The Cole Trilogy: The Physician, Shaman, and Matters of Choice

by Noah Gordon

  Men died and were sewn into the dirtiest sheets. He amputated half a dozen times more, the worst cases, and among the thirty-eight dead when they reached their destination were eight of twenty amputees. They reached Cincinnati early on Tuesday morning. He had been without sleep, and almost without food, for three and one-half days. Suddenly no longer responsible, he stood on the pier and watched stupidly as others divided the patients into batches that were sent off to the various hospitals. When a dray was laden with men for the Southwestern Ohio Hospital, Rob J. climbed in and sat on the floor between two stretchers.

  When they unloaded the patients, he wandered through the hospital, moving very slowly because the air in Cincinnati seemed thick as pudding. Members of the staff looked askance at the middle-aged, unshaven giant who stank. When an orderly asked him sharply what it was he wanted, he said Shaman’s name.

  Eventually he was brought to a little balcony overlooking the surgical theater. They had already started operating on the patients from the War Hawk. Four men stood around a table, and he saw that one of them was Shaman. For a brief time he watched them operate, but too soon the warm tide of sleep rose above his head and he drowned in it with perfect ease and eagerness.

  He didn’t remember being led from the hospital to Shaman’s room, or being undressed. The rest of the day and all that night he slept all unknowing in his son’s bed. When he awoke it was Wednesday morning, brilliant sunshine outside. While he shaved and took a bath, Shaman’s friend, a helpful young man named Cooke, picked up Rob J.’s clothing from the hospital laundry, where it had been boiled and ironed, and went to fetch Shaman.

  Shaman was thinner but seemed healthy. “Have you heard anything of Alex?” he asked at once.

  “No.”

  Shaman nodded. He led Rob J. to a restaurant away from the hospital, for privacy. They had a solid meal of eggs and potatoes and side meat, and poor coffee that was mostly parched chicory. Shaman allowed him to take the first hot, sourish swallow of coffee before he began to ask questions, and he absorbed the story of the War Hawk’s trip with great attention.

  Rob J. asked questions about the medical school, and said how proud he was of Shaman.

  “At home,” he said, “you know that old blue steel scalpel of mine?”

  “The antique, the one you call Rob J.’s knife? Supposed to have been in the family for centuries?”

  “That’s the one. It has been in the family for centuries. It goes to the first son to become a doctor. It’s yours.”

  Shaman smiled. “Hadn’t you best wait until December, when I graduate?”

  “I don’t know that I’ll be able to be here for your graduation. I’m going to become an army doctor.”

  Shaman’s eyes widened. “But you’re a pacifist! You hate war.”

  “I am, and I do,” he said in a voice more bitter than the drink. “But you see what they do to one another.”

  They sat long, sipping renewed cups of bad coffee they didn’t want, two large men looking intently into one another’s eyes, speaking slowly and quietly, as if they had plenty of time to be together.

  But by eleven A.M. they were back in the operating theater. The onslaught of wounded from the War Hawk had taxed the hospital’s facilities and surgical staff. Some surgeons had worked all through the night and the morning, and now Robert Jefferson Cole was operating on a young man from Ohio whose skull, shoulders, back, buttocks, and legs had taken a shower of small Confederate shrapnel. The procedure was long and painstaking, because each piece of metal had to be dug from the flesh with a minimum of damage to the tissues, and the suturing was equally delicate in order that muscles might hopefully grow together. The small gallery was filled with medical students and several faculty members, observing the kinds of terrible cases doctors must expect from the war. Seated in the front row, Dr. Harold Meigs poked Dr. Barney McGowan and with a motion of his chin indicated a man who stood to one side on the operating floor below, far enough removed so he wasn’t in the way, but able to witness. A large, paunchy man with graying hair, he stood with his arms folded and his eyes fixed on the operating table, oblivious of everything else around him. As he observed the steady competence and confidence of the surgeon, he nodded in unconscious approval, and the two professors looked at one another and smiled.

  Rob J. went back by train, arriving at the Rock Island depot nine days after he had left Holden’s Crossing. In the street beyond the railroad station he met Paul and Roberta Williams, in Rock Island to shop.

  “Hey, Doc. You just get off that train?” Williams said. “Heard you been away, little vacation?”

  “Yes,” Rob J. said.

  “Well, you have a good time?”

  Rob J. opened his mouth, then closed it again. “Very pleasant, thank you, Paul,” he said quietly. Then he went to the stable to get Boss and go home.

  49

  THE CONTRACT SURGEON

  It took Rob J. most of the summer to plan. His first thought had been to make it financially attractive for another doctor to take over in Holden’s Crossing, but after a time he had to face the fact that this was impossible, because the war had created an acute shortage of physicians. The best he could do was arrange for Tobias Barr to come to the Cole dispensary every Wednesday, and for emergencies. For less serious matters the people of Holden’s Crossing would make the trip to Dr. Barr’s office in Rock Island or consult the nursing nuns.

  Sarah raged—as much because Rob J. was joining “the wrong side” as because he was going off, it seemed to him sometimes. She prayed and consulted with Lucian Blackmer. She would be defenseless without him, she insisted. “Before you go, you must write to the Union Army,” she said, “and ask them if they have records to show that Alex is their prisoner or a casualty.” Rob J. had done this months before, but he agreed it was time to write again, and he took care of it.

  Sarah and Lillian had become closer than ever. Jay had worked out a successful system of sending mail and Confederate news through the lines to Lillian, probably with river smugglers. Before the Illinois newspapers published the story, Lillian told them Judah P. Benjamin had been promoted from the Confederacy’s secretary of war to its secretary of state. Once Sarah and Rob J. had dined with the Geigers and Benjamin when Lillian’s cousin had come to Rock Island to confer with Hume about a railroad lawsuit. Benjamin had seemed intelligent and modest, not the kind of man to seek out an opportunity to lead a new nation.

  As for Jay, Lillian said her husband was safe. He had the rank of warrant officer and was assigned as steward, or administrator, of a military hospital somewhere in Virginia.

  When she heard Rob J. was going to the Northern army, she nodded carefully. “I pray you and Jay will never meet while we’re at war.”

  “I think it highly unlikely,” he said, and patted her hand.

  He said good-bye to people with as little fuss as possible. Mother Miriam Ferocia listened to him with almost stony resignation. It was part of a nun’s discipline, he thought, to say farewell to those who had become part of their lives. They went where their Lord ordered; in that respect, they were like soldiers.

  He was wearing the Mee-shome and carrying one small suitcase on the morning of August 12, 1862, when Sarah saw him off at the steamboat dock in Rock Island. She was crying, and she kissed him on the lips again and again, almost wildly, oblivious of the stares of the other people on the dock.

  “You are my own dear girl,” he told her gently.

  He hated to leave her that way, yet it was a relief to board the boat and to wave good-bye as the craft tooted two short signals and a long one and moved into the pull of midstream, and away.

  He stayed out on deck most of the trip downriver. He loved the Mississippi and enjoyed watching the traffic in its busiest season. To date, the South had had fighting men with more recklessness and dash, and far better generals than the North. But when the federals had taken New Orleans that spring, they had linked the Union’s supremacy over the lower and upper sections of the
Mississippi. Along with the Tennessee and other lesser rivers, it gave federal forces a navigable route straight at the vulnerable belly of the South.

  One of the military jumping-off centers along that water road was Cairo, where Rob J. had started his voyage on the War Hawk, and it was here that he disembarked now. There were no floods in Cairo in late August, but that was scant improvement, for thousands of troops were camped on the outskirts, and the detritus of concentrated humanity had spilled over into the town, with garbage, dead dogs, and other rotting offal piled in the muddy streets in front of fine homes. Rob J. followed the military traffic to the encampment, where he was challenged by a sentry. He identified himself and asked to be taken to the commanding officer, and soon was led to a colonel named Sibley, of the 176th Pennsylvania Volunteers. The 176th Pennsylvania already had the two surgeons allowed it by the army’s table of organization, Colonel Sibley said. He said there were three other regiments in the encampment, the 42nd Kansas, the 106th Kansas, and the 201st Ohio. He volunteered that the 106th Kansas had an opening for an assistant surgeon, and it was there Rob J. went next.

  The commanding officer of the 106th was a colonel named Frederick Hilton, whom Rob J. found in front of his tent, chewing tobacco and writing at a small table. Hilton was eager to have him. He spoke of a lieutenancy (“Captain, soon as possible”) and a year’s enlistment as assistant medical officer, but Rob J. had done a good deal of investigation and thinking before leaving home. If he had chosen to take the surgeon general’s examination, he would have qualified for a majority, a generous quarters allowance, and posting as a medical staff officer or as a surgeon at a general hospital. But he knew what he wanted. “No enlistment. No commission. The army employs temporary civilian doctors, and I’ll work for you on a three-month contract.”

  Hilton shrugged. “I’ll draw up the papers for acting assistant surgeon. You come back here after supper, sign em. Eighty dollars a month, you supply your own horse. I can send you to a uniform tailor in town.”

  “I won’t be wearing a uniform.”

  The colonel appraised him. “You’d be advised to. These men are soldiers. They’re not going to jump at orders from a civilian.”

  “Nevertheless.”

  Colonel Hilton nodded blandly, spat tobacco juice. He called for a sergeant and instructed the man to show Dr. Cole to the medical officers’ tent.

  They hadn’t gone far down the company street before the first bugle notes signaled retreat, the ceremony for lowering the colors at sundown. All sound and motion ceased as men faced the flag and snapped into salute.

  It was his first retreat, and Rob J. found it strangely moving, for he sensed it was akin to a religious communion among all these men who held the salute until the last quavering note of the far-off bugle had fallen away. Then the activity of the camp resumed.

  Most of the shelters were pup tents, but the sergeant led the way into an area of conical tents that reminded Rob J. of tipis, and stopped in front of one of these. “Home, sir.”

  “Thank you.”

  Inside, it was just two sleeping places on the ground, under cloth. A man, doubtless the regimental surgeon, lay in sodden sleep, giving off sour body odor and the heavy smell of rum.

  Rob J. put his bag on the ground and sat next to it. He’d made many mistakes and had played the fool more than some and less than others, he thought. He could but wonder if perhaps now he wasn’t taking one of the most foolish steps of his life.

  The surgeon was Major G. H. Woffenden. Rob J. quickly learned that he’d never attended medical school, but had apprenticed for a while “under ole Doc Cowan” and then struck out on his own. That he’d been commissioned by Colonel Hilton in Topeka. That a major’s pay was the best regular money he’d ever earned. And that he was content to devote himself to serious drinking and let the acting assistant surgeon handle daily sick call.

  Sick call took almost the entire day, every day, because the line of patients seemed unending. The regiment had two battalions. The first was up to strength, five companies. The second battalion had only three companies. The regiment was less than four months old, and had been formed when the fittest men already were in the army. The 106th had taken what was left, and the second battalion had taken the dregs of Kansas. Many of the men who waited to see Rob J. were too old to be soldiers, and many were too young, including half a dozen who seemed barely into their teens. All of them were in extremely poor condition. The most prevalent complaints were of diarrhea and dysentery, but Rob J. saw a variety of fevers, heavy colds involving the chest and lungs, syphilis and gonorrhea, delirium tremens and other signs of alcoholism, hernias, and lots of scurvy.

  There was a dispensary tent containing a U.S. Army medicine pannier, a large wicker-and-canvas chest containing a variety of medical supplies. According to its inventory list, it should also have contained black tea, white sugar, coffee extract, beef extract, condensed milk, and alcohol. When Rob J. asked Woffenden about these items, the surgeon appeared to be offended. “Stolen, I suppose,” he snapped, too defensively.

  After the first few meals, Rob J. could see the reason for so many stomach problems. He sought out the commissary officer, a harried second lieutenant named Zearing, and learned that the army gave the regiment eighteen cents a day to feed each man. The result was a daily ration of twelve ounces of fat salt pork, two and one-half ounces of navy beans or peas, and either eighteen ounces of flour or twelve ounces of hardtack. The meat was liable to be black on the outside and yellow with putrefaction when cut, and the soldiers called the hardtack “worm castles” because the large thick crackers, often moldy, were frequently tenanted by maggots or weevils.

