The Life of Florence Nightingale Volume I Part 20

(1) To provide us with food.

(2) With Hospital furniture and clothing.

(3) To keep the daily routine going.

These are now the three offices of the unfortunate Purveyor; and none of them are performed.

But the Purveyor is _supposed_ to be only the channel through which the Commissariat stores _pa.s.s_. Theoretically, but not practically, it is so. (For practically Wreford gets nothing through the Commissary, but employs a contractor.)

Now, why should not the _Commissariat purvey_ the Hospital with food? perform the whole of Purveyor's office, No. 1? The practice of drawing _raw_ rations, as here seen, seems invented on purpose to waste the time of as many Orderlies as possible, who stand at the Purveyor's office from 4 to 9 A.M. drawing the patients'

breakfast, from 10 to 12, drawing their dinner--and to make the patients' meals as late as possible--because it is impossible to get the diets, thus drawn, cooked before 3 or 4 o'clock. The scene of confusion, delay, and disappointment where all these raw diets are being weighed out by twos, and threes, and fours, is impossible to conceive, unless one has seen it, as I have, day after day. And one must have been, as I have, at all hours of the day and night in this Hospital to conceive the abuses of this want of system--raw meat, drawn too late to be cooked, standing all night in the wards, etc., etc., etc. Why should not the Commissariat send _at once_ the amount of beef and mutton, etc., etc., required into the kitchens, without pa.s.sing through this intermediate stage of drawing by Orderlies?

Let a Commissariat Officer reside here--let the Ward-Masters make a total from the Diet Rolls of the Medical Men--so many hundred full diets--so many hundred half-diets--so many hundred spoon diets, and give it over to the Commissariat Officer the day before. The next day the _whole_ quant.i.ty, the _total_ of all the Ward-Masters'

totals, is given into the kitchens direct.

It should be all carved in the kitchens on hot plates, and at meal-times the Orderlies come to fetch it for the patients--carry it through the wards, where an Officer tells it off to every bed, according to the Bed-ticket, on which he reads the Diet, hung up at every bed. The time and confusion thus saved would be incalculable.

Punctuality is now impossible; the food is half-raw, and often many hours after time. Some of the portions are all bone, whereas the meat should be boned in the kitchen, according to the plan now proposed, and the portions there carved contain meat only. Pray consider this.

There might be, _besides_, an Extra Diet Kitchen to each division; a teapot, issue of tea, sugar, etc., to every mess, for which stores make the Ward-Master responsible; arrow-root, beef-tea, etc., to be issued from the Extra Diet Kitchens.

But into these details it is needless to enter to you.

(2) The second office of the Purveyor now is to furnish, _upon requisition_, the Hospital with utensils and clothing. But let the Hospital be furnished at once, as has been already described in former letters. If 2000 beds exist, let these 2000 beds have their appropriate complement of furniture and clothing, stationary and fixed. Whether these be originally provided by a Commissary or a storekeeper, let those who are competent decide. The French appear to give as much too much power to their Commissariat, who are the real chiefs of their Hospitals, while the Medical Men are only their slaves, as we give too little. But the Hospital being once furnished, and a store-keeper appointed to each division to supply wear and tear, let the Ward-Masters be responsible. Let an inventory hang on the door of each ward of what _ought_ to be found there. Let the Ward-Masters give up the dirty linen every night and receive the same quant.i.ty in clean linen every morning. Let the Patient shed his Hospital clothing like a snake when he goes out of Hospital, be inspected by the Quarter-Master, and receive, if necessary, from Quarter-Master's store what is requisite for his becoming a soldier again. While the next patient succeeds to his bed and its furniture.

(3) The daily routine of the Hospital. This is now performed, or rather _not_ performed by the Purveyor. I am really cook, housekeeper, scavenger (I go about making the Orderlies empty huge tubs), washer-woman, general dealer, store-keeper. The Purveyor is supposed to do all this, but it is physically impossible. And the filth, and the disorder, and the neglect, let those describe who saw it when we first came....

Let us have a Hotel-keeper, a House-steward, who shall take the daily routine in charge--the cooking, was.h.i.+ng and cleaning us--the superintending the housekeeping, in short, be responsible for the cleanliness of the wards, now done by one Medical Officer, Dr.

M'Grigor, by me, or by no one--inspect the kitchens, the wash-houses, be what a housekeeper ought to be in a private Asylum.

With the French the _chef d'administration_, the Commissary, as we should call him, is the master of the Orderlies. And the Medical Men just come in and prescribe, as London physicians do, and go away again. With us the Medical Officers are everything, and have to do everything, however heterogeneous. The French system is bad, because, though there may be twenty things down on the Carte for the Medical Man to choose his patient's diet from, _nominally_, the Chef d'Administration may have provided only two, and the Patient has no redress.

