But a lack of surgical know-how was not the heart of the problem. Many surgeons did wield saw and scalpel with dexterity. The Civil War was a medical catastrophe not because of surgical misadventures but because of rampant and uncontrollable infections. A nearly certain follow-up to surgery, infection was the central fact, and the unsolved mystery, of Civil War medicine. Infection rates were so high that Confederate surgeons suspected that Northern soldiers had somehow poisoned their bullets.
Amputation was a desperate attempt to solve the problem by lopping off infected tissue before it could spread its poisons. “Hospital gangrene,” for example, began as a dime-shaped black spot. In days, it could transform a healthy arm or leg into a seeping, putrid hunk of dying flesh. No one knew where it came from or how it could be stopped.
Poignantly, the great advance that could have revolutionized the care of the hundreds of thousands of soldiers wounded in the Civil War—the insight that germs cause disease—came a few years after the war’s end. That revolution in medicine was the work of Lister in England, Pasteur in France, and Koch in Germany, among others. It is worth noting that there are no American names on that list. The mid-nineteenth century was a low point in the history of American medicine. In medicine and science, Europe led the way and the United States trailed far behind. It was 1868 before Harvard Medical School acquired its first stethoscope, for example, 1869 before it obtained its first microscope. Even if there had been no war, the 1860s were not a good time to look for medical care in America. But war did come, at the worst time, and with it came hundreds of thousands of sick and wounded men clamoring for help.
The Civil War still holds us in its grip, in part because the soldiers who fought in it seem so close to us. From the newly somber young man who wrote home, after Shiloh, that “we were playing Soldiers but now we know what it is to Soldier” to plainspoken, rumpled, cigar-smoking Ulysses S. Grant, who became a general only after failing as a farmer, failing as a debt collector, failing as a clerk in his father’s business, these are people we can imagine knowing. But, in crucial ways, they lived in a world that is utterly foreign to us. In its medical aspect, above all, a battlefield in the 1860s presented scenes of almost medieval grimness.
From the instant a man entered the army, he was in trouble. In North and South alike, a soldier was twice as likely to die from disease as from a battlefield injury. Many men had been sick even before they arrived—physical examinations of new recruits were so cursory that four hundred women passed as men and went on to fight in the war—and sick soldiers infected others. Crowded into huge and filthy camps where a single latrine might serve for hundreds and garbage lay strewn everywhere and the water supply was almost certainly contaminated, men fell ill in droves. Poor nutrition made matters worse. A soldier’s diet consisted largely of beans, bacon, and the rock-hard crackers called hardtack. Meal after meal, complained one Union soldier at Shiloh, was “mouldy crackers and sowbelly with hair on it.”
Measles, mumps, and smallpox struck the camps first. Country boys fell harder than city dwellers, who were more likely to have been exposed to such childhood illnesses before. Then came a second wave of illness, headed by typhoid, malaria, and dysentery. It was common for a regiment to lose half its men to death and disease before it ever saw battle. “A man risked his life simply by being in the army,” Bruce Catton observed, “even if he never got near a battlefield.”
For those who did see combat, the casualty rate at Shiloh and other major battles was about one in five. Worse still, as we have seen, the wounded were largely left to their own devices, especially at early battles like Shiloh. (In theory, a regiment’s musicians were responsible for carrying its wounded men safely away from the line of fire, but they performed this nonmusical mission with about the degree of enthusiasm and skill one might expect.) Injured men found someone to drag them off the field, or dragged themselves, or lay where they had fallen. At Fort Donelson, in February 1862, two months before Shiloh, one wounded man lay on the ground for two days before help arrived. He had to be chopped free from the frozen ground before he could be put on a stretcher.
Nurses and orderlies were in short supply. At Shiloh, a few volunteer nurses roamed the edges of the battlefield, doing their best to help the wounded men by tearing strips from their dresses to make bandages. The Union army had established some primitive field hospitals, and surgeons treated the living while surrounded by dead men no one had yet had time to bury. “You may imagine the scene,” one exhausted and overworked surgeon wrote, “of from two to three thousand wounded men at one point calling to have their wounds dressed.”
Once the wounded arrived in a hospital, further dangers lurked. “There stood the surgeons,” wrote a Union officer at Gettysburg, “their sleeves rolled up to the elbows, their bare arms as well as their linen aprons smeared with blood, their knives not seldom held between their teeth, while they were helping a patient on or off the table or had their hands otherwise occupied.”
Knowing nothing of bacteria, surgeons of the day believed that a finger was the ideal tool for probing wounds. They poked inside the torn flesh of arms and legs with unwashed, ungloved hands. (A man who had been shot in the gut, in contrast, was virtually beyond help. Photographs of Civil War battlefields often show dead men with their clothing ripped apart, as if some thief in a great hurry had ransacked their bodies. In fact, the men had clawed their clothes open themselves, frantic to see whether or not they had taken a bullet in the belly.)
To the harm done by the bullet itself was added the risk of bone infection and blood poisoning caused by the surgeon’s attempts at treatment. Time after time, surgeons noted that an operation had gone well and the patient seemed to be recovering, only to find a few days later that he had sickened and died. “However bad the wound may be,” cynics observed, “art can make it worse.”
For the operation itself, the patient was given chloroform or ether. Despite Hollywood images to the contrary, the era of “biting the bullet” predated the Civil War. “The surgeon snatched his knife from between his teeth . . . ,” the officer at Gettysburg continued, “wiped it rapidly once or twice across his bloodstained apron, and the cutting began. The operation accomplished, the surgeon would look around with a deep sigh, and then—‘Next!’ ”
A single sponge and a single unspeakable basin of water might be used to wash every wound in a ward. Looking back on his Civil War experience in his old age, the eminent surgeon W. W. Keen could hardly believe what he had participated in. “We operated in old blood-stained and often pus-stained coats, the veterans of a hundred fights,” he recalled. “We operated with clean hands in the social sense, but they were undisinfected hands. . . . We used undisinfected instruments from undisinfected plush-lined cases, and still worse used marine sponges which had been used in prior pus cases and had been only washed in tap water. If a sponge or an instrument fell on the floor it was washed and squeezed in a basin of tap water and used as if it were clean.”
Powell had been shot late in the afternoon of April 6 and brought to a hospital that evening. Emma nursed him through the next day while Medcalfe, the druggist turned surgeon, occasionally checked the wound. On April 8, Medcalfe decided to operate. The surgery was quick but not especially skillful—Powell’s stump of an arm would torment him throughout his life, and he would eventually undergo two more operations in the hope of easing the pain—but the true danger still lay ahead.
Powell came to after the operation long enough to acknowledge Emma but then fell into a feverish, drugged sleep. At this point a surgeon had no cards left to play. The patient, newly transported from the battlefield, himself became a battlefield in a vast but silent war between disease-producing microorganisms and the body’s natural defenses. Powell slept a great deal in the next several days, and recovered enough to ask for news of the battle and of his men, and fell back into a feverish sleep, and complained of mysterious, phantom pains in the forearm he no longer had. Lean and hard at the best of times, Powell g
rew positively scrawny as the fever hammered at him. But he lived.
On June 30, he rejoined the men of Battery F, by now in occupied Corinth. They gave him three rousing cheers—Powell had to wipe the tears away—and then he shook hands, left-handed, with each man in turn. The reunion was brief. Powell was far from fit, and he was assigned to a desk job for six months.
He had decided, though, that even with only one arm he would return to active duty. His sole condition, quickly granted, was that Emma receive a “perpetual pass” entitling her to visit him wherever the war might bring him. Over the next three years, notably at Vicksburg and at Nashville, Powell returned to his place with the men of Battery F.
In the summer of 1864, he endured a second operation intended to ease the pain in his arm. It failed. Finally, in 1865, with peace imminent, Powell resigned from the army. It was time to decide what to do next. Powell was thirty years old, with a wife and responsibilities and a homemade education and no particular prospects. “Wes, you are a maimed man,” his father advised him. “Settle down at teaching. It is a noble profession. Get this nonsense of science and adventure out of your mind.”
CHAPTER NINE
HELL’S HALF MILE
We have seen already how well Powell heeded his father’s advice. Powell was not one for second thoughts—indeed, he had such faith in his spur-of-the-moment decisions that sometimes he neglected first thoughts as well—but at Disaster Falls, on the evening of June 9, 1869, we can imagine that he found himself mulling over his father’s words. He had bet his life on “science and adventure,” and at Disaster Falls it had begun to look as if the bet had gone bad.
Disaster Falls had been a near miss. Everyone had made it through alive, but the expedition had lost a boat and more than a ton of supplies. Now the exhausted and jumpy men needed to regroup. Bradley managed to spare a thought for the scenery, which was “sublime” but hardly soothing. “The red sand-stone rises on either side more than 2000 ft.,” Bradley wrote, “shutting out the sun for much of the day while at our feet the river, lashed to foam, rushes on with indescribable fury. O how great is He who holds it in the hollow of His hand, and what pygmies we who strive against it.”
Religious sentiments came easily to Bradley, who was the most devout of the party, but this was more than boilerplate. The scale of the canyons seemed designed to make any human being feel puny and insignificant, regardless of his creed. Worn-out and disheartened after their first truly life-threatening adventure, the men were perhaps more vulnerable than usual to such discouraging thoughts. Where Bradley turned to thoughts of divine providence, Sumner sought more practical consolation. “After taking a good drink of whisky all around,” he wrote, “we concluded to spend the rest of the day as best suited.”
The men loafed or puttered around camp according to their taste. “Some packed freight for future use,” Sumner wrote, “[and] the rest slept under the shade of the scrubby cedars.” Powell was neither lugging freight nor napping. “Major and brother,” wrote Bradley, “are gone ahead to see what comes next.”
Much as he hoped for good news, Bradley knew perfectly well that any reassurance would be fleeting at best. Scouting the river more than a short distance ahead was impossible because the terrain was so difficult. “Can’t rely on anything but actual tryal with the boats,” Bradley noted, “for a man can’t travel so far in a whole day in these cañons as we go in a single hour.” And so the men were constantly in the position of motorists speeding down an unknown road—and possibly headed off a cliff—while never able to see more than a car length ahead.
Never knowing what surprise the river would spring next was the great hardship Powell and his men were forced to endure, far outweighing the dunkings and near-drownings and injuries and exhaustion and inadequate food. They could all have braced themselves to cope with nearly any privation—Powell wrote a three-hundred-page, first-person account of his expedition and never found reason to mention that he was missing an arm—but this was worse. Perpetual uncertainty was a greater burden than any physical ordeal.
“To travel hopefully is a better thing than to arrive,” Robert Louis Stevenson remarked, but the observation is also true if it is turned on its head. To travel in dread is worse than to face even the grimmest reality. Brave as they were, Powell and his crew were forever in fear that they would round the next bend and find themselves flung against knife-edged boulders or tumbling over a waterfall. At the outset, not knowing what lay ahead had been a comfort. Had they known, Powell and the men might never have ventured downstream. Now, having committed themselves to the expedition, they found themselves nearly crushed by the weight of living with endlessly dashed hopes and endlessly renewed fears that the next ordeal would be the worst one yet. They lived each day, Powell wrote, with “the shadow of a pang of dread ever present to the mind.”
All explorers confront that burden, which is the cost of being first into the unknown. It can also be a feature of ordinary life. Unknown terrors often loom larger than specific, named ones because the mind can project whatever torments it fancies on a blank screen. (Perhaps this is part of the reason for our fear of the dark.) “There’s a spot on the X ray I want to look at,” the doctor says, and the weeks of waiting, which one might think would be mollified by hope, are in fact exquisite torture. “I’m afraid it’s cancer,” she finally announces, and, faced with an ultimatum that cannot be appealed, people somehow manage to endure.
The same is true of children who live with abusive parents. Beatings are bad in themselves, but the capriciousness of life with a parent who might deal out blows one day and hugs another is far worse. This was, in a sense, the load that weighed so heavily on Powell and his men. Their challenge was not to endure an almost insupportable burden but to live perpetually in suspense, like a servant subject to a tyrant’s whims.
“The sensation on the first expedition,” wrote one of the first explorers to try to duplicate Powell’s 1869 journey, “when each dark new bend was a dark new mystery, must have been something to quite overpower the imagination, for then it was not known that, by good management, a boat could pass through this Valley of the Shadow of Death, and survive. Down, and down, and ever down, roaring and leaping and throwing its spiteful spray against the hampering rocks the terrible river ran, carrying our boats along with it like little wisps of straw in the midst of a Niagara.”
On several occasions, moviemakers have gone to considerable trouble to re-create Powell’s expedition. They have commissioned painstakingly crafted replicas of Powell’s boats—built using nineteenth-century techniques—and hired professional river runners to play Sumner and Bradley and the others. But authentic as they may appear in their period costumes of grimy shirts and suspenders and torn pants, these expert boatmen can never truly put themselves in the shoes of Powell’s pioneering crew. They know too much. They have put in years on the water, first of all, and they are the indirect beneficiaries of the accumulated wisdom of all their river-running predecessors besides.
A man who has grown up rich can give away his fortune, but he can never experience the world as it appears to someone who grew up poor. Nor can a veteran boatman today forget all he has learned and imagine what it was like to run a wild river in the days when almost no one had done such a thing. Like mountaineers who compete to achieve first ascents of unconquered peaks, river runners today do still roam the world in search of first descents, on rivers that plummet far more steeply and pose far greater dangers than the Green or the Colorado. But a modern-day first descent, because it is a venture undertaken only by experts who have logged thousands of demanding river miles, is less of a venture into the unknown than was Powell’s. “Basically, Powell and his men were on their first river trip,” says Brad Dimock, a highly regarded boatman who rowed a “Powell boat” for a National Geographic film. “We ran all the rapids—Powell portaged as many as he could—but we had 120 or 130 years of white-water skills on our side, plus we knew within an inch where every rock in the river was
.”
The value of knowing the river so well can hardly be exaggerated. It made for confidence and security, first of all, but it had more tangible importance as well. Even in the hands of modern-day experts, Powell’s boats remained hard to maneuver. The key to making it successfully through a rapid was to cut the maneuvering to the minimum possible, which meant understanding where to enter the rapid in the first place and at what angle. A good start made a good run possible; a bad start made disaster almost certain.
An experienced boatman scanning a rapid quickly identifies what are, in effect, entrance ramps. But that recognition only comes with practice and experience. A novice might find the ramp but take it at the wrong angle and careen out of control, or never identify the proper entrance in the first place, barrel through a “Wrong Way” sign, and spin into a guardrail. Veteran boatmen almost never make such blunders. They are experts at reading rivers in general, and, in the case of the boatmen replicating Powell’s expedition, were rereading a text they had long since committed to memory.
“We knew intimately what was around every bend,” says Bruce Simballa, a retired boatman who participated in an IMAX movie about Powell’s trip. By the time he rowed for the cameras, Simballa was a veteran of about twenty-five Grand Canyon trips. Kenton Grua, who rowed in the same boat, had made some seventy Grand Canyon trips.* “When you do the river all the time, you have little markers,” Simballa goes on. “You can be a mile above a rapid and look over at a rock along the shore, and by seeing the river’s level on that rock you’ll know exactly what you’ll find around the next bend.”
On June 10, 1869, Powell and his men had no time to think ahead to any challenges beyond the immediate ones. “The river in this cañon is not a succession of rappids as we have found before,” Bradley lamented, “but a continuous rapid.” The result was a seemingly endless stretch of brute labor. The supplies (and sometimes the boats as well) had to be carried across a field of enormous fallen boulders. At one point, when the men were lining the boats down a rapid, “poor Kitty’s Sister got a hole stove in her side” by a rock. The damage could be repaired, but it meant more delay. After a full day’s labor, the expedition had advanced perhaps a mile.
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