Surgeon In Blue

by Scott McGaugh

  Letterman’s medical duties at Fort Ripley were typical of military outpost medicine in the 1850s. He examined newly arrived recruits, managed the one-room cabin called a hospital, and recorded weather and geographical features of the region at the direction of the surgeon general. Weather observations had been standardized among all outposts. Letterman kept a weather log filled with daily readings taken at sunrise, 9:00 a.m., 3:00 p.m., and 9:00 p.m.22

  He treated disease with limited resources under primitive conditions, which led to relapses and sometimes permanent disability. Every army outpost doctor faced the same. “Intermittent fever is a subject of much interest to the army medical officer, inasmuch it is encountered at every step of the progress. He has to deal with the disease under circumstances hostile to his remedial means; for his patients have frequently only the shelter of a tent from the chill night air and the burning sun, and their continuance in unhealthy positions, which for military reasons, cannot be abandoned, subjects them to the continued influence of the cause of the very disease he is attempting to cure; hence the liability to relapses and fresh attacks, which prove so harassing to the surgeon, and, occasionally, so ruinous to the health of the soldier,” wrote Assistant Surgeon Robert Southgate in 1853. “Soldiers, as a class are proverbially reckless. Although warned, when returned to duty, against throwing themselves into currents of fresh air after having been heated by drill or other military duty, I have known relapses repeatedly induced by such exposure. An hour’s exposure in the ardent rays of the sun, in the passive amusement of fishing, has repeatedly brought back to the hospital soldiers who, a few days before, were returned to duty in perfect health.”23

  Letterman spent one winter at Fort Ripley before the army transferred him to the Department of New Mexico. He traveled down the Mississippi by steamer in April 1854 and disembarked at St. Louis. He then took an overland route to Fort Leavenworth, Kansas, where, on July 1, he joined troops on a march toward the southwest, and reported for duty in Albuquerque on September 6. There he received orders for Fort Defiance in northeastern Arizona. He reported for duty there on September 20.24

  Letterman had never seen anything like the region of Fort Defiance. A high, desert sun baked the soil chalk dry. Naked, red ridges and crumbling mesas alternated with deep arroyos and canyons. Dense stands of trees in sandy riverbed bottoms revealed a reachable subsurface water table and the course of seasonal flash floods. Ancient lava flows hundreds of feet thick and sometimes nearly a mile wide sat frozen on a long-ago course of their choice. Dry, bone-chilling winter cold gave way to dusty spring winds. Summer baked everything to the horizon, briefly punctuated by towering, smoke-gray thunderstorms that pounded the parched desert along their paths.

  At the outbreak of the Mexican War in 1846, the army had sent a detachment from Fort Leavenworth to seize control of the New Mexico territory. Colonel Stephen Kearny met no meaningful resistance. Following the war, the army established Fort Union near Santa Fe in 1851, and in the same year Colonel Edwin Sumner founded Fort Defiance in the heart of territory long occupied by the Navajo. The outpost had been built on the southern slope of the Chuska Mountains at an elevation of nearly seven thousand feet, about one mile west of the present Arizona–New Mexico border and about eighty miles south of the Four Corners region.25

  When Letterman arrived in 1854, a rough collection of buildings formed Fort Defiance, at the mouth to Quartzite Canyon. Five enlisted men’s barracks on the east and west sides of the parade ground each measured one hundred long by twenty feet wide. Officers on the north side lived in two-room quarters that included a small kitchen. The post also comprised storerooms, a guard house, a shop, and a hospital the same size as an enlisted barrack. Log buildings with sod roofs failed to block northeastern Arizona’s cold winds.26

  Once again Letterman found harsh conditions. During the heat of summer, monsoon rains from late June to September made all but a few well-worn paths impassable. Pine, pinon, scrub oak, and scrub cedar were in sparse supply, and there was little grazing for the horses. The troops lived in poorly ventilated barracks and suffered from a variety of respiratory ailments. A deficient diet often led to additional medical issues. Scurvy, a preventable vitamin C deficiency, sickened many men.

