BITE THE BELT: THE SURGEON IN CIVIL WAR LITERATURE By SARAH K. TRAPHAGEN A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY UNIVERSITY OF FLORIDA 2014
2014 Sarah K. Traphagen
3 ACKNOWLEDGMENTS I have had many great teachers who taught me to pursue what means most to me. Sally Osborne, I cannot find the words to truly thank you for your guidance and profound love. The roots of this project began with John Michalko. Should he read this, he will smile at the thought of a young girl dressed up as a Civil War soldier with a mustache drawn on her face. John, thank you for showing me that to teach is to touch a life forever . Picnic with Scott Schauman changed my life forever and made me realize who I am. Thanks, Scott. Many thanks to Paula Kot, Bill Martin, Jamie Carr, and Tom Chambers at Niagara University for guiding me into a very bright future. The groundwork for this dissertation began at the University at Buffalo. Thank you, Carrie Tirado Bramen, for your encouragement with my Civil War literature research. Over the past ten years, I have met so many wonderful people who became my close friends and steadfast supporters. My dear friends, thank you for your wisdom, encouragement, and kindness. Thank you so much especially to Ashwak Fa rdoush, Michelle Denham, Anthony Cirilla, Zach Mills, Beth Whistler, Danielle Puleo, Taylor Brodie and Kelton Fredrick , Jordan Youngblood, Sarah Lennox, Elliot Kuecker , Dave and Ginny Lawrimore, Rebekah Fitzsimmons , Amisha Sharma, Rachel Butikofer, and the Miles family . Many thanks to Diane Garrison, Nellie Es hleman, Stacey Walden, Glenn Cameron, Erin Dorman, Dr. Lori Scott, Kelsey Chesteen, Kate Ellison , Ana Mango, and Abby Reichardt for â€œmidwifingâ€ me through the last stage of my schooling. To my students over the years, thank you for your validation and creativity . Alix Krzemien, Kristi Mitchell, Najwa AlTabaa, and Sarah Pitcher Hayes, thank you for your abundant love and strength. I am so lucky to know each of you. I hope I can pay back to you everything that you have doneâ€“ and still do â€“ for me as I make my
4 way through life. Gage LaFleur, my heart carries you in it. Thank you for your talks, for growing with me, and for giving my thoughts and everything I have worked so hard for an incredible name. To m y director, Stephanie A. Smith, and doctoral committee, Jodi Schorb, Ed White , and Matt Gallman, I am forever indebted to all of you. This project exists because of you. Each of you has given me gifts beyond anything I could ever ask for. Each of you helped me grow as a scholar, writer, thinker, and human being over the past four years. I will pay forward to my students every bit of care, guidance, and honesty that you so graciously bestowed upon me. With all of my heart, thank you. I owe a great deal to Sean Kelly who has taught me to live life a little more outside of my books. Sean, you have the ability to take my complex thoughts and make them simple. Thank you for making me meals, giving me your calm, and for taking a plane ride when you did. I am so grateful to have you in my life. In finite thanks to Lynette and Obby Tavano and family, JoAnne and Donald Yott and family, Rich Yahn and family, Joe and Laurie Traphagen and family , and Mary Ellen Hill. I would not be where I am without your support and love. Grandma and Grandpa, thank you for moving me to Florida, and for feeding me and doing my laundry when I came to visit. You were my home away from home. Aunt Net, thank you for being my best friend, telling it to me straight when I need it, and for all the laughs. To my mother and father, Christina and Ed Traphagen, I am so blessed that you have always supported my choices without judgment. Every day of my life you encourage me to dance to my own beat. You always tell me to reach for the stars and never give up even
5 when I feel like I cannot go any further. I am so fortunate for that kind of love. Dad, thank you for introducing me to Hawkeye and Trapper. This project surely stems from the many, many episodes of M*A*S*H we have watched together. Mom and Dad, t hank you for the work ethic and compassion that you have instilled me. My accomplishments are your accomplishments.
6 TABLE OF CONTENTS page ACKNOWLEDGMENTS .................................................................................................. 3 LIST OF FIGURES .......................................................................................................... 8 ABSTRACT ..................................................................................................................... 9 CHAPTER 1 INTRODUCTION: LIFE AND LIMB ......................................................................... 11 2 HALF FACES DESPERATE: AMBROSE BIERCEâ€™S WAR PHILOSOPHY AND THE MEDICAL MISPERCEPTION OF WOUNDED BODIES ................................. 23 A Manual and an Opportunity ................................................................................. 29 Father and Son ....................................................................................................... 34 Little Boys and Jawless Men ................................................................................... 37 Notes ...................................................................................................................... 58 3 WITH HINGED KNEES AND STEADY HAND: WALT WHITMAN AS SURGEON SCRIBE ............................................................................................... 62 In Medias Chirurgia ................................................................................................. 64 The Inverted Triangle .............................................................................................. 72 Walt Whitman as SurgeonScribe ........................................................................... 77 Notes ...................................................................................................................... 93 4 BLOODSTAINED PETTICOATS, PROTESTING PANTALOONS, AND IMAGINING SURGEON EDUCATION FOR THE CIVIL WAR NURSE: RETHINKING LOUISA MAY ALCOTTâ€™S TRIBULATION PERIWINKLE ................. 99 Medical Education and the Civil War Nurse .......................................................... 108 Bloody Petticoats, the Revision of the Woman in the Black Dress, and Protesting Pantaloons ....................................................................................... 120 Tribulation Periwinkle (Future M.D.) ..................................................................... 127 Notes .................................................................................................................... 136 5 CONSERVATIVE RESECTION: RECONSTRUCTION AND MARK TWAINâ€™S MEDICAL COMPLAINT ........................................................................................ 142 Pre Op Persistence .............................................................................................. 145 The Clinicâ€™s Medical Students ............................................................................... 155 Re Section Complaint ........................................................................................... 161 Notes .................................................................................................................... 179
7 6 CONCLUSION: UNSEVERED: THE REIMAGINED CIVIL WAR SURGEONâ€™S LESSONS IN E.L. DOCTOROWâ€™S THE MARCH ................................................. 184 The Reimagined Civil War Doctorâ€™s Perception .................................................... 190 Lesson One: Open Wound ................................................................................... 196 Lesson Two: Always Now for All of Us .................................................................. 200 Notes .................................................................................................................... 209 7 AFTERWORD: REHINGING LIFE/SCALPEL TO TEXT: NARRATIVE MENDING IN DR. DAVE HNIDAâ€™S PARADISE GENERAL .................................. 2 11 Medical Autopilot .................................................................................................. 214 Every Slice, Every Stitch ....................................................................................... 218 The Final War Body .............................................................................................. 225 APPENDIX: THE GROSS CLINIC BY THOMAS EAKINS .......................................... 227 WORKS CITED ........................................................................................................... 228 BIOGRAPHICAL SKETCH .......................................................................................... 239
8 LIST OF FIGURES Figure page A 1. The Gross Clinic (1875) by Thomas Eakins ....................................................... 227
9 Abstract of Dissertation Presented to the Graduate School of the University of Florida in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy BITE THE BELT: THE SURGEON IN CIVIL WAR LITERATURE By Sarah K. Traphagen August 2014 Chair: Stephanie A. Smith Major: English Bite the Belt: The Surgeon in Civil War Literature demonstrates how the literature of the C ivil War is a literature of surgeons which contemplates, through the surgeon figure and other medical mediums, how literary artists narrated the war to make sense of it and participated in revising national discourse. Recent scholarship presents a limited view of the Civil War literary surgeon. Studies of Civil War literature disregard surgeons and studies of surgeons in nineteenthcentury American literature leave out the Civil War. This dissertation remedies the critical oversight by re reading Ambrose Bierceâ€™s Tales of Soldiers and Civilians , Walt Whitmanâ€™s Drum Taps, Louisa May Alcottâ€™s Hospital Sketches , Mark Twainâ€™s novels, and E.L. Doctorowâ€™s The March. With the notion that the war was a medical event because of the surgical work that wounded bodies r equired, this project poses that the medical fieldâ€™s increased visibility gave authors the opportunity to contemplate prevalent nineteenthcentury issues such as the competency and empathic capacity of surgeons, the role of women in the medical field, and the legacy of slavery in reconstructing the nation through interactions with surgeons and to use surgeonsâ€™ discourse, i.e. amputation and resection, to metaphorically describe and understand the national crisis. The surgeon figure in Civil War literature
10 m atters because authors imagined, confronted, and reconceived this figure as one who encountered the war torn national body while attempting to repair war torn soldiersâ€™ bodies. The historical, artistic, and literary narratives of Bite the Belt uncover how the physicality of Civil War medicine informs the relationship between literature, the surgeon figure, and cultural debates from the eve of war through Reconstruction.
11 CHAPTER 1 INTRODUCTION: LIFE AND LIMB Was it possible to lose the nation, and yet preserve the constitution? By general law life and limb must be protected; yet often a limb must be amputated to save a life; but a life is nev er wisely given to save a limb. â€“ President Abraham Lincoln April 4, 1864 The amputation of a limb is a severe trial to feeling, but necessity is a full justification of it to reason. â€“ Frederick Douglass The Life and Times of Frederick Douglass Drew Gilpin Faust has argued that the work death required was the most collective experience of the Civil War (xviii). Soldiers prepared to die before battle, and, when they did die, the labor of death began for the gravedigger on the field and the mourners at home. Some soldiers on the battlefield did not die right away or at all, though. Some were taken to the hospital operating table where a belt was often pl aced between their teeth and a surgeon went to work on a limb. Many bodies arrived home from the hospital uneven, and these bodies became the hallmark of what the war would be remembered for. Thus, the Civil War was not just an occasion for mass death. Rather, the Civil War was a medic al event because of the surgical work that countless wounded bodies demanded. So prolific was the medical experience of the war that President Abraham Lincoln viewed himself as a surgeon with a decision to make about the national body. The crisis of slavery pushed him to perceive himself as a doctor with the ability to amputate the South, a diseased limb. He declared, I have sometimes used the illustrationof a man with a diseased limb, and his surgeon. So long as there is a chance of the patientâ€™s restor ation, the surgeon is solemnly bound to try to save both life and limb; but when the
12 crisis comes, and the limb must be sacrificed as the only chance of saving the life, no honest man will hesitate. (Masur 330) Lincolnâ€™s use of medical discourse to manage the warâ€™s problems makes sense because the doctor was a major cultural actor leading up to and during the war. In the first half of the nineteenth century, efforts were made by doctors to solidify their profession. The establishment of professional Ameri can medicine began with Dr. Benjamin Rush in the era of the newly formed republic. Rushâ€™s contributions shaped medical education and practice, especially his philosophies about heroic dosing in pharmaceutical therapies. With Rushâ€™s famed philosophies, students of physic learned a body of knowledge designed around the most prevalent form of medical crisis they were confronted with: disease. To treat diseases, â€œschools inculcated in their students the regimen of bloodletting, cathartics, blistering, and all t he other therapies characteristic of heroic medicine,â€ William G. Rothstein explains (125). No doubt Civil War doctors were up to their elbows in rapidly spread diseases. But, they were also up to their elbows in blood and viscera. Rushâ€™s therapies only di d so much for mangled bodies with missing parts. Before the war, doctors were not adequately trained for surgery. They learned based on rote memory and were not held to set standards for completion of medical school (Rutkow 51). N ew philosophies about ac quiring anatomical knowledge through dissection gradually integrated into medic al thinking as the century progr essed . Michel Foucault notes, â€œmethods of analysis, the clinical examination, even the reorganization of the schools and hospitals seemed to deri ve their significance from pathological anatomyâ€ (124). The dissecting room became a popular place for education when anatomical material was available. D uring the war, the operating room took over. To be
13 sure, the Civil War made surgeons because battlebr oken bodies required surgical intervention. The war shifted surgery into the public arena, and influenced the development of surgical medicine and practice. As Walt Whitman aptly observed, the nation was â€œone vast hospitalâ€ between 1861 and 1865. Surgeries after battle lead to heaps of amputated limbs, convalescent bodies, and, sometimes, the dead. Years after the war , Frances Ellen Watkins Harper still employed medical discourse in her novel to discuss the fate of the nation. In Iola Leroy; or, Shadows U plifted, nurse Iola states, â€œslaverywas a fearful cancer eating into the nationâ€™s heart, sapping its vitality, and undermining its lifeâ€ (216). The surgeon she works with, Dr. Gresham, responds, â€œand warwas the dreadful surgery by which the disease was e radicated. The cancer has been removed, but for years to come I fear that we will have to deal with the effects of the diseaseâ€ (216). Here, Dr. Gresham foresees the persistent problems of the warâ€™s legacies in metaphorical medical terms speaks to Civil War medicineâ€™s cultural impact. Considering the rise of the medical profession throughout the first half of the nineteenth century, the development of surgeons during the war, Lincolnâ€™s words, and the recurring appearance of medical circumstances in Civil War literature, this leads me to ask, what can be learned about Civil War literature through the surgeon figure? What exactly Civil War literature is has caused debate. According to Edmund Wilson, pamphlets, memoirs, private letters, diaries, and journal r eports are the most important pieces of Civil War literature.1 This literature, based completely on real experience, tells the same story of the war but from several points of view. For Wilson, there was nothing imagined about the war. Daniel Aaron recogni zes how the Civil War
14 influenced fiction and nonfiction writers, yet he believes that none have truly captured the war on the page.2 So, he argues, while there are innumerable amounts of text recounting the war, not one can be considered the magnum opus. Alice Fahs argues against Wilson and values inclusivity more than Aaron. She views popular literature as an indicator of how war was interpreted by scores of people, especially the nonelite. Fahs describes how Northern and Southern popular literature shaped the social politics of the war and engaged both combatants and noncombatants in a conversation about the relationship between individual and nation. More similar to Fahs, Bite the Belt takes an integrative, interdisciplinary approach to the study of Ci vil War literature. This project reads doctor narratives, nurse narratives, surgical manuals, poetry, fiction, popular pieces, slave narratives, clothing, and visual texts as equally important in understanding a full picture of how wartime medicine influenced conversations about cultural issues . Surprisingly, Civil War literature schola rship largely neglects the surgeon. Critics favor the soldier and, regarding the hospital, the nurse. Craig A. Warren sums up the appearance of soldiers in Civil War literature perfectly: â€œthousands of pageshave confirmed that Union and Confederate soldiers occupy an essential, even iconic, place in the American imaginationâ€ (1). The soldier makes the war, no doubt. One need only think of Stephen Craneâ€™s The Red Badge of Courage, which is accepted as the literary piece that best illustrates the Civil War soldierâ€™s story. Stephen Crane did not experience the war for himself, and not coincidentally, the gut wrenching medical element of the war is absent from the novel. Aside from fiction, soldier memoirs, diaries, letter collections, and regimental histories have long recapitulated the battle experience. Focused specifically on veterans, Warren goes on to say, â€œsurely other familiar types
15 populate the landscape of Civil War [literature] as wellâ€“ among them, slaves, Southern belles, politicians, journalists, abolitionists, and childrenâ€ (1). Warren leaves out surgeons, or any other medical figure for that matter. The soldier as an amputee is a recurring, iconic image wit hin Civil War literature and history as well and is important to this project. For example, Frances M. Clarke discusses veteransâ€™ narratives of losing a limb or becoming a victim of disfiguring injuries. Many amputees viewed their â€œphysical lossâ€ as a sacr ifice for the country or an â€œ[expression] of patriotic commitment, Christian fortitude, [and] self disciplineâ€ (146). Others who found themselves without work and without pay because of their loss often could not find higher meaning in living an uneven lif e. Regardl ess, postwar America granted the empty sleeve symbolic value without truly understanding the needs of the onelimbed men. With the focus on the amputee, it is surprising that the wartime actor who was responsible for making the soldier an amputee is not investigated thoroughly by scholars. Instead, the nurse figure garners more attention.3 This is probably because of the abundant availability of nursesâ€™ diaries, journals, and memoirs. Jane E. Schultz unearths how female nurses functioned in a new environment that demanded emotional and physical fortitude as well as close work to convalescent male bodies. Of course, the nurse is viewed in relation to her patients, ultimately bringing the focus back onto soldiers. Semi fictional pieces such as Louisa May Alcottâ€™s Hospital Sketches , according to Fahs, helped to create a tender, individualized nationalism and democratization of heroic ordinary soldiers in which the suffering, wounded soldier became the icon of the nation. Like the wounded soldier, womenâ€™s suffering and tears consecrated the national
16 value of war. While the work of Schultz and Fahs is foundational, neither adequately assesses the role of surgeons in nursesâ€™ writings though nurses have much to say about them. Studies that do focus on the doctor figure either leave out the Civil War entirely or disregard all aspects of the Civil War surgeonâ€™s role. Stephanie P. Browner interrogates the role of the fictional doctor in the nineteenthcentury American conversation about the rise of white, elite authority. She argues that fiction challenged the knowledge believed to be held by doctors and â€œexposed the violence inherent in medicineâ€™s drive to epistemological masteryâ€ (4). She does this without considering the overt violence of the Civil War e ra. Randall Fuller reiterates the usual narrative that accompanies critiques of the literary war hospital: he comments on Walt Whitmanâ€™s compassion, Louisa May Alcottâ€™s poignant humor, and S. Weir Mitchellâ€™s effort to finally produce a piece of literature that chronicles â€œthe personal life of a war surgeonâ€ (147). However, Mitchellâ€™s wartime novelâ€™s surgeon spends most of his time away from the battlefront, and his short story â€œThe Case of George Dedlowâ€ examines the neuroses of phantom limb, which again pl aces emphasis on the soldierâ€™s experience. Thus, w ith the war in mind, Lisa A. Long examines the relationship between the doctor and the body in postbellum works. She attributes the writings during and after the war as attempts at healing the wounded national and individual bodies that populated both cultural and textual landscapes. She perceives rehabilitation in postbellum texts in the form of mending: mending the nation, mending historical narrative, and mending current cultural needs. Through this lens, she argues that the war accrues therapeutic value because mangled bodies are frequently coupled with the figure of a woundmender. Her view of mending
17 is important, but she ignores the surgical processes that created the results that she claims need heali ng. While it is true that doctors did do their best to heal wounds, they were not always menders. The war also created a rupture that allowed surgeons to slice bodies â€“ literally and figuratively â€“ wide open. In short, surgeons were menders and rupturers . The surgeon has been critically neglected, yet is an immensely valuable figure through which to understand the Civil War, its representations, and the warâ€™s unacknowledged costs and consequences. To remedy the critical oversight, Bite the Belt demonstrates how the literature of the Civil War is, in large measure, a literature of surgeons which contemplates, through the surgeon figure and other medical mediums, how literary artists narrated the war to make sense of it and participated in revising national discourse. This study rereads Ambrose Bierceâ€™s Tales of Soldiers and Civilians , Walt Whitmanâ€™s Drum Taps , Louisa May Alcottâ€™s Hospital Sketches , and Mark Twainâ€™s Adventures of Huckleberry Finn, Life on the Mississippi , The Gilded Age, and A Con necticut Yankee in King Arthurâ€™s Court . Each author experienced the war up close. The medical fieldâ€™s increased visibility gave authors the opportunity to contemplate wartime culture through interactions with surgeons and to use surgeonsâ€™ discourse, i.e. a mputation and resection, to metaphorically describe and understand the national crisis. The surgeon figure in Civil War literature matters because authors imagined, confronted, reshaped, and reconfirmed this figure as they thought about major cultural debates in flux during the war such as the competency of surgeons and the impact of their r equired work on themselves, the role of women in medicine, and the legacy of slavery and medical racism in reconstructing the nation. More importantly, authorsâ€™
