Mike Magee MD

Elizabeth Blackwell and Florence Nightingale: Lifelong Sparring Partners

Social Science Club of Newton, MA. Lecture, February 2, 2022

Description: Born months apart, and dying in their 9th decade within weeks of each other, Elizabeth Blackwell and Florence Nightingale were lifelong sparring partners. But what they shared in common, including guiding values and mutual respect for the role of women in society, outweighed their differing pathways to success.  How did they meet, compete, collaborate, and challenge each other?

For several years, I have had an interest in presenting historic women in pairs, notable achievers who arose at the same time in history, pursued similar goals but often followed different pathways to ultimately arrive at the same destination.

I seized on this technique originally when I happened on two unique personalities, Elizabeth Blackwell, our nation’s and Britain’s first official registered woman doctor, and Florence Nightingale, the widely acclaimed founder of the profession of Nursing.

My interest was piqued by a biographer who described the two as “Lifelong Sparring Partners.” This originally struck me as a bit harsh, since they certainly shared more in common than the factors that separated them.  They were both committed Anglophiles, though Elizabeth also shared dual citizenship in the United States. They were both intensely religious. They were both more interested in leading their professions than being practicing members of their professions. They were both intensely ambitious and highly political. They were both stubborn and determined. They both have complex relationships with sisters who were lifelong companions. They both saw marriage as an obstacle to achieving their professional goals. And finally, they were born and died within months of each other, in their 90’s.

Their lives crossed paths multiple times, as we will see, over a nearly six-decade span. But cooperation only went so far, as each declined to be dominated by the other. As a result, they moved most often in parallel, with paired but distinct timelines.

I was introduced to Elizabeth Blackwell in the Summer of 1969 in Syracuse, New York. I was an entering first year medical student at the State University of New York/Upstate and this was the first day of our orientation. In a class of 115 students, there were 10 women. As we entered the Library, we were met by Joseph S. Kozlowski’s 1965 painting of Dr. Blackwell. The companion exhibit noted Elizabeth’s comments on receiving her diploma in 1858. She said, It shall be the effort of my life, with the help of the Most High, to shed honour on my diploma.”

Though Upstate claimed her as their own, she graduated from Geneva Medical College in Geneva, NY. Geneva Medical College was officially dissolved in 1871 and reopened in their new location and with a new name – the College of Physicians and Surgeons of the Syracuse University. But Elizabeth’s story was anything but straight-line, as the exhibit hinted. It began this way, “This diminutive, softly spoken doctor with the glass eye was not a figure to be dismissed lightly.”

Her life began on February 3, 1821 in Bristol, England. She was the 3rd of what would become 9 children of parents, Samuel and Hannah, described as “pious but not dour”…who enjoyed “good food, servants, music, humour, and holidays.” They were married in a Congregationalist Church in 1815, three months after the Battle of Waterloo that ended the Napoleonic Wars.

The Blackwell’s were fundamentally conflicted. Samuel was a committed and outspoken abolitionist whose sugar refinery in Bristol relied on slave labor to unload raw sugar supply from ships arriving from the West Indies. In his factory, the materials were boiled, filtered, granulated and molded.

The profits covered a decent, if not fabulously opulent standard of living, supporting children, maiden aunts, servants, and vacations at seaside. As Elizabeth recalled years later, from her childhood bedroom, she could look out on the Duchess of Beaufort’s lavish gardens. It was a “good life” – until it wasn’t.

Trouble seemed to follow Samuel Blackwell. As one biographer noted, “Swift reversals of fortune were a recurring theme in the Blackwell family.” To begin with, he was in a risky business. Sugar refineries were always prone to fire and explosion. In 1828, his building burnt to the ground. Just as he began to get his feet back on the ground, riots broke out in Bristol in 1931over their representation in the Parliament. After three days of open conflict, 250 citizens lay dead and the city was in shambles.

The final blow occurred that same year when Samuel found out that his fortune, which he entrusted to his reckless younger brother, James, had all been lost in a dubious Dublin venture.  That was enough to cause Samuel and Hannah to pull up roots and search out a new beginning in America.

There were now eight children with three older sisters in the lead – Anna, Marian, and Elizabeth. With the parents, 1 governess, 2 servants and 2 aunts, they numbered 15 in the group. Elizabeth at the time was 11 and understated the predicament saying: “A grave change of social surrounds took place.” Her older sister Anna, who she quarreled with throughout her life, was less diplomatic. Her damning words: “By his impetuous actions, he plunged his numerous young family into the world of loss, ruin, anxiety, and misery.”

In 1832, they arrived safely in New York City with a plan. The city was booming with 200,000 inhabitants, and Samuel reengaged in sugar refining on Duane Street. The Erie Canal had opened up access to interior waterways in 1825, and trade was in full swing. In 1834, Samuel moved the family out to Flushing after his new refinery burnt down, and was exploring growing beets as a sugar source to relieve the moral conflict of his reliance on slave supported sugar cane. But almost immediately, he took ill from malaria which was endemic at the time. Seeking safe ground, the family decamped to Jersey City on the other side of the Hudson River in 1935.

By 1937, Samuel was ready to pull the trigger on his grand plan – to raise his own beets, supply his own morally acceptable sugar, refine it, and sell it at a remarkable profit. This was the same year that 17-year-old Queen Victoria assumed the throne on her Uncle’s death, on her way to a 63 year reign. America was on the move as well. That year Mount Holyoke became the first women’s college. Others would follow, and by 1891, 10,000 women would be enrolled in higher education in the U.S.

But as Samuel prepared once again to move his family, this time to Michigan where he had purchased 320 acres of land, he was laser focused on beets. To say his timing was poor is something of an understatement. In May, 1937, speculative investments in the West, and a land bubble, fueled a run on the banks, which launched the “Panic of 1937”, which then flowered into a full-blown Depression. They lost their home, and relocated to Cincinnati where they worshipped in Lyman Beecher’s church and befriended his children, Henry Ward Beecher and Harriet Beecher Stowe. By May, 1938, Samuel was dead. His inheritance? Twenty dollars.

Three weeks later, in July, 1938, Anna, Marian, and Elizabeth opened The Cincinnati English and French Academy for Young Ladies. During this period, Elizabeth moved between being an Episcopalian, to attending Unitarian services, and experimenting in transcendental thought. All of which created a religious backlash in the community, a drop in enrollment, and closure of the school in 1943.

In 1844, Elizabeth accepted a teaching job for 6 months in Kentucky, and then in Ashville, NC, at the invitation of their town doctor. 20% of the town’s population was slaves. During this period, she became fully aware of the plight of women at the time. Women had no vote, no safety net, no security, no justice, no rights, no health, no future…and no women doctors of their own. She was especially moved at the time by a woman friend, dying of uterine cancer, who said she wished she had had a woman doctor to take care of her.

It was clear to Elizabeth at the time that women were beginning to flex their muscles. Politicians and religious leaders were promoting women as guardians of children, and nurturers of patriotic and moral virtues. Public schools were spreading across the nation and needed teachers. Medical science was just beginning to become organized. Woman remained the fall back healers in times of crisis. And religious leaders were beginning to recruit women to help agitate to end slavery, expand voting rights, and oppose alcohol. In short, if you were a young, aggressive leader in America at the time, with access to some resources, there was room to lead.

Elizabeth returned to Cincinnati in 1846 believing that women physicians had a role to play not only in the care of other women, but in transforming society. She imagined a woman run hospital that was “a center of science but also one of moral growth…Attached to the hospital would be a church, workshops and studios, forming in effect ‘a whole society’”

She now decided to seek medical school entrance in earnest, and faced more than one rejection before being offered entrance to Geneva Medical College in New York on Oct. 20, 1847.  She arrived as student #130, after her entrance was put to a vote by the 129 male students in the class. The response was unanimous on a dare from several of the student ringleaders.  There were seven professors, a lecture room, dissecting rooms, a well-equipped laboratory, and an excellent collection of specimens. She was required to complete two 16-week courses (each $62) and several years of apprenticeship under a qualified doctor. Three strands were emphasized – basic sciences, diagnosis, and treatment.

In July, 1948, she was briefly distracted by a request from women’s rights activist, Elizabeth Stanton, that she join 300 men and women for a soon to be famous gathering 18 miles to the east in Seneca Falls. She sent her regrets, making it clear that “She did not hold men responsible for her sex’s subservient status. She blamed women for not aiming higher – ‘not feeling the soul too large for the body’ as she said.”

One biographer suggested that “She was not eager to join a movement in which she risked becoming just one of the crowd. She liked to lead from the front.” On January 23, 1849, she received her degree with the well wishes of her fellow students. Less than three months later she became an American citizen, and made preparations to sail to France to accumulate additional clinical experience. 

British citizens were already aware that one of their own was now a celebrity in America. The satirical British pamphlet, Punch, memorialized her achievement in a mock epic 7-stanza poem titled “M.D. in a Gown”. It ended with:

“Young ladies all of every clime,

Especially of Britain,

Who wholly occupy your time,

In novels and in Knitting,

Whose highest skill is but to play,

Sing, dance, or French to clack well,

Reflect on the example, pray,

Of excellent Miss Blackwell.”

She had secured a position at Paris’s renowned Le Maternite’, and began work, with some restrictions. But she was anxious to proceed, intending to become a surgeon, and happy to accept a limited role. Several months into her tour of duty, she developed a scratchiness in her left eye. Within 24 hours it developed into a full-blown infection that soon involved both eyes. She had developed a gonorrheal eye infection while assisting in deliveries. The diagnosis at the time was a serious setback. After several weeks, her right eye cleared. But her left eye was lost forever, and in August, 1850, was removed and replaced with a glass prosthesis.

With her dreams of becoming a surgeon now in the past, she returned to Britain to complete her recovery. She carried with her certain notoriety being now the first woman doctor in the United States. This gained her access to a variety of clinical experiences in London as she awaited her response to the request to be listed on the British Medical Registry. In the meantime, any chance of starting her own practice was placed on hold.

On April 17, 1851, she was greeted enthusiastically by the soon-to-be woman Superintendent of the 20-bed Hospital for Gentle Women During Illnesses, one of the earliest institutions set up to care for sick and needy governesses. 31 years old, well connected and aristocratic – her name was Florence Nightingale. At the time, Blackwell had the edge in fame, carrying the mantle of “1st woman doctor in America.” But a decade later, things would look quite different.

One biographer described their first meeting as “love at first sight.” Nightingale later reported that Elizabeth had told her that “She would be perfectly happy working with me, she would want no other husband.” Shortly after their meeting, Blackwell joined Florence for a planned four month training visit to the renowned German hospital run by Lutheran nuns, Kaiserswerth. The focus here was on strict sanitary practices with personal and institutional hygiene.

Order had always been part of Florence Nightingale’s life. Her father was William Edward Shore, a Country Squire, who at age 21 inherited his rich uncle’s huge fortune as well as his name. On his death, the younger (now) Nightingale, seamlessly managed the profits of the family’s lead smelting business, as well as, not one, but two named estates – the 1300 acre Lea Hurst in Derbyshire, and the equally impressive Embry Park in Hampshire.

He and his wife had two daughters, each named after the Italian cities where they were born while vacationing. Parthenope carried the Greek name for Naples, and Florence arrived one year later 300 miles north. The family was well connected with members of Parliament, none closer than Baron Sidney Herbert. It was he who the family turned to for reassurance and guidance when Florence declared at age 16 that her life’s work would be nursing the sick and ill in the service of the Lord.

This was quite a surprise to her father who had taken special care to see that she was classically trained in Greek, Latin, French, German, Philosophy and Religion. But in Florence’s words, she “craved for some regular occupation, for something worth doing instead of frittering away time on useless trifles.” To do so, she was willing to decline suitors and her mother and older sister’s life of comfort and philanthropy. Parthenope was unimpressed, making it clear that  “She is ambitious—very, and would like…to regenerate the world.”  In comparing the two sisters, a biographer put it this way, “Both sisters were trapped in a gilded cage growing up, but only Florence broke out of it.”

Sidney Herbert was willing to support the strong willed woman, 10 years his younger, carrying her along on fact-finding trips to Egypt and beyond. None of it shook her commitment. Her intent was clear when she noted in her diary, “On February 7, 1837, God spoke to me and called me to his service.” The calling was specific – nursing the ill in institutional settings.  As luck would have it, her goal aligned well with the voluntary efforts of Sidney’s wife, the Lady Elizabeth Mary Herbert.

