She only partially succeeded in her wider aim. In 1889, in a lecture,54 she said that in recognizing “the failure of so many panaceas for the intolerable evils that afflict society” she, like everyone else, longed for “the untried force – the action and co-operation of good women.” Women, she maintained, were waking up to this truth in ever-increasing numbers – “women are . . . rising above the errors of the past and blind acceptance of imperfect authority.” They were entering medicine in great numbers (3,000 registered doctors in America, 73 in Britain when she spoke) and would soon be capable of revolutionizing society through the practice of medicine. She directed their attention to midwifery, to preventive medicine, to chronic illness and to the treatment of the poor – all areas where their influence was not only most needed but could be most powerful. She reminded them that Love, Intelligence and Will were as important as knowledge. “It will be a real service that we, as medical women, may render to the profession if we search out – calmly, patiently but resolutely – why what revolts our enlightened sense of right and wrong is not true.” Aware that this might sound vague and high-minded, she then gave some specific advice which irritated some of her audience. She announced that the true future of women must be as family physicians and not as specialists. She did not want to see them “rushing to exciting operations” but studying the common diseases where they began. She thought it their “special duty” to “thoroughly master measles” and worried that they were not valuing obstetrics enough because in that field they could gain a mother’s confidence for the future. Women were not, in short, to become doctors to satisfy any cravings of their own but to do good, to fight in a moral crusade.
This undoubtedly carried feminism forward but at a price. It was an improvement on Caroline Norton’s initial brand of feminism, on the claim that all that women wanted was the protection of men, safeguarded and enshrined in law. But the moral obligations of Elizabeth Blackwell’s feminism, although more attractive initially, were just as perilous for the future, as women soon found out. Many of them did not wish to be crusaders any more than men did. This was reflected in medicine itself. Elizabeth Blackwell got her wish about women mainly becoming family physicians but they did not follow her directions as to what those who specialized should specialize in. Today, almost one hundred years after she gave this order, the biggest specialist area in which women have gone to the top and become consultants is anaesthetics followed by radiology with obstetrics well down the list. Women, in fact, have not been attracted to those areas which Elizabeth Blackwell thought cried out for them: they are outnumbered 8 to 1 in gynaecology and obstetrics by men. (Ironic, when it is remembered why women were moved to enter medicine in the first place.) Nor have they entered medicine in the droves she so confidently envisaged. In 1980–1 the number of women admitted to the medical curriculum throughout Britain was 1,580, the number of men 2,328. In the same year, the percentage of women consultants was 11.4 of the total.55 Clearly, although progress has been steady, it has not followed the path she predicted nor soared to the heights she expected.
The answer to the question of why women have not taken over the medical profession and used it to embark on a moral crusade is of great interest to feminist historians. It is twofold. On the one hand it seems to be true that medicine requires a degree of commitment incompatible with other demands upon women. The training is long, arduous and at some stages barbarous. Women in their twenties find it unacceptable to shut themselves off from child-bearing and this is effectively what anyone ambitious in medicine has to be prepared to do – either that or proceed in a series of disruptive bursts almost impossible to organize. It can, of course, be done but never easily, not if the final aim is a consultancy (nor is it easy for men but the additional handicaps for women must at least be acknowledged). The single woman may still do it but most women are not single and spinsterhood ought not to be a prerequisite for becoming a consultant.
On the other hand, it is also true that women appear to have rejected the “moral crusade” notion. There are no measurable signs that the entry of women into the medical profession has significantly humanized it. No broad changes exist for the better which are the result of female medical action. Once women become doctors they become as one with the men, as a body, whatever individual capacities they retain for different action. This is, of course, desirable. Elizabeth Blackwell, after all, wanted women to become doctors not women doctors. But at the same time it would have been curiously disappointing to her, she would have seen it as some sort of failure, and in feminist history that is what it has come to be.
Yet the entry of women into the medical profession signposted a wonderful new direction for all women to take if they wished hard enough. “Attractive industry,” wrote Elizabeth Blackwell to Lady Noel Byron, “. . . can alone render every individual happy . . . I know that a Life of Duty is not a life of happiness.”56 For all those to whom sewing and housekeeping and child-rearing was not attractive, to whom dabbling in painting and piano playing and learning conversational French was not industry, Elizabeth Blackwell provided an alternative. Women, her own life said, can be anything and not lose their femininity in the process. That great fear – that trying to enter man’s spheres might either be beyond woman’s scope or else make her masculine in the process – was laid to rest.