18 varying conceptions of the surgeon positioned this figure as one who encountered the war torn national body while attempting to repair war torn soldiersâ€™ bodies. The visual metaphor for this project is Thomas Eakinsâ€™s 1875 painting, The Gross Clinic . I chose this visual because, I argue, the painting is connected to the Civil War. The paintingâ€™s central subject, Dr. Samuel D. Gross, wrote a manual for field surgeons at the beginning of the war and taught surgeons during the war. The painting shows Gross performing a c onservative resection on a limb. In Civil War medicine, Alfred Bollet explains, â€œthe main alternative to amputation [was] a procedure called excision or resection, [which] involved removing the portion of the limb containing the shattered bone [or diseased section] in the hopes that healing would bridge the defectâ€ (147). T he surgical implications of resection are essential to my arguments about the surgeon figure in Civil War literature. Also, Dr. Grossâ€™s son, Dr. Samuel Weissell Gross, who was a Union brigade surgeon, stands in the background of the painting observing his father. I discuss the elder and younger Gross at length throughout my analyses . Next, the paintingâ€™s history points to a connection with Civil War medicine. Scholars skim the fact that The Gross Clinic was placed in the Medical Section of the U.S. Army Pos t Hospital Exhibit at the 1876 Centennial Exhibition.4 Among an array of â€œphotographs of difficult and successful amputations,â€ the eight by six feet painting stood adorned in black drapes (McCabe 216). Side by side, the amputation photographs and the paintingâ€™s conservative resection coalesced into a narrative about the nationâ€™s medical experience of the war. The conservative resection surgery in the painting does not appear methodical and clean. Rather, the scene gives the impression that surgery can be a gritty medical free for all and a hasty procedure for the sake of
19 pedagogy by demonstrationâ€“ a scene straight out of Civil War literature. As I will show in detail, The Gross Clinic enacts each point of perception that my project considers: the surgeon m ade by the Civil War, the scribe who records the scene and accesses the surgeonâ€™s interiority, the woman who protests the mainstream in favor of her own ideas, and medical students in their element of the clinic space, who represent a history of medical racism and experimentation on African Americans. Moreover, I make use of three paradigmatic stages of surgical operation as my projectâ€™s organizing principle to capture the temporal linear narrative of before, during, and after the war: preoperation, operat ion, and post operation. Each moment offers a new way to think about the relationship of surgeons to the national crisis and how both surgeons and writers conceived of this relationship. Because I employ historical narratives as a way to reconsider literat ure, the painting provides a visual representation that ties the two mediums together. Merging the visual, the historical, and the literary reinforces how the physicality of Civil War medicine informs the relationship between the surgeon figure and social debates from the eve of war through Reconstruction. Thus, each chapter contains an historical, visual , and literar y section. This studyâ€™s second chapter reconsiders Ambrose Bierceâ€™s Tales of Soldiers and Civilians . I pose that, indirectly through his phi losophies, Bierce comments on the development of the war surgeonâ€™s wisdom when confronting new wounds and disfigured bodies. I pair a surgeonâ€™s manual from 1861 with Bierceâ€™s stories to convey how the stories could be read as an allegory about surgeonsâ€™ mi sperceptions of their abilities and inherited ideologies at the s tart of the war. In the third chapter, I construct a new way to read Walt Whitmanâ€™s poetry from
20 Drum Taps through self reflective Civil War doctor narratives. The doctor narratives show one type of surgeon figure: the surgeonscribe who has very precise emotional and psychological traits derived from the difficult aspects of failing medical work. The surgeonscribe writes with the technique of what I term â€œ in medias chirurgiaâ€ in an attempt to understand the nature of wartime surgical work. Tragically, what this figure often discovers is that his knowledge and emotional response cannot keep up with his practice. Whitman possesses the same empathic vision of doctors who took the visceral cutti ng up of bodies to heart. His poetry reveals that he, too, is a surgeonscribe, not just a nurse as he is criticall y perceived to be. In the fourth chapter, I reread the role of Tribulation Periwinkle in Louisa May Alcottâ€™s Hospital Sketches by linking ni neteenthcentury debates about medical education for women with Civil War nurse rhetoric. Trib then becomes a commentary on how the war offered women the opportunity to perceive their professional medical capabilities beyond nursing. She first vocalizes in literature the broader logic that war nurse narratives tend to show: that wartime nursing is not only about becoming a nurse; it is about thinking of the possibilities of medical education and becoming a surgeon. The fifth chapter begins with a removed episode from Mark Twainâ€™s Adventures of Huckleberry Finn referred to as â€œThe Lost Episode.â€ I argue that the episode summons up antebellum medical practices of experimentation and punishment in slavery. When paired with Civil War hospital moments, I show t hat surgeons with antebellum thinking carried this legacy of enslavement to the war front and into the postwar era. With â€œThe Lost Episodeâ€ from Huck Finn as an interpretive lens, examples of ignoring medical racism and slavery in The Gilded Age, Life on t he Mississippi , and A
21 Connecticut Yankee in King Arthurâ€™s Court clarify Twainâ€™s complaint that the inhumanity perpetrated on African Americans was obscured from the nationâ€™s conscience and memory during Reconstruction. I conclude with a discussion of E.L. Doctorowâ€™s The March. Doctorow chose a war surgeon, Dr. Wrede Sartorius, to teach the novelâ€™s central message that America, as a culture, still grapples with some of the warâ€™s problematic legacies: racism, regional differences, and divisive politics. Doc torowâ€™s novel forces the reader to confront twenty firstcentury problems, especially damage to soldiersâ€™ bodies caused by new warfare, within the historical context of the Civil War. The Civil War was a new industrial war with new wounds. The same concept stands today with the wounded from the wars in Iraq and Afghanistan, an issue that I explore further in the afterword to this study. A connection between Civil War surgeons and current combat surgeons should not exist, but it does. That connection is amputation. The number of amputees from our two recent wars is near that of our midnineteenthcentury war. Though amputation presents removal (and renewal), as Doctorowâ€™s reimagined surgeon Dr. S artorius explains, we are not severed from the Civil War . Notes 1. See Patriotic Gore: Studies in the Literature of the American Civil War . New York: W.W. Norton & Company. 1962. 2. See The Unwritten War: American Writers and the Civil War . New York: Alfred A. Knopf, 1973. 3. T he relationship between nurse and patient often evokes the issue of eroticism because of nursesâ€™ constant closeness to bodies. Walt Whitmanâ€™s nursing descriptions are most associated with this. For example, Robert Leigh Davis argues that Whitmanâ€™s writing recognizes the value of a â€œconvalescent democracy â€ that emerged during the war in which America, like a convalescent hospital body between death and health, was suspended in a liminal space between conservative
22 and radical ideals. Whitman perceives political representation through the body and equates therapeutic medicine with homosexuality. Davis contends that â€œhomosexuality, like medicine and convalescence, evokes a mode of relation based on continual risk, continual doubt,â€ and Whitman writes through this body and values this risk as â€œenabling poetry, medicine, and democracyâ€ (14). See Whitman and the Romance of Medicine. Berkeley: University of California Press, 1997. 4. The Centennial Exhibition held in Fairmount Park, Philadelphia in 1876 was the site of a vast celebration of American culture and history. James D. McCabeâ€™s voluminous work, The Illustrated History of the Centennial Exhibition, proves that the Exhibition was meant to be an overt display of a powerful, united America. However, the Exhibition was fraught with irony. President Ulysses S. Grant attended the Exhibition with Emperor Dom Pedro II of Brazil, a nation state built upon slave labor. Similarly, few notice the political and social climate of this time period when considering the Exhibition and the life of The Gross Clinic. The wounds of the war and the deep scar of slavery were still fresh and painful. In other words, the nation was still convalescent, still diseased with racial prejudice and societal division, and without a promising prognosi s, though desperately in need of one.
23 CHAPTER 2 HALF FACES DESPERATE: AMBROSE BIERCEâ€™S WAR PHILOSOPHY A ND THE MEDICAL MISPERCEPTION OF WOUNDED BODIES People sometimes imagine that a practicing physician can be transformed into an army surgeon merely by putting a uniform on him. I was not lacking in ordinary intelligence and was willing to work, but I was utterly without training. â€“ William Williams Keen, M.D. Except for a short description of a field hospital in â€œWhat I Saw of Shiloh,â€ Ambrose Bierce hardly seems to contemplate the state of medical affairs during the Civil War in his fiction. The gruesome description of the field hospital in â€œWhat I Saw of Shil ohâ€ reveals only a slight glimpse of what Bierce may have thought about war surgery. Cynical and matter of fact, he observes that â€œthese tents were constantly receiving the wounded, yet were never full; they were continually ejecting the dead, yet were nev er empty. It was as if the helpless had been carried in and murdered, that they might not hamper those whose business it was to fall to morrowâ€ (99).1 Despite the lack of textual focus on the medical aspect of the war, clearly Bierce observed and thought critically about the work of surgeons. He also spent time in a hospital recovering from a head wound which gave him the opportunity to witness surgeonsâ€™ successes and failures. He saw, like surgeons, what industrialized machinery could do to the human body, and he describes in intricate detail the limbless or wounded bodies that doctors confronted and tried to put back together. Yet, in spite of this massive pile of mutilated bodies in his texts , not one scholar considers how the consistent aftermath of batt le present in Bierceâ€™s short fiction could be read within a Civil War medical context. Historically, in the beginning of the war, surgeons were forced to confront their misperceptions about their abilities to understand and fix wounded bodies. When
24 Bierceâ€™s short fiction is interpreted within this context, the stories that allude to surgeons or in which surgeons appear exemplify his war philosophy oft noted by scholars of his work: that war reveals misperceptions when what is imagined collides with what is experienced.2 To remedy the oversight of surgeonsâ€™ role in Bierceâ€™s work, this chapter rereads three of Bierceâ€™s tales from his short story collection, Tales of Soldiers and Civilians : â€œChickamauga,â€ â€œA Tough Tussle,â€ and â€œParker Adderson, Philosopher.â€ First, I spend a great deal of text discussing â€œChickamaugaâ€ because this short story is the foundation for my medical interpretation of Bierce . A surgeon character does not appear in â€œChickamauga,â€ however I interpret the plot and main characterâ€™s actions in relation to Civil War surgeonsâ€™ early misperceptions about wounded bodies. Next, â€œA Tough Tussleâ€ and â€œParker Adderson, Philosopherâ€ are the only two stories in which a surgeon character appears. The surgeon figures come into the plot at the very end and are paired with each storyâ€™s main point. â€œA Tough Tussleâ€ shows how the surgeon is haunted by his misperceptions through an aversion to the war wounded and dead. â€œParker Adderson, Philosoph erâ€ emphasizes how the surgeon confronts the disparity between b elieved ideologies and the realities of war. Together, all three stories present a narrative of the inexperienced surgeon in the very beginning of the war. This narrative reveals that Bierceâ€™s project is not just about conveying soldiersâ€™ misperceptions of battle and war, but is, in fact, also about surgeonsâ€™ misperceptions of dealing with wounded bodies, which suggests a more complex and nuanced conception of the war messa ge that he explicitly emphasizes in his fiction. This chapter does not include the physicians that appear in the â€œCiviliansâ€ section
25 of Tales of Soldiers and Civilians . Physicians appear in â€œA Watcher By the Dead,â€ â€œThe Man and the Snake,â€ and â€œAn Heiress from Red Horse.â€ The differences between the collectionâ€™s sections have to do with war and medicine. Surgeons appear only in the â€œSoldiersâ€ section and physicians appear only in the â€œCiviliansâ€ section. While these differences ultimately give more clout to the ideas I present here, the separation of the doctors by title and experience s uggests that Bierce believed these roles to be vastly different.3 Surgeons go to war, or are made by war, and physicians do not. The physicians in Bierceâ€™s three civilian stories range from being a jokester to a scientist of zoology to the object of oneâ€™s affections. None confront terribly mutilated bodies with lacerated flesh wounds or leaky bullet holes. Like most scholarly assessments of his literature, Bierceâ€™s war days are crucial to this analysis. He lived the war as a soldier for about one thousand three hundred and seventy five days.4 â€œOf all the literary combatants of the Civil War,â€ Daniel Aaron asserts, â€œnone saw more action or steeped himself so completely in the essence of battleâ€ (183). Bierce was fascinated by the psychological element of battle. His writing portrays â€œsingle incidents, sometimes bounded by a few minutes, to show intimately what an individual soldier feared, saw, believed and did at the moment of his mortality,â€ Russell Duncan and David J. Klooster explain (24). Howard W. Behr states that Bierce respected the hard truth about soldiering; a truth revealed in battle when soldiersâ€™ cowardice trumped their courage and when soldiersâ€™ selfish desire to live proved stronger than their desire to die for an ideological cause. His war st ories show heroes who are not always heroic, and antiheroes have one purpose: to expose the realities of war. Eric Solomon highlights the unequivocal â€œfrustrationâ€ that emerges in Bierceâ€™s
26 literature when characters and readers alike understand that â€œwar i s not an abstract moral condition but a physical concrete realityâ€ with a t ough conclusion (185). As stated by Duncan and Klooster, the talesâ€™ tough conclusion is that â€œmen died, and that was thatâ€ (26 27). While veterans were looking back upon their war days through silver lined lenses and writing regimental histories in the latter half of the nineteenth century, Bierce wrote about the moments in the war when all the profound glory and romanticism evaporated and when men died for no noble reason. He publis hed Tales of Soldiers and Civilians in 1891, which questioned battle glory.5 Roy Morris, Jr. asserts how â€œhis realistic portrayal of war, his hardearned cynicism, and his keen insight into the minds of soldiers facing the overwhelming existential crisis of the battlefield are now commonplace in literature, [but prior] to Bierce, they were notâ€ (125). For the literary punch that he packs, Bierce is often oversimplified and ignored.6 Unlike most critical assessments, my argument considers only two integral aspects of his military career: t he fact that he was a topographer and present at the Battle of Chickamauga and that he endured a head wound which landed him in a hospital (and subsequently ended his war participation) . These facts create a new interpreti ve context for Tales of Soldiers and Civilians . First, as a topographer for General Hazen, Bierce evaluated and mapped geographical surfaces. This occupation influenced him intensely. He wrote long after the war, â€œto this day I cannot look over a landscape without noting the advantages of the ground for attack or defense; here is an admirable site for an earthwork, there an able place for a field batteryâ€ (Fatout 394). Landscapes spoke to him. His topography skills crept into the making of his literary landscapes. The malleability of his war scenes exemplifies this because they have
27 texture and tell stories within stories. The landscapes are more than just trees mowed down by lead. The wounded are woven into these scenes (and sometimes trees) carefully. I c laim that the landscapes full of contorted men in Bierceâ€™s short stories evoke an unrealized layer of interpretation: the wounded bodies naturally signify a need for surgeons and for medical f ixing. Bierceâ€™s head wound placed him in a position to observe wartime medical care. Bierce was shot by a Confederate sharpshooter at Kennesaw Mountain on June 23, 1864. He sustained a bullet wound to the left side of his head right near his ear (Morris 88). He w as sent to Chattanooga, Tennessee by train. Berkove notes that Bierce remembers witnessing countless wounded men alone in agony on the train ride (5). This image stayed with him and so did his head wound. For the rest of his life, Bierce endured bouts of f ainting and extreme headaches (Morris 88). Physically and psychologically, Bierceâ€™s Civil War never ceased. In other words, he was a perpetual wounded body with a surgical history. Doctors operated on him and he survived though the odds were not in his fav or. True, Bierce spent time in the hospital in the latter part of the war when doctors had ironed out many of the medical difficulties they first encountered. However, the point is that he was informed about the medical part of the war process because he w ent through the process. This urges me to reconsider the influence of his war experiences on his literary production. This also urges me to contemplate once again, how might his hospital days forge a new interpretation of his literature that considers the medical aftermath of the Civil War? To answer this question, I merge his topography skills and his war wound experience with his constant literary focus on perception. Together, all three elements set up the foundation for
28 rereading Bierceâ€™s collection in a new way . Bierce constantly emphasizes the consequences of misperception and the dangers of imagined security in his writing. He does it through reiterating how war resolves nothing; war only reveals self deception and misreading oneâ€™s own perception. B erkove elucidates Bierceâ€™s â€œtechniqueâ€ in these terms: his goal â€œis to conceal nothing from the protagonistâ€™s perception, but then to enable readers to see that the protagonist has misinterpreted his perceptionâ€ (78). Essentially, Bierceâ€™s desire is for r eaders to witness a psychic collision between what a character believes and what reality reveals to the character about the shape of their beliefs. Cathy N. Davidsonâ€™s authoritative work on Bierceâ€™s recurring use of misperception in his fiction undergirds my interpretation. She argues, â€œBierce structures nearly all of his stories around breakdowns in perception and communicationâ€ (2). The â€œmisperception of events,â€ she claims, â€œattest[s] to the limitations of the perspective of a particular protagonist who misreads his or her universeâ€ (2). The misreading of abilities and limitations speaks to my interpretations of â€œChickamauga,â€ â€œA Tough Tussle,â€ and â€œParker Adderson, Philosopherâ€ in a medical context, that as the nation fractured, the medical field experienced a fracture between illusion and reality, and this is the very fracture that the surgeon figures in these short stories experience. Davidson notes that Bierceâ€™s characters become â€œvictims of their own illusions and unexamined rhetoricsâ€ (17). The characters become victims of their own misperceptions because they rely too heavily on â€œinherited beliefsâ€ (11). I elaborate upon the creation of â€œinherited beliefsâ€ in the medical field in the first section with two historical examples: an 1861 military surgery manual by Dr. Samuel D. Gross and an
29 1861 lecture by Dr. Edmund Andrews to medical students. I present both examples to illustrate the making of surgeonsâ€™ misperception of wounded bodies like the ones that appear in the stories I discuss. The second section reassesses the visual of this project, Thomas Eakinsâ€™s The Gross Clinic . The painting includes Dr. Samuel Gross and his son, Dr. Samuel Weissell Gross. The elder doctor embodies the prewar moment and the younger doctor embodies the wartime moment in Civil War surgical history. I argue that the father son dynamic in the pai nting conveys the medical fieldâ€™ s passing along of traditions, faulty ideologies, and unrealistic expectations in the beginning of the war. The last section closely reads â€œChickamauga,â€ â€œA Tough Tussle,â€ and â€œParker Adderson, Philosopher.â€ A Manual and an Opportunity The preoperation preparation for surgeons in 1861 put them in a position to recognize their previously unrecognized limitations when the wounded came to their operating tables. Dr. Samuel D. Grossâ€™s 1861 Military Manual of Surgery and Dr. Edmund Andrewsâ€™ 1861 lecture to new surgeons at Lind University show vast misjudgment about the medical aspect of the coming war. The manual and the lecture symbolize doctorsâ€™ collecti ve imagining of fixing war wounds without experiencing the true nature of the wounds to come. And both insist on the greatness that will come to the medical field because of warâ€™s natural side effect of producing bodies for practice. Like fathers to sons, Gross and Andrews passed along inherited perceptions and methods that would often prove unfit for the surgical needs of the warâ€™s wounded. The surgeonsâ€™ misperceptions of the wounded became blatantly clear when they confronted the new and unexpected medical situations created by the war.