Queen Victoria assumed the throne of England following her Uncle’s death just 4 months after Florence’s religious awakening. The two were born exactly 1 year and 12 days apart. Both the young Queen and her husband, Albert, were military enthusiasts, and saw themselves as active participants in the nation’s armed conflicts. In September, 1854, they had a front row seat in a simmering conflict between the Ottoman Empire and Russia. Britain and France had thought they had brokered a deal between the two primary combatants when the truce fell apart.

Russian Emperor, Nicholas I, then ordered the invasion of what is now current day Romania in July of 1853. By January, 1854, the British and French fleets had entered the Black Sea, and the war was on.  Britain’s Prime Minister, Lord Palmerston, suggested the effort was preventive. As he said in words that ring true today, “The main and real object of the war is to curb the aggressive ambition of Russia.” 

Queen Victoria leaned heavily on her new Secretary of War, Sidney Herbert, and Florence Nightingale saw a once in a lifetime opportunity for clinical experience and seized it. She and the 38 nurses in her charged arrived at Barrack Hospital at Scutari, outside modern day Istanbul, ill prepared for the disaster that awaited them. Cholera, dysentery and frostbite – rather than battle wounds – were rampant in the cold, damp, and filthy halls. During that first winter, 42% of her patients perished, leaving over 4000 dead, the vast majority absent any battle wounds. She later described her work setting as “slaughter houses.” Their enemy wasn’t bullets or bayonets, but disease -typhus, cholera and typhoid fever.

Nightingale’s initial assessment was that warmer clothing and food would stem the tide. Going over the heads of medical leadership, she did what she could, and leaked details of what she was observing to Herbert and journalists who, for the first time, were stationed within the war zone. In the process, she became a celebrity in her own right, and as Spring of 1955 approached, a Sanitary Commission was sent to the war zone and Victoria and Albert themselves, with two of their children, visited the area.

What became clear to Florence and others was that infection and lack of sanitation were the culprits, and corrective actions on the facilities themselves, along with sanitary practices that Nightingale led, caused the subsequent mortality rates to drop to 2%.

Famed artist Jerry Barrett made hasty sketches of what would become The Mission of Mercy: Florence Nightingale, which hangs to this day in the National Gallery in London. During this same period, the first lines of Henry Wadsworth Longfellow’s poem, Santa Filomena, would take shape, including “Lo! In that house of misery, A lady with a lamp I see, Pass through the glimmering of gloom, And flit from room to room.” And the legend of Nightingale, the actual “Lady of the Lamp”, appeared on the front page of the Illustrated London News complete with etched images.

By the time the war drew to a halt in February, 1856, 900,000 men had died. Florence Nightingale remained for four more months, arriving home without fanfare on July 15, 1856.  Her older sister recalled how she arrived, “…“like a bird, so quietly no one found her out.” Yet, in truth thanks to the first ever war correspondents, she was now the 2nd most famous woman in Britain, after Queen Victoria.

She had plenty to say, and committed most of it to writing. Working closely with Britain’s top statistician, William Farr, she documented in dramatic form, the deadly toll in Crimea and tied it to disease and lack of sanitation in “Notes Affecting the Health, Efficiency, and Hospital Administration of the British Army”, which she self-published and aggressively distributed. Illustrated with spin wheel designs divided into 12 sectors, each one representing a month, she graphically tied improved sanitation and plummeting death rates.  Understanding their long-term value, she carefully approved the paper, ink, and process that have allowed these images to remain vibrant a century and a half later. As she said later with some cynicism, they were “designed ‘to affect thro’ the Eyes what we may fail to convey to the brains of the public through their word-proof ears.”

In that first year of her return, she was described as “a one woman pressure group and think tank…using statistics to understand how the world worked was to understand the mind of God.”

Meanwhile, the Herbert’s continued fund raising on her behalf, and rapidly raised 44,000 pounds to support establishing a hospital and nursing training school that would bear her name.  It opened on the Thames at St. Thomas Hospital, in the shadow of the Houses of Parliament. In modern times, the work of the Herbert’s and Nightingale is viewed by some as foundational. As one biographer claimed: “…the pioneering National Health Service was born on the floor of the Scutari Barrack Hospital.”

Nightingale was a crusader for this new profession intended “to promote the honest employment, the decent maintenance and provision, to protect and restrain, to elevate in purifying…a number…of poor and virtuous women,” As for content, by 1860, her “Notes for Nursing” was published, selling 15,000 copies in first two months.  It purposefully championed sanitation (“the proper use of fresh air, light, warmth, cleanliness, quiet, and the proper selection and administration of diet”) and promoted cleaniness as a path to godliness. It targeted “everywoman” while launching professional nursing. At the time two-thirds of the nurses in Britain were employed in private homes. Half were 19 years of age or younger.