Whether, in any new plan, the House Stewards have the command of the Orderlies, or the Medical Man, which I am incompetent to determine, whichever it be let us have a Governor of the Hospital.

As it is a Military Hospital, a Military Head is probably necessary as Governor.

On September 20, 1855, a Royal Warrant was issued, reorganizing the Medical Staff Corps, "for the better care of the sick and wounded,"

revising the duties of the several officers, and improving their pay.

Any one who cares to refer to this Warrant, and to compare it with Miss Nightingale's letters just given, will see that in large measure her suggestions were adopted by the War Department.

Miss Nightingale was careful, as we have seen, not to interfere with the doctors, and, though she thought that as administrators some of them were ineffective, she bore willing testimony to their skill and devotion (with some few exceptions) in their proper work. But she could not abstain from deploring one great omission, and she offered to subscribe largely towards repairing it:--

"One thing which we much require," she wrote to Mr. Herbert (Feb.

22, 1855), "might easily be done. This is the formation of a Medical School at Scutari. We have lost the finest opportunity for advancing the cause of Medicine and erecting it into a Science which will probably ever be afforded. There is here no operating room, no dissecting room; post-mortem examinations are seldom made, and then in the dead-house (the ablest Staff Surgeon here told me that he considered that he had killed hundreds of men owing to the absence of these) no statistics are kept as to between what ages most deaths occur, as to modes of treatment, appearances of the body after death, etc., etc., etc., and all the innumerable and most important points which contribute to making Therapeutics a means of saving life, and not, as it is here, a formal duty. Our registration generally is so lamentably defective that often the only record kept is--_a man died_ on such a day. There is a kiosk on the Esplanade before the Barrack Hospital, rejected by the Quarter-Master for his stores, which I have asked for and obtained as a School of Medicine. It is not used now for any purpose--300 or 400 (which I would willingly give) would put it in a state of repair. It is not overlooked and is in every way calculated for the purpose I have named. The Medical teaching duties could not be carried on efficiently with a less staff than two lecturers on Physiology and Pathology, and one lecturer on Anatomy, who will be employed in preparing the subject for demonstration, and performing operations for the information of the Juniors."

This suggestion also was in part adopted. An excellent dissecting-room was built, provided with numerous instruments, microscopes and other apparatus.[138]

[138] See _Pincoffs_, p. 55.

V

And so this woman of ideas went on, week by week, month by month, pouring in requisitions, hints, plans, to the Government at home; sometimes getting things done as she wanted, at others making suggestions which, had they been adopted, would still more have conduced to efficiency. Something of that calm and clear sagacity, which impressed Queen Victoria and Prince Albert when they made her personal acquaintance,[139] was reflected in her appearance and demeanour as observed by eye-witnesses at Scutari. "In appearance," wrote Mr.

Osborne, "Miss Nightingale is just what you would expect in any other well-bred woman, who may have seen perhaps rather more than thirty years of life; her manner and countenance are prepossessing, and this without the possession of positive beauty; it is a face not easily forgotten, pleasing in its smile, with an eye betokening great self-possession, and giving, when she wishes, a quiet look of firm determination to every feature. Her general demeanour is quiet and rather reserved; still, I am much mistaken if she is not gifted with a very lively sense of the ridiculous. In conversation, she speaks on matters of business with a grave earnestness one would not expect from her appearance. She has evidently a mind disciplined to restrain under the principles of the action of the moment every feeling which would interfere with it. She has trained herself to command, and learned the value of conciliation towards others and constraint over herself. I can conceive her to be a strict disciplinarian; she throws herself into a work as its head. As such she knows well how much success must depend upon literal obedience to her every order."[140]

[139] See the words cited at the head of this chapter, and below, pp. 324, 325.

[140] _Scutari and its Hospitals_, p. 25.

It was soon perceived at Scutari that Miss Nightingale was a power. She mentioned incidentally at a later period a curious fact, which shows the way in which officers appealed to her as a kind of emergency-man. In 1862 she was pressing the War Office to separate the function of Banker from that of Purveyor, and she ill.u.s.trated the confusion caused by the amalgamation from her own experience. Among the instances was this: "I had at Scutari thousands of sovereigns at a time in my bedroom, entrusted to me by officers who preferred making me their banker because of the perpetual discord. 'Offend the Commissary or Purveyor, and you won't be able to get your money.'"[141] It was soon perceived also that Miss Nightingale was the person who, if any one, could get things done, and any official who had an idea took it to her. In the letters to Sidney Herbert she sometimes bids him know that what she says does not merely come from "poor me," but represents the views "of all the best men here." But she, I think, was the best man of them all.[142] Such was the opinion, at any rate, of a man among men, the redoubtable Sydney G.o.dolphin Osborne. "Every day," he wrote in describing his experience at Scutari, "brought some new complication of misery to be somehow unravelled. Every day had its peculiar trial to one who had taken such a load of responsibility, in an untried field, and with a staff of her own s.e.x, all new to it. Hers was a post requiring the courage of a Cardigan, the tact and diplomacy of a Palmerston, the endurance of a Howard, the cheerful philanthropy of a Mrs. Fry. Miss Nightingale fills that post; and, in my opinion, is the one individual who in this whole unhappy war has shown more than any other what real energy guided by good sense can do to meet the calls of sudden emergency."[143] And hence it was, too, that any official who felt the urgency of some particular need in his own department carried his case to the Lady-in-Chief. Did a surgeon want some point represented with special urgency to the authorities at home?

He went to Miss Nightingale. Did a purveyor want some special authority from the military to facilitate his task? He went to Miss Nightingale.

The centre of initiative at Scutari was in the Sisters' Tower; and going to Miss Nightingale had something of the magic that in earlier days was found in "going to Mr. Pitt."[144]

[141] Letter to Captain Galton, June 28, 1862. On the general question, see vol. ii. p. 64.

[142] It was a _mot_ of Mr. Stafford's that he had only met two men in the East, Omar Pacha (the Turkish Commander) and Florence Nightingale.

[143] _Scutari and its Hospitals_, p. 27.

[144] See _Kinglake_, vol. vi. pp. 43, 436.

CHAPTER VII

THE MINISTERING ANGEL

Then in such hour of need ...

Ye, like angels, appear, Radiant with ardour divine!...

Order, courage, return ...

Ye move through the ranks, recall The stragglers, refresh the outworn, Praise, reinspire the brave!

Eyes rekindling, and prayers, Follow your steps as ye go.

MATTHEW ARNOLD.

In the preceding chapters we have seen at work the impelling power of a brain and a will; but, with these, Florence Nightingale brought to her mission the tenderness of a woman's heart. She was the matron of a hospital no less than the mistress of a barrack. She was a resolute administrator; but also, as was said at the time in a hundred speeches, letters, articles:

When pain and anguish wring the brow, A ministering angel thou.

Upon those behind the scenes, upon ministers and officials, it was the former side of her activity that made the profounder impression. Some of them applauded what she did, recognizing that only the advent of a new force could have driven a way through the quagmire; others complained that in her methods there was something too imperious and masterful; all alike perceived her power and strength of will. But to the sick and wounded among whom she lived and moved, and to the great public at home which heard of her work, it was the softer side of her character that made the more instant appeal. By them she was known and honoured not as the rigid disciplinarian or creative organizer, but as the compa.s.sionate and tender nurse. Those who had no means of knowing what other work she had to do supposed that ministration to the sick, in the narrower sense, comprised it all. But, in fact, as she wrote to Mr. Herbert (Jan. 14, 1855), nursing was "the least important of the functions into which she had been forced"; and those on the spot, who watched the arduousness of these other duties, wished that she could be persuaded to spare herself more of one kind of work or of the other. The marvel is that in unstinted measure she combined them both.

Her devotion and her power of work were prodigious. "I work in the wards all day," she said, "and write all night"; and this was hardly exaggeration. A letter from Miss Stanley (Dec. 21, 1854) gives an interesting glimpse of Florence Nightingale at work in the Barrack Hospital:--

We turned up the stone stairs; on the second floor we came to the corridors of sick, on low wooden stands, raised about a foot from the floor, placed about 2 feet apart, and leaving 2 or 3 feet down the middle, along which we walked. The atmosphere worsened as we advanced. We pa.s.sed down two or three of these immense corridors, asking our way as we went. At last we came to the guard-room, another corridor, then through a door into a large busy kitchen, where stood Mrs. Margaret Williams, who seemed much pleased to see me: then a heavy curtain was raised[145]; I went through a door, and there sat dear Flo writing on a small unpainted deal table. I never saw her looking better. She had on her black merino, trimmed with black velvet, clean linen collar and cuffs, ap.r.o.n, white cap with a black handkerchief tied over it; and there was Mrs.

Bracebridge, looking so nice too. I was quite satisfied with my welcome.... A stream of people every minute. "Please, ma'am, have you any black-edged paper?" "Please, what can I give which would keep on his stomach; is there any arrowroot to-day for him?" "No; the tubs of arrowroot must be for the worst cases; we cannot spare him any, nor is there any jelly to-day; try him with some eggs."

"Please, Mr. Gordon [the Chief Engineer] wishes to see Miss Nightingale about the orders she gave him." Mr. Sabin comes in for something else. Mr. Bracebridge in and out about General Adams,[146] and orders of various kinds.[147]

[145] Miss Nightingale's camp bedstead was at this time behind a screen in the kitchen, for she had given up her room to the widow of an officer.