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Brotherly Medicine

The poet who helped bind up the nation’s wounds

By Robert Roper | July 16, 2020
Wounded Union soldiers following the Battle of Spotsylvania (National Archives/Wikimedia Commons)
Wounded Union soldiers following the Battle of Spotsylvania (National Archives/Wikimedia Commons)

In July 1863, after the murderous draft riots in New York, Walt Whitman wrote to his mother in Brooklyn, “We are in the midst of strange & terrible times—one is pulled a dozen different ways in his mind, & hardly knows what to think or do.”

Walt had been spending time in the soldiers’ hospitals in Washington. He was a comforter of the sick and wounded. Not a nurse, not a doctor, he assisted at operations and sat through the night with soldiers dying of typhoid fever. The doctors warned him not to get too close. But Walt was all about closeness, connection, the mysterious healing power of presence.

He brought the soldiers useful gifts. Writing paper. A peach. A needle and thread. Slugs of brandy out of a flask. During the course of the Civil War, he made some 600 visits to the hospitals, some of them not much more than canvas tents in a field. He saw more than his fill of “butcher sights,” as he told his mother.

His vocation as consoler to the soldiers had deep roots in his character. But the immediate inspiration was brotherly. Hearing, in December 1862, that his younger brother George had been wounded at the Battle of Fredericksburg, he rushed south, finding George not bad off but thousands of others in a condition that was harrowing to see. “One of the first things that met my eyes,” he wrote his mother, “was a heap of severed limbs under a tree in front of a hospital,” a local mansion that had been commandeered by the army.

Back in Washington, Walt threw himself into hospital work. His four years of almost daily visits, to hospitals and also to camps for escaped slaves, is rightly reckoned one of the larger compassionate labors in our history. Less is said about the poet’s emotional breakdown. “Mother, it is serious times,” he wrote her in 1864. “I do not feel to fret or whimper … but I dare say, Mother, I feel the reality more than some because I am in the midst of its saddest results.” Whether it was seeing a particular soldier die that pushed him over the edge is hard to tell. He had recently cared for a boy “very sick of brain fever; only 19, and so good,” who raved for eight days and then was gone. “It was very sad. His talk was so affecting it kept the tears in my eyes.”

In June 1864, he wrote again,

Things are going pretty badly with the wounded—they are crowded here in Washington in immense numbers. The papers are full of puffs, but the truth is, the largest proportion of worse cases got little or no attention—we receive them here with their wounds full of worms—some all swelled and inflamed, many of the amputations have to be done over.”

One new feature of the wounded was that many had broken down emotionally. “Every ward has some that are wandering,” Walt reported, “they have suffered too much, and it is perhaps a privilege that they are out of their senses. Mother, it is most too much for a fellow, and I sometimes wish I was out of it.”

He soon took himself out of it. He went home to his mother’s house, where he remained for the next six months. He was unable to get out of bed, plagued by headaches and a sore throat that would not go away. Andrew, another of his brothers, had recently come home too, only to die of tuberculosis of the throat.

One measure of Walt’s dedication to his work is that he kept at it until he collapsed. Another is that he returned when he was psychologically able. Though he witnessed outrageous instances of improper, not to say fatal, treatment of soldiers, he respected many of the medical officers he came to know. Thousands of amputations performed in haste, in unsterile conditions, often outdoors, had produced a cadre of surgeons who knew at least how to ligate major arteries fast. It was a time of ignorance but also of attempts to learn. Hospital gangrene, the most feared clinical infection, with a mortality rate of 50 percent, raged during the second and third years of the war but became rare by the fourth, as surgeons began bathing wounds in solutions of bromine, an analogue of chlorine. Some doctors found that they had good results if they quarantined their gangrenous and other infectious patients. Some began insisting that nurses wash their hands in chlorinated soda.

