Louise Penner. Victorian Medicine and Social Reform: Florence Nightingale among the Novelists. New York: Palgrave Macmillan, 2010. ISBN: 978-0-230-61595-3. Price: US$80.00/£55.00

It is no longer necessary today to begin a book on Florence Nightingale—or a review of such a book—by contesting the once received image of the angelic lady with the lamp. Deserving neither hagiographic adulation nor the mockery and scorn that Lytton Strachey famously heaped on her in Eminent Victorians (1918), Nightingale is a complicated figure whose writing and life work continue to attract the robust scholarly interest of biographers, historians, and, in Louise Penner’s case, literary critics. Penner’s approach makes use of a few key Nightingale biographies (especially those of Mark Bostridge and Hugh Small) as well as of Nightingale’s relatively well-known published works such as Notes on Nursing (1860), Notes on Hospitals (1859), and Suggestions for Thought after Truth among the Artizans of England (1860), but yokes these resources to material newly available via Lynn MacDonald’s sixteen-volume work-in-progress, Collected Works of Florence Nightingale. Rather than showcase an individual blazing trails for those who followed her, Penner wisely aims to demonstrate that “Nightingale shared ideals about governance and reform in common with reformist essayists, philanthropists, and novelists of her time” (3), even while she critiqued a variety of their philosophical or scientific positions. The value of this approach is that it helps readers appreciate a figure influenced as much by a life lived “here, now, in England” (to quote from George Eliot’s Middlemarch [1871-72], a novel that looms large in this study) as by the Crimean War that established her moral authority and status as national heroine. More specifically, Penner turns frequently to the literature of the period to contextualize Nightingale’s ideas and writing. Influence is not, in Penner’s hands, a one-way street; the traffic flows in both directions as she studies the fiction writers who most directly shaped Nightingale’s thought and assesses the impact of Nightingale on her contemporaries. These fiction writers—including Charles Dickens, Elizabeth Gaskell, and Eliot, but also the Evangelical writer Hesba Stretton and the sensational novelist Wilkie Collins—provided Nightingale with a treasure trove of rhetorical strategies which she adapted for different audiences and purposes. Nowhere does Penner make more of the disparate audiences that Nightingale wrote for than in her analysis of Notes on Hospitals and Notes on Nursing, the first written for government bureaucrats and the latter for middle-class women. She persuasively claims that the rhetorical differences between these key texts indicate “Nightingale’s willingness, particularly when addressing women, to exploit the fears that her texts were ostensibly written to alleviate” (11). To demonstrate the extent to which Nightingale deployed a narrative technique and agenda gleaned from sensation fiction (i.e. the desire to exploit fear), Penner identifies a rhetoric of dispassionate observation and vigilance pervasive in this subgenre of fiction and suggestively demonstrates the sensationalism of Nightingale’s analogous battle with intruders (“the intruder representing, of course, disease in general” [26]). Penner compares Nightingale’s attitude and stance to that of Walter Hartright, Collins’s central narrator in The Woman in White (1859-60), a novel peppered with ideas of cleanliness and contagion that, she contends, echo Nightingale’s own. Penner is nevertheless on firmer ground when discussing those who more directly influenced Nightingale, especially in terms of her reformist impulses and efforts. The second chapter, a study of Nightingale’s interest in Poor Law reform, shows how she sought to promote efforts that would encourage economic independence among the pauper class, with government-provided opportunities for education and remunerative work. It focuses primarily on Dickens and Stretton, whose works were openly admired by Nightingale and distributed to the military men and nurses with whom she worked. Perhaps out of a perceived need to distance herself from the celebrity-seeking “lady …