Surgeon In Blue

by Scott McGaugh

  After two days of fighting, 12,000 wounded men had become the responsibility of Letterman’s medical corps.6 More than five thousand had been wounded in the wheat field and peach orchard.7 That night, flickering ambulance lanterns cast a dancing, ghostly glow across the battlefield as crews collected the wounded and took them to more than 100 temporary hospitals that had been established in farmhouses and barns and along creeks. Within six hours after the fighting had stopped, nearly all of the wounded not in enemy territory had been collected by the ambulance corps and regiment volunteers, who braved enemy fire while searching for the injured soldiers.

  With one exception, a lack of supplies had plagued Letterman’s surgeons throughout two days of fighting. Only the Twelfth Corps remained in good shape, because its medical director, John McNulty, had disregarded the army’s standing order of leaving medical supplies in the rear prior to battle and had retained his full complement. As a result, McNulty gathered and treated all his wounded within six hours after the fighting stopped and performed all necessary operations within twenty-four hours.

  Although Letterman’s supplies remained largely confined to Westminster, supply wagons from the Sanitary Commission and Christian Commission originating in Frederick had skirted the worst of the fighting throughout the day in search of Letterman’s hospitals. The First, Second, Third, Fifth, Eleventh, and Twelfth Corps all benefitted from Sanitary Commission wagons delivering brandy, beef soup, sponges, chloroform, lint, and bandages. “U.S. SAN. COM.” became a welcome sign on the side of a wagon rolling to a stop in front of a barn filled with wounded, dehydrated, and hungry men.8

  Letterman’s corps and division medical officers had established hospitals while on the move throughout the day. As battle lines shifted, seemingly safe locations became vulnerable to enemy artillery fire. As the Army of the Potomac’s position gradually became more concentrated, Letterman’s relocated hospitals were squeezed into a more confined area, inside a triangle formed by Emmitsburg Road approaching Gettysburg from the southwest and the Baltimore Pike approaching Gettysburg from the southeast. Six corps hospitals were located within the triangle, four of them alongside the winding Rock Creek. Fresh water was a requisite for any field hospital. Although, close together like this, the hospitals were easier to supply, they also became vulnerable en masse if the Confederates broke through the Union line defending them.

  Nearly every major farm inside the triangle was turned into a hospital. Commandeered by Eleventh Corps medical officers, George Spangler’s farm was typical. The massive, “Pennsylvania Bank Barn” was cut into a hillside, creating a ground-level entrance on the low side and a second-story entrance on the uphill side. The smells of manure, straw, and dust soon mixed with those of open wounds and lacerated bellies. About 150 men lay side by side inside the barn, with more than 1,000 a few yards away in tents and unprotected in farm fields.

  Despite suffering nearly 12,000 casualties over two days, Lee decided to launch one final assault against Meade on July 3. This time Lee would amass more than 12,000 men opposite the center of Meade’s army, pummel Meade’s men with approximately 150 pieces of artillery, and then stampede the Union line, shoulder to shoulder and on foot. A desperate tactic by a frequently aggressive general, it was certain to produce prodigious numbers of casualties on both sides. Lee turned to General Longstreet to lead the all-or-nothing charge.

  The temperature reached eighty-seven degrees with 70 percent humidity early in the afternoon of July 3. Pale gray clouds massed to the west as Union units waited along sunken roads, in creek beds, and behind stone walls. Most of the stands of timber between farm fields groaned with wounded men, most of them lying on the shaded ground where they had been placed after evacuation from the open battlefield. Those attendants not assisting surgeons during marathon operating sessions walked among the wounded, reassuring them that medical supplies surely would be arriving soon.

  At approximately 1:00 p.m., the Confederate artillery opened fire in volleys so thunderous they could be heard miles away. After nearly two hours, the responding Union artillery slowed to conserve dwindling supplies of ordnance. A smoldering and quieted battlefield separated thousands of men prepared to charge across 1,400 yards of open ground toward each other, their rifles primed and ready. The Confederates then attacked across the open ground, reaching a broken fence along the Emmitsburg Road, where the Union infantry concentrated its fire in a flood of lead that pulverized faces, chests, and torsos. Hundreds fell dead and wounded in what became known as Pickett’s Charge. Confederate losses amounted to approximately 50 percent in one of the deadliest assaults of the war.

