Florence Nightingale was the founder of the profession of nursing  for the English-speaking world. That profession was inevitability growing toward some realization and she stamped it “F.N.” in ways more significant than many founders of nation-stateFN-Statues or religions could claim.

Many find something Marian in the way her founding spirit hovers over the secular profession of nursing. Because of Florence Nightingale, nurses have become respected for their honor and their scientific training as well as for their labor and service. Because of her they remain the guardians of our health. They are there for us.

In the unlikely event she had joined the Roman Catholic Church there would be a decree of beatification on the 100th anniversary of her death. That decree, I read, gives formal permission “to venerate one whose life is marked by the exercise of heroic virtue.”

She did not convert and was hardly Church of England, although very religious. More like a Quaker or a rebel Mormon woman (if those categories are meaningful to you). Such categories were not important to her. Most simply, she was one of those who have been called, one of the beautiful ones, one of those we have been waiting for.

In accord with her notion of Christ’s modesty, she wanted nothing but to be buried in an unmarked grave. If that proved impossible she wanted her grave marked only “F.N. Born 12 May 1820 Died 13 August 1910.” That wGrave-Wellowas done.

Sketch artists and encyclopediasts, in their anonymity and vast audience, fail to convey Florence Nightingale’s many qualities and contributions. They leave her as an icon: “The Lady of the Lamp,” “The Angel of the Crimea.” Nevertheless, she has had fine biographers making contributions toward more fully understanding her: Sir Edward Cook in 1913; Ida O’Malley in 1931; Cecil Woodham-Smith in 1950, Gillian Gill in 2004; and Mark Bostridge in 2008. And there have been many other biographies and contributions. Several selections from Nightingale’s letters are works of some scholarship and care: Martha Vicinus in 1989; Sue Goldie in 1990; Mary C. Sullivan in 1999, and others. There are several fine studies of Nightingale’s contributions to public health, administration, and religious thought.

Now a Collected Works of Florence Nightingale is underway (the first volume of a planned 16 was published in 2001) under Lynn McDonald of the University of Guelph by the Wilfrid Laurier University Press in Waterloo, Ontario. Finally having her Collected Works will improve all new Nightingale writing. McDonald’s text, introductions, and annotations are very fine: generous and always scholarly.

All the products of this Nightingale industry—scholarly and, for the most part, responsible work—have and probably will continue to have a touch of imagination, of speculation, of wonderment about them.  Not surprising that sketch artists fail.

We grope for a full understanding of Nightingale as if knowing would throw a switch somehow illuminating a great deal that concerns us. Or—with the nurses who always learn something from her—we turn her light onto contemporary issues and benefit from what it reveals.

No surprise that some have fought hard to diminish her, as if to keep their privledge, property, and preconceptions hidden. She has never been an easy woman.

Mark Bostridge in the most recent full biography chooses an apt head-note quotation from Nightingale’s close friend Mary Mohl (”Clarkey”)

I study Flo as if she were a language and as she is a deep one I have not mastered it by any means.

One thing can be said with certainty: there was a great force behind Nightingale’s association with others well beyond her extended family. Although she put considerable practical effort into conciliating her family and into diverting all credit for shared accomplishments onto men like Edwin Chadwick (the great sanitarian and Director of the Poor Laws Commission), William Farr (founder of the discipline of medical statistics), John Sutherland (colleague in War Office reorganization and something like “Surgeon General” of the UK), Sidney Herbert (repeatedly Secretary at War in the cabinet and her main ally in government), Benjamin Jowett (preeminent Oxford classicist), and many, many others, all owe a significant part of their reputations to their work with her. Herbert, Farr, Sutherland, the poet Arthur Hugh Clough, Jowett, and—excepting in Jowett’s case—their wives literally gave significant years of their lives over to Nightingale. Along with them were the resolute Bracebridges, the Shore aunts, the Smith, Bonham Carter, and Nicholson cousins, and others. From her twenties into her seventies she played life-defining, career-making, or influential roles in many additional lives. Many were eminent Victorians.

When reading even the most generous biographies or studies, I am always convinced that not enough has been said. I do not mean that I want to take away her intense personal privacy.  But I do want more said that applies to major public events and issues, that sheds more of her light.

For instance, in likelihood, Nightingale did not go to the Crimea as a result of Billy Russell’s newspaper reports on the criminal conditions facing the troops (inadequate supplies, disease, no medical services, French superiority in health care through their nursing nuns). Nor did she go at the initiative of the Secretary at War. She had read the newspapers from before the Battle of Alma, knew the conditions from her correspondence, and herself initiated the Times’ reportage of the lack of medical services (through her military contacts, Ambassador Stratford de Redcliffe and Lady Stratford, young Thomas Chenery who actually wrote the first reports as a stringer for the Times, and Times editor Thomas Delane). The reportage had a powerful impact on the British public because of the new telegraph connection between the Crimea and London. More than likely she herself—in immediate days before spent investigating medical conditions among the poor with Sydney Herbert—initiated the plan for a team of nurses to be sent to the Crimea.

Again, in likelihood, Nightingale was mainly responsible for the weakening and fall of the Aberdeen government in 1855 and for the reform of the British War Department following the Crimean War, as well as the reforms brought about through Royal Commissions she urged to life, especially the Commission on India, and the performance of Indian Viceroys. There was much else.

Not much good can come from pandering to celebrity culture—with its powerful underwriters in publicity and marketing—nor from pushing a Great Man theory of history.  And Nightingale herself teaches us what cooperation, colleague, and collaborator mean.  However, there was such a force and pertinence about her that it weakens my reluctance to emphasize.

Her name should be associated with the dissolution of the British East India Company (a primary agency of Great Britain’s colonial depredations). Her name should be significantly associated with the whole course of English reform legislation (she had learned from Chadwick’s painful experiences). Her name should be associated with the founding and successes of the British Social Science Association—as it was known—and the London Epidemiological Society.

And there are many smaller matters. Nightingale’s family is never mentioned in history in connection with Adolphe Quetelet’s invitation to England and the consequent founding of what became the Royal Statistical Society (Malthus was there, Babbage was there). There is the significance of her use of statistics in Parliament (through her MP allies) and in statistical graphics. The anthropologist/eugenicist/coiner of words Sir Francis Galton (1822-1911) figures more prominently in the history of science than does Nightingale who was tutored by the great James Sylvester and with Quetelet her “dear comrade.” And so forth. There are many historical oversights and injustices.

I expect to discover much more about her accomplishments. For instance, the history of epidemiology—that foundation of social medicine—does not yet have a historian who will speak a single word about the significance of Nightingale’s fight against the primacy of graft—in the form of misused grants and funds, position, and privilege, as well as common trade in medicine-for-profit—in the history of their science. They avoid she who avoided nothing.

