Doctress and Nurse (2)
Mary Seacole and Florence Nightingale: Doctress and Nurse
by Lynn McDonald
The Nursing Standard, the Royal College of Nursing, and many nurses, nursing organizations and unions have for long been promoters of Mary Seacole, typically as a means of celebrating diversity. Diversity is a worthy goal, and Seacole herself deserves celebration for her adventurous travels and generous volunteering. The problem arises when Seacole supporters attribute Nightingale’s work to her, as they do in making her out to be a founder of professional nursing.
Some ask, “Is there not room for two women founders of nursing?” However, their contributions in fact were very different, as “doctress” or herbalist and “sutler” or proprietress of a restaurant/bar/catering service (Seacole) and nurse, public health advocate and hospital reformer (Nightingale).
Seacole herself held no grudge against Nightingale. The two met probably for about five minutes, as Seacole recounted it in her 1857 memoir, Wonderful Adventures of Mrs Seacole in Many Lands (for which a later edition is used here: Seacole 1988). It was an entirely amicable meeting, according to Seacole (Seacole 1988 90-1). But references to it in the now copious secondary literature show Nightingale to have been variously condescending and/or racially prejudiced. Channel 4's film, “Mary Seacole: The Real Angel of the Crimea,” depicts her as disdainful and barely polite. That film is labeled “documentary,” but the encounter it portrays contradicts Seacole’s own account--the only one that exists, for Nightingale left no report of it. The use of “real angel” in the film’s title makes clear that the purpose is not merely to celebrate Seacole for her work, but to discredit Nightingale--not that she, a nurse, statistician and health care reformer, ever liked the “angel” imagery.
Seacole as “Doctress,” Before and During the Crimean War
In her memoir, Seacole described herself mainly as a “doctress” (Seacole 1988 34, 36), sometimes as “nurse and doctress” (Seacole 1988 7, 127), or “doctress and nurse” (Seacole 1988 125-6), but this with reference to meals supplied to officers, and once as “doctress, nurse and mother” (Seacole 1988 124). In her introduction, Seacole explained that she had been trained in traditional Creole medicine by her mother, “an admirable doctress” (Seacole 1988, 2). She never called herself a “doctor” although she claimed “medicinal skills and knowledge” (Seacole 1988 24), experience of “the science of medicine” (Seacole 1988 125), and gave “surgical treatment” (Seacole 1988 40, 42). She described having done, on her own, one post-mortem examination, of a year-old infant, which gave her “useful” information, “what every medical man well knows” (Seacole 1988 30). Of course she, no more than Nightingale, ever attended a medical school, for women could not attend university at all at that time.
As a doctress Seacole diagnosed the patient, and prepared and administered the treatment herself. Whether or not her remedies worked we cannot say, for she left no precise list of ingredients or quantities. Claims her supporters make of her today, however, are unequivocally positive. One, for example, credits her with developing a medicine which “cured yellow fever and cholera and which was put to good use in Panama in 1850 when there was a yellow fever epidemic there” (Huntley 1993 43). The doctors who appeared on the Channel 4 program on Seacole also declared firmly that her treatments worked. But Seacole’s own claims of success were few--non-existent for yellow fever--while her accounts of sad deaths were numerous (Seacole 1988 59-63).
Pre-Crimea, in Cruces, Panama, where there was no doctor, Seacole explained that her “medicinal skill and knowledge were put to the test” on cholera. She examined a deceased man and pronounced cholera to be the cause of death (Seacole 1988 24). She treated a patient with “what I deemed necessary...mustard emetics, warm fomentations, mustard plasters on the stomach and the back, and calomel,” this last in diminishing doses: “I succeeded in saving my first cholera patient in Cruces (Seacole 1988 25). But the cholera spread rapidly and there was little resistance (Seacole 1988 26). She painted a dismal picture of people who would not clean out their own huts and surroundings, and with difficulty did she get anyone to clean and ventilate (Seacole 1988 28). Some sick were beyond any care.
Seacole frankly admitted that she made “lamentable blunders” at first, and “lost patients which a little later I could have saved.” Some notes on cholera medicines which she reread later “made me shudder” (Seacole 1988 31). Treatments had to be varied, Seacole found, for “few constitutions permitted the use of exactly similar remedies,” and “the course of treatment which saved one man would, if persisted in, have very likely killed his brother” (Seacole 1988 31-2).