  Again, Meade reinforced at the point of attack, at the same time as he and his staff abandoned his headquarters when it came within range of enemy artillery. Once more, Letterman asked Meade that wagons filled with medical supplies and tents be brought forward as the casualties mounted. Again, Meade demurred, but this time he allowed half of Letterman’s wagons to be driven onto the battlefield.9

  As Pickett’s Charge bogged down in pools of fresh blood, the Army of Northern Virginia’s defeat at Gettysburg became certain. The cost to both armies exceeded the catastrophic. The Army of the Potomac had suffered nearly 15,000 wounded casualties and more than 3,000 deaths. Including those listed as missing, Meade had lost about one in four men, and Lee had suffered a cumulative loss of approximately one in three.10 Some units in the heaviest areas of battle on July 1 and 2 had suffered unbearable losses: Letterman’s medical officers managed casualty rates in makeshift aid stations and primitive, barnyard hospitals that approached 52 percent in the 19th Indiana Regiment; 56 percent in the 24th Michigan; 60 percent in the 2nd Wisconsin; and 68 percent in the 1st Minnesota.11 Overall, the two armies lost more than 50,000 men in about twenty-four hours of fighting over three days.

  July 4, 1863, was the first anniversary of Letterman’s promotion to medical director of the Army of the Potomac. In the year that had elapsed, he had forged the army’s most forwardthinking and best-organized medical department, despite the turnover in his commanding officer after almost every major battle. He spent part of the day pleading for supplies and making sure those still on the battlefield were found and ferried to a field hospital. “I have it from the most reliable authority and my own observation that not one wounded man . . . was left on the field within our lines on the morning of July 4. A few were found after daylight beyond our farthest pickets, and these were brought in, although the ambulance men were fired upon when engaged in this duty by the enemy,” wrote Letterman.12

  Lee expected a counterattack by Meade on July 4. But neither bloodied army had the strength to attack the other in established positions. Like several of his predecessors, Meade opted not to press the Army of the Potomac’s numerical advantage without a more precise assessment of the enemy. Instead, he planned a reconnaissance mission for July 5. By the time a torrential overnight downpour eased on the morning of the fifth, General Lee’s army had disappeared.13 His invasion of the North had ended in failure, and now his exhausted and demoralized men faced a long march back to Virginia in the mud. The Confederate wounded who had not been left behind for Letterman’s surgeons faced a ghastly wagon ride back to Virginia over gutted and rutted countryside roads.

  The sight of Lee’s men retreating away from Gettysburg shocked Reverend J. C. Smith. “A more crestfallen, woebegone mob may never have been seen. Hurry was the order of the day. . . . No one counted the wounded. They could not be counted because hundreds of wagons loaded with them were part of this train. . . . When passing over any part of the street where the wagons would jolt, they would yell and groan in pain. Many had received their hurt on Wednesday or Thursday with no attention paid to them by surgeons, the doctors having been kept busy with graver injuries. All who were wounded in the head, the arms, the shoulders, the nonvital parts of the body, were compelled to walk through the mud ankle-deep, with no food save a little flour mixed with water and baked on a few coals.”14

  The sl
ow, agonizing march did not include approximately 6,000 wounded Confederate soldiers and nearly 100 surgeons left behind in twenty-four hospitals within twelve miles of Gettysburg. The wounded Confederates added to the 15,000 wounded men already the responsibility of Letterman’s surgeons.

  Letterman’s ambulance corps cleared the battlefield of wounded so completely that the torrent of injured men arriving at dozens of temporary field hospitals resulted in chaotic overcrowding in the days following the battle. Some surgeons could not adequately prepare for so many wounded because they had had to move their hospitals during the fighting. Others remained critically short of medical supplies due to the temporary embargo that had been placed on delivery prior to and during the battle.

  After every day of battle and in the immediate aftermath, mangled bodies littered the ground. Some squirmed and others twitched among the countless dead lying in ditches, on logs, and across fences. Shell-shocked whimpering mixed with gasps and groans from bodies that yet held life. More than 4,500 men were wounded the first day. Twenty-four hours later, Letterman’s surgeons faced an additional 7,250 wounded men. Then, on the third day, more than 2,700 wounded soldiers arrived at aid stations and hospitals.

  “There were some (wounded) in churches, some in barns, some in tents among the fruit trees, some in tents in the fields, some under such shelter as a farmer would be ashamed to show for his cows. Some were under blankets hung over cross-sticks, and some without even so much shelter as that. There were some scattered groups of men outside the hospitals. It sometimes appeared as if an experiment had been made to see how many wounded could be crowded in a given space in a house,” wrote medical inspector G. K. Johnston.15

  Many surgeons, attendants, and volunteer nurses became haunted by the sounds of care and complaint. “Shrieks, cries and groans resounded on all sides, not only from those in the tents but on the amputating tables, which were almost constantly occupied; and who could pass them without a dreadful shudder at those ghastly bleeding limbs heaped without, which the eye, however cautious, could not always avoid,” wrote nurse Jane Moore.16

  Civilians, with no training in medical care, gagged at the smell of war. Gettysburg resident Sarah Broadhead agonized over the condition of the wounded her family tended in their home. “It is heart-sickening to think of these noble fellows sacrificing everything for us, and saving us, and it is out of our power to render any assistance of consequence. I turned away and cried.”17 Volunteer nurse Cornelia Hancock, twenty-three years old, felt equally overwhelmed, writing: “So appalling was the number of wounded as yet unsuccored, so helpless seemed the few who were battling against tremendous odds to save life, and so overwhelming was the demand for any kind of aid that could be given quickly, that one’s senses were benumbed by the awful responsibility that fell to the living.” Hancock also wrote her cousin that “[i]t is a very beautiful rolling country here; under favorable circumstances I should think healthy, but now for five miles around, there is an awful smell of putrefaction.”18

  After most of the wounded had been carried off the battlefield, the sight and stench sucked the breath out of most observers who struggled to find context or comparison. The following account is typical of attempts by observers to convey the cluttered lunar landscape abandoned by the two armies: “The appearance of the field was as if an army of men, with every kind of material, had started up in the night, leaving everything but what was fastened to their bodies. Knapsacks, blankets, coats, hats, shoes, stockings, testaments, letters, cards, plates, knives, bread, crackers, meat, candles, cartridge boxes, percussion caps and bullets without count, ramrods drawn to load, and in the fury of battle thrown away to use their bayonet or butt of the guns, broken guns, broken wagons of ammunition and of cannons, wheels that had been driven a hundred yards from the wagon by a cannon ball or shell, shells by the wagon load which had not yet exploded, solid shot, and fragments of shells in every direction.”19

  As the eggs laid on dead bodies by millions of green bottle flies hatched into maggots, survivors searched for wells that had not been sucked dry by tens of thousands of soldiers. Supplies of chloride of lime used to staunch the smell of putrid flesh of man and animal proved woefully inadequate.

  Even as Letterman began to organize his post-battle hospitals, Meade was anticipating an attack by Lee on the following day, July 5. He believed that if the Confederates attacked it would “. . . probably determine the fate of the country.”20 No attack came, and Letterman ultimately had three days to assess the total carnage, determine the precise location of dozens of temporary field hospitals, and find ways to move medical supplies forward onto the battlefield. On July 6, the bulk of the Army of the Potomac, including Letterman and the majority of his medical department, left Gettysburg in pursuit of General Lee and his retreating Army of Northern Virginia.

  Before leaving Gettysburg, Letterman assigned the overall treatment of the wounded to Dr. Henry Janes, a young and inexperienced surgeon who had demonstrated the knack for organization that Letterman so highly valued. Letterman departed knowing that tents for patients had become more widely available as medical supplies had begun arriving the day before. On July 5 to 6, 30,000 rations arrived in the Gettysburg area.

  The day Letterman left with the army, it is unclear whether he and his superiors had a complete understanding of the unprecedented number of wounded in light of available surgeons, ambulances, and supplies. On July 6, Surgeon General Hammond remained convinced that there were adequate numbers of surgeons and accommodations at Gettysburg. The same day, a notice appeared in the Pittsburgh Gazette asking that civilian doctors not be sent to Gettysburg in the absence of a working railroad. Letterman also told General Robert Schenck in Baltimore not to send civilian surgeons, possibly because he didn’t think they were needed or perhaps because Letterman viewed civilian doctors on the battlefield as counterproductive.21

  The Confederates had burned key bridges on the main rail line leading to the Union army’s main supply depot at Westminster, so distribution of supplies to more than one hundred hospitals took time. Reports from across the battlefield made it clear a critical shortage of supplies, tents, and experienced surgeons persisted. On July 8, a nurse reported: “The men lie on the ground their clothes having been cut off them to dress their wounds; they are half naked, having nothing to eat only as Sanitary Commissions, Christian Commissions, and so forth have to give them.”22

  Starving and dehydrated soldiers suffered in the brutal heat that gripped the Pennsylvania countryside. It became so stifling hot that officers suspended noncritical work by troops on July 8. However, relief remained elusive for the thousands of wounded men lying in barns, tents, and fields. The battle at Gettysburg was far from over for the medical corps that Letterman had left behind.

  What few supplies might be found among Gettysburg farmers came at a steep price. Some of Letterman’s surgeons became furious with Gettysburg farmers once the fighting stopped. Farmers shocked Surgeon William Watson when they offered bread that had cost ten cents a loaf before the war to the surgeons and their patients for seventy-five cents each. He lamented: “The brave army that has protected this State deserved better treatment.”23 A newspaper reporter shared his indignation when he wrote: “Here is a farmer who has twelve stray cows, all of which he had milked daily, in addition to his own, whose farm and crops have been protected from the hands of the despoiler, by the blood of the slain, and whose barn is filled with two hundred bleeding, dying patriots. Does he give them milk when they ask and plead for it? Yes. At five cents a pint! Does he give them one loaf of bread when they have saved him ten thousand? Yes. At forty cents a loaf. . . . They [the farmers] seem to be proud of the opportunity, and laugh at their cunning in counting their gains—it is not cunning, it is something less than duplicity.”24

  Several field hospitals benefitted from supplies provided by the Sanitary Commission. Its deliveries amounted to more than 11,000 pounds of poultry and mutton, 10,000 loaves of bread, 8,500 dozen eggs, 7,1
00 shirts, and more than 6,000 pounds of butter.25 Sometimes donated parcels included handwritten notes. “This is a poor gift, but it is all I had; I have given my husband and my boy, and only wish I have some more to give, but I haven’t,” was written on a package of bandages. Another: “This pillow belonged to my little boy, who died resting on it; it was a precious treasure to me, but I give it to the soldiers.”26

  Some army surgeons chafed at the credit given to the relief organizations. “A mistaken idea prevailed at home, that the agents of the Sanitary Commission resorted to the battle-field, ministering to the wants of the wounded, dressing the wounds, bringing the crippled from the field, and feeding the hungry. . . . Nothing of the sort was done,” wrote surgeon George Stevens of the 77th New York Regiment.27 He noted the commission’s agents were confined to “large hospitals after the roar of the battles had passed away; but they had nothing to do with the care of the wounded on the battle-field.”

  It took nearly a week following the end of the fighting to repair secondary rail lines in the Gettysburg area so that reasonably adequate supplies could be distributed from the regional supply depot at Westminster. The Union army’s railroad engineer, Herman Haupt repaired the York & Cumberland Railroad from Gettysburg to York by July 7. Work on the line leading from Hanover to Gettysburg progressed. On July 9, the army quartermaster reported he had amassed 300,000 rations at the regional supply depot.28

  The surgeon Letterman had placed in charge of Gettysburg area hospitals, thirty-one-year-old Henry Janes, turned his attention to building a central field hospital and consolidating the region’s wounded. Janes had worked closely with Letterman during the fighting as the medical director for the First Corps, which had lost more men than any comparable unit in the battle. More than 3,200 had been wounded, and some of Janes’s doctors had been taken prisoner.