0:15

Pushkin. The

0:26

Grand Barracks at Scutari and Istanbul

0:29

were said to be the largest in the world when

0:31

they were completed in the eighteen twenties.

0:33

By the eighteen fifties, a grim

0:36

war would turn them into the world's

0:38

largest hospital. Two inexperienced

0:41

eyes, the Scutari buildings were magnificent

0:44

to ours. In their first state. They

0:46

were truly whited, sepulchers, pest

0:49

houses. Those

0:51

are the words of a British nurse named

0:54

Florence Nightingale. She sailed

0:56

out to Istanbul during the Crimean War,

0:59

a pointless conflict between Russia

1:01

and an alliance including the British. Nightingale

1:05

arrived late in eighteen fifty four the

1:07

small team of nurses. Their

1:09

task was to assist in the care of wounded

1:12

British soldiers coming back from the battlefront

1:14

to the hastily converted barracks hospital

1:17

at Scutari. What did

1:19

they discover waiting for them? Oh,

1:22

you gentlemen of England can have little

1:24

idea from reading the newspapers of

1:26

the horror and misery of operating

1:28

upon these dying and exhausted men.

1:31

That this is the Kingdom of Hell. No

1:34

one can doubt. Within

1:37

days of her arrival. With fewer than

1:39

forty nurses, hundreds

1:41

of casualties started arriving every

1:43

day from the fighting in the Crimean Peninsula.

1:46

These men were bleeding from abdominal

1:48

wounds, their faces black with

1:51

gunpowder and mud, their bodies

1:53

crawling with vermin. After

1:55

each man died, he'd be stitched up

1:57

in his own blanket and carried to

2:00

a mass grave, making space

2:02

for the next to take his bed. As

2:05

for the hospital itself, Nightingale

2:07

was appalled by the conditions, the shambolic

2:09

organization. The heating system

2:12

didn't work and there was no clean water. The

2:15

army supply chain sent the wrong equipment

2:17

to the wrong place at the wrong time as

2:19

a matter of routine, and

2:22

they also seemed to delight in refusing

2:24

to deal with Nightingale, a woman

2:26

in a man's world. No

2:29

mops, no plates,

2:31

no wooden trays, no slippers,

2:33

no shoebrushes, no blacking,

2:36

no knives and forks, no spoons, no

2:38

scissors for the cutting of men's hair, which

2:41

is literally alive. No basins,

2:43

no toweling, no chloride

2:45

of lime. What

2:47

unfolded that winter was

2:50

a catastrophe. In

2:52

January eighteen fifty five, the

2:54

British army in Crimea lost one

2:56

man in ten to the ravages of diseases

2:59

such as dysentery and cholera. Many

3:02

of them died at the hospitals in Scutari.

3:05

Infectious disease tore

3:07

the British Army to shred back

3:11

in the UK, the reputation of the generals

3:13

and politicians was also in

3:15

tatters. One figure

3:18

alone emerged with reputation

3:20

intact. Florence

3:23

Nightingale, the leader of

3:25

the nurses in istan Bull, was celebrated

3:27

as the Lady with the Lamp, a

3:30

near religious icon of gentleness

3:32

and dedication, and the most

3:34

famous woman in the British Empire. Except

3:37

Queen Victoria herself. There

3:40

is not one of England's

3:42

proudest and purest daughters who

3:44

at this moment stands on so

3:47

high a pinnacle as Florence

3:49

Nightingale. The soldiers loved her too.

3:52

If there is any angels on earth, she is

3:54

one. What glory to see

3:56

her delicate form gliding about amongst

3:58

hundreds of great rough soldiers.

4:01

How to say the looks of love and gratitude

4:03

that they cast on her beloved face. It

4:06

would be a brave man at dare insult would

4:09

not give a penny furries chance. In

4:11

May eighteen fifty five, with

4:14

conditions at her hospital's improving,

4:16

Florence Nightingale sailed to the front

4:19

in Crimea, where she was moved

4:21

both by the spectacle and by the devotion

4:24

of the men. The men of the thirty

4:26

ninth Regiment turned out and gave

4:28

Florence Nightingale three

4:30

times three. As I rode away.

4:33

There was nothing empty in that chair.