Meanwhile, across the Atlantic, Elizabeth Blackwell watched with some envy, as she too focused on raising funds for a new hospital in New York City. Supported by wealthy Quakers and a few industrialists, she achieved her goal on May 12, 1957, Florence Nightingale’s 37th birthday, when she opened the New York Infirmary for Indigent Women and Children. Along with her sister Emily, now a doctor as well, they treated over 1000 women and children in their first year of operation.

The year 1958 was something of a homecoming for Elizabeth Blackwell. Leaving the actual practice of Medicine to her sister Emily, she looked forward to rejoining the British community, and hoped to attract the support of Nightingale to establish herself as the first woman physician in Britain.

Florence had a goal as well.  Her interests were in writing, lobbying, and advancing the measurement, design and performance of future hospitals in Britain. To free up her hand, she hoped that Elizabeth Blackwell would accept her offer to oversee her new school and hospital. She was destined to be disappointed.

What Elizabeth Blackwell wanted was a country hospital run by women doctors for women patients. But Nightingale was comfortable and allied with the male medical profession and believed her first institutional foray needed to be in the city. Not one to mince words, her reflexive response to Dr. Blackwell’s suggestion was “That all Hospitals will ultimately be in the country I have emphatically said, but I should say the way to hinder, not to help this desirable consummation, would be to begin with a small pottering Women’s Hospital on a Farm in the country”.

At the same time, Nightingale wished Blackwell well. She wrote a letter to the President of the Medical Council in support of Dr. Blackwell’s application to be licensed as an MD in Britain. One year later, Elizabeth Blackwell MD returned to New York with an important strategic first – she was now the first woman ever to be listed on the British Medical Register.

But there is no denying that by now they were official sparring partners. Consider Elizabeth’s comment to her sister Emily on the publication of Nightingale’s “Notes on Nursing”: “I see how difficult it would have been for me to do her work, the character of our minds is so different…her little Nursing book is welcome to me because I expected nothing higher.”

Nightingale, in turn, gave as good as she got, as when she described their impasse as two complimentary pathways with different destinations: “You to educate a few highly cultivated [women]—I to diffuse as much knowledge as possible.”

“Ill tempered, dogmatic and exaggerated…I see how difficult it would have been for me to do her work, the character of our minds is so different”, came the reply from Blackwell later in life.

The British doctors, even as they delivered the recognition that Blackwell sought, made their comparative views of the two clear in an editorial in the British Medical Journal on April 9, 1959, writing: “The mission of Florence Nightingale was one of mercy and benevolence…which women alone could give them. The mission of the lady doctors of medicine is – what is it? …arrogance and self-glorification.”

Though some biographers define Nightingale as physically and mentally incapacitated for the decade following the Crimean War, she was remarkably productive. In the first few years following her return, she was described as “a one woman pressure group and think tank…using statistics to understand how the world worked was to understand the mind of God.” In 1858, she became the first woman to be made a fellow of the Royal Statistical Society.

As for Blackwell, she returned to the states as the South prepared to secede from the Union. Clearly following the Nightingale playbook, she aggressively lobbied the Lincoln administration in 1861 to assign her oversight responsibilities for recruiting and managing nurses to support the soldiers. As she stated later, there was “a perfect mania amongst them to act Florence Nightingale.” While allowing her to recruit, in an obvious slight to her credentials, they assigned oversight to Dorothea Dix, a civilian with no formal training in health care.

By 1870, as they approached their senior years, their politics were relatively aligned. Blackwell returned to her native England and participated in establishing a medical school for women. She also collaborated with Nightingale in opposing the Contagious Disease Acts that Nightingale labeled “the most dreadful crisis ever known in the history of mankind.” Under these statutes prostitutes could be arrested and undergo compulsory checks for venereal disease. If positive, they were placed in “locked wards” for treatment and confinement for up to a year. The Acts were finally repealed in 1886.

