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Rising to the challenge: Florence Nightingale (1820-1910)

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Abstract

Many of the greatest achievements of humanity have engaged the help of numbers. This makes the celebration of the birth of Florence Nightingale, born 200 years ago on 12 th May 2020, particularly relevant today. She is remembered for bringing discipline and care to nursing, but she was also an accomplished statistician. By carefully collecting evidence she took personal and political action to minimise deaths in military hospitals during the Crimean War. Her skilled use of data and coloured diagrams gained public and political attention for the conditions she found there. These methods of explaining facts were quite revolutionary in her time but are regularly used now as society strives for acceptance of policies to contain the new virus. Today, it is COVID-19 and the need for isolation and the suspension of normal economic life. In the hospital at Scutari in Florence Nightingale's time, it was septicaemia and the need for nursing and proper hygiene. Then, there was no cure for such infection, just as today, there is no vaccine for the virus. In both, the need is for respect for numbers and social discipline moderated by personal care. Viruses and bacteria evolve. Their battle with human life, biology against biology, is ever present and intrinsically unpredictable. New viruses and anti-bacterial resistance will present themselves in the future, and old ones return. In a similar way life-on-life confrontations with other human regimes will also recur, sometimes leading to conflict. However, threats from the agents of physical science are different. They do not evolve and so are more predictable. Fire is unusual for being "infectious" and catching. But most other agents, like thunder and lightning, are not. The more you learn about them the less alarming they become. Education can act like a vaccine, providing confidence and immunity from fear, though needing an occasional booster. Although some powerful threats can be handled in this way, others appear more dangerous the more the evidence is understood. In particular, James Lovelock has written of the future threats from climate change and nuclear energy, that those who know most about climate change are the most concerned, whereas those who know most about nuclear energy are the least worried.
Rising to the challenge: Florence Nightingale (1820-1910)
Wade Allison, Emeritus Professor of Physics and Fellow of Keble College, Oxford University
Many of the greatest achievements of humanity have engaged the help of numbers. This makes the
celebration of the birth of Florence Nightingale, born 200 years ago on 12th May 2020, particularly
relevant today. She is remembered for bringing discipline and care to nursing, but she was also an
accomplished statistician. By carefully collecting evidence she took personal and political action to
minimise deaths in military hospitals during the Crimean War. Her skilled use of data and coloured
diagrams gained public and political attention for the conditions she found there. These methods of
explaining facts were quite revolutionary in her time but are regularly used now as society strives for
acceptance of policies to contain the new virus.
Today, it is COVID-19 and the need for isolation and the suspension of normal economic life. In the
hospital at Scutari in Florence Nightingale’s time, it was septicaemia and the need for nursing and
proper hygiene. Then, there was no cure for such infection, just as today, there is no vaccine for the
virus. In both, the need is for respect for numbers and social discipline moderated by personal care.
Viruses and bacteria evolve. Their battle with human life, biology against biology, is ever present and
intrinsically unpredictable. New viruses and anti-bacterial resistance will present themselves in the
future, and old ones return. In a similar way life-on-life confrontations with other human regimes will
also recur, sometimes leading to conflict.
However, threats from the agents of physical science are different. They do not evolve and so are
more predictable. Fire is unusual for being “infectious” and catching. But most other agents, like
thunder and lightning, are not. The more you learn about them the less alarming they become.
Education can act like a vaccine, providing confidence and immunity from fear, though needing an
occasional booster. Although some powerful threats can be handled in this way, others appear more
dangerous the more the evidence is understood. In particular, James Lovelock has written of the
future threats from climate change and nuclear energy, that those who know most about climate
change are the most concerned, whereas those who know most about nuclear energy are the least
worried.
An understanding of the basic science shows why replacing fossil fuels with nuclear power as the main
source of energy is the surest way to mitigate climate change.
i
However, any mention of the words
nuclear or radiation strikes alarm in modern society. How might Florence Nightingale have portrayed
the evidence to reassure todays society and its politicians?
Marie Curie, pioneer in nuclear science and
medicine, knew no such fear. Thanks to her
work, nuclear radiation is used today both to
diagnose and to treat cancer. Nevertheless,
since the Cold War many have seen radiation as
a significant cause of cancer. At normal doses
there is no scientific evidence for this.
ii
The effect
of radiation on life is the same as it was a
thousand million years ago, and life has had
plenty of time to find ways to recover from the
small amount of damage a radiation dose
causes.
Florence Nightingale might have explained this
with a simple coloured diagram to illustrate the
numbers, like she did for the benefits of hygiene
and nursing over 160 years ago. In this diagram
the area of each circle shows the size of a radiation dose received in a month. The big red circle is the
treatment dose given to a tumour in radiotherapy to kill its cells. The yellow circle is the dose received
by nearby healthy tissue in the same treatment. Its cells usually survive but just occasionally suffer a
secondary cancer. The green circle is a monthly dose that never leaves any lasting damage, either in
humans or in animals. The tiny black dot in the green circle, a factor a thousand times smaller, is the
super-cautious maximum monthly public dose allowed by the regulations. These could be relaxed a
thousand times with no health consequences.
iii
Medical treatments would be simpler, and nuclear
power the reliable replacement for fossil fuels would be two or three times cheaper. If Florence
Nightingale were able to reassure the public this way, the threat of climate change could be mitigated,
and that would be best for nature, too. Our task is to emulate her.
9th May, 2020
i
More discussion in a lecture on YouTube https://www.youtube.com/watch?v=qymncyTbB-4 and an article
https://www.researchgate.net/publication/339629356_Nature_Energy_and_Society_A_scientific_study_of_th
e_options_facing_civilisation_today
ii
A recent review https://journals.sagepub.com/doi/full/10.1177/1559325820921641
iii
The remit of many authorities in health, the environment and energy is to protect people from radiation.
People in those jobs are reluctant to face the scientific truth. As Upton Sinclair wrote It is difficult to get a man
to understand something when his salary depends on his not understanding it.
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