4:36

Florence Nightingale was becoming a

4:38

saint, but the battle

4:41

with disease that had shaped her reputation

4:44

was about to take a sudden turn. On

4:46

the thirteenth of May, a few days

4:49

after arriving in Crimea, and

4:51

just a day after her thirty fifth birthday,

4:54

she collapsed. The room

4:56

was quickly spread around the British Army. Florence

5:00

Nightingale was dying. I'm

5:04

Tim Harford and you're listening

5:06

to cautionary tales. Even

5:30

today, it is as a nurse

5:32

that Florence Nightingale is revered

5:34

in Britain. Twenty

5:36

five years ago, my mother took her

5:39

last breath in a Nightingale

5:41

hospice. Nightingale's

5:43

face adorned British bank notes and

5:45

the front cover of magazines during the COVID

5:48

nineteen pandemic, all hail

5:50

the handwashing Queen, and we even

5:53

named our emergency COVID hospitals

5:56

the Nightingale Hospitals. Nightingale

5:59

is the ultimate nursing icon.

6:02

It's as though she had died the day

6:05

she collapsed in Crimea in May

6:07

eighteen fifty five at the age of

6:09

thirty five. Her mission as

6:11

a nurse had been accomplished, her march to heaven

6:13

was assured, and there was nothing more to be

6:15

said, which is strange because

6:18

despite the trauma and the sickness

6:21

staying with her, Nightingale

6:23

lived until she was ninety years

6:26

old, and she didn't bask

6:28

in her celebrity nor retire to her

6:30

country home. She had a much bigger

6:32

battle to fight, one woman

6:34

and a hand picked team of geeks

6:37

versus the entire military and medical

6:40

establishment of the country, with hundreds

6:42

of thousands of lives at stake. That

6:45

huge fight is what this cautionary

6:48

tale is about. That

6:51

and the strangely modern weapon she used.

6:55

Because Florence Nightingale was not only

6:57

a nurse, she was also, and

6:59

I mean this as a most sincere

7:01

compliment, a total nerd.

7:05

She became a statistician, the first

7:07

female Fellow of the Royalty Called

7:09

Society, and an honorary member

7:11

of the American Statistical Association. She

7:14

was a master of data visualization.

7:17

If you wanted to be dismissive, and

7:19

some people do, you'd say she was very

7:21

good at drawing pretty diagrams. But

7:24

those pretty diagrams change

7:26

the world. This is the

7:28

story of how to fight for

7:30

a public health revolution armed

7:33

with a souped up pie chart. I

7:37

don't need to tell you how ubiquitous

7:39

data visualization is. Everywhere

7:41

we look, whether we check social media,

7:44

turn on rolling news, or flip through

7:46

a newspaper, we see graphs and

7:48

charts, flashy pictures of data

7:51

designed to persuade us of something. They're

7:53

not just decorations. These graphs

7:56

push and pull us into taking high

7:58

stakes decisions. COVID nineteen

8:01

reminded us of just how high the

8:03

stakes can be. People have

8:05

lived or died because of the decisions

8:07

they've made after king at a chart

8:09

on Facebook. That's why

8:12

I wanted to understand what Florence

8:14

Nightingale did with graphs and

8:16

how she did it. But the deeper

8:18

eye went into the Florence Nightingale archives

8:21

the stranger the story became, and

8:24

it raises a question. If graphs

8:26

are so powerful, shouldn't

8:28

we worry about how that power is

8:31

used. From

8:38

the hospital in Scutari, Florence,

8:40

Nightingale had tirelessly lobbied

8:42

for support and assistance, expertly

8:45

dealing with the press and her political contacts

8:47

to get what she needed, and in March

8:49

eighteen fifty five came

8:52

a turning point. A sanitary

8:54

commission arrived from Britain with

8:56

the task of cleaning up the hospitals in Scutari.

8:59

There was a lot of cleaning to do. Over

9:02

the following weeks. They discovered that the drains

9:05

leading away from the Barrack hospital were

9:07

blocked effectively, meaning the hospital

9:09

sat on a cesspool. The main

9:11

water pipe supplying part of the hospital

9:14

was blocked by a decomposing

9:16

horse. Two dozen more animal

9:18

carcasses were found on the hospital's site.

