The hundred-year anniversary of the outbreak of World War I reminds us once again of the many ways in which the experience of modern warfare shaped the culture and society of the twentieth century. Although historians now recognize the importance of the war's impact on gender relations, there are many areas of gender history that have not yet been thoroughly investigated. Among these, argues Astrid Stölzle, is the story of German nurses who worked in military hospitals at or near the war's many fronts. Stölzle, a researcher at the Institute for the History of Medicine of the Robert Bosch Foundation in Stuttgart, contends that German nurses of this era have received much less attention than their counterparts in the English-speaking world—an oversight that she attributes to the still relatively low professional status of nursing in Germany.

Stölzle provides expert accounts of the medications, surgical procedures, and nursing protocols practiced at the time, but bases her story chiefly on the archives of the many religious orders—both Protestant and Catholic—to which most German nurses belonged during World War I. She also includes information about Jewish medical personnel. Many records of religious orders were discarded or destroyed during the two world wars, but the author has nevertheless found a rich body of source material. Military nurses wrote letters to their mother houses describing their daily lives, and many of these letters have been preserved. More males than females served as military nurses, but the women apparently wrote more letters than the men did. The author adapts to the availability of source material by focusing on the women's letters, but she does not seek to explain this difference—by asking, for instance, whether women were more aware of, or more interested in, the emotional or psychological aspects of their work than men were.

The “ego-documents” that Stölzle uses have many advantages as historical sources. Military histories that center on the decisions of commanders and on large-scale accounts of battles and troop movements sometimes overlook what most participants consider to be the most important aspects of their wartime existence: day-to-day experiences and emotional states. Even after the passage of a century, the nurses' accounts of daily life at the front remain vivid and immediate. The short training courses that most had taken in no way prepared them to treat bodies shattered by artillery. Many patients had spent days lying helpless on the battlefield before they were even brought to the hospital, and, in some cases, the nurses could do little more than watch them die. Hospitals were frequently only sheds or barns; supplies were inadequate; patients and nurses slept on the floor or on sacks filled with straw; clothing was contaminated by lice; contagious diseases spread through the wards, often sickening or killing medical personnel as well as patients. Even while recording these experiences through their letters, the nurses frequently warned their readers that the descriptions were inadequate and that those who had not seen the front could not imagine conditions there.

In many ways, these accounts attest to the resilience of the human spirit, even under the most extreme conditions. The letter writers rejected the idealized picture of the nurse as the saintly “lady with the lamp.” They acknowledged their human failings and wished only that they could have done more for their patients. Despite long hours and stress, they tried to avoid institutional impersonality and instead give individualized care. They established friendly, sometimes motherly relationships with the patients, and the soldiers were, for the most part, grateful and courteous in return. Though physicians could sometimes be harsh and imperious, most were considerate and their dealings with nurses were cordial.

Although the letters provide fascinating insights, they deserve a more nuanced and contextual analysis than the author provides. As Stölzle tells us, nurses addressed most of their correspondence to the authority figures of their religious orders. Were these superiors likely to look favorably upon nurses who gave a positive account of their work and unfavorably upon those who expressed despair, exhaustion, or disillusionment? The letters were not private, but intercepted and reviewed by military censors before reaching their destination. Under these circumstances, were the writers likely to complain about their superiors (including physicians who were also military officers), or about the army's failure to provide adequate supplies, facilities, and personnel, or about the war itself? Stölzle might have speculated more about how these constraints bear upon the reliability of these primary source materials.

The material similarly raises questions about gender orders and hierarchies that the author only occasionally addresses. The letters suggest that the soldiers formed more cordial relationships with the female nurses than they did with the males, and the author explains this by casting the female nurses in the role of surrogate mother. But what might the effect of these relationships have been on conventional views of masculinity? Did the nurse-patient encounter disrupt military ideals of tough and fearless manhood by placing adult men in the position of vulnerable and frightened children who turned to strong women for reassurance? And if so, how did these men reflect on that experience after the war? Like many interesting works of history, Stölzle's book raises more questions than it answers.