Many wars turn out to be marches of folly, but the Crimean War (1853–56), a sectarian affair that arrayed Catholic and Protestant Europe and Muslim Turkey against the Russian Orthodox faithful, was exemplary in this regard, producing near half a million dead soldiers, the vast majority killed not by bullet or blade but by exposure, malnutrition, and dysentery—in other words, by the incompetence of generals and governments.

Particularly inept was the British war office, which expended 21,000 men over three years, only 5,000 of whom died as a consequence of battle. When peace arrived, glory was in short supply, and the British settled for the one war hero on whom all could agree, 36-year-old Miss Florence Nightingale, known to us as the inventor of professional nursing. To her contemporaries, however, she was, in Longfellow’s celebrated phrase, the “lady with the lamp,” who in the groan-filled night wards at her hospital in Scutari, Turkey, ministered to bedridden soldiers who “kiss[ed] Her shadow, as it falls Upon the darkening walls.”

Poems were the least of it. Statues of Nightingale were erected, and Staffordshire figurines of the lady with the lamp were in the shops. From the palace came invitations for tête-à-têtes with Queen Victoria, and from the general public came a substantial “Nightingale Fund” for her use; within a year of her return, a wax likeness stood in Madame Tussauds. None of this suited the real Florence Nightingale, who was not the plaster angel England yearned for but a brilliant, judgmental, ambitious, and acerbic woman with a personal and scholarly penchant for Christian mysticism, particularly of the shockingly Catholic self-abnegating variety; or, as one recent biographer put it, she was part Joan of Arc and part Margaret Thatcher.

Born to privilege, Nightingale early on rejected the solid humdrum to which she was entitled and—called by God, she wrote in her diary—determined to do some large, self-sacrificial good. As a young woman she went to Germany to see how nursing was practiced there, and then, to the dismay of her family, took work as a supervisor of nurses at a London hospital. In 1854, she was tapped by a British government desperate to find a woman of suitable class who could deal with the emerging scandal of the first British army ever to be destroyed by the lack of wool socks and soap. That November, Nightingale and a small group of nurses arrived to work at the hospital in Scutari that might be called makeshift if makeshift could be made to encompass clogged sewers; shortages of food, dressings, medicine, and staff; and a mortality rate of nearly 50 percent.

Nightingale spent two years trying to straighten out Scutari and its ilk, with limited success. A sick man was safer in his tent than under Nightingale’s care, it’s been shown. Government bureaucracies remained obtuse. And what Nightingale and her colleagues didn’t know about microbes and germs turned out to be lethal. Her letters to London were at once practical (demands for underwear), strategically manipulative (she signed herself “deputy inspector of hospitals,” a pure invention), learned (she made herself a virtuoso statistician of death), and shrewdly comic. Of a group of Catholic nuns whom she wanted transferred from Scutari, she wrote, they were “fit more for Heaven than for a Hospital.” Nightingale was by all accounts an assiduous bedside nurse, plugging open arteries with lint, cleaning messes, massaging the limbs of the dying. She found the work, she wrote in her diary, a “great serenefier.” As to the story of her walking the corridors—four miles of them—with lamp in hand, it was true.

A year after she returned to England, Nightingale disappeared into her London home, later retreating to her bedroom, convinced, she said, that she was dying. In 1859 she published the bell-clear Notes on Nursing: What It Is and What It Is Not, which remains useful and in print today; and over the next two decades—still dying—she worked, through correspondence and private secretaries, to reform medical care and social service in Great Britain. And she worked on associated issues of public good until she did die, at age 90.

Her reclusiveness has consumed much ink in the field of “Nightingale studies.” Was her illness and its associated pains real or imagined? Was it brought about by neurasthenia? Depression? Bipolar disorder? Guilt over the deaths she’d not prevented at Scutari? Syphilis?

Among the medical possibilities, brucellosis seems to fit the reported symptoms best. Among the fanciful, I favor the notion that the unapproachable invalid was another invention by the subject herself—as with “deputy inspector,” a way of wresting a chosen life from a society that was prepared to grant such a thing to the “lady with the lamp” but not to the lady herself.

Our story on the chosen lives of student nurses begins here.