Disease was an enemy that took more lives than bullets. Hospitals were more dangerous than battlefields. Twice as many men died from disease during the Civil War as died of wounds from fighting the enemy. Even without war, illness was a fierce enemy in the nineteenth century. The Alcott family way of dealing with illness through rest and homeopathic medicines was probably more effective than most medication and less deadly. Nineteenth-century doctors subscribed to the theory that disease fed on whatever was in the body and that, therefore, the body must be emptied. The liver was thought usually to be the source of disease, and a mercury compound named calomel was believed to be a great healer of all liver ailments. We now know that mercury is poisonous, but doctors during the Civil War mistook the effects of the poison for signs of healing and continued to do so as their patients died. To become sick was often a death sentence.
As Burnside, shattered, retreated, Louisa May Alcott arrived in Washington 45 miles north and took a horse-drawn cab to her destination, a hospital that turned out to be hardly changed from its former life as a hotel. A Union Hospital ward was still labeled “Ballroom,” and the renovations had not removed fetid damp rooms, or peeling walls and leaking ceilings. The hospital was so disorganized that Alcott immediately gave it the Dickensian name Hurly-burly House and herself the name of Nurse Tribulation Periwinkle.
After a fitful first night, she was ordered to be superintendent of a ward with forty beds. Her duties would be washing the patients, serving meals, and giving medicine to men with pneumonia, diphtheria, and typhoid. A dozen “dilapidated patriots, hopping, lying and lounging about,”25 looked on. Hannah Ropes, the matron of the hospital, wrote, “We are pleased by the arrival of Miss Alcott from Concord—the prospect of a really good nurse, a gentlewoman who can do more than merely keep the patients from falling out of bed.”26 Alcott and Ropes often worked together in the wards.
On the morning of December 16, everything changed. Louisa May Alcott looked out the window at what seemed to be rows and rows of farmers’ market carts stretching as far as the eye could see. With growing horror, she realized that the carts were piled not with vegetables and produce but with men, wounded and dying men, survivors of the Battle of Fredericksburg on their way to her hospital, needing her care. “My ardor experienced a sudden chill,” she wrote, “and I indulged in a most unpatriotic wish that I was safe at home again, with a quiet day before me.”27 Louisa May Alcott spent a total of six weeks working at the Union Hospital. She arrived December 13 and left at the end of January. In that six weeks, she lived a lifetime of experience, an experience that changed her forever, physically and as a writer. Fredericksburg was Louisa May Alcott’s Fredericksburg.
“In they came, some on stretchers, some in men’s arms, some feebly staggering along propped on rude crutches, and one lay stark and still with a covered face, as a comrade gave his name to be recorded before they carried him away to the death house.”28 Confronted with this army of the wounded, Alcott was unable at first to summon the courage the situation required. This bold woman whose brashness had often gotten her into trouble lost her nerve and hid behind a pile of clothing. Another matron spotted her in her hiding place, pulled her out, and told her to get to work and wash the men, many of whom were caked with mud and dirt from the battlefield and filth accumulated during their journey in the carts with piles of their fellow soldiers. Alcott noted that if she had been asked to dance a hornpipe on the stove funnel she would have been less staggered, “but to scrub some dozen lords of creation at a moment’s notice was really—really—. However there was no time for nonsense, and having resolved when I came to do everything I was bid, I drowned my scruples in my washbowl . . .”29
Her first patient was an Irishman with a head wound, and as Louisa went after him with soap and water, he began to laugh, something he hadn’t done for a few days, days that seemed like a lifetime, Alcott wrote in Hospital Sketches, her detailed account of her time at the Union Hotel Hospital. Something about being washed by a woman amused this Irish soldier. Soon, Alcott and her patient were laughing together, and later he rested his tired head against her shoulder like a sleepy child. Although Alcott had probably never seen a naked male body before this day, she overcame her inhibitions and became a competent and loving nurse. She washed off the layers of mud and gore and dressed their awful wounds, and most of all she listened to their stories. One was a sergeant who was worried that on Judgment Day there might be confusion among the thousands of amputated legs and arms and he might end up with the wrong ones. Another man from Michigan had his arm blown off at the shoulder. After washing the men, Alcott helped feed them from trays of bread, meat soup, and coffee that appeared from the kitchen. “Great trays of bread, meat, soup and coffee appeared,” she wrote, “and both nurses and attendants turned waiters, serving bountiful rations to all who could eat.”30
Now, at the Union Hospital in Washington, D.C., everything shifted for the protected Alcott. Dr. John Winslow, a Quaker who was the surgeon on Alcott’s ward, took a romantic interest in her. “He comes often to our room with books, asks me to his (where I don’t go,) & takes me to walk now & then. Quotes Browning copiously, is given to confidences in the twilight, & altogether is amiably amusing,” she wrote in her journal.31 Winslow’s friendship was not confined to whispering sweet nothings in the twilight; he and Louisa walked all over Washington. They went to hear William Henry Channing, the chaplain of the House of Representatives, give a speech at the Capitol Building, which Louisa found boring, and they had dinner at a local German restaurant.
But it was the wounded and dying men who captured Louisa’s attention and her heart in the first weeks after Fredericksburg. At first she was on the day shift; she began her morning by running through the ward and opening the windows. The men grumbled at the cold but Alcott was convinced—like all medical professionals at the time—that disease was carried by stale air. “A more perfect pestilence box than this house I never saw—cold, damp, dirty, full of vile odors from wounds, kitchens, washrooms, & stables. No competent head, male or female, to right matters,” she wrote.32 After a breakfast of fried beef, butter, grainy bread, and weak coffee taken with her coworkers, Alcott, a former vegetarian, ran around the hospital making beds, tending wounds, sewing bandages, and helping the surgeons who, she thought, were often too rough with her beloved patients. After a similar lunch, Alcott would continue working until 9 P.M. when the lights went down and she was free to retire to her own spartan room.
Louisa used every trick she knew to comfort and care for the men. She read Dickens to them and recited the parts of Sairy Gamp from Martin Chuzzlewit. She quoted poetry and told them stories. She listened to them. She wrote letters for them, and when they died and letters still had to be written, she did that too. “The answering of letters from friends after someone has died is the saddest and hardest duty a nurse has to do.”33
In this setting where social conventions and class distinctions fell away, Alcott came to love many of the men she nursed. She was astonished by their quiet bravery and she grieved when they died. The stakes were high at the hospital. There was no time for chitchat or any place for all the things in life Louisa despised—phoniness, snobbism, the shame of being poor. Here where all was life and death, she found an intimacy with those who needed her that had eluded her in life, and she relished it. Later, when her shift changed from the day to the night shift—she first worked from noon to midnight, and then from 9 P.M. until dawn—she came even closer to the men she cared about as she hovered over them in the red head-scarf that was her nurse’s uniform. “It was a strange life—asleep half the day, exploring Washington the other half, and all night hovering, like a massive cherubim, in a red rigolette over the slumbering sons of man.”34
One 6-foot-tall New Hampshire man who could not sit up, asked Alcott to come and feed him the soup that was splattering on his face and beard when he tried to feed himself. As she did, he told her his version of the battle of Fredericksburg. This had been his
first experience in combat. The man he fought next to, a friend, was killed early on and this angered him. As a result, he explained, “a lot of us larked around Fredericksburg, and give some of them houses a pretty consid’able of a rummage.”35 Later he was near a shell explosion that had ruined his leg.
In gratitude for her nursing and her help in feeding him, he offered Alcott two gorgeous pieces of jewelry purloined from a fine house in the looted city—earrings made to represent “corpulent grapes” and a pin made to look like a basket of fruit. She accepted the grapes but not the basket only because, as she wrote, she felt “delicate about depriving him of such valuable relics.” Did she also feel delicate about taking part in the spoils of war?
One man who stood out in the ward of dying men was a Virginia blacksmith named John Suhre. He had never married but devoted his life to helping his mother and family. Now he lay dying with a musket ball lodged in his lungs, but since his wound was in his back, he could hardly believe the pain he felt or understand his peril. Tall and extremely handsome, he was dying without complaint or remorse, and Alcott spent as much time with him as she could. “His mouth was grave and firm, with plenty of will and courage in its lines,” Alcott wrote, “but a smile could make it as sweet as any woman’s.”36 John Suhre wanted to live, and in spite of his pain, he believed he would. But when Alcott asked the surgeon what John’s chances were, the doctor said that John was suffering more pain than anyone else in the ward and that he would be dead in a day or two. Then the surgeon gave Alcott the awful job of telling the handsome blacksmith, who was exactly her age, that he only had a few days longer on this earth.
Alcott was devastated and had no training or experience in such a task. Terrified and suppressing tears, she approached the bed of this dying man as his wounds were being dressed. She leaned in and offered him her hand and shoulder to help him bear the pain. After that, his eyes followed her everywhere, and she did everything she could for him, bringing flowers and writing a letter for him to his brother. Finally he asked her if this, his first battle, would be his last. She was able to tell him that yes, he had fought his last battle. This exchange brought the two of them even closer, and both waited for a letter that might reassure him that his mother and younger sister would be taken care of.
The night John died, Alcott sat grieving by his bed, wiping his brow, holding his hands, and listening to him—powerfully reminded of what it had felt like to sit next to her own sister Lizzie’s bed as she had died. As John’s body struggled to survive, futilely, the big man wept in Alcott’s arms. “For a little while, there was no sound in the room but the drip of water, from a stump or two, and John’s distressful gasps, as he slowly breathed his life away,” Alcott wrote.37 “I thought him nearly gone, and had just laid down the fan . . . when suddenly he rose up in his bed, and cried out with a bitter cry that broke the silence, sharply startling every one with its agonized appeal.
“‘For God’s sake, give me air!’
“It was the only cry pain or death had wrung from him, the only boon he had asked; and none of us could grant it.” When John Suhre’s body finally failed, he was holding Alcott’s hand so tightly that she could not pry his fingers away. After another patient helped her untangle her hand from the dead man’s hand, she still had four white marks where his fingers had dug into her flesh as he died.
In the letter she wrote home about John Suhre’s death, Louisa took a great story and embroidered it to reflect the vividness of her feelings. In her version, the blacksmith dies just as dawn’s light floods the room. The letter from John’s home arrives in time to be buried with him. And although Alcott had a special connection to John Suhre, many of the other men needed her ministrations just as much. In many ways, in spite of the smells and sleeplessness, in spite of the fear and grief, she had found a place in the world where her strength and boldness and outspoken ways were assets instead of liabilities.
Then she got sick.
Both Alcott and Hannah Ropes came down with pneumonia in the beginning of January. “Sharp pain in the side, cough, fever & dizziness. A pleasant prospect for a lonely soul 500 miles from home!” Alcott wrote.38 The doctors gathered around their suffering comrade giving her doses of calomel, taking her pulse, and examining her lungs. John Winslow turned himself into a nurse and brought cologne, flowers, and wood for her fire. And the doctors advised her to give up and go home.
Louisa May Alcott was as stubborn as Ambrose Burnside. She refused to leave and stayed in her room nursing her fever, taking more calomel, sewing, and learning even more about hospitals and the way they work from being a patient in the place where she had been a nurse. “I was learning that one of the best methods of fitting oneself to be a nurse in a hospital, is to be a patient there; for then only can one wholly realize what the men suffer and sigh for; how acts of kindness touch and win; how much or little we are to those about us,” she wrote.39
When President Lincoln’s Emancipation proclamation was passed on New Year’s Day, Alcott got out of bed and danced a little jig, but she was soon prostrate again. Decoding the signs and symptoms of nineteenth-century medicine is not an exact science, but Alcott seems to have contracted pneumonia and then typhoid, a disease carried through the drains or water that has been infected with fecal matter. Her illness started with a cough and soon progressed to the high fevers and delusional fever dreams that are typical of typhoid. Then, as the pneumonia and typhoid resolved, her body was racked by the effects of the mercury poisoning caused by the doses of calomel medicine that the kind doctors provided her with every day in the hospital. Mercury poisoning is insidious, damaging the central nervous system, distorting the mental processes and causing muscle weakness, salivation, sores on the gums and teeth as the patient’s body begins to shut down.
The news of Hannah Ropes’s death electrified the hospital staff, and the arrival of Bronson Alcott, summoned by Dorothea Dix herself, overcame all Louisa May Alcott’s protests. Bronson had rushed south and arrived on the morning of January 16 to find an emaciated Louisa, semiconscious on a thin mattress, alone in a freezing cold room with broken windowpanes and rats scuttling in the walls. Five days passed before the doctors decreed she was well enough to travel. She was bundled up and shivering with fever when she and her father boarded the train to Boston, where they spent the night, and got to Concord the next day. “Louisa was faint and overcome by the long ride, but much better in the morning,” her father wrote his daughter Anna after the grueling journey.40
The Louisa who returned to Concord was dramatically different from the healthy eager girl who had left six weeks earlier. “The amount of pleasure and profit I got out of that month compensates for all after pangs,” Alcott wrote later.41 She may have learned everything she needed to know as a writer and as a woman, but the effort almost killed her. She was, Edward Emerson noted, a white, tragic mask of what she had once been. Julian Hawthorne was also shocked at the changes in the woman he had seen off less than two months earlier.
Not only was she a weak, shrunken version of her former robust, tall self, but also there seemed to be an emotional veil between her and the rest of the world, almost as if she had already left on the first stages of a long trip. Neighbors helped spell Abba at Louisa’s bedside. Emerson provided as much household help as Abba would tolerate. Looking in the mirror, Louisa saw a queer, thin big-eyed face she didn’t recognize. When she tried to walk, she found that her legs were useless and this made her weep. Concord’s Dr. Bartlett ordered her head shaved to discourage the fever. Alcott complied and was glad, she wrote, to have given her hair for her country although she could not give her life. This thought, percolated into fiction, reappears in Little Women when Jo sells her hair.
During the weeks of illness and fever, Alcott’s brain seemed to rebel against everything she had seen in Washington. She had a series of nightmares right out of the melodramas of A. M. Barnard. She would bolt up in bed muttering incoherently, and she failed to recognize her mother, who was desperate
ly trying to find a way to care for her. In her delusions, she was married to a fat, handsome Spaniard dressed in black velvet who was continually saying “Lie still, my dear.” This man terrified her and seemed to be everywhere, in the closets, at the windows of her front bedroom on the Lexington Road, and in the dark after night fell. She thought she had married him. Her appeals to the pope to intervene with the Spaniard didn’t work.42
In another semiconscious dream, Alcott went to heaven and found it twilit and ordinary. “I thought it dark & ‘slow’ and wished I hadn’t come,” she recalled.43 In other delusions, she was being pursued by a mob in Baltimore that was trying to break down the door to the room where she had taken refuge. Sometimes her mother or sister Anna found her crying out as a result of these visions. One night, hearing a crash from Louisa’s bedroom, May rushed in to find her sister on the floor. Louisa scolded May for leaving her alone with so many men.
In her waking dreams, she was also burned, stoned, and hung as a witch, and she was tempted by John Winslow and two of the Union Hospital nurses who urged her to worship the devil. “Such long long nights—such feeble idle days, dozing, fretting about nothing, longing to eat and no mouth to do it with, mine being so sore and full of all manner of queer sensations it was nothing but a plague.”44 Outside the windows of her room, the Concord winter set in with its snowdrifts and icicles and impassable roads. Snow fell on the elms in front of the house and on the flower beds and on the ice of Walden Pond, where Thoreau had lived what seemed a century ago. February passed in a haze of illness, semiconsciousness, and unsuccessful efforts to do simple things like sewing or reading.
By the beginning of March, appropriately the beginning of an early New England spring, Alcott seemed to be getting better, and her father left her bedside to give some Conversations. It became clear that she wasn’t going to die; it was also clear that she was not the same person who had so blithely gone off to war. “At the hospital her duties collided with her fear of men,” writes Martha Saxton. “She had to repress her terrors and be physically intimate with many males. . . . The imagery of Louisa’s hallucinations was richly gothic. . . . The Spanish grandee, a character Louisa had used since childhood dramas, was a romantic but fearsome scoundrel, full of vitality and sexuality, who worked his way with women. Tamed, these fantasies were material for stories. Untamed, they were expressions of Louisa’s deepest sexual and emotional horrors.”45
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