  Scurvy surfaced seasonally at many military outposts in locations where the soil was too poor for vegetable gardens and too remote for a steady supply of fresh produce from regional supply depots. The symptoms included fatigue, nausea, bleeding gums, loosened teeth, generalized aches, slow-healing wounds, and internal bleeding into muscles and joints.

  Long before Letterman had joined the army, its first surgeon general, Joseph Lovell, had considered the army-sanctioned diet that emphasized meat to be a major cause for concern. The daily food ration included twenty ounces of beef and twelve ounces of pork, about a third of a pint of whiskey, and no daily requirement for fruits or vegetables. Usually soldiers found themselves cooking for the first time in their lives. They tended to overboil the beef, which destroyed its nutrients, while the salt pork was eaten raw. Some soldiers drank diluted whiskey with meals for weeks at a time instead of water or coffee. Lovell had advocated less meat and more vegetables (in soups), molasses or beer instead of liquor, and more bread. Attempts at supplying barely edible dried vegetables were met with disdain by the troops. In the Southwest, edible native plants rich in vitamin C offered an alternative. They included pokeweed, prickly pear cactus, and wild onion.27

  Other outposts were less fortunate. When Fort Laramie assistant surgeon Edward Jones requisitioned vegetables, the army’s commissary department replied, “Attempts have on several occasions have been made by this department to forward potatoes, fresh, to Fort Laramie from Fort Leavenworth, but the loss and decay has been so great as to make the expense for the benefit conferred, very heavy. On this occasion it was deemed less necessary, as that post was liberally supplied with desiccated mixed vegetables, and desiccated potatoes.”28

  While Letterman monitored his troops’ diet at Fort Defiance, his former medical school classmate, William Hammond, conducted dietary experiments on himself while stationed at Fort Riley, Kansas. Hammond published a paper on the results that received an award from the American Medical Association. The deleterious effects of self-experimentation and national recognition earned him a leave of absence to recuperate and study with one of the nation’s leading medical scientists, Silas Wier Mitchell, in Philadelphia.29 Hammond, a physician of insatiable curiosity, boundless ego, and a willingness to challenge conventional thought, had taken the first step on a path that would lead him to becoming the army’s surgeon general and to a close relationship with Letterman during the Civil War.

  The variable desert weather affected troop health as well. January sunrise temperatures in the twenties were common, while summer heat routinely rose into the nineties. For the third consecutive post, Letterman’s troops suffered from record-breaking winter cold. On December 25, 1855, the temperature sank to thirty-two degrees below zero, and the winter of 1855–1856 became one of the most severe in recent memory, according to the Navajos who lived in huts made of branches and twigs or in caves among the rocky outcrops.30

  The Navajos did not impress Letterman. As at all military outposts, medical officer responsibilities included written reports on the region’s local population. Although the Navajos got along well with the Fort Defiance troops, selling them peaches in August, “Like all Indians, they will not work more than is necessary for subsistence. . . . They are, however, industrious beggars,” wrote Letterman. “Theft and mendacity are common vices. The habit of stealing is so common, that they will appropriate to themselves whatever they can lay their hands on, whether of any use or not, such as door-knobs and keys.”31

  In May 1857, Letterman marched with Colonel William Loring on an expedition into the Mogollon Mountains in southwestern New Mexico to capture renegade Mogollon Apaches who were suspected of kidnapping Indian agent Henry Dodge. Originally educated as a lawyer (he had practiced law i
n Florida), Loring had been wounded three times in the Mexican-American War and had lost an arm. During the California gold rush, he had taken command of the Oregon Territory before being assigned to a series of military outposts, including Fort Union. He favored long hair that curled over his ears and a mustache wrapping around his mouth and merging into a narrow beard covering his chin and hanging down in front of his throat. The one-armed veteran had become noted for his aggressive attacks against an enemy. The year before, at the age of thirtyeight, Loring had become the youngest colonel in the army.

  Loring’s expedition could not find the Mogollon Apaches but crossed paths with a band of Mimbres Apaches who were herding two thousand stolen sheep into deep canyons formed by vertical red cliffs. Loring tracked them into a particularly rocky canyon. Rifle fire echoed between the canyon’s walls when Loring’s soldiers ambushed the Indians on May 24, 1857. A number of Indians fell dead as warriors launched arrows up into the expedition’s elevated positions. Several soldiers were wounded before the Indians abandoned the herd, leaving their chief, Cuchillo Negro, and six others lying dead among the scattered sheep.

  Letterman treated the soldiers who suffered arrow wounds in the battle. The procedure was usually as follows: the surgeon would stick his finger into the wound along the shaft to find the arrowhead and then use long forceps to yank the arrowhead out. While that procedure might avoid blood poisoning, an infected wound almost inevitably resulted. Wound treatment at the time generally left the wounds open, which extended the healing process.

  The Loring expedition returned in September to Fort Union, New Mexico, where Letterman became that post’s medical officer. Loring was so impressed with him that in a letter to a friend years later he described him as responsive and professional, qualities that endeared him to fellow soldiers, and wrote: “I never knew an officer who was all the time more ready to act at the call of duty; full of many sympathies, he was ever ready to render timely aid to the suffering, whether at the summons of an officer or the call of a private soldier.” He concluded that Letterman was “an ardent student” in quest of “the highest knowledge in the scientific advancement of his profession.”32

  Once more Letterman confronted the challenge of maintaining the health of soldiers stationed at a poorly built, exposed, and crumbling military outpost. Fort Union was located in the barren Mora Valley east of Santa Fe, near the junction of the Cimarron and Mountain branches of the Santa Fe Trail. It sat at the edge of the plains in a sea of gamma grass at an elevation of nearly 6,700 feet. The nearest source of timber was seven miles away, and the Mora River flowed five miles from the outpost.33 Its singular strategic value lay in protecting caravans on the Santa Fe Trail as they passed through Southern Ute and Apache land in the north as well as Comanche and Kiowa land on the plains.

  The assistant surgeon wasn’t surprised by Fort Union’s dilapidated condition. A year earlier, in 1856, Letterman had inspected the collection of more than two dozen buildings made of pine and adobe. He had submitted a particularly critical sanitary report on the outpost, which had been built five years earlier and housed a fighting force of about 160 men. “Unseasoned, unhewn, and unbarked pine logs, placed upright in some and horizontally in other houses . . . and as a necessary consequence are rapidly decaying. . . . The unbarked logs afford excellent hiding places for that annoying and disgusting insect the cimex lectaularius (bedbug), so common in this country . . . the men almost universally sleep in the open air when the weather will permit.”The hospital was in worse condition. “The building at present used as a hospital, having a dirt roof, has not a room which remained dry during the rain in the later part of September last, and I was obliged to use tents and canvas to protect the property from damage.” Letterman recommended that the entire military post be rebuilt.34

  Fort Union was another post where the troops’ diet concerned him. Lack of reliable irrigation and grasshopper infestations that ravaged the prairie limited the post’s ability to grow vegetables and other crops. “Extra issues of pickles, etc., from time to time, were deemed necessary for the health of the troops who were liable at any time to be called upon for hard service,” wrote Letterman.35

  He left Fort Union on September 15, 1858, when he accompanied the outpost’s sick commanding officer, Brigadier General John Garland, to St. Louis along with a small contingent of officers and five mounted riflemen. For the second time in eight years’ service Letterman received a leave of absence for several months. He visited colleagues in Baltimore and Philadelphia. Two years later the army assigned one thousand men to demolish and rebuild Fort Union.

  Letterman reported for duty at Fort Monroe, Virginia, on March 24, 1859. A few months short of his tenth anniversary in the military, in mid-April, the army promoted him major at a fort that later would play a prominent role during the Civil War, in the region bounded by the Confederacy’s capital in Richmond and Washington. Its strategic location on the Virginia peninsula where the James and York Rivers empty into the Atlantic made it an ideal staging area for the Union’s Army of the Potomac to guard against Confederate incursions toward Chesapeake Bay and attacks against Washington. Surrounded by a moat, it was the largest fort in the country. Many called it the “Gibraltar of the Chesapeake.”36

  Letterman spent a few months at Fort Monroe before he was transferred to the army’s medical purveyor’s office in New York City. That assignment lasted only four months, and at the end of the year Letterman again rode west, this time to California. In February 1860, he reported for duty at Fort Tejon, a military outpost in the foothills north of Los Angeles.

