please; I’m not done for so bad, but I can get away back and see!’ And many of these brave fellows, with a lump of towel wrung out in cold water, wrapped around their stumps, crawled to the rear of the fight, and, with shells bursting round them, and balls tearing up the sods at their feet, watched the progress of the battle. I tell you, as a solemn truth, that I took off the foot of an officer, Captain –, who insisted on being helped on his horse again, and declared that he could fight, now that his ‘foot was dressed.’25
Like the French, Pirogov attached great importance to the role of nurses in his hospitals. Nurses helped to sort the wounded and brought comfort to the men. They dispensed medicines, brought them tea or wine, wrote letters to their families, and gave spiritual support to the dying. The affection of the nurses won the hearts of many men, who often likened them to their mothers. ‘It is astonishing’, wrote Pirogov to his wife, ‘how the presence of a woman, nicely dressed, among the helpers in a hospital alleviates the distress of the men and relieves their suffering.’ Pirogov encouraged the initiatives of Russian noblewomen to recruit teams of nurses for the Crimea. The Grand Duchess Elena Pavlovna, the Tsar’s German-born sister-in-law,ao founded the Community of the Holy Cross shortly after news of the defeat at Inkerman. Its first group of thirty-four nurses followed Pirogov to the Crimea, arriving in Simferopol on 1 December after a long and difficult journey over a thousand kilometres of dirt roads from St Petersburg. Most of them were the daughters, wives or widows of military men, with some from families of merchants, priests and state officials of the minor nobility, though they themselves of course had no experience of the harsh conditions of a battle zone and many of them soon fell ill with typhus and the other epidemics that raged among the men. Pirogov divided the nurses into three groups: those who were to attend to the wounded and help in operations; those who dispensed medicines; and those in charge of the general housekeeping in the hospital. For Alexandra Stakhovich, who was assigned to the operating room, the first amputation was a personal trial, but she got through it, as she wrote to tell her family:
I was at two operations by Pirogov; we amputated an arm in one, and a leg in another; and by the grace of God I did not pass out, because in the first, where we cut off his arm, I had to hold the poor man’s back and then dress his wound. Of my boldness I am writing only so that you are reassured that I am not afraid of anything. If only you knew how gratifying it can be to help these suffering men – you cannot imagine how much the doctors appreciate our presence here.26
In the Crimea itself, women from various communities had organized themselves into teams of nurses and made their way to the dressing stations and field hospitals of the battlefields around Sevastopol. Among them was Dasha Sevastopolskaia, the girl who had cared for the wounded at the Alma, who worked with Pirogov in the operating theatre at the Assembly of Nobles. Another was Elizaveta Khlopotina, the wife of a battery commander wounded in the head at the Alma, who had followed her husband into battle and worked as a nurse in the dressing station at Kacha. Pirogov was full of admiration for the courage of these women, and battled hard against the objections of the military establishment, which was opposed to a female presence among the troops, for more teams of nurses to be organized. The influence of the Grand Duchess eventually told, and the Tsar agreed to recognize the work of the Community of the Holy Cross. Much of its early medical work in the Crimea was financed by the Grand Duchess, who had purchased medical supplies, including precious quinine, through family contacts in England and stored them in the basement of her home in the Mikhailovsky Palace in St Petersburg. But once it had the blessing of the Tsar, donations poured in from the Russian aristocracy, merchants, state officials and the Church. In January two more contingents of nurses organized by the Community arrived in Sevastopol, the second of them led by Ekaterina Bakunina, the daughter of the governor of St Petersburg and a cousin of the revolutionary anarchist Mikhail Bakunin (at that time imprisoned in the Peter and Paul Fortress in the Russian capital). Like many of the Russian upper class, she had spent her childhood summers in the Crimea, and was horrified by the invasion of her favourite holiday resort. ‘I could not imagine that this beautiful little corner of our great empire could be turned into a brutal theatre of war.’27
Florence Nightingale had a similar administrative drive to the Grand Duchess. Born into a family of successful industrialists in Derbyshire, she was better educated than most of the men in the British government, among whom her family had a number of connections, though because of her sex she was forced to limit her activities to the field of philanthropy. Inspired by her Christian faith, she entered nursing at the age of 25, much against the will of her family, working first as a social reformer among the poor and then in a Lutheran religious community at Kaiserswerth-am-Rhein near Dusseldorf in Germany, where she observed Pastor Theodor Fliedner and his deaconnesses care for the sick. Graduating from Kaiserswerth in 1851, Nightingale brought back its principles of nursing to the hospital in Harley Street, where she took over as superintendent in August 1853. It was these principles – basic cleanliness and good housekeeping on the wards – that Nightingale would take to the Crimea. There was nothing new in her ideas. The British medical officers in the Crimea were well aware of the benefits of hygiene and good order in the hospital. Their main problem in turning these commonsense ideals into active policies was a lack of manpower and resources – a problem Nightingale would only partly overcome.
In his capacity of Secretary at War, Herbert appointed Nightingale as superintendent of the Female Nursing Establishment of the English General Hospitals in Turkey, though not in the Crimea, where she had no authority until the spring of 1856, when the war was almost at an end. Nightingale’s position was precarious: officially she was subordinated to the military hierarchy, but Herbert gave her instructions to report to him on the failures of the Army Medical Department, and her whole career would depend on fighting tooth and nail against its bureaucracy, which was basically opposed to female nurses at or near the front. Nightingale was domineering by nature but she needed to assume a dictatorial control over her nurses if she was to implement her organizational changes and gain the respect of the military establishment. There was no recognized body of professional nurses from which she could draw her team in Turkey, so with the help of Mrs Herbert she had to establish one herself. Her selection criteria were ruthlessly functional: she favoured younger women from the lower classes, who she thought would buckle down to the hard work and conditions that lay ahead; and she took a group of nuns with experience of nursing to supervise their work, regarding them as a practical concession to the Irish Catholics who made up one- third of the army’s rank and file; but she rejected hundreds of applications from well-meaning middle-class women, whose sensitivities she feared would make them ‘less manageable’.
Nightingale and her team of thirty-eight nurses arrived in Scutari on 4 November 1854, just in time for the mass transport of the wounded from the battle of Balaklava. The French had already taken over the best buildings for their hospitals, and those left for the British were badly overcrowded and in a dreadful state. The wounded and the dying were lying all together with the sick and the diseased on beds and mattresses crammed together on the filthy floor. With so many men suffering from diarrhoea, the only toilet facilities were large wooden tubs standing in the wards and corridors. There was almost no water, the old pipes having broken down, and the heating system did not work. Within days of Nightingale’s arrival, the situation became much worse, as hundreds more wounded men from the battle of Inkerman flooded the hospital. The condition of these men was ‘truly deplorable’, as Walter Bellew, an assistant surgeon at the Hyder Pasha Hospital near Scutari, noted in his diary: ‘Many were landed dead, several died on the way to the hospitals, and the rest were all in a most pitiable condition; their clothes were begrimed with filth and alvine evacuations [from the abdomen], their hands and faces blackened with gunpowder & mud &c and their bodies literally alive with vermin.’ The men were dying at a rate of fifty to sixty every day: as soon as one man breathed his last he was sewn into his blanket and buried in a mass grave by the hospital while another patient took his bed. The nurses worked around the clock to feed and wash the men, give them medicines, and bring them comfort as they died. Many of the nurses were unable to cope with the strain and began drinking heavily, some of them complaining about the bossy manner of Miss Nightingale and about their menial work. They were sent home by Nightingale.28
By the end of December Nightingale had a second team of nurses at her disposal, and control of the
