A nurse's journal provides a firsthand account of a historic expedition.
We celebrate Nurses Week during the week of Florence Nightingale’s birthday. It seems an appropriate time to share the story of a member of the original party who was under Nightingale’s leadership during this historic expedition.
Several years ago, I read a book by Robert G. Richardson, published in 1977. Among its pages was the edited journal of Sarah Anne Terrot. A Sellonite sister (Anglican), Terrot was a member of the original party of 38 women who accompanied Florence Nightingale to Scutari, Turkey, during the Crimean War. The firsthand account vividly describes her experiences during the first four months of the expedition, a time when conditions for the military and those who cared for them were at their worst. The following is a brief synopsis of Terrot’s story.
“Are you willing?”
“Our soldiers in the East want nurses. Some are going. I wish to send eight,” Terrot’s superior told her on 20 October 1854. “Are you willing to be one?” Terrot agreed and was excited about embarking upon a new adventure. On the evening of 23 October, she departed from the London Bridge Station and traveled to Marseilles, France. From there, the party embarked upon the “Vectis,” a small steamer bound for Turkey.
The voyage was horrific from the start. At one point, the ship almost sank. Just about everyone, including Nightingale, became desperately seasick. Terrot was one of the few who were spared from it. She called the Sellonite’s quarters “the chamber of horrors” and described her own berth as “a coffin full of crawling creatures.”
On 4 November, the party arrived at the Golden Horn of Constantinople. That evening, they crossed the Straits to Scutari in small boats and were led up a steep hill to the Barrack Hospital, where they would live and work. Built as a Turkish barrack and given to the British army, the hospital was a massive building of different heights set around a central courtyard.
The Nightingale party was comprised of Catholic nuns, Anglican sisters, and lay nurses. After recovering from seasickness, Nightingale assigned each group to various quarters inside one of the hospital’s four towers. The sisters’ quarters, occupied just two days earlier by a wounded Russian general who died, was filthy, and they began cleaning it immediately. Initially, there was no furniture. To eat, they sat on the floor and used boxes for tables. They slept on hard, flea-infested divans that lacked mattresses.
Unfit for humans
The roof leaked, and the windows were broken. When it rained heavily, water would pour onto the floor. If the sisters did not collect it immediately, it would overflow into Nightingale’s room, directly beneath them. The situation in the rat-infested wards was even worse. The latrines were prone to backing up, and Terrot described the conditions as unfit for humans.
She worked at the Barrack Hospital from early November until the beginning of December. At that point, she was transferred to the General Hospital, previously a Turkish military hospital. Together with the other nurses, Terrot enjoyed walking the half mile each day between the two hospitals. The General, as it was known, was smaller than the Barrack and had somewhat better facilities, although the wards were extremely cold. Another drawback was the stench that came from the latrines and the burial grounds, where the dead were not properly buried.
Nursing care was provided to patients who were either wounded or suffering from infectious diseases, malnutrition, or exposure to cold. The soldiers from the Crimea had to be transported by ship to Scutari, which took several days. When they arrived, they were filthy, hungry, and neglected. Many had lost limbs and had ghastly gunshot wounds. After physicians examined the patients, the nurses bathed them and dressed their wounds. Many had to lie on cold pavement on makeshift beds of straw. Surgeries were performed in the wards and corridors. There were no tables for operations. The quality of food was so appalling that many could not eat it, and there were days when dried bread was the only food available. Terrot would sometimes save some of her own food to give to the patients.
Beef tea and negus
Comfort measures and nutrition were the major nursing functions provided. Physicians ordered the administration of beef tea and negus (warm, watered-down port or sherry). Terrot carried a pailful of these liquids throughout the wards, distributing them to patients. Except for cod liver oil, she seldom administered medications. After the “dressers” appeared, she was less responsible for wound care, which left more time to feed patients or read and write for them.
Terrot wrote of the difficulties obtaining supplies. The soldiers’ shirts, apparently used as hospital gowns, were a major concern. Laundered by the Turks, the shirts were often returned full of lice—with only one sleeve or without sleeves entirely. At times, patients occupying an entire ward would be shirtless.
