Florence NIghtingale

When Florence Nightingale died, aged 90, in 1910, a female doctor signed the certificate that allowed the event to be recorded and registered. In 1820, the year of Nightingale's birth, there had been no female doctors, no systematic registration of births and deaths and no training institutions for nurses. The lack of any perceived connection between hygiene and disease ensured that mortality rates in crowded, poorly maintained hospitals were high.

Little change had taken place by the time that Nightingale, then in her mid-30s, arrived at Scutari in the Crimea in the autumn of 1854 to take charge of a vast, ramshackle barracks-turned-hospital into which wounded and dying soldiers were being brought at a rate that sometimes exceeded 700 in a single day. No anaesthetic was available for the surgical operations that were performed, unscreened, with saws. Bandages and sheets were in short supply. Following one of her daily visits to the Purveyor's Store, Nightingale reported: "No knives & forks, no spoons, no scissors (for cutting the men's hair, which is literally alive . . .), no basins, no towelling, no Chloride of Lime." Scutari hospital, poetically envisioned by one lady visitor as a night scene from Rembrandt, might more aptly have been compared to a season in hell.

Even Lytton Strachey, an acid-penned early critic of Nightingale's bossiness and what he privately decried as her "tiresome religiosity", admired her heroic reform. Mark Bostridge's masterly study enables us to appreciate the courage with which Nightingale had already defeated the conventional expectations of her parents and the neediness of a possessive sister, Parthenope, to pursue what was regarded by her family and her peers as a thoroughly unsuitable career.

Nightingale's scorn for the privileged life of her own class is nicely caught in her characterisation of the fashionable water cure (to which her family were addicted) as a remedy "for those indefinite diseases which a large income and unbounded leisure are so well calculated to produce". Placed, at an early age, in the power of an evangelical governess, Nightingale never doubted that she had been intended to serve God through active service - and also, whenever He fell behind, as his prompter. "O God, are you sure you are doing all you can for the Bosnians?" she once remonstrated with the Almighty. But an active life was also Nightingale's method of dealing with an aspect of herself that she found troubling and demeaning: from youth, she had been prone to falling into curious states of dreaming trance (a subject upon which Bostridge has disappointingly little to say, beyond the matter of factual record).

Following in the footsteps of Gillian Gill, whose excellent family biography, Nightingales, appeared in 2004, Bostridge draws heavily on a vast collection of unpublished family papers. He paints a vivid and absorbing portrait of the Nightingales' stately annual progress from Cromford in the industrial heartland of Derbyshire (July to October), to a faux-Elizabethan home in Hampshire (November to March), and on, to suit the diary of a sociable mother, to London. This was the crushingly dull regime from which Florence, assisted by sympathetic friends and unhampered by a husband - her best-known rejection was of Richard Monckton Milnes, a poet, politician and prodigious collector of pornography - managed to make good her escape. Returning to England as "the Heroine of the Crimea", she used personal illness (a disabling condition that Bostridge and his peers identify as brucellosis) to hold her family at bay so as to be free to focus on the business of sanitary and medical reform for which she has become justly celebrated.

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Bostridge writes illuminatingly and thoroughly about Florence's achievements as a reformer, his one flaw being (in Henry James's words, which he himself quotes) "not knowing where to stop". We really do not need to know that Florence, while superintending her first London hospital, purchased two dresses, one black, one grey, costing - respectively - pounds 1.12s and pounds 1.8s. Nevertheless, on the creation of the Nightingale myth, Bostridge proves enthralling. The Crimean war had no hero, so a heroic female filled the gap. Following Holman Hunt's recent success with his romantic portrayal of Christ as The Light of the World, images started to appear, in both words and pictures, of Nurse Nightingale also holding up a light to banish despair. Staffordshire pottery was cast in her angelic image; songs about a "sweet nightingale" were churned out, by 1856, at a rate of three a week. Comparisons were regularly drawn with Joan of Arc. It is to Nightingale's credit that she shunned the temptations of celebrity. Her last 50 years were devoted to sanitary reform, both in Britain and in India, where she helped to revolutionise female education and healthcare. Her energy, almost to the end, remained inexhaustible. In 1895, aged 75, her one worry was that her time was slipping away: "There is so much to live for." Few Victorian women lived so fully, and none, as Bostridge convincingly argues, with more devotion to the great cause of the public good.

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