Surgeon In Blue

by Scott McGaugh

  Letterman, Lee, and the commanding officer of the Army of the Potomac at the time, George McClellan, spent two hours at the Lee estate, called Old Needwood. Petite, with a long face and soulful countenance, Mary served her houseguests in the first-floor parlor. They made an impression during their brief stay. In an October 26 letter to her brother Thomas Sim Lee, who was studying in Rome to become a priest, Mary called McClellan “my hero.”1

  Old Needwood was part of Needwood Forest, a tract that had been in Mary’s family since the late 1770s, when her grandfather, also Thomas Sim Lee, purchased the parcel. Rolling farmland, stands of timber, and mountains to the west marked it as an estate worthy of the Lee family’s standing in Maryland. Lee had been a leader in the Revolutionary War and served as Maryland’s second governor. Mary’s father, John Lee, had served in Congress in the 1820s. Her mother’s great grandfather, Charles Carroll, had signed the Declaration of Independence.

  The family remodeled a former schoolhouse into a towering, two-story Georgian-style manor, featuring expansive, two-story porches on the east and west sides. It was one of four family homes that formed a square. Nearby were agricultural outbuildings and quarters for slaves. When Letterman visited, Mary’s mother owned the 144-acre Old Needwood. Her father’s frequent financial troubles had forced the purchase of the property by Mary’s grandmother, who deeded it back only to Mary’s mother, Harriett Chew Carroll.

  Unfortunately, no correspondence between Letterman and Mary survives, but the next documented Letterman visit to Old Needwood followed Gettysburg nine months later, this time with General George Meade, who knew Mary’s mother. By that time Letterman had become an important part of the Lee household and the subject of family correspondence. On August 11, 1863, Thomas Sim Lee wrote Mary from Rome. “I know how anxious you must have been during the invasion of Maryland and Penna, nor is the war yet over. However the safety with which Dr. L (Letterman) has passed through so many bloody battles, is an earnest of his future preservation from harm. . . . I am very glad that Dr. L. has not offended the political foresight of the blind president (Lincoln). His is not to tear down but to build up, and therefore cannot injure the opposite party.”2

  Jonathan Letterman married Mary Digges Lee on October 15, 1863, in a small ceremony at Old Needwood, two days short of her thirtieth birthday. Since Letterman was not a Catholic, Mary’s brother in Rome had obtained special dispensation for the marriage to take place. Letterman was nine years older than his bride. Michael Tuffer of the Society of Jesus and Thomas Foley from the Baltimore Cathedral officiated in the family chapel. A few family members served as witnesses, including Outerbridge Horsey who owned a nearby distillery.

  According to one newspaper report, Letterman’s medical officers presented the couple with a $2,000 silver set. A note accompanied it, saying “The Medical Officers of the Army of the Potomac request you accept the accompanying present as a mark of their great regard for you as an officer and a gentleman, with best wishes for the happiness of yourself and lady.” A thank-you note written by Letterman two days later while on his honeymoon in Washington revealed his deep affection for his colleagues: “It is well known to you how deep an interest I have felt in being an officer of (the Army of the Potomac), and while I have felt this interest in its officers, in their reputation and usefulness, it is a source of deepest pleasure to be assured of the feelings of kindness which this present so handsomely makes known and entertained towards me by the Medical Officers of the Army of the Potomac.”3

  A few weeks later Letterman returned to the Army of the Potomac and a battlefield he knew well. By late November, Meade and Lee’s armies had drifted south through the Virginia countryside, east of the Blue Ridge Mountains, in a series of battles that amounted to little more than skirmishes compared to what both sides had endured at Gettysburg four months earlier.

  On October 13, the Confederates’ Major General J. E. B. Stuart cavalry had discovered the Army of the Potomac’s rear guard near Warrenton, about thirty miles south of the Maryland border. Both armies had been depleted the previous month when Lee sent part of one corps to the western theater and Meade sent two corps to reinforce Union armies in Tennessee.

  A series of small battles had ensued over the next three weeks, at Auburn, Buckland Mills, and then south near the Rappahannock River. By the second week in November, Lee had withdrawn to a position south of the Rapidan River, destroying the Orange & Alexandria Railroad as he retreated. Lee’s army sat only a few miles west of Chancellorsville, while the Army of the Potomac encamped north of the Rapidan, near Culpeper. The series of five engagements had produced about 2,300 wounded and killed on both sides, less than the losses suffered in a single hour’s fighting at Gettysburg.

  As winter approached, Meade commanded a superior force of approximately 80,000 men, far more than Lee’s 50,000 troops. The Union general still held out hope for a decisive victory before both armies settled into winter quarters. But just as bad weather had hampered earlier Army of the Potomac advances, heavy rains again stalled a Union attack that had been planned to begin on November 24.

  On November 26, the Army of the Potomac celebrated America’s first Thanksgiving by crossing the Rapidan.4 The delayed crossing, nearly impassable roads, and scouting reports gave Lee time to reposition some of his forces to blunt what Meade had hoped would be an unexpected and lightning-fast attack on the Confederates’ position. Counterattacks followed enemy advances over the course of several days. Flanking strategies were thwarted by shifts in the enemy’s troop deployment and by overnight temperatures that plunged below freezing, sapping troop energy.

  By November 30, it became evident to Meade that a final thrust into the heart of Lee’s army near Mine Run on the eve of winter had failed. There would be no decisive victory to blunt criticism of him for not aggressively pursuing Lee after Gettysburg. Low on supplies, Meade retreated back across the Rapidan under the cover of darkness, cold, and rain on December 1. Letterman agreed with Meade’s decision when he later wrote: “it required high moral courage in the Commanding General to order a retreat; in Major-General Meade that courage was fortunately found, and the Army retired, during the night of December 1st, to its former camp on the north side of the Rapidan.”5

  Following Jonathan Letterman’s fifth campaign in a year and a half, the Army of the Potomac settled into winter quarters, not far from where it had waged major battles at Fredericksburg and Chancellorsville. After he had taken medical command of a badly depleted army following the Peninsula Campaign, his medical department had seen and contributed to strategic victories at Antietam and Gettysburg. His medical officers had coped with crushing Union defeats at Chancellorsville and Fredericksburg. In what would prove to be Jonathan Letterman’s final battlefield campaign, Mine Run had ended in a draw of modest strategic consequence.

  He now faced a long and cold winter apart from his wife, who often rented a room at Tudor Place, a grand mansion in the Georgetown Heights area of Washington that had been designed by William Thornton, the architect of the U.S. Capitol. The owners regularly entertained political and business leaders.

  In December, he returned his attention to troop health as the army dug in for the Virginia winter. He continued to establish more structured and comprehensive standards of medical care and expected his medical officers to adopt them. That month he restricted the dispensing of alcohol, which doctors administered or prescribed as a stimulant. Prevalent prescription of alcohol “led to hasty and therefore incomplete examination of cases of disease. It is easy, in the case of a weak pulse, to prescribe stimulates, and this practice accords with ideas of unprofessional persons, and the cause of the disease is apt to be overlooked,” he wrote.6

  Yet, after eighteen months of war, he concluded he had completed his mission on the battlefield. Through the course of battles that left tens of thousands of wounded men in their wake, Letterman had remained focused on reorganizing nearly every aspect of the battlefield medical department. The realities of war
that he had confronted and the resulting requirements for battlefield medicine that he had addressed had dwarfed the medical needs of soldiers assigned to remote military outposts before the war. A single artillery shell at Gettysburg produced more casualties in an instant than a weeks-long patrol into Indian territory. Serving with the Army of the Potomac, Letterman had faced an unimagined scale of human suffering that demanded critical and analytical retooling of battlefield care. In responding, he implemented a fundamental shift from outpost medicine to effective mass-casualty combat care.

  In December 1863, Letterman asked to be relieved of medical command of the Army of the Potomac. “It is evident no military movements can be made by either army. . . . The medical department has been fully reorganized in its branches,” he wrote.7 He made it clear his decision had been a difficult one, that weighed intense personal loyalty to the men he served and treated against the intellectual conclusion that he had done all he could to prepare an army’s medical department for the new realities of war.

  “For eighteen months of arduous and eventful service, I had shared the varying fortunes of that gallant Army (of the Potomac), and formed many warm friendships with the best and bravest, some of whom were not fated to accompany their comrades, on many a bloody field, to the final triumph that purchased our peace, and restored our Union. But whether the grass grows over them, or they are wanderers, far from the scene of their perils and victories, those who labored together with but one heart, in their country’s hour of agony, will live among the many memories that cluster around the dear old Army of the Potomac,” he wrote after the end of the war.8 He also left his post with pride, noting the army sick call rate had dropped from an unacceptable 20 percent when he had joined the Army of the Potomac in 1862 to 3 percent when he left.9

  Letterman offered no detail in his military reports and postwar writing on what led to his decision to ask for a transfer. His mentor, Surgeon General William Hammond, was under increasing political fire from Stanton and his allies in Washington, and that may have played a role. If Hammond were to lose his job, Letterman may not retain his unfettered authority to enact sweeping changes. Having very recently married at the relatively advanced age of thirty-eight, perhaps he desired to be near his wife and start a family.

  While Letterman may have seen his job as complete, his philosophy of battlefield care had yet to become Union army doctrine, even as public support for an army-wide ambulance system had grown throughout 1863. Much of that support had stemmed from a campaign by a vehement abolitionist, Henry Bowditch, who also was a physician and professor of clinical medicine at Harvard.

  Bowditch’s son had died from an abdomen wound earlier in the war. He had lain unattended on the battlefield next to his dead horse, and Bowditch claimed that army doctors at nearby field hospitals were powerless to help for want of available ambulances. The scarcity of ambulances enraged him in particular because his son had lain in the rear area of the army, easily retrievable, and not in enemy-held territory. Bowditch wrote a widely distributed pamphlet decrying the lack of an ambulance corps in all Union armies. He contended that: “[A] corps of detailed soldiers, or, what may be deemed better, a corps of honest, brave, and humane men, enlisted for this special (ambulance) duty is needed. Such a corps exists in every army in Europe . . . by having such a corps, the number of combatants would not be so rapidly lessened, as it is now, by several men taking one wounded from the field.”10 He cited Letterman’s system as the desired forerunner of what all Union armies needed and offered a written endorsement by General McClellan of an army-wide ambulance system.

  On December 23, 1863, Senator Henry Wilson of Massachusetts introduced ambulance corps legislation. As chairman of the Military Affairs Committee, he wielded significant influence. Massachusetts governor John Andrew was among those who endorsed the systemization of the Letterman approach.

  Not everyone shared that belief. Major General Gouverneur K. Warren, a corps commander of the Army of the Potomac, became an outspoken critic of institutionalizing an ambulance corps. Trained as an engineer, Warren had been teaching at West Point at the start of the war. He had risen to prominence as General Meade’s chief engineer at Fredericksburg and Chancellorsville. Warren believed that he had a better understanding of the medical needs of his men than his medical officers. “Responsible as I am for the safety and success of the command which I am entrusted, I claim to know better with my experience what is better in any subordinate part of my command even than the officer who devotes himself to that part especially,” wrote Warren.11

  Letterman had known for several months that Warren opposed his system. During the Bristoe Campaign in October, Warren assumed that he could prorate Letterman’s required number of ambulances per regiment in regiments that were not at full strength. Letterman believed it impractical to know precise troop levels in all regiments at all times, so it made more sense to allocate a set number of ambulances to each regiment. When Warren’s medical director, Justin Dwinelle, sent Letterman an October 31 report detailing Warren’s reduction of ambulances, Letterman became so angry that he filed a complaint against the corps commander. Warren staunchly defended his actions, disagreeing with nearly all of the premises on which Letterman had forged his ambulance corps plan.

  Warren had been told by his medical director that more than 1,000 able-bodied men had fled to Second Corps field hospitals one night during the battle of Gettysburg. That came at a time when Letterman’s ambulance system was in place throughout the Army of the Potomac. Although Letterman believed that a designated ambulance corps would reduce the likelihood of healthy or frightened soldiers leaving the battlefield to help the wounded to the rear, Warren felt vindicated. “I think, then, the ambulance detail as a means of increasing effective strength of this army on the battle-field is a failure, even if the officers do their duty,”Warren wrote in one report.12

  He also contended that the number of ambulances in a corps, that was prescribed by Letterman’s ratio of ambulances per regiment occupied as much road space as a division of frontline troops, which was too much; and that ambulance trains, division trains, and ammunition trains became confused in the heat of battle. Large trains produced vulnerable targets for the enemy, he maintained. “To put (ambulance) wagons in large groups would leave places in the column without any defense, and an attack of the enemy at such point would cut the column in two and destroy entirely the control of the commander over one part or the other of his army, and probably prove disastrous.” He acknowledged the same held true for ammunition and artillery trains but noted those were necessary for battle.13

  While public debate of the Ambulance Act continued in January 1864, Letterman reported to the Department of the Susquehanna, under the command of Major General Darius Couch. Couch had been given command of the Pennsylvania’s militia, which had been established in June 1863 to repel General Lee’s invasion of the state. Couch previously had commanded the Second Corps at Fredericksburg and Chancellorsville, making it likely that he and Letterman at least were acquainted.

  The 1846 graduate of West Point had proven himself a solid and aggressive tactician and despite generally poor health, was well known for his poise in battle. He had served in the Army of the Potomac since Letterman’s arrival. He had served under Generals Burnside and Hooker, both of whom had rebuffed his proposals to attack Lee. Frustrated, Couch had taken the extraordinary step of going over Hooker’s head and complaining directly to President Lincoln. He then refused Lincoln’s offer of command of the Army of the Potomac. When Hooker retained command, Couch resigned from that army and was given command of the Department of the Susquehanna.14

  Letterman made a lateral transfer not to become Couch’s medical director but rather a medical inspector of hospitals. Although there is no written record documenting it, it seems plausible that Letterman may have specifically requested a posting in the Department of the Susquehanna, since its area of operations was within a few days’ ride of his in-laws’ Needwood estate i
n Maryland. It was also close to Washington, the epicenter of the Union army’s medical department. As a hospital inspector, he would remain involved with the thousands of casualties at Gettysburg, many of whom were still recovering in the region’s hospitals. It was also a relatively pleasant posting. Army hospital inspectors often traveled between cities by rail and stayed in hotels with their wives. Gone were the days of pitching a tent in the cold or choking on the dust of a massive army on the move. It wasn’t uncommon to see a well-regarded battlefield medical officer be rewarded with a hospital inspection post off the battlefield. Best of all, Jonathan could spend more time with Mary, his bride.

  Now his inspections enforced many of the military medicine standards he had pioneered with the Army of the Potomac. His oversight responsibilities included officers’ quarters, enlisted men’s barracks, hospitals, medical supplies, camps, field hospitals and transportation. Treatment of disease, wound care, preventive medicine, nutrition, hygiene, and recordkeeping by hundreds of medical personnel for tens of thousands of men became his responsibility.

  The Department of the Susquehanna sat on the fringe of the Civil War in early 1864. A rumored Confederate incursion into Pennsylvania had failed to materialize. As President Lincoln issued calls for tens of thousands of additional volunteers, Couch spent much of his time arguing with Secretary of War Stanton about how best to recruit local volunteers and whether they should become part of the state militia or part of the United States service. Once again, Letterman’s commanding officer was waging a personal war with the Union’s Secretary of War.

  Letterman’s legacy on the battlefield persisted nonetheless. His fellow medical officers presented a memorial to the Senate’s Military Committee, proposing that Letterman be promoted and receive attendant raises in pay.15 They wrote:

  We express not the sentiments of Medical Officers only; we give the opinion of Military Commanders, when we affirm that not only the remarkable state of health, but in great measure the tone, the vigor, and in part the discipline of this Army, is due to the efficient officer at the head of its Medical Department. When we contrast this Army at present, with what it was when Surgeon Letterman assumed the charge of its medical department, when the tide of men flowing to the rear depleted its ranks, owing to a lax system of discharges, or no system at all, and owing to an unchecked license of granting passes to hospitals; when we compare the provisions now made for the wounded with what they were before his time, we cannot help congratulating the Army and the country upon the change, and cannot forbear bringing to your notice the merit of the officer to whom that change is due.