At last Florence could start to take meaningful action, but the end they had been thrown in at could hardly have been deeper. "We had but half an hour's notice before they began landing the wounded" she wrote on 14th November. "Between one and nine o'clock we had the mattresses stuffed, sewn up, laid down - alas! only upon matting on the floor - the men washed and put to bed and their wounds dressed.....Twenty four cases died on the day of landing. The dysentry cases have died at the rate of one in two."
The doctors and surgeons were working flat out. There were no operating theatres - operations were carried out on the wards on a board and two trestles beside the patient's bed. "One poor fellow exhausted with haemorrhage has his leg amputated as a last resort and dies ten minutes after the surgeon has left him ...the mortality of the operations is frightful. We have Erysipelas (fever and gangrene)." From September through November 1854 there were 44 secondary amputations of lower limbs - 36 of these were fatal.
Florence brought in screens from Constantinople so at least operations could be carried out away from the gaze of the other poor fellows waiting for the knife. There was rarely time to administer anaesthetics - this must have warmed the heart of Dr Hall who maintained that 'the smart use of the knife is a powerful stimulant, and it is much better to hear a man bawl lustily than to see him sink silently into the grave.' But experience showed the amputee more often likely to finish up eternally silent after having been forced to bawl lustily. Florence's heaviest cross to bear, she dubbed Hall 'a fossil of the pure red sandstone.' She respected the older hospital doctors who were often on their feet the full twenty four hours; they worked, she said 'like lions'. She showed indulgence to the studied indifference affected by the 'cubs' who 'while a man is breathing his last under the knife, lament the annoyance of being called up from their dinners by such a fresh influx of wounded. But unlicked cubs grow up into good old Bears, 'tho I don't know how, for certain it is the old Bears are good."
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