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No Comfort for the Lost, A Mystery of Old San Francisco, by Nancy Herriman, $15.00 paperback, 374 pages.

I have a long-standing fascination with characters who work in medical fields and feature them regularly in my books. So when it came time to develop the idea for my new mystery series set in 1860s San Francisco, I gravitated toward my sleuth being a nurse, a woman who would regularly encounter death. And not just any nurse, but a British woman who had served in the Crimea before coming to America.

Now for a little background. According to the 1867 Directory for San Francisco, there were approximately seventy-five women working in various medical occupations–midwives, nurses, female physicians (a euphemism for abortionists), and a handful of self-styled physicians utilizing spiritual or water cures. Even for those women offering traditional care, the training would have been sparse, the medical professions still ruled by men who resisted the attempts of females to invade their territory. The only information most women gained came from books, or from their mothers or other female relatives who knew how to prepare herbal treatments or homeopathic remedies.

Beginning in the 1840s, religious societies in Europe were the main source of trained nurses. Their training also was rudimentary, with nearly as much or more time spent on receiving religious instruction as on any clinical exposure to patient care. In America, it wasn’t until 1849 that the first woman, Elizabeth Blackwell, received a degree in medicine, and her path to achieve that degree had been difficult and nearly accidental. Even with her success, avenues for women to pursue legitimate training remained elusive.

Furthermore, nursing as an occupation was considered unsuitable for gently-raised women. However, the need for nurses came to the forefront during the Crimean War, when understaffed British field hospitals suffered high mortality rates among the soldiers. But even through much of the American Civil War, nursing duties consisted primarily of women providing ‘female companionship.’ Viewed as fragile and possessing an inferior intellect, female nurses were generally restricted to simple chores–preparing and serving meals, bathing feverish foreheads, reading to the patients or writing letters for them. Any tasks resembling what we consider today to be the jobs of nurses were left to male orderlies and doctors. Nonetheless, some women gained a taste of their possible roles in the medical field and hungered for the opportunity to become physicians.

Beginning in 1850, when the Female Medical College of Pennsylvania opened, those opportunities had begun to grow. This was the first college in the world with a primary purpose of conferring medical degrees upon women. In 1861, the school’s role expanded to include the training of nurses, and it is at this school that my fictional sleuth, Celia Davies, receives her education.

Celia will put that education to use when she opens a free clinic in San Francisco treating women of limited means. The world she serves is a world often struck by violence. When one of her patients is found murdered in the opening scenes of No Comfort for the Lost, she is drawn into uncovering the killer. This won’t be the last time Celia becomes entangled in murder, though.

So I’m curious–what do you think of the use of nurses as sleuths?