A Meeting of Minds

The Crimean War that raged from 1853 to 1856 is often referred to as the first "modern war" (though far from the last) and I won't get into the murky issues that were involved or the various European nations that took part.  All that matters for now is a memorable encounter between two remarkable figures in the history of medicine and what came of that meeting...

Florence Nightingale, also known as the Lady with the Lamp, began her career in nursing in 1851 despite strong family objections (being a nurse was not considered a proper vocation for "respectable" ladies in those days).  While she held positions in various London hospitals, it wasn't until the outbreak of the Crimean War that she began the work that made her famous.  After reports started trickling back of appalling casualties, she and her colleagues traveled to Turkey to tend the wounded soldiers.  Establishing themselves at a military hospital in Scutari (now a suburb in Istanbul), they made dramatic changes in how the wounded were being treated and Nightingale developed an innovative approach to medical statistics.  Unfortunately, the death count began to 220px-Florence_Nightingale_three_quarter_length[1] rise as more patients began to die from infectious diseases than from actual wounds.  Nightingale insisted that the deaths were being caused by poor nutrition and overwork.    

Dr. James Barry, a British army surgeon with a long and colourful history of medical service had a reputation for being tactless, opinionated, and argumentative.  He had made a number of enemies over the years with his disrespect for authority and his innovative medical practices.  His insistence on the importance of sanitary conditions in hospitals had doubtless saved countless lives over the years but it was still a novel idea that wasn't widely accepted.  He was posted in Corfu during the Crimean War and went to Scutari (without permission) to investigate the high number of casualties being reported at the hospital.  What he found appalled him and he didn't hesitate to give Florence Nightingale what she would later describe as "the worst scolding of my life".   He condemned the poor hygiene that he found in the hospital and insisted on berating her from horseback.  While Nightingale came to accept that Barry was right (grudgingly), she would never forgive him for how he had treated her.  The death rate dropped dramatically once ventilation was improved and the defective sewers in the hospital were flushed out.

After the Crimean war ended, Nightingale returned to London and was lauded as a national heroine.  Her activism sparked a Royal Commission that led to a major overhaul of army medical care.  Barry, on the other hand, didn't fare so well.  Not only was he forced to retire in 1864, he was also denied his long-sought knighthood.  It remains unclear whether his feud with Florence Nightingale played a role in the end of his military career but it certainly couldn't have helped.   He had made numerous enemies with his brash manner and outspokenness so it wasn't a surprise when he was forced out of service at long last. 

The real surprise came with Barry's death in 1865 when the women who laid out his body discovered something that even his personal manservant had never known.   Dr. James Barry was a woman.  Although some later claimed to have suspected it all along, there are still numerous unanswered questions about her 220px-James_Barry_(surgeon)01[1]true name or her history before she began her remarkable disguise.  It isn't even clear whether she was truly female or intersexual.  Despite the furor over this discovery, she was buried at Kensal Green Cemetery in London, England with the name and the full military rank that she had earned.   Until her own death in 1910, Nightingale never forgave Barry for what had passed between them and revelations about her gender did nothing to change her opinion.   

The historic meeting between Barry and Nightingale is not mentioned in many history books and Barry's role as a medical pioneer seems to have been largely forgotten.  If she is remembered at all, it's for her lifelong disguise.  Still, between the two of them, Florence Nightingale and James Barry changed the face of battlefield medicine forever.  It is an achievement that seems especially ironic considering that it happened during an era in which few, if any, women were allowed to practice medicine at all. 

Such is life. 


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