9:22

Prefabricated privies had been built

9:24

in the central courtyard, but excrement

9:26

was leaking out of the trench beneath them

9:29

and into an adjacent water tank.

9:32

By late March, the Army was carrying

9:35

out the commission's recommendations,

9:37

clearing and flushing the sewers,

9:39

cutting air vents in the ceilings, removing

9:42

rotten wood floors, and whitewashing

9:44

everything. The Sanitary Commission

9:46

is really doing something and has set

9:48

to work burying dead dogs and whitewashing

9:51

walls, two prolific causes

9:54

of fever. The death toll

9:56

was far lower after the Commission had

9:58

done its work, and before it

10:01

was a perfect example of what could

10:03

be achieved to save lives with simple

10:06

cleanliness and keeping sewage

10:08

away from the water supply. A Nightingale

10:11

did not forget the lesson. When

10:15

Florence Nightingale returned from the war,

10:18

Queen Victoria summoned her

10:20

for a royal audience. Ah,

10:24

Miss Nightingale, your

10:26

majesty, we have heard

10:28

so much about you. Nightingale

10:31

didn't think much of Victoria. She

10:33

is the least self reliant person I've ever

10:35

known. But

10:39

the Queen could be useful to her. Florence

10:42

Nightingale had returned from the Kingdom

10:44

of Hell with a mission. She

10:47

wanted to make sure the awful toll

10:49

of disease in Scutari never

10:51

happened again in any British

10:53

hospital anywhere in the world. So

10:57

Nightingale persuaded Victoria to

10:59

support a royal commission investigating

11:02

the health of the army. As

11:04

a woman, Nightingale was unable

11:06

to sit on the commission herself, but

11:09

she assembled her geek allies and

11:11

worked behind the scenes to figure out the problem.

11:14

She turned down Queen Victoria's

11:16

offer of a suite at Kensington Palace,

11:19

there would be far too many visitors. Instead,

11:23

she took rooms at a low rent London

11:25

hotel. So what

11:27

had been the underlying cause of the

11:29

death toll in the Scutari hospitals

11:32

to modernize The answer is obvious.

11:35

Disease spreads thanks to poor hygiene,

11:38

poor ventilation, and contaminated

11:40

water, and the hospitals in Scutari

11:42

suffered from all three. It

11:45

was not so obvious to Nightingale. Germ

11:47

theory didn't exist in the eighteen fifties.

11:50

Although the science was mysterious.

11:53

Nightingale was one of a group of Victorian

11:55

thinkers who were convinced that one way

11:57

or another, good sanitation

11:59

should help. With her ally the

12:01

great statistician William Far, she

12:04

assembled and examined the data. Far

12:07

and Nightingale became convinced that wherever

12:09

they looked, premature death went

12:12

hand in hand with open sewers,

12:14

bad ventilation, and unclean

12:16

conditions. It wasn't just about

12:19

the Crimean War. It was an

12:21

ongoing public health disaster

12:24

in barracks, civilian hospitals,

12:26

and beyond. The

12:28

pair began to campaign for better public

12:31

health measures, and here

12:33

the epic battle was joined. They

12:36

faced powerful opposition. The

12:38

government didn't want an embarrassing report

12:41

about the Crimean War, already

12:43

regarded as a fiasco. The Queen,

12:45

of course, was an instinctive conservative,

12:48

whose idea of reform was to replace

12:51

one over promoted bureaucrat with

12:53

another. And neither the army

12:55

nor the medical profession cared to

12:57

take constructions from a woman, not

13:00

even the Angel of Scutari, Florence

13:02

Nightingale. In

13:04

any case, they believed she was surely

13:07

wrong. A couple of years after

13:09

the end of the Crimean War, in eighteen

13:11

fifty eight, the Chief Medical

13:13

Officer, John Simon acknowledged

13:16

that contagious diseases such as cholera

13:18

and dysentery were a cause

13:20

of premature death in every civilized

13:22

country, but that they were practically

13:26

speaking unavoidable. These

13:29

diseases just happened, said

13:31

John Simon, and yes they killed

13:33

people. Deal with it. And

13:36

don't take any lessons from Florence Nightingale.

