Cold Open

It’s the afternoon of September 20th, 1854, on the banks of the River Alma on the Crimean Peninsula.

A bloody battle is underway. On horseback, British Colonel Sir Colin Campbell waves his sword above his head, urging his Highland Brigade away from the river and forward up the hill.

His men are stretched out in a line more than a mile wide. Cloaked in gun smoke, they march steadily toward the enemy position on the bluffs above them, firing as they advance.

One year ago, war broke out in Eastern Europe between the Russian Empire and an alliance made up of Britain, France, and the Ottoman Empire. Last week, Britain and France attempted to take the war into Russian territory by invading the Crimean Peninsula. British and French troops are now trying to clear the enemy from hills overlooking the River Alma. But the Russians have a strong position, and hundreds of allied troops have already fallen as Sir Colin Campbell tries to lead his men forward.

Musket fire intensifies as the Highland troops near the summit. Russian gunfire rips into them. Soldiers fall, screaming in pain, but Sir Colin bellows encouragement and the line never stops moving.

But then a bullet catches Sir Colin’s horse. The animal buckles beneath him, its legs writhing, throwing Sir Colin to the dirt.

Dazed, he finds himself momentarily face-to-face with a wounded British soldier sprawled out on the ground. The young man’s mouth moves soundlessly as blood soaks into the earth beneath him.

There’s nothing that can be done for him. So with a roar, Sir Colin rises to his feet and lifts his sword above his head so all can see him.

Bullets slice through the air. But Sir Colin is not deterred. He leads his men up the hill, toward the Russian position - and on to victory.

The intervention of Sir Colin Campbell’s Highland Brigade is a decisive moment in the Battle of the Alma. The Russian army will be forced to retreat, allowing allied forces to lay siege to the nearby port city of Sebastopol. But this success comes at a cost. More than 4,000 Allied soldiers are killed or wounded on the banks of the Alma. Tens of thousands more will fall during combat or to disease during the Siege of Sebastopol. And this number of casualties will threaten to overwhelm the British Army, until a young nurse begins a mercy mission to Crimea that will transform the history of medicine on October 21st, 1854.

Introduction

From Noiser and Airship, I’m Lindsay Graham and this is History Daily.

History is made every day. On this podcast—every day—we tell the true stories of the people and events that shaped our world.

Today is October 21st, 1854: Florence Nightingale’s Crimean War.

Act One: A Calling

It’s October 21st, 1854, in London, England, one month after the Battle of the Alma.

Florence Nightingale walks down a line of uniformed women standing to attention. As war continues on the other side of Europe, these 38 volunteer nurses are Florence’s own troops, and she is their commander. In a little over a week, they’ll all be in a warzone, and it’s Florence’s job to make sure these young women are up to the task.

Florence was born into a wealthy and well-connected family. But from a young age, she wanted to be a nurse. This was considered an unsuitable calling for a woman of her class. But after overcoming resistance from her family, Florence completed her training and began work as a nurse at a hospital caring for upper-class women. When the Crimean War broke out a year ago, though, Florence was horrified by the reports she read about the conditions facing wounded soldiers in military hospitals. She became determined to do something about it.

Several years earlier, she happened to meet and befriend a British politician while traveling in Rome. That politician was now the Secretary of War, and Florence approached him with a proposal to recruit a team of nurses to help in Crimea. He quickly agreed, and, today, Florence is meeting most of her volunteers for the first time - just hours before they are due to depart.

Florence knows that many people in Britain oppose her efforts. They think a warzone is no place for an upper-class woman. So, Florence is determined not to give her critics any reason to find fault with her nurses.

As she moves down the line, Florence grills the women, trying to establish their level of medical knowledge. Most have years of experience in busy London hospitals. But Florence spots two younger women giggling and joking. She fixes them with a steely gaze and tells them to step forward. Florence then bluntly orders the two women to pack their things and go home, because there is no place for such foolishness in her ranks.

After she finishes reviewing her staff, Florence and her nurses leave for the docks and begin their journey to the front. It’s an uncomfortable voyage by sea, and sea sickness confines Florence to her cabin most of the way. She tries to focus herself and her nurses on the task ahead, but it’s hard to do when Florence can barely get out of her bunk. She’s relieved when they finally reach land, and her work can begin properly.

More than a week after leaving London, Florence walks into the main British army hospital at Scutari Barracks near Istanbul, the capital of the Ottoman Empire. But as soon as she walks through the door, Florence is hit by a wall of hot, putrid air. It has the stench of rotting flesh—and Florence soon discovers why.

The hospital is woefully understaffed and undersupplied. There aren’t enough beds for the wounded. Many soldiers lie on the floor in the wards and hallways. Others are propped up against bare stone walls. Mingled amongst them are corpses that haven’t yet been moved and are quickly rotting in the heat. There’s almost no sign of anyone caring for these soldiers, and the few doctors that Florence does see look exhausted.

So, Florence approaches one soldier who’s lucky enough to have a bed—but he isn’t much better off than his comrades on the floor. His wounded leg is festering and his entire body is hot with fever. Florence is sure that he’s going to lose his limb to amputation - but even that might not save his life.

And as she makes her way through the wards, Florence tries to hide her disgust. The sound of men sobbing and groaning in pain reverberates off the stone walls. Patients cry out for help as she passes, desperate for attention. Some complain that it’s been days since they were even offered bread or water.

Florence thought the reports she’d read would prepare her for the horrendous conditions she’d face here. But in reality, things are far worse than she expected.

But despite all that she witnesses on her first day in Scutari, Florence’s resolve will not waver. She’ll immediately set to work planning how to improve the care of wounded soldiers—but before she can make a difference, she’ll need to overcome opposition from those who feel threatened by her arrival and think that a woman like her has no place in a warzone.

Act Two: The Lady with the Lamp

It’s November 4th, 1854, inside Scutari Hospital, two weeks after Florence Nightingale left England for the Crimean War.

Florence stands in front of a desk while Surgeon-General Duncan Menzies reads a letter. When he finishes, he puts it down on a pile. But rather than address Florence standing there waiting, he ignores her and takes up another letter. Florence feels her face go red. Dr. Menzies has already kept Florence waiting a day and a half before agreeing to see her and now he seems to be deliberately humiliating her.

Dr. Menzies is the officer in charge of the Scutari Hospital—and he views Florence and her nurses with suspicion. He thinks that the women will get in the way, that their presence in a military hospital risks a breakdown in discipline, and that they won’t be able to stomach treating the brutal injuries that these soldiers have suffered.

But Florence knows she and her nurses can. So, she ignores Dr. Menzies’s petty show of power. She’s accustomed to people trying to stop her, and getting into a shouting match will only give Dr. Menzies the excuse he’s looking for to send her home. So instead, Florence just waits.

After what feels like ages, Dr. Menzies finally looks up and asks Florence why she's come. Florence explains that she is here to assist in whatever way she and her staff can - but that, of course, it is the doctors who will remain in charge.

Florence’s respectful and conciliatory attitude is not what Dr. Menzies expected. But he still doesn’t give her or her nurses permission to treat wounded soldiers. Instead, after staring at her for a few seconds of uncomfortable silence, he just nods curtly and dismisses Florence to her quarters.

But despite what she said in Dr. Menzies’s office, Florence has no intention of waiting for directions to get to work. Dr. Menzies may not have given his go-ahead for the nurses to treat soldiers, but he also hasn’t expressly barred them from the wards - and lots needs doing there. Florence is adamant that the filthy hospital is preventing men from getting better. So, she orders her nurses to scrub the walls, floors, and windows, to wash clothes, and make fresh bandages.

But before these efforts can pay off, 600 more casualties arrive from Crimea. Faced with such a large influx of patients, Dr. Menzies realizes he needs all the help he can get. So, he grants permission for Florence’s team to treat patients directly. Working in teams of two, the nurses run errands for doctors, help them dress wounds, and even assist in operations. Florence encourages her nurses to use their initiative wherever possible - to wash patients, change their clothes, and administer fresh bandages, even if they’ve not been asked to do so. And thanks to their diligent work, the nurses quickly gain the respect of the army doctors.