EMPLOYMENT
Florence Nightingale
(BBC Hulton Picture Library)
Florence Nightingale
1820–1910
THE MOST IMPORTANT point about the opening up of medicine as a profession for women was that it gave them high aspirations as well as emphasizing their equal right to such a career. But nobody, least of all the pioneer women doctors themselves, ever imagined that the entire female sex, or even very large numbers of that sex, would actually avail themselves of the opportunities now before them. It was recognized that there would not be an overwhelming majority of women who would in the first place be clever enough and in the second dedicated enough. Nor was this necessarily regretted. Elizabeth Blackwell, with her passionate convictions about motherhood as a woman’s highest calling, was echoed by countless others. It was absurd to pretend that the so-called “choice” was a real one for all but a minority of fortunate women. What, then, of the rest? There were millions who felt just as frustrated with their lot as Elizabeth Blackwell had done but who could not begin to contemplate becoming doctors. Their desire to work might be just as consuming as hers but it was unthinkable for them to follow a path like that taken by Miss Blackwell. They might be, apart from any other considerations, simply lacking in her massive energy and single-mindedness. What was needed was some other “profession” which would not only be less academically difficult but also more accessible. Nursing was the first of the mass-market professions for women to answer these requirements, and it was Florence Nightingale who established it as such.
Florence Nightingale was Elizabeth Blackwell’s exact contemporary and she began, so far as feminism is considered, from a remarkably similar standpoint. But there was, from the beginning of her work, a crucial difference. Florence Nightingale rejected absolutely any suggestion that women should enter men’s spheres and compete to be as good as they were. What she wanted was for women to make a new sphere for themselves and to keep it for themselves. Therefore she was not interested in women becoming doctors and would do nothing to help them along. Although she was at first friendly towards Elizabeth Blackwell she nevertheless sneered at her in private and said she had “only tried to be a man,” which was of course grossly untrue. (She also accused the world’s first woman doctor of rating little higher than “a third rate apothecary of thirty years ago.”) It irritated her profoundly that women like Elizabeth Blackwell were breaking into new territory when she herself saw so much to be done in the old. This greed to break into a man’s world was, she thought, plain stupid. It filled her with disgust to see so much written about “woman’s work” – “the enormous Jaw, the infinite ink which England p
ours forth . . .”1 There was no “want of a field” for women in her opinion – the field was right there under women’s feet and they could not even see it. What they ought to be doing was getting down to the existing work all around them for the asking instead of complaining men would not let them do their work. “The more chattering and noise there is about Woman’s Mission,” she wrote furiously, “the less efficient women we can find. It makes me mad to hear people talk about unemployed women. If they are unemployed it is because they won’t work. The highest salaries given to women at all we can secure to women trained by us. But we can’t find the women. They won’t come.”2
It sounded like contempt for her own sex and a definite anti-feminist approach, which is how it has been interpreted ever since. The famous statement “I am brutally indifferent to the wrongs or the rights of my sex”3 appears quite straightforward and indisputable and so does Florence Nightingale’s equally famous refusal to become a member of the first Committee of the London National Society for Women’s Suffrage when asked by John Stuart Mill. But these comments have been removed from their context. They amounted to flashes of anger on Florence Nightingale’s part and masked a feminism far more real and deeper than that of many of the Woman’s Rights supporters. In fact she explained fully to John Stuart Mill exactly what she did mean in her letter declining to join the committee. “I can’t tell you,” she wrote to him on August 11th, 1867, “how much pleased I was nor how grateful I feel that you should take the trouble to write to me . . . That woman should have the suffrage I think no one can be more deeply convinced than I. It is so important for a woman to be a ‘person’ as you say. And I think I see this most strongly in married life. If the woman is not a person it does almost infinite harm even to her husband. And the harm is greatest when the man is a very clever man and the woman a very clever woman.”4 What held her back from lending her name, then, was not any anti-feminist belief “. . . It will be years before you obtain the-suffrage for women,” she went on, “and in the meantime there are evils which press so much more hardly on women than the want of the suffrage.” She was worried that fighting for the vote would actually “retard still further the legislation which is necessary” to give women other rights which the existing legislature might otherwise be willing to grant them. She said she suggested this “humbly” and was “afraid you will laugh at me”. Far from being “brutally indifferent” to her sex she wrote that, as a matron, she was horribly aware of how hard poor married women in particular were pressed upon. “Till a married woman can be in possession of her own property there can be no love or justice,”5 she wrote and in case there should be the slightest misunderstanding as to her position she emphasized “woman’s political power should be direct and open not indirect.”6 Her refusal, therefore, was based on practical considerations and not on any essential difference in principle. And both John Stuart Mill and the zealous Harriet Martineau were at pains to reply that they fully understood her point of view – far from being anti-feminist it was (in its day) perfectly tenable.
What Florence Nightingale thought she had done was spotted a trap. “I would earnestly ask my sisters,” she wrote “to keep clear of both jargons now currently everywhere (for they are equally jargons); of the jargon, namely, of the ‘rights’ of women, which urges women to do all that men do, including the medical and other professions, merely because men do it and without regard to whether this is the best women can do; and of the jargon that urges women to do nothing that men do, merely because they are women, and ‘should be recalled to their sense of duty as woman’ and because ‘this is women’s work’ and ‘this is men’s’ and ‘these are things women should not do’ which is an assertion and nothing more. Surely woman should bring the best she has whatever it is to the work of God’s world without attending to either of these cries . . . You do not want the effect of your good things to be ‘How wonderful for a woman!’ nor would you be deterred from good things by hearing it said ‘Yes but she ought not to have done this because it is not suitable for a woman.’”7 Any woman who held back from doing work she was equipped to do because she thought it might not be ladylike ought to be “burnt alive”.