The best remedies for cholera, Seacole concluded, were mustard plasters, emetics, calomel, and mercury applied externally. Opium was to be avoided, for it lulled the patient into sleep and death. To thirsty patients she gave “water in which cinnamon had been boiled.” She recounted a cure achieved against a “stubborn attack” with “an additional dose,” additional to what not specified, “of ten grains of sugar of lead, mixed in a pint of water, given in doses of a tablespoonful every quarter of an hour” (Seacole 1988 31). Sugar of lead is lead acetate, a substance now considered toxic in any amount. Whether or not she continued to use lead is not known. She treated a girl by rubbing her “with warm oil, camphor and spirits of wine” (Seacole 1988 31). Clearly the occupation of “doctress” is quite different from that of a nurse, who works under the direction of a doctor, who makes the diagnosis and oversees the treatment.
Back in Jamaica in 1853, Seacole recounted a yellow fever epidemic, when she treated sufferers, “officers, their wives and children,” often from incoming ships at her boarding house (Seacole 1988 59). Her account is harrowing, but she spared the reader many “scenes of suffering and death” (Seacole 1988 60). For some victims all she could do was soothe their last moments. She made no claims of successful treatments. She next related being “sent for by the medical authorities” to provide nurses for the sick at Up-Park Camp, a mile from Kingston, “but it was little we could do to mitigate the severity of the epidemic” (Seacole 1988 63). She gave no specifics of remedies she attempted there. Altogether it is a sobering account. Yet secondary sources credit her with success.
During the Crimean War, while running the “British Hotel,” effectively a restaurant and store, Seacole continued to practise as a doctress, dispensing her herbal remedies for purchase at the store. She called her clients “patients,” but it should be noted that they were all well enough to walk in, not hospital patients.
Contrary to many secondary sources, the British Hotel was never a hospital or convalescent establishment. Seacole had first advertised the intention of establishing a “mess table and comfortable quarters for sick and convalescent officers” (Seacole 1988 81), but in fact there never were quarters for overnight stays. Nor was the British Hotel a “rest home,” with a canteen that served “wholesome food” (Griffon 1998 8). Unlike either a hospital or rest home, it was not open on Sundays and closed nightly at 8:00 p.m. (Seacole 1988 145).
Seacole in her memoir used “nurse” for Nightingale and her nurses, not herself (Seacole 1988 87, 89, 90). In three places she used the verb to nurse for the care she gave: (1) to her patroness and (2) to her husband in their dying days, both at home in Jamaica (Seacole 1988 5); and (3) in West Granada she nursed Mr Day “through a sharp attack of illness” (Seacole 1988 69). During the Crimean War she nursed a “boy in the Artillery with blue eyes and light golden hair,” through a “long and weary sickness” (Seacole 1988 153). In none of these instances did Seacole give details as to either the illness or the treatment.
Seacole’s Relationship with Nightingale
Nightingale’s work and reputation have been under serious attack now for thirty years, beginning with the publication of Florence Nightingale: Reputation and Power (Smith 1982), followed by another book which focussed on her Crimean War work, Florence Nightingale: Avenging Angel (Small 1998). The current campaign to replace Nightingale with Seacole as the “real heroine” of the Crimean War, and the real founder of nursing, builds on these two sources and the vast number of hostile secondary sources that they prompted. Refutations on Smith and Small and their major followers are available (McDonald 2000, McDonald 2001 843-47, McDonald 2005 1039-49, McDonald 2010a xii-xv, and McDonald 2010b 32-40).
Most of new editions of Seacole’s memoir contain introductions with much misinformation, both about Nightingale and Seacole. For example, in the introduction to her edition, Washington stated that Seacole was “snubbed by all the nurse-recruitment agents, by the War Office and finally by a visibly impatient Florence Nightingale.” Jealousy might have been the motive, Washington conjectured, “because Seacole’s fame at this point rivaled Florence Nightingale’s own” (Washington 2009 xiv-xv). This editor was distressed also by reading “of how Florence Nightingale rebuffed Seacole’s attempts to join her nursing teams in the Crimea and of her uncomfortable interview with Nightingale herself” (Washington 2009 xvii). But Seacole’s own depiction of the interview was friendly, not uncomfortable (Seacole 1988 90-1), and Seacole never accused Nightingale of having rejected her offer to nurse, recognizing that Nightingale had already left for the Crimean War when she, Seacole, decided she wanted to go to the war.