30 Alfred Bollet puts the reality that doctors confronted bluntly: â€œthe first year of the Civil War was a medical disasterâ€ (7).7 The profession was seriously lacking. For example, in the decade before the war, Massachusetts General Hospital surgeons â€œperformed fewer than 200 surgical procedures of any kind on average per year,â€ yet â€œwithin months of the opening hostilities, surgeons, most of whom had no relevant surgical experience to draw from, were required to perform greater numbers of surgical procedures in the matter of hours â€ ( xvi). Inadequately trained doctors performed surgeries and medical procedures without knowledge or distinct rationale. When treating wound complications and illnesses doctors were â€œforced to render care for diseases that were neither visible nor understood,â€ Ira Rutkow notes (64). Blame for this unpreparedness was manifold. Like the early societal belief that the war would only last three months, military, medical, and government personnel could not conceive of what war could do to the human body in terms of illness or death. They did not prepare for the inundation of mass battle casualties. Even the idea of a military hospital at the onset of the Civil Wa r seemed â€œunreasonableâ€ ( 27). All felt the c lash of unpreparedness with how badly industrialized warfare wounded bodies.8 The â€œconvulsiveâ€ nature of the war, in Whitmanesque terms, put a convulsive crack in the medical profession and doctors scrambled to fix it. Much of their promised glory was lost in the wave of piecemeal bodies, blood, and failure. Before this catastrophic wave of wounded bodies, military surgery manuals published in the first year of the war were essentially â€œmapsâ€ or â€œtopographicalâ€ tools for surgeons to utilize in preparing f or and executing their duties.9 Published in May of 1861, barely a month after the war began, Dr. Grossâ€™s manual was one of the first
31 wartime medical manuals. He presents a history of military surgery, a listing of the most recent surgical treatises that he cites from, and instructions on certain illnesses and wounds. The entire manual is mostly based on the instructions found in the recent European treatises and recollections of Crimean War surgeons. Gross is precise only on what he can be certain about because much of his manual is complete conjecture about what many Civil War volunteer surgeons will encounter. He is specific about the posture of patients, ventilation in the hospitals, and cleanliness. The standards he suggests are somewhat unrealistic in hindsight considering the chaos that ensued as the medical departments on both sides realized that the war would last longer than ninety days. As for actual surgical instructions, Grossâ€™s manual is inconclusive. His chapter on amputations and resections, f or instance, gives circumstances and procedures for both surgeries, but not with the detail that later manuals give.10 He does not give a definitive answer on when to amputate or when to perform a resection, though he proves quite forcefully that making a decision on which procedure to perform is difficult. He states, the cases which may reasonably require and those which may not require interference with the knife are not always so clearly and distinctly definedin very many instanceswhile the surgeon endeavors to avoid Scylla, he mayrun into Charybdis, mutilating a limb that might have been saved, and endanger ing a life by the retention of one that should have been promptly amputated. (79) Throughout his medical career, Gross advocated resection surgeries over amputations surgeries. But, in this manual, he states that both can produce similar results leaving the decision up to the inexperienced surgeons he is essentially trying to direct. Grossâ€™s manual is an important artifact that gives great insight into how he and other midnineteenthcentury doctors viewed what the war could do for the medical field.
32 Gross and his colleagues hoped that the war would strengthen their surgical practice, which it eventually did, but not at the very onset of conflict. When Grossâ€™s manual is placed side by side with the injuries and wounded men that appear in the three stories I am looking at from Tales of Soldiers and Civilians , the manual represents a coll ective idealistic imagining on behalf of the medical field. The manual represents imagining being able to fix war wounds and injuries not yet known, imagining scenarios not yet experienced, and imagining a sense of professional control before the profession was forced into chaos. Gross, the professionâ€™s â€œFather of Trauma Surgery,â€ passed along his war surgery guidance to his many professional â€œsonsâ€ and to his actual son, Samuel Weissell Gross. The manual is dedicated to the younger Gross who would eventually spend the entire war performing surgeries.11 Though the elder Gross had fears about newer doctors, he saw the opportunity that the war created for the medical field for newer doctors like his son. Dr. Edmund Andrews felt the same. Andrews fervently bel ieved in the opportunity that the war occasioned for young surgeons. Both Gross and Andrews were paternal figures with the desire to prepare the next generation â€“ a generation that would reflect their forefathersâ€™ teachings. Gross produced a text while Andrews gave a rally speech to medical students on the verge of performing countless surgical procedures. Lectures to medical students were essentially the same as early manuals. Andrewsâ€™ lecture is an example of an eminent doctor handing students a mental ma p of conjectured geography. Dr. Andrews gave his lecture on October 14, 1861. He emphasizes in the lecture the romantic aspects of the coming war for young doctors: masculinity and heroism. â€œI must talk to
33 you as men to be moulded by the influence of this tremendous hour,â€ he begins (177). He implores them to have courage, to be noble and cool under fire, and to endure the tests of the moment because the first trait necessary to be a good surgeon is â€œto be a manâ€ (178). His words are filled with the possibi lity of pending heroism through great control. His words no doubt matched what many young soldiers heard from their commanding officers upon donning a uniform. The opportunity created by the war for the medical profession underscores every part of the lect ure. Andrews clearly conveys that the opportunistic quality of wartime medical care should shape the studentsâ€™ perceptions of the duties they will perform. He goes on to say, â€œit is with throes like these that heroes are bornâ€“ amid convulsions such as these, nations grow giant like and renew their vigor, their youth, and powerâ€ (177). In a way, Andrews implies that the medical field is like a childâ€“ perhaps a prodigal sonâ€“ in need of adversity in order to grow. Yet, his romantic imaginings overpower any wisdom he might impart on the fraternity before him. He inadvertently constructs for them the misperceptions they will have when confronting bodies wounded by war. He focuses on the power they will assume and how they will be viewed by home front noncombatant s: patrons â€œlook upon an eminent surgeon much as they do upon a renowned soldier. They yield the tribute of high admiration to one who dares put his hand to the machinery of life and cantake out its living wheelsâ€ (180).12 So much power lies in the hands of these young men who are eager to get to the battlefront. All they have to do is embrace this power and perform their duties. He sends them off to the front with imagined success at their fingertips. He calls upon them to heal the â€œhearts that love noblenessâ€ and heal â€œthe sufferings of the afflictedâ€ (181). But, what if these young medical men are
34 not schooled in the kinds of sufferings that the afflicted bear? What if the scalpels they wield are uninformed? What if they will develop an aversion to wounded bodies because those bodies signify their misperceptions? Bierceâ€™s Tales indirectly ponders and answers these questions. Father and Son Recall Ambrose Bierceâ€™s philosophy about war: war reveals misperception when what is imagined collides with what is experienced. Bierceâ€™s philosophy applies significantly to the medical field in the beginning of the war. Older doctors, like Dr. Gross and Dr. Andrews, were like fathers sending their sons to war with idealistic expectations of what they could achieve. The surgical fraternity then came to terms with their limitations in the wake of the wounded. This section integrates The Gross Clinic into conversation with my interpretation of Bierceâ€™s stories. One way to view the painting in relation to rereading Bierceâ€™ s stories in a Civil War medical context is to see it as a visual narrative about two related surgeons, a father and a son. In the painting, a student leans over the rail of the amphitheater and looks down at the father and son. The studentâ€™s line of sight looks directly at what their connection reveals: the two elements of Civil War surgical history â€“ the preoperation moment and the operation moment â€“ that once clashed. Eakins art scholars tend to disregard the deep interconnected professional and personal t ies between Dr. Gross and his son . Instead, Michael Fried, for example, perceives the familial connection in the painting to be between Dr. Gross and Thomas Eakins, whose self portrait appears in the clinic audience. Fried focuses on the â€œpaternal auraâ€ that Gross embodies and Eakins reveres (39).13 He argues, â€œGross may
35 be seen as a glorified father figure and Eakinsâ€™s self portrayal [in] the painting assubordinating his persona to that of the older man, and by virtue of the affinity between their respect ive actions, establishing a connection between themâ€ (40). After his provocative interpretation, in parentheses, he states, â€œthe painting includes still another filial personage, Dr. Samuel W. Gross, son of the great surgeon and his eventual successor; but he seems to me largely to escape the play of forcesâ€ (41). Indeed, Gross holding a scalpel and Eakins holding a sketching utensil correlates artistic production with surgery â€“ two professions that rely on anatomical precision (see next chapter). But, Friedâ€™ s idea that Grossâ€™s paternal force exists mostly because of his connection with Eakins is weak in light of the fact that the strongest familial connection in the painting is between Gross and his own son.14 Like Fried, Elizabeth Johns focuses intensely on Grossâ€™s paternal force as medical historyâ€™s â€œFather of Trauma Surgery.â€ Her analysis of the painting stems from Eakinsâ€™s goal of accentuating what Dr. Gross symbolizes by painting him in his occupational setting (249). But, I stress that his son also embodies an important era in medical history that was defined by learning surgical procedures in a catastrophic event. The presence of the younger Gross considerably influences the forces at work in the painting as the artwork seeks to specifically highlight th e professionâ€™s history. I n the painting, Dr. Gross stands prominent and commands attention. Akin to his manual, he is teaching medical students. To the right of the elder Gross is his son. The younger Gross is positioned with his left shoulder nudged up against the clinicâ€™s hallway entrance. His stance is nearly analogous to his fatherâ€™s . The subtle dissimilarity between their stances defines their differences. The son is surely the younger image of his
36 father; however, he embodies an experience that his father does not have. Samuel Weissell Gross was a Union brigade surgeon in the Civil War with an extensive service record. Similar to Bierceâ€™s war experience, he spent nearly one thousand four hundred and twenty one days in the war.15 He began his career in Ohio and, interestingly, in Bierce fashion, mapped his way around the fractured United States. He served in New York, South Carolina, Florida, and Pennsylvania (475). During the war the elder Gross play ed a minor role in lecturing how to perform amputations to surgeons, but he did not serve in the same capacity as his son. Father and son are separated by an operating table in the painting as if to exemplify what caused their collision and to show a snapshot of the two elements of Civil War surgical history. On one side of the table, Dr. Gross represents the preoperation situation of the war. He is one of the professionâ€™s paternal authorities â€“ the manual maker â€“ who, in the beginning of the war, did his ver y best to exhibit control and to prepare the younger generation. Dr. Gross had a lifetime of surgical experience at the time Eakins painted him. Eakins â€™s intention is to underscore Grossâ€™s eminence. But the presence of Grossâ€™s son demands a closer focus. R ecall that he dedicated his imperfect manual specifically to his son. His 1861 dedication emphasizes that he believed in what he had created for the younger generation of surgeons. He embodies a legacy of guidance that was once tinged with his own inexperi ence. On the other side, Dr. Samuel W. Gross represents the operation moment of the war that played out on the fields and in the hospitals. He is one of the professionâ€™s sons â€“ the war surgeonâ€“ who, educated by crisis, entered the field hospitals without any previous war surgery experience. He represents the next generation of doctors made by war. He embodies the â€œafterâ€ of
37 Bierceâ€™s collision; or, the cleaning up of the disastrous medical situation in the first half of the war. Little Boys and Jawless Men If Ambrose Bierce were looking at Eakinsâ€™s painting, he might ask the following questions: What does the father son relationship between the elder Dr. Gross and the younger Dr. Gross signify in the medical history of the Civil War? How might each surgeon approach the wounded men crawling and dying on battlefields? Who would be able to fix a soldier with a complex jaw injury if he were the patient on the table in between them? He ultimately answers these questions in Tales of Soldiers and Civilians . â€œChickamau gaâ€ begins the narrative of the inexperienced surgeon with the collision between the preoperation moment and the operation moment that forced surgeons to become aware of their lack of preparation. The little boy in the short story represents the inexperienced surgeon who looks into the face of a jawless man, misunderstands him, only to finally realize he cannot save him. Like this imaginative little boy who first embraces what he reads about war in books (or manuals) of old, the inexperienced surgeonâ€™s per ception, which will ultimately become his misperception, is that he will be able to fix the wounded soldier long before he encounters him. And the narrative further progresses in â€œA Tough Tussleâ€ when the surgeon figure is haunted by his misperceptions and the wounded body (that eventually becomes a dead body) that he cannot save. The narrative concludes with â€œParker Adderson, Philosopher,â€ in which the surgeon embodies how war ideologies, lectures, and philosophies do not match war realities. This is ultim ately Bierceâ€™s main point in his war tales and further illustrates the importance of the surgeon figure in his work.
