In mid-19th century London, a young nurse is found brutally strangled at the Royal Free Hospital. One of the hospital's Board of Governors, Lady Callandra Daviot, engages her friend former Inspector William Monk to investigate the killing. The victim was not an ordinary Victorian nurse, most of whom were poorly educated, morally suspect, and distinctly lower class. Rather, the dead woman came from a middle class family and was an outspoken professional who had worked side-by-side with Florence Nightingale in the Crimea.

In fact, Nurse Prudence Barrymore had had pretensions of studying to become a doctor--an unthinkable goal for a Victorian woman! As Monk and his colleague, Hester Latterly--another Crimean nurse--investigate the inner workings of the Royal Free Hospital, they soon discover a quagmire of secret passions and deceit.

Monk gains access to letters from Nurse Barrymore to her married sister that appear to incriminate Sir Herbert Stanhope, the hospital's leading surgeon and a paragon of propriety. Was Sir Herbert Nurse Barrymore's secret lover? As Sir Herbert's trial progresses, it appears that he was, but then events suddenly take an unexpected turn.


This novel presents a fascinating portrait of nursing, medicine, and hospital care in mid-19th century England. Not surprisingly, physicians sit at the top of the heap, their decisions unquestioned, and their ranks entirely male. The availability of anesthesia (ether and chloroform) has recently revolutionized surgery. A subplot of A Sudden, Fearful Death relates to abortion, which remains a serious criminal offense.

Hospitals are pestilential. The "orthodox" medical establishment rejects the new-fangled concepts of light, cleanliness, and good ventilation, arguing that they are too difficult to achieve and, in any case, useless. Florence Nightingale and her followers are determined to turn nursing into a respectable profession with high moral and scientific standards.

These "new" nurses promote hospital cleanliness and ventilation, but the old order fights a violent rearguard action. After all, why should anyone take these women's opinions seriously? They are misfits who should be at home knitting or arranging flowers, rather than working side by side with the drunks and whores who comprise the traditional hospital nursing staff.


The author was born Juliet Marion Hulme.


Fawcett Columbine

Place Published

New York



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