Washington has Seacole, pre-Crimea, following epidemics to be able to treat the victims, specifically following cholera to Cuba, so that, “along the way,” she “gained expertise in treating dysentery, yellow fever and other dreaded tropical diseases as well” (Washington 2009 xiii). But Seacole’s memoir says nothing of the kind, mentioning Cuba only in passing, namely that, after acquiring shells and shell work in the Bahamas, which sold well back in Jamaica, “I visited also Hayti and Cuba” (Seacole 1988 5).
A number of sources claim that Seacole set up hospitals or nursing stations in the Crimean War, variously at the British Hotel or elsewhere. A military historian claimed that she “set up a rough and ready nursing station” (Royle 2000 257). Another author has Seacole taking teams of nurses to the battlefield to nurse soldiers on the spot (Barnham 2002 24-5).
The entry on Seacole by the National Library of Jamaica has her building a “hotel for invalids.” It also gives a positive account of Seacole’s skills “when yellow fever raged all over Jamaica” despite Seacole’s own acknowledgment of being unable to help mitigate it (Seacole 1988 59-63).
Nightingale, in contrast with Seacole, saw the nurse as the person who carried out the doctor’s medical instructions, at a time when few women had even the equivalent of a high school education, and none had a university education. Seacole worked independently, using the traditional Creole medicine taught her by her mother. Some sources, however, treat Seacole as being on the same professional footing as doctors, a claim Nightingale would never have made. In a foreword to Wonderful Adventures, referring to Seacole’s time in Cruces, Panama, the editor called her the “only trained medical professional” (Washington 2009 xiii). The major biography on Seacole calls her “a mixture of doctor, apothecary and entrepreneur” (Robinson 2005 141).
There is simply no evidence that doctors treated Seacole as a doctor. The official report on the Crimean War hospitals lists referrals from the regimental hospitals to the general hospitals, with no mention of any referrals to Seacole (Smith 1858, vol. 1). Doctors who wrote memoirs on their war experiences do not refer to her as a medical colleague. Dr George Lawson, for example, described her store at Kadikoi, and her giving hot tea to soldiers waiting to board ship: “Mrs Seacole was in fact one of the many sutlers or camp followers who sold goods (mostly food and drink) to the troops, and who followed the Army on every campaign, appearing in the most unlikely places” (Bonham-Carter 1868 157). A British doctor with the Turkish Army called her a sutler who kept a store at Kadikoi, two or three miles from British headquarter, where, in an emergency, one could obtain some kind of a meal (Buzzard 1915 179).
In her memoir, Seacole herself described the limits placed on her by the doctors, when she was took tea, lemonade and sponge cake to soldiers waiting at the wharf for transport to the general hospitals, “all the doctors would allow me to give to the wounded” (Seacole 1988 101). A medical historian of the Crimean War said that the doctors knew her well and, although they thought her rather a quack, they were appreciative of her good works (Shepherd 1991 2:507).
Misinformation on Seacole’s Recognition in Medals
A popular misrepresentation is that Seacole was recognized at the time for her heroism and work, by being decorated with medals, the accounts ranging from three or four--Britain and France, plus Sardinia or Turkey or both; some that she may even have received a medal from the enemy, Russia (Washington 2009 xvi). The website of the National Portrait Gallery credits her with having been awarded three, the British Crimean medal, the Turkish Medjidie, and the French Legion of Honour, adding that “Mary Seacole was known to have received these honours” (National Portrait Gallery). The Channel 4 documentary awards her “four government medals” (Bruce 2005). Yet a major biographer of Seacole, who sought assiduously to verify these claims, could find no documentation for any of them, and concluded that it was “more likely that Mary ‘distinguished’ herself” with the medals (Robinson 2005 167). (The names of recipients of the French Légion d’Honneur can be easily checked online at wikipedia.org/wiki/List_of_Légion_d’honneur_recipients_by_name.)The statue proposed as a Seacole memorial is to display “her medals, of which she was proud...pinned to her chest” (Mary Seacole Memorial Statue Appeal 2011). The National Library of Jamaica also incorrectly credits Seacole having been presented with the Crimean medal, which she “always wore on her dress” (National Library of Jamaica).A publication of the Guy’s-St Thomas’ Trust asserts wrongly that Seacole received “four medals including the Crimean Medal and the Légion d’Honneur” (Sorensen 2011 2.1). This document also falsely asserts that Seacole “gave her life’s work” in the support of early nursing, although it names not one instance of such a contribution. Moreover, in her memoir, Seacole describes two early trips to England, the first when she stayed for a year, the second for two years, for neither of which did she mention any nursing. On the second she earned her livelihood by selling West Indian preserves and pickles (Seacole 1988 4).