38 â€œChickamaugaâ€ is a story of a six year old boy who wanders from his home into the woods to play battle. He embarks on such an adventure because of his education about the glories of battle and his fatherâ€™s war ancestry that he feels coursing through him. He marches onward ready to confront enemies. But, when startled by a rabbit, he runs through the forest directionless and anxious to ret urn home. He sobs himself to sleep when he realizes he is lost. After several hours pass, he awakes and sees a strange object which he cannot identify right away. He sees more than one crawling and creeping along the ground toward him and a brook nearby. The child finally realizes the objects are men crawling by hundreds. He moves among them curiously peering into their faces. He crawls upon the back of a jawless man who throws him to the ground. The child gathers himself and continues on, but he remains confused as to why so many of the men are face down in the water not moving. His attention then turns to a fire in the distance, which he runs to and finds his home in flames and his mother dead. The last lines reveal that the child is deaf and mute. He had slept through the battle that produced all of the wounded men. Yet, the battle itself does not obliterate his romantic notions of war, rather the aftermath of the battle does. One major critical focus on â€œChickamaugaâ€ is the repeated trope of soldiersâ€™ di sillusionment with battle. As stated previously, Bierce was fascinated by how soldiers endured the obliteration of their heroic war ideals in the heat of battle. The short storyâ€™s narrative fits perfectly with the path of soldiersâ€™ disillusionment: a young boy goes to war with his sword and courage only to find senseless suffering, horror, and unfair consequences. To illustrate, Michael W. Schaefer contends that, despite his lineage, the little boy in â€œChickamaugaâ€ â€œdoes not recognize actual war when he enc ounters itâ€
39 (99). Bierce thickens the boyâ€™s romanticism of war so much that the boy cannot recognize the most dire consequences of battle: wounded and dead bodies. Tim Edwards perceives Bierceâ€™s tale as an authorial â€œwar against romanticismâ€ as his â€œaimis to explode romantic and nave notions about war by showing its brutal realitiesâ€ (1). These analyses hinge on soldiersâ€™ experiences.17 But the warâ€™s â€œbrutal realitiesâ€ also existed in hospitals. The boyâ€™s lack of recognition of the wounded again leads bac k to the historical moment when surgeonsâ€™ encountered what the Civil War demanded of them and realized they were not equipped to meet such demands. Another critical approach to interpreting â€œChickamaugaâ€ relies on historical war contexts. Kelli Larson interprets â€œChickamaugaâ€ based on the historical events of the actual Civil War battle on September 19, 1863. The Battle of Chickamauga proved to be a detrimental loss for the Union Army. The Federal loss occurred because General Rosecrans withdrew Union troops from the line of battle leaving his army vulnerable to the Confederate Army (11). Larson parallels the trajectory of the battle to the trajectory of the childâ€™s actions in the story. She explains how Bierce â€œtransforms the Georgia battlefield into a childâ€™s playground while the blundering leadership is cynically depicted through the playful and nave antics of the textâ€™s six year old protagonistâ€ (9). The success of General Rosecransâ€™s earlier campaigns forged his misperception of his armyâ€™s abilities. Susan Kalter considers an entirely differ war context. She interprets Bierceâ€™s short story as an IndianWars narrative. Bierce witnessed the Battle of Chickamauga, she concedes, yet â€œnot one piece of internal evidence from the text securely situates its ev ents as occupying the 1860s periodexcept for the title itselfâ€ (5758). The images that Bierce illustrates are not specifically tied to the Civil War
40 allowing Kalter to consider the long history of Indian warfare in the region. She also cites the influenc e of â€œmassive offensive[s] against Indian nationson the writing of theâ€ late nineteenth century that may have captured Bierceâ€™s attention (58). While both reads consider the importance of historical context l ike I do, I claim that the nearly thirty five t housand dead and wounded in the aftermath of the Battle of Chickamauga captured Bierceâ€™s attention and captures the fact that the wounded crawling on the ground after the battle needed surgeons. Contemplating the influence of scientific discourses on Bi erceâ€™s writing, James Baltrum focuses on â€œBierceâ€™s connection of animal traits to those of humansâ€ in â€œChickamaugaâ€ (227). He contends that this connection â€œillustrates the scientific influences and cultural impact of Darwinian thoughtâ€ (227). He further c laims how critical interpretations â€œfall short of acknowledging the influence that dominant scientific discourses have in the cultural developments of a particular eraâ€ (227). But, I would argue that Baltrumâ€™s analysis falls short of including other import ant erashaping scientific discourses. In keeping with the notion that â€œChickamaugaâ€ is indeed a Civil War tale, medical science practice, blunders, and surgical developments influenced cultural perceptions of the medical field during this era. The medical element of the war should be included in interpreting the meaning of the wounded bodies that litter Bierceâ€™s literary landscape, not just Darwinism. Of all the critical approaches, Davidsonâ€™s â€œstages to epiphanyâ€ are essential to my read of â€œChickamaugaâ€ as a medical allegory. Davidson utilizes this formula to assess how Bierceâ€™s characters come to terms with their limitations. She regards this course of events as â€œperceptual evolutionâ€ (28). Three stages construct her theory of
41 perceptual evolution to epiphany. First, Bierceâ€™s protagonists â€œreact to extraordinary in much the same way as they respond to the ordinaryâ€ (25). Next, â€œwhen standard reactions do not solve the crisis confronted, the conventional is called into questionâ€ (25). The last stage is â€œ awarenessâ€ in which the character endures â€œthe painful acknowledgement oflimitationsâ€ (25). Davidson applies these stages to the little boyâ€™s movements in â€œChickamauga.â€ Her assertion is that the boy moves from complete naivety to a transparent understanding of war, which endorses the usual read of the story as a tale of the collision between soldiersâ€™ romanticism and the loss of their glorified ideals in battle. While my claims are certainly hinged upon the general process that Davidson outlines, I make a radical push to move away from the process of soldiersâ€™ disillusionment with battle to the process of medical disillusionment of inexperienced surgeons with wounded bodies similar to Bierceâ€™s wounded. The tale then becomes a new allegory about the perceptual evolution of Civil War surgeons coming to terms with what they would have to fix and the fact that they did not know how. I trace the movement of the little boy in the story by looking at four moments that emphasize my arguments. The first moment i s the very beginning of â€œChickamauga.â€ This is prior to the first stage of Davidsonâ€™s evolution to epiphany for Bierceâ€™s war characters. The story commences with the little boy straying from his home to the woods to â€œbattleâ€ with his â€œwooden sword.â€ At a v ery young age, he feels his fatherâ€™s military legacy pulsing through him. He imagines himself akin to his â€œancestorsâ€ who â€œhad for thousands of years been trained to memorable feats of discovery and conquestâ€ (Bierce 189). His
42 father, once a soldier in his youth, passed along his perpetually kindled â€œwarrior fireâ€ to his young son through â€œmilitary books and picturesâ€ (189). The little boy absorbed what he learned and felt himself ready to advance into his makebelieve fray. He feels confident with his weapon. His weapon is infused with his lineage of heroics as the little â€œintrepid victor was not to be baffledâ€ because he believes he is â€œunconquerableâ€ and aptly prepared (189). The first moment in the narrative of surgeons confronting the war wounded is the preoperation situation before all out war. The little boy represents the inexperienced and (mostly) young surgeon who emerges out of the security of his professional home, allegorically the medical school, and is infused with the teachings of manuals and eminent doctors. He first travels into the wilderness, a geographical location not yet known to him, with his toy wooden sword, an object that is surely endowed with meaning, but is not functional. The wooden sword does not demand responsibility. The woo den sword cannot perform the duties that a real sword can. Metaphorically, many surgeons who volunteered for service at the onset of the war went to the front with â€œwoodenâ€ scalpels. Early lectures like Dr. Andrewsâ€™ gave ideological notions of fixing wound ed bodies. Early manuals like Dr. Grossâ€™s gave general directions that only produced mystified surgeons when confronting men with half faces. Many of the professionâ€™s fathers failed their sons. The fathers thought the books were enough. The little boy surgeon in â€œChickamaugaâ€ goes off to war with a foundation of beliefs that sets him up for the psychic blow that will reveal his detrimental misperceptions. The second important moment involves the boyâ€™s first confrontation with the battle wounded. This moment in the story embodies Davidsonâ€™s first stage in perceptual
43 evolution when the character reacts to extraordinary circumstances with habitual response, but does not yet comprehend their misperception. The little boy sees â€œbefore him a strange moving object which he took to be some large animal â€“ a dog, a pigâ€“ he could not name it; perhaps it was a bearâ€ (Bierce 191). He believes this because â€œhe had seen pictures of bears,â€ though he ultimately concludes that the objectâ€™s â€œawkwardnessâ€ proves that it is not a bear (191). One after another approach him. The narrator notes that â€œthey were men. They crept upon their hands and knees. They used their hands only, dragging their legs. They used their knees only, their arms hanging idle at their sidesâ€ (191). But, the boy only notices their creeping â€œlike babesâ€ and their unnatural appearance (191). In a state of confusion, he peers â€œinto their faces with childish curiosityâ€ (191). His initial response to the unnatural beings before him is derived from what he knows. He sees their faces are â€œsingularly whiteâ€ and â€œstreaked and gouted with redâ€ (191). These qualities remind him of circus clowns that he once saw in books. He immediately relies on his textual education. Davidson observes that in Bierceâ€™s war stories â€œwe s ee perceivers who cannot make sense of what they see because it does not correspond to any categories of reality â€“ natural or supernatural â€“ confirmed by their previous education and experienceâ€ (85). Certainly, Davidsonâ€™s assertion connects to the boyâ€™s rever sion to his education by military legacy in â€œChickamauga.â€ I assert that her argument further aligns with war surgeonsâ€™ reversion to their traditional, legacy infused education upon encountering the wounded in the war as well. Recall Bolletâ€™s telling stati stic about the lack of surgeries performed per year before the war compared to during the war: in the first months of war, green surgeons were required to perform more surgeries in hoursâ€™ time than the
44 amount of surgeries that were performed per year befor e the war. Coupled with the profound lack of surgical practice, the traditional medical school curriculum prior to the war involved hardly any â€œpatients for clinical examinationâ€ so â€œlecture upon laborious lecture was given by preceptors turned pedagogues, â€ Rutkow explains (51).18 Medical schools demanded learning by rote memory, not precision with hands and instruments in flesh. At the end of the â€œtwo four month sessions, each identical to the other,â€ hardly any concrete standards were in place to pass or fail a student ( 51). Graduation rates were connected to professorsâ€™ monetary interests. In other words, inexperienced, degreeholding doctors went into the unknown in wartime hospitals. They encountered, like the little boy, how battle mutilated and tore apart bodies. No doubt their reactions were similar to the boyâ€™s â€“ curiosity, misunderstanding, and confusionâ€“ which forced them to improvise based on what they had learned. The results were often mistakes and patient deaths. In the story, the little boy looks out across the landscape he stands in to see the wounded coming â€œby dozens and by hundredsâ€ â€“ nearly never ending ( Bierce 191). The description here is reminiscent to Bierceâ€™s description of the field hospital after the Battle of Shiloh, of overwhelmed surgeons, and of desperate wounded men. One by one go to the operating table. One by one the doctor curiously peers at. One by one emerge either limbless or lifeless. The third moment is the boyâ€™s interaction with the jawless man. This moment encapsulates Davidsonâ€™s second stage for Bierceâ€™s characters in perceptual evolution when the character notices that a traditional response does not â€œresolve the crisis,â€ therefore the basis of their knowledge, their abilities, and their perception are called i nto question. The child sees a creeping man upon the ground and he plays â€œmake believeâ€
45 by crawling upon the manâ€™s back like a horse ( Bierce 192). Like when he reasons that the crawling men appear to be clowns, he does what he knows with this man: he rides the manâ€™s back like a horse similar to the way he does with one of his planter fatherâ€™s slaves. In perhaps one of the most jarring visceral images in war literature, the man looks at the little boy with a face that lacked a lower jaw â€“ from the upper teeth to the throat was a great read gap fringed with hanging shreds of flesh and splinters of bone. The unnatural prominence of the nose, the absence of chin, the fierce eyes, gave this man the appearance of a great bird of prey crimsoned in throat and breast by th e blood of its quarry. ( 192) At first, the fact that the wounded man is still alive after receiving such a wound appears to be an act of Bierceâ€™s invention. However, Sam Watkins, Confederate soldier, recorded in his memoir what he saw on the battlefield after the Battle of Chickamauga: â€œmen were lying where they fell, shot in every conceivable part of the bodystill alive. Some with their under jaw torn off, and hanging by a fragment of skin to their cheeks, with their tongues lolling from their mouthâ€ (94). The half faced man i n Bierceâ€™s short story existed. Just as Watkins tried to make sense of the wounded soldiersâ€™ aliveness after being put through the grinding machinery of war, the child is utterly terrified and he notices that he cannot make sense of the being in front of his eyes. He runs away, but not without picking up his wooden sword signifying a return to old beliefs, or what Davidson refers to as â€œinherited beliefs.â€ There are two ways to read the childâ€™s interaction with the jawless man in this medical allegory. First, the fact that the child correlates the jawless wounded soldier to a slave from his fatherâ€™s plantation incites the underside of surgical history in which doctors experimented upon black bodies for the benefit of white medic al car e, which I take up in the fifth chapter. Just like the South profited on the backs of slaves previous
46 to emancipation, the medical field advanced on the backs of slaves. The medical field also profited from free black individuals whose bodies were taken from their graves after burial. The jawlessness of the man the child believes he sees is integral here because, as Kalter avers, â€œthe crawling manâ€™s missing jaw signifies the voicelessness of the manâ€ (68). While Kalter is really noting the voicelessness of Native Americans, the jawless manâ€™s voicelessness could also be viewed as the voicelessness of countless slaves who were forced to submit to painful, and often fatal, medical experimentations by curious, callous doctors. Scholars tend to overlook is sues of slavery and race in Bierceâ€™s work because these issues do not appear in abundance. Yet, biographical accounts cite how the antislavery cause was near to him as he came into adulthood. For example, Morris describes that at fifteen years of age, Ambr ose left his parentsâ€™ farm and worked with the editor of an abolitionist newspaper titled the Northern Indianan (15). He was close to his uncle, Marcus Aurelius Bierce, who was an abolitionist. He ultimately ended up in the home of his other uncle, Lucius Verus Bierce, in early 1859 in Akron, Ohio after his stint with the newspaper. Morris explains, â€œby this timeLucius had been mayor of Akron four different times, and he was a founding member of the state Republican partyâ€ (16). Uncle Lucius was an â€œardent abolitionist,â€ and notably a friend to John Brown of Harpers Ferry fame (17). In fact, when Brown hit the road to Kansas after the Kansas Nebraska Act of 1854 in hot pursuit of his antislavery cause, â€œhe took with him, compliments of Lucius Bierce, a wagonload of arms and ammunitionâ€ (17).19 In December of 1859, on the day of Brownâ€™s execution for his actions at Harpers Ferry, Uncle Lucius â€œurged that Akronâ€™s courts and businesses be closed, and mourning bells
47 tolled for a solid hour across the townâ€ (17). That evening, Lucius gave an address on the martyrdom of his dear friend. One line from the address that truly shows his reverence for Brown and his antislavery sentiment is this: â€œRather would I have the honor of Brownâ€™s death on a [scaffold], for his gl orious principles, than a monument erected by slaveholders with the price of human bloodâ€ (10). Whether or not Ambrose was at this public address is unknown because he began to attend Kentucky Military Institute in late 1859. But, what is evident is that he was intimately acquainted with men who believed in the cause of antislavery â€“ men who he revered. The degree to which these men influenced Bierceâ€™s thinking is ambiguous because he does not convey his feelings about African Americans and racial equality ov ertly in his war fiction. He does comment on African American Civil War soldiers in his newspaper writing, though. In an 1898 Examiner article, Bierce remembered being unsure at first about the fighting skills of black troops. Referring to them as â€œdarkies ,â€ he recalls feeling foolish as he looked on at Overton Hill as black soldiers took the offensive with fervor and force against the Confederates (Morris 96). Traces of racism emerged in his journalistic antiwar rhetoric in the late nineteenth century as A mericans urged war against Spain, but he was referring to Cuban rebels and he stated around the same time that American soldiers were a race of ravenous â€œgluttonsâ€ and â€œdrunkards,â€ thus painting an unattractive picture of predominantly white men ( 231) . T he second way to read the childâ€™s interaction with the half faced man is to continue the thread of thinking from the previous moments. The jawless man is symbolic and representative of soldiers with wounds that required surgery and care beyond the scope of doctorsâ€™ antebellum medical education. The little boy implements
48 what he has learned to make sense of the situation he is in. But when he sees the jawless man crawling to the river, only to join the dead men faced downward, he barely understands why the m an appears the way he does and why he dies. He calls into question what he knows for he cannot make sense of what he sees. His bafflement is most important here because his reaction conveys a similar bafflement that doctors first experienced in field hospi tals as they failed to fix and to save with the education and training they had received. Failures prompted them to call into question their training. They came to terms with what they were not taught to do. Consider again Dr. Grossâ€™s early 1861 manual. H is manual does not give instructions on how to treat a soldier with half of his face or entire lower jaw injured or missing. He also does not include instructions on how to, at the very least, approach a fractured jaw injury. John Julian Chisolm does brief ly discuss fractured jaw injuries in his 1861 manual, A Manual of Military Surgery for the Use of Surgeons in the Confederate Army . Chisolm describes how â€œfractures of the lower jaw are not a rare accident on the battlefieldâ€ (271). To treat a fractured jaw, the surgeon â€œapplies a folded handkerchief or band under it to support itâ€ and accompanies the soldier from field to hospital (271). He discusses the use of a splint to keep the jaw in place. Chisolm then briefly notes, â€œat times, the entire jaw may be swept off by a round shot, leaving the mouth and throat exposedâ€ (271). Here, Chisolm recognizes that the injury sustained by Bierceâ€™s jawless soldier is probable in warfare. Even still, he does not give instructions on how to care for a wounded soldier wh o is missing his mandible, still alive, and desperately crawling around for aid. If a less experienced surgeon encountered Bierceâ€™s jawless soldier in the first year of the war and if he carried Grossâ€™s manual or Chisolmâ€™s manual in his pocket,
49 he would not have precise instructions on how to approach this particular wound. The fourth and final moment of the inexperienced surgeon narrative and misperception of Bierceâ€™s wounded is the moment when the child understands that he was wrong about war. This is Davidsonâ€™s third and final stage of â€œawareness,â€ which is especially anguishing to Bierceâ€™s characters. The boy returns to his homestead only to find flames have ravaged the walls. In the yard he comes across his dead mother. â€œThe greater part of [her] for ehead was torn away,â€ he sees, â€œand from the jagged hole the brain protruded, overflowing the temple, a frothy mass of gray, crowned with clusters of crimson bubbles â€“ the work of a shellâ€ ( Bierce 194). The head wound he sees is the physical manifestation of the psychic â€œhead woundâ€ that the boy endures as he moves to the awareness of his limited abilities in the evolution of perception. The work of a real shell obliterated any power that he imagined he had and that he imagined his wooden sword possessed. Con fused, he makes â€œwildâ€ gestures. He shakes his hands in a similar way that the jawless man shook his fast at the boy as if to ask, why? Such a tragic moment denotes when his romantic and idealistic views of what he could do in â€œbattleâ€ crash into his recognition of limitations. He was not victorious in battle. He did not save the men in the woods. He could not protect his mother from the enemy. The books were wrong. The books were sometimes wrong for Civil War surgeons, too. In this final moment, the text reveals the boyâ€™s limited perceptionâ€“ his inability to hear or speak â€“ at the very end of the tale. In fact, the entire short story is void of sound, which forces the reader to experience the fields of Chickamauga in the same way as the boy. Though Bierce do es not reveal the boyâ€™s handicap until the end, the fact is that the child is already impaired by his early education when he enters the woods. Bettina
50 Hofmann argues that â€œthe boyâ€™s misperceptions grow out of his interpretative blindness more than from hi s inability to hear and speakâ€ (1). He is blind to interpret the scenes around him because he never encountered them before. The terrain he traverses is unwieldy and frightening because he never traversed it before. But, he persists in his travels and in his â€œinterpretive blindnessâ€ into and out of the woods. According to Davidson, â€œby making him a deaf mute Bierce creates a protagonist who must read directly by sight and feelthe scenes he encountersâ€ (37). In this sense, the little boy is exactly like the surgeons at the beginning of (and throughout) the Civil War. They were limited by what they could see and what they could feel. â€œA Tough Tussle,â€ like â€œChickamauga,â€ is structured around a scene of wartime encounter. The story begins in a forest in the fall of 1861. Second Lieutenant Brainerd Byring is on night watch about two miles away from his sleeping Federal comrades. In the darkness, Byring sees an object that appears in the shadows. He investigates and finds the figure to be the dead body of a Confederate soldier. Disgusted, Byring returns to his vigil spot, but not without thinking that the dead body has moved closer to him. He stares at the corpse, noticing how unnatural it looks. Feeling frightened, he fantasizes about running away. He then sees the corpseâ€™s arms reanimate. To Byring, â€œthe horrible thing was visibly movingâ€ toward him ( Bierce 135). At the same time, a band of Confederates on foot and horseback appear nearby on their way to the Federal camp. Byring does not warn his comrades and a skirmish ensues. The next morning, a party led by a captain and a surgeon come across two dead soldiers: a Federal officer and a Confederate private. The officer, Byring, has a sword thrust through his heart and the private, the dead Confederate, has five stab wounds but no blood. The story ends with
51 the surgeon and captain looking at one another. One significant point is that thi s story takes place in a forest, a space associated in Bierce â€™s fiction with character contemplation and f luidity . As discussed previously, the little boy in â€œChickamaugaâ€ is usually read as a soldier, yet his encounters in a disorienting setting full of wounded men open up interpretation to include a medical read. â€œA Tough Tussleâ€ not only does the same, but Bierceâ€™s main charact er in the text vocalizes that the environment in which he sits allows for things to take on new shape. In the forest, Byring ponders, â€œhe to whom thenight and solitude in the heart of aforest is not an unknown experience needs not to be told what another world it all is â€“ how even the most commonplace and familiar objects take on another characterâ€ (127). The key phrase here is: â€œanother character.â€ Who is Brainerd Byring? What else could he be? In the woods, Bierce sets up Byring to â€œtussleâ€ with his perception making him grapple with the same misperceptions as the little boy who could be read as a wartime surgeon: Byring cannot discern if what he is seeing is what he is experiencing so he finally believes in his (mis)perception and suffers the consequences . The most important aspect of the story, though, is that it ends with this sentence: â€œthe surgeon looked at the captain and the captain looked at the surgeonâ€ (137). Bierce ends the story with the surgeon and the captain as mirror i mages of one another. By mirroring the two , then the relationship between the surgeon and the captain open the door for a fluid connection to be made between the surgeon and Byring. Though, unlike Byring, the surgeon appears calm, resolute, and alive, the surgeon essentially enacts the movements made by Byring. Moving backward through the story to the point when the Confederates appear shows that Byring is a surgeon figure, too.
52 At the end, after the captain of the search party and the surgeon find Byring and the Confederate private dead, the surgeon removes the impacted sword from Byringâ€™s chest and looks closely at it. Byring i mpaled the sword into his chest; the surgeon removes it. The sword in the surgeonâ€™s hand resembles a scalpel, just like the wooden sword in the little boyâ€™s hand in â€œChickamauga.â€ This time, the scalpel is able to perform its slicing function. Significant to this moment is that the surgeon notices â€œan undischarged revolver in the dead officerâ€™s beltâ€ (137). Byring could have used his gun against the reanimated Confederate soldier coming after him or on himself to stop the haunting of the mutilated body. But he does not. He chooses his sw ord, which further underscores the sword/scalpel connection. He commits suicide after restabbing the dead body. The lack of blood beneath the Confederate soldier confirms that the body Byring thought to be alive could not have been alive when he stabbed him. To get away from his haunting aversions, he tries to rid his vision of the body by using the very instrument meant to surgically save a body and then turns the â€œscalpelâ€ on himself. The surgeon then moves to the dead Confederateâ€™s body after examining Byring. Laying down Byringâ€™s sword, â€œthe surgeonapproached the other bodyHe took hold of the left foot and tried to straighten the leg. In the effort the body was displacedit protested with a faint, sickening odor. Where it had lain were a few maggots â€ (137). Here, the surgeon physically moves the dead body and the body actually responds to him, thus signifying reanimation. The surgeonâ€™s actions parallel the actions of Byring. Recall that the entire story is Byringâ€™s confrontation with the corpse moving closer to him. Since we know that the dead body cannot truly move, Byring essentially moves the body in his perception.
53 Byring has the mindset of a surgeon who cannot confront the product of his misperceptions. The dead signify a complete failure of medical know how. â€œThe sight of the dead,â€ Bierce writes, â€œwith their clay faces, blank eyes, and stiff bodies, which, when not unnaturally shrunken, were unnaturally swollen, had always intolerably affectedâ€ the Federal officer (125). When seeing the dead body, â€œheturned from it with a feeling of sickness and disgustâ€ (129). In the structure of the story, Bierce interrupts Byringâ€™s disgust. Confederate soldiers descend upon the area that Byring is supposed to keep watch for. Bierce turns the attention away from the interaction between Byring and the dead body to the battle scene, though the two are not separate as the end of the story describes. The focus on the battle followed by Byringâ€™s suicide reiterates that battle cannot teach Byring to handle wounded bodies. â€œA Tough Tussleâ€ comes after â€œChickamaugaâ€ in Tales of Soldiers and Civilians . The collectionâ€™s narrative of the inexperienced surgeon progresses from the surgeon with misperceptions about the war wounded to the surgeon who is haunted by his misp erceptions through an aversion to horribly mutilated bodies. Surgeons are not supposed to be averse to the bodies that come to their tables, but â€œA Tough Tussleâ€ shows that at the beginning of the war, the new mutilated body was difficult to confront because the war wounded body was not part of surgeonsâ€™ routine medical training. Now, in the narrative I am tracing from story to story, when surgeons finally do recognize wounded bodies, they are immediately confronted with their inabilities and realize war will not resolve their lacking skills. This parallels how Bierceâ€™s soldiers confront the ironies of battle only to find out that war resolves nothing; it only reveals how deluded people are.
54 â€œParker Adderson, Philosopherâ€ is the last story in the â€œSoldiersâ€ section of Bierceâ€™s collection and the final component to the medical narrative I am elucidating. Parker Adderson is a Union sergeant taken prisoner by the Confederates. The story begins with Adderson speaking to General Clavering on a stormy evening insi de the Generalâ€™s tent. Adderson is a â€œcaught spyâ€ who came into the camp dressed as a Confederate soldier in order to see how many men were there. Adderson believes that, as per military protocol, he will be put to death by hanging the following morning at sunrise. He feels ennobled by his death to come. He spouts grand notions about how he will face death without fear and tells his captor that he does not know that death is a serious matter because he will not be conscious of anything after he dies. General Clavering responds that death is horrible, and in an ironic turn of events, he orders for Adderson to be put to death immediately. This causes Adderson to panic, escape his restraints, and pull on the ropes and stake holding the tent up. The tent collaps es and a â€œbattleâ€ ensues beneath the canvas between the General, Adderson, and a captain on guard. The raucous alarms the camp and brings onlookers, including the camp surgeon. The captain is killed with a knife thrust through his throat and jaw. General C lavering emerges with two wounds: sword jabs through his thigh and his shoulder. He faints as the skirmish comes to a close. Adderson also emerges as a wounded body: â€œhis face, swollen by blows and stained with gouts of blood, nevertheless showed white beneath his disheveled hair â€“ as white as that of a corpseâ€ (161). Adderson is a corpse before he actually becomes one. When General Clavering comes to, he orders for Adderson to be put to death. Adderson begs for his life but is killed by the shotguns of twent y men. The General, now dying, remarks upon the silence that ensues after the execution. A
55 surgeon is by his side looking at him as he contemplates, â€œso this must be death,â€ just before his eyes close forever (163). Michael Tritt compares Bierceâ€™s short story to the famed message about the futility of life from William Shakespeareâ€™s Macbeth. Tritt argues that Parker Adderson embodies Macbethâ€™s words: â€œLifeâ€™s but a walking shadow, a poor player,â€ it does not last long, and is a tale â€œtold by an idiotâ€ (44) . Tritt explains, â€œsurely Adderson is just such a player[he] swaggers in his bravado, in his proud affirmation of his â€˜advancedâ€™ powers of reasonâ€ (46). But then the quick smashing of his philosophies by the General turns him into a shell of a man without confidence in his ideologies and desperately begging for his life. Trittâ€™s interpretation builds from Alfred Kazinâ€™s read of â€œParker Adderson, Philosopher.â€ Kazin notes how this short story accomplishes Bierceâ€™s goal to â€œ[show]man as aself deluderâ€ (31) . Parker Adderson, indeed, faces his delusions. Bierce forces Parker to confront his philosophies in a moment that he is not prepared for. Parker is calm about death and planning to meet it, until he is forced to confront it on someone elseâ€™s terms. Accord ing to Kazin, in order to show how â€œlife is a trick,â€ Bierce forces the reader to understand that â€œthe only sure element in it is a mischievous, insidious kind of surpriseâ€ (33). Bierceâ€™s characters endure a loss of control over their situations when life surprises their faculties. His characters start out in complete control and gradually unravel. The reversal that Bierce employs is so characteristic to his style. Both Tritt and Kazin concentrate on this fact, but do not give much regard to how the surgeon who appears at the end of this short tale is paired with the punch of the taleâ€™s message. After the battle beneath the tent canvas, the surgeon appears. Two moments
56 explain the surgeonâ€™s function in the story and in Bierceâ€™s formulation of his philosophy in Tales of Soldiers and Civilians . First, what the surgeon sees in Parker Adderson reveals the subtle connection between them. Like â€œA Tough Tussle,â€ Bierceâ€™s narrative reversals set the stage for character fluidity in addition to plot changes that flip events upside down. As argued previously, in â€œA Tough Tussle,â€ the surgeon and Byring are images of one another. Since â€œA Tough Tussleâ€ comes before â€œParker Adderson, Philosopher,â€ the surgeon figure that Bierce includes in this story has already seen a ca se of fright with Second Lieutenant Brainerd Byring. When the surgeon looks over Parker Adderson, he states, â€œthe man is not insanehe is suffering from frightâ€ (161162). The surgeon knows this from his previous encounters and because he himself experienc ed the same aftermath of his misperceptions. In the narrative of the surgeon in the collection that I pose, at this point, the surgeon also sees himself in Parker Adderson: once confident and now filled with fear and insecurity at the change of events; what Parker Adderson imagined and planned is not what is happening to him. This occurrence circles back to the little boy as an inexperienced surgeon in â€œChickamaugaâ€ and his first confrontation with the war wounded. What he planned as an educated warrior hel l bent on success turned out to be a catastrophic confrontation with his misperceptions. Next, at the very end the surgeon sits silently near General Clavering as the highranking military official dies. Here, Bierce drives home his point about wart ime mi sperceptions. Originally, the General believed death to be torturous, horrible, and frightening. As he is dying, however, his â€œface [is] suffused with a smile of ineffable sweetnessâ€ (163). Don Kunz argues that Parker Adderson and General Clavering
57 experience the same realizations upon their deaths: â€œthe death each man experiences is not the one he imaginedâ€ (65). Certainly, such an observation reemphasizes Bierceâ€™s outlook on both battle and life in general. I would argue, too, that Bierceâ€™s fiction can be used to show how the war each surgeon experienced is not the one he imagined either. This figure is present at the most crucial moment of his stories: when the disparity between beliefs and reality obliterate a manâ€™s ability to cope with his circumstances . No manual on life or surgery can explain how to deal with the disparity. The clash between ideology and practice that war forces is what fascinates Bierce. The fact that Parker Adderson bears the ironic title of â€œphilosopherâ€ though his philosophies ar e completely groundless illustrates Bierceâ€™s fascination. Recall how â€œChickamaugaâ€ situates Bierceâ€™s project within the preop moment, a moment that is on the cusp of clashes with faulty ideologies. Because I view â€œChickamaugaâ€ as a commentary on medical m isperceptions of the war wounded, the fact that a surgeon appears at the very end of â€œParker Adderson, Philosopher,â€ like â€œA Tough Tussle,â€ reinforces that the surgeon figure embodies the clash between believing in perception and the reality that undermines that perception in Bierceâ€™s fiction. And the fact that â€œParkerâ€ is the last tale in the â€œSoldiersâ€ section of Tales brings the narrative of the perceptual development of Bierceâ€™s surgeon in relation to his war philosophy to a decisive conclusion: surgeons are the disparity between what is imagined about war and what is actually experienced in the production of carnage that Bierce returns to so often in his work. Tales of Soldiers and Civilians takes on a new shape when situated within a Civil War medic al context. Bierceâ€™s war philosophy comes through in a new way. When
58 Bierceâ€™s stories are viewed as landscapes full of desperate wounded men in need of surgeons, the aftermath moves front and center and reorients the focus onto the medical actors. In Bierc eâ€™s tales, surgeons symbolize that war cannot be trusted to fulfill heroic hopes and to confirm educations by legacy and ideology. I return once again to the little boy in â€œChickamaugaâ€ who shows this most forcefully. The little boy represents the inexperi enced Civil War surgeon rushing to war with his scalpel, manual, and lofty ideas about what he can accomplish. He learned from father figures, like Dr. Gross and Dr. Andrews, who guided him and instilled in him legacies of tradition. He believed in what he had been told from books and lectures. In the wave of wounded bodies and in the field hospitals situated on the outskirts of tremendous battles, he also learned from wounded bodies such as jawless men that he was unprepared. He tried to save these wounded bodies with the knowledge he carried to war. He failed. He returned again and again to the foundation of his profession only to find it in flames â€“ obliterated by the shell and machinery of warfare. Bierceâ€™s wounded are in need of surgery in this short sto ry, and in most of his war fiction, so why are the surgeons forgotten? If looking closely at Bierceâ€™s collection, surgeons are present and important. In one way, perhaps Bierceâ€™s surgeon figure in â€œChickamaugaâ€ is so reminiscent to the prewar version of th e young Dr. Samuel W. Gross. He is the little boy peering into half of a face so desperate for care. Notes 1. What Bierce describes is very reminiscent to what General Carl Schurz recalls watching surgeons work in the aftermath of the Battle of Gettysburg: aprons stained with blood and up to their elbows in fluid and viscera, â€œtheir knives not seldom held between their teeth,â€ surgeons would examine wounds and resolve â€œupon cutting off the injured limb.â€ Then â€œthe surgeon snatched his knife from between his t eethwiped it rapidly once or twice across his bloodstained apron, and the cutting
59 began. The operation accomplished, the surgeon would look around with a deep sigh, and thenâ€“ â€˜Next!â€™â€ (118). General Schurzâ€™s description is quoted by George Worthington Adam s in Doctors in Blue: The Medical History of the Union Army in the Civil War . New York: Henry Schuman, 1952. For more about Civil War medicine, see the fraternal companion text, H.H. Cunninghamâ€™s Doctors in Gray: The Confederate Medical Service. Baton Rouge: Louisiana State University Press, 1958. 2. Lawrence I. Berkove is one scholar who does not ascribe to the idea that Bierce had a war philosophy that taught readers about the inevitable impact of war on ideological human ideas. Instead, he argues that Bierce â€œfailed to put together a philosophyâ€ because â€œhis deepest values were not rational but humanitarianâ€ (48). Illusion and â€œits moral deceptionâ€ infuriated Bierce, which speaks to the mistrust of human emotions, calculations, and decisionmaking in his s tories. Therefore, the tragic quality of Bierceâ€™s work is not an example of the authorâ€™s cynicism about how deluded humans are, rather it is an indicator of his passion for humanity because he saw humans as victims of nature and of war (48). For Berkove, B ierce is a sentimentalist, not a cynic. Berkove reverses the usual read of Bierceâ€™s themes. While I appreciate Berkoveâ€™s arguments, I contend that the thematic recurrence of disillusionment with war in Bierceâ€™s fiction shows that Bierce spent time mulling over his war experiences and his beliefs about the power of war on himself and on humans between 1865 and the 1880â€™s. His â€œdigestingâ€ of the meaning of war and warâ€™s consequences crafted a philosophy that he returned to again and again in his tales. 3. Interestingly, Bierce does not include a definition for â€œsurgeonâ€ in his well known Devilâ€™s Dictionary . He does, however, include a definition for physicians: â€œone upon whom we set our hopes when ill and our dogs when well.â€ 4. Bierce entered the war with the Ninth Indiana Volunteers in the spring of 1861. He effectively moved up the ranks as a sergeant, second lieutenant, and first lieutenant. He experienced battle in places such as Shiloh, Chickamauga, Missionary Ridge, and Pickettâ€™s Mill, among many others . He was mustered out of service after his head wound. He left the military in the fall of 1864. 5. â€œChickamaugaâ€ was first published in January of 1889 in the San Franciscoâ€™s Examiner . 6. Most scholarly attention focuses on the relationships between Bierceâ€™s bitter personality, the realism of his texts, and his obsession with war and death. Critics regard Bierce as a cynic because of the hard nature of his war stories. His texts contain horrifying, disparaging, and jarring qualities. Larzer Ziff notes that in Bierceâ€™s stories, his â€œtone was a natural outgrowth of a personality so shocked by war that it had held itself together only by the compulsive demonstration that meaningless slaughter contained all the meaning there wasâ€ (170). My own interpretation of the
60 impact of Bierceâ€™s Civil War days on his writing proves that it is difficult to separate him from his war hardened status. Moreover, the realism of his texts captures critical interest with a connection to his paradoxical personality. Behr argues that Bierceâ€™s realism was not to just reveal him as â€œa complete and confirmed misanthrope who derived sadistic pleasure from presenting both man in general and individual menin as lurid a light as possibleâ€ (156). In fact, Lawrence I. Berkove views Bierce as â€œext raordinarily sensitiveâ€ (36). Indeed, he was very sensitive about feelings. He was contemptuous about women and brides to be because he had marriage problems. His son was killed in a duel in a quarrel over a woman. Though he had these feelings about women, Richard Sanders describes him â€œas a lady killer, possessing a decidedly macho type of animal magnetismâ€ (17). Sanders is sure to point out the thickness of Bierceâ€™s mustache as well. His obsession with death or the horrifying nature of his literature, though, tends to yield more conversation than any other aspect of his writing. Edmund Wilson compares him with Edgar Allan Poe. Compared to the achievements of Poe in his metaphorical prose, Wilson argues that â€œthe horror stories of Bierce have only in a very few cases such psychological interest as may come from exploiting dramatically some abnormal phenomenon of consciousnessâ€ (623). See Richard Saunders, Ambrose Bierce: The Making of a Misanthrope. San Francisco: Chronicle Books, 1985.; Edmund Wilsonâ€™s Patr iotic Gore: Studies in Literature of the American Civil War . New York: W.W. Norton & Company, 1962.; and Larzer Ziffâ€™s â€œThe Poles of Violence: Ambrose Bierce and Richard Harding Davis.â€ The American 1890s: Life and Times of a Lost Generation. New York: The Viking Press, 1966. 7. The disastrous medical situation at the beginning of the Civil War persisted into 1862 and beyond. Bollet explains, â€œduring the Spring of 1862, the administration of the Union Medical Corps had barely changed. No system for evacuating the wounded existed. Small regimental hospitals, overwhelmed with their own men, turned away those from other regiments. Many of the wounded lay untreated in the sun for daysâ€ (3). Though the Confederate Medical Department experienced less chaos in adminis tration, the lack of efficient treatment at hospitals was a problem. 8. â€œWeapons became more effective and more deadly during the course of the war,â€ Bollet tells us. The new minie ball bullet created most of the wounds that surgeons encountered. Minie balls shattered bones and ripped through organs. Round musket balls also caused significant damage. Bullet wounds were probed with surgeonsâ€™ fingers and instruments for retrieval of embedded projectiles. The lack of knowledge concerning bacteria poised wounded soldiers for gangrene. 9. To read more Civil War doctor manuals from 1861, please see: Frank Hastings Hamilton, M.D.â€™s A Practice Treatise on Military Surgery . New York: Ballire Brothers, 1861; Stephen Smith, M.D.â€™s Handbook of Surgical Operations . New York: Ballire Brothers, 1861; and Chas. S. Tripler, A.M., M.D. and George C. Blackman, M.D.â€™s HandBook for the Military Surgeon, Second Edition. Cincinnati: Robert Clarke & Co., Publishers, 1861. Most Civil War military surgery manuals went through subsequent revision and publication. For example, Smithâ€™s manual went through at least four editions with the fourth edition published in 1863.
