Bellevue

by David Oshinsky

  At forty-seven, with a large family to support, Hamilton was not the typical volunteer. “Of medium stature, slightly built in appearance, with a mercurial temperament,” he’d enlisted to be close to his oldest sons, who were already at the front. “I believed the war would not last but a few months,” Hamilton recalled, “and I wished to be near my dear children in case they were wounded. In all this, my dear wife consented.”

  There was another reason, of course. As the nation’s foremost military surgeon, Hamilton was expected to serve. Indeed, he’d been preparing two hundred Bellevue students “for the field” when the war broke out. A surgeon’s job began with an examination of the recruits, Hamilton told them. Be alert for maladies that could cripple a regiment, he warned, listing hernias, severe limps, missing digits, rheumatism, chronic coughing, and strabismus, the medical term for “cross-eyed.” And watch out for troublemakers, especially those “excited by liquor.”

  Severe limps and hernias would be the least of Hamilton’s problems. In July 1861 his regiment was dispatched to Manassas, Virginia, along a creek known as Bull Run, to confront the Rebels in the first major battle of the war. Hamilton set up shop “in a snug wooden house, occupied by Negroes, as if we were in Bellevue,” he wrote later. “The operating table was ready, the bed arranged, and the instruments, sponges, bandages, cordials, &c., in order.” As the wounded fell, they were to be brought to the house in stretchers borne by “the drummer boys and a few volunteer aides, who together composed my ambulance corps.” That, at least, was the plan.

  The day went badly for Union forces. Poorly trained and led, they proved no match for Stonewall Jackson’s infantry and Jeb Stuart’s Black Horse Cavalry. Within hours, Hamilton was forced to abandon his position and move farther to the rear. His operating room became a tavern, then a private home, and finally a church. Supplies ran out. His stretcher-bearers fled. Hamilton performed two amputations that day, one below the knee, the other above the elbow joint. “Both of them, I confess, were done very badly,” he recalled, “but I could, at the time, and under the circumstances, do no better. My back seemed broken and my hands were stiff with blood. We [soon] had no sponges and scarcely more water than was necessary to quench the thirst of the wounded men.”

  The Union retreat soon became a rout, with fleeing soldiers leaving the dead and injured behind. Though Hamilton would be captured twice by Confederate forces in future engagements—once in Tennessee and again in Kentucky—the panic at Bull Run would remain his most haunting wartime memory. “I could not tell them I was about to leave them,” he said of the wounded, “and [trust] I did no wrong. I could be of no more service to them…and presumed they would be in the hands of a civilized and humane enemy who could care for them better than we could.”

  As with most desperate presumptions, it turned out to be wrong.

  —

  Like Dr. Hamilton, most Northerners had expected a quick and easy fight. Their adversary seemed badly overmatched. The North had more troops, more capital, more factories—indeed, more resources of almost every kind. “A Short War Probable,” the New York Times had boasted. “We are opposed by troops who, whatever may be their personal courage or endurance, are vastly inferior in soldierly qualities to those of the North….It is discipline that wins, and this is the last quality of which Southern soldiers are capable.”

  Bull Run demolished this fantasy. For the next eighteen months, Confederate troops easily beat back the Union’s ponderous attempt to encircle Richmond, the South’s wartime capital, inflicting heavy losses. Yet the fighting had proved an early bonanza for the North’s large cities, none more so than New York. To finance the war, the Treasury Department had borrowed heavily from Wall Street to award military contracts to the city’s factories, foundries, shipyards, and slaughterhouses. New Yorkers, wrote the admiring Journal of Commerce, have “learned how to prosper without the South.”

  A surreal quality took hold in the city. Shoppers who flocked to Macy’s Department Store on 14th Street, or the more fashionable Lord & Taylor, couldn’t help but pass the survivors of Bull Run and a dozen other battles, many without limbs, some with their faces shot away, others ravaged by disease. It was impossible to walk the streets without seeing a soldier’s widow dressed in black or a military hearse go by. Or to pick up a newspaper without scanning the names, row upon row, of the missing and the dead.

  Dark stories circulated, some of them true. New York’s J. Pierpont Morgan took advantage of the conflict to sell defective weapons to the army, while Brooks Brothers produced such shoddy uniforms for the local regiments that public rage forced the clothier to replace them free of charge. More troubling, though, was the growing chasm between the city’s rich and poor. While the war boom created many jobs, severe inflation had caused a drop in working-class spending power. Meanwhile, the number of millionaires in New York jumped from a dozen to more than three hundred, with the top one percent of the pyramid accounting for close to 60 percent of the city’s wealth. The resentment over poor soldiers fighting and dying in the midst of such avarice grew with each new luxury paraded by the rich. In terms of class conflict, a fuse had been lit.

  —

  The war dramatically transformed daily life at Bellevue—depleting its medical staff, on the one hand, while adding severely injured troops, on the other. In most cases, these soldiers would be treated first by the regimental surgeon, then at a facility behind the lines, and finally at a hospital near the patient’s home. “The major event in my world has been the arrival of 400 sick and wounded soldiers from the James River,” Dr. Titus Coan, a Bellevue physician, wrote his family in 1862. “We look every day for another transport from the seat of war with a new load for us.” He added: “I think that our loss is much greater than is popularly supposed.”

  The numbers grew so large that General George McClellan, the top Union commander, visited Bellevue several times. “He spoke with each man,” the physician noted, “asking such questions as ‘What’s the matter with you? What’s your regiment? How is your wound? Does it give you much pain? Are you getting along pretty well?’ ” His concerns seemed heartfelt, a staffer observed. “He inquires with as much interest as their fathers would & they love him more than ever.”

  As physicians and medical students left for the front, Bellevue filled the void with inexperienced “contract doctors” hired by the government at $100 for a three-month stint. “I am house surgeon of the second surgical division [at Bellevue] and have besides the Lying-In Department, with 60–70 mothers and babies to take care of,” Coan, just twenty-five, proudly wrote his family. “I have sole management unless I call in the visiting physician in cases of extreme gravity.” Coan wasn’t complaining: wartime Bellevue offered him a rare chance for growth and advancement. “This,” he admitted, “is the ideal place for learning medicine.”

  John Vance Lauderdale, another “contract doctor,” got to perform major surgery at Bellevue because so much of the staff was away. “I was just in blood to my elbows,” the twenty-nine-year-old Lauderdale told his sister. “The scalpel was handed to me and an unfortunate man was relieved of a horribly lacerated leg.” The patient was “doing well,” Lauderdale boasted, adding: “It is very seldom that house staff are allowed to do anything of this sort.”

  There was less room now for Bellevue’s former clientele. As the wounded poured in, hundreds of “noncritical” patients were packed off to Blackwell’s Island. This process helped the bottom line, since the government paid a weekly stipend for each soldier and spent freely to outfit the recovery floors. “A stroll of inspection in and about Bellevue is not now what it was short years ago,” a visitor observed, “when rats ran riot through the wards seeking whom they might devour, occasionally concentrating on a pauper baby for a midnight lunch.”

  Yet even with several thousand soldiers arriving at Bellevue during the war, the number of admissions actually declined. One reason, it appeared, was that the group most likely to burden the local jails, asylu
ms, and hospitals had joined the army and left town. In the words of one relieved city official, “this reduction may be accounted for by the enlistment of men who have heretofore been driven to crime, or fallen into habits of inebriation and folly”—a clear stab at the Irish. “In regard to the female portion,” he added, regretfully, “the war continues to keep up an increased supply.”

  There was more to these numbers, though, than the exodus of immigrant “riff-raff” from the city. Slow but steady changes had been occurring at Bellevue as it progressed from an almshouse appendage to a public hospital. By 1860, its patient base had moved beyond “the worst fed and worst nurtured” to include a fair share of the city’s working classes. Bellevue would retain its primary mission, receiving “only patients who are unable to pay for their care.” But its rules now required the superintendent to weed out those “who feign sickness to enjoy the comforts of a hospital.”

  The Bellevue ledgers of the 1860s give some sense of this change. One study of close to seven hundred nonsurgical patients showed the majority to be young, unmarried Irish immigrants holding down jobs as laborers and domestics. The most common illnesses included phthisis (tuberculosis), pneumonia, diarrhea, and acute alcoholism. About half of these patients would be discharged within two weeks, regardless of the diagnosis. Unlike the almshouse days, almost no one turned a stop at Bellevue into an indefinite stay.

  Titus Coan’s ledgers showed much the same thing. A number of Coan’s admissions included drifters plucked from the city streets—men like “Thomas Rigney, 36, Irish: Went on a spree…Sick to stomach…Hands trembling…Face and eyes have peculiar expression.” But for each Thomas Rigney one finds three or four entries like that of “John Crane, 45, Irish, manual laborer, never sick before, fell from a stone cart, broke right femur.” And “Nicholas Duff, 13, run over by a coal-cart, fracturing his jaw, brain injury.” And “Ellen Cummings, Irish, 52, domestic, had cramp in her leg and fell, fracturing right tibia.” And “Michael Edwards, 19, Irish, cut off finger with an axe while chopping wood.” In Coan’s minute scribble can be traced Bellevue’s evolution from a warehouse for the decrepit to a hospital for the working poor.

  There would be curious exceptions, of course—the society woman badly mangled in a carriage accident, or the mysteriously poisoned financier needing his stomach pumped. And there’d be occasions, even then, of someone famous arriving in a state of unconsciousness and disarray. In the winter of 1863, a thirty-eight-year-old man was rushed to Bellevue from a Bowery flophouse with “injuries accidentally received.” He had come in a police wagon following a fall that split open his head. He would die there three days later, with a few coins in his pocket.

  No one recognized the patient at first, despite the odd notations on his chart. Under the column listing “nativity” was written “Pennsylvania,” not “Ireland,” and for “occupation” the odd word “composer” appeared. The man brought to Bellevue that day, his name spelled incorrectly, was Stephen Foster, the nation’s most popular songwriter.

  A prolific artist, Foster had written hundreds of ballads in his short life, including “Oh! Susanna,” “Jeanie with the Light Brown Hair,” and “My Old Kentucky Home.” His final years were spent in New York City, living alone. It was there, in the back room of a tavern, that he composed “Beautiful Dreamer,” his most memorable song. “What killed Stephen Foster?” his biographer wrote. “Drinking too much and eating too little had reduced him to a medically tenuous state that hemorrhaging exacerbated.” Days before Foster’s death, his brother in Pennsylvania had received this note: “Stephen I am sorry to inform you is lying in Bellevue Hospital in this city very sick. He desires me to ask you to send some pecuniary assistance [and] if possible he would like to see you in person.” By the time Morrison Foster reached Bellevue, Stephen was dead. His body, stuffed under a pile of coffins in the morgue, was claimed just in time to avoid a pauper’s grave—or worse, a medical school anatomy slab.

  The story doesn’t end there. Fifty years later, at a musical gala honoring Foster’s legacy, an elderly man approached a reporter covering the event. “He introduced himself as Dr. John Vance Lauderdale, a retired United States Army surgeon…and said, ‘I was the intern who received Stephen Foster at Bellevue Hospital when he was admitted to the charity ward. I remember it was a bitter winter’s day….I learned by accident that he was a famous songwriter and I said: “This man is a genius and should receive the best of care.” I turned him over to another physician and we did the best we could for him until he died.’ ”

  “Why was the body removed to the morgue to be with the unknown dead?” the reporter asked.

  “Because there was nobody to claim him at the time,” Dr. Lauderdale replied, knowing how close Foster came to a trip to Potter’s Field.

  —

  In the summer of 1863, the Civil War took a decisive turn. At Gettysburg, Union troops under General George E. Meade repelled the Confederate assaults of Robert E. Lee, ending the South’s long-planned invasion of the North. That very day—July 4—came word of the Confederate surrender at Vicksburg, putting Union forces in control of the Mississippi River and splitting the South in two. The toll was enormous: at Gettysburg alone, more than three thousand Union troops were killed and another fifteen thousand wounded—many from New York City. Bellevue would receive 618 men in the weeks following the battle, all badly injured, a surgeon noted, “but for one or two.”

  The victories at Gettysburg and Vicksburg came shortly after Congress passed the National Conscription Act of 1863. With the war in its third year, the Union could no longer count on volunteers to bear the load. Casualties were mounting, and desertions were on the rise. The act required all men between twenty and thirty-five (and single men up to forty-five) to register for the first compulsory draft in the nation’s history—names to be drawn at a public lottery in mid-July. New York City’s quota was a staggering 24,000.

  The Conscription Act fell hardest on the working classes. Among other things, it excused anyone from service who paid a $300 fee or hired an “acceptable substitute” to go in his place. (Those who paid the fee included J. Pierpont Morgan and Theodore Roosevelt, Sr., father of the future president.) For many of the city’s “dollar-a-day” laborers, such exemptions made it “a rich man’s war but a poor man’s fight.” And the timing could hardly have been worse. The Conscription Act coincided with President Lincoln’s recent Emancipation Proclamation, which revived fears among white immigrant workers of a massive slave exodus from the South. Trouble seemed likely, yet there were few federal troops in New York City to maintain order. Most had gone to Gettysburg to join General Meade.

  On July 11, a hostile crowd gathered in midtown Manhattan to watch the lottery. Chanting “Down with the Rich,” volunteer firemen from the Black Joke Engine Company, well known for their racism, charged the building and set it ablaze. What began as a protest against the draft soon engulfed the city in murderous conflict. Long-simmering divisions boiled over: rich against poor; white against black; Catholic against Protestant; immigrant against native-born. Before it ended, five days later, more than a hundred were dead and parts of Manhattan lay in ruins.

  At first, anti-draft sentiment had enjoyed wide public support. But the rioting that followed—what The Irish-American, New York’s largest ethnic newspaper, called “a saturnalia of pillage and violence”—had a strong ethnic tinge. Irish immigrants appeared to dominate the mobs that destroyed the townhouses of the rich, ransacked the better department stores, torched the Colored Orphan Asylum, and lynched dozens of helpless blacks in an orgy of race-based, class-fueled rage. George Templeton Strong described the rioters as a mix of “the lowest Irish day laborers…stalwart young vixens and withered old hags.” Others reluctantly agreed. “There is no denying it!” fumed the New York Tablet, organ of the Catholic archdiocese. “Shame! Shame on such Irishmen; they are a disgrace to the country from which they came.”

  Confronting these mobs first fell to the city’s outmanned
, largely Irish American police force. “New York’s Civil War generated its own fratricide,” wrote one historian. “If many of the rioters were Irish, so were the police who challenged them in hand-to-hand combat.” But it took five thousand federal troops, rushed back from Gettysburg, to finally clear the streets with bayonet charges and field howitzers fired at point-blank range.

  Bellevue, meanwhile, filled up with bodies—some grievously wounded, others dispatched to the morgue. The victims included “Mary Williams, 24, a colored woman, terribly injured while being pursued by the infuriated mob,” and “a colored man, name unknown, whose head was beaten to a jelly, and there is no such thing as recognizing him.” There were mortally wounded policemen (“Peter McIntyre, 34, beaten with an iron pipe”), innocent bystanders (“John Mills, 8, shot through the right eye while looking out the window of his residence”), and scores of street rioters (“Patrick McSweeney, 24, barkeeper, shot in both legs,” “Margaret Mullaney, 28, domestic, shot in the breast,” “John Ennis, 16, plumber, injured by a club to the head”). “A gong has struck again,” a surgeon wrote in his diary, noting Bellevue’s emergency call. “A large [Irishman] is carried up. We visit him. A ball has gone through his body [and] he vomits blood. All we can do won’t save him. We leave him to Father Larkin the priest who will get him to answer a few questions concerning his faith in the Catholic religion. This won’t save him either for time or eternity, I fear.”

  There was irony, no doubt, in treating draft protesters where wounded Union soldiers lay. The surgeon chose his words carefully. Punish the violent lawbreakers, he wrote that evening, but don’t ignore their rage. “I hope the scenes that have been enacted in this city this week will remind [us] that people, no matter how humble, are not to be trifled with. Life is the gift of every man and no one can say to his neighbor that his life is more valuable….All must stand on equal footing….All must be alike.”