Professor Paul Crawford talks about his recent work on the subject of Cabin Fever, including the life and experiences of Florence Nightingale.
Coronavirus has disrupted what home is for us, can be for us, and the boundaries between home and work, home and society. It has also subjected us to cabin fever, particularly so during the dark winter.
If she were alive now, Florence Nightingale would empathise with our recent experiences of lockdown and all other kinds of prolonged confinement but ask, challenge us, that we find our purpose despite this limitation.
As we note in our book, Florence Nightingale at Home, the work of this great nursing leader was greatly influenced by her life at home and the concept of home so key to Victorian society. Nightingale felt trapped at home in her early years; brought home comforts to wounded soldiers in Scutari Hospital during the Crimean War (1854-56); championed approaches to fight contagious disease at home (not unlike Covid responses in terms of social distancing, ventilation, hygiene, and washing hands etc.); and, became disabled after being infected with brucellosis, contracted from unpasteurised milk at some point during her time at Scutari Hospital in Turkey, or in the Crimea.
By Christmas 1861, after her much-celebrated return from the Crimean War in 1856, Nightingale suffered a severe attack from brucellosis that continued until 1881, some twenty years! In this period, she could barely walk and was effectively bedridden.
Importantly, chronic pain, fatigue and depression plagued Nightingale for most of the rest of her life. Yet despite being disabled and housebound, she continued her mission, transforming the health of the nation while working from home, literally from her bed or chaise longue.
Indeed, she achieved her many notable social reforms from home, such as pioneering the training of nurses at St Thomas’ London, the use of statistics to advance public health and many other initiatives, not least improving sanitation and living conditions for the poorest in society.
As a devoted Christian, Nightingale continued to worship at home rather than at church due to her illness – an experience that many people of different faiths will have shared at various points during the last year when prevented from public gatherings due to social distancing rules.
A pervasive sense of Nightingale’s prolonged general isolation and confinement leaked out in a letter to her companion, The Reverend Benjamin Jowett in 1866, when she described herself as a kind of spiritual castaway in a largely faithless London: ‘I must be Robinson Crusoe come to life again as a female.’ Later, in 1870, her inability to worship at church was, she wrote, ‘one of [my] greatest afflictions’, bemoaning the extensive period that had passed since she had last stepped inside a place of worship.
Sometimes, Nightingale’s poor physical health compromised her home-based religious observances directed by Jowett, since the obligation to converse afterwards left her excessively tired. ‘[T]he fatigue to me of taking the sacrament is so great’, she wrote to her mother in 1870, suggesting that she ‘take Mr Jowett back to his house’ immediately afterwards.
In this last year many people have been living as urban castaways, on their own ‘desert islands’, experiencing ‘the greatest confinement in history’ with more than 4 billion people, over half the global population, subject to complete or partial lockdowns at the height of the pandemic in 2020.
In truth, we could view the earth as a kind of scientific analogue station, like those in Antarctica, to study the impact of confinement and isolation for long duration space travel, such as the planned expedition to Mars. Many of us may feel we have been to that distant planet over the last year, either on our own or with a crew, but also in an involuntary way!
During this time, we have all become more aware of the real mental health impacts of prolonged isolation and confinement. Even now, at the tail end of the current lockdown in the UK, and after a winter of dark nights and long periods indoors, we are more fully aware of just how important it is to be socially connected.
Now we will all be familiar with the popular term ‘cabin fever’ to capture the challenge of managing prolonged confinement through winter or other extreme conditions alone or in remote locations on land, at sea, in the air, and of course, in space.
Cabin fever is not a medically defined condition but a culture-bound or ‘folk syndrome’ commonly understood to refer to some combination of fatigue or lassitude, irritability, moodiness, boredom, depression resulting from isolation, confinement, bad weather, routine, or lack of stimulation. We will all know something of this after a year of coping with the ‘dead time’, the waiting time, the ‘social death’ resulting from social distancing, and feeling caged-in between four walls—experiences similar to those in prison or hostage environments, not least solitary confinement.
When my son, Jamie, and I researched the topic of ‘cabin fever’ during the first lockdown (as a kind of shared creative survival), we found barely anything written on this topic from a cultural, historical or mental health perspective.