Also her name should be significantly associated with the novelist careers of major Victorian novelists. Nightingale felt that some of their most important accomplishments was work she might have and perhaps should have done. She was often conflicted about the use of her resources. However—true to form—she used the thought of writing great novels the way actors use the joke “I could have done that” to keep her head on straight. She knew full well a great writer when she read one and knew that her devotion lay elsewhere.

If Nightingale and English literary history seems a stretch consider that to leave her out is exactly like imagining that Nightingale—massive correspondent, activist, reader of everything, reformer, office/residence in London just off Hyde Park, burner of midnight oil and candles at both ends—had no contact with the revolutionary struggles for social change beyond  the boundaries of gentry-acceptable reform politics. There too she is left out.

Sometimes you have to wonder about history writing. For instance, in behalf of historical business-as-usual there is a great underestimation of the Elizabethan license-to-power for women in the early sixteen hundreds. And the continuity of that license. Historian get stuck on the well-documented legalities and formalities of gender relations and ignore the living reality. Also, way too often, historians ignore or understate the power which deep and intimate learning (classical and scientific) conferred on women when they possessed it. As if to talk of such learning is to admit you yourself do not possess anything like it. That is an obvious truth and therefore a closed subject.

Also, very often, our own twentieth century class preoccupation with the home gets read back into Victorian culture where that preoccupation was only in its infancy. Dozens of studies tell history hind side to. Yes, the Victorians were giving rise to the middle class culture we know so well.  But it is we, not they, and especially not Nightingale, who indulges all the limitations of that particular class phenomena.  And as for her “invalid” status, a society that honors exercise over accomplishment and idle socializing over influence is in no position to judge Nightingale’s great energy and precious time and space.

You should also know that most prominent Victorians were censors, concerned with privacy, careful of reputations and of the feelings of others. Nightingale destroyed many reams of paper in her own fire and often ordered letters and papers to be destroyed. Undoubtedly her family and first biographer (a family friend) continued the practice on their own. The British Museum holds 15,000 Nightingale letters, spoken of as a great number. Yet that is far fewer than a letter a day over her 60 active years, while we know that she wrote constantly, day long and into the night, exercising her influence by correspondence. Yet only 15,000 or so letters remain. Even these generations later critics deliberately neglect or actively suppress aspects of Nightingale’s life for no more reason than their inability to provide their version of scholarly annotation.

I suspect they sometimes have darker reasons of their own. “How small a thing is woman.” Even such a woman.

Therefore, with Nightingale, may we not stretch the boundaries of propriety somewhat? Whole dramas could be composed of scenes of great interest. For instance, an aggressive, brilliant child interrupting her father and their neighbor Lord Palmerston at their weekend chess to demand answers to her incisive questions on British political issues; her meeting with Frederick Engels in Hyde Park and their inevitable discussion of The Conditions of the Working Class in England in 1844 and their own diverse aspirations; private conversations with the Brontë sisters; Nightingale on a horse at night in the rain overlooking a Crimean battlefield with a favorite officer—one of the many who became life-long friends and supporters—in discussion of the war.

We still lack even a developed scene in which she attempts to mesmerize a tame bear in the Oxford apartment of a friend, accompanied by her would-be fiancé, R. Milne, who was the first biographer of Keats and himself an extraordinarily accomplished strange duck and, inevitably, a MP, Lord, and life-long supporter of her causes.  Clearly they all had a bit too much wine.

We do have many invented scenes from her childhood, necessary in the very numerous popular biographies of the Lady of the Lamp, but they are lame by comparison.

These are only poor illustrations.

Although she was a woman of machinations, angers, and lament—or as Sutherland said, “a woman of iron filings and sawdust”—Nightingale could also be an amusing woman, occasionally a comedian, mimic, and a scandalous delight for her sister, cousins, and close friends. Her humor was most often informed by her knowledge of the inadequacies of her nation, its BrokenColumn leadership, and its culture. Replying to a friend’s question “What Is To Be Done?” she said, “Perhaps we should advertise for the answer.” Describing a defense of inadequate statistics, she said “He claimed there were even uglier bonnets in the store.” When the Crimean brass could not grasp the differences between a Latin or Greek cross or a Crescent for a Turkish cemetery monument at Scutari, she wrote that she had proposed Themistocles’ broken column, “only nobody could see the sentiment of it.”

If Nightingale had converted to Catholicism—which she seriously considered—that would have made Cardinal Manning’s career. He was a former beau and close friend, fellow reformer, and a most famous English convert. But far more than Manning’s career, her conversion would have changed the course of religious history in England and would have answered “The Irish Question.” Her Crimean experience lay ahead. For a considerable time she was the most famous woman in the world. Nightingale’s sense of religion was enormously radical. Religious caterpillars, as she called them, categorize too easily, as if religion were a bug or butterfly that you catch and that Science must give a scientific name.

Any woman knows what it is to be belittled. Nightingale does not allow it. There are now six million trained nurses in the English-speaking world. Every one of them knows something of Florence Nightingale.

Concerning getting a reform accomplished, Nightingale once said “I shall eat straight through England.” They will think they are in a forest of Nightingales.

She was a great tree of a woman and the scaffolding that made the profession of nursing possible. As a great tree does, she left behind a forest of leaves. As from such a solid scaffolding, schools of nursing throughout the world will celebrate the 100th anniversary of her death this August, 2010.

A note on her leaves follows. Also, I may append some of the many moving anecdotes.  For one instance, when Japanese nurses—after days of horrors following the Hiroshima atomic bombing and in real danger of suiciding themselves or running home—repeated together each day the Nightingale Pledge, they stayed there in Hiroshima working at their profession.

When I can locate it, I will append a list of the many nicknames (some quite overwrought) by which Florence Nightingale was known in her time.

Jim (written in 2007, edited August 16, 2010)

All of you will have noticed the emergence of the multi-billion dollar market in “energy drinks,” those high-priced water/sugar/caffeine drinks with names like Red Bull (“It gives you wings”), Monster (“Unleash the Beast”), Vault (“The Taste, The Quench, The Kick”), Khaos, Cocaine Energy, SpikeShooter (“The caffeine of three Red Bulls”) and—naming just one more of many—Super Mario Brothers Energy Drink.  They are being marketed primarily to children with kid-oriented packaging, youth sports sponsorships, youth accessories (called Swag), youth celebrity endorsements, MySpace promotions, kiddy signage (“Reach Out–It’s Yours”) and displays.  The corporations deny that they market to children and I have yet to see a journalist call them on this obvious lie. Primarily their youth marketing takes the form of aggressive product placement in aisles of greatest access for the young in all the key kid venues (7-Elevens, CVS, Walgreens).

Read the rest of this entry »

Childhood

This continues the draft novel, "Nightingale At Large." The form is e-mail correspondence, notes, and other documents exchanged between two brothers along with others about a film project based on Florence Nightingale’s life. One brother, Robin Landsman, is a Florence Nightingale enthusiast and a part-time instructor at the American University in Beirut and elsewhere. The other, Richard Landsman,is an A-list Hollywood director. A third party, introduced here, is Richard’s wife Rachael Landsman who is responsible for bringing the two long-separated brothers together on this project.