61 10. Amputation is the complete removal of all or part of a limb. Resection is an alternative procedure that removes the shattered or diseases portion of the limbâ€™s bone and connects the remaining pieces together to keep the limb intact. Both procedures were risky, yet Civil War surgeons tended to opt for amputation because resection often resulted in infection. 11. Samuel Weissell Grossâ€™s obituary is one of the most comprehensive sources of information about his life and war service. He did aid in the creation of his fatherâ€™s autobiography. 12. Bollet notes how home front people were mortified at what they read in newspapers about surgeons: â€œnewspapers reported a picture of neglect, even purposeful crueltyâ€ (3). This signifies how the war influenced changing perceptions of medical work in the nineteent h century. 13. Fried pays close attention to Eakinsâ€™s relationship with his calligraphist father, Benjamin Eakins, whom he also painted ( The Writing Master 1882). Eakins was very interested in painting paternal figures, especially ones in the medical professi on. Aside from painting Dr. Gross (and his son), he also did a portrait of Dr. John H. Brinton. Brinton was connected to both the elder and younger Grosses through his professorship at Jefferson Medical College in Philadelphia. I elaborate more on Dr. Brin ton and his memoir in my discussion of E.L. Doctorowâ€™s The March. 14. The other â€œfamily memberâ€ considered in the painting is the seated woman in black. See my interpretation of her role in the painting in chapter four. 15. Samuel W. Gross began his wartime medi cal career as a Brigade Surgeon on August 3, 1861. He ended his service on June 24, 1865. 16. Because Bierceâ€™s war tales tend to be less than redemptive, critics conclude that his repeated return to soldiersâ€™ disillusionment convey antiwar sentiment. Berkove views â€œChickamaugaâ€ as â€œa compelling denunciation of warâ€ (83). Donald T. Blume comments on the young boyâ€™s function of revealing the blindness of not only soldiers, but also prowar Americans. Blume argues that the tale â€œrevolves around the destructive c ollision of military and civilian worldsâ€ (124). See Donald T. Blumeâ€™s â€œChickamaugaâ€ in Ambrose Bierceâ€™s Civilians and Soldiers in Context: A Critical Study . Kent: The Kent State University Press, 2004. 124144. 17. Rutkow details the typical curriculum of antebellum medical schools: â€œanatomy; physiology and pathology; materia medica; therapeutics; and pharmacy; chemistry and medical jurisprudence; theory and practice of medicine; principles and practices of surgery; and obstetrics and the diseases of women and childrenâ€ (51). 18. The Kansas Nebraska Act of 1854 outlined the territories of Kansas and Nebraska and gave settlers (predominantly white men) the option of instituting slavery by majority rule.
62 CHAPTER 3 WITH HINGED KNEES AND STEADY HAND: WALT WHITMAN AS SURGEONSCRIBE â€œTo realize the surgeonâ€™s experience,â€ Dr. Frederick Winsor noted in 1880, â€œyou must not only see with his eyes and hear with his ears, you must feel with himâ€ (186). Long after the hospitals of the Civil War were committed to mem ory, Winsor felt that a narrative of the surgeonâ€™s experience had not been fully told. So he wrote one and implored his reader to feel with him as he stuck his finger into a gunshot wound to find a bullet. He did not want the reader to feel the flesh enwr apped around his finger so much as how he felt performing his duties and contemplating the possibility of another amputation. To be sure, the warâ€™s most avid composer, Walt Whitman, understood Winsorâ€™s experience. Whitman felt himself to be an intermediary between the world outside of the hospital and the relatively new world inside concentrated with the warâ€™s aftermath. He shared his sentiments in March of 1863 in a letter to Nathaniel Bloom and John F.S. Gray. He wrote that he found himself among men with â€œall sorts of wounds, operated on, pallid with diarrhea, languishing, dying with fever, [and] pneumoniaâ€ (52). He believed strongly that these men and the doctors â€œopen a new world somehow to me, giving closer insights, new things, exploring deeper mines yetâ€ (52). The poet recorded this new world filled with wounded men and confounded doctors grappling with unforeseen ways the war machine affected the human body. In doing so, he successfully captured the power of amputation rhetoric and metaphorical medic al discourse while accessing the empathetic element of the doctorâ€™s perspectiveâ€“ a perspective that he felt connected to. In this chapter, I will show how self reflective Civil War doctor narratives, such as Winsorâ€™s, construct a new w ay to read Whitmanâ€™s Drum Taps . S elf reflective doctor
63 narratives show one type of surgeon figure that appears in Civil War literature: the surgeonwriter, or surgeonscribe, figure that has very precise emotional and psychological traits derived from the difficult aspects of failing medical work. The surgeonscribe is a radical response to the master surgeon and a figure who replaces authority and mechanistic medical practice with empathy. In Drum Taps , Whitman accurately conveys the way in which the visceral and psychological de memberment of the nationstate was inscribed on the bodies of all who were forced to participate. This quality of his work suggests that he possesses the same empathic vision as doctors who took the visceral cutting up of bodies to heart. Therefore, his poetry can be reread through a honed medical lens. Whitmanâ€™s writing is consistently examined through his experience as a nurse. But I resituate Whitman as a surgeon; the kind of surgeon he envisioned gave the best care. His poetry, while exemplifying the impact of medical and surgical rhetoric on wartime composing, reveals that Whitman has the traits of a surgeonscribe. The first section examines the narratives of Dr. Reed and Dr. Winsor. Their narratives are distinctive in the collection of Civil W ar doctor narratives because each applies their skills as doctors to engage with the reality and results of their work from an observing perspective. Their perspectives convey a self reflective process whereby each see â€œin the middle of surgery.â€ Each compose within this process to access the more emotional dimension of their work and how they imagine the consequences of war through a medical lens. Because of this, Reed and Winsorâ€™s work present the traits that comprise the surgeon scribe figure. The second section conveys how Thomas Eakinsâ€™s The Gross Clinic depicts a scene in the middle of surgery and visualizes the surgeon-
64 scribe figure. Lastly, the third section argues how Whitman, with his prolonged acquaintance with medical scenes and medically trained individuals, explores the war doctorâ€™s subjectivity and experience poetically. He gains access to doctorsâ€™ subjectivity through his view as a surgeonscribe, and in doing so, s hows that he possesses the qualities to be a better surgeon because of his empathic and artistic vision . In Medias Chirurgia Dr. Reedâ€™s memoir, Hospital Life in the Army of the Potomac , published in 1866, and Dr. Winsorâ€™s initially anonymous account of field surgery titled â€œThe Surgeon in the Field Hospitalâ€ published in the Augus t 1880 Atlantic Monthly are two narratives that serve as a framework for thinking about Whitmanâ€™s poetic project. Scholars disregard1 an important self reflective representation of the writing Civil War surgeon these texts provide. Dr. Reed and Dr. Winsor step outside of their onduty surgeon roles to engage with their work from a peripheral perspective. In doing so, both Reed and Winsor assume a world of emotion and revealing vision. Their narratives, unlike some written by their war colleagues,2 emphasize their feelings about what war does to the human body and the weight of their role as experts in putting back together soldiers or taking away parts so that the soldiers might live. The composing doctors engage in writing that, similar to Whitmanâ€™s thoughts, â€œopens a new worldâ€ to reveal the feeling side of the doctor that manages the inner battle of defeat with words, not the occupational side that demands complete control. They imagine and construct warâ€™s situations metaphorically through a scr een made up of their medical knowledge. When not holding the scalpel, the doctors see wounded bodies with feelings that reflect their own. Both doctors (and Whitman) see and write in
65 what I term â€œ in medias chirurgia. â€ Reed and Winsor compose war hospital s cenes with a strategy conceptualized out of how they operate and how the physical and emotional results manifest after such operations. Each moment is explored like a surgery. Their writing hones in on their skills as doctors with their incising eye as they swiftly move from one patient to another, but instead their hands are absorbed in narrative, not flesh. And their minds are more focused on the internal and external turmoil not only of their patients, but of themselves. Because of their focus on the inner turmoil of their patients and themselves, the surgeonwriters exhibit extreme sensitivity to their pr actice and affect. For example, Dr. Reed explains what the Civil War surgeon comes to quickly realize: war disrupts automatic assumptions about the hum an body and how this disruption forces surgeons to come to terms with the burden of their responsibilities. Reed notes wounds in recordkeeping fashion, but his tone presents a loving, tender connection with the men. Throughout his writing, he conveys his desire to know soldiersâ€™ inner wounds more than just their outer ones. Reed pays close attention to identities, faces, and the dying. His vision is absorbed with the sufferer when looking from the periphery, yet he does not completely forget the weight of his medical responsibility tied to each sufferer. He reflects upon the overwhelming feelings associated with such an unfathomable responsibility as he witnesses overworked surgeons surrounded by thousands of men waiting. â€œIn recollection of agonizing sight s and sounds,â€ he recalls â€œthe sense of accumulating duties, of sleepless nights, of days crowded with painful experiences, of heart and brain overwhelmed with the effort to relieve so much sufferingâ€ (59). Efforts to relieve suffering were frequently undermined by failure. While observing the surgeons at
66 work, Reed hears what the working surgeons do not hear because they are so engrossed in their occupational efforts. The futility of their tasks drenches them as much as the blood drenches their arm sleeves and aprons. Reed notices how â€œthe surgeons were at work, probing, extracting balls, amputating in the open air, while upon every hand were cries of agony from the poor fellows, which would have melted any but a heart of stoneâ€ (33). Separate from the oper ating surgeons he hears what is to come for them and gives voice to the element of their work that they cannot acknowledge in the discharge of their tasks. I n â€œThe Surgeon in the Field Hospital,â€ Dr. Winsor revisits his former field hospital to help readers understand the excruciating responsibility of cleaning up the warâ€™s aftermath. His intentions for writing this narrative are clear as he asks the reader to â€œpicture to yourself, as you can, the dim sceneâ€ of the field hospital with â€œfew sounds save low , abrupt directions, short and pointed but not unkind questions, and repressed groansâ€ (186). He wants the reader to feel the turmoil that comes along with his practice. His awareness of what is to come after the Siege of Port Hudson on May 27, 1863 gnaws away at his stomach.3 His anticipation builds as the sound of the battle wages. Though he conveys that the role of the surgeon is opposite to the role of the soldier, surgeons also engage in â€œbattleâ€ and feel defeat from tremendous loss. He imagines battle in the same way that he views his work on the wounded body: the feeling of â€œstrungup suspense of expectation, the intensity of effort while the struggle hangs in doubtful balance, the exaltation of victory, [and] the depression of defeatâ€ (183). The verdict that he must render upon bodies is embroiled in the â€œintensity of effortâ€ that he must exert to either save a life, take a limb, or make a decision to keep
67 the soldier comfortable as he dies. His experience with â€œdoubtful balanceâ€ speaks to what may result from his surgical work: either failure or a lack of symmetry. And the victory of saving and healing comes in glimpses with the depression of being defeated by forces beyond any control the daily occurrence. Winsorâ€™s battle conveys his awareness of the difficulties that come for him and his colleagues with the arrival of the wounded. Reed also recognizes the pain of waiting for the wounded. He examines further how he as a doctor is a mirror image of the mangled soldier in need of care. Reed first noti ces the preoperation periphery with so many soldiers waiting for a doctorâ€™s verdict to be made upon their bodies.4 He saw their only â€œrelief in unconsciousnessâ€ with the administration of pain medication (27). Here, Reed notes that consciousness is suffer ing. The entirety of his narrative suggests that in the war hospital, all consciousness is suffering. He emphasizes through his observation that the feeling surgeon is the inversion of the wounded patient corporeally intact, yet internally struggling. In t he makeshift hospital wards in Fredericksburg, for instance, Reed encounters William H. Chambers, a soldier with a debilitating spinal wound. Reed observes his â€œnoble, athletic frameâ€ and his preference to be alone out in the lawn of the hospital away from the bustle. Reed looks upon him noticing â€œthe touching contrast between the poor, wrecked body and the bright, clear intellect which seemed to be burning like a flameâ€ (27). Immobile, stiff, dead but not dead, the soldier has a vibrancy that accentuates t he tragic situation simply because he would live if doctors knew how to prepare him for a life of half paralysis. Reed was drawn to him in a â€œstrangeâ€ way, but this strangeness only represents the unspoken pull of similarity even though their
68 circumstances are asymmetrical. Reed felt himself endeared to Chambers because he perceived himself in the â€œstrong man in all but his shattered bodyâ€ in an inverse way (28). Chambersâ€™ mind is strong, alert, and knowing, but his body is in shambles, wrecked by the unfai r objective of war. Reed, conversely, has a strong body, resolute, whole, and untouched. However, his writing suggests that his work takes an emotional toll. The reality is the death knell for Chambers resounded the moment the bullet penetrated his spine a nd the doctors could do nothing to save him. Looking at this man, Reed feels his medical limitations and composes the ironic relationship between surgeon and patient. Like Chambersâ€™ consciousness of what is to come, Reed self reflects that , as he moves â€œ from room to room, from entry to entry,â€ he will never escape the accumulation of devastation in his vision (21) . He will never escape the reality that he often cannot fix what is desperately in need of fixing. He takes ownership of what he sees â€œin mansions of the grandest proportions, in leaky sheds and outhouses crumbling to decay, in rooms, entries, attics, and upon porticos [where] our wounded men were laidâ€ (21). Our wounded, he poignantly notes, lay strewn upon landscapes and in structures resembling their own bodies, leaky, crumbling, and in decay. Ours, he says, meaning ours as doctors for only they know what can be done to help them and, more importantly, what cannot be done.5 Ours â€“ of the dead and wounded â€“ is what Whitman also chanted. Whitman moved from room to room placing his hands upon the grey brows of languishing men like Reed. He, too, surely felt â€“ similar to so many surgeons â€“ the limitations of the care he provided. Next, Reed and Winsor â€œseeâ€ in amputations because the removal procedure is
69 t he center of their practice. Both employ metaphorical amputation vocabulary to describe scenes that are not medical. Both describe images of wholeness, lack, and symmetry and asymmetry concerning the body, situations, and spaces in the same way that Whitman poetically reiterates that wounded, amputated, and dying bodies connect to the national body at war. Writing about performing amputations or witnessing the result of amputations once again exemplifies the strategy of the surgeonscribe: the surgeons anal yze situations in a textual space free of professional constraints but with their occupational tools. For example, Reed imagines â€œin amputationâ€ scenes of war beyond the hospital. Seeing â€œin amputationâ€ presents a lopping off of the crisis that will ironic ally bring relief and healing. Reed envisions, like the movement of the blade in an amputation operation, how the war reaches families: â€œthe news of battle, it comes swift and sureâ€ (102). â€œFor days there is unnatural quiet through the household,â€ he explains, â€œwhich goes on with the silent routine, under the painful pressure of uncertainty, until at last a message or a letter tells the wholeâ€ (102). The painful pressure of uncertainty is akin to what Reed knows about the uncertainty of wounds and whether or not such traumatic wounds upon the body can be healed or will succumb to disease. In this way, the medical experience is essentially sent home and felt even if the familyâ€™s soldier does not return scarred or limbless. Just by opening the envelope the fam ily endures an emotional and genealogical amputation with the loss of a familial limb. Reed explains that the letter â€œtells the wholeâ€ even though the family will feel from that point forward a perpetual loss. Reedâ€™s memoir also â€œtells the wholeâ€ because he tells the entire story, not just the professional story that nods at surgical moments or the realities of inundation after a battle.
