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Authors: John Mitchinson,John Lloyd

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June 29:
Four long days of absolute slavery.
June 30:
I cannot write a letter, can do nothing.
July 1:
I lay in bed at night and called upon God to save me. My soul spoke to His & I was comforted.

These enigmatic entries read very like the tortured spiritual travails of the Christian mystics she had studied: St. Teresa of Avila or St. John of the Cross. Like them, she often refers to God as her “husband.” There is more here than just religious ecstasy. No one can be fully sure what the “dreaming” that so disturbed her at night was, but it seems most likely to have been sexual fantasy, possibly even masturbation. In rejecting Milnes, she was rejecting marriage itself, and, by extension, sex. She makes it plain that she was physically attracted to Milnes and we will never know what passed between them privately. He was certainly not a sexual innocent: After he died it was revealed that he had one of the largest collections of erotic literature ever assembled, with a particular fondness for the works of the Marquis de Sade. Her embrace of mysticism, of marriage with God, may well have offered her a way of sublimating some of this energy. But by the end of the year, she was convinced that the solution to her “dreaming” was to keep her hands and her mind busy.

In 1851 she went to Kaiserswerth Hospital in Germany to take a basic three-month course in nursing with the Institute for Protestant Deaconesses. This was a revelation to her: “The nursing there was nil, the hygiene horrible,” she later wrote, “But never have I met with a higher tone, a purer devotion than there. There was no neglect.” She followed this with a stint with the Sisters of Mercy near Paris, but on her return home, plunged into another depression in which she hardly stirred from her bed. The family doctor persuaded her parents that moving her out of the house would be good for Florence’s “nerves” and in 1853 she was appointed superintendent of the Institution for Sick Gentlewomen in Distressed Circumstances at Harley Street in London. An outbreak of cholera in nearby Soho allowed her to demonstrate for the first time her flair for administration and unflappability under pressure as she helped local hospitals manage the huge flood of patients.

Toward the end of 1853 Britain became embroiled in the Crimea, siding with France to support Turkey against Russia. Newspaper reports alerted the British public to the poor standards of care given to the troops evacuated from the Crimean peninsula to Scutari in Turkey. Sidney Herbert, a close friend of Florence’s, was appointed secretary of state for war and asked her if she would lead a party of British nurses to the war zone. In November 1854 she arrived at the Barrack Hospital with thirty-eight nurses and proceeded to reorganize it from top to bottom. Fresh air, cleanliness, good diet, and exercise were her principles, and in the midst of the chaos and the stench, her nurses were impeccably turned out and records were kept with a military precision. Florence set an inspiring example, covering four miles each evening walking through the wards, helping injured soldiers to write letters home, and checking on their welfare. Although she was
always more of a nursing theoretician than an actual emptier of bedpans or bandager of wounds, these nocturnal walks are what gave rise to her legend among the troops and the public back home.

Her first few months at Scutari were disastrous. Death rates at the hospital soared and even nurses and doctors succumbed to disease. The death rate began to drop only after the sewage system had been overhauled and the source of infection was removed. Nightingale didn’t make this connection herself until the war had ended. She returned to London in 1856 a heroine and, despite being traumatized and ill, threw all her energy behind getting a Royal Commission on army health established. She met Queen Victoria and Prince Albert to press her case. Afterward the queen remarked, “What a head! If only we could have her at the War Office.” Her efforts paid off and Sidney Herbert was appointed to chair the commission.

In 1858 Florence submitted her evidence to the commission in the form of an 830-page report,
Notes on Matters Affecting the Health, Efficiency, and Hospital Administration of the British Army.
Appended to it was what she called her “coxcomb” of statistical diagrams, devised with the help of William Farr, head of the General Registry Office. This included her famous “polar area diagram,” a kind of pie chart that has since become a standard of statistical graphics. What the figures and diagrams showed came as a profound shock. During the first awful winter of the war, soldiers had been three times more likely to die in Scutari than they had been in the basic field hospitals at the front. What had killed most of the soldiers in the Crimea wasn’t their wounds, but infections caused by poor sanitary conditions in the wards. Scutari, as one historian put it, was more of a death camp than a hospital. Florence was mortified. If she had overhauled the
sewage and general hygiene sooner, thousands of soldiers’ lives might have been saved. All the hand-holding and ward walking had been beside the point. In an agony of trepidation she put forward her report, fully expecting “the Lady of the Lamp” to be exposed as a fraud: “The lamp shows me only my utter shipwreck.” The report was never published. Although its conclusions framed British policy on hospital hygiene and nursing practice for generations to come, the government decided that to present the full weight of the evidence would be too damaging to national morale. This was too late to save Florence. The stress of preparing the figures, the weight of personal blame she felt, and the symptoms of her worsening brucellosis led to a physical collapse, and she came close to death. At the age of thirty-seven she took to her bed and never really emerged again.

Nonetheless, her fame and her influence grew steadily. From her bed in Mayfair, insulated from the disruptions of her family, she directed the course of health, hygiene, and sanitation all over the world. A public collection in her name raised £45,000 (equivalent to more than $1 million in today’s money) and was used to set up the Nightingale School of Nursing at St. Thomas’s Hospital in London. She became the first woman to be made a Fellow of the Royal Statistical Society (her experience in Scutari had taught her that “statistics were the measure of God’s purpose”). In 1860 she published
Notes on Nursing: What It Is, and What It Is Not
, a book that made her “fresh air and cleanliness” gospel available to everyone. Although she rarely ventured out, she corresponded with many of the most famous people of her time, including Mrs. Gaskell, General Gordon (of Khartoum), William Gladstone, and Harriet Beecher Stowe. As far as romantic entanglements went, the closest she came to that was a long and
witty correspondence with Benjamin Jowett, the master of Balliol College in Oxford, who became her spiritual confessor, encouraging her to write the last in her now tall pile of unpublished books,
Notes from Devotional Authors of the Middle Ages
, a history of mysticism. He called her “Florence the First, Empress of Scavengers, Queen of Nurses, Reverend Mother Superior of the British Army, Governess of the Governor of India.” She responded with: “Maid of all dirty work rather, or, the Nuisances Removal Act, that’s me.” As Lytton Strachey remarked, “She remained an invalid, but an invalid of a curious character—an invalid who was too weak to walk downstairs and who worked far harder than most Cabinet Ministers.”

Against all odds, Florence Nightingale outlived the misery of her condition. She died in her sleep at the age of ninety, shortly after becoming the first woman to receive the Order of Merit. In the last two decades of her life, she had mellowed. The intellectual arrogance, the not-suffering-fools-gladly impatience, and the perfectionism that had driven her faded, and she became an indulgent, eccentric old lady, devoted to her cats. Animals had always been a solace to her and she had often recommended the healing power of pets to her patients. For a while she had shared her life with a small owl she had found while visiting the ruins of the Parthenon in 1850. A fledgling, it was being tormented by some Greek boys after falling from its nest. Florence gave them a farthing and kept the owl, which she named Athena. It lived in a bag in her coat pocket during the day and flew around the house at night. But cats were her constant companions during the long years spent in bed. She owned more than sixty over the years, including Quiz, Muff, Dr. Pusey, and Bismarck. As enigmatic, self-contained, and sedentary as a cat herself, you can see why she liked them:

I learned the lesson of life from a little kitten, one of two. The old cat comes in and says, “What are you doing here, I want my missus to myself.” The bigger kitten runs away. The little one stands her ground, and when the old enemy comes near, kisses his nose and makes the peace. That is the lesson of life: kiss your enemy’s nose while standing your ground.

Few people have stood their ground like Florence Nightingale. She once boasted she had never been “swayed by a personal consideration.” Her body may have let her down, but she always knew her own mind. The Portuguese writer
Fernando Pessoa
(1888–1935) suffered from an entirely different affliction. He had a hundred different minds to choose from. Like Florence Nightingale he was a depressive who died a virgin. He was also an alcoholic hypochondriac who died of liver failure at forty-seven. He had published almost nothing. The problem with Pessoa, though, is, who exactly was “he.”

After Pessoa died, a wooden trunk was discovered containing more than twenty-five thousand handwritten sheets of his work, much of it still unsorted to this day. The archive contains both poetry and prose, everything from horoscopes to detective stories. The contents established him as one of the great poets of the twentieth century, or maybe several of the great poets—the work was written by Pessoa’s hand but under more than a hundred different names, not mere pseudonyms but individual literary identities who wrote in consistently different styles. Pessoa said that the names were not synonyms but “heteronyms.” He described his alter egos as “nonexistent acquaintances.”

Pessoa began creating heteronyms at age six, writing letters to himself in French from “Le Chevalier de Pas.” His best-known creations are Alberto Caeiro (1889–1915), whom he described as “an ingenious unlettered man who lived in the country and died of TB,” and Ricardo Reis, a doctor who wrote classical odes. There was also Alvaro de Campos—a monocle-wearing existentialist and naval engineer who liked writing in free verse. Caeiro, Reis, and de Campos even wrote about one another’s work, dissecting it and being critical when needed. Some of the minor heteronyms were exotic, like the Baron of Tieve, a suicidal aristocrat, or Jean Seul de Méluret, a French essayist with an interest in dancing girls. Only one of Pessoa’s heteronyms was a woman—Maria José, a tubercular hunchback with crippled legs who pined after a handsome metalworker who passed by her apartment every day.

Pessoa’s best-known identity is Bernardo Soares, who wrote most of
The Book of Disquiet
, a remarkable, sprawling biography that reads, in part, like a diary and was published long after Pessoa’s death. In his letters, Pessoa referred to the book as “a pathological production” and a “factless autobiography.” At the beginning of the book he wrote, “These are my confessions, and if in them I say nothing, it is because I have nothing to say.” Soares’s personality, said Pessoa, “is not my own, but it doesn’t differ from it, but is a mere mutilation of it.” He said Soares “appears when I am tired and sleepy, when my inhibitions are slightly suspended; that prose is a constant daydreaming.” This might sound more like fun than misfortune, but that would be to miss the quiet desperation of much of Pessoa’s life, a pain he numbed with drink. It also assumes that he was in control of his heteronyms, which it seems he wasn’t. That is what makes him so
fascinating. As far as we can tell, he wasn’t suffering from a psychological condition like schizophrenia or multiple personality disorder, but his “possession” was so extreme and complete that it chips away at our stable notions of “self” and “personality.” In his influential essay, “Tradition and the Individual Talent,” another great poet, T. S. Eliot, makes a very pertinent observation:

Poetry is not a turning loose of emotion, but an escape from emotion; it is not the expression of personality, but an escape from personality. But, of course, only those who have personality and emotions know what it means to want to escape from these things.

What was Pessoa escaping from?

He had spent much of his childhood in South Africa: His stepfather was the Portuguese consul in Durban. As a result, he became bilingual in Portuguese and English from the age of seven. His father had died from tuberculosis two years earlier (the year before Fernando created his first heteronym), and the following year he lost his younger brother, too. His mother and stepfather soon produced two half sisters and two half brothers, but the rapid disappearance of his original family left Fernando feeling isolated and rejected.

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