Battle Field Angels (4 page)

Civil War

S
uffocating humidity thickened the uniforms of thousands of Union soldiers as they milled about, nearly shoulder to shoulder, in a park in Washington, D.C., (then known as “Washington City”) on July 15, 1861. Some paced between and around hundreds of white conical tents. The previous night’s campfires smoldered, and smoke drifted straight up into a lifeless sky. Sweat rolled down Foster Swift’s face as he knelt to inventory the contents of a wooden box he had pulled out of a wagon. The surgeon attached to the 8th New York Regiment had supplies to check and requisition requests to complete while rumors swirled about where General Irvin McDowell soon would be taking the Union army.

About twenty-five miles away in Virginia, Confederate generals Joseph Johnston and Pierre Beauregard reviewed battle plans. They commanded more than thirty thousand troops who were southeast of Washington near Manassas Junction. Intersecting railroad lines at Manassas offered direct routes to both Washington and the Confederate capital of Richmond. Manassas lay at the crossroad of a war that had yet to erupt on the battlefield.

Swift had heard that the first major land battle of the Civil War probably would take place near Manassas. It was clear that both sides were mobilizing for battle.

In 1861, military medicine was far from ready for battle. Very little medical progress had been made since the end of the Revolutionary War, when the medical corps had been disbanded. By 1802, the military medical corps had shrunk to less than thirty personnel. During the War of 1812, it had been crippled by a shortage of qualified doctors, the absence of a battlefield evacuation system, and military hospitals that were little more than tents and temporary shelters. The practice of bloodletting and ignorance about the causes of disease were as profound as they had been during the Revolutionary War.

Soldiers in the Mexican-American War of 1846–48, which successfully annexed Texas, suffered from a lack of care. The American army of 7,000 men was assigned only 72 medical officers at the outset of the war. When the army grew to 100,000, there were only about 250 medical officers and volunteers. Once again, the medical corps was badly outnumbered and unprepared for the ravages of what became the American army’s most deadly war. More than 11,000 soldiers died from illness, about seven times as many as those killed in battle. One out of six soldiers in the Mexican-American War died in combat or from disease. The disease rate in the military was ten times that of the civilian population. Thousands came home from war debilitated by chronic cases of dysentery.

There was no system to evacuate the wounded from the battlefield. Those who made it faced an uncertain future at best. Gunshot wounds that resulted in compound fractures were almost always deadly. Although some soldiers survived amputation and then infection of an arm or lower leg, the closer the wound was to the torso, the more likely it would be fatal. A Navy doctor who accompanied the army to Mexico noted that he did not see a single patient survive a gunshot wound to the thigh that had resulted in a fracture.
²

Almost nothing had changed by early 1861. At the start of the war, the Union army’s entire medical corps numbered only eighty-seven men. Its parsimonious eighty-year-old surgeon general, Thomas Lawson, a veteran of the War of 1812 who died shortly after the beginning of the Civil War, refused to buy them medical textbooks. Many of the doctors supplied by the state regiments had no experience with battlefield injuries, and some had never operated on a patient. Many had never seen the inside of a living patient’s abdomen. Yet by July 1861, tens of thousands of young men relied on them for survival.

Sullivan Ballou was a handsome major in the 2nd Rhode Island Regiment. At thirty-two years of age, he was considered an old man in the army, and he was uncommonly accomplished. As a lawyer, he had served as clerk and speaker of the House of Representatives in Rhode Island. Ballou had said goodbye to his wife, Sarah, and two young sons when he volunteered in early 1861.

As Swift inventoried his medical supplies elsewhere in the camp, Ballou wrote his wife:

Six days after writing this letter and placing it in his trunk, Sullivan Ballou, surgeon Foster Swift, and more than twenty-eight thousand Union soldiers marched out of Washington, D.C. It took the unseasoned and poorly trained troops two days to hike twenty-two miles toward Manassas and their campsites near Centreville, Virginia. A Union general left twenty wagonloads of medical supplies behind for fear they would slow the tedious advance even further. Undisciplined soldiers often fell out of formation to pick berries before arriving at Centreville and setting up camp.

On July 21, at 0230 hours, under a cloudless sky, twenty thousand Union soldiers moved out toward the Confederate positions. The summer heat was so oppressive that stragglers simply dropped to the ground along the route. Shortly before dawn, thousands of Washington residents climbed into their carriages for a ride out into the country to watch the battle between sixty thousand soldiers. The Civil War was a spectator sport in 1861.

Most were still in their carriages at 0515 when the first Union cannon fired on General Beauregard’s headquarters, launching the battle that became known as Bull Run. Three columns of advancing Union soldiers soon ran into logistical and communications problems. Within a few hours, the battle had become concentrated in a small patch of eastern Virginia filled with gentle hills and forested ridges, divided by small creeks and rivers. Isolated stone farmhouses became battlefield landmarks as incessant rifle fire and artillery attacks turned the forests into a landscape barren of cover. Both Union and Confederate troops faced barrages of defensive fire as men fell, screaming for help. Within an hour of the battle’s onset, Foster Swift and the rest of the medical corps were treating grisly wounds most had never encountered before.

At 0915, Sullivan Ballou’s unit emerged from a thicket of trees and advanced up a hill. The enemy, waiting on both sides, opened fire. A cannonball broadsided Ballou’s prized horse, Jennie, killing it instantly and crushing Ballou’s leg into a bloody pulp. Blistering pain shot up Ballou’s hip and into his brain. A brief flush of dizziness passed. Lying on the hillside, Ballou grew thirsty as he bled and waited for help. Union soldiers dragged him behind some cover, then carried him to a tall, narrow church that sat atop a ridge, near a creek and sulfur spring. Sudley Church and nearly every other building still standing were quickly converted into field hospitals by both sides.

Foster Swift and other surgeons were ordered to Sudley as dozens, then hundreds, of wounded and writhing soldiers were brought there. Planks balanced across pews became operating tables. Assistants and the walking wounded hauled water from the creek in buckets. Surgeons dipped bloody scalpels in them between operations. Swift and the other Union doctors were unprepared for what confronted them: Weaponry had progressed faster than battlefield medicine.

Their biggest challenge was posed by the Minié ball, a new kind of bullet that cut a wide path of destruction through the human body. Made of soft lead, it traveled 950 feet per second and was accurate to 600 yards when fired by a rifled musket, about 10 times further than the maximum lethal range of a smooth bore musket in the Revolutionary War. Worse, the lead flattened when it penetrated the human body. It shattered bones, destroyed blood vessels, tore through intestines, and severed fingers, hands, and arms. It also had the nasty characteristic of ricocheting within the human body when it glanced off bone.

Surgeons at Sudley Church assessed Ballou’s destroyed leg and prepared to cut it off. Far too much damage had been done, and a quick amputation might keep Ballou from life-threatening shock or infection. In less than five minutes, Ballou’s leg was tossed onto a growing pile of mangled and severed limbs. Speed was paramount in the face of mounting casualties. The smells of blood, bile, and seared flesh filled the church.

By late afternoon, the Confederates had broken through one side of the Union assault. General McDowell’s defensive line collapsed under the Confederate advance. Union soldiers retreated and then ran. They fled back toward Washington, D.C., and collided with the thousands of civilian spectators in their carriages who were escaping to safety. Wounded soldiers were abandoned on the battlefield, left to crawl through the dirt in search of shade to escape the sweltering July heat.

Swift, a handful of surgeons, and some assistants, including Gustavus Winston and Charles DeGraw, chose to stay at Sudley Church to care for more than three hundred wounded men. They performed one surgery after another—nearly all of them amputations—as Confederate troops surrounded them. By 1600 the Confederates had seized Sudley Church. Swift, Winston, DeGraw, Ballou, and the wounded lying on pews and under trees became prisoners of war.