  The collection of adobe buildings that formed Fort Tejon was located near Tejon Pass in Southern California’s Tehachapi Mountains at the top of Grapevine Canyon. It had been built in 1854 in the heart of territory occupied by Chumash Indians. Poppies, lupines, and goldfields carpeted rolling hillsides in the spring, while native grasses and dense copses of oak dominated the landscape. Despite the semi-arid climate, bears prowled Fort Tejon’s reliable mountain-fed stream. Its benign climate was considerably more pleasant than Florida’s summers and Minnesota’s winters. It was by far Letterman’s most comfortable assignment after more than ten years of military service.

  Like many of the posts where Letterman had served as the sole medical officer, Fort Tejon was relatively small, typically housing about two hundred men. In 1858, Fort Tejon had become a stop on an overland stage route stretching from California to St. Louis. It also was located along a major trail used by gold prospectors headed for the Sierras. Telegraph lines soon reached Fort Tejon, connecting the fort to the East Coast. Fort Tejon was one of the least-isolated outposts in Letterman’s pre– Civil War career.

  Two months after Letterman’s arrival, Major James Henry Carleton mounted an expedition to the east against the Paiute Indians in California’s Mojave Desert. The son of a ship captain had joined the army in 1838. After serving at a number of Great Plains outposts, he arrived at Fort Tejon in early 1858 with several hundred new recruits. His eyes radiated intensity, matching his zealous disciplinary demeanor. Carleton had demonstrated a particular brutality against Native Americans, and he intended to punish the Indians who allegedly had been attacking travelers on the road between Salt Lake and Los Angeles.

  Widely scattered apricot mallow, lilac sunbonnet, and prickly poppy blooms dotted the Mojave Desert when Letterman accompanied Carleton’s troops on the weeklong, 170-mile march to the Mojave River, near present-day Barstow.37 Fine dust floating in their wake marked the progress of their column of horses and wagons along the nomadic Indian trails that connected the Colorado River and the Pacific Ocean. Letterman crossed salt marshes and skirted low hills dotted with sagebrush, creosote bush, and yucca as the desert grew more barren as the expedition headed east. Cottonwoods and clouds of insects marked where the river cut between heavy sand and gravel ridges that stretched to the horizon.

  Upon arrival, the expedition built a crude camp, mostly comprised of dugouts carved out of
the desert sand and covered with brush and wet mud that passed for adobe. A square five-foot-high perimeter wall, forty feet long on each side, protected the temporary camp. Shortly afterward, Carleton dispatched patrols in search of Paiutes in the area, apparently with little regard to whether they had been involved in the reported attacks. On April 19, Second Lieutenant B. F. Davis’s patrol found two Paiutes hunting game. On orders by Davis, the troops charged, firing their weapons. The Paiutes’ meager return fire of arrows wounded two soldiers. Soldiers carried the wounded men twelve miles back to Camp Cady for Letterman’s treatment. “In the affray, two men were seriously wounded, one in the neck and one in the abdomen, by Indians. . . . Both were doing well, but the one wounded in the abdomen is not out of danger yet,” wrote Letterman.38 It became the last documented instance in which Letterman treated “combat” casualties before the outbreak of the Civil War.

  Carleton’s patrols searching for the Paiutes continued for weeks, sometimes covering as much as thirty miles a day in the Mojave Desert whose summer temperatures routinely stayed above one hundred degrees. One group covered more than three hundred miles of desert before returning to the camp. By the end of June, Carleton convinced himself the road to Los Angeles had become safe. His troops left Camp Cady on July 3 and returned to Fort Tejon.

  Letterman spent an uneventful eleven months at Fort Tejon before transferring on June 21, 1861, to Camp Fitzgerald, a training post in present-day Los Angeles that was hampered by too little water or forage for the army’s horses. He arrived in a time of uncertainty within the military medical corps. One month earlier Surgeon General Thomas Lawson had died. By the time the Confederates attacked and seized Fort Sumter in the Charleston, South Carolina, harbor on April 12, 1861, he was old and sick. He succumbed less than six weeks after the start of the Civil War.