Surgeon In Blue Read online

  SURGEON

  IN BLUE

  Also by Scott McGaugh:

  Midway Magic

  Midway Memories

  USS Midway: America’s Shield

  Battlefield Angels: Saving Lives Under Enemy Fire

  from Valley Forge to Afghanistan

  SURGEON IN

  BLUE

  Jonathan Letterman,

  The Civil War Doctor

  Who Pioneered Battlefield Care

  Scott McGaugh

  Copyright © 2013 by Scott McGaugh

  All Rights Reserved. No part of this book may be reproduced in any manner without the express written consent of the publisher, except in the case of brief excerpts in critical reviews or articles. All inquiries should be addressed to Arcade Publishing, 307 West 36th Street, 11th Floor, New York, NY 10018.

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  10 9 8 7 6 5 4 3 2 1

  Library of Congress Cataloging-in-Publication Data

  McGaugh, Scott.

  Surgeon in blue : Jonathan Letterman, the Civil War doctor who pioneered battlefield care / Scott McGaugh.

  pages cm

  Includes bibliographical references and index.

  ISBN 978-1-61145-839-8 (hard cover : alk. paper)

  1. Letterman, Jonathan, 1824-1872. 2. Surgeons–United States–Biography. 3. United States. Army–Surgeons–Biography. 4. United States–History–Civil War, 1861-1865–Medical care. 5. Medicine, Military–United States–History–19th century. 6. United States. Army of the Potomac–Biography. I. Title.

  E621.M36 2013

  973.7’75092—dc23

  [B]2013010329

  Printed in the United States of America

  To all in the military medical corps

  who bring our sons and daughters home

  “It requires a man with a steel nerve and

  a case-hardened heart to be an army surgeon.”

  —James Houghton, 4th Maine Infantry

  CONTENTS

  Acknowledgments

  Introduction

  “We are almost worked to death.”

  1 Not a Learned Profession

  “Open-hearted frankness”

  2 Outpost Medicine

  “We had no bandages.”

  3 The Hammond Alliance

  “Their wounds, as yet, undressed”

  4 Taking Medical Command

  “I found it in a deplorable condition.”

  5 Antietam

  “I pray God may stop such infernal work.”

  6 Fredericksburg

  “A huge serpent of blue and steel”

  7 Chancellorsville

  “What will the country say?”

  8 Gettysburg

  “I turned away and cried.”

  9 Validation

  “Little more remained to be done.”

  10 Wildcatter

  “A good kind husband”

  11 Compassionate Coroner

  “I have done my duty faithfully.”

  12 An Enduring Legacy

  “War is a terrible thing at best.”

  13 Epilogue

  “Today I am used up.”

  Notes

  Bibliography

  Index

  ACKNOWLEDGMENTS

  Each time I embark on a book project, I find myself enormously grateful for the many people and organizations dedicated to preserving our nation’s history. I am reminded just how much of history binds our cultural identity. Our history is woven into the fabric of our culture, and without its preservation, the tapestry of our values, beliefs, and shared experience would unravel.

  When I first approach a book’s topic, the vista it offers can be as broad as it is overwhelming. An endless number of paths stretch out before me. Some lead to unexpected forks and side paths that yield enormous treasure. Others become box canyons. Surgeon in Blue is no different from my other books in this respect, for its research led me to rural towns, dusty archives, and generous strangers who quickly became kindred spirits, colleagues, and sometimes good friends.

  Many people helped me set a research course at the outset. Brett Kelley and Janice Mullin of the National Civil War Museum suggested several routes of inquiry. Renowned Civil War devotee Michael Echols was a marvelous online resource, while Dr. Dale C. Smith, professor of medical history at the Uniformed Services University of the Health Sciences, articulated the challenges and opportunities inherent in my book concept.

  The gracious people of Canonsburg, Pennsylvania, were remarkably helpful. Michael McCoy, Phi Kappa Psi’s historian; Jim Herron of the Jefferson College Historical Society; local historians Maryann Magra and Gina Nestor; and Jefferson Medical College’s archivist, Michael Angelo, all were as responsive to a stranger’s request for information as they were supportive.

  When I reached the National Civil War Medicine Museum in Frederick, Maryland, I discovered a dedicated group of people devoted to this largely overlooked aspect of Civil War history. Gordon Dammann, a retired dentist in Illinois, founded the museum. He and his wife, Karen, welcomed me into their home, a den of irreplaceable historical documents and artifacts that included Jonathan Letterman’s desk. George Wunderlich, Terry Reimer, and Adele Air at the museum were enormously helpful.

  When my odyssey reached Fredericksburg, staff historian Donald Pfanz provided letters, diaries, and reports. Beth Malmquist and Jake Struhelka at the Chatham House extended personal courtesies, as did Randy Washburn, Rebecca Welker, and David Elrod at the Fredericksburg Visitor Center. Chief historian John Hennessy’s review of the manuscript was greatly appreciated.