Racial Slurs in Wonderful Adventures of Mrs Seacole
In addition to Seacole being given the positive attributes of Nightingale, especially of her work to improve the life of ordinary soldiers, when the British Hotel largely served officers, Nightingale has been given Seacole’s besetting sin, a frequent use of racist language and even racial slurs. That Seacole did not identify with her African forebears has only reluctantly been acknowledged by some authors (Robinson 2005 172), who also noted the frequent, negative aspersions Seacole made to blacks and “niggers.” A careful read of Wonderful Adventures will show that Seacole did not once refer to herself as black, but all references to blacks are to others, often to her own servants (Seacole 1988 12, 19, 21, 37, 39, 45, 58, 66, 113, 138, 180), as are also references to “negroes” (42-4, 50-2, 69) and “niggers” (20, 45). Additionally, there are “good-for-nothing black cooks” (141) and a “grinning black” (38). In Panama Seacole described natives’ fare of roasted monkey “whose grilled head bore a strong resemblance to a negro baby’s,” while from a stew made of monkey meat your ladle could bring up what “closely resembled a brown baby’s limb” (69).
At the British Hotel she employed “Jew Johnny” (Seacole 1988 92, 104, 113) and had to deal with Greeks who were “craven” and “villainous-looking” (106) or “cunning-eyed” (86), while Turks were “the degenerate descendants of the fierce Arabs” and “deliberate, slow and indolent” (Seacole 1988 106, 109). Yet, despite these (and other) examples, authors attribute racism to Nightingale. Wilson, for example, asserted that she rejected Seacole’s services “on racialist grounds,” whereupon Seacole “nursed the sick the front line of battle” and whose hotel “provided the men with home cooking” (Wilson 2002 178).
Seacole, as a person of mixed race, herself suffered from racial discrimination, on the part of Americans much more than Britons, according to her memoir. It reports two flagrant instances pre-Crimea, to both of which she rose admirably. In the first, an American man called her, in a toast, a “yaller woman,” but not entirely black, so that she could be admitted into their company with “bleaching.” Seacole declined the bleach job, and declared that if her skin were as “dark as any nigger’s, I should have been just as happy and as useful and as much respected by those whose respect I value.” She drank a toast to “the general reformation of American manners” (Seacole 1988 48). In the second incident, American white women refused to let her into the ladies’ salon on an American ship returning to Kingston from Panama; she went to the captain, got her fare back, and returned without incident on a British ship (Seacole 1988 58).
The Memorial Statue for St Thomas’ Hospital
The statue of Seacole at St Thomas’ Hospital is 3 metres high, taller than those honouring Florence Nightingale and Edith Cavell elsewhere in London (Mary Seacole Memorial Statue Appeal 2011). Not only will her (fictional) medals be displayed, Seacole is to be shown alone, on foot, carrying a medical bag to the front. Yet her own memoir describes her expeditions quite differently. As a sutler she went with food and drink to sell as well as first aid supplies: “sandwiches...fowl, tongue, ham, wine, spirits,” all packed on two mules. How many people went with her she did not say, but she took her “steadiest lad” to look after the mules; she rode on horseback. With these supplies she also took the “large bag I always carried into the field slung across my shoulder with lint, bandages, needles, thread and medicines” (Seacole 1988 156).
It is no coincidence that the nursing union Unison, a major supporter of the Seacole statue campaign, has since 1999 also been campaigning against Nightingale. At the Unison meeting which unanimously voted to “ditch” Nightingale as the symbol of nursing, health visitor Wendy Wheeler argued that nurses must “start to exorcise the myth of Florence Nightingale” (BBC Online News 1999), perhaps oblivious to the reality that Nightingale did more than anyone else to found the modern profession of nursing, took up health and occupational health and safety of nurses, was a successful hospital reformer and had a vision of public health care, much of which she saw achieved, as early as 1864.
