Profiles in Nursing

Agnes Von Kurowsky (1892–1984), Literary Muse

The nurse who inspired Ernest Hemingway

Nurses sometimes leave a lasting impression on their patients, but seldom one as literary as Agnes Von Kurowsky, the Red Cross nurse who inspired a central character in Ernest Hemingway’s acclaimed novel A Farewell to Arms.

Wartime Duty

Born in Germantown, Pa., Agnes Von Kurowsky was the daughter of an aristocratic German immigrant (hence her surname’s “Von” prefix) and spent her childhood in rural Alaska and Vancouver, Canada. After attending high school in Washington, D.C., she went to work for the Washington Public Library, but found it dull and moved to New York City to train at Bellevue School of Nursing.

After graduating in 1917, she joined the Red Cross Nursing Service and volunteered for wartime duty. On June 15, 1918, she sailed for Europe and was soon assigned, along with 17 other nurses, to a Red Cross hospital in Milan, Italy.

Like many wartime nurses, she was initially unprepared for the gruesomeness of battlefield injuries, but she had the right temperament for the work. She could detach herself from the horror without losing her gregarious attitude. Von Kurowsky was also a flirt who broke hearts while treating wounds.

After the grind of nursing school — in her diary, she said she’d gone “practically three years without the least bit of sentiment or romance, and very little attention” — she was giddy at the romantic possibilities of her new assignment. Tall, shapely and attractive, she had her pick of suitors, including several dashing Italian officers. By her own account, she had “three serious affairs” in her first month overseas. (“I was very fickle in those days,” she later explained.)

The Boy From Illinois

One of Von Kurowsky’s patients in Milan was a young man from Oak Park, Ill., named Ernest Hemingway. Hemingway had joined the Red Cross ambulance corps after being rejected for military service, but after only five weeks in Italy, he was severely wounded by a mortar round and machine gun fire at Fossalta di Piave.

Nursing Education

When Hemingway arrived at the Milan hospital 10 days later, he’d already undergone surgery to remove the bullets and shrapnel from his legs, but his convalescence was protracted. Von Kurowsky soon took a liking to him; he was handsome, and quite jovial despite his injuries. By September, he’d become the latest of her whirlwind romances.

By today’s standards, Von Kurowsky’s relationship with Hemingway was somewhat inappropriate. Not only was he a patient who’d just suffered a severe trauma, he was significantly younger than she: Von Kurowsky was 26 when they met, while Hemingway celebrated his 19th birthday shortly after arriving in Milan.

In those days, it wasn’t uncommon for wartime nurses to flirt with their patients, if only to bolster the morale of grievously wounded young men far from home. Von Kurowsky’s relationship with Hemingway appears to have begun in much that way.  “‘Ernie’ is far too fond of me, & speaks in such a desperate way every time I am cool, that I dare not dampen his ardor as long as he is here in the Hospital,” she wrote that August. “Poor

A Passing Fancy?

Over the following weeks, however, they began to socialize outside the hospital and Von Kurowsky’s tone became more and more affectionate, soon leading to protestations of love and even talk of marriage.

Von Kurowsky later insisted it was all quite chaste. Hemingway had suggested otherwise, but she declared, “I wasn’t that kind of girl.” For her, the affair seems to have been just another passing fancy, since she was still juggling several other men, including her erstwhile fiancé, a Bellevue physician. Nonetheless, her ardent letters (which Hemingway kept) make it easy to understand why a naïve 19-year-old would see it as a grand passion.

In any case, their relationship was brief. In October, Von Kurowsky was transferred to Florence and then Treviso. Hemingway returned to active service, only to almost immediately end up back in the hospital with hepatitis. After the Armistice ended the war that November, they saw each other only a few more times before he sailed for home. Hemingway still imagined that Von Kurowsky would marry him, but her attention had already shifted to a new romance with Italian aristocrat Domenico Caracciolo. She broke things off with Hemingway in March 1919, telling him, “I am now & always will be too old … I can’t get away from the fact that you’re just a boy — a Kid.”

Novel Inspiration

Von Kurowsky didn’t marry Caracciolo, whose family mistrusted her, but she found she wasn’t ready to return to America either. She soon rejoined the Red Cross, serving for two years as a visiting nurse in Romania. She was posted to Haiti in 1926, spending five years as director of nursing for the Haitian Public Health Service, a challenging and diplomatically sensitive role.

In 1928, she married an auditor from the American delegation in Haiti, but she divorced him in 1931. She remarried in 1934 and eventually settled in Key West, Fla. Although Hemingway was then living in Havana, Cuba, with his fourth wife, Von Kurowsky never contacted him, put off by reports of his heavy drinking.Von Kurowsky never contacted him, put off by reports of his heavy drinking.

While Von Kurowsky moved on, Hemingway had continued to dwell on their romance. He incorporated fictionalized versions of the relationship into several short stories and eventually his 1929 novel A Farewell to Arms. Not only was the novel’s heroine — Catherine Barkley, a nurse who falls in love with her wounded patient in Italy — clearly inspired by Agnes Von Kurowsky, Hemingway based a different character on Enrico Serena, another of Von Kurowsky’s wartime beaus!

Print the Legend

The connection between Von Kurowsky and the characters she’d inspired became public knowledge after Hemingway’s suicide in 1961. Hemingway had always tended to exaggerate the events of his own life even when he wasn’t using them for literary fodder, so by the time Von Kurowsky died in 1984, many scholars and Hemingway aficionados had difficulty separating the facts from the fiction.

In 1989, Von Kurowsky’s 1918 diary and her letters to Hemingway were published in a nonfiction book that threw some cold water on the legends that had grown up around Hemingway’s wartime exploits. However, the book’s 1996 film adaptation, also entitled In “Love and War,” again parted ways with reality, casting Chris O’Donnell and Sandra Bullock as Hemingway and Von Kurowsky in a soapy romance as sensationalized as anything Hemingway had written or said.

It seems that sometimes, fiction is more powerful than truth.


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