Soviet Nightingales: Care Under Communism by Susan Grant (review)

Reviewed by: Soviet Nightingales: Care Under Communism by Susan Grant Golfo Alexopoulos Susan Grant. Soviet Nightingales: Care Under Communism. Ithaca, N. Y.: Cornell University Press, 2022. 336 pp. Ill. 24. 95 (978-1-5017-6259-8). In this brilliant, deeply researched, and beautifully written book, Susan Grant seeks to "show that nurses were crucial symbols of the new Soviet state" (p. 3). The author draws from a variety of sources: archives in Russia (Moscow, Saint Petersburg, Sochi, and Tambov) as well as Ukraine, the United Kingdom, and the United States. She uses a range of Soviet periodicals and newspapers, films and photographs, and other material to produce a compelling and important work. What is really different about Soviet nurses? The Soviet state prioritized the ideological and political role of nurses alongside their role to care for and administer to the sick. Soviet "health authorities worried about the social and class background" of medical workers (p. 77) and stressed the importance of "training ideologically reliable workers" (p. 100). The problems in health care reflected the problems of Soviet society generally, such as economic realities of shortage and informality (bribes, tips, etc. ). One of the great strengths of the book is that it provides a history of the Soviet Union through the lens of health care. In the years that coincided with Stalinist repression and hunt for enemies, medical workers like other ordinary citizens were denounced, investigated, arrested, and even executed. During the war, medical workers faced deteriorating conditions. "By late 1941 and 1942, measles, typhus, and other diseases spread eastward along evacuation routes. … By 1943 and 1944, medical workers had to cope with vast numbers suffering from starvation and tuberculosis" (p. 145). Soviet authorities focused nurse training on the country's unique health care problems, such as high levels of infant mortality and tuberculosis. In the Soviet Union because there was a spectrum of middle- and junior-level medical workers that were typically lumped together, "nurses, feldshers, and doctors worked together, and their roles often overlapped" (p. 74). Although the Soviet context was unique in many ways, in other ways it was not. One common feature of Soviet nursing was that women dominated the nursing profession. The state's gendered discourse stressed the need for "care" and "compassion" and for medical workers to have "maternal" sensibilities, while male doctors often looked down upon nurses and diminished their value. The Soviet state paid them less too: "Efforts to place women on a par with men did not always play out in practice. Conservatism was still entrenched at state and societal levels" (p. 97). Moreover, in the Soviet Union, the United States, and elsewhere, rural areas were underserved because few medical workers could be drawn to work outside the major cities. The endemic problems of Soviet health care may not have been terribly unique: chronic underfunding, profound shortages of medical supplies and trained personnel, overcrowded hospitals, frequent labor turnover, insufficient wages, and heavy workloads. Yet the Soviet context appears especially challenging. During the war, "nurses and medical workers at the front experienced trauma and posttraumatic stress disorder" (p. 141). Grant describes how violence against medical workers largely End Page 166 emerged from a context of societal suspicion and distrust, as "medical workers in hospitals and clinics largely stirred up feelings of fear and hostility among the population" (p. 92). This was certainly not uncommon globally. Nonetheless, the book underscores how Soviet medical workers faced serious violence, verbal abuse, and assault on the job. "Compared to statistics for those working in crime or security or in correctional facilities, death rates among medical workers were higher, especially among feldshers" (p. 76). Like all good history, the narrative effectively traces change over time. The profession went from having low prestige in the prewar years to being heralded as a respectable profession. The profession became more militarized in the late 1930s. Nurses played an important role in creating "a fortress of sanitary defense" (p. 135) that would advance the country's military preparedness. During the war, they were praised for their patriotism, sacrifice, and everyday heroism. I especially enjoyed the book's case studies. In the 1920s, international groups like the Quakers of the American Friends Service. . .