13:41

Nightingale was outraged at the complacency.

13:44

The deaths from disease in British Army

13:47

barracks were criminally high.

13:49

It was just as bad, she said, as it would

13:51

be to take one thousand, one hundred men

13:53

out upon Salisbury playing and

13:56

suit them. The same for civilian

13:58

hospitals, private homes, slums

14:01

all over the country, men, women and

14:03

children were dying, and self

14:06

satisfied men like John Simon

14:09

insisted that these deaths were practically

14:12

speaking, unavoidable. The

14:14

chief medical Officer, the generals,

14:16

and the entire British establishment

14:18

stood against her. Her

14:21

geek sidekick, statistician William

14:23

Farr warned her to be careful.

14:26

Well, if you do it, you will make yourself

14:28

enemies. After what I've seen,

14:31

I can fire my own guns. And

14:33

the nineteenth century heroine

14:35

had a twenty first century weapon. It

14:38

was a diagram.

14:45

It's not an accident that these days

14:47

were surrounded by graphs and charts. They're

14:50

the sweet spot between solid statistical

14:52

evidence on one hand, and shareable

14:54

gifts and filtered photos on the other.

14:57

Hard data plus striking images.

15:00

Scientific evidence backs up what any

15:03

news editor or social media consultant

15:05

will tell you. Graphs attract

15:07

attention and they persuade people.

15:11

Researchers at Tuft's Visual

15:13

Analytics Lab found that people

15:15

formed an impression of a graphic within

15:17

five hundred milliseconds

15:20

just half a second. That's

15:22

far too brief to understand what the graph is

15:24

about, but it's not too brief

15:26

to think what a mess or ooh

15:28

shiny. We respond

15:31

to images without conscious

15:33

thought. Another team

15:35

of researchers data scientists at

15:38

New York University showed people

15:40

evidence about practical policy questions,

15:43

For instance, does a high corporate income

15:45

tax drive jobs overseas

15:48

or does prison work as a deterrent.

15:50

Sometimes the relevant data was in the form of a

15:52

table, and sometimes in the

15:55

form of a chart. Unless people

15:57

already had a strong position on the subject,

15:59

the charts were much more persuasive

16:02

than the tables. If you saw a chart,

16:04

you were much more likely to change your

16:06

view. That seems obvious

16:08

today, it wasn't obvious in the eighteen

16:11

fifties. Statisticians were

16:13

much more likely to present their data in the

16:15

form of a table, even if the table

16:17

sprawled across page after page.

16:20

Beautiful design was thought

16:22

to be superfluous. Florence Nightingale,

16:25

not for the first time in her life, begged

16:28

to differ. She would create

16:30

a graph so compelling that the

16:32

British establishment would have to bow

16:35

in acquiescence. The graph

16:37

in question is titled Diagram

16:40

of the Cause of Mortality in

16:42

the Army in the East. It

16:44

was published in eighteen fifty nine, the

16:46

year after doctor John Simon declared

16:49

that death from infectious disease was

16:51

practically speaking unavoidable.

16:54

Now I'm going to try my best to describe

16:57

this image. I've seen an original

16:59

printing up close in the library of

17:01

the Royal Statistical Society in London.

17:04

It's amazing, but you can find

17:06

copies online. The first

17:08

thing you would see, say, if you were shown

17:10

the graph for five hundred milliseconds,

17:12

is that it consists of two pale

17:15

blue spirals, one larger

17:17

than the other. Look more closely

17:19

and you see that each spiral is built

17:22

of twelve equally angled wedges,

17:24

like the hours of the clock. Some

17:27

of the wedges are small, clinging near the

17:29

center. Others sprawl out

17:31

hugely, which is what gives the diagram this

17:33

sense of spiraling in or out.

17:36

The Rose diagram is a beautiful

17:38

image, but describes some horrifying

17:41

numbers. Each of the wedges

17:43

represents the deaths in a particular

17:45

month, and the two circles

17:48

describe the loss of life over two years,

17:50

from April eighteen fifty four to

17:53

March eighteen fifty six. The

17:56

first circle spirals out like a

17:58

snail. October is not

18:00

too grave. November, when

18:02

Nightingale arrived at the hospital in Scutari,

18:05

is worse. December is worse

18:07

still. Jan Ury and February

18:10

are awful swollen wedges

18:12

of blue, so large that they threatened

18:14

to bleed off the edge of the page itself.

18:17

In the center of the diagram are tiny

18:19

black and red wedges. They indicate

18:22

a handful of deaths from miscellaneous

18:24

causes and from wounds. The

18:26

huge blue wedges show the

18:28

overwhelming death toll from

18:31

infectious diseases. No

18:33

one ever made a decision because of a number.

18:36

They needed a story, so said

18:38

Daniel Carneman and Amos Tversky,

18:41

the two psychologists whose collaboration

18:43

would win Carneman and Nobel Prize

18:46

after Tversky's death, and

18:48

Florence Nightingale's diagram more

18:51

than anything, is a story. The

18:54

first half of that story is

18:56

a catastrophe, but the second circle

18:58

continues the narrative. In April

19:00

eighteen fifty five, just after

19:03

the sanitary Commission arrived in Scutari,

19:06

the change is dramatic. The

19:08

circle is much smaller, and while

19:10

the first circle spiraled outward

19:12

in an ever worsening death count,

19:15

the second circle shrinks inward

19:18

as the casualties dwindle. It's

19:20

a tale with two halves. After

19:23

the catastrophe comes the redemption

19:26

in between, the two of them flushing out

19:28

the sewers, casting away the dead horse, disinfecting

19:31

the hospital buildings. In eighteen

19:33

fifty eight, John Simon, the Chief

19:35

Medical Officer, had declared that death

19:38

from infectious disease was practically

19:40

unavoidable. In eighteen fifty

19:43

nine, Florence Nightingale's graf said,

19:45

that's a lie. Not only

19:48

a death's avoidable, but with simple

19:50

practical measures the army

19:53

had avoided them. Those

19:55

two pale blue circles delivered

19:58

a powerful two part payload.

20:00

John Simon and his allies felt

20:03

the force of both barrels. As

20:05

Nightingale explained to an old friend,

20:07

an influential politician, whenever

20:10

I am infuriated, I revenge

20:12

myself with a new diagram.

20:17

The graphs and the rose diagram in particular,

20:19

were part of a deliberate strategy.

20:22

In another letter to the same friend, written

20:25

on Christmas Day, eighteen fifty seven,

20:27

she sketched out a plan to use data

20:30

visualization for social change.

20:32

She declared her plan to have her diagrams

20:35

glazed, framed and hung

20:37

on the wall at the Army, Medical Board and

20:39

War Department. This is what they

20:42

do not know and did ought to,

20:44

she added, None but scientific

20:47

men even look into the appendices of a

20:49

report. And this is

20:51

for the vulgar public. Now,

20:54

who is the vulgar public? Who is to

20:56

have it? The Queen Prince

20:58

Albert, all the crownheads in Europe,

21:00

with the ambassadors or ministers of each, all

21:02

the commanding officers in the Army, all

21:04

the regimental surgeons and medical officers,

21:07

the chief sanitarians in both houses

21:09

of Parliament, all the newspapers, reviews

21:12

and magazines. Nightingale's

21:16

visual story was impossible to

21:18

ignore. Opinions started

21:20

to shift, Parliament past new

21:22

laws, doctors adopted

21:24

new practices. Nightingale

21:26

understood earlier than most that

21:29

a chart has a special power.

21:33

But I can't just end this cautionary

21:35

tale there on a happy note, because

21:38

perhaps charts have a little

21:40

too much power. Our

21:48

visual sense is potent, so

21:50

potent that we even use the phrase I

21:53

see as a direct substitute

21:56

for I understand. Seeing

21:59

can be believing, but seeing

22:02

can also mean fooling yourself. Edward

22:05

Tufty, perhaps the most influential

22:08

graphical guru alive, understand

22:10

the power of visual explanation as

22:12

well as anyone. His books include

22:15

envisioning information and beautiful

22:18

evidence. But we

22:20

can envision misinformation too,

22:23

and it can be just as beautiful, and

22:26

we can now share it with a

22:28

click. In mid

22:30

March twenty twenty, as

22:32

we were just beginning to grasp the enormity

22:35

of the unfolding pandemic, Eric

22:38

Fagelding, an epidemiologist

22:40

with a large following and a quick fire style,

22:43

fired off a graph from the Centers for

22:45

Disease Control with a warning

22:47

newsflash for young people, you

22:49

are not invincible. You're just

22:52

as likely to be hospitalized as older

22:54

generations. Even CDC says

22:56

so that the CDC's

22:58

graph didn't show that at all. It

23:01

showed that vastly more over

23:03

forty fives than under forty fives

23:05

were in hospital. But it was easy

23:08

to misunderstand, and the graph if you didn't

23:10

look closely at the tiny, tiny

23:12

labels on the axes, and who

23:14

looks at the tiny tiny labels eh,

23:17

And so an epidemiologist who should

23:19

have known better but was just a little too

23:21

eager to tweet unwittingly

23:23

spread misinformation to his three hundred

23:26

thousand followers. It gets

23:28

worse. A few days later, the

23:31

right wing pundit and Coulter tweeted

23:33

a pair of graphs and a comment

23:36

for people under sixty, coronavirus

23:38

is less dangerous than the seasonal

23:41

flu. But the graphs showed

23:43

the precise opposite of Coulter's

23:45

claim. COVID nineteen was about

23:47

eight times as deadly as flu for people

23:49

in their fifties and five times

23:52

as deadly for people in their thirties and

23:54

forties. It's like tweeting

23:56

a picture of a cow next to a cat with

23:58

the title cows are smaller

24:01

than cats absurd, except

24:04

Coulter's up is down message

24:06

was retweeted more than eleven thousand

24:09

times. Within a few hours

24:11

of each other. Two Twitter influencers,

24:13

one overplaying the risk of COVID and

24:16

the other underplaying it, were

24:18

tweeting graphs that they hadn't understood.

24:21

It didn't seem to stop those tweets going

24:23

viral. All too many people

24:25

seem to think any claim with a graph attached

24:28

must be true. People make

24:30

life changing decisions because of graphical

24:32

misinformation, like this, quitting

24:35

a job in fear, but in fact the risk

24:37

is low, or recklessly exposing

24:39

others to deadly risk because they've

24:41

been told the virus is fake news. It

24:45

turns out that data visualization is

24:47

a dual use technology. It

24:49

can be a tool or a weapon. Florence

24:52

Nightingale was perhaps the first person

24:55

in history to grasp that a well

24:57

designed graph based on solid data

24:59

can be remarkably persuasive. Experience

25:03

has taught us the unfortunate lesson that

25:05

a badly designed graph or a graph

25:08

based on flimsy data, well,

25:10

they can be remarkably persuasive too. There

25:20

is a strange twist in this story,

25:23

because while Florence Nightingale is

25:25

revered by many graphic designers,

25:27

many others despise her Rose

25:30

diagram. Edward Tufty, the

25:32

influential author of Beautiful Evidence,

25:34

criticized the graph on his website. The

25:37

inherent problem as the difficulty of

25:39

making good comparisons across

25:41

the wedges. In general, for

25:43

such small data sets, tables

25:46

will I'll perform graphics.

25:49

The diagram's unclear, and since

25:51

there aren't that many numbers to portray, Nightingale

25:54

should simply have used a table. Nightingale's

25:57

statistical contemporaries would have agreed.

26:00

But I've seen the data in Nightingale's

26:03

graph presented as a table. And

26:05

the first thing that sprang to mind was Nightingale's

26:08

own comment to her friend in

26:10

that Christmas Day letter of eighteen fifty

26:12

seven. In this form, printed

26:14

tables and all in double columns, I do

26:17

not think anyone will read it. Remember

26:20

to whom she sent this earth shaking

26:22

diagram, the Queen, Prince

26:24

Albert, all the crownheads in Europe,

26:26

all the newspapers, reviews and magazines.

26:29

Tables can be clearer, but

26:31

tables don't grab your attention in

26:34

five hundred milliseconds, and kings

26:36

and queens and ministers and newspaper editors

26:38

are busy. As Nightingale rather

26:41

acidly noted when she sent her report

26:43

to Queen Victoria, she may

26:45

look at it because it has pictures. Fine,

26:49

the message demands a graph,

26:51

but surely there's a better, clearer graph

26:54

conveying the same message. Certainly

26:56

that's what Edward Tufty's followers

26:58

believe in the comments on his website.

27:00

Is it wrong that I'm erased by a graphic?

27:03

Good design is not drawing

27:06

pretty pictures and shoehorning

27:08

the fact seen later, these Nightingale

27:11

roses are just a type of pie chart

27:13

and contain all the disadvantages of pie charts.

27:16

Wow, that's quite a burn. The

27:18

charts are difficult to read. I

27:21

would have thought that a stacked bar chart on

27:23

a timescale would have been a better choice.

27:26

Good idea. Let's try a bar chart.

27:29

And here's where the plot thickens, because

27:31

when I first saw the data presented

27:34

as a bar chart, my jaw dropped.

27:37

It is absolutely clear and

27:39

easy to read. And that's the problem.

27:41

When you see the data presented in

27:44

a clear, modern format, you

27:46

start to realize something. Maybe

27:48

Florence Nightingale wasn't quite

27:51

as saintly as everyone thought.

27:57

Florence Nightingale's diagram divides

27:59

the data into two halves. That's

28:02

not an accident. The color diagram

28:04

number one shows the salutary

28:06

stage of the army before the arrival of the commission.

28:10

The colored diagram number two shows

28:12

what it became after that

28:15

event catastrophe, before, recovery

28:18

after, and as I've mentioned,

28:20

Nightingale was aiming not at a post

28:23

mortem of the Crimean War, but

28:25

at the far bigger goal of public health

28:27

reform. Similar diagrams

28:29

might be constructed for towns

28:31

in their unimproved and improved

28:34

state. Nature is the same everywhere

28:37

and never permits her laws to be disregarded

28:39

with impunity. The argument

28:42

is powerful, and the conclusion is

28:44

correct. Life expectancy strikingly

28:47

improved in the second half of the nineteenth

28:49

century and the Sanitarian Revolution.

28:52

Cleaner water, cleaner homes, cleaner

28:54

air deserves much of the credit. But

28:57

that's why it's so shocking to see the

28:59

data from the Rose diagram replotted

29:02

as a bar chart. When

29:04

you do that, the stark before

29:06

and after story is lost. By

29:08

the time the Sanitary Commission arrived in

29:10

March, flushing horses out of the

29:13

water supply and carrying away tons

29:15

of human excrement, deaths had

29:17

already been falling sharply for

29:19

a couple of months. Mark

29:22

Bostridge, the author of an award winning

29:24

biography of Nightingale, argues

29:27

that deaths were falling because new arrivals

29:29

were in better health, in part

29:32

thanks to the better weather. They were less

29:34

numerous, so the hospital was less overcrowded,

29:37

and with fewer soldiers in the hospital, of

29:39

course there'd be fewer deaths. There's

29:41

no doubt that better sanitation works.

29:44

But an unvarnished presentation of

29:46

Nightingale's data would have suggested

29:48

that the truth was complicated,

29:51

and complicated wasn't

29:54

going to serve her purposes, so

29:57

she created her Rose diagram.

29:59

The same data, artfully presented,

30:03

tells a very different story.

30:07

There's a famous remark in a letter that

30:09

passed between Nightingale and her ally,

30:12

the great statistician William Farr,

30:15

You complain that your report would be

30:17

dry. The dryer, the better

30:19

statistics should be the driest of all

30:22

reading. Several biographers

30:24

have reported that remark as being written

30:27

by Far to Nightingale.

