Say Little, Do Much: Nurses, Nuns, and Hospitals in the Nineteenth Century (review)

Sioban Nelson's study of Catholic women religious engaged in nursing is a succinct and original contribution to the history of nursing. An Irish-Australian nurse with a background in history, Nelson has written an engaging book that is intended in part to enlighten historians of nursing on the role of women religious at the foundation of the profession of nursing in the nineteenth century. She is countering those historians who view the significance of sister nurses as simply an inconsequential prelude to the Nightingale take-off point into modernity. She is grateful for the spate of recent works on the history of women religious by such scholars as Carol K. Coburn, Sue Ellen Hoy, Jo Ann McNamara, Martha Smith, and several others, but Nelson's departs from their methodology. Nelson enlarges the historical focus to consider the contributions of "vowed women," a term that embraces Anglican sisters, Methodist and Lutheran Deaconesses (who do not profess vows but are "set apart"), and Catholic sisters in the United States, England, and Australia. The term also allows Nelson to refer collectively to all those religious-women nurses who lived in community.

The title, Say Little, Do Much, is a quote from Vincent de Paul in the 1948 film, Monsieur Vincent. Though it is unlikely that the founder of the Congregation of the Mission and the cofounder of the Daughters of Charity actually uttered the directive, the phrase is in Vincent's character. Because this innovative community was committed to working in the lanes of poverty, ecclesiastical authorities could have considered them suspect for living outside an enclosure. Vincent could have urged the Daughters of Charity to attend to the great needs of the poor in relative quiescence. Despite the fact that they were not canonically religious and did not profess perpetual and solemn vows and professed only annual vows, their way of life was still suspect. In my own book on Catholic health care I cited Vincent's spiritual maxim for the Daughters: "When you leave your prayers for the bedside of a patient, you are leaving God for God. Looking after the sick is praying." In the few references to her own experience Nelson leaves the impression that her self-understanding as a Catholic nurse may include a strand of Vincent's spirituality.

Nelson depicts the scriptural Mary/Martha roles in terms of the enclosed nun as a Mary and the activist or apostolic sister as a Martha. It is in the chapter "Martha's Turn" that Nelson concentrates on the religious life that concludes with a discussion of the innovative character of the Daughters of Charity, the revival of apostolic religious communities in the nineteenth century, and the foundation of Protestant nursing communities. These developments converge in this work, one that stands as a major revision of the history of nursing.

This is not a comparative history, but the book does include a case-study chapter of immigrant-German deaconesses and German-Catholic sister nurses experiencing some common problems of adapting to American culture. Other chapters are also organized on the principle of case study: two of the United States, one of England, and one of Australia. Each of these case studies is situated in social, religious, and hospital contexts. In the case study of England the reader is introduced to the positive relationship between the Sisters of Mercy and Florence Nightingale during the Crimean War. Despite the strong anti-Catholic animus regnant in British society, this latter relationship flourished. The dominance of the Nightingale system is woven into the context in that chapter, while in the following case study there are tensions between the Nightingale nurses and the Irish Sisters of Charity in Sydney,Australia. While the Church in England did not greatly interfere with the women religious, the...