And while her nurses alleviate the suffering of these wounded soldiers, Florence embarks on a wider reform of the hospital. She sketches a plan of the building in a small notebook. Using this blueprint, she comes up with a new layout for the wards. Rather than cram in as many soldiers as possible, Florence creates a regimented system with numbered beds that are spaced out to slow the spread of disease.

Florence then requests the hospital procedures change, so that amputations are carried out in private rather than in the general ward. Since there are no anesthetics, all surgeries are performed while the patient is conscious. And there’s little the doctors can do about the sound of the patient’s cries, but Florence argues that there’s no reason that surgery should be done within sight or earshot of other wounded men.

Florence is tireless in her work. She spends her days organizing the hospital and her nights walking the wards with a small oil lamp. She keeps an eye on those recovering from surgery. She administers food and medicine to those who need it. She talks to patients unable to sleep, listening to their concerns and reassuring them that they’ll soon be able to go home.

The death rate at Scutari begins to fall. And back in Britain, newspapers get wind of the improvements in medical care and send reporters to write about it. Many focus their stories on Florence and her midnight rounds, and one journalist describes her as “the lady with the lamp.” An accompanying newspaper sketch paints Florence as an angelic figure, whispering soothing words to those in her care.

And the image catches the public’s imagination. After the Crimean War ends in July 1856, Florence will return home as something of a celebrity. But she won’t return to her old job. Instead, with her increased public profile, Florence will set to work improving Britain’s healthcare system, just as she improved the hospital at Scutari.

Act Three: A Legacy

It’s the morning of June 21st, in 1871, in London, 15 years after the end of the Crimean War.

Accompanied by a large entourage, 52-year-old Queen Victoria walks the empty wards of St. Thomas’s Hospital.

Although St. Thomas’s has existed for around 700 years, it’s about to embark on a new phase in its history. A brand-new hospital building has been built on the banks of the River Thames, and the Queen is here for a private tour ahead of its official opening.

Queen Victoria turns to one of the officials leading the tour and jokes that the hospital is almost as grand as her own home, Buckingham Palace. The official smiles and replies that the new St. Thomas’s is the most expensive hospital in the world. It has 588 beds and large, airy wards. The floors are made of solid oak, the walls are painted, and there are glass windows in every ward.

In the final part of the tour, the Queen visits the most famous department in the hospital. The world’s first School of Nursing was set up here at St. Thomas’s by Florence Nightingale soon after she returned from the Crimean War. It’s already trained hundreds of nurses who’ve been appointed to jobs in hospitals and workhouses around the country. And now that the school has new, purpose-built facilities, Florence hopes to increase the number of nurses it can train.

When the tour is over, Queen Victoria formally opens the new hospital building. In her speech, she takes time to praise the work of Florence Nightingale as “the lady whose name will always be associated with the care of the wounded and the sick.”

But Florence does not hear the Queen’s words in person. Instead, she is recovering at home after her own illness. It’s become a common occurrence. Since returning from Scutari Hospital, Florence has struggled to stand for long periods of time and frequently takes to her bed to recover. Some claim that Florence’s work in the Crimean War has permanently damaged her body. Others suggest that she uses her health problems as an excuse to avoid intrusive press attention. Whatever the reason, Florence herself won’t visit the new School of Nursing at St. Thomas’s for another 11 years, by which time her days as a nurse will have long ended.

But despite her absences, Florence’s legacy as a pioneer of modern nursing will endure. Her insistence on cleanliness, efficiency, and discipline will be adopted by hospitals around the world. And her new way of nursing will save numerous lives, just as it did in Scutari after Florence Nightingale departed on her mission to help the victims of the Crimean War on October 21st, 1854.

Outro

Next on History Daily. October 22nd, 1934. Federal agents track down the notorious outlaw Charles “Pretty Boy” Floyd and kill him in a gunfight.

From Noiser and Airship, this is History Daily, hosted, edited, and executive produced by me, Lindsay Graham.

Audio editing by Muhammad Shahzaib.

Sound design by Gabriel Gould.

Music by Thrumm.

This episode is written and researched by Owen Paul Nicholls.

Edited by Scott Reeves.

Managing producer Emily Burke.

Executive Producers are William Simpson for Airship, and Pascal Hughes for Noiser.