Robin to Richard 

Rich, here is something of the Nightingale childhood settings—Lea Hurst and Embley—to go along with the photos sent.

I meant for you to throw those lame photocopies from encyclopedias and the life-sketches away after reading. I am suggesting that we do not employ any of the child-is-father-to-the-man clichés used about this famous reformer and the founder of modern nursing: binding the broken leg of the gardener’s dog Spot, or whatever; arranging her dolls in rows in the closet, their appendages wrapped in scraps of muslin; running pell-mell to any relative who sneezes. I hope to see none of this.

And yet some dress rehearsal for a life is necessary and I hope I can provide useful suggestions. We cannot just have the public woman—Bam!—like that. First there has to be the spindly five-year-old in a dusty play smock, the grotesque and dirty shoes, tearing around the grounds of Lea Hurst and hiding behind the great tree, Flo and Pop and governess at hide-and-seek.  Or we see her stamping her feet with impatience as she is dressed and combed by a nurse in the children’s austere bedroom. Or as little Miss Dutiful, counting silver in the pantry, or attempting to report properly to her mother—the graceful and aristocratic Fanny, née Shore, Nightingale—on that week’s calling cards.

Later there may be an onyx drop necklace, hardly worn, never her favorite, thrown into the corner in a snit. That necklace might have been rough mined in Africa, polished in Amsterdam, set by a jeweler in Haddon Garden—and she may well have known all this—but it was a string of useless baubles to young Miss Nightingale.

Here are some ideas of events in the settings I described earlier.

Flo and Pop’s charity visits to cottages in the village with their mother were routine. The servants—Flo will address the oldest by name—will show they know what is to take place beforehand and have set aside what is needed. Again we have Fanny Nightingale’s managerial mother manner—lots of presence and formality—as she instructs the girls, who show by fetching and placing this and that into the worn charity baskets before being ordered to do so that no instruction was needed. Flo, in particular, operates just at the little girl edge of discourtesy. This is not new.

We see Flo’s avidness as well as her tendency to obedient disobedience, a child already living the two lives of supplying the required courtesy while attaining her own ends. We will also see a touch of this cruel village world, one without welfare beyond the occasional philanthropy, this parish care. The teeth are poor, complexions bad, an ill-set bone, imperfect drainage abound the cottages. At the cottages we will see that the folks are used to caring for themselves, moving to and fro at their routine tasks around the ladies. Even so, the occasional largesse from “the House” is welcome and they are not indifferent, yet not obsequious.

There is a scene in the Miramax “Emma” where Paltrow and “Miss Smith” do a similar visit, mainly used to show Miss Smith as an inexperienced bumbler. I mention this in case you want to do visual “quotes” from other Victorian setting films?

With the Nightingales visiting the cottages, we see Flo touching a goiter or a scar. We should see the poverty, the thin children in the corners attentive and clearly hungry, the smoking fire, all that. And this is one of William Nightingale’s villages, a relatively generous landlord, but one where the lead mines have closed down, agriculture is uncertain, and Nightingale’s money is now invested elsewhere.

The village near Lea Hurst will soon be a mill town.  There is an old factory there—if you want to mess with chronology—which still operates. Mainly for tourists.  Still operating in the Midlands and the North you will find small tucked-away mills, foundries, and dye works. Lots of images of the late nineteenth century. Mainly for tourists. 

In a subsequent “Sisters” scene (if, for instance, the childhood scenes are done as flashbacks) Flo and Pop will talk of this local economy and of their charity visits with Flo indicating—even at a quite young age, you be the judge—that she sees their occasional, incidental philanthropy is as near as you can get to nothing. without actually being nothing.

I didn’t say that it was nothing, Pop. [Imitating Fanny’s voice] “Our Christian duty” is nothing next to what they do for themselves every day of their lives. We shouldn’t make ourselves big. We are little.”

“But we are little,” says Pop.

“What we do is little.”

Even as a child, she always knows her proportions.

You remember our trips to Nicaragua, our liberal bit of building outside Matagalpa, off and on for a few weeks? Of course you do. 35,000 good liberals went that year: picking coffee, doing whitewash, roofing, bits of painting and not representing one hundredth of one percent of the country’s own efforts carried on without any aid from Oxfam volunteers. I’m thinking of that lecture we got from that hard-nosed Sandinista? “So, thanks in advance for your testimony that we are not godless communist terrorists bent on invading Texas. And also, thanks for your bit of work.” Por nada.

Rich, here is another scene:

EXT. Mother and daughters are in the carriage for charity calls at a set of poor cottages in the parish. There is game and fruit in baskets, a few sheets of elevating prayers for mock reading to the households (”mock” because the Nightingale ladies had them by heart and most of those they visited were illiterate). There were also meals in special wrap from the Nightingale kitchen and some oils and tea.  Also old linen and muslin stripped of its hemming, pieces folded for whatever use, all in the well-used charity baskets. There are also several bottles of port and, well hidden, Flo has tucked away with Cook’s connivance a bottle of brandy that she intends to give to Mrs. Garrett who was dying.  There is a bit of jostling and words between the sisters about who sits shotgun on the cottage-side of the open rig.

Pop, dear, change with your sister, please

Mum, may we visit Mrs. Garrett today?

Her injury is so unpleasant, dear, and we do it no good.

It eases her to have me touch it. And she must need jam just as well as others.

No, Florence, not again this week.

Their weeks are seven days, just as ours are.

Did you fail to hear me, Florence?

…Mamma, why do so many people have things wrong with them?

We are bringing comfort to our parish. It is our Christian duty.

Mum, how many people are there here?

You know that, dear, all the cottages, perhaps twenty or thirty.

Twenty houses times five or six. Or thirty. This week and last and when I came down with George on Wednesday, I counted seventeen people who have something wrong with them, limbs and fingers missing or deformities or scars.

Scars don’t count. [Says Pop. They have been over this ground.]

They do too. The boys are always getting beaten. And I did not count small scars.

Florence, you are to be silent this minute. This work is the Christian charity that God makes possible for us and I will not have you deny Him with your . . . You are to sit quietly and remain so.

Seventeen people of 100 or 180.

[And Florence is seen slipping the brandy to Mrs. Garrett, who is dying in the smoky corner of her cottage. And touching her enormous goiter or tumor. Pop is hesitant. And Fanny is the kind lady, a bit imperious. And, remember, no bread or vegetables should be brought. I didn’t like that in “Emma.” These people do, after all, have a life in spite of their scars, smoke, and need.  They have bread and vegetables.  William Nightingale is not a monster.

From:landsman@landsmanla.com"
Sent: Saturday, June 09, 2007 10:48 Pm
To: alandsman%aub.edu.lb
Subject: Re: Childhood

I get it. Doug McGrath’s charity scene in “Emma” was totally for comedy. The whole thing was Austin irony. I don’t do movie “quotes,” visual or otherwise, as you must know. And whole minutes for a fucking carriage ride! What’s with that?

From: alandsman%aub.edu.lb
Sent: Saturday, June 09, 2007 11:21 Pm
To: landsman%landsmanla.com
Subject: Childhood

Fuck you too, Bobby. Assigning minutes to the charity visit scene is unfair. You know I mean all this Childhood establishing stuff to be very brief. Anything can be sheered away. I just need to know how to proceed.  How to be useful.

He asks how to proceed.

Robert, just open your heart.  Surely everything is useful and certainly encouragemetn is useful to your brother.  Just pile up his notes, read them at a sitting, don’t always e-mail back, but frequently just a comment back.  I will explain to NNN and I’ll be the emancuensus for both bothers, keeping everything, ready to sort of shufflewhy not pile up my notes and read them at a sitting rather than e-mailing back counting minutes.

From: alandsman%aub.edu.lb
Sent: Wednesday, June 13, 2007 3:28 Pm
To: landsman%landsmanla.com

Subject: Re: Continue childhood

From: Rachael Landsman
Sent: Monday, June 11, 2007 1:18 Am
To: landsman%landsmanla.com
Subject: On Arni

From: Rachael Landsman
Sent: Monday, June 11, 2007 1:18 Am
To: landsman%landsmanla.com
Subject: On Arni

From: alandsman%landsmanla.com
Sent: Saturday, June 09, 2007 11:51 Pm
To: Rache
Subject: On Arni
Attachments: England, Childhood

Honey, I’ll call at your 10 PM tomorrow. If Arni is not cc-ing you all his e-mails I’m attaching some here. And to follow. He’s still an irritating ass.  Still, how glad am I we had that day? Any normal pitch, I would have been outta there. Now we have my brother and I talking. A relationship! Nightingale is like an unconsummated affair for him—a bit like the way he looks at you—someone incomplete contemplating a very complete woman. Love, R

From: Rachael Landsman
Sent: Monday, June 11, 2007 1:18 Am
To: landsman%landsmanla.com
Subject: On Arni

They came. Get the office to clump related mail and forward it to me to this address, not my handheld. Robert, remember; don’t be too hard on him. It is great simply that he is writing. A lost sheep found. That you may really want to do the film is just frosting. Missed your call. Tonight? Love, Rache

From: landsman%landsmanla.com
Sent: Monday, June 11, 2007 11:31 Pm
To: alandsman%aub.edu.lb
Subject: Continue childhood

Where are my installments, my night-reading? Just imagine the awful the scripts I read and pass on. Looking forward. Robert

From: alandsman%aub.edu.lb
Sent: Wednesday, June 13, 2007 3:28 Pm
To: landsman%landsmanla.com
Subject: Re: Continue childhood

All right, I understand, forthcoming. I have a need to convey that Nightingale was more than a “clever child,” which is cliché. She felt she must become one. That’s a different thing. Never to be the cipher, never “dull” (which in her grandmother’s blunt Derbyshire talk meant both blind and foolish). In the live time of such minds between plunging awake and giving in to sleep she was determined to make her impression even on the air.

At times at home she would wake early, four or five AM, to steal some plus time for her own purposes before maid and governess arrived, before duties—counting linen and silver, list-making, watchful eyes peeled for imperfections, before lessons and the required exercises they called “arms”—before the calls, visiting, entertaining, and the laborious transcribing into a special journal copies of Francis Nightingale’s social notes; before the precious time with father who offered up trunks of wealth from Athens, Rome, Alexandria, and Cathay to be picked over. If you had the keys!

Florence wrote an autobiography, La Vie de Florence Rossignol, at eleven. Even it is not childish. I hate that mockery of life you find in soft memoirs and biographies with their little childhood scenes. The dear pets: old Muff, pour Bismarck, all the birds, and the insect corpses. “Watch Florence Nightingale promote advances in Veterinary Science and sublimated love while taking a hard look at the thing called life.”

I want childhood scenes, however they are used, to describe the struggle that is growth when the child was called “Emergency Man” and “Stage Manager.” When you heard a visiting Lady’s child, years beyond Flo’s age, whine, “Mamma, I don’t want to play with the bossy girl.” When that child would soon be known as “Pope of the Wards,” “Mother of the Coldstreams,” and—with no sense of exaggeration—”Chief.”

“A Privileged Victorian Childhood” chapter in Gillian Gill’s biography gives more breadth and detail than I can. I’ll send you a copy.

But here are scenes:

—EXT. Two girls are formally burying a dead frog in the garden at Lea Hurst; and, a year later, a cat; and later, a dog. No. No. I’m just being pissy.

Real scenes:

—INT. Lea Hurst. Children’s bedroom. Austere, board floor with small worn oriental, furniture of Shaker aspect. This seen in panning to corner wall where 13 children’s dolls are laid out in a perfect row, clearly a tiny hospital ward. Some of the dolls wear bandages.

—INT. Children’s bedroom. Florence ill with flu, turpentine dampened flannel scarf wrapped round her neck, rises, secures a doll and a small bottle of turpentine secreted from under the bed, dampens a small cloth, makes a face tasting the turpentine, and wraps the cloth securely around the doll’s neck.

I like this one. Alternative version:

—INT. In the Quaker-seeming large bedroom lit by the moon the girls are sleeping. The younger of the two, Florence, is feverish, glowing with perspiration. She wakes, rises, locates matches hidden in a near closet and lights a candle. Returns matches. She collects a number of dolls lying about the room and removes the heavy flannel cloth that is wrapped round her neck. Grimacing at the taste, she uses her teeth to tear small strips from the end of the wrap each of which she wraps around the neck of a doll. She places the dolls on the floor in a neat row of sick dolls. She rewraps the remaining flannel about her own neck, wets two fingers in her mouth, grimaces, pinches out the candle, and returns to bed and to sleep.

—EXT. Embley, rear, lower kitchen entrance. Florence hugs the cook as cook hands the child some rolls of flannelette bandages torn from old sheets, prepared and set aside for her. Child runs off through the back garden with armload of “bandages” flying.

—EXT. Embley, rear garden. Tall WEN stands waiting as Florence leads a troop of groundskeeper and village children up the lawn some distance to the garden. They are bandaged elaborately—arms in slings, splints, heads wrapped, boys limping and embarrassed on home-made crutches. Generous use has been made of berry stain. WEN greets this war theater, this pageant, with a wave and grand smile, and then makes a stern formal bow. He asks, “Victory or defeat.” The child answers: “Father, Both will produce wounded.”

—INT Embley, withdrawing room, Florence and Parthe seated at sunny window seat, no cushions, doing their Cicero with stern, serious WEN. Or the girls reciting their Euripides. Parthe concludes her recitation with a down turning “I realize that wasn’t very good” look; Florence stands and recites with feeling and gesture. We can almost imagine the scene from “Iphigenia in Tauris.”