  At Gettysburg, Phil Lechak provided a personal and inspirational tour of the battlefield. To sit in a forest clearing where Letterman’s surgeons treated bleeding men took my breath away. Imagining the cries of battle brought tears. Dru Anne Neil connected me with historian John Heiser, who provided archival Gettysburg materials and later offered manuscript feedback. Gettysburg guide Tim Fulmer clearly spent a great deal of time reviewing and improving the Gettysburg chapter.

  Meanwhile, other strangers became greatly appreciated colleagues. Marjorie R. Bardeen provided key historical perspective from the Lancaster Historical Society, while David Haugaard, Sara Heim, and Don Rolph at the Pennsylvania Historical Society in Philadelphia delivered a treasure trove of historical records otherwise out of my reach.

  When the odyssey reached California, Joe Sanchez of the National Archives in San Francisco and Dr. Terence Allen, who wrote a history of the San Francisco’s coroner’s office, provided insights I never would have developed. Medical history author John Haller was especially helpful in reviewing the manuscript from the larger military medicine perspective.

  Of course, all this was to document Jonathan Letterman’s life’s path and legacy. Regrettably, almost none of his personal papers remain. Only a handful of official reports and some handwritten notes have been found. Graphologist Sheila Kurtz was enormously helpful in “reading between the lines” and in helping me develop a more personal understanding of one of the Civil War’s great unsung heroes.

  None of their contributions would have seen the light of day without the sage counsel of my agent, Scott Mendel, and the unerring editing and manuscript polishing by Arcad
e Publishing’s Cal Barksdale. Finally, as I write this on Valentine’s Day, 2013, I know in my heart that each of my books has been made possible only by the unwavering support of Marjorie, my best friend, wife, and mother of my son.

  I am indebted to all who helped me chart this course of discovery. Each has contributed to the preservation of an important part of our nation’s military history. Thus, each has added to our understanding of who we are as Americans.

  INTRODUCTION

  “We are almost worked to death.”

  One out of nine of America’s sons, brothers, and fathers fought each other in the Civil War. The human carnage was unimagined. For many, decades passed before the scars began to fade. Our civil war has been well chronicled, from its orders of battle to its sociological implications. Its history, one hundred fifty years later, is well preserved through the wealth of contemporary first-person accounts, a remarkable compilation of military medicine’s medical records, and unending study and analysis in the ensuing fifteen decades.

  I have always been fascinated by the building blocks of history, the individual human experience. Surgeon in Blue is the result of a personal journey that began when I became involved in saving the retired USS Midway aircraft carrier as a museum. I discovered its unprecedented forty-seven years’ service to America represented the collective legacy of an estimated two hundred thousand men who served aboard Midway, at an average age of only nineteen. Their legacy became Midway Magic, my first book.

  Midway Magic led to other books, including Battlefield Angels: Saving Lives Under Enemy Fire from Valley Forge to Afghanistan. Battlefield Angels chronicles the remarkable heroism and compassion of fourteen individual corpsmen and medics, emblematic of many others charged with saving lives in battle. It spotlights the American spirit in the dust and debris of the war. The book also weaves the story of the remarkable legacy of military medicine and how it has influenced civilian health care today. Anesthesia, blood banks, transfusions, antibiotics, hospital design, life flights, microsurgery, certain medical specialties, X-rays, and much more have been either validated through widespread use or pioneered on the battlefield.

  Buried in the middle of that book is Jonathan Letterman, a young military doctor from Canonsburg, Pennsylvania. After spending thirteen years at army outposts in the Far West, where he tended sick soldiers, mended broken bones, and treated the periodic arrow wound, he was thrust into the heart of the Civil War. He became responsible for the survival and health of the Army of the Potomac’s 100,000 men. He was given medical charge of an emaciated, exhausted, dispirited army in which nearly four of ten soldiers were sick or wounded.

  In only eighteen months, he recast military medicine into a strategic element of an army’s order of battle. He served as the medical director of an army that fought three of the Civil War’s bloodiest battles, including America’s single day of greatest loss of life. Against that backdrop, Letterman pioneered military preventive health standards of diet, sanitation, and hygiene. He became known as the “Father of Battlefield Medicine” after he established the first professional ambulance corps, restructured military hospital care to bring it closer to the battlefield, recast the medical supply chain to more closely match the realities of battle, and developed a system of officer accountability to make all that possible. His approach to medical command and control is echoed by the military medical command structure of today.

  The impact of Letterman’s remarkable accomplishments can be seen today, which makes it all the more remarkable that no full-length biography has been dedicated to him before now. It has been my honor to work with the National Museum of Civil War Medicine and a wide range of Civil War experts to remember the man and call attention to his legacy in this book.

  Surgeon in Blue is not intended as a compendium of Civil War medicine. That subject has been studied thoroughly. Excellent books, including Gangrene and Glory;Civil War Medicine: Challenges & Triumphs; Doctors in Blue; and the multivolume Medical and Surgical History of the War of the Rebellion, offer extraordinary analysis and first-person data for study. Nor is my focus on Letterman’s role intended to disregard the role of women in Civil War medicine, Navy medicine, military medicine in the South, prisoner-of-war health care, or a myriad of related aspects of mid-nineteenth century military medicine. Surgeon in Blue focuses on a single man who rose above the hell of battle to craft a vision of more humanitarian and effective care for the sick and wounded in uniform.