  Each soldier received his ration uncooked and prepared it himself over the flame of a small campfire, usually boiling the beans and frying both the meat and the crumbled hardtack—even frying flour—in pork fat. Combined with disease, the diet spelled disaster for thousands of stomachs, and there were no latrines. The men defecated anywhere they chose, usually behind their tents, although many with loose bowels made it only as far as the space between their tent and their neighbors’. About the camp was an effluvia reminiscent of the War Hawk, and Rob J. decided the entire army stank of feces.

  He realized he could do nothing about the diet, at least at once, but he was determined to improve conditions. Next afternoon, after sick call, he walked to where a sergeant from Company C, First Battalion, was drilling half a dozen men in the use of the bayonet. “Sergeant, do you know where there are some shovels?”

  “Shovels? Why, yes, I do,” the sergeant said warily.

  “Well, I want you to get one for each of these men, and I want them to dig a ditch,” Rob J. said.

  “A ditch, sir?” The sergeant stared at the curious figure in the baggy black suit, the wrinkled shirt, the string tie, and the wide-brimmed black civilian hat.

  “Yes, a ditch,” Rob J. said. “Right over here. Ten feet long, three feet wide, six feet deep.”

  This civilian doctor was a large man. He appeared very determined. And the sergeant knew he had simulated rank of first lieutenant.

  The six men were digging industriously a short time later, while Rob J. and the sergeant watched, when Colonel Hilton and Captain Irvine of Company C, First Battalion, came down the company street.

  “What the hell is this?” Colonel Hilton said to the sergeant, who opened his mouth and looked at Rob J.

  “They’re digging a sink, Colonel,” Rob J. said.

  “A sink?”

  “Yes, sir, a latrine.”

  “I know what a sink is. Their time is better spent at bayonet practice. Very soon these men will be in battle. We’re showing them how to kill rebels. This regiment is going to shoot Confederates, and bayonet them, and stab them, and if it’s necessary, we will shit and piss them to death. But we will not dig latrines.”

  From one of the men with shovels came a guffaw. The sergeant was grinning, watching Rob J.

  “Is that clearly understood, Acti
ng Assistant Surgeon?”

  Rob J. did not smile. “Yes, Colonel.”

  That was on his fourth day with the 106th. After that, there were eighty-six more days, and they passed very slowly and were counted very carefully.

  50

  A SON’S LETTER

  Cincinnati, Ohio

  January 12, 1863

  Dear Pa,

  Well, I claim Rob J.’s scalpel!

  Colonel Peter Brandon, a principal aide to Surgeon General William A. Hammond, delivered the commencement address. There were those who said it was a fine talk, but I was disappointed. Dr. Brandon told us that doctors have tended to the medical needs of their armies all through history. He gave a lot of examples, the Hebrews of the Bible, the Greeks, the Romans, etc., etc. Then he told all about the splendid opportunities the wartime United States Army offers a doctor, the salaries, the gratification one receives when serving his country. We yearned to be reminded of the healing glories of our new profession—Plato and Galen, Hippocrates and Andreas Vesalius—and he gave us a recruitment speech. Moreover, it was unnecessary. Seventeen of my class of thirty-six new physicians already had arranged to enter the Medical Department of the Army.

  I know you will understand when I write that although I would dearly have loved to see Ma, I was relieved by her decision not to attempt the trip to Cincinnati. Trains, hotels, etc., are so crowded and dirty nowadays that a woman traveling alone would have to suffer discomfort, or worse. I especially missed your presence, which gives me another reason to hate the war. Paul Cooke’s father, who sells feed and grain in Xenia, came to commencement and afterward took the two of us for a grand feed, with wine toasts and nice compliments. Paul is one of those going directly into the army. He’s deceptive because he’s so full of fun, but he was the brightest in our class and was awarded his degree summa cum laude. I was of help to him in the laboratory work, and he helped me earn magna cum laude, because whenever we finished a reading assignment he asked me questions that were a lot fiercer than any our professors ever asked.