—INT Embley, sewing room scene: picture, brightly lighted, Fanny, Pop and Flo, doing needlepoint as Fanny reads to them. Flo impatiently jams the needle and plunges up from her chair: “I cannot stand being read to! It is like lying on your back and having water poured down your throat.”

—EXT Embley villages. young Florence concentrating intensely on a bloody birth. She holds steaming water in a pan with cloth-wrapped hands. Or she is ready in the same way with hot water at the lancing of a boil.

—EXT village. Florence somewhat older walking a dark road lined with barely lit village cottages, a heavy basket with cloth packages and bottles of Port or Brandy showing.

No offense, Robert, but thinking of the way of some movies work the above scenes might be followed by child-is-father-to-the-man jump cuts to:

—EXT. Kaiserswerth Hospital outbuilding. The woman Florence in rough Protestant nursing uniform is closely and intensely attending an autopsy being explained in German.

—INT. Assembly room in London. Banner reads “Royal Statistical Society of London.” Florence is delivering a paper with the same tone of angry drama and same gestures as when reciting Euripides for her father.

—EXT. Scutari Hospital. Florence, on her knees as with the dolls above, removing a rotten bandage from a common soldier’s amputation—eyes and voice are with the soldier for these clearly routine motions—then, with intense eyes on the wound, she presses her thumb into a nerve in his shoulder then clears the wound of maggots with a short-handled wooden spoon she has taken from her corpsman’s shoulder bag and applies a fluid also from the bag. Finally, eyes and voice to the soldier again, she expertly applies a fresh bandage.

From: alandsman%aub.edu.lb
Sent: Monday, June 19, 2007 04:11 Pm
To: landsman%landsmanla.com
Subject: Childhood

Thank you Robert. I have left out the childhood wounds, its battles and rages, the throwing of jewelry, inarticulate frustration, bitter withdrawal, vicious needlework, bedside prayers in tears, slapping a servant, pleading forgiveness on her knees, exhausting and articulate private self-recriminations, as well as the counting silver, taking notes, making lists, catalogs, and the endless reading. And, okay, I’ll not send any books!

I realize I’m putting off the Crimea and the struggle for reform. Maybe a few adult scenes with family and friends first, how about that?

To tell the truth, I approach the Crimea on my own frost-bitten, bloody feet. Maybe I’m sick to death with my own brucellosis—her probable recurrent malaria-like disease—contracted in my own wars.

And God never said a word to me.

Not to mention Vietnam, our current “Crimea” now approaches its million dead, needless dead.  On top of the second English-speaking empire’s other crimes. Here one hundred and fifty years from Florence Nightingale! I hear her quoting Horace.

Time’s canker sore enlarges.
Parents more vile than their parents
Raise up our shoddy selves
While we set forth our own base offspring,
Worse yet.

From: landsman%landsmanla.com
Sent: Monday, June 18, 2007 11:03 Pm
To: alandsman%aub.edu.lb
Subject: Re: Childhood

Okay, you’ve got “Blues on Monday.” What about me? Looking forward, Bob

From: alandsman%aub.edu.lb
Sent: Tuesday, June 19, 2007 04:28 Pm
To: landsman%landsmanla.com
Subject: Childhood

Robert,

Here’s a passage from one of Mrs. Elizabeth Gaskell’s contemporary letters describing one of her stays with the Nightingales at Lea Hurst. Maybe for Props, part of our team.

High as Lea Hurst is, one seems on the pinnacle, with the clouds careering round one. Down below is a garden with stone terraces and flights of steps—the planes of these terraces being perfectly gorgeous with masses of hollyhocks, dahlias, nasturtiums, geraniums, etc. Then a sloping meadow losing itself in a steep wooded descent (such tints over the wood!) to the river Derwent, the rocks on the other side of which form the first distance, and are of a red colour streaked with misty purple. Beyond this, interlacing hills, forming three ranges of distance; the first, deep brown with decaying heather; the next, in some purple shadow, and the last catching some pale watery sunlight.

And another:

I am left alone established high up, in two rooms, opening one out of the other—the old nurseries. It is curious how simple it is. The old carpet doesn’t cover the floor. No easy chair, no sofa, a little curtainless bed, a small glass. In the outer room—the former day nursery—Miss Florence’s room when she is at home, everything is equally simple; now, of course, the bed is reconverted into a sofa; two small tables, a few bookshelves, a drab carpet only partially covering the clean boards, and stone-coloured walls—as cold in colouring as need be, but with one low window on one side, trellised over with Virginian creeper as gorgeous as can be; and the opposite one, by which I am writing, looking over such country!

As needed I’ll send other clips from this novelist and friend of the family although not particularly intimate with Florence. Letters and her biography of Charlotte Bronte are good sources as well as Bronte’s novels; she was also an acquaintance living not 30 miles away in a familiar culture.

From:landsman%lansmanla.com
Sent: Tuesday, June 19, 2007 11:53 Pm
To: alandsman%aub.edu.lb
Subject: Re: Childhood

It is Set Design. Props do not get creative input. The Mrs. Gaskell and whoever stuff is okay to send, but better what you have seen or thought. We’ll buy professional literalism as we need it. Now we’re on for the woman and her story. Get that right and we can cut Design budget significantly. No groping around for the right “look.” Carry on. Love, Bob

From: alandsman%aub.edu.lb
Sent: Thursday, June 21, 2007 5:15 Pm
To: landsman%landsmanla.com
Subject: Later, but the Sisters

Robert,

There is another Sister Conversation much later, post-Crimea. These conversations can be a recurrent visual “theme” in the film. I mean cinematographically established as recurring such that they do not require set up or explanation or being placed in context. The audience says, “Ah, the sisters privately together again for a ‘heart felt.’”

[This is Parthenope, concerned about a suitor or Parthenope about to be married, 17 July 1858, at 40 to Sir Harry Verney who is 57, four children by his previous marriage and already, as Liberal member of Parliament from Buckinghamshire and a pioneer in rural housing issues, he has become one of “Florence’s men” in reform work. FN is much embroiled in politics and other work at this time and impatient with Parthenope but is prevailed upon to walk. Parthenope is weeping.]

You are not a true sister. We never talk. You don’t care about my fears.

Parthe, you and Mama lay about telling each other not to get too tired by putting flowers into water. You would ask me twelve questions an hour if I’d allow it. You tinker with the hotel accounts overcharging me at random and I am supposed to take it up with you, discuss the bloody accounts endlessly. And go walking with you. Parthe, I am totally exhausted. . .

Cruel. [still crying]

Pop, dear Pop, what is the matter with you? I am under the empire of work day long. And now this clatter of pots and pans among my family. Since the past fifteen years—at least!—there has never been any question where my life was going; and, still, the same old demands. Even now. Admit it! You are enjoying my popularity while I hate it…

. . . I answer your correspondence; I write endless condolences, we entertain for you, sort your mail, and make possible all the friends…

Who want only to be among the Nightingales.

…We… And you never talk to me. And now I am about to be married…  I hope you find time to attend.

Dear Parthe, my love, don’t you be cruel. I hate it that you and Mama pursue “excitements” and myself as an “excitement” now after years of opposing my doing anything. You make an excitement of my labors and can’t wait for the next opportunity. It is madness. Remember I have been in Hanwell with the lunatics. Some conceive themselves to be tea-pots and others have 30,000 men fighting in their insides or think themselves to be Christ resurrected. They are not more mad then you people, trying to live by excitements while spending the day on the sofa persuading yourselves and others that you are the victims of devotion, devotion to another who is heedless of your trials. Meanwhile that other is dying from over-work.

But I am about to be married. . . Please talk to me, Flo. Say something to put my mind at rest.

Pop. . . So be it! But take it for a measure of my love for you, a full and overflowing measure.

[Florence continues] You know that I loved Monckton. We would entertain each other. His pleasure was that I should emerge from one of our conversations flushed, swollen, and fairly dripping. And he would know, somehow, and feel himself to be the man. My pleasure was that, never having been at university, never having participated in those funny, lewd and learned conversations that were so much a part of their social life, never having had the least touch of those experiences which they could buy several evenings a week for the cost of a carriage ride. It was an acting-out of passion and release upon each other which the boys enjoyed commonly. And that was at least as exercising as using my learning in some other way.

[Florence, in more somber tone, continues] Parthe, if this kind of thing, this excitement, leads to anything worthwhile it leads directly to companionship. Whatever else, it is companionship that you will most enjoy with Harry who is a fine man. And, I believe, companionship also with his children who are a benefit to your new marriage. They must to some extent reflect Harry’s fine qualities.

Yes, I see

As for Monckton, with whom else could I talk Horace and Plautus and Terrence and retell old stories and bat about quotations and pretend innocent ignorance of the full implications? Father was a total failure at protecting me from those passages that I could easily translate in my mind but never commit to paper.

But why talk of Latin?

Companionship is the thing, dear Pop. But it is no good denying we have bodies. Didn’t you know or can’t you imagine Mama becoming warm in front of the Donatello in her father’s collection. She so loved art! And the Shore’s home. I can still see her standing there in the Uffizi en grande tenue holding her note card and newly invented prize pencil, becoming warm. Harry Verney is a handsome man, as still and tall as a tree, so imagine your companionship and mother’s with father. Doesn’t matter, Latin or Donatello or only our proud, thin Papa taking Mama’s hand on a walk that I know you to have seen many times., Fanny was once a new wife and perhaps more warm than I have ever been or you may be, having greater experience and opportunity than ours.

Flo, don’t you have a suggestion?

Dear, I suggest you remember to touch you husband frequently and not only when both of you are in front of guests receiving, not just at Malvern. It will bring you closer.

Flo, did you and Monckton have sex?

No, dear, we had what I have described.

I mean to ask…

We did not have intercourse. Only “intercourse.” We did not make the beast with two backs. In the literal sense we did not horse around, Pop. I remember flouncing my skirt outrageously and being in heat…

Florence!

…Nothing for someone who’s spent her entire life hot under the collar. [pause, walking] And here we are like those two sister cows licking each other about the neck and waddle [landscape background shot of exactly that.].

Parthe, I am admitting to you that I approached our conversations with some gaiety. It was my body thinking, as it has a perfect right to do. And remember, I actually loved the man, so to say. But we did not conclude, however exciting some days may have been…the words…and the flouncing of skirts. If we had been children, yes, we might have had a look see, given the man’s current interests, although I doubt it. We would have compared any more profound activity to poking each other with sticks. And beneath us. We were thinking of ourselves both as sacred persons, temples, confusing the highest with the lowest. [Remembering her audience] But love’s mansion is the mind and the sentiments. [Back, wanting to complete the thought] Horace could make a joke of the unity of higher and lower. And Ovid could make it a comic religion: Me miserum! certas habuit puer ille sagittas. Uror, et in vacuo pectore regnat Amor.

Not the Latin…please.

No, I was never poor in Latin. So, you have had the story. Children and flouncing skirts and years passing until adult is on us and responsibilities are taken up. And the essence of it, Parthe, is companionship. Less than and greater than excitement….but to pursue genuine companionship at every opportunity. As with me, you will find there are too few opportunities for companionship. But that only serves to make a person more calm and the opportunities more precious.

Flo, you know what they say about Monckton?

Of course I know and I discharge what they say and so should you. … Still, you are fortunate that such stories never circulated about your husband and never will.

Certainly not!

Pop, companionship and friendship! As for Monckton, a frivolous gift is still a gift. A friend should remain a friend. And he has proven over the last several years that reform can triumph over a joke with an old Cambridge companion. And, sometimes, over a suspect hobby. I expect him to continue as a valuable ally and have told him so. If a time comes to England when reform cannot triumph over boy’s indulgences, you will have fakery for reform and thoroughgoing irresponsibility for a hobby. Those will be the kind of men I cannot care for. I can still care for Monckton.

I love you, dear sister.

And I you. And, if it is not too silly to say, you have my blessing.

From: alandsman%aub.edu.lb
Sent: Friday, June 22, 2007 1:51 Am
To: landsman%landsmanla.com
Subject: Re: Later, but the Sisters

On and on. Clearly we can forget about a thwarted love affair.

From: alandsman%aub.edu.lb
Sent: Friday, June 22, 2007 05:01 Pm
To: landsman%landsmanla.com
Subject: Re: Later, but the Sisters

That was about 1,000 words. Depending on the talents of the actors I can imagine it being reduced to 10-20% of that. The eyes can have it.

I’ve forgotten the title but do you remember Meryl Streep in a comedy hiding just outside the door to a trailer in which others are holding a revealing conversation? We can’t hear what they are saying, only occasional words and mum-mum-mum rumbling man talk. What we see is her face in a long sustained set of reactions to the inaudible conversation.

From: alandsman%aub.edu.lb
Sent: Friday, June 22, 2007 10:29 Pm
To: landsman%landsmanla.com
Subject: Re: Later, but the Sisters

Forget it. We can’t have Meryl Streep. The title was “Postcards from the Edge.” I meant you should continue on.

From: alandsman%aub.edu.lb
Sent: Sunday, June 24, 2007 10:44 Am
To: landsman%landsmanla.com
Subject: Another Side

Another Side of the Milne Relationship

[About 1844. He proposed first in 1842 and got his final refusal in 1849 following which she said “I know that since I refused him not one day has passed without my thinking of him, that life is desolate without his sympathy.” But likewise “I could not bear his life…nailed to a continuation, an exaggeration of my present life without hope of another…voluntarily to put it out of my power ever to be able to seize a chance of forming for myself a true and rich life would seem to me like suicide.” She subsequently often praised marriage as an alternative for others—both as the possibly perfect companionship and also, for many, as the best practical accommodation to circumstances—but only after she had absolutely rejected it for herself.]