Cabin Fever: Surviving Lockdown in the Coronavirus Pandemic provided a new and revealing theme to the earlier book; it gave additional colour and pertinence to the influence of the material reality and concept of home on Florence Nightingale in terms of confinement and isolation.
The combined investigations reveal that Florence Nightingale suffered from, battled against and surmounted the psychological challenge of cabin fever during her early years, living up to the Victorian ideal of the woman’s role of superficial domestic entertaining, which Nightingale found so wearing and boring, and the large part of her adult life restricted to the home.
As with many people confined to their rooms with long-term, debilitating illness, perhaps her bouts of depression resulted as much from this background of spatial and imaginative confinement as it did from her chronic pain and fatigue.
Curiously, the developing idea of ‘cabin fever’ was contemporaneous to Nightingale’s life, with the earliest published definition appearing in the year of her birth, 1820, by Sylvanus Urban [Pseudonym for Edward Cave] in The Gentleman’s Magazine, linking the term with typhus infection.
On further investigation, we traced the development of this physical affliction of typhus underpinning the notion of ‘cabin fever’ from the crowded cabins of the poor in Ireland where typhus took hold and spread to North America after the Great Famine (1845-9). There the Irish cabin building in extremely isolated and challenging environments of the North American frontier, led to a more psychological application of the term ‘cabin fever’.
Investigating the history of cabin fever really emphasises and foregrounds the huge importance of our lived environments, the spaces we inhabit, and how fragile we can become when constrained, disconnected and isolated—when home turns from a sanctuary into a prison.
Nightingale was very experienced in the whole business of homes (and much bigger ones than we might describe as cabins) – her family were very wealthy and she lived at the capacious Lea Hurst in Derbyshire, the enormous estate at Embley Park in Hampshire and various more modest yet comfortable London accommodations, famously at South Street, Mayfair.
She was also steeped in and passionate about households - something which lies at the heart of her work as a nursing pioneer and social reformer. at a time when public health was in its infancy in her book Notes on Nursing (1860).
Nightingale came to view the home as the seat of health - the place where the health of any nation begins and ends, developing a commitment to improving the lives of the poor in their homes to advance public health. She drove changes to combat the unseen dirty dangers lurking in our homes, hospitals and elsewhere, working to drive death from people’s thresholds, from the doors of their homes.
Yet Nightingale’s experience of life at home, as for many people, was not always happy and she fought against the entrapment of women in the domestic world. She did not want to sit around and fit in like her sister Parthenope did; she did not accept or wish to marry into a lacklustre, boring life of domestic ornament. Home for Nightingale came to feel increasingly sour and psychologically confining. It became a prison marked by idleness and lost aspiration.
Nightingale had ambition beyond ornament and battled her family to be out in the world, working as a nurse (a disreputable kind of labouring at the time), and got her way, carving an active life - a life of work and deeper purpose.
It was perhaps this determination, and settling on purpose and goals, that likely ensured that her later experiences living with disability and subject to cabin fever, did not overwhelm or destroy her. Ironically driven by illness into the domestic reality that she aspired to leave, and rather like the resilient astronauts of the future, dealing with long-term confinement and isolation, work and purpose kept her intact.
In a very strong sense, work became Nightingale’s home, where she found her identity. Working from home and work as home were to mark her life profoundly.
After her famous time supporting wounded soldiers in the Crimean War, she spent much of the rest of indoors - in lockdown. Indeed, as noted earlier, she achieved her greatest work from her bed! In the popular photograph of her by Bosanquet, tucked up under a voluminous quilt in her bed at South Street, we see Nightingale as she mostly was.
The life of Nightingale at home alerts us to the challenges of losing purpose in uninspiring, domestic visions, being housebound or confined at home and how having purpose, working from home, can be as much about emotional survival as being agreeably productive.
Nightingale’s prodigious, epistolary life, her hyper-connectedness on paper through her many publications and letters may have mirrored our own reliance during lockdown on all kinds of online and social media sharing. Her prodigious writing, and overachieving in society, may have been her way of avoiding or mitigating for cabin fever.
Her life reveals how we can oscillate between home as sanctuary and as prison, and how prolonged isolation can seed mental health difficulties, not least depression, but also spur us on to transcend, to overcome, to adapt, if we have the energy and drive to do so.
The Florence Nightingale Comes Home exhibition is on at Lakeside Arts until September 5th.
Read more about Florence Nightingale and Cabin Fever here: