Heroines of Mercy Street

by Pamela D. Toler PhD

  Caring for a soldier’s physical needs was often the first step toward caring for his emotional and spiritual needs as well. Many nurses spent evenings in the wards, where they read to soldiers, soothed them to sleep, or listened to their stories. Von Olnhausen told one of her correspondents: “You would be amused to hear me entertaining them in the evening. I go the whole rounds, taking my little campstool, or kneeling by their beds. They all treat me with such confidence. I know all their histories and sorrows; they talk just like I was their mother.”26 Always a night owl, Alcott took the late-night shift once she felt she understood her work. She traveled among her patients, visiting one with “a dressing tray full of rollers, plasters, and pins; another, with books, flowers, games and gossip; a third with teapots, lullabies, consolation and, sometimes, a shroud”27—needed when a patient did not survive the night. Ropes would often hold a troubled man’s hand until he relaxed enough to sleep. These quiet evening moments seemed to sooth the nurses as well as the nursed, as if they needed to time to recognize each man or boy as an individual rather than a medical case. To remember that the patient was a person, not the chest wound in ward B.

  Caring for the person and not just the wound often included helping patients write letters; von Olnhausen claimed that if she had known writing letters for patients would be part of her duties she never would have enlisted.28 Some suffered from broken, wounded, or missing arms that made it impossible to hold a pen, some were too feeble to sit up, and some were illiterate, but they all had things to say. With the help of the nurses they wrote to their wives, parents, pastors, old friends, brothers, sisters, and sweethearts. Sometimes they dictated a letter and added a line in their own hand at the end. Sometimes they struggled to find the words and left the nurse to fill in the blanks for them. They asked for warm socks and apples. They thanked ladies’ aid societies for the comforts they had received and begged family members to come visit. All too often they wrote to say goodbye.

  Nurses of all denominations believed it was important to sit with a dying man. Sometimes they helped him write a will or a farewell message. They bathed his forehead, held his hand, and gave him sips of water. They assured him that the pain would soon be over. When a man wanted prayer, they prayed with him or participated in the last rites alongside the hospital chaplain. Often after a man died, nurses had the hard job of telling family members who arrived too late that their son, brother, or husband was dead.

  The concept of a “good death” was important in mid-nineteenth-century America. Dying words mattered. In some cases they provided an ending to the story of a life, lived well or ill. In other cases, they offered lessons or insights to those who attended the deathbed. Family members gathered around a dying relative not only to give and receive comfort, but also to act as witnesses to the state in which a man died. Nurses often played that role for the men under their care, witnessing their last words on behalf of their families. In one case, von Olnhausen witnessed a soldier’s last words and then invented something better for his grieving parents to hear. “He was the wickedest boy I have ever seen die,” she wrote. She tried hard to make him say a word of farewell for his parents, but he refused. Almost his last breath was an oath. When his parents arrived several days later, his mother longed so much for one word from him that von Olnhausen couldn’t bear it: “I had to invent a bit just to make her a little comfort.”29

  Wicked or heroic, Union or “secesh,” “I never leave a man to sleep or to eat when I think he will soon die,” von Olnhausen wrote. “It seems at least as if a woman ought to close these poor fellow’s eyes; no mother or wife or sister about them. I feel I must be all to them then, and the last words of many dying men have been thanks for what I have done. It is so splendid to be able to do anything for them; I do not lose my interest or enthusiasm one bit. Everybody said, when I first came, ‘Oh, you’ll get over this after a while and be hard just like us,’ but I never can. If possible I feel more than then.”30

  Chapter 7

  Becoming Indispensable

  “The one fault that they find is ‘that I have too much sympathy for the sick’!”

  —Amy Morris Bradley1

  “I have been a ‘female nurse’ since a year ago last October and only regret that I did not go in the beginning when a mistaken humility was all that withheld me… I went with many misgivings—but now I know what women are worth in the hospitals. It is no light thing to hear a man say he owes you his life and then to know that mother, wife, sister or child bless you in their prayers.”

  —Ella Wolcott2

  “I am hearing too many blessings now-a-days from sick and dying men to be in doubt any longer whether or not I am doing good.”

  —Elvira Powers3

  When they first began the job, many Civil War nurses—new to hospital work, uncertain of their skills, and often faced with opposition to their decision to nurse both in the hospital and at home—doubted whether their work was valuable. But over time, as they saw the impact they had on the lives of individual soldiers, they came to believe they were indispensable to the men they served.

  As a group, nurses were committed to caring for soldiers as individuals. They complained that doctors often viewed wounded soldiers as “cases” rather than people, a position Katharine Wormeley described in a letter to her mother, written on May 30, 1862, from the hospital transport ship Knickerbocker: “Squads of civilian doctors are here, waiting about for ‘surgical cases.’ There must be dozens of them doing nothing, and their boats doing nothing,—waiting for a battle. They would not look at a sick man; bless you, he’s not their game! It is ‘cases’ they want.”4

  This fundamental conflict reflected the basic difference in the nature of the work done by the two groups. Military doctors were overburdened by the sheer numbers of wounded soldiers after a battle and could seldom devote more than a few minutes to individual cases. On the battlefield, the surgeons’ first job was “the paralyzing task of sorting the dead from the dying, and the dying from those whose lives might be saved.”5 Amputations in particular depended on speed: tissues had to be cut, bones sawed, and blood vessels tied off in a matter of minutes to minimize a patient’s suffering and maximize his chances of survival. After Gettysburg, by one account, it took three hundred surgeons, many of them civilian volunteers who arrived after the battle, five days to perform the necessary amputations.6 There was no time to think about individuals.

  Even when a new rush of wounded arrived, nurses’ work occurred on a slower and more intimate schedule; they spent time comforting patients as well as tending to their physical ailments. Nurses attached to a specific regiment often had existing relationships with the men they took care of. The first soldier Amy Morris Bradley nursed in the Third Maine Volunteers was a former student of hers. “And now I have got to fill his mother’s place by his bedside,” she told the surgeon, who was also an old friend. In the military’s general hospitals, which took patients from all regiments, nurses developed new relationships with their patients. They often spoke of the men in their wards as their “boys”; reciprocally, wounded men frequently referred to nurses as “mother,” which the younger nurses found difficult until they realized it was an expression of respect. Louisa May Alcott, tending a dying man, was surprised to realize that “to him, as to so many, I was the poor substitute for mother, wife or sister,”7 a realization that changed how she treated the soldiers under her care thereafter.

  Because of this sense of connection, nurses would fight to keep a man alive even after a surgeon pronounced his case hopeless, and celebrate when they won because, as Harriet Foote Hawley put it, “I can’t let them die—If they do a piece of my life goes too.”8 Anne Reading detailed a case in which her sister Jenny saved a patient’s arm with careful nursing after the surgeon decided amputation was required, dressing it three times a day instead of once, burning off the slough, a layer of dead fibrous tissue that separates from a previously clean wound, with nitric acid, and scraping the exposed bone. To her
delight, the soldier not only returned to active service thanks to her efforts, but he was promoted while still in the hospital; “and Jenny had the satisfaction of sewing his first shoulder straps on his uniform,”9 another task performed by a nurse in the absence of mother, wife, or sister.

  Nurses began to define themselves as advocates for patients, a role that both built on and stepped beyond hospital nurses’ traditional duties of dressing wounds, giving medicine, feeding patients, sitting with the seriously ill, and scrubbing wards. As advocates, nurses quarreled with doctors and hospital stewards over details of diet, control over boxes from the ladies’ aid societies, and the very nature of patient treatment. Most saw themselves as promoters of more humane care. Some exposed corruption, greed, and neglect at the risk of losing their positions. At least a few reached the conclusion that they could run the hospital better than those in charge. Katharine Wormeley, after several months with the hospital transport ship program, summed up the feeling of many women who were frustrated by the failures of the system: “I should like to have charge of a hospital now. I could make it march, if only I had hold of some of the administrative power.”10

  Breaking through Red Tape

  The army’s general hospitals stood at the intersection of two overlapping and sometimes contradictory organizational structures: the medical hierarchy of the hospital itself and the larger hierarchy of the army. The volunteer nurses of the Civil War did not fit neatly into either structure.

  In the civilian general hospitals of the 1850s, which were few in number and located only in the largest cities, medical and administrative functions were divided. A panel of visiting physicians and a house staff of doctors provided medical care, assisted by rotating cadres of medical students, while a warden, who reported to the board of directors rather than to the physicians, ran everything else, including hiring and firing nonmedical staff and providing and distributing food and supplies for the wards. A resident matron, who served as the housekeeper for the hospital, reported to the warden and was the immediate supervisor of the female staff, including nurses, cooks, cleaners, and laundresses. Day-to-day care of patients was left to female nurses and male orderlies, none of whom had anything resembling specialized training.

  When the army established its own general hospitals at the beginning of the war, they combined the structure of a civilian general hospital with that of an army post. The chief surgeon held an officer’s rank and functioned as a military commander within the hospital, with authority over both his staff and his patients. He was supported by a ward physician for every seventy-five to one hundred patients and, later in the war, by a handful of medical students working as wound dressers and assistants. Other than the chief surgeon, the most powerful member of the staff was the hospital steward, who filled the same role as the warden in a civilian hospital. The steward was responsible for the condition of the wards, the hospital’s commissary, and the apothecary—a combination that gave him considerable control over the comfort of patients and staff and provided enormous opportunities for black market dealing and other forms of corruption. Stewards exercised their authority in the hospital through ward masters, often convalescent soldiers, who were in charge of the nursing and cleaning in each ward. Male nurses and cooks, who were also usually convalescents, stood below the ward masters in the hospital’s organization.

  Within the larger structure of the military, a general hospital’s chief surgeon reported to the regional medical director. (In the case of Alexandria, the medical director was based in Washington.) Medical directors in turn reported to the surgeon general. Although the chain of command was clear, the relative autonomy of military hospitals created tensions with higher-ranking military officers, who often tried to exercise authority over a general hospital in their vicinity. This problem was common enough that the War Department sent out occasional reminders that the heads of military hospitals reported to the surgeon general; and that they were in charge of both the medical and military operation of their institutions.

  If military hospitals were an anomaly within the military hierarchy, volunteer female nurses were an anomaly within the hierarchy of the hospital: it was as difficult to find their place within the hospital’s structure as it was to find them a place to sleep within the hospital’s walls. Although nursing as a function held a clearly defined place in the military hospital, female nurses’ status as civilians placed them outside the established chain of command, at least in their own minds. In theory, nurses came under the authority of the ward master. But many female nurses were recruited with the expectation that they would hold a position with the moral authority of a traditional hospital matron; they saw their role as supervising not only the male attendants in their ward but the ward master as well. Moreover, those nurses who did not receive a salary for their work often did not consider themselves bound by the hospital’s rules or chain of command. When a ward master “came tripping up” to tell Mary Newcomb that by staying in the ward late to tend to a patient she was violating the chief surgeon’s order that lights had to be extinguished at nine o’clock, she exploded: “You tell that surgeon whoever he is, I will burn just as many lights as I please. I am no hired nurse. I volunteered my service free and there shall be no red tape, but I will break it when humanity demands it.”11

  The willingness to ignore bureaucracy in the name of humanity was a regular theme in Civil War nurses’ interactions with authority. Sometimes nurses broke through army red tape without meaning to, especially when the issue was small and the rule was rigid. Mary Phinney von Olnhausen found herself “always running against some of their rules.” Even when she was in the right she was tempted to say “darn the rules”; between the army and the hospital there were so many regulations she found it hard to keep track of them, and they sometimes seemed designed to keep the work from getting done. 12

  By contrast, women on the transport ships actively encouraged each other to break the rules, including what Katharine Wormeley described as a “prevailing disease” of “kleptomania” among the nurses, who boarded steamers headed back to Washington or Philadelphia and carried off anything they felt could be of use to their patients—pails, essence of beef, sugar, lemons, whiskey, nutmeg graters, corkscrews—on the grounds that “they are going back where they can get more; while to us who remain here such articles are as precious as if they were made of gold.”13 Amanda Akin Stearns, who nursed at Armory Square Hospital in Washington, did not hesitate to order special-diet meals for thirty new patients or give medicine without a prescription when the occasion seemed urgent and no doctor was available, claiming she had “been in the army long enough not to ask questions.”14

  The same disregard for hospital, military, and, occasionally, social rules led nurses to ignore the chain of command altogether when they saw something they felt was not right. In the name of defending their patients, they called on whatever authority was available, up to and including the secretary of war.

  Food Fights

  Hospital food was often the first issue on which nurses spoke up against the established order, perhaps because they were also affected by the quality of the food, and perhaps because they saw cooking as their area of expertise. For the most part women in nineteenth-century America knew more about cooking than the convalescent soldiers pressed into duty in hospital kitchens.

  Nurses’ diaries and memoirs are full of complaints about the quality and monotony of the food that appeared at their table. A month after she arrived at Mansion House Hospital, Mary Phinney von Olnhausen described the lack of variation in the menu:

  Our bill-of-fare has been unvaried from the time we came till now (I mean at the nurses’ table); almost always sour bread, and always the worst possible butter, and coffee that can be imagined (I am speaking of breakfast), with sometimes a bit of tough, overdone steak, often no milk, and sometimes no butter. At dinner invariably worse beef, very much done, sometimes potatoes and sometimes not, and once in a while sweet potatoes, which, you know, I ha
te (but I always claim my share, as I can take it to some poor fellow in my ward), together with, about once a week, a small piece of pie. Twice we have had a change of baked salt pork instead of beef. For supper there are always the same sour bread and butter and such tea; and that is all.15

  Elvira Powers, writing in 1864, soon after the institution of special-diet kitchens, noted that “the usual rations, such as tough army beef, baker’s bread and stale butter, with muddy coffee, served in brown mugs, has been the diet for so long a time that it has ceased to be very palatable.” She went on to suggest that “Northern people, who think that all Government employees fatten on commissary stores, ought to see the table which is set at this hospital. It is exceedingly plain; and it sometimes requires more moral courage than all are very long capable of exercising to inhale the odor” of the delicate foods produced by the special-diet kitchens “or daily to deal out jellys, blanc-mange and canned fruit without ever tasting.”16 Louisa May Alcott too complained the three meals each day were “pretty much of a muchness” and argued that “variety being the spice of life, a small pinch of the article would have been appreciated by the hungry, hard-working sisterhood.”17 The absence of edible butter was a particular sore spot; Powers jokingly requested someone “make a raid and capture a dairy—milkmaid and all.”18

  Food that was unappealing to nurses could be literally deadly for patients, particularly those suffering from gastrointestinal diseases such as cholera, dysentery, or typhoid. A typical midday full-diet meal, served to active duty soldiers, convalescents, and nurses, would be pork and beans and bread pudding, or the monotonous round of army beef, bread, and stale butter described by von Olnhausen and Powers. Sick patients on half-diet would be served mutton soup with meat, boiled potatoes, and bread. (Desperate for a little variety, von Olnhausen once begged the cook to give her a little mutton soup. He grumbled, saying that the soup was only for the patients, not the nurses; then he gave her a bowl. When she tasted it she thought it wasn’t even good enough to serve to the well, let alone to the sick, with their capricious appetites and delicate digestions.19) Those so sick that they required the low or special diet would dine on cooked wheat cereal and bread, if they could bring themselves to eat at all. Fruit and vegetables were rarely on the menu except in those hospitals that maintained kitchen gardens during the growing season.