Bull Run was an unmitigated military medical corps disaster. A massive Union army had marched into battle with no practical system or capability for treating its wounded. Bull Run was a huge battle that dwarfed any seen during the Revolutionary War catching both the Union and the Confederate military unprepared to evacuate thousands of wounded off the field of battle. Many military doctors had no or minimal surgical experience. Medical supplies were sacrificed in the interest of expediency. The lack of treatment capability was so acute that some of the walking wounded wandered the nation’s capital for days after the battle until one of the city’s four general hospitals had room for them.

The fiasco reflected the state of military medicine as it struggled to cope with unprecedented casualties. A chronic shortage of qualified doctors persisted throughout the Civil War. It was especially acute in the South, where nearly all medical schools closed during the war. The shortage created a spirit-crushing burden on doctors in uniform. After one battle, surgeon John Shaw Billings wrote:

Billings was one of only two hundred fifty Union doctors available after the battle to treat twenty thousand wounded Union and Confederate soldiers.

Millions of soldiers faced a withering barrage of enemy fire in more than two thousand engagements during the Civil War. The development of a rifled musket significantly extended the range of the dreaded Minié ball ammunition. The battlefield was lengthened even further by the lightweight and portable “Napoleon” cannon, capable of firing a twelvepound shot up to 1,700 yards and ideal for the hilly country where numerous Civil War battles were fought. The Napoleon also could fire canisters filled with iron balls that sprayed enemy troops, a kind of deadly long-range shotgun. Toward the end of the war, a basic machine gun was introduced, as well as the repeating rifle, which could fire seven rounds in the time a musket could discharge a single shot. Unprecedented numbers of soldiers fell as rifle and artillery fire quickened and grew more efficient. The battlefield’s killing zone widened and deepened as a result.

At the outset of the war, a primitive battlefield evacuation system was plagued by incompetent personnel. Unfit soldiers who had been assigned as stretcher bearers became infamous for drinking the medicinal alcohol and hiding from enemy fire.

Assignment to a stretcher team was gut-wrenching duty. Following the Battle of the Wilderness in 1864, Lieutenant Colonel D. Watson Rowe wrote that:

The destination of stretcher bearers was usually a field dressing station just beyond the range of rifle fire. There, assistants stemmed the flow of blood and gave the wounded a shot of alcohol (and perhaps a dose of opium) to withstand the frequently brutal trip to a field hospital. Often the ride was so rough and painful that wounded soldiers chose to walk if they could stay on their feet. Sometimes located five miles from the battlefield, exhausted surgeons and surgeon’s mates established field hospitals in commandeered buildings, sheds, and houses; under trees; and alongside specially designed wagons whose sides folded down to become outdoor operating tables. The wagons held supplies such as mercury-based calomel for intestinal problems as well as arsenic and strychnine for other ailments.

Surgeon’s mates doled out opium and morphine to the wounded waiting their turn on the operating table. Because stomach, head, and chest wounds were considered almost always fatal, surgeons prioritized leg and arm injuries suffered by soldiers who still had hope for survival. Even then, thousands of wounded men lay outdoors in congested hospitals for a day or longer before a mangled leg or arm was treated by a doctor.

Pain-wracked patients breathed deeply against rags soaked in chloroform as they lay on a table sometimes chest high to the surgeon. As his predecessors had done in the Revolutionary War, a surgeon often stuck a finger into the wound in search of the bullet. In only a few minutes, he decided whether a leg or arm had to be cut off. If that were the case, one assistant administered more chloroform. Instead of becoming unconscious, sometimes the sedated soldier became agitated, moaning and thrashing on the operating table. Another assistant pressed on a major artery to slow bleeding during the operation, while a third held the limb about to be severed. Practiced surgeons who had grown proficient after hundreds of amputations often earned the nickname “Sawbones.”