This was a very peculiar feminist stance but it had tremendous appeal and was far more attractive, to men as well as women, because it seemed less revolutionary. Once Florence Nightingale had made nursing respectable, and made payment for it just as respectable, it seemed the ideal solution for all those legions of unemployed women. If anything, it reinforced the Victorian idea of femininity. A Nightingale nurse, in her starched and spotless uniform, working in one of the new hospitals in an atmosphere of order and discipline, really did appear an angel. If letting women out of the home to work for money meant this, where was the harm? None. The harm lay in the demand for martyrs. What Florence Nightingale wanted was for women to give up the “soft option” of motherhood and marriage. She wanted them to choose work instead. She wanted them to realize that work could be even more fulfilling than a husband and children. When they refused to do so in the numbers she had imagined she was disappointed and furious. “My doctrines have taken no hold among women,” she wrote bitterly. “Not one of my Crimean following learnt anything from me . . . or gave herself for one moment after she came home to carry out the lesson of that war.”8 She despised her sex for being obsessed with romantic love. “Women crave for being loved . . . they scream at you for sympathy all day long, they are incapable of doing anything in return . . . People say to me ‘you don’t know what a wife and mother feels.’ No, I say, I don’t and I am very glad I don’t. And they don’t know what I feel . . . I am sick with indignation at what wives and mothers will do of the most egregious selfishness. And people call it all maternal or conjugal affection and think it pretty to say so.”9 She did not think it pretty. She thought it cowardly, and through nursing she presented women with what she wanted them to see as a much more fulfilling life. The way in which she did this makes her, ironically, a feminist extremist, far more radical than Elizabeth Blackwell and far more significant in feminist history.
* * *
Florence Nightingale spent thirty-two years trying to conform to the feminine stereotype of her day. She was born on May 12th, in Florence (hence the name), to Frances and William Nightingale who were still on their two-year protracted honeymoon. (Their first daughter, Parthenope, had been born the previous year in Naples.) Shortly after Florence’s birth the couple returned home to Lea Hurst, their country-home in Derbyshire and took up the threads of their extremely comfortable existence. William Nightingale, although not outrageously rich, had inherited his estate while still a minor and when a lead mine was discovered on it the income from this was wisely invested for him. He could afford to be lazy, which he was, and to indulge his taste in good books, which he did. His wife Fanny, six years his senior, had “never thought of anything all day long” but her own pleasure. She intended to continue doing so. When the Nightingale house at Lea Hurst proved not as pleasurable to live and entertain in as she wished, she persuaded her husband to buy Embley Park, near Romsey in Hampshire, which was in a much more attractive area where Fanny’s two married sisters lived. So the pattern of Florence’s childhood was set: summer in Derbyshire, the rest of the year in Hampshire, and two annual visits to London.
There were no more children which both Fanny and William regretted, not just because the estate needed a son to secure the inheritance, but because they loved children. But with so many relatives near them (Florence had twenty-seven cousins before she was fourteen) the house never felt empty. Neither Florence nor Parthe could ever have felt lonely. They appeared to lead an enviable existence in a beautiful home with loving parents, surrounded with every kind of comfort and pleasure. Yet by the age of six, Florence recorded, she had decided her way of life was “distasteful”. She feared she was a monster, not like other children and unable to act as they did. She hated being sociable which made things difficult in her mother’s extremely sociable house. Florence hi
d and moped and irritated Fanny by being “unreasonable”. Parthe, on the other hand, was the daughter Fanny wanted except that she was not as pretty as Florence nor as intelligent. It was Florence, in fact, who had it within her to be the credit to the family that Fanny wished for. It was Florence who could undoubtedly shine in society should she choose to do so. But she did not choose to do so. She was awkward and attached herself to her father instead of her mother. To her mother’s horror, she began to show a marked preference for the library rather than the drawing-room. William Nightingale was delighted by this. He may have turned himself after his Cambridge days into a model country gentleman but he was still well-read and passionately interested in all the topics of the day. It gave him such pleasure to talk with both his daughters, but particularly with Florence, that he decided in 1832 when they were thirteen and twelve to continue their education himself. A governess was engaged for accomplishments – music and drawing – but he himself took on the real work. And it was “real work”. The syllabus included Greek, Latin, German, French and Italian as well as history and philosophy. Every day the girls and their papa proceeded to the library to work to a strict timetable, leaving Fanny to her entertaining, and every day the work became more exacting. Very few girls indeed were ever privileged enough to obtain quite such a complete education. Florence appreciated it but Parthe quickly found it unbearably hard and began to trail behind. Fanny defended her against such a monstrous unfeminine régime and very soon Parthe was dropping lessons to help her mother do vital jobs like put new flowers in the vases.
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