Terrot repeatedly wrote about the attitude of the soldiers. She found them undemanding, appreciative of the simplest things. She often witnessed the kindnesses and concern they expressed toward each other. Many of the dying soldiers were restless and noisy, but the others never complained.
The sister often prayed for her patients’ recovery. Despite the nurses’ best efforts, patients often died. Writing of the distress this caused her and others, Terrot stated that she would “miss the face she had just learned to know and love.” Her reward, she observed, was knowing she had provided comfort and kindness and that her patients had expressed gratitude.
For the most part, the physicians respected Terrot. She also interacted well with the chaplains and relied on them to provide spiritual care to her patients. She was quite disturbed, however, by the behavior of the orderlies. Except for a few, she found them neglectful, disrespectful, and rough on patients—and she witnessed them stealing food and personal possessions. Rather than relying on their unwilling service, Terrot often performed the orderlies’ duties herself.
On 15 December, another party of nurses, under the leadership of Mary Stanley, unexpectedly arrived in Scutari. Since no arrangements had been made for their accommodations or employment, compromises had to be made, and several members of the original party were sent home. Among them was Sister Elizabeth Wheeler. Wheeler and Terrot had developed a close relationship, beginning when they were together on the Vectis.
Wheeler was a devoted, competent nurse, adored by her patients. Unfortunately, she had written a letter to a family member describing the substandard conditions in Scutari. The letter, which was published in the London Times in early December, generated a series of complaints throughout England. Ultimately, it was judged to be untruthful, and, on 23 December, Wheeler was dismissed. Terrot was devastated. That evening, she accompanied her friend on rounds for the last time, and the next day, she went to the pier to watch Wheeler and her other peers embark for home. It was a depressing Christmas in Scutari for the remaining members of the party. In the evening, Terrot visited Wheeler’s patients but never told them Sister Elizabeth was gone.
In late December 1854, Nightingale asked Terrot if she would be willing to live at the General Hospital, and she agreed. She now shared a large room with the lay nurses and was thankful to be living in the same building as her patients, so she could spend evenings with them. She was also grateful to be at General, because the Barrack reminded her of Wheeler.
In January, the mortality rate from diseases escalated, and several physicians, chaplains, nurses, and orderlies became ill. Terrot was also affected. Symptoms of her illness actually began around the time Wheeler was dismissed. However, she continued to work until about the beginning of March, when she experienced changes in her mental status and was too ill to get out of bed. Nightingale and other nurses who took care of her thought she was dying. When Terrot improved, Nightingale had her moved back to her old quarters at the Barrack Hospital.
Going home worse than staying
Terrot stated that her greatest suffering began when she was told she was being sent home. She was allowed to visit her former patients but did not tell them she was leaving. The following day, she boarded a French ship, “Le Gange.” She wrote, “In the evening as we steamed away … we looked back to the great Hospital and saw the lights glimmering through the wards. How I envied those who were still ministering to the sick and suffering.”
According to Charles H. Terrot, a descendent of Sarah Anne Terrot, there is limited information about her during the postwar period. Apparently, she continued to suffer from health issues. In 1887, during the Queen’s Diamond Jubilee, Terrot received the Royal Red Cross. In her final years, her mind drifted back to the months she had spent in Scutari. She died in 1902, believing she was still in her quarters at the Barrack Hospital. During World War II, a train carrying the Terrot family’s possessions was bombed, and all of Sarah Anne Terrot’s correspondence was lost (Richardson, 1977).
When Terrot initially met Florence Nightingale on 21 October 1854, she wrote, “From the first moment I felt an impulse to love, trust, and respect her. Her appearance and manner impressed me with a sense of goodness and wisdom, of high mental powers highly cultivated and devoted to the highest ends.” Terrot later confirmed that her initial impression of Nightingale was correct.
Although I have read many accounts about the Crimean War, Sarah Anne Terrot’s journal remains my most memorable. The above information is only a superficial version of her experiences. For greater insight, appreciation, and historical background about Terrot and the expedition, I recommend reading Richardson’s book in its entirety.
Joy Shiller, MS, RN, CAPA, is a clinical mentor and pre-op nurse at Houston Methodist Hospital in Houston, Texas, USA.
Richardson, R.G. (1977). Nurse Sarah Anne with Florence Nightingale at Scutari. London, England: John Murray Ltd.