30:29

That makes sense. The fusty,

30:32

middle aged statistician was advising

30:35

the fiery younger advocate to

30:37

reign in her righteous campaigning

30:39

influences, and thankfully she ignored

30:41

him. Except the

30:44

biographers are wrong, confused

30:47

perhaps by the fact that the surviving draft

30:49

of this letter was dictated to an assistant

30:51

and unsigned but while researching

30:54

my new book, The Data Detective,

30:57

I tracked the letter down and

30:59

it wasn't from Far to Nightingale. It

31:02

was the other way around. You complain

31:05

that your report would be dry. The

31:07

dryer, the better statistics

31:09

should be the driest of all reading. She

31:13

was telling him to play it straight

31:16

and avoid editorializing solid

31:19

evidence first, she said, and worry

31:21

about the sales pitch later. Good

31:23

advice for any scientist. In

31:26

the same letter, she added, we

31:29

want facts. Factor

31:31

factor. Factor is the motto which ought

31:33

to stand at the head of all statistical

31:35

work. It's puzzling

31:38

how could she produce the famous Rose

31:41

diagram, an artfully constructed

31:43

piece of statistical storytelling, while

31:46

being the same person who told William Farr

31:48

to keep it dusty dry. My

31:51

guess is that she was far too clever

31:53

to build an argument on shaky foundations.

31:56

The more spectacular the statistical

31:59

acrobatics, the more solid

32:02

the numbers needed to be. But

32:04

it's just a guess. I don't know. I

32:07

don't even know if this cause Retale

32:09

has a happy ending, if

32:12

the end justifies the means. I

32:14

suppose it does, because she

32:16

won Nightingale and

32:18

her allies saved countless

32:20

lives, transforming the health

32:23

of Victorian Britain and arguably

32:25

of the world. Most

32:28

of Nightingale's campaigning took place

32:30

while she was confined to her bedroom

32:32

by the long illness she had acquired in Crimea,

32:35

and she emerged triumphant.

32:38

Germ theory had vindicated her focus

32:41

on hygiene and public health. Her

32:43

sanitarian reforms had been broadly

32:46

implemented, the everyday

32:48

health of ordinary citizens had

32:50

been transformed. Even

32:52

doctor John Simon, it seems, had

32:55

quietly recognized his mistake. He

32:58

published a collection of his essays, and

33:00

without acknowledging the change, he

33:03

altered the line that said that deaths

33:05

from disease were practically speaking

33:08

unavoid instead saying

33:10

they were in some degree unavoidable.

33:14

From saying there's nothing we

33:16

can do to save lives, John

33:19

Simon had softly sidestepped

33:21

into saying, well, we

33:23

can't save everyone. Florence

33:26

Nightingale and her Rose diagram

33:29

had defeated him. But

33:31

let's be careful, because

33:34

it seems that if you give us five hundred

33:36

milliseconds alone with a pretty graph,

33:38

we're all suckers. The

33:41

first data visualization to change

33:44

the world did so by

33:46

exploiting our visual gullibility.

33:50

Florence Nightingale's beautiful graphic

33:53

proved a powerful weapon, and

33:56

now it's a weapon that anyone with

33:58

any motive can pick

34:01

up and news. Key

34:06

sources for this episode include Mark

34:09

Bostriche's biography and Lynn McDonald's

34:11

collected works of Florence Nightingale,

34:14

Hugh Small's presentation to the Royal Statistical

34:17

Society, and my own book, The

34:19

Data Detective Ten Easy

34:21

Rules to Make Sense of Statistics.

34:24

For a full list of references, see Tim

34:27

Harford dot com.

34:30

Cautionary Tales is written by me Tim

34:32

Harford with Andrew Wright. It's

34:34

produced by Ryan Dilley and Marilyn

34:36

Rust. The sound design and original

34:39

music is the work of Pascal Wise.

34:41

Julia Barton edited the scripts.

34:44

Starring in this series of Cautionary

34:46

Tales Helena Bonham, Carter and

34:49

Jeffrey Wright, alongside Nazzar

34:51

Alderazzi, Ed Gohan, Melanie

34:54

Gutteridge, Rachel Hanshaw, cobenerholdbrook

34:57

Smith, Greg Lockett, Miss

34:59

Siamunroe and Rufus Wright.

35:02

This show wouldn't have been possible without

35:04

the work of Mia LaBelle, Jacob Weisberg,

35:07

Heather Fane, John Schnars, Carlie

35:10

mcgliory, Eric Sandler, Emily

35:12

Rostick, Maggie Taylor and

35:15

Yellow Lakhan and Maya Kanig.

35:18

Cautionary Tales is a production

35:21

of Pushkin Industries. If

35:23

you like the show, please remember to rate,

35:26

share, and review.