Florence Nightingale (1820 – 1910) was a disruptor of both medicine and data. Statistician, campaigner, nurse, and inventor, she is best known as the founder of modern nursing. Known honourably at as ‘the lady with the lamp’, Nightingale Florence reformed and modernised the 19th century medical profession in Britain by improving sanitation and using data to inform nursing practises. Returning from the Crimean war, she took it upon herself to communicate the miserable conditions she witnessed, creating pioneering using data visualisations to make her case.
Born in 1820 and raised in Embley Park, Hampshire, Florence Nightingale grew up in an affluent family. She was educated by her father William Edward Nightingale –- a notable English Unitarian – in mathematics, history, Latin and philosophy. She never married; rejecting a nine-year long courtship in the worry that a formal union would distract her from pursuing her work. She broke the norm for women of the day not just by rejecting the role of wife, but also refusing to rest content with a simple education. She continued to learn, and pursued radical subject areas that were looked down upon by the upper classes.
The Crimean war was a call to action for Nightingale. In 1854, she took a small group of nurses to Scutari, part of modern-day Istanbul, where they cared for wounded soldiers, perhaps naïve to the magnitude of misery and pain they would encounter. The war is infamous for its harrowing death rates: for the British Army 23% of the troops sent lost their lives, for the French it was 31%. Her team worked tirelessly to improve the sanitation of hospitals in Scutari and even influenced the government to establish a new hospital.
Nightingale’s greatest achievements occurred on her return to Britain. In Crimea, she had taken it upon herself to keep a record of all patient admissions and causes of death. When she met William Farr at a dinner party they compared notes: he worked as the official ‘Compiler of Abstracts’ in the General Registry Office, and was tasked with constructing a ‘mortality table’ of the general population. Nightingale’s data showed the magnitude of neglect in the barracks and she found that even in peacetime a soldier faced twice the risk of dying when compared to a civilian. The pair were instrumental in establishing a Royal Commission to investigate sanitary conditions during the war.
But with all this data flying around in masses of tables, Nightingale knew that her findings could easily lose their impact. Her solution was to invent a new kind of chart. By adapting Playfair’s pie chart a new visualisation was born: the polar area chart. A collection of ‘coxcombs’ were used to depict the causes of death during the Crimean war. They were divided into three categories: "Preventible or Mitigable Zymotic Diseases" (we would later simply call these ‘infections’, coloured in blue), "wounds" (red) and "all other causes" (black). The chart clearly shows the number of avoidable deaths in a given month during the war.
Nightingale sent her chart to the War Office, as part of a report that could be understood by civil servants and Members of Parliament alike. Her findings had a direct impact on improvements in military hospitals. She continued her research and campaigning on sanitary conditions in India and the UK. Florence Nightingale died in 1910. She led a remarkable life and her experiences reinforced a view that William Playfair had become fixed on a century before: that research which is easy to understand and non-technical has a greater likelihood of effectively influencing policy, and that if those are your aims a good chart will help.
By Rahat Siddique