The Confederates’ General Robert E. Lee saw an opportunity following the defeat of McClellan in the Peninsula Campaign. McClellan’s Army of the Potomac had been shredded and demoralized, leaving it undermanned and undersupplied on the eastern tip of Virginia. Not far away, General John Pope’s Army of Virginia near the Rapidan and Rappahannock Rivers appeared vulnerable. Lee’s Army of Northern Virginia near Manassas needed to attack Pope before McClellan could reinforce his army. As McClellan executed Halleck’s order and commanded that two of his corps join Pope thirteen months after the first Union army defeat at Bull Run, Lee positioned his army for a second assault against a Union army over the same ground.
Confederate strategy again forced the Union army to react rather than attack. On August 28, approximately 25,000 Confederate soldiers under the command of General Thomas “Stonewall” Jackson completed a fifty-four-mile march that flanked Pope’s army and cut off his supply and communications lines. Pope reacted, marching his force in search of Jackson. On the night of August 28, Jackson had his troops ready to ambush Pope’s force, while a second Confederate force of 25,000 commanded by General John Longstreet was poised to attack the Union army as well.
The armies collided near dusk. Thousands of soldiers unleashed artillery and small arms fire sometimes only seventy yards apart. Lead tore into men, producing horrific casualties. When darkness stilled the fighting, one brigade had lost 40 percent of its men and another, the 2nd Wisconsin, lost 50 percent.
The following day the Confederates’ firepower, coupled with General Pope’s poor strategy and vague communications, proved deadly for the Union army. Pope’s plan to launch a pincer attack on the Confederates dissolved into chaos when Union army units were placed in the wrong position, flanking attacks failed to materialize, and the Confederates launched furious, continuous fire for more than nine hours. A massive flanking attack by Pope in late afternoon proved disastrous by leaving some of his troops unprotected. General Longstreet counterattacked with 30,000 fresh men, destroying exposed Union army units. In ten minutes of fighting, the 5th New York lost nearly half its men. By midnight, the Union army had again retreated at Bull Run, heading back to the familiar defensive line near Washington. They had left nearly 10,000 men dead, wounded, or captured by the Confederates.
Only the Army of the Potomac’s corps that had been briefly trained by Letterman had any sense of battlefield care at Bull Run. While its level of battlefield evacuation was superior to the remainder of Pope’s medical department, they, too, were crippled by minimal supplies and poor medical department leadership. Some of the Army of the Potomac’s divisions had no ambulances, and the entire corps had about one-fourth of the 170 needed ambulances: “the ambulances with their equipments (sic) were left behind to be sent after the troops as vessels could be spared for that purpose. A large portion of the medical supplies were also left behind, and, in some cases, everything but the hospital knapsacks, by orders of colonels of regiments, quartermasters, and others; in some instances without the knowledge of the medical officers, in others notwithstanding their protest. It would appear that many officers consider medical supplies to be the least important in an army; the transportation of their baggage is of much more pressing necessity than the supplies for the wounded,” a frustrated Letterman later wrote.22
Army of Virginia medical director Thomas McParlin’s decision to establish the main military hospital seven miles away from the worst fighting exacerbated the lack of ambulances.23 Too few supplies, not enough ambulances, and the remoteness of the battle’s principal hospital forced army surgeons to leave thousands of wounded men on the battlefield.
Meanwhile, Letterman had returned to Washington and to new sources of frustration: a paucity of surgeons and inadequate hospital capacity. Fully occupied city hospitals had no room for the torrent of Bull Run casualties that would flow into Washington. As reports from Bull Run arrived, he searched for surgeons to ride the bloody battlefield that remained littered with nearly 3,000 wounded men three days after the fighting had stopped. Meanwhile, Surgeon General Hammond procured 200 private carriages and wagons to ferry critically needed medical supplies to Bull Run. But that proved bittersweet, as many private contractors driving the wagons stole the supplies, refused to pick up some of the wounded, and sometimes stole from those they loaded onto their wagons.24 One wagon train departed Washington with 200 vehicles. “About daybreak on Sunday Fairfax Courthouse was reached, in a heavy rain. The road from here on was filled with troops, artillery, wagons, ambulances, and stragglers. When the column struggled up the Centreville hill there remained but sixteen of the vehicles that had started. Some had broken down, the horses of others had given out, many had escaped from the line and returned to Washington on Monday.”25
Frustration and anger mounted in the days following the battle as rumors of patient care that bordered on neglect for lack of advance preparation. Dispassionate reports from medical officers bore witness to the suffering. “I was not attached to any organization and nobody gave me orders; but as I found in the little church in Centreville one hundred wounded men who needed attention, I saw my duty well marked out. All these men were severely wounded, for slightly wounded marched away with the army. Upon a few mattresses, and with almost no other conveniences or comforts, the men were laid in rows upon the floor. Most of them had, in fact, not even a mattress, but only a little straw under them,” wrote medical officer W.W. Keen. “The third day after the battle I passed such a night as I had never before experienced in my life. Long trains of ambulances arrived, carrying wounded men from the field of battle back to Washington, and there were but four surgeons to look after them and their many imperious needs. Fifty poor thirsty fellows were crying for water; fifty more were crying with the pain from a jolting ride of nine miles over a corduroy road. Most of them had had nothing to eat for one, two, or three days, save for what they had obtained from haversacks of the dead,” wrote another surgeon.26
Hammond grew livid with Secretary of War Stanton, writing, “Up to this date (Sept. 3), six hundred wounded men still remain on the battlefield, in consequence of an insufficiency of ambulances and the want of a proper system of regulating their removal in the Army of the Virginia. Many have died of starvation; many more will die in consequence of exhaustion, and all have endured torments which might have been avoided.”27 It wasn’t until September 7, a week after the fighting had ended, that the last of the wounded Union soldiers had been evacuated off the battlefield. Jonathan Letterman’s barely established ambulance system saved hundreds of wounded soldiers in the two corps that had been transferred from the Army of the Potomac to Pope’s command. It came too late to save thousands more who were left stranded on the battlefield and then faced a primitive, undersupplied field hospital organization that, in fact, was not organized at all.
By that time, President Lincoln had fired General Pope and returned command of the once again consolidated Army of the Potomac to McClellan, over the objections of some of his cabinet members, including Secretary of War Stanton. McClellan’s popularity with his troops made him the president’s choice. But the selection left Lincoln with an army’s commanding general who didn’t have the confidence of the cabinet or the War Department. His surgeon general bickered with both the quartermaster general and the secretary of war. Meanwhile, a highly visible Sanitary Commission pressed its public campaign for continued reform of battlefield care. The Union army command lacked cohesion at a time when rumors of a Confederate invasion into Maryland and a possible attack on Washington abounded.
Letterman took medical command at what some historians consider the Union’s low point in the Civil War. Crushing early defeats had destroyed any illusions of a hasty end to the fighting. There had already been more battlefield casualties than those suffered in the entire history of the nation up until the attack on Fort Sumter. Reports of abandonment, neglect, and nearstarvation suffered by wounded soldiers horrified civilians. No one had imagined such human devastation. Few had
the intellectual capacity to determine how to cope with the new battlefield reality. Military outpost medicine had to be abandoned and an entirely new approach to combat care had to be forged simultaneously on the march, at the highest levels of government, and within the civilian community. It had to be completed almost immediately, as massive clashes of armies on the battlefield would not wait for thoughtful deliberation, discussion, and then implementation.
Against this backdrop, Jonathan Letterman resumed medical command of the Army of the Potomac on September 2. He wrote: “I found it in a deplorable condition. The officers were worn out by the excessive and harassing labors they had undergone during the time they were attached to the Army of Virginia. A large portion of their supplies had been left behind, as I have said, at Fortress Monroe, and even much of what they had brought was thrown away by commanding officers when on the way to join General Pope. The labor expended at Harrison’s Landing in rendering this Department efficient for active service, seemed to have been expended in vain, and required to be completely refitted before it would be again in proper condition.”28
Beginning in July, Letterman had begun to fundamentally overhaul battlefield care and had laid that foundation in less than a month. But in the ensuing thirty-one days that he and McClellan did not have command of the Army of the Potomac, much of the progress had been gutted.
Only three days after they returned to command, the Army of the Potomac marched out of Washington toward new army headquarters at Rockville, Maryland, fifteen miles northwest of the capital. The army’s mission again was to stop a feared invasion of the north by General Lee, an assault that some thought could reach as far as Philadelphia, Boston, or New York City. For hours the army’s march out of the city passed the front door of General McClellan’s house, instead of following a route past the White House according to common practice. While McClellan once again propped up his command at the expense of his commander in chief, Letterman prepared for battle by ordering ambulances from Alexandria. He also ordered supplies from the medical purveyor in Baltimore, although “[i]t was impossible at that time to know where the proper place to direct them to be sent.”29 Those decisions would have to be made in a two-story brick farmhouse in the rolling hills of Maryland.
5
ANTIETAM
“I pray God may stop such infernal work.”
Lieutenant Thomas Jefferson Spurr’s legs seemed to evaporate when the Minie ball slammed into his thigh. He fell in the shadow of where he stood, exposed to the enemy on a small hill overlooking a fenced cornfield. Initial numbness gave way to searing pain. As his blood soaked the ground, he waved off his rescuers. “Do not stay for me,” he told them. “Take care of yourselves.”1
The 15th Massachusetts Volunteers retreated as the Confederates advanced on Spurr. Gunfire and artillery ripped through men as they sought cover among the cornstalks and in shredded stands of nearby trees. More than 300 men fell wounded or dead. Within twenty minutes, enemy fire destroyed more than half of Spurr’s regiment.
For more than three hours, bitter fighting had raged on September 17, pitting more than 90,000 Confederate and Union soldiers against each other in rolling western Maryland farm country, bordered by the Potomac River in the west and South Mountain to the east. Jonathan Letterman had been given two weeks to prepare for the first major battle of his military career and one of the most horrific battles of the Civil War. Thomas Spurr became one of thousands of wounded men whose lives depended on a fledgling battlefield medicine system Letterman had yet to complete.
Letterman had been as shocked as he was discouraged when he had resumed medical command of the Army of the Potomac on September 2. The progress he had made in his first two months as medical director—when he began to fundamentally overhaul battlefield care with an ambulance system that replaced the former haphazard approach—had been largely gutted. He barely had time to assess the damage before the Army of the Potomac received new orders. Four days later, on September 6, lead elements of the Army of the Potomac marched out of Washington. They headed for Frederick, Maryland, a regional hub of 8,000 residents, that advance units of General Lee’s invading Army of Northern Virginia had already reached.
The Frederick residents, some of them sympathetic to the South, had known for two days that Lee’s troops were approaching. They evacuated 398 patients to hospitals in York, Pennsylvania, and in the streets burned bulk supplies that could not be moved out of town. The fires still smoldered when 5,000 men commanded by General Stonewall Jackson marched down Patrick Street in Frederick.
As Letterman confronted a disorganized medical department on the march, he also had to assimilate the medical personnel of thirty-six newly formed state regiments of volunteers that were now part of the Army of the Potomac. Those regiments’ medical personnel were wholly untrained in military medicine, and many held a “my state” philosophy of treating their regiment’s wounded first and sometimes exclusively. Making matters worse, McClellan’s army moved northwest across a twenty-mile front toward Lee’s troops. Warm, dry weather created a hot, dusty march and stragglers, especially in the new regiments, soon became a major problem. By September 11, the army was within six miles of Frederick.
Letterman could not train an expanded medical department on the move. Nor was it possible to scout and establish hospitals in the absence of a known battlefield. That left one priority that he could address: supplies. He wasted no time. “I had ordered a number of ‘hospital wagons’ from Alexandria, Virginia, which reached me after we left Washington, and were at once distributed to different corps. While at Rockville, Maryland, I directed the Medical Purveyor at Baltimore to put up certain supplies and have them ready to send to such place as I should indicate. It was impossible at that time to know where the proper place to direct them to be sent,” Letterman wrote.2 Meanwhile, he was hamstrung by the illness of McClellan’s chief quartermaster, Rufus Ingalls, which delayed the arrival of nearly 5,000 horses, more than 200 wagons, and 100 ambulances.3 The sole good news he received on the march was the arrival of 200 wagons after he reached Rockville.
As Letterman assembled supplies for an unidentified battlefield, his commanding general did him no favor with his estimate of enemy strength and, by extrapolation, potential numbers of Union wounded. As a matter of routine, McClellan vastly overestimated the strength of his foe. Some officers derisively commented that McClellan “tended to see double.” McClellan thought his 80,000-man army was marching toward a Confederate force of nearly 125,000. Based on casualty rates in earlier battles, if McClellan’s estimate proved accurate Letterman had to plan for an unprecedented number of wounded men. The high end of McClellan’s estimate envisioned a massive clash of perhaps 200,000 soldiers from both sides.
As the Army of the Potomac neared Frederick, Lee ordered a withdrawal from the town, ceding the strategic location to McClellan. Frederick was located along Monocacy River, a generally shallow creek lined with trees. The national pike and a railroad made it a natural army headquarters location. Recognizing that, the Rebels destroyed the railroad bridge over Monocacy River before they departed, severing the critical railroad supply line from Frederick east to Baltimore. Unbeknownst to Letterman at the time, that single act nearly a week before battle would prove to be a tremendously complicating factor in his plan to treat the wounded.
When the Army of the Potomac reached Frederick on September 12, Letterman brought medical supplies forward. The bulk of Lee’s troops remained less than twenty miles away in Hagerstown, near Harpers Ferry and on South Mountain, still in Maryland, and generally northeast of the meandering Potomac River, which separated Maryland from the South. Battle loomed. It became clear that Frederick would be a central staging area, regardless of where the battle took place.
“I directed the establishment of hospitals in that city (Frederick) for the wounded in battles which were imminent— ordered the supplies to be sent from Baltimore, and sent for a large amount of articles, in addition, for the field and hospital
s,” wrote Letterman.4 He ordered the conversion of thirty-four buildings, often redbrick churches and inns, into hospitals. Most featured wide, double doors that provided good access for the wounded, open space on the ground floor for maximum capacity, and tall windows for added light to help with surgeries and treatment.
They were organized into seven general hospitals, augmented by some homes that would be used for patient care and two tent hospitals. In Frederick, many were concentrated along and near Church Street. All were within a town about twelve blocks wide, making it easier for Letterman to efficiently supply them.
McClellan arrived in Frederick at 9:00 a.m. on September 13. Although frequently faulty intelligence plagued the general and affected Letterman’s plans, about two hours after McClellan’s arrival he received irrefutable evidence of his enemy’s intent. Corporal Baron Mitchell had found an envelope in a meadow. It held an official-looking document wrapped around three cigars. The heading read “Hd Qrs Army of Northern VA Special Orders No 191.” General Lee’s chief of staff had signed it. Although it did not detail troop strength, it contained his army’s plan to capture nearby Harpers Ferry and seize its supplies. It was a remarkable find that gave McClellan invaluable intelligence on Lee’s intentions as well as his troop deployment in western Maryland.
Letterman’s attention, however, was directed to the rear. A massive traffic jam had developed on the railroad line that stopped at the destroyed bridge south of Frederick. Everything had to be loaded into wagons for the final four miles. In some cases, medical supplies were near the rear of a twenty-mile backup of railroad cars, more than a third of the distance back to Baltimore. While Letterman prepared for the medical needs of an 80,000-man army about to engage in battle, critical supplies languished in trapped railroad cars.
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