Over 12,000 personal letters of Nightingale’s survive. She described herself as a “sanitarian” and championed her society’s disadvantaged for the rest of her life. 1866 had been a particularly challenging year with 18,000 British citizens dead from a raging cholera epidemic. From her privileged position among the landed gentry, with direct reach into Buckingham Palace and the Houses of Parliament, she took on the status quo with some regularity, For example, she opposed the Poor Laws, prodding Parliament to improve the workhouses—seeking alternate shelters for the indigent, and separate hospital wards for the sick and the infirm. She demanded that the least fortunate be cared for by trained nurses and insisted on oversight boards focused on continuous improvements. Her lists of interests were more social than medical and included crime, fair labor, clean air and water, and criminal justice. In later years, she worked to gain battlefield protection rights for Red Cross workers.

As they aged, both continued to lean heavily on their religion and deep spirituality. In 1880, Nightingale wrote, “Today, O Lord, let me dedicate this crumbling old woman to thee. Behold the handmaid of the Lord. I was thy handmaid as a girl. Since then, I have backslid.” At around the same time, Blackwell philosophized, “It is through the moral, guiding the intellectual, that the beneficial influence of women in any new sphere of activity will be felt.”

Blackwell biographers remember her as “conservative and filled with ambiguities” and as “a social prophet who was unable to compromise.” For example, she supported sex education, natural family planning to control poverty, and sexuality in women – but was “horrified by artificial contraception, claiming that it would lead to dire physical consequences for women and increased immorality.” She saw male doctors as enslaved to secular science, and warned they were converting hospitals from “houses of charity into butcher shops.” And she saw doctoring as a means to an end. With women doctors, she sought not to simple heal the physically infirm, but more importantly, the morally sick society.

The male medical establishment, and the societies they controlled, showed little willingness to relinquish control to Elizabeth Blackwell’s legion of young female physicians. Dr. George Brune Shattuck, Editor of the Boston Medical & Surgical Journal, the predecessor of today’s famous New England Journal of Medicine and the namesake of today’s renowned annual Shattuck Lecture, wondered aloud  in 1884 who needed women doctors in an age of “too much bad piano and too little good cooking and sewing.”

As they approached their ninth decades together, it is clear that they shared a great deal more than what separated them. Both were committed Anglophiles with deep connections to Britain’s power elite. While Elizabeth would never receive the public recognition – Nightingale was the first woman to receive the Order of Merit from King Edward VII in 1907 – she was still a notable celebrity at least within medical circles.

Both women were strong-willed non-conformists disinterested in a life within a Victorian defined “women’s sphere”, and they were more than willing to forego marriage to pursue their goals.  They focused on their careers, on morality, and on personal responsibility. They both sought out war service for personal advancement, and as a hook for future fund-raising. They were both committed spiritualists and sanitarians who served as hospital managers from time to time. Surprisingly, they both were cautious about buying into new germ theories, believing they undermined a focus on sanitary practice and weakened personal responsibility. Finally, they both suffered the effects of illness throughout their adult lives – Elizabeth from the loss of her left eye, and Florence from mental and health issues tied to Brucellosis and likely PTSD in the wake of the Crimean War.

And yet, even for all they shared, they stubbornly refused to give ground to each other. One biographer put it this way: “While Elizabeth strove to persuade society that female doctors were part of God’s creation, Florence wished to set them apart from other women and turn them into a quasi-religious order.”

Of Elizabeth Blackwell: “She would have liked to be remembered as a social prophet who had helped guide humanity towards that elusive perfect society. But her inability to compromise her ideals gave them little chance of converging with the real world. Yet it was this same determination…that made her such an effective pioneer. Her absolute refusal to accept second best for women doctors, whether in terms of education or practice, was an inspiring example and legacy.”

“Blackwell never claimed to be much of a doctor, her motives and instincts being essentially political… Equally, Nightingale’s greatest contribution was not nursing per se but her administrative, strategic, and reforming vision. She was a master statistician, politician and fundraiser, and arguably the first true hospital administrator who laid the groundwork for a new health profession and for her nation’s National Healthcare System.

As she wrote, “The very first requirement in a hospital is that it should do the sick no harm.  Let whoever is in charge keep this simple question in her head (not, how can I always do this right thing myself, but) how can I provide for this right thing to be always done.

Finally, deep in their recesses, they respected each other, having shared and competed for the limelight for over a half-century. They were women, and they were leaders. Born less than a year apart, they died within 2 ½ months of each other”