Not Just 'The Lady with the Lamp'

On how her love for data and the ability to show it in action created lasting change

‘My life’s work is just not being seen as this angelic lady with the lamp’.

It was late 1850’s and Florence Nightingale had just come back to England after her services as the director of Nurses at a field hospital in the Crimean War. She and her team of young nurses were horrified to confront the ugly, unhygenic conditions and the lack of medical supplies in the barracks. The hospital conditions were killing the British soldiers more than the opposing army. The mortality rate was 42%.

Nightingale, the trained nurse, got into immediate action. Raised funds on her own, recruited and trained a team of nurses. She designed a pre-fabricated hospital ward, built her own hot laundry, kitchens, and supply lines. Years before the germ theory of disease was confirmed by Louis Pasteur and Joseph Lister, Nightingale enforced an obsessive commitment to sanitation in that hospital and bought down the mortality rate to 2%.

And all this while, Nightingale also recorded data meticulously, on how the soldiers died: whether from contagious disease, wounds or other causes. She had a natural inclination to record data that was spurred by her love for mathematics and writing.

When Nightingale returned to England, her stellar work in Crimea was glorified in the press and her image of holding the lamp gave her an angelic status. But little did the world sense that the Lady with the Lamp was burning with a bigger purpose inside.

The biggest resistance she faced was from the senior doctors inside the system. The monumental data that she had gathered was of no use as the senior docs did not want to understand it. Florence knew her task was to get the larger public get this for her plans to gain momentum: ‘There has to be a better show of this data. Printed tables & all in double columns I do not think anyone will read it. None but scientific men ever look in the Appendix of a Report. And this is for the vulgar public.’

It was then that she connected with William Farr, an epidimeologist and a pioneer in data visualisation. She took his help in designing the famous Rose Diagrams - or the polar area graph which was based on the mortality rates of the British soldiers.

In her most famous pair of roses, below, Nightingale visually showed the causes of high Army mortality. The number of soldiers who died of preventable diseases are represented in blue and the ones who died due to battle wounds in red.

Diagram of the causes of mortality in the army in the East" by Florence Nightingale, 1858 via Wikimedia Commons

For the first time, it was starkly demonstrated how deaths from preventable disease outweighed combat fatalities enormously in 1854 and early 1855, and how the changes she put into place managed to greatly reduce those deaths by April 1855.

In another singular rose, Nightingale showed the effectiveness of her sanitation ideas by comparing mortality rates before and after her interventions. Note the significant dip in numbers from about 9 o’clock position and the subsequent clockwise decline in hospital mortality.

Nightingale framed these mortality diagrams, delivered them to influential VIP’s and commanded them to hang in their offices so that the public could see. ‘No one frames a table of data and hangs it on the wall. But people do frame maps.’

Nightingale’s innovation was less about technique than about her purpose. She was not the first one to use bar graphs, pie charts or scatter diagrams but perhaps the first one to bring the data and narrative together to create a powerful visual impact.

Florence Nightingale was one of the greatest data storyteller of our times. At the core was her purpose to alleviate the sufferings of her fellow human beings. Her vision was to drive compelling hospital reforms.

But above all, she took complete responsibility to ensure that the impact of her work was understood by everyone. She made it easy by creating data visualisations that told powerful stories triggering worldwide hospital reforms.

And that is how the Lady with the Lamp shed her real light.

Story Notes

Lots of Story Notes. Almost impossible to capture Florence Nightingale’s story in the framework of #1MinuteStories. I would consider this my bravest, toughest attempt.

The wiki itself is phenomenal - has many more links on the work Florence Nightingale has done for sanitation reforms in hospitals and her work in the field of nursing.