn’t time to comment in detail about the books on St. Teresa of Avila and St. Francis Xavier that Reverend Mother had sent her.

She is not, however, about to return these books, although in a long letter a few days earlier she had said she would: I am going to send you back S. Francis Xavier. His is a life I always like to study as well as those of all the early Jesuit fathers. But how much they did& how little I do. You see I keep St. Teresa still.

Mary Sullivan is surely right in concluding that Mother Mary Clare contributed to Florence Nightingale’s spiritual development. In a way, she was a successor to a certain Madre Santa Colomba, the superior of the Convent Trinità de Monti in Rome, from whom Florence learned methods of meditation during a 10-day retreat in 1848.

Florence used to refer to this nun who died in 1860 as My Madre. Mother Mary Clare discreetly continued that spiritual direction by sharing biographies of saints and treatises on prayer with Florence and discussing the reflections stirred by these readings.

Barbara Dossey in her thoroughly satisfying book emphasizes the importance in Florence Nightingale’s life of a mystic impulse. When she was interviewed for the January 1999 issue of a journal called Alternative Therapies, Ms. Dossey, speaking of Nightingale, said: The more I researched her life, the more clearly I saw that she indeed appeared to be a genuine 19th-century mystic. Her life journey was similar to that of St. Catherine of Siena, St. Catherine of Genoa and Teresa of Avila. That’s when I began to say: Maybe this is what I can add.’

That is not all she has added. When the 73rd General Episcopal Church Convention met in Denver last July, it approved a resolution to commemorate Florence Nightingale by placing her name on the list of Lesser Feasts and Fasts in the church’s Book of Common Prayer. Three of the five documents that argued the case for that resolution were written by Barbara Dossey.

Not long ago, Ms. Dossey’s press representative was asked why her client had taken on that extra work, since she is not herself a member of the Episcopal Church. Because, she said with considerable warmth, Florence deserves it!