Hell Hath No Fury (35 page)

Inglis's life was devoted to her twin passions, suffrage and surgery. Her name lives on in the Elsie Inglis Unit of the Scottish Women's Hospitals, a children's home in Yugoslavia, and a wing of the Royal Infirmary in Edinburgh.

Reference: Margo Lawrence,
Shadow of Swords: A Biography of Elsie Inglis,
1971.

KEIL, LILLIAN KINKELA

US Military Flight Nurse, World War II and Korea, One of the Most Highly Decorated Women in US Military History, b. 1916, d. 2005

During her service, Lillian Keil was awarded the impressive total of nineteen medals and ribbons, including four Air Medals, two Presidential Unit Citations, a World War II Victory Medal, four World War II battle stars, and a Korean Service Medal with seven battle stars.

She was born in Arcata, California and, after her father left the family home, was brought up by her mother in a convent where she worked as a cleaner. Following high school, she enrolled in a nursing program at St. Mary's Hospital in San Francisco. She later became a flight attendant with United Airlines, which then required its stewardesses to be registered nurses.

In World War II she enlisted as a flight nurse with the US Army Air Corps, attending wounded soldiers on casualty evacuation flights from combat zones to hospitals in the rear areas. In that war, and later in Korea, Keil took part in eleven major campaigns, including Normandy and the Battle of the Bulge (both 1944) and the Inch'on landings in Korea (1950). It is estimated that in these conflicts Keil tended some ten thousand US troops. In the air she was careful to remain well groomed and made up, to raise the morale of her wounded charges, and to remind them of girlfriends back at home.

A 1954 Hollywood movie,
Flight Nurse,
starring Forrest Tucker and Joan Leslie, was in part based on Keil's wartime experiences. Seven years later Keil appeared on the television show
This Is Your Life,
generating a flood of correspondence from veterans for whom she had cared in northwest Europe and Korea.

Reference: Barbara Tomblin,
G. I. Nightingales: The Army Nurse Corps in World War II,
1996.

NIGHTINGALE, FLORENCE

British Nurse and Administrator, b. 1820, d. 1910

A pioneer of modern nursing and hospital-sanitation reform, Florence Nightingale was also a trailblazer in the use of statistics to demonstrate that social phenomena can be objectively measured and subjected to mathematical analysis. Known to British troops in the Crimea as “the Lady with the Hammer” for her prowess in breaking into a locked cupboard full of medical supplies, she was equally fearless whether fighting wartime dysentery and disease or mounting pitched battles with the boneheaded, reactionary, and misogynistic military commanders who stood in her way.

Nightingale was the second daughter of wealthy and well-connected parents who were traveling in Italy when she was born and named her after the city of her birth (her sister Parthenope was named after the ancient city that is now Naples). Florence was very close to her father, William, who taught her classics and mathematics and encouraged her to study modern languages.

At the age of seventeen Nightingale underwent the first of a number of religious experiences calling her to nursing, a prospect that dismayed her mother, who was determined that Florence make a good marriage. Active involvement in Poor Law reform hardened Nightingale's resolve. In 1850, while traveling in Europe, she visited an innovative hospital at Kaiserswerth, Germany, which was staffed by an order of Lutheran deaconesses. She also received encouragement from Elizabeth Blackwell, who had been the first woman to earn a medical degree in the United States and who worked for a time in London at St. Bartholomew's Hospital.

Nightingale's nursing career began in earnest in 1851, the year when, to the distress of her mother, she rejected a proposal of marriage from the poet and politician Richard Monckton Milnes, the first Baron Houghton. Overcoming the strenuous objections of her family, she proceeded to Kaiserswerth, where she received four months' training as a deaconess. This deliberate choice of the single life in an era when a “spinster” was widely derided and despised was highly controversial, but guaranteed Nightingale her lifelong independence.

In August 1853, thanks to a five-hundred-pound annual allowance from her father, Nightingale was able to assume the post of unpaid superintendent at the Institute for the Care of Sick Gentlewomen in London, where she gained her first experience of day-to-day administration. In 1854 she was recruited by an old friend, Sidney Herbert, secretary of war, to train and lead a contingent of thirty-eight volunteer nurses to the Crimea, where Britain, France, and Turkey were at war with imperial Russia. Reports in the
Times
of London filed by its correspondent in the field, William Howard Russell, had been highly critical of the British army's treatment of its wounded.