The war was “somehow” about the crime of slavery, President Lincoln said in his Second Inaugural Address. But it was also about Union, a bold assertion of the state’s centralizing powers. The U.S. Sanitary Commission came into existence via Lincoln’s executive order. Nominally private, it was actually an arm of the government—Lincoln called it a “fifth wheel on the coach.” It raised funds, secured lines of supply, amassed bedding, dressings, surgical instruments, healthful food, hospital gowns, medicines, and a thousand other necessaries, and in the person of its first executive secretary, Frederick Law Olmsted, it became known for focus and a somewhat overweening administrative style.

Olmsted had personal knowledge of the terrors of contemporary surgery. After breaking his thigh in a carriage accident in 1860, he was slated for an amputation at the hip, a procedure many patients did not survive, only to be spared when a doctor decided he was too weak to go under the knife. His leg healed; nine months later, limping on the shortened limb, he witnessed the Union rout at First Bull Run, afterward writing to his wife of “the disgrace” of it, of the complete failure to prepare the men for battle.

Olmsted was still in his 30s. Partly through his influence, the government chose a new surgeon general, William A. Hammond, who was younger still. Hammond had been an army doctor on the frontier. He was also a researcher who published solid papers, and during his term in office, the construction and sensible equipping of hospitals progressed swiftly. A best-practices approach became if not standard, then more common. Mercury-based medicines, often grotesquely destructive in their effects, were banned. Women nurses, formerly a rarity in the army, became common, when Hammond—initially uncomfortable around “insubordinate” women—mandated that a third of all new nursing hires be female.

Another innovator, Jonathan Letterman, designed and implemented a new system for the rapid evacuation of the wounded. His Army Ambulance Corps consisted of medics especially trained in what might now be called shock-trauma response. At Second Bull Run in August 1862, it took a full week before all Union casualties had been evacuated from the battlefield; a month later, at Antietam, with the Ambulance Corps fully operational, an equivalent number of Union casualties reached hospitals within 24 hours.

Olmsted, the force behind these changes, worked himself into a collapse much like Whitman’s. Sometimes, after working all night, he was said to breakfast on black coffee and pickles. He served on hospital transport ships during the 1862 Peninsula Campaign in Virginia, encountering some of the most gruesome scenes of the war. Feeling the immensity of the suffering he was pledged to lessen, he fell out of favor with his superiors and resigned the following year.

Walt did not much admire either Olmsted or the Sanitary Commission. The professionalization of caregiving, the rational bureaucratic approach, did not ring bells with him, yet he recognized the solid improvements made under the Commission’s authority. Halfway into the war, he wrote in a tone of mild surprise that one of Washington’s most distressing hospitals now consisted of “25 or 30 wards, beds for 60 patients per ward … you see a U.S. hospital here is quite an establishment, has a regular police force, a great staff of surgeons, cadets, women and men nurses etc. etc.” The national effort had begun to give an impression of being adequate to the crisis.

Walt’s greater problem with the Commission was its improving tone. The Commission president, Henry Whitney Bellows, was a nationally known minister who authored Unconditional Loyalty, a pamphlet widely circulated in the North that argued that a popularly elected president was answerable only to God. The responsibilities of the ordinary citizen, then, lay in the direction of unquestioning submission. The war might prove of value, Bellows thought, if it forced on overly individualistic Americans a more serviceable uniformity.

Walt was a Unionist of a more democratic stripe. The whole notion of moral improvement through battle disgusted him. In the thousands of letters he wrote during and after the war, to the parents and spouses and siblings of soldiers who had died in his care, he carefully avoided any suggestion that son or husband or brother had died for a good cause, that the death had been “worth” it—that whole line of argument, as well as the idea that individualism was a problem for Americans, he utterly rejected.

He continued to visit hospitals even after the fighting was long over, still bringing presents of candy, jam, lemons, pocket change, tobacco, and various other comforts for the soldiers. The wounds they had suffered, improperly treated to begin with, with sites of infection allowed to scar over and never fully heal, resembled those of the nation.

 

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