REVIEWED BY SUZY FARREN
Enlightened Charity — The Holistic Nursing Care, Education, and Advices Concerning the Sick of Sister Matilda Coskery, 1799-1870
By Martha M. Libster, Ph.D., R.N., and Sister Betty Ann McNeil, DC
Golden Apple Publication, LLC, 2009
528 pages, $29.95
www.goldenapplehealingarts.com
In their scrupulously researched new book, Dr. Martha Libster and Sr. Betty Ann McNeil offer a glimpse into a little-known chapter of American nursing history. They have extensively documented the story of Sr. Matilda Coskery, a Daughter of Charity and one of the nation's early nurses.
The book stemmed from a happy coincidence. Libster, a psychiatric nurse, was doing research for a book on herbal botanicals, and McNeil, the Daughters of Charity archivist, discussed a 76-page text by Sr. Coskery: Advices Concerning the Sick. Much of Sr. Coskery's work centers on care of the insane, a topic that spoke strongly to Libster. This book is the result of their years of collaboration.
For more than a century, the text had lain dormant in the Daughters' archives in Emmitsburg, Md. Speculating that it was never published because it was a "work in progress" with "a number of open spaces on some of the pages," the two delved into the text and in the process, they have filled in some gaps in American nursing history.
Acknowledging that Sr. Coskery's humility posed a challenge, as she would not have allowed herself "to be singled out by name," the collaborators responsible for this volume nonetheless consider her to be the author of the work, and they have pieced together a remarkable amount of information about nursing during what they describe as a formative, yet heretofore little known, era.
To set the context, they begin with some background. And that is the one criticism I had of the book. Most readers may appreciate the level of detail the book provides, but I found it a bit overwhelming. Founded in 1809, the Sisters of Charity of Saint Joseph (to be renamed the Daughters of Charity in 1850) were the first Roman Catholic sisterhood native to the United States. The sisters started schools and orphanages and cared for the sick in their homes. When Sr. Coskery entered the order in 1827 at the age of 28, the sisters were already established as nurses. Sr. Coskery was described as "small, slight, rather pale with piercing black eyes, a quick and often abrupt manner of speech." Other descriptions note that she was prone to anxiety and inner conflict. One of her early assignments was to nurse patients at the Maryland Hospital for the Insane.
By 1840, the Sisters opened an asylum for the insane, and with more than a decade of nursing experience, Sr. Coskery was named Sister Servant. There she oversaw the other sisters, and they became known for their humane handling of the insane and for treating patients with kindness rather than force. The authors observe that Sr. Coskery and the Sisters of Charity's "zealous approach to the care of the insane, some of the most marginalized individuals in society, stemmed from their religious fervor for charitable service to their fellow human beings."
Much of the book focuses on Sr. Coskery's text: Advices Concerning the Sick. The text is divided into sections, including care of the insane, the field in which Sr. Coskery made her most significant contribution. The authors point out that she taught nurses to treat the insane as rational beings and to provide care that elevated the patients' self-esteem. The text describes how to create a healing environment and how to offer compassionate care.
Sr. Coskery's thoughts on nursing care are wonderfully practical, while demonstrating compassion and a concern for patient safety.
"Always keep a bed or two ready, so that the poor sick may not be kept waiting."
"If he is faint-like, give him a little wine or toddy."
"Let every phial or box of medicine have its name on it and the quantity to be given, or serious mistakes will be the consequence … ."
"Never reproach those suffering from intoxication, for their own thoughts are often more than they can bear … ."
The authors are quick to reference the inequities of the times. Physicians regarded Sr. Coskery as an "oracle of wisdom," yet she could never have become a physician herself. Her own brother earned a medical degree after graduating from school and writing an 11-page thesis on fever. Although her contribution to medicine was far greater, it would be nearly a century (1849) before the first American woman obtained a medical degree.
Sr. Coskery nursed soldiers during the Civil War and continued to provide nursing care almost until her death at 71. In late May 1870, after caring for the poor near Emmitsburg, she became ill herself. She died after a 12-day illness.
Advices Concerning the Sick was most likely completed years before Florence Nightingale's text Notes on Nursing appeared in 1860. Libster and McNeil ponder why it was that American nursing adopted the secular model of Florence Nightingale, a British woman, rather than the more spiritual approach of Sr. Coskery and the early Daughters of Charity. After reading this enlightening book, it is a question that gives us pause.
Editor's note: Suzy Farren is the author of Call to Care, The Women Who Built Catholic Healthcare in America (St. Louis: Catholic Health Association of the United States, 1996), a book of stories about the many ways Catholic sisters have been meeting health care needs from the early 18th century through today. Here she reviews two recent books related to that history. Ms. Farren, founding editor of Catholic Health World at the Catholic Health Association, is vice president for communications at SSM Health Care, St. Louis.