The British expeditionary force had arrived on the Crimean Peninsula singularly ill equipped to deal with the scourge of cholera then raging in southern Europe. At the vast military hospital in Scutari, on the Asian shore of the Bosporus, men were kept in filthy conditions without blankets or decent food, and slept in uniforms “stiff with dirt and gore.” Wounds accounted for only one death in six, and the overall death rate from disease was running at 60 percent.

Nightingale arrived at Scutari (modern-day Usküdar, a suburb of Istanbul) on November 4, 1854, on the eve of the Battle of Inkerman. Herbert had promised her “unlimited power of drawing on the government for whatever you think requisite for the success of your mission.” However, she had first to overcome the hostility of the army's male medical staff, who regarded her arrival as a slur on their own professionalism. Nevertheless, by the end of 1854, Nightingale had brought a degree of order to the chaos at Scutari. Another forty-six nurses had arrived from England, kitchens and laundries had been established, and the wives and children of the soldiers at Scutari were cared for.

Nightingale regularly worked a twenty-hour day and was the only woman permitted to enter the wards after eight at night, when the nurses were replaced by orderlies. The Grecian lamp she carried on her nightly rounds at Scutari earned her enduring fame as a Victorian icon, when the
Times
war correspondent adapted the troops' admiring nickname of “the Lady with the Hammer” into something more feminine and acceptable to readers back home, “the Lady with the Lamp.” More practically, it also provided illumination for her meticulous updating of medical records. This painstaking work led to her invention of the “coxcomb,” a graphic depiction of changing patient outcomes similar to a modern pie chart, which was to become a vital tool in her subsequent campaign for hospital reform.

Early in 1855 the hospital at Scutari suffered a setback when its defective sewage system, which Nightingale had not tackled, led to a renewed outbreak of cholera and typhus fever. To these were added frostbite and dysentery contracted in the trenches before Sebastopol. In February 1855 the death rate was still an alarming 42 percent. The War Office intervened to order the immediate implementation of sanitary reforms, and within four months the death rate fell to 2 percent.

In May 1855, Nightingale fell ill with “Crimean fever” while visiting hospitals on the front line. She returned to the Crimean Peninsula in March 1856 and remained there until August, when she sailed to England to be received as a national heroine. She compiled an exhaustive and confidential report based on her experience in the Crimea, and in 1858 published
Notes on Matters Affecting the Health, Efficiency and Hospital Administration in the British Army.
That year she gave evidence to the Royal Commission on the Army, which led to the formation in 1859 of the Army Medical College at Chatham and in 1861 to an army hospital in Woolwich. As a woman, Nightingale could not sit on the commission, but she wrote its one-thousand-page report, compiled its exhaustive tables of statistics, and was closely involved in the implementation of its findings. She subsequently developed a Model Hospital Statistics Form, enabling hospitals to collect and generate consistent data. She had been elected a fellow of the Royal Statistics Society in 1858 and in 1874 became an honorary member of the American Statistical Association.

In 1860 she used the forty-five thousand pounds raised by public subscription for the Nightingale Fund to establish a training school for nurses at St. Thomas's Hospital (now part of King's College, London). The same year saw the publication of
Notes on Nursing,
which remains a classic introduction to the field. But although Nightingale urged the removal of restrictions that prevented women from pursuing professional careers, she remained convinced that it was more important to have better-trained nurses than women doctors and withheld her support from feminist campaigners such as Elizabeth Garrett Anderson, the first woman in England to qualify as a doctor.

Following the Indian Mutiny of 1857, Nightingale became a political expert on imperial India, writing influential papers on the improvement of health and sanitation on the subcontinent. In all these endeavors she preferred to work behind the scenes, living the reclusive life of an invalid. This was possibly caused by her exertions in the Crimea or the result of a psychosomatic condition that may also have triggered her early religious experiences. From 1896 she was bedridden.

