What can we learn from Florence Nightingale?
Florence Nightingale was probably the second most important woman in the Victorian era in Britain, behind only Queen Victoria herself. She was a hero during the Crimean War, and she can be considered as the founder of modern nursing. ‘The Lady with the Lamp,’ this is how she was called as she was making rounds at wounded soldiers at night.
Nightingale, however, apart from her incredible work as a nurse, became also the first woman to be made a fellow of the Royal Statistical Society, and we can easily consider her as the first person in using a ‘rose diagram,’ a landmark in data visualisation and thus, communication.
During the last MCAA Conference, which took place virtually in March 2021, we learnt more about her, thanks to the keynote lecture of Tim Harford — economist, journalist, broadcaster, and author of many books. In his talk, he analysed chapter/rule number 9 of his last book, ‘How to make the world add up (Ten rules for thinking differently about numbers)’ (or, ‘The Data Detective’ if you’re from the US/Canada), which focusses on the story of Nightingale and that underlines that ‘misinformation can be beautiful too.
Nightingale and statistics
At the age of nine years old, Nightingale was starting to discover her passion for data as she was categorising the plants that grew in her garden. Later on, she managed to convince her parents to receive high-quality tuition in maths. Growing up, she met and became a friend of Charles Babbage and Adolphe Quetelet amongst others. Babbage then became the designer of a now-famous proto-computer, whilst Quetelet became the person who made popular the concepts of ‘average’ and ‘arithmetic mean,’ which at the time represented a great revolution when it came to summarising complex data. In the end, these two figures became also the founders of the Royal Statistical Society, and Nightingale, as previously mentioned, the first female fellow.
She was interested in statistics, and even more in the best way to communicate it; her motto was ‘Facta, facta, facta.’ However, this didn’t mean that her scientific communications were completely dry; on the contrary, she was very capable of transforming a dry statistic into a meaningful infographic, as she knew that people would have paid more attention to a vivid diagram than to a huge table of numbers.
Nightingale and the Crimean War
Nightingale was deeply interested in the world of maths and statistics, but her main job was as a nursing superintendent in a small hospital in London. It was then in 1854 that she was sent to lead a delegation of nurses to support wounded British soldiers during the Crimean War.
Once she arrived at the Barrack Hospital in Scutari, Istanbul, she found a devastating situation: lack of hygiene, rats and fleas everywhere, lack of bed and blankets as well as food. The results of this was a huge number of soldiers dying from typhus, cholera, and dysentery while trying to recover from their wounds. Another major problem Nightingale found was the lack of a standard medical record and there wasn’t a consistent report between the various British army hospitals.
She knew that to improve the situation she would have needed good statistics. So, she started organising all the information that was collected and in 1855 she requested a ‘sanitary commission’ to help clean up the hospital and maintain the buildings as clean as possible. The results of this campaign? The death rate was reduced from more than 50% to 20%. It was at this point that she wanted to fully understand what happened.
Nightingale and scientific communication
As soon as she returned from the War, she persuaded Queen Victoria to support a Royal Commission to investigate the health of the army. She was in fact convinced that poor sanitation had caused many of the deaths in the Crimean War. However, she found herself in a situation in which she had to convince the country’s medical and military establishment, and she would have had to persuade them to change an approach they were carrying on for a long time. Even more difficult, she was a woman in men’s land.
She needed a great idea… She needed science communication!
She realised that what she needed was a diagram, something that everyone could easily visualise, but at the same time, she knew she had to present powerful data. The results of her thoughts, together with the help of William Farr — another brilliant statistician she met during her life — resulted in her famous ‘rose diagram,’ realised in 1858 and published the year after (Picture below).
In this graph, she showed how many more English soldiers were dying of cholera and other preventable diseases (light blue) than battle wounds (light red) during the war. The chart on the right represents the situation before the sanitation measures, whilst the one on the left the situation after, and it clearly shows the reduction of dead soldiers.
At this point, she decided to share this graph to a very particular audience: “the Queen, Prince Albert, (…), all the crown heads in Europe, all the regional surgeons and medical offers, the chief sanitarians in both houses of Parliament, and all newspapers and magazines.”
In the 1870s, several new public health passed, death rates in the UK began to fall, and life expectancy increased. All thanks to Nightingale’s diagram.
What do we learn from Florence Nightingale?
From this story, we can learn how powerful an infographic can be. ‘The lady with the Lamp’ firstly understood the power of numbers and statistics, but she also understood that presenting dry data would have been useless as no one would have understood them. On the contrary, she realised that creating an infographic was fundamental to present the data in the most persuasive way possible. And she was right. I would also add that she perfectly chose the audience with whom share this information; we can consider her recipients as the stakeholders of the time.
She sent her data to an audience who could change things.
“All that glitters is not gold”
The relationship between Florence Nightingale and statistics was perfect: she did everything right, and she was able to convince the government to make positive changes.
But is it always like that?
The answer is of course no.
A powerful graphic can also carry misinformation (remember the ‘misinformation can be beautiful too’ at the beginning?) and here is the problem: are we able to detect when we are seeing something that is reporting wrong information? Sometimes yes, but other times no.
To help solve this problem in the future, Tim Harford ended his talk (and the chapter of his book) by giving a piece of great advice. You’ll just have to follow the 3C’s rules:
· Calm: before diving into a graph pause for a moment and notice how the graph makes you feel: triumphant, angry, celebratory? Always consider your feelings and try to look at the graph in a more detached way.
· Content: the question you have to ask you for this point is simple: do you understand what the graph is telling you? Do you have the context to understand? Think about it.
· Curiosity: you always have to be curious when looking at a graph; think about how the graph was created, why the authors decided to represent the information in one way and not in another. Asking yourself questions will permit you to better analyse the graph itself.
In short, don’t trust everything you see!
Ruben Riosa is a PhD student and scientific copywriter of the MSCA ITN project MANNA, working between the University of Bonn (Germany) and the University of Glasgow (UK). His project focuses on dairy cows’ nutrition and physiology.
He is deeply interested in science communication and loves to write.
Website: https://rubenriosa.com
