They came from every walk of life. They were overwhelmingly single, including many widows, but otherwise they represented a cross-section of women in the mid-19th century. Some were wealthy and donated both their time and money while others were so poor that the meager salary they earned and access to regular meals actually improved their standard of living. Some were well educated but most, while literate, had little formal schooling.
And, very few had ever had any medical training, but they had an impact on modern medicine which benefits us all today. They were the Nurses of the Civil War.
We do not know many of their names as almost all are lost in the fog of history. Hanna Ropes, Amanda Akin, Mary Ann Bickerdyke and Georgeanna Woolsey were among the heroes of the Civil War who have left some record of their service and are known to a few. Dorothea Dix has also been remembered by some and Clara Barton probably by more. But these women were only a small part the nearly 8,000 nurses who cared for the wounded and dying during the Civil War, whether their patients wore blue or grey. Dorothea Dix, called Dragon Dix by some, became noteworthy in history as the first appointed leader of the Union Nurses Corps. And Clara Barton, a nurse who had lobbied to gain access to the front lines, persevered until the Generals caved in to her demands; then served valiantly in the battlefields. Miss Barton later became a leader for the formation of nursing schools and reached fame as the founder of the American Red Cross. That we know these other names at all is because the women left letters or diaries of their experiences; with some of the most profound commentary describing the terrible carnage of the War.
Georgianna Woolsey wrote of her transition from empathetic compassion for each soldier, to a recognition that the waves of new patients required some pragmatism. “I deliberately turn my lantern on a wounded soldier’s face and ask the doctor, ‘is this man dead’ and watched coolly as he pronounced him dead. Then I said, ‘Well, that will make one more bed.’ I could not have said that a year ago.”
The chances are that the dead soldier had succumbed, not directly from a wound received in battle, but from pneumonia, dysentery, typhoid, other diseases or infections. Of the hundreds of thousands of young men who died while serving in the military of the Union and Confederate forces, more than 50% fell to causes other than directly from a battlefield wound. Poor sanitation was perhaps the number one killer. As the war progressed, there were improvements in surgical procedures, basic medical care, and general sanitation, but the numbers of non-battle losses were still horrific by today’s standards.
Miss Woolsey also wrote about how she spent her time, “Most days were the same. They (dead and dying) were up and down what seemed like a mile of uneven floor; coaxing some back to life, watching the youngest and best die. Then the next day would begin again.”
Amanda Aiken wrote of her first day, “I meekly followed (the nurse) through the long ward unable to return the gaze of the occupants and with a sinking heart watched her raise the head of a poor fellow in the last stages….my courage failed.” But later she wrote, “We pass up and down among these rough men without fear of the slightest word of disrespect. They feel their dependence upon us for comfort and the difference in the wards where there is no lady, shows how much can be done for them.” And then, “While I pray to help them all, I know cannot.”
Early in the War, women would simply appear wherever wounded soldiers were assembled, usually in hastily organized hospitals away from the battle lines. They just wanted to help, but, at first, many were turned away. The Victorian customs of modesty and protection of the “sensibilities” of women prompted most doctors and hospital administrators at the time to oppose women assisting in the personal care of men who they did not know. In fact, before the Civil War, almost all women involved in medical care in America served only women and children; an exception was a few dedicated nuns in hospitals run by convents.
As the War began, in addition to the few male hospital attendants, both Union and Confederate Armies expected that other convalescing soldiers who were able to help, would provide care to their more seriously wounded or ill comrades. Most Generals and doctors did not want, and thought they did not need, additional help from these women.
But the unprecedented carnage of the Civil War quickly overwhelmed most male hospital staffs and some women were finally welcomed as care givers; slowly at first, but the onslaught of wounded soon erased the last barriers. Less than a year into the war, President Abraham Lincoln asked Dorothea Dix to organize a “Women’s Nurses Corps” in Washington DC to care for the tremendous influx of patients. Reflecting society’s concerns about interactions with soldiers, her early rules stated that the nurse was to be “over thirty years of age, plain in looks and in dress.” Records indicate that hospitals in Washington DC probably cared for about 1,000 soldiers in May and June of 1861 but over 30,000 by December; and thousands more were served in other cities. Lincoln also authorized the formation of the Sanitation Commission, with branches in every major northern city, to raise money and to develop procedures to improve the level of care for soldiers; and he encouraged that women be appointed to roles overseeing the effort. One of the goals of the Commission was to improve the survival rate of wounded soldiers; and gradually, over the four years of the War, the situation improved; but thousands of the patients still died before they could be sent home.
Hanna Ropes had read several articles and a book by Florence Nightingale, the famous English nurse who organized the first “Red Cross” during that county’s conflict in the Crimea. Miss Ropes decided to join the Nurses Corps and her superb organizational skills were soon recognized and she became the Director of the largest Union hospital in Washington DC. One of her recruits was the author, Louisa May Alcott, who would later write “Little Women” but whose published “Letters Home” in the Atlantic Monthly during the War became instrumental in gaining public support for the Sanitation Commission and respect for the nurses who served. Miss Alcott, who contracted typhoid during her service and came close to death, said that her experiences in the hospitals were essential to the later development of her empathetic characters in her books.