In her old age Nightingale received many honors, and in 1907 she became the first woman to be awarded the Order of Merit. She died in 1910 at the age of ninety and was buried, according to her wishes, at St. Margaret's, East Wellow, near her parents' home in Hampshire. After the queen herself, she was probably the best-known woman of the Victorian era.

Reference: Florence Nightingale,
Notes on Nursing,
2007.

SEACOLE, MARY “MOTHER”

Jamaican Nurse and Writer, b. 1805, d. 1881

A heroine of today's multicultural historians, Mary Seacole was one of the most remarkable women of the nineteenth century, an intrepid traveler, a pioneer of military nursing, and a beacon of cheerful self-reliance. She once observed, “Whenever the need arises—on whatever distant shore—I ask no higher or greater privilege than to minister to it.”

She was born in Kingston, Jamaica, the daughter of a Scottish officer and a free black woman who ran a boardinghouse for British officers. Being of mixed race, Seacole was technically free but enjoyed few civil rights: she could not vote, hold public office, or enter a profession.

In her early years Seacole's love of travel resulted in two trips to England, where she was the butt of racial taunts that prompted her to protest, “I am only a little brown—a few shades duskier than the brunettes whom you all admire so much.” She was briefly married to Edwin Horatio Seacole (one of Admiral Nelson's godchildren) but after his death resolved to live an independent life as a hotel keeper and nurse, acquiring much practical experience during the cholera and yellow fever epidemics that were a regular feature of life in Jamaica. During a yellow fever outbreak, Seacole supervised the nursing at Up Park Military Camp. She also made a postmortem dissection of an infant cholera victim in an attempt to discover more about the disease.

After the loss of her mother, Seacole joined her brother in New Granada (now Colombia and Panama), which was a magnet for adventurers and gold prospectors. Here the resourceful Seacole combined work as a hotelier with prospecting and nursing.

After the outbreak of the Crimean War in 1854, Seacole traveled to England and badgered the War Office to send her to the theater of war as a nurse. She was cold-shouldered by the military and by Elizabeth Herbert, the wife of the secretary of war, who was recruiting nurses. Undaunted, Seacole made the three-thousand-mile journey to the Crimea as a sutler, supplying provisions to the troops, and established the British Hotel at Spring Hill, two miles from Balaklava, to provide a “mess table and comfortable quarters for sick and convalescent officers.”

Both officers and other ranks found hospitality and a warm welcome at Spring Hill. The French chef Alexis Soyer, who was to revolutionize army catering in the Crimea, praised Seacole's “soups and dainties.” She also provided sound medical treatment based on traditional Caribbean remedies to combat diarrhea, dysentery, and cholera. Armed with her medicines, lint, bandages, and needle and thread, “Mother” Seacole treated the wounded on the battlefield, and on September 8, 1855, was the first woman to enter Sebastopol.

Seacole's work in the Crimea drew only faint praise from her contemporary
Florence Nightingale
(see Chapter 8). While conceding that Seacole had done “some good,” Nightingale discouraged her nurses from visiting Spring Hill, which she wrongly considered to be a nest of “drunkenness and improper conduct.” Nightingale's uncharitable attitude was colored by the fact that Seacole had secured the support of one of her old enemies, Dr. John Hall, inspector general of hospitals in the Crimea.

In 1856, after the conclusion of the Crimean War, Seacole returned to England in debt and in poor health. When she was forced to declare herself bankrupt, a veteran of the Crimean War wrote to the
The Times
to ask whether “while the benevolent deeds of Florence Nightingale are being handed down to posterity with blessings and imperishable renown, are the humbler actions of Mrs. Seacole to be entirely forgotten, and will none now substantially testify to the worth of those services of the late mistress of Spring Hill?”

The answer came when the press highlighted Seacole's plight and in July 1857 money was raised by a four-night benefit in her honor at the Royal Surrey Gardens. Seated in the place of honor, surrounded by members of the military establishment, Seacole received the acclaim of the public. Sadly, much of the money raised by the benefit was mismanaged, but she recouped her losses with the publication of a successful autobiography,
The Wonderful Adventures of Mrs. Seacole in Many Lands,
which is suffused with her sense of humor, indomitable self-confidence, and practical good sense. The book conveys “how hard the right woman had to struggle to convey herself to the right place.”