Answer:
When Louisa moved to Washington, she started to work at the Union Hotel Hospital as a nurse.
Just after a few weeks after starting her job, she started to fell ill. She wrote in her journal that "bad air, food, water, work and watching are getting too much for me" and also "A more perfect pestilence-box than this house I never saw". The Union Hotel Hospital was actually a ghastly and dirty place, which was full of patients and medical workers. Moreover, the food was the same for patients and workers, which was unhealthy, repetitive and difficult to digest. These all things contributed to her illness.
But on the other side.
Even though her days were tiring and full of fatigue, she really liked it. She wrote in her journal that "Though often homesick, heart sick and worn out, I like it". She used to find her pleasure by comforting and cheering her patients.