One Southern nurse wrote, “I have never worked so hard in my life and I would rather do that than anything else in the world.”
Unlike some of the military doctors of both the Union and Confederate armies, who notoriously refused to treat enemy combatants, nurses rarely discriminated when helping the soldiers. While Washington DC had separate hospitals to care for Union soldiers and Confederate prisoners of war, nurses frequently served in both wards. One nurse, who lived in the city wrote, “They were all just boys who desperately needed aid and comfort. Who was I to choose?”
An unfortunate fact is that wounded or ill Confederate soldiers who were hospitalized in southern cities, faced more difficult circumstances, including shortages of medical supplies, food, and trained personnel. The Confederate efforts to care for their injured were further hampered by a continuing resistance to having women care for men whose wounds were more intimate. One southern politician stated that; “It is unladylike for our women to care for ruffians,” indicating his low regard not only for the common soldier, but also for the women who wanted to serve. In a direct response, Sally Tompkins, who had started a private hospital with six other nurses in Richmond for badly wounded Confederate soldiers, replied; “A woman’s respectability must be at a low ebb if it can be endangered by helping our soldiers in a hospital” and added, “It is not the propriety of the nurses or the soldiers that should be questioned.”
But the main hindrance to better care in the South was pure economics. The southern population was enduring such financial hardships that there was no equivalent of the privately funded Sanitary Commission, which was proving so helpful in the North. As a result, the rates of subsequent deaths of wounded Confederate soldiers, who were sent to Southern hospitals after they were taken from the field, were substantially worse than for Union forces. Perhaps the only advantage for women in the south, who wanted to serve as nurses, was that they did not usually have to go far from home; as most of the War was fought in and around their own farms, towns, cities, and sometimes even in their own back yards. One noted; “With us, every house was a hospital.”
The North certainly had an advantage with its larger and wealthier population, and the financial contributions by citizens provided much of the funding for medical care.
As a fierce Unionist and abolitionist, Clara Barton was determined to serve in the War in some capacity. She decided to try to take medical care to battle areas and began to raise funds from New England supporters to buy her own supplies. Then she pulled every string she could, including a request to President Lincoln, to overcome the objections of the various Generals she challenged; and when they finally relented, she said, “I went in while the battle raged.” She was not exaggerating. In one instance, while she was tending to a wounded soldier, a bullet tore through her sleeve and struck the soldier in the head, killing him instantly. On another occasion, she performed the first recorded surgery by a woman in the War when she removed a bullet from a soldier’s cheek, then cleaned and dressed the wound. It was probably not the only such occurrence but she did not want to draw attention to herself because most doctors did not want women involved at all with surgery. In a letter she wrote; “While our soldiers fight, I can at least stand and feed and nurse them.” After observing her courage under fire, one doctor, who welcomed Miss Barton, referred to her as “The Angel of the Battlefield.”
Another who served near the front lines was Mary Ann Bickerdyke, a Quaker, who was fifty-five when the war broke out. She became known to Union General William Tecumseh Sherman for her courageous efforts, and resourcefulness, near battlefields. One doctor said “She would find medical necessities and food in a manner that is much like the Biblical loaves and fishes.” Miss Bickerdyke became the only woman General Sherman would allow in his army camps and, when he was asked why, he replied “She (out) ranks me!”
However, even after overcoming public apprehension over women providing nursing care to men, still only a few women were permitted by doctors to assist in surgery. In fact, despite a government order that women, if they volunteered, be permitted help with surgeries, acceptance by the doctors was rare. Georgeanne Woolsey wrote, “Hardly a surgeon treated (the nurses) with even common courtesy. The Army surgeons determined to make their lives so unbearable that they should be forced in self-defense to leave. I did not.”
These women, sharing a common existence, became close. A nurse from Virginia, praising her fellow nurses, wrote, “Would that I could thank my dear friends. Any labor rendered effective by me for the good of the South, if any sick soldier ever benefited from my pleasant smiles at his bed-side, or death was ever soothed by gentle words of hope and tender care, such results were owing to the encouragement I received from them. My only wish was to live and die among them, growing each day better from contact with their gentle, kindly sympathies, and heroic hearts.”
Despite the early resistance to women nurses, we know that several thousand did serve. The names of most, however are lost in history and, later in her life, Clara Barton wrote this poem in their honor.
“And who were they all, and they were many, my men.
Their record was not kept by table or pen.
They exist in traditions from father to son,
Who recalls, in dim memory, now here and there, one.
A few names were writ, and by chance live today.
But is perishing fast, just fading away.”
For the care we receive from today’s nurses, we owe these “Angels of the Battlefield” from the Civil War, at the very least, a moment of reflective thought for the wonderful legacy they left.
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