Christoph Schwamm reframes the twentieth-century history of German nursing around the experience of men. It is a fact uncontested among historians that men have long been actively involved in the care of the sick, especially in the German context. Yet they are rarely the subject of deeper historical inquiry and empirical study. Schwamm endeavors to explain why by pointing to a pattern of repeated marginalization or erasure within what he describes as a feminized historiographical narrative rooted in Claudia Bischoff's classic text, Frauen in der Krankenpflege (1984). Like other professions and occupations, nursing history was written by middle-class reformers seeking to demonize past practice and amplify their own professional aspirations in the late nineteenth and early twentieth centuries. While men held a significant-enough presence in the field to prompt gendered reinterpretation of nursing as women's work, this is less visible than the ubiquitous legacy of these reform movements in the continued linguistic and cultural association between women and nursing.
Given so few chronological overviews of nursing, especially in the German context, Schwamm's historiography and historical context is a useful temporal reference. The periodization begins with the nineteenth century, when men were active in the care of the sick in the traditionally masculine roles of hospital attendants/orderlies, monks, and soldiers. Chapter 2 serves to rebuke timeless gendered assumptions that presume nursing was always women's work and introduces how women's professional organizing recast public expectations over time. In chapters 3-6, the twentieth century is then divided into three eras. The first half of the century was dominated by military mobilization and religious modes of nursing, as one in five men in nursing belonged to a Christian order through 1960. In the second and third eras, West German statistics show that men in nursing rose from 10.8% to 16.2% between 1952 and 1986 (GDR statistics are not disaggregated by gender), but then declined in the 1990s to settle at about 13%. Schwamm points to the late 1960s as the definitive turning point for men in German nursing: after decades of looking to Christian orders and trade unions to represent the interests of men in nursing, the Agnes-Karll-Verband officially opened its membership to men in 1967 and then became the more inclusively named Deutsche Berufsverband für Krankenpflege (DBfK) in 1973.
Contrary to assumptions that nursing reforms opened the nursing profession to men in Germany around 1970, this is not a progressive narrative of historical triumph. Schwamm provocatively argues the opposite: “Vielmehr wurden Männer dadurch erst zur Anomalie. In diesem Sinne wurde die Pflege erst um 1970 zu einem Frauenberuf.” (78) Still, men, excluded from the feminized images of nursing, also often benefited from their minority status as men: being promoted more quickly and gaining more status through perceived capacities for modern technology, leadership, or suitability for new masculine roles in health care. Throughout the book, there is a sense that the more things change the more they stay the same; both men and women in nursing are depicted as feeling a need to justify their presence.
The most interesting sections of the book come toward the end, as Schwamm engages oral histories and archival sources that lead him beyond the male/female binary to posit how public perceptions of German nursing often mirrored or absorbed generational tensions over gender and sexuality. Schwamm points to the continued hold of hegemonic masculinity in German society even after young men inclined away from military service after World War II. For example, the interest of young German men in nursing as part of their service year rose in the 1960s (from 250 to 4,000 men per year), due in part to the influence of the student movements and anti-war youth sentiment, but the push and pull of men to and from traditional military service was wrapped up in cultural debates over gender roles, hegemonic masculinity, and the military. Nursing work, viewed as an alternative to military service, was targeted by the Ministry of Defense. Yet, in spite of the institutionalized gender equality, Schwamm illuminates how the coeducation and qualification of nurses created new gendered discomfort and power dynamics that led to efforts to “remasculinize” nursing against the veiled homophobia directed at men in nursing (106). These are topics worthy of more consideration and a broader historical context in order to understand these competing socioeconomic interests and claims in the Federal Republic as well as the comparative case of the GDR. Though the historical records are illusive, Schamm's oral history approach might be particularly well-suited to explore and compare men's experiences in East and West German nursing.
The value and resonance of this volume will vary by audience. Scholars of German and transnational nursing history will find the rereading and synthesis of the existing historiography to be a helpful orientation and synthesis, though it does not endeavor to provide new empirical research. The widely diagnosed “research gap” in detailed investigation and illumination of men's experience in nursing continues to require more diversity of scholarly engagement. For historians of gender, Schwamm's observations that nursing history is defined by contested gender ideologies more than the daily practice of nurses’ work will resonate, though it is not the intention of the volume to employ or develop gender theory or critiques in re-envisioning or challenging our existing gender constructs. Overall, in the emergent field of German nursing history, Schwamm has broadened the chronological scope of often-fragmented twentieth century narratives and has given scholars new questions and research topics to ponder.