  Approximately 10,000 engagements were fought in the Civil War. Surgeons treated thousands of wounded from a single battle, taking little time to meticulously record each treatment or procedure, much less document all the walking wounded who reached a field hospital. Diarrhea and dysentery were considered nearly synonymous in the Civil War, and other conditions and illnesses were similarly confounded, so statistical compilations of disease are difficult to analyze. The War Department might list an army’s strength at 108,000, while that army’s commanding officer might consider the 80,000 troops who were available for duty to be a more realistic description. Did a few skirmishes on one day mark the start of a battle or was an armed collision of tens of thousands of men the following day the true start of a battle? Dates of some Civil War events periodically vary.

  As a result of such factors, many statistics and dates can be fodder for discussion and disagreement. When variances came to light, I relied on either the most commonly reported figure or version or the one from what I considered a reliable source. I’ve footnoted many figures and quotes for the reader’s additional edification. Regrettably, a disastrous fire in Richmond in 1865 destroyed the bulk of Confederate medical records. Any errors or omissions are mine, and I always welcome suggested corrections.

  Much of Letterman’s organizational work focused on the corps, division, and brigade level, so a brief description of military organization is in order. The Army of the Potomac where Letterman served as medical director is a good example. It generally was comprised of three corps, each with about 30,000 men. A corps was divided into three divisions of about 10,000 soldiers each. Each division was comprised of three brigades of about 3,500 men each. Each brigade was comprised of three 1,000-man regiments. To be sure, the size of each component varied greatly throughout the war depending upon circumstance, the arrival and departure of volunteer regiments, and the health of soldiers.

  Line officers, the men who led the troops in battle, answered to an army’s commanding officer. However, medical officers were not only members of the fighting army but also part of the army’s medical department, led by the surgeon general. Their participation in two chains of command could create tensions. In addition, equivalencies in rank between military officers and surgeons in the medical department could be confusing or problematic. A surgeon held the rank of major, and an assistant surgeon was either a captain or first lieutenant. In practice, military officers often disregarded suggestions by surgeons as unimportant or threatening to their authority.

  The Union army was comprised of career military men, a force far too small to fight the Confederates. Regiments of volunteers were therefore organized by individual states to supplement the so-called regular army. Volunteer regiments would consist of approximately 1,000 men—untrained farmers, craftsmen, merchants, lawyers, doctors, and others—who often furnished their own uniforms. They selected their officers, sometimes on the basis of popularity or political connections. While necessary to the war, volunteer regiments were a source of great frustration among career military officers such as Letterman, who chafed at the volunteer soldiers’ lack of training and discipline.

  Terminology can sometimes be confusing, given the changes of usage over the years. In Surgeon in Blue I’ve relied on contemporary terms for diseases, drugs, and treatments. To simplify and clarify, I considered physician and surgeon synonymous, given the realities of battlefield medicine and its organization in the Civil War. Our nation’s capital at that time was Washington, one of several cities in the District of Columbia. It
became Washington, DC when those cities were consolidated in 1871. Finally, the term hospital wasn’t what we view as a hospital today. During the Civil War, a field hospital could have been a commandeered barn or a collection of tents in a ravaged cornfield.

  On a more personal note about Letterman, a quirk of his life is how the spelling of his last name changed. The original family name, of German origin, was Lederman, “leather man,” reflecting the family’s tradesman past. Jonathan Letterman’s father, a physician, went by Leatherman. Records of Jonathan’s early life include Leatherman and Letherman references. In 1856, Letterman submitted a report to the Smithsonian Institution under the name Letherman. Shortly thereafter, in military records, the form of the name became exclusively Letterman. Regrettably, the written historical records discovered to date do not reveal the reason for the change. In the interest of clarity, I use Leatherman for Jonathan’s father and Letterman for Jonathan.

  It is especially important to note that Surgeon in Blue is not a detailed account of the Army of the Potomac’s major battles. Antietam, Fredericksburg, Chancellorsville, and Gettysburg were the canvases on which Letterman developed a new concept of battlefield medicine. I’ve offered descriptions of those battles in order to provide context for Letterman’s achievement but have not tried to be comprehensive. Certainly, there is a wealth of other material for readers interested in battle plans, corps commander strategies, troop movement, fighting, and heat-of-battle decisions.

  This is a book about Jonathan Letterman and the hundreds of doctors he commanded, about his leadership and their collective legacy. His innovations were possible only through the dedication of the sort of men he considered to be good medical officers, who, in his view, “. . . should possess a thorough knowledge of the powers, wants, and capabilities of the human system of food, raiment, and climate, with all its multiplied vicissitudes, the influences for evil which surround the health of any army, and the means necessary to combat them successfully. They should also possess quickness of perception, a sound judgment, promptness of action, and skill in the treatment of medical and surgical disease.”1