The Book of the Dead

because that will at least secure me from the evil of dreaming. But would it? I could be satisfied to spend a life with him in combining our different powers in some great object. I could not satisfy this nature by spending a life with him in making society and arranging domestic things.

By early 1849 Mr. Monckton Milnes decided he needed a definite answer. She said no. Her parents were furious and Florence tortured herself with remorse:

I know that if I were to see him again… the very thought of doing so quite overcomes me. I know that since I refused him not one day has passed without my thinking of him, that life is desolate without his sympathy.

By the end of the year, she was in a state of near mental collapse, and friends of the family offered to take her on a trip through Greece and Egypt. She would turn thirty in 1850 and was determined to make it a new beginning.

To-day I am 30–the age Christ began his mission. Now no more childish things. No more love. No more marriage. Now Lord let me think only of Thy Will, what Thou willest me to do.

But her diary of the year is anything but a peaceful acceptance of God’s will. She was obviously still being assailed by “the evil of dreaming”:

March 15: God has delivered me from the greatest offence and the constant murder of all my thoughts.

March 21: Left the boat ringing our hands. Such a delicious hour in the gardens of Heliopolis—where Plato walked and Moses prayed. Undisturbed by my great enemy.

June 7: But this long moral death, this failure of all attempts to cure. I think I have never been so bad as this last week.

June 12: To Megara! Alas it matters little where I go—sold as I am to the enemy—Whether in London or Athens, it is all alike to me.

June 17: After a sleepless night physically and morally ill and broken down, a slave—glad to leave Athens. I have no wish on earth but sleep.

June 18: I had no wish, no enemy, I longed but for sleep. My enemy is too strong for me, everything has been tried. All, all is vain.

June 21: Two delightful days at Corfu. My enemy let me go. I lived again, in both body and mind. Oh! today, how lovely it was, how poetic—and I was free

June 29: Four long days of absolute slavery.

June 30: I cannot write a letter, can do nothing.

July 1: I lay in bed at night and called upon God to save me. My soul spoke to His & I was comforted.

These enigmatic entries read very like the tortured spiritual travails of the Christian mystics she had studied: St. Teresa of Avila or St. John of the Cross. Like them, she often refers to God as her “husband.” There is more here than just religious ecstasy. No one can be fully sure what the “dreaming” that so disturbed her at night was, but it seems most likely to have been sexual fantasy, possibly even masturbation. In rejecting Milnes, she was rejecting marriage itself, and, by extension, sex. She makes it plain that she was physically attracted to Milnes and we will never know what passed between them privately. He was certainly not a sexual innocent: After he died it was revealed that he had one of the largest collections of erotic literature ever assembled, with a particular fondness for the works of the Marquis de Sade. Her embrace of mysticism, of marriage with God, may well have offered her a way of sublimating some of this energy. But by the end of the year, she was convinced that the solution to her “dreaming” was to keep her hands and her mind busy.

In 1851 she went to Kaiserswerth Hospital in Germany to take a basic three-month course in nursing with the Institute for Protestant Deaconesses. This was a revelation to her: “The nursing there was nil, the hygiene horrible,” she later wrote, “But never have I met with a higher tone, a purer devotion than there. There was no neglect.” She followed this with a stint with the Sisters of Mercy near Paris, but on her return home, plunged into another depression in which she hardly stirred from her bed. The family doctor persuaded her parents that moving her out of the house would be good for Florence’s “nerves” and in 1853 she was appointed superintendent of the Institution for Sick Gentlewomen in Distressed Circumstances at Harley Street in London. An outbreak of cholera in nearby Soho allowed her to demonstrate for the first time her flair for administration and unflappability under pressure as she helped local hospitals manage the huge flood of patients.

Toward the end of 1853 Britain became embroiled in the Crimea, siding with France to support Turkey against Russia. Newspaper reports alerted the British public to the poor standards of care given to the troops evacuated from the Crimean peninsula to Scutari in Turkey. Sidney Herbert, a close friend of Florence’s, was appointed secretary of state for war and asked her if she would lead a party of British nurses to the war zone. In November 1854 she arrived at the Barrack Hospital with thirty-eight nurses and proceeded to reorganize it from top to bottom. Fresh air, cleanliness, good diet, and exercise were her principles, and in the midst of the chaos and the stench, her nurses were impeccably turned out and records were kept with a military precision. Florence set an inspiring example, covering four miles each evening walking through the wards, helping injured soldiers to write letters home, and checking on their welfare. Although she was always more of a nursing theoretician than an actual emptier of bedpans or bandager of wounds, these nocturnal walks are what gave rise to her legend among the troops and the public back home.

Her first few months at Scutari were disastrous. Death rates at the hospital soared and even nurses and doctors succumbed to disease. The death rate began to drop only after the sewage system had been overhauled and the source of infection was removed. Nightingale didn’t make this connection herself until the war had ended. She returned to London in 1856 a heroine and, despite being traumatized and ill, threw all her energy behind getting a Royal Commission on army health established. She met Queen Victoria and Prince Albert to press her case. Afterward the queen remarked, “What a head! If only we could have her at the War Office.” Her efforts paid off and Sidney Herbert was appointed to chair the commission.

In 1858 Florence submitted her evidence to the commission in the form of an 830-page report, Notes on Matters Affecting the Health, Efficiency, and Hospital Administration of the British Army. Appended to it was what she called her “coxcomb” of statistical diagrams, devised with the help of William Farr, head of the General Registry Office. This included her famous “polar area diagram,” a kind of pie chart that has since become a standard of statistical graphics. What the figures and diagrams showed came as a profound shock. During the first awful winter of the war, soldiers had been three times more likely to die in Scutari than they had been in the basic field hospitals at the front. What had killed most of the soldiers in the Crimea wasn’t their wounds, but infections caused by poor sanitary conditions in the wards. Scutari, as one historian put it, was more of a death camp than a hospital. Florence was mortified. If she had overhauled the sewage and general hygiene sooner, thousands of soldiers’ lives might have been saved. All the hand-holding and ward walking had been beside the point. In an agony of trepidation she put forward her report, fully expecting “the Lady of the Lamp” to be exposed as a fraud: “The lamp shows me only my utter shipwreck.” The report was never published. Although its conclusions framed British policy on hospital hygiene and nursing practice for generations to come, the government decided that to present the full weight of the evidence would be too damaging to national morale. This was too late to save Florence. The stress of preparing the figures, the weight of personal blame she felt, and the symptoms of her worsening brucellosis led to a physical collapse, and she came close to death. At the age of thirty-seven she took to her bed and never really emerged again.

Nonetheless, her fame and her influence grew steadily. From her bed in Mayfair, insulated from the disruptions of her family, she directed the course of health, hygiene, and sanitation all over the world. A public collection in her name raised ?45,000 (equivalent to more than $1 million in today’s money) and was used to set up the Nightingale School of Nursing at St. Thomas’s Hospital in London. She became the first woman to be made a Fellow of the Royal Statistical Society (her experience in Scutari had taught her that “statistics were the measure of God’s purpose”). In 1860 she published Notes on Nursing: What It Is, and What It Is Not, a book that made her “fresh air and cleanliness” gospel available to everyone. Although she rarely ventured out, she