Snooze

by Michael McGirr

  Nightingale arrived at Scutari in November 1854, not long after the Charge of the Light Brigade and within a month of the most alarming reports appearing in the Times. She brought with her a team of almost forty women, including a contingent of nuns. The women found they were not welcome; they were given five small rooms in which to sleep, one of which still contained the body of a dead Russian general whose hair had entirely fallen out.

  In the twenty-one months that followed, Florence Nightingale was to become—perhaps after Queen Victoria—the most famous woman in the world. She is remembered as the woman who stayed up late, looking after sick and wounded soldiers for whom the experience of the hospital had become more fearful than battle itself. After 150 years, the image of the “lady with the lamp” is about all that remains of the Crimean War, a pointless military escapade that has been all but wiped from memory.

  The war came about in the first place for no better reason than because England and France wanted to wag their finger at Russia and be nice to Turkey. England hadn’t had a decent war for years and was worried about its military machine getting rusty. It wanted to show off the fact that its navy could move an army to the other side of Europe within a couple of weeks. Indeed, it could. But once it got to the shores of what is now Ukraine, it didn’t have a clue what to do next.

  Upon the arrival of the English, the Russians made soothing noises, but the English decided that it would be a shame to have come all this way and go home without a decent outing. The Battle for Sevastopol ensued, and that city’s streets were soon churned into mud. The whole situation was absurd. The injured were tied onto donkeys, manhandled onto ships, and then shipped to the hospital in Scutari, where disease was rife, sanitation was laughable, and the limited supply of water was poisonous. The soldiers would have fared better if they’d stayed behind and fended for themselves in the mud.

  English soldiers were known for their colorful turns of phrase, but in Scutari, a pall of silence hung over the place. When Nightingale suggested to her superiors that a screen might be erected to prevent soldiers having to watch others undergoing amputations, her request was met with incomprehension. The same thing happened when she suggested that the soldiers might drink less if they were actually able to send some of their pay home. When she argued that a teacher might be employed to educate the men as they recovered, the boss told her not to “spoil the brutes.” She was up against the rule book. It didn’t matter how many people died as long as correct military procedure was followed. The Crimean War was so mad that it made Nightingale herself look sane. This is saying something. She was no simple sister.

  By the time Alexis Soyer arrived on the scene five months after Nightingale, she was beginning to work a transformation. Soyer’s flamboyant personality belied his own capacity to get things done—something that endeared him to Nightingale, who, all her life, had been hamstrung by an inability to suffer fools. Nightingale was not a fool. But her soul was made of stainless steel. She was appreciative when Soyer came up with new designs for teapots and camp ovens that could handle the demands of the situation; he developed decent soups and stews. On top of this, Soyer was a writer who sent his own material back to the papers and who, when he got home, published a book with another fine title: Soyer’s Culinary Campaign. In it, he describes walking the wards in the early hours of the morning and encountering the figure of Florence Nightingale. His depiction of her at 2:00 AM has become part of the iconography of nursing:

  As we turned the angle of the long corridor to the right, we perceived, at a great distance, a faint light flying from bed to bed, like a will-o’-the wisp flickering in a meadow on a summer’s eve, which at last rested upon one spot. …

  But alas! As we approached we perceived our mistake. A group in the shape of a silhouette unfolded its outline in light shade. As we came nearer and nearer the picture burst upon us. A dying soldier was half reclining upon his bed. Life, you could observe, was fast bidding him adieu; Death, that implacable deity, was anxiously waiting for his soul to convey it to its eternal destination.

  But stop! Near him was a guardian angel, sitting at the foot of his bed, and most devotedly engaged in pencilling down his last wishes to be despatched to his homely friends and relations. A watch and a few more trinkets were consigned to the care of the writer; a lighted lamp was held by another person, and threw a painful yellow coloris over that mournful picture, which a Rembrandt alone could have traced, but which everybody, as long as the world lasts, would have understood, felt and admired. It was then near two o’clock in the morning.

  Another contemporary report, first published in the Times, is even better known: “When all the medical officers have retired for the night and silence and darkness have settled down upon these miles of prostrate sick, she may be observed alone, with a little lamp in her hand, making her solitary round.”

  The lady with the lamp was a woman of unbending religious conviction. She worshipped an unreasonable God, one who infuriated her by not doing as she said. Sometime in the 1870s, she wrote on a piece of scrap paper: “I MUST remember that God is not my private secretary.” Nightingale was essentially a Platonist, a believer that this world serves only to provide fuzzy clues about an ideal world that exists beyond it. It is no wonder that one of the few strong friendships she formed in old age was with Benjamin Jowett, the celebrated translator of Plato. For Nightingale, the world was essentially a dark place, a cave of shadows, and humankind was, in a spiritual sense, nocturnal. As far as she was concerned, all of us fumble across a dark terrain, helped by the light of a moon that sometimes emerges from behind clouds to throw the shadows into relief and even to create an impression of fragile beauty. The light of day was never going to be part of this world, althoug now and again, a stronger illumination might cause trouble. This had been her experience when, on February 7, 1837, at the age of seventeen, she received her calling. “God spoke to me and called me to his service,” she later claimed. That call, she believed, meant she was never to marry, despite at least two tempting proposals, and it was so significant that she celebrated its anniversary throughout her life, always with a sense of duty rather than joy. She had been called in the same year that Victoria came to the throne, and as the queen was celebrating her golden jubilee in 1887, Nightingale was marking hers with an unflinching spirit.

  Nightingale grew to love her patients and came to think of herself as a virgin mother, a higher order of motherhood in her mind than the unvirgin type. Yet at the same time, the hospital ward was a place of shades, part of the obstacle course this world presents to those who want to qualify for the real world. It was part of the penumbra that reality cast upon the earth, and she, too, moved across it like a shade. One of the soldiers who was able to write sent a letter home, saying, “We lay there by hundreds; but we could kiss her shadow as it fell and lay our heads on the pillow again content.”

  In the days before electric light, Nightingale’s lamp cast a long shadow over the beds, up the walls, and along the ceiling. Her presence was like that. The men worshipped her.

  Florence Nightingale knew the world had a lesson to learn from the Crimean War, and she was determined to teach it. One of the messages she wanted to get across was about the importance of bedding. It seems obvious now, but she was among the first to wonder if it was such a good idea for a wounded soldier to be wrapped in a bloody blanket, packed off in it to hospital, and then, in all likelihood, buried in it a short time later. In Notes on Nursing, the influential guidebook she published in 1860, she brings her customary obsession with detail to bear on the nature of bedding: “Feverishness is generally supposed to be a symptom of fever—in nine cases out of ten it is a symptom of bedding.”

  Above all else, Nightingale believed that bedrooms need to be well aired. She was an evangelist for the power of fresh air. Likewise, bedclothes need to be aired and dry. Bedrooms need good light and, if possible, a view. Beds should be low to the floor so that a patient doesn’t feel the roof is closing in upon h
im and burying him alive. Nobody should ever put their head under the blankets. The role of the pillow is to take the weight off the chest so that the patient can breathe more easily. Careless nurses fold blankets back and leave too much weight on the chest of the patient. Nothing should ever be damp. Florence Nightingale was a force against moisture in all its forms:

  My heart always sinks within me when I hear the good housewife, of every class, say, “I assure you the bed has been well slept in,” and one can only hope it is not true. What? Is the bed already saturated with somebody else’s damp before my patient comes to exhale into it his own damp? Has it not had a single chance to be aired? No, not one. “It has been slept in every night.”

  In Notes on Nursing, Nightingale describes patients as “entirely, or almost entirely, prisoners to bed.” By the time she wrote these words, she was herself in bed. Nightingale had left the Crimean War in mid-1856, at the age of thirty-six. She died in 1910 at the age of ninety. In those fifty-four years, she made no public appearances, gave no interviews, and did all in her power to extinguish her celebrity. The lady with the lamp became an even more shadowy figure. She spent almost all her time in bed. Her bed became a place of refuge, if not safety: there was one occasion in which, lying in bed, a cistern fell onto her through the ceiling.

  There are umpteen possible reasons why Florence Nightingale took to her bed and stayed there for more than half a century. No single item on the following list can explain what was going on, and some of these suggestions may be mutually exclusive, although Florence Nightingale was no stranger to paradox.

  First, it’s quite possible that she was simply tired. One theory is that she suffered from chronic fatigue syndrome (CFS) and indeed her birthday, May 12, has become international CFS awareness day. There are a lot of myths about CFS, sometimes known as myalgic encephalomyelitis (ME). People who suffer from this mysterious malady don’t necessarily sleep all day; it is more common for ME to play its baffling hand in the disturbed, inadequate, or shallow sleep of those forced to share their lives with it.

  It’s also quite possible that she had another illness. Various possiblities have been suggested. One biographer endorses the theory that Nightingale suffered from brucellosis, a bacterial infection sometimes called Malta fever. The disease’s long list of symptoms includes depression, poor sleep, exhaustion, and episodic paralysis. And there are some possible hints of this in Nightingale’s writings. In 1875, she wrote to a friend, “A more dreadful thing than being cut short by death is being cut short by life in a paralysed state.” (The Irish poet W. B. Yeats was diagnosed with Malta fever in Italy in the late 1920s and he, too, found himself glued to bed, sleeping long hours. When awake, Yeats coped by drinking champagne and reading pulp fiction, remedies unavailable to the austere Nightingale.)

  Perhaps Nightingale suffered from a mental issue that caused her to take to her bed. She may have had post-traumatic stress disorder. It’s hard to imagine more traumatic conditions than those she found at Scutari. But it’s also quite possible that she suffered from agoraphobia, a fear of open spaces, that had struck her later in life, also conceivably the product of trauma.

  Or it may be that the reason is even simpler than that. What if she simply wanted to avoid her family? Florence was always impatient with women, perhaps because they were not as easily directed as men, and much of her frustration was reserved for her mother, Fanny, and sister, Parthenope, known as Parthe. Nightingale believed that the two women dined out on her fame when it suited them but never lifted a finger to help in her campaigns for better sanitation. The relationship was dysfunctional. By staying in bed, she could shut the door on them. When her mother proposed visiting her in 1865, Nightingale wrote back, “Even ten minutes’ talk with those I love best secures me a night of agony and a week of feverish exhaustion.” She said that her mother could enter her room at 4:00 PM and kiss her, but under no circumstances was she to say anything.

  Nightingale certainly was particular about her schedule and visitors, but it’s also important to remember that other people have done the same thing (although perhaps not quite as thoroughly). In 1745, at the age of nineteen, a man named Josiah Carlton took to his bed and stayed there until he died in 1805. Carlton said that he wanted to avoid sinning. Charles Darwin also took to his bed for an extended period of time after he returned from five vigorous years on the Beagle. No one knew what was wrong with him, but he was so mysteriously and so completely indisposed that he was scarcely able to get out for his daughter’s wedding. John Milton, Mark Twain, Robert Louis Stevenson, and Winston Churchill all set up offices in their beds. In 1909, G. K. Chesterton published an essay called “On Lying in Bed,” in which he remarks that he’d be happy to remain on his back all day “if only one had a coloured pencil long enough to draw on the ceiling.” His advice: “If you do lie in bed, be sure you do it without any reason or justification at all.”

  The difference between Nightingale and most of the great bed workers of history is that the latter have managed to face the world by early afternoon. One notable exception was Cardinal Richelieu who, as chief minister of France from 1624 to 1642, was not to be inconvenienced by rising from bed. He simply had the bed carried to wherever he needed to do business, even if walls had to be removed to get him in. He gave his own twist to the idea of pillow diplomacy, the ancient art of sleeping in high places, often to achieve low ends. Brian Wilson, founder of the Beach Boys, also took to his bed for long periods, hardly the image of sunshine, surf, and outdoor fun so seriously projected by that band, although perhaps it was a wave bed.

  What is true is that, even from the depths of her bed, Nightingale was nothing if not prolific. From under her covers, Nightingale started a training school for nurses. She designed hospitals. She wrote endless submissions, briefs, and textbooks. She ran a Royal Commission from bed. She organized sanitation for the whole of India, a place she never visited. She advised on medical requirements for the Civil War in America, another place she never got to. Indeed, as her world became increasingly abstract she acquired encyclopedic knowledge of all sorts of places she never set foot. In all, over fourteen thousand of her letters survive, most of them including the time of day at which they were written, often 4:00 AM or 5:00 AM. She was simply too busy to get out of bed.

  Nightingale may have been busy and engaged, but in many ways, her bed provided a buffer—not just from her family but also from the public at large. Maybe she believed that if she was going to be the author of change she needed to be anonymous. When she left the Crimea, Florence Nightingale returned to England as “Miss Smith,” deliberately avoiding the heroine’s welcome that was in store for her. She made a conscious judgment that the changes she wanted to bring about in public health could never be brought about by grandstanding. She orchestrated inquiries and a Royal Commission from behind closed doors. Over the years, the mere rumor of her presence in public could trigger near-hysteria. She knew that applause meant the end of a performance, so she never took the bow.

  Being in bed also seemed to be a way for Nightingale to transcend her body. In her youth, she had castigated herself for the habit of “dreaming,” by which she meant absenting herself from reality. The real problem for her was that she actually enjoyed “dreaming”; those dreams may have even had an element of sexual fantasy. Her frenetic approach to doing good was at least partly a way of dealing with this. Her virtue was compulsive. She had a deep-seated fear of disorder or chaos. In Crimea, she had confronted the darkest of these forces and put them in their place in about twenty-one months. Yet fifty years were nowhere near enough to get herself into the same kind of order. Her theology increasingly became an attempt to force God around to her way of thinking, a strenuous effort to control the uncontrollable. She wrote a kind of anxious spirituality, keen to find a system for God that would spare her an experience of God. In the year she published Notes on Nursing, she also wrote Suggestions for Thought to the Searchers after Truth among the Artizans of England, a work whos
e title took up most of the first of three volumes. In Eminent Victorians, Lytton Strachey memorably unfolds Nightingale’s cold idea of a God for whom the tragedies in the Crimea were a necessary part of an eternal plan:

  Yet her conception of God was certainly not orthodox. She felt towards Him as she might have felt towards a glorified sanitary engineer; and in some of her speculations she seems hardly to distinguish between the Deity and the Drains. As one turns over these singular pages, one has the impression that Miss Nightingale has got the Almighty too into her clutches and that, if He is not careful, she will kill Him with overwork.