Nearing the village they come upon a rundown building and she asks a man with a barrow, “Sir, what sort of place is this.” He downs the barrow, removes cap, and answers “A sleeping barrack for the miners, Ma’am, a-for the lead mines closed down.”

“I want to see the inside.” [But she can’t budge the door.]

[Milne puts a boot to the door and pushes.] “Allow me.”

“Ma’am…” says the local warningly.

[Milne enters and immediately retreats out with a handkerchief at his nose indicating ‘that’s enough of that,” but she steps around him and enters.]

“Flo!”

It is dark, about 18 feet long and 12 wide with wooden berths as on shipboard, one above another. It will sleep about 50. There is no opening above for the escape of foul air. Light is provided from the doorway and cracks between and wallboards. She exits, wiping cobwebs from her dress and hair.

“Thank you, sir. Would you close it back for me?” and takes Milne’s’ arm.

“Perhaps not as bad as an American slave ship but no better than those doing the transporting to Australia.” As they proceed, “It must have housed the lead miners brought in to supplement the local men. Imagine the place on a hot summer night after 12 hours in the mines.”

Milne: “Yes.”

“Or coming to it in winter, sweating from the climb up the ladders.” They continue on.

“The Swedish life tables—everyone respects their accuracy—give their workers an average of 57 and a half years. What would you say for these miners?

“You know your villages better than I, Flo.”

“Ten less years of life, I judge. Taken from them for a cheaper lead.”

“’Old before they are young,’ is the coal miners’ saying.”

They continue on.

From: alandsman%aub.edu.lb
Sent: Monday, June 25, 2007 10:45 Pm
To: landsman%landsmanla.com
Subject: Arni, notice this!

Sorry about the stumbling around on the phone yesterday. Essence was you’ll be back at your base today or tomorrow and a couple of people will call for meetings with you. Expect them to come to you once a time is arranged. They are from North West Vision in Manchester and/or Northern Film and Media. They do location, crew, facilities, etc. We have nothing specific to give at this time; our names will be enough. The meetings will get us on their schedules for some time in 2009 better than a phone call from here. And a contact. Pick the two most Nightingale appropriate seasons—one as sunny as possible, one winter, both 2009. You are an associate producer, my brother, looking around in a preliminary way. Bob

Today’s Times (Dec. 12, 2009, page 1) has “Poor Children Likelier to Get Antipsychotics” opens with:

“Now federal financed drug research reveals a stark disparity: children covered by Medicaid are given powerful antipsychotic medicines at a rate four times higher than children whose parents have private insurance.”

The rest is summarizing detail: More drugs for less severe conditions, conditions that are controlled without drugs by middle class parents. Severe physical side effects from the drugs. But never mind. A group of medical doctors in 16 states has formed an organization, “Too Many, Too Much, Too Young” and they are ignored. Health Affairs will publish the federally financed research early next year. A “stunning disparity,” doctors say.

The reason is insurance reimbursements: costly (via Medicaid) but cheaper than counseling. The easiest justification is “bipolar disorder.” What is that? Medicaid without co-pay pays for the drugs, which cost up to $400/month. These drugs are the single biggest expenditure for Medicaid. The kids are age 3 to 17. They are often “off label” prescriptions (without FDA approval). Once on the drugs, some parents report comments like “It is impossible to stop now.”

Get the picture?

This has been going on for several years. And, please, we do not give a shit about the cost. After our deficit terrorists, who always declare “We cannot afford it, whatever it is!,” have had their say the responsible (independent) apologists puts it this way: “Medicaid kids are subject to a lot of stresses that lead to behavior issues which can be hard to distinguish from more serious psychiatric conditions.”

Do you smell stink of pitch in that remark?  The non-apologists point out that “a lot of these kids are not getting any other mental health services.”

We are talking schizophrenia, autism, and bipolar disorder. All of these diagnostic categories are questionable; even the related more minor diagnoses (attention deficit, hyperactivity, persistent defiance, etc.) are included when Medicaid, with its big bucks, is involved. .

The structure of this drug pushing is, as you might expect, profit driven. Profit-driven corporations who produce these drugs are a monopoly (Pfizer, GlaxoSmithKline, Sanoff-Aventis, Johnson & Johnson, Merk, Novartis, AstraZeneca). Shame on them. They employ thousands—actually thousands, no exaggeration, of well-paid lobbyists—to pressures legislators, legislative staff, Medicaid and FDA official’s staff, and “opinion leaders,” to promote these drug buys. These thousands of corrupted salesmen are good at what they do. They are smart enough to reach the neighborhood poverty docs and the docs working for peanuts in the hinterlands.

I wanted to share this with you, a piece of everyday intelligence.

Jim

Below under “PROBLEMS” are a series of quotations from doctors I have taken from the transcript of a recent a PBS documentary film. Each thought from these doctors is more or less separate. The quotations are unified only by the doctors’ willingness to be interviewed in a PBS documentary titled “Money-Driven Medicine.” Please assume the necessary quotation marks. Following this I have some remarks of my own titled “MUDDLE IN THE MIDDLE.” Then I present the “SOLUTION.” That is also a quotation, the summary presentation of the widely endorsed, 17,000-member Physicians for a National Health Program. It is essentially what is often called a “Medicare-for-all” solution. My thought was that reading these quotations and remarks will take about a quarter of the time required to watch the PBS documentary (Bill Moyers Journal, August 28, 2009) and is far superior to the readily available YouTube clips.

Read the rest of this entry »

For my infrequent audience: First, I love you. Being able to say these things is very important to me (other than when dog walking on the street; other then when collaring a friend on the phone or in a drive-by; other than when, on an occasion we’ve forgotten, we are each holding something to drink).

Read the rest of this entry »

These highlights are for those who would hear a bit more about health in California but do not wish to wander, as I’ve been doing, through the valuable and actively maintained web sites of the 86,000 nationwide membership California Nurses Association http://www.calnurses.org/ and the 17,000 member Physicians for a National Health Program http://www.pnhp.org/

Read the rest of this entry »

clip_image002Golden California, our most populated state, was once widely admired. Now you hear of lay-offs and foreclosures and there are wild cries of “fiscal crisis,” “bankruptcy,” and “bail-out.” In fact the current state deficits ($24 billion) are less than under Governor Schwarzenegger in 2004 and substantially less then he decried during his earlier run to replace recalled Governor Gray Davis ($38 billion). Davis’s sin was being one of the first to oppose Enron’s crimes.

Read the rest of this entry »

A policy-enforced disparity between the health of the rich and the poor is evident in any major urban hospital. All the staff is aware of it. As you proceed from the worried well to the barely ambulatory, from brief physical examination to technologically sophisticated costly medical diagnostics, from scant to full staffing, from simple to thorough lab tests, from wards to the single rooms with adjoining kitchens and accommodations for family—nice views, hospital-supplied flowers, comfortable seats, etc. —so you proceed from health care for the rich to health care for the middle-class.

Read the rest of this entry »

Health policy in America is a nurses’ joke, the black humor that is part of carrying on, doing what you can in spite of whatever. Health policy aims directly at suppressing the demand for health care. Nurses in our hospitals see it most clearly. First, most cost cutting aims at suppressing demand. Understaffing is only the most obvious example. Why should health care always be a matter of hurry up and shortcuts? (“Be patient and I‘ll get to you as soon as I can.”) Then there are the all too obvious deferrals, denials, long delayed treatment, skipped appointments (“Maybe I’ll get better”). Hospital and HMO administrators urge doctors and nurses to a thousand daily decisions whose rationale is “cost containment.” The intent and effect is to reduce demand. What kind of a health god is cost containment? (“They talk of care as if it were some deadly sin?”) Why are there no local clinics? Why are all hospitals monstrosities? Is transport so primitive, so expensive? No.

Read the rest of this entry »

Frequent articles and ads promote while others oppose the widespread application of antipsychotic and other powerful drugs to children with mild behavior issues. You might think there is controversy here, that “medical/scientific opinion is divided.” A better explanation is the excesses to which the drug industry, seeking ever AAimage2 greater profits, has gone is pushing these drugs. That industry—ten or so unrestrained, unregulated capitalist corporations (with prescription revenue of something like $250 billion in 2007)—seeks ever larger populations, ever more “conditions” in which to promote their ever growing pharmacy of interventions. Using their grand revenue as weapon, the drug industry has captured the regulatory agencies, institutions, and “thought-leaders” that should have reduced such drugs to a necessary trickle but have brought them to a flood.

In a nutshell it is a war of drugs on children with the drug industry using the trust of parents in doctors, false analogy with developmental disorders such as autism, the helpless anxiety of parents over their children’s behavior, the billions in profits, and the background noise of our judgmental, over-medicated society to sell ever more, and ever more expensive, drugs.

Read the rest of this entry »

As we all notice the belated media attention now given to the Democratic Republic of Congo, our first response should be “Utt-Oh! This can’t be good.”

Read the rest of this entry »

During Barack Obama’s first inaugural address we will hear something on the model of Franklin Roosevelt speaking at his first inaugural in Depression 1933:

First of all, let me assert my firm belief that the only thing we have to fear is fear itself—nameless, unreasoning, unjustified terror which paralyzes needed efforts to convert retreat into advance. In every dark hour of our national life a leadership of frankness and vigor has met with that understanding and support of the people themselves which is essential to victory. I am convinced that you will again give that support to leadership in these critical days.

Read the rest of this entry »

I was given a copy of AIDS in Nigeria; A Nation on the Threshold (Harvard Center for Population and Development Studies, 2006) some time ago by a student friend who happened to have been employed with others in the editing and design of this large, expensively produced anthology of twenty-four commissioned HIV/AIDS/antiretroviral drug articles. The book was funded by the Gates Foundation and includes many beautifully reproduced color photographs of dying children.

Read the rest of this entry »

Here is today’s NY Times follow-up by Elisabeth Rosenthal, health journalist. I’ll call her our Esther of the NYT (not the OT) for her work against two pharmaceutical corporate giants and their campaign for an unnecessary, possibly dangerous, expensive (for us), profitable (for them) national cervical cancer vaccination program.

"Articles Question Wide Use of 2 Vaccines" (August 21, 2008; A 15) by Elisabeth Rosenthal (and see Cervical Cancer Vaccines – Golden Opportunity)

Read the rest of this entry »

Going for a Pulitzer, Elisabeth Rosenthal has an article in today’s New York Times on the drive by Merck and GlaxoSmithKline to establish a market for their new cervical cancer vaccines.* Rosenthal gives her article all the best features of Times-style investigative journalism: exposure of how the pharmaceutical industry has pushed their products into a reluctant market, misrepresented need, bought voices of approval, done PR and lobbying and massive amounts of dishonest advertising (young professionals urging girls to become “one less statistic,” young stars leaning forward to confide “my dreams don’t include cervical cancer’). Rosenthal quotes six or so physicians and professors of medicine—and some of them sound pissed off at being pushed around—and two industry apologist marketing people. However, Merck and GlaxoSmithKline have been able to sign up hundreds of physicians (providing $4,500 per 50 min. public talk), put them on “Advisory Boards,” provided them media exposure, and run cervical cancer awareness conferences and programs. I assume they have also printed millions of pieces of “informational” literature.

Read the rest of this entry »

Matthew P. Dumont (b. 1937) is a physician and psychiatrist driven to Social Medicine by his concern for his patients and his long street engagement with mental illness. I mean "street" as in "street savvy" from Dumont’s sixteen years of community mental health work in Chelsea. MA (from fall 1975 through spring 1991 ).* Read the rest of this entry »

I am reading Ralph Nader’s Study Group Report on the Food and Drug Administration titled The Chemical Feast and using one of the health web sites of one of his organizations, Public Citizen, to look up information on dietary supplements found listed on cans of the "energy drinks" being marketed so actively to kids.  This was for my article "To Protect Children from Beasts of Prey."  Good time to add Ralph Nader to my Social Medicine notes (See my introduction for the rationale).* 

Ralph Nader’s (b. 1934 in Winsted, CT) is the author of Unsafe at Any Speed (1965), and responsible for a number of other books (The Chemical Feast (1968), Vanishing Air (1970) and see below).  He has made significant contributions to public health. Read the rest of this entry »

Beginning in 1955 Tom McKeown (1912–1988) published a series of professional articles in the journal Population Studies.* He argued from his studies of mortality data that curative medicine was not the great savior of modern man it was said to be, that advances in medical technology, beginning only in the late 1890s, were not the primary cause of the sharp decline in early death from infectious disease that led to the great nineteenth century expansion of population. Nor was it the sanitary reforms that ended “The Great Stink of London.” The major positive factor, McKeown argued, was the improvement in the lot of ordinary humanity by industrial employment and rising wages. Furthermore, he consistently pointed out that these findings have implications for contemporary social well being, for health service legislation, and for international aid policy. Humanity is inherently healthy. The human environment—in the most broad sense of access to clean water, nutrition, and some measure of income equality making these possible—is the key to social health anywhere. Read the rest of this entry »

This Introduction begins my reading notes on the topic of Social Medicine. First I must explain why we should not leave this topic to the experts: the physicians, scientists, and the journalists who have given it their professional attention.

Social Medicine emerged with Florence Nightingale, her colleagues Edwin Chadwick, William Farr, and others in the mid-nineteenth century. They recognized that medical services must go beyond the care of patients who seek the assistance of a doctor. TB, cholera, and typhoid could not be treated effectively in individual patients. Private medicine, philanthropy, and profit-driven enterprises were entirely unwilling to deal with the causes of these plagues. In fact private enterprises were deeply implicated in people’s ill health and their poisoned environment just as they were implicated in the continuation of slavery in the colonies and child labor in the mines. Read the rest of this entry »

« Older entries