Wheeler added that “Florence Nightingale believed nurses should be subordinate to doctors,” a frequent statement, which assumes equal relations with doctors to have been possible. In the early 1850s, when Nightingale began to reform nursing, nurses at St Bartholomew’s Hospital were housed in “wooden cages” on the landings--Nightingale always argued for private rooms for nurses. Hospital “nurses” in civil hospitals at the time were mainly cleaners (exceptionally, a doctor would give informal training to a “nurse” who would then look after his patients). Army nurses were recruited from among the wives of private soldiers and non-commissioned officers, reported to a sergeant, and were paid less than a cook or laundress (Smith 1929 11-14); they did not so much as speak to a doctor.
When Nightingale set to work, nursing was not a profession at all, but an occupation of ill repute. Women were not then allowed in any university in the UK, and few had the equivalent of a high school education. To have called for these women to be on an equal footing with well- educated men doctors would have ensured that no hospital would have taken them. Nightingale began where women were, with apprenticeship-style training. Literacy was the only requirement for admission to her school, and occasionally a woman was admitted who could not read or write.
It is ironical that the nursing union keen on “ditching” Nightingale has its new headquarters in the renovated Hospital for Women, founded by Elizabeth Garrett Anderson, on Euston Road. Nightingale advised on the plan for the hospital (the initial version made it impossible to nurse adequately, she thought), supported the fund raising for the hospital with a letter to the Times and herself contributed £50 to the fund (McDonald 2005 63-66).
Anionwu E (5 October 2010) A History that Lives on, Nursing Standard 26,5 18-19.
Barnham K (2002) Florence Nightingale: The Lady of the Lamp. White-Thomson, Lewes.
BBC Online News (27 April 1999) Nurses ditch Florence Nightingale image. London.
Bonham-Carter V (Ed) (1868) Surgeon in the Crimea: The Experiences of George Lawson Recorded in Letters to his Family 1854-55 Constable, London.
Bruce A (Dir) (2005) Mary Seacole: The Real Angel of the Crimea. Channel 4, London.
Buzzard T (1915) With the Turkish Army in the Crimea and Asia Minor: A Personal Narrative. John Murray, London.
Griffon, D (1998) “A Somewhat Duskier Skin”: Mary Seacole in the Crimea. Nursing History Review 6 115-27.
Huntley E (1993) Two Lives: Florence Nightingale and Mary Seacole. Bogle-L’Ouverture, London.
Mary Seacole Memorial Statue Appeal 2011. www.maryseacoleappeal.org.uk
Mary Seacole (1805-1881) Biographies of Jamaican Personalities. National Library of Jamaica. www.nlu.gov.jm/bios-n-z
McDonald L (December 6 2000) Florence Nightingale Revealed in her own Writings, Times Literary Supplement 14-15.
McDonald L (2001) Appendix B, The Rise and Fall of Florence Nightingale’s Reputation, in McDonald, L (Ed) Florence Nightingale: An Introduction to her Life and Family (Waterloo. Wilfrid Laurier University, Waterloo ON.
McDonald L (2005) (Ed) Florence Nightingale on Women, Medicine, Midwifery and Prostitution Wilfrid Laurier University, Waterloo ON.v
McDonald L (2010a) Florence Nightingale at First Hand. Continuum, London.
McDonald L (Ed) (2010b) Florence Nightingale: The Crimean War. Wilfrid Laurier, Waterloo ON.
Robinson J (2005) Mary Seacole: The Charismatic Black Nurse Who Became a Heroine of the Crimea. Constable, London.
Royle T (2000) Crimea: The Great Crimean War 1854-1856. Little Brown, New York.
Seacole M (1988) Wonderful Adventures of Mrs Seacole in Many Lands. Oxford University, Oxford.
Small H (1998) Florence Nightingale: Avenging Angel. Constable, London.
Smith A (1858) Medical and Surgical History of the British Army which served in Turkey and the Crimea. 2 vols. Harrison, London.
Smith F (1929) A Short History of the Royal Army Medical Corps. Gale & Polden, Aldershot.
Smith FB (1982) Florence Nightingale: Reputation and Power. Croom Helm, London.
Sorenson K (20 July 2011) Mary Seacole Memorial Statue Update, Guy’s-St Thomas’ NHS Foundation Trust, London.
Washington H (2009) Foreword. Wonderful Adventures of Mrs Seacole in Many Lands (Ed) Harriet Washington. Kaplan.
Wilson A The Victorians (2002) Arrow, London.