70 Like Reed, D r. Winsor looks upon amputation surgery from both performance and peripheral perspectives. From a performance perspective, Winsorâ€™s self awareness culminates in a poignant moment in which he reencounters a colonel of twenty two years of age with a wound to his left hand. Winsor looks at this young man and sees that he longs â€œto know the surgeonâ€™s verdictâ€ (185). Acquainted with the soldierâ€™s medical history, Winsor explains that this colonel was the only mounted soldier in the battle because of the loss of his leg. Winsor assesses the new wound and imagines forward to the amputation process that he may have to engage in: â€œI shuddered to think of having to take away another limb from the already maimed body that had borne so bravely his unmaimed, mighty, and alert spiritâ€ (185). In the same penetrating eye as Reed, Winsor sees past this manâ€™s injury to his vigorous spirit with the feeling that if he takes away another limb then he might amputate the quick and the vitality of the manâ€™s life. Winsor also writes with peripheral vision, forcing the reader to look from a distance and to feel his work along with him : T hat space more lighted than others, where you can see, al though vaguely, entire figures stooping or moving, that is the amputating table. But to re alize the surgeonâ€™s experience you must not only see with his eyes and hear with his ears, you must feel wi th him; for he and his patients are all feeling; they feel the suffering; he feels with the sense of touch, the skilled touch. Perhaps none but a blind man can k now how all sensation seems to centre in the surgeonâ€™s finger at such times, as it takes up momentous investigation where the eye fails. Try â€“ for it is wort h an effort â€“ to realize. (186) Winsorâ€™s description of the surgeon akin to a blind man accurately depicts the lack of knowledge that Civil War era doctors constantly confronted. Rutkow explains how doctors in the midnineteenth century could only act upon what they could see with conditions such as â€œabscesses, broken bones, bulging tumors, cataracts, and herniasâ€
71 (6364). The Civil War doctor â€œwas forced to render care for diseases that were neither visible nor understood extracting bullets; staunching bleeding; [and] amputating hopelessly shattered fingers and hands on the spotâ€ (64). Winsor then projects his vision forward to the home front of the colonelâ€™s family as he is reminded of the men he has already seen. He admits in candid tone that he is, indeed, aware of the undulating effect of his surgical work on his patients and their families: â€œA vision of the fond father and mother, who had charged me as I left home to look after their boy, r ose before me and wrung my heart,â€ he explains, and further reveals how his wrungout heart was â€œalready sore over the wounds of a score of other friends whose blood had stained my hands within an hourâ€ (185). The stain of their blood upon his hands matched the stain of his experience upon his psyche and heart. Yet, he continues his work after this point. He does not amputate the colonelâ€™s hand; rather, he performs a conservative resection surgery that saves the limb momentarily but prepares the body for the inevitable infiltration of disease and gangrene.6 Writing in recollection after the discovery of the modes of germ and disease transmission and the advent of medical sanitation practices, Winsor most likely recognized the good intentioned harm that he perpetrated. Undoubtedly, he felt the grief of what Rutkow poignantly notes concerning the reality of Civil War medical treatment: perplexed at the deaths that resulted from surgeries meant to heal, doctors â€œcould not reconcile [the] lack of hygiene and timely care that together compelled the operating surgeon to become, in effect, a soldierâ€™s ultimate executionerâ€ (12). Winsorâ€™s reflection reveals the last and most integral trait that embodies the surgeonscribe figure: a lack of understanding about futile efforts to save bodies. Cutting
72 up bodies is not an opportunity to learn for the feeling surgeon. Instead, cutting up bodies creates emotional sympathy about producing ugly, asymmetrical, or often dead bodies. Reed and Winsorâ€™s narratives convey that they and other surgeons did not understand what they were doing and they tried to work out the flaws in their medical practice through self reflection and writing. Essentially, the surgeon scribe is a tragic figure whose knowledge and emotional response cannot keep up with his practice. Most importantly, the narratives reveal a set of characteristics specific to the empathic surgeonscribe figure. These characteristics provide a new framework for rereading what Whitman pays attention to in Drum Taps and for rec onsidering the role he enacts as hospital observer and composer. The next section presents the surgeonscribe figureâ€™s traits in a visual format, which ultimately serves to enhance a medical rereading of Whitmanâ€™s poems. All of the traits described above a re visually shown in The Gross Clinic in a triangular correlation between writing, artistic/emotional vision, and surgical performance. The Inverted Triangle The simultaneous acts of sketching, composing, and performing surgery in The Gross Clinic offer a visual that represents how surgeonscribe figures like Thomas Eakins, Drs. Reed and Winsor, and Walt Whitman observe clinic scenes and conceptualize visual and compositional strategies out of medical discourse and procedures. Comparing Whitman to Reed and Winsor makes sense because the poet felt himself to be a vital element to the war hospitals and part of the doctoring cohort. In the same sense, thinking about the work of Thomas Eakins in regards to Whitmanâ€™s poetry is new. Whitman and Eakins wer e friends and their work shows similar scenes
73 with both enacting the perspective of clinic observer. Therefore, Thomas Eakinsâ€™s self portrait, the Jefferson Medical College clinicâ€™s scribe (Dr. Franklin West), and Dr. Samuel D. Gross in The Gross Clinic ma ke up the visual points of perception of the surgeonscribeâ€™s approach. Eakins and the scribe sit parallel to one another evoking a symmetrical relationship between medical and artistic interpretation: Eakins sketches Dr. Gross in the middle of surgery acc ording to his own interpretation while the scribe records Grossâ€™s lecture dictation word for word. The surgeon turns away from his patient with scalpel in hand in what appears to be a pause to lecture, yet the portrait also insinuates that the surgeon coul d be in deep thought. Based on what he shares in his autobiographical writing, in the middle of surgery, Dr. Gross occupies only one part of his thinking, which is complete focus on his abilities with his more empathetic and sentimental concerns for the patient muted. Considering this muted part of his thinking illuminates the emotional lens through which Reed, Winsor, and Whitman see and reflect. In the painting, Eakins embodies a convergence of professions â€“ art and surgery â€“ with an emphasis on thorough k nowledge of the body and knowledge of the experience of opening the body.7 Eakins silently weaves into the canvas the same knowledge of the body as the surgeon he is observing and sketching. He situates himself in the role of intermediary between writing and the medical profession with the ability to converge each professionâ€™s strategies to deconstruct a scene in order to construct a narrative. And, if looking closely at the painting, Eakinsâ€™s signature is etched on the operating table, which John Wilmerding perceives as a metaphorical representation of Eakins â€œstanding next to that table of instruments to the lower left, in the space between two
74 foreground physiciansâ€ (qtd. in Shattuck). The artistâ€™s signature engraved into the operating table reinforces t he convergence of professions that Eakins symbolizes. In the space between the surgeonsâ€™ tools and the doctors his presence bridges the factual reality of the scene with artistic possibilities of interpreting it. The surgeonâ€™s tools become his tools. He is a surgeon of scenes and moments and emotions. He incises with his eye and explores with his pencil filled hand. He sees how the doctor sees because he himself knows what the doctor knows. The act of sketching and writing replicated in the painting is i mportant to note. Michael Fried perceives a relationship of composition between the instruments held by Eakins, Grossâ€™s assistant, Gross, and the clinicâ€™s scribe. Fried views Eakinsâ€™s self portrayal as a decisive act to emphasize â€œvariants of what he is shown doingâ€“ concentratedly sketching and/or writing, in any case wielding a pencil like implementâ€ (12). Here, the scalpel conflates with the pen, which is precisely what Reed and Winsor do to narrate their experiences and what Whitman captures in his poetry . Friedâ€™s interpretation is bolstered by the fact that Gross holds his scalpel as one might hold a writing instrument or paintbrush (15). Eakins thus conveys two essential qualities of the eminent surgeon just by how Gross holds his scalpel: he is surgical and compositional. As Fried makes clear, Eakins binds himself to Dr. Gross in the scene as surgery and composition come together in an analogous relationship. Gross and Eakins simultaneously perform the same work in the clinicâ€™s amphitheater with both hav ing, in the words of Elizabeth Johns, a â€œprofound commitment to human bone and fleshâ€ (236). This commitment to writing bodily veracity is indicated by the color that connects the patientâ€™s open flesh, the clinic scribeâ€™s recording pen, Eakinsâ€™s pen, and G rossâ€™s scalpel
75 as each instrument is tinged with red signifying blood. Red blood and red paint, in Friedâ€™s analysis, insinuate an â€œindirect or metaphorical representation of the enterprise of paintingâ€ (1314). In circular fashion, the red of the blood and the red of the paint enjoin the inscribing, incising utensils. While there is a circular relationship between the pens and scalpels in the painting, Johns also sees a visual triangular connection. She notices how â€œGross does not occupy the precise center of the painting,â€ yet, â€œhe, his patient, and, by implication, the operation, are bound up in together form a large triangle, with the absolute center of the picture falling just off Grossâ€™s shoulder above his patientâ€ (234). Johnsâ€™ interpretation is enli ghtening and cordons off the surgery from the rest of the painting to accentuate Grossâ€™s position as a pillar of surgical history, which was Eakinsâ€™s goal. However, if the triangle is inverted and expanded, then the two parallel points of the triangle are the clinic scribe on the left and Eakins on the right with the downward point of the triangle as the pensive Dr. Gross and the visceral surgical procedure. The inverted triangle provides a new way of looking at the connections between the points, specifically if considering Dr. Grossâ€™s mentality as the point not only in which the triangle lines culminate downward, but also as a beginning point for the two lines to emerge from. If the starting point of the inverted triangle is Dr. Gross, then, the triangle illustrates the dichotomy of his surgeon mentality . This mentality that he reveals in his autobiography, Autobiography of Samuel D. Gross, M.D. , suggests separate subjective stances of perception revealing his differing feelings associated with performi ng surgery and observing surgery. Writing in recollection, he conveys that observing surgeries instead of performing them made for an emotional and sickening experience. â€œAfter
76 having performed thousands of operations, and spilled gallons of blood,â€ he exp lains, â€œI seldom feel comfortable as a looker on at a great and protracted feat of this kindâ€ (170171). Rather, he confesses, I am naturally sensitive and sympathetic, and would r ather at any time use the knife myself than see it used by another. In the one case I forget myself in the discharge of my duties, while in the other case my mind is absorbed in what concerns the poor sufferer. ( 170171) Observing surgery from a distance forced him to inhabit another dimension of his consciousness with his mind and heart absorbedâ€“ not just his mechanically moving hands â€“ with the human body before him. But , the fact that he is a surgeon and is trained to think like one is never lost no matter where he stands. Gross suggests that there is a difference between being t he surgeon and being the watcher. This difference enacts the possibility of an empathic perception of surgery that Drs. Reed and Winsor convey in their narratives and Whitman accesses poetically. Therefore, beginning with Dr. Gross as the starting point of the triangle, the two lines emerge from this point and trace upward and outward to the scribe and Eakins exemplifying the separate, dual points of perception upon surgery that Gross describes in his autobiography. Like the professional side of the ment ality, the clinic scribe is the doctorâ€™s medical mind surrogate who understands the auditory narrative Gross is speaking and is embroiled in the discourse of the surgical act completely. The more emotional side of the mentality is Eakins, who, infused with medical knowledge, is the artist with the capacity to capture the poignant, nuanced elements of the doctorâ€™s interaction with the patient. Thus, Eakins and Whitman are the same.8 Both see the silenced narrative and the multitude of feelings that imbue the surgical scene, which reflects the candid qualities Gross, Reed, Winsor, and Whitman signify.
77 Walt Whitman as SurgeonScribe The Gross Clinic â€™s tacitly conveys the complicated relationship between the inner and outer selves of the surgeonscribe figur e. The surgeonscribe is not merely an element of the painting; the surgeonscribe is the painting. Walt Whitmanâ€™s hospital poetry is the written expression of what the painting depicts. This moves him beyond the nurse category that scholars like to place hi m in. Thus, unexplored until now is how Whitmanâ€™s surgical scenes embedded in poems from his 1865 collection Drum Taps illuminate a narrative about the surgeonscribeâ€™s work with wounded bodies. As George B. Hutchinson contends, Whitman â€œconsidered the heart of the national crisis to be concentrated in the hospitalsâ€ and â€œvitally connected, in his own mind, with his ministrationsâ€ (137138). In Whitmanâ€™s mind, America was in his vast literary hospital in need of a doctor to fix the failing body. He felt s trongly about his healing abilities with wound dressing and letter writing. Hutchinson regards Whitmanâ€™s letter writing role as a liminal position â€œbetween the living and the deadâ€ (139). Such a position would precisely be that of the doctorâ€™s but Hutchins on does not explore this reality.9 Further, Mark B. Feldman examines Whitmanâ€™s writings through the poetâ€™s continuous use of the word â€œconvulsiveâ€ associated with diseased or injured bodies. The word â€œconvulsiveâ€ simultaneously describes tearing apart and putting together. Feldman believes that the war for Whitman â€œhad [a] contradictory double valence of pulling the nation apart and bringing it together into a more lasting union based on adhesivenessâ€ (2). Feldman perceives the contradictory nature of both the war and Whitmanâ€™s habitual note of the impossibility of representing the war though he wrote of it extensively. Feldman does explore Whitmanâ€™s metaphor of imagining the nation as a body and argues that the war made this â€œproblematicâ€ because the â€œwounded and broken bodiesâ€
78 made â€œany metaphoric exchange impossibleâ€ (4). He states that Whitman previously relied on the exchange, but could no longer with his war poetry, to which I disagree. True, the war bodies could no longer do the work of the â€œmultitudes â€ of bodies and landscapes in Leaves of Grass . But, this is because the prewar bodies and landscapes Whitman illustrated were, to use Feldmanâ€™s framework, convulsed in the wake of the national cataclysm. Rather, it makes more sense that the wounded war bodies would translate to metaphorical discourse about the nation because the nationâ€“ politically, geographically, and ideologically â€“ resembled that body more accurately. Reexamining Whitmanâ€™s hospital writing ironically requires an exploratory surgical process because of the intense scholarly focus on the poet that the Civil War influenced.10 Whitmanâ€™s poetry offers a vision of the wounded and the war through a medical scope. Hence, this section makes an assessment of four poems with the doctorâ€™s work in mind: â€œA March in the Ranks HardPrest and Unknown,â€ â€œThe WoundDresser,â€ â€œLong, Too Long America,â€ and â€œAdieu to a Soldier.â€ The poems, examined through a lens constructed out of the devastating realities of Civil War medicine, can be reread as representing the inner consciousness of the war doctor at work. Whitman poignantly reveals the immediate impact of constant, extensive, and often failing surgical procedures. He is attuned to surgeonsâ€™ work because he sees like the surgeonwriters discussed previously: as a scribe, artist, and performer of â€œsurgery.â€ He conveys doctorsâ€™ seemingly unspoken surgical experience in a tide of never ending wounded soldiers â€“ an experience that he absorbed deeply. Like the clinic scribeâ€™s role in the painting, Whitman was aware of his position as surrogate medical student in the hospital. He wrote to his mother about becoming more
79 â€œwound roundâ€ and learning about the body as his hours accumulated in the wards. In fact, Whitman (like Thomas Eakins) may have had more of an acquaintance with the body than some doctors. As Rutkow explains, students learned lecture by lecture â€œwith no patients for clinical examination or surgical observationâ€ (51). Unlike the untrained doctors, Whitman encountered numerous patients, examined them, recor ded their identities along with their wounds, and observed surgeries. He felt so acquainted with his patients that they became his. So intensely did he take ownership of the convalescents that he joined their community by imagination and by believing himself in unison with their suffering. In â€œSong of Myself,â€ he fashioned himself in garments of agony and declared, â€œI myself become the woundedâ€ (1898). Though he aligned himself so intricately with the wounded, to further his connection with the medical world, his poetry and thoughts expressed in letters home to his mother suggest that he believed himself to be a better doctor on his own terms. Whitmanâ€™s expansive hospital writing reveals the possibility that he may have believed in a variation of his Leaves of Grass line: â€œI myself become the doctor.â€ His constant vigil and transcription of hospital scenes initiated him into a systematic interpellation of surgical subjectivity. Seeing like the doctors, he felt more capable of healing than the medical men in charge. He often boasted in letters home of his soul healing work with the soldiers and his prodding of doctors to take another look at a patient.11 Moreover, Whitman thinks like a doctor moving through the hospital, assessing wounds, and â€œoperatingâ€ by c andlelight. His surgical strategy to narrate is evident in how his poems from Drum Taps accumulate visual and experiential incisions. His random use of the dashâ€“ appearing like scattered limbs â€“ reinforces the reality that limbs are indeed piling
80 up near the amputation table. T he notion that Whitman assumed a surrogate doctor figure role while observing the warâ€™s hospital scenes is not entirely unique. In Whitman and the Romance of Medicine, Robert Leigh Davis provocatively describes how Whitman claims â€œthe r ole of doctor poet that he discovered in Emersonâ€ (6). Yet, there, Davis ceases commentary without any thorough explanation of Emerson or any interpretation as to what the role of â€œdoctor poetâ€ entails.12 Instead, Davis claims that â€œmedicine is a mode of perception for Whitmanâ€ especially in Memoranda During the War . He incorporates Foucaultâ€™s notion in The Birth of the Clinic of doctors â€œseeing and not seeing the body,â€ or the mode of medical perception that only considers the illness, not the entire indi vidual.13 Whitman was often agitated with doctors who did not see the whole person in their medical care. But, according to Davis, he â€œsees and not seesâ€ to oppositely cover the infirm bodies since Foucaultâ€™s historical tracing of the medical fieldâ€™s panoptic gaze in order to control the body does not fit the poetâ€™s romantic, rather than clinical, description of war medicine. While I do agree that medicine does provide a mode of perception for Whitman, he claims to see directly â€“ to see all, though not for control in the Foucauldian sense. He sees all to emphasize his valuable knowledge and learned care. And more can be said about what â€œmedicineâ€ entails. Davis focuses primarily on illness and the meanings attached to the infirm body. Whitmanâ€™s poetic representations of medicine clearly include surgical scenes in need of interpretation. Davis further explores the liminality of the hospital space and how Whitmanâ€™s writing creates a middle ground in between philosophical and theoretical claims regarding literature and medicine.14 He argues that Whitman, in his hospital writings,
81 situates himself within a liminal space of â€œconv alescent democracyâ€ in which the liminality of convalescence between living and dying signals democratic experience. In other words, Whitmanâ€™s hospital literature presents convalescence as an analogy to the â€œinfirmâ€ political process of democracy that is always hanging in the balance of the desires and directions of the body politic â€“ a body that is incomplete (8). An ideal democracy, in Whitmanâ€™s view, is always incomplete and therefore â€œin hospitalâ€ and subject to change. This, of course, speaks to Davisâ€™s larger point that Whitmanâ€™s romance of medicine is shaped by his homosexuality, which is a mode that is similar to romance and medicine as it is constantly positioned between â€œrisk and doubtâ€ like an infirm body (14).15 For the purposes of this conversat ion, Davisâ€™s attention to Whitmanâ€™s knowledge of the centuryâ€™s medical debates is most important. Fascinated by the growing and transforming antebellum medical field, Whitmanâ€™s lengthy writings about his stay in the Washington D.C. hospitals come as no sur prise. Before the war, he commented on the centuryâ€™s medical debates as a reporter for Brooklynâ€™s Daily Eagle : â€œWhitman enthusiastically reviewed books and articles by conservative doctors, raged against the dogmatism of heroic medicine, and welcomed the t urn from drugs and depletions to the healing power of nature as a crucial advance in medical practiceâ€ (Davis 13). Whitman undoubtedly felt himself part of a community examining the role of American doctors. E ntrenched in the medical disc ourse of his day, Whitman perceived the overwhelming literary and cultural implications of war surgery. Davis certainly recognizes how the war occasioned a moment for Whitman to â€œ[seize] [up]on a remarkable conjunction between literature and medicine at this period in Ameri can history, one that brought together the
82 therapeutic skepticism of conservative medicine and the philosophical skepticism of American romanceâ€ (12). This â€œtherapeutic skepticismâ€ favored the suspense of the injured body because of the possibility of change. Growing skepticism during the war opened the medical field to other possible modes of treatments and procedures that helped rather than hindered. Thus, Whitman capitalized on the eraâ€™s conjunction of literature and medicine, not only in terms of therapeutic and philosophical skepticism, but also in terms of reciprocity between discourses as the medical experience developed into a major part of the nationâ€™s war experience that so many sought to narrate, discuss, and represent through artistic mediums. Edward Lybeer further examines a variation of the medical/ literary phrase â€œdoctor poet . â€ Lybeer believes Whitman to be a â€œpoet nurseâ€ who integrates the surgical element of the hospital into writing (34).16 He insinuates that Whitman moves from â€œpoet nurseâ€ to â€œone of Foucaultâ€™s strange surgeonsâ€ after he passes through the following stages that interestingly, unnoticed by Lybeer, resemble the immersive effects of medical training by war: â€œnonreciprocityâ€; â€œexperiences of failureâ€; â€œhardening effectâ€; and â€œthe nonrecuperative nature of deathâ€ (88).17 He goes on to further say that the Foucauldian â€œstrange surgeonâ€ is one who knows â€œthat â€˜knowledge is not made for understanding; it is made for cuttingâ€™â€ (88). If knowledge is made for cutting, then the surgeons of the Civil War would have cut precisely, accurately, and without hesitation. Rather, if considering the environment Whitman spent three years in, the inverse is true: cutting is made for knowledge. With surgeries in progress, the doctor scribe in Whi tman writes medical moments â€“ and knowledgeâ€“ into the poems proving that while a poet and a dresser of wounds, he also assumed the doctorsâ€™ subjectivity.
83 Whitmanâ€™s doctor sense comes through in his ability to link places and concepts poetically. Faith Barr ett perceives Drum Taps as an â€œ[attempt] to reunite a war torn country with poetrylinking those at home with those on the front linesâ€ (77). Whitmanâ€™s efforts to link the home front with the war front through his poetry and the letters he wrote for countl ess soldiers is central to scholarly conversation about his writing.18 The medical parallel to Whitmanâ€™s efforts lies in what he witnessed surgeons produce out of mangled parts. Linking the war front to the home front, surgeons sent home amputated men with wounds of war tended to, meddled with, and carefully sliced open or sutured quickly with inadequate threads. Their scarred bodies (engraved with war) speak a silent narrative about war surgery and the Civil War hospital. Put differently, the doctor sent home these narratives â€œcomposedâ€ with their scalpel hands while Whitman composed letter after letter for so many of the wounded and dying soldiers with his poet hands. Aside from the impact of his letters, Whitman was aware of what he hoped to accomplish with his first war poetry collection, Drum Taps . Joan R. Wry cites one of Whitmanâ€™s 1865 letters to William Douglas Oâ€™Connor about what Drum Taps as a poetic project achieves and what he as a man of multitudes can see in the space of the hospital.19 Wry notes how Whitman believes his poems to be â€œmore perfect as a work of artâ€ with â€œan undertone of sweetest comradeship & human loveâ€ (197). But, if the other components of Whitmanâ€™s words to Oâ€™Connor are focused upon, the poetry completed â€œby invisible handâ€; being acquainted â€œwith the unprecedented anguish of wounded & sufferingâ€; and observing â€œwholesale death & agony, everything sometimes as if in blood color, & dripping blood,â€ then a fuller picture of potential interpretations of Drum Taps
84 emerges (qtd. i n Miller 109). Wry further argues from Whitmanâ€™s description that he â€œdefines his desired role as the lyric interpreter of the Civil War, positioning himself in the lines and spaces between the warâ€™s â€˜large and conflicting fluctuations,â€™ and promising to t hread compassion inside chaos through lines of poetryâ€ (197). â€œThreadâ€ summons up a doctor suturing with needle and thread in flesh, thus reading Whitmanâ€™s passage within a medical scope reveals a nuanced interpretive scheme that includes operations on bodies. Resembling the doctorâ€™s process, the poetry makes an assessment of the damage, makes whole out of fragments, and makes fragments out of the wholeâ€“ sending the war home in hobbling packages of experienceâ€“ verses lacking rigid shape. Barrett notes the paradoxical nature of Whitmanâ€™s poems as they intend â€œto bind the nation together againthrough his depiction of warâ€™s violenceâ€ (78). What Barrett does not connect to the paradox of violence/healing is that the act of deconstructing to construct â€“ even if what is constructed is not completely whole againâ€“ in the hospital space is the surgeonâ€™s objective. As Jerome Loving points out, â€œalthough Whitman took an ac tive part in assisting [doctor s] in the war (his narrator in Drum Taps assists in amputations), much of his talent as â€˜nurseâ€™ probably lay in the area of psychologyâ€ (75). Loving acknowledges Whitmanâ€™s role as amputation assistant and emphasizes Whitmanâ€™s ability to enact the role of self appointed psychologist to patients. What Loving misses, however, is the less noted abilities of Whitman to intuitively engage with the inner consciousness of the doctor and to deconstruct to construct. In mimetic fashion, his poems â€œfeelâ€ deconstructed but construct a narrative about war surgery. Drum Taps is uneven with forty three poems. The collection is reminiscent to the
85 asymmetrical body that emerged from the Civil War hospital and could also be viewed metaphorically as a body wounded by war.20 If viewed in this way, Whitman as a surgeonscribe works through the bur den felt by doctors when operating: to have all the answers to the riddles that a mangled body presents. Four poems from Drum Taps , â€œMarch in the Ranks HardPrest and Unknown,â€ â€œThe WoundDresser,â€ â€œLong, Too Long America,â€ and â€œAdieu to a Soldier,â€ when tied together, construct a narrative representing the self reflective Civil War surgeon. As stated previously, like Reed and Winsor, Whitman writes in medias chirurgia. The narrative looks like the medical process of treating a wounded war body: the soldier is wounded in battle and brought to the hospital, the wounded body is assessed by doctors and is either operated or made comfortable for death; if surgery , inclu ding amputation, is neces sary, then the body is placed on the table in a process that physically deconstructs to construct life again, and following that, the body is reflected upon from a personal, medical, and national perspective. â€œA March in the Ranks Hard Prest, and the Road Unknownâ€ is the first in Drum Taps to engage with the post battle realities of the hospital. The narrator, presumably Whitman himself, carefully moves his way through a massive expanse of inanimate bodies strewn about waiting to be tended to by the surgeons. In this poem, the narrator experiences a full assault upon his senses with the â€œthe smell of etherâ€ and â€œthe odor of bloodâ€ flooding his nose and â€œthe crowd of the bloody formsâ€ filling up his vision similar to the surgeons (30). This poem captures the observerâ€™s doctor like point of view being immediately initiated into the aftermath of battle, and making assessments about the wounded men, all while capturing the inner voice of the surgeonscribe .
86 Entering â€œa large old churc hâ€ Whitman is immediately initiated into the aftermath of battle and the medical staffâ€™s responsibilities for fixing what is undone. Through this threshold of gore, Whitman encounters the warâ€™s medical realities in another form. Though he encountered a pil e of limbs at Fredericksburg while searching for his brother,21 he is now thrust backward from those limbs to the actual surgical processes that produced the limb pile to â€œsee a sight beyond all the pictures and poems ever madeâ€ (30). Once in this moment, he, like the doctors who recognized that their medical abilities before 1861 were being tried by war, becomes aware that any life lived after the church will be perpetually altered after crossing the threshold. Whitmanâ€™s poem inaugurates the shift of his poetry into the hospital space. Here, he knows that his poetry will emerge from the surgical scenes he witnesses: battleworn poems with wounds and bodies that speak story upon story, sometimes silent, sometimes screaming. â€œA Marchâ€ presents a series of moments in which there are textual juxtapositions between action and thought. This is exemplified by Whitmanâ€™s strategic use of parentheses: â€œAt my feet more distinctly a soldier, a mere lad, in danger of/ bleeding to death, (he is shot in the abdomen,)â€ and â€œI staunch the blood temporarily, (the youngsterâ€™s face is what as a/ lily,)â€ (30). The parentheses contain the inner voice of reaction while the uninhibited verse explains the action. He sees wounded bodies strewn about on pews, the floors, on stretchers , and on the bare ground outside waiting for the surgeonâ€™s instruments. All at once in a packed moment, Whitman hears â€œan occasional scream or cry, the doctorâ€™s shouted order or calls,â€ and sees â€œThe glisten of the little steel instruments catching the gli nt of the/ torchesâ€ (30). Whitmanâ€™s vision shifts
87 from observer and listener to operator. With the doctor scribeâ€™s ability to visually incise, Whitman takes the glistening steel instruments at work, a parallel to his writing utensil, and furiously works aw ay to describe the medical process. He translates the juxtaposition of their outward actions with their inward contemplation to prose and text. His verses and lines speak to the warâ€™s universal medical experience. Whitmanâ€™s poem is similar to Dr. Frank Hamiltonâ€™s descriptions of a makeshift hospital in a church after the Battle of Bull Run: Arriving in the dark, Hamilton and his retinue found hundreds of severely wounded men â€˜lying upon every seat, between all the seats, and on every foot of the floor .â€™ So tightly packed was the throng that Hamilton felt he was â€˜constantly in danger of treading upon the wounded, indeed, it was impossible to avoid doing so.â€™ By the light of little more than two or three tallow candles, Hamilton completed two amputations, one below the knee and one above the elbow. With unusual soul baring frankness for any surgeon, he confessed that both of them â€œ were done very badly, but I could, at the time, and under any circumstances, do no better. My back seemed broken and my hands were stiff with blood. (Rutkow 24) Dr. Hamiltonâ€™s blood covered hands were most likely stiff in the shape of holding his instruments. Amputations â€“ upper and lower body â€“ exemplify the result of this necessary work. Whitmanâ€™s next poem about the hospital focuses on such results. The reciprocity between the narratives further emboldens Whitmanâ€™s medical comprehension and surgical strategy to compose a representation of the doctorâ€™s emotional and occupational labor. Perhaps the most overlooked line of Walt Whitmanâ€™s poem â€œThe WoundDresserâ€ is â€œwith hinged kneesâ€ (36 and 37). Hinged knees summon forth the image of prosthetics associated with amputation cases. Though Whitman never endured an amputation surgery, he sometimes imagined himself â€œunder the knifeâ€ and felt â€œashamed to be so wholeâ€ observing doctors at work removing a limb.22 Returning, â€œthreadingâ€ like
88 the doctor through the ward, Whitman reimagines himself undoing â€œthe clotted lint,â€ removing â€œthe slough,â€ and washing off â€œthe matter and bloodâ€ from â€œthe stump of the arm, the amputated handâ€ (37). He moves from patient to patient embodying the dichotomous mentality reminiscent to Drs. Gross, Reed, and Winsor necessary for the Civil War doctor: actions with â€œimpassive handâ€ but inside the â€œbreast a/ fire, a burning flameâ€ (38). Again, after his ministrations, Whitman reinforces the axes of his movement: â€œwith hinged knees and steady hand to dress the woundsâ€ (37). Whitmanâ€™s use of â€œhinged kneesâ€ suggests amputation and the possibility of what is to come for many soldiers with wounded limbs who survive. â€œSteady handâ€ speaks to â€œwriting in surgeryâ€: keeping impassive in the moment though on the inside feeling â€œa burning flame.â€ Lisa A. Long refers to Whitman as a â€œdoctor historianâ€ in her reading of â€œThe WoundDresser.â€ She perceives the wound dresser as â€œthe Civil War doctor historian as he attempts to re member the national body through his ministrationsâ€ (13). Longâ€™s assertions are based on the idea that the Civil War provided a healing trope in post war America. I agree with Longâ€™s point that literature refashioned the warâ€™s circumstances into malleable scenes allowing readers to imagine healing physical and emotional wounds. Remember suggests that the dresser reconnects amputated limbs from the national body in the poem.23 However, the dresser tells that he removes â€œthe sloughâ€ and washes â€œoff matter and bloodâ€ from what is left of amputated parts. He does not perform restorative surgery, nor does he do what Lybeer describes as â€œprotecting the w ounds for future exposureâ€ (35). Rather than remembering, the dresser accepts what he finds and removes the matter and bloodâ€“ a curtain that obscures direct visionâ€“ to
89 reveal and expose the veracity of the medical experience of the war, which in turn, ultim ately indicates and tells a narrative of the doctorsâ€™ surgical processes. Moreover, Long describes, â€œthe wounddresserâ€™s archive is the Civil War hospital, his documents the dismembered bodies of the patientsâ€ (13). While certainly Whitman moves backward in time in this poem, Longâ€™s descriptions suggest a research task to learn about the experience rather than the personal recollecting task that it really is: â€œarchiveâ€ suggests a static collection to be accessed from an outsiderâ€™s perspective, and â€œdocumentsâ€ suggest flat nonexistence as if Whitman never encountered the stumps of the dismembered bodies up close. Instead, Whitman takes on the more immediate role of surgeonscribe examining warâ€™s wounded up close and writing with the â€œtoolsâ€ and knowledge employed by the doctor. Whereas Reed and Winsor imagine warâ€™s circumstances through a screen of their medical knowledge, for the poem â€œLong, Too Long America,â€ Whitman reverses the lens and illuminates the medical experience through a screen of national v ernacular. He applies the trope of symmetry so closely resembling the wounded body soon to be asymmetrical by the doctorâ€™s blade. He does this to describe Americaâ€™s geographical and ideological fractures. â€œLong, Too Long Americaâ€ is situated right after â€œT he WoundDresser,â€ which emphasizes its significance. â€œDresserâ€ is about soldiers with amputations, how they look, how they are cleansed, and the delusion of the soldier who refuses to look upon where his limb used to be. What follows this is a short, unev en set of lines without shape that enact the previous physical unevenness represented in the dresserâ€™s experience. Through this poem, the dresserâ€™s experience is transposed from a hospital narrative to one projected onto the national landscape, which pushes the
90 hospital outside of its structural boundaries and turns the process of amputation surgery inside out so that it becomes a national, collective experience. This is reminiscent to what Eakinsâ€™s painting did in 1875 with its portrayal of a conservative resection, the opposite of amputation. Furthermore, Davis argues that â€œWhitman resists totalitarian medicine in the same way he resists totalitarian politics. Both forms of authority are based on the same premise: the claim to see and know directly, the claim to certain knowledge. Whitman undermines this assuranceâ€ (105). I argue that Whitman does not undermine this assurance associated with medicine, rather his letters reveal that he embraced medical authority with his claim to see and know directly in â€œLong, Too Long America.â€ He claims to know Americaâ€™s â€œchildren enmasseâ€ and who they really are. In fact, only he knows: â€œwho but me?â€ he asks. He knows them because of his prolonged acquaintance with the medical sphere. He claims to have the vision that others do not: the vision that perceives the need for empathy, not the need for control. Therefore, Whitman was more than a nurse. Davis also argues that Whitmanâ€™s â€œmode of vision [was] alert to the limits of its own perspectiveâ€ (106). If Whitmanâ€™s mode of vision is alert to the limits of its own perspective, then that still speaks to the perspective of the doctor. Not only is Whitman alert to his own limited power and knowledge of what he can do to heal the wounded, but he is also alert to doctorsâ€™ limi ted power and knowledge to save every torn up individual that comes to the operation table. The healer or doctorâ€™s potential post failure anguish is what the next poem quietly works through. â€œAdieu to a Soldierâ€ could be read from the doctorâ€™s self refl ective perspective after performing war surgeries. In this poem, Whitman places himself side by side with a
91 combat veteran as he shares with him â€œrude campaigningâ€ though his campaigning is not yet finished (61). He battles to write of what he endured, and to â€œgive expressionâ€ to what cannot be expressed. Though the surface of this poem presents a congratulatory farewell to a comrade, the language could be read alternatively as the doctor thinking about the battles he endured just like Dr. Reedâ€™s and Dr. Wi nsorâ€™s imagined battles with the wounded body. He then tells the story of saving and losing bodies and of saying goodbye. The line â€œYour mission is fulfillâ€™d â€“ but I, more warlikeâ€ immediately indicates the possible post hospital feelings of the war doctor. The linear symmetry of â€œfulfillâ€™dâ€ and â€œwarlikeâ€ separated by a dash illustrates the uncertainty of emotional and occupational healing post hospital. The doctor, moving through Lybeerâ€™s stages of â€œnonreciprocityâ€ and â€œhardening,â€ has inevitably become mor e warlike because of combat surgeryâ€™s violent elements. With the war over, he now searches to resituate himself in an altered medical field. Whitman writes: Myself and this contentious soul of mine, Still on our own campaigning bound, Through untried r oads with ambushes opponents lined, Through many a sharp defeat and many a crisis, often baffled, Here marching, ever marching on, a war fight out â€“ aye, here, To fiercer, wei ghtier battles give expression. (61) To read this considering the doctorâ€™s point of view after countless surgeries and countless losses, Whitman presents the doctor as battlehardened in his own way. Like what he conveys in â€œThe WoundDresser,â€ the campaigning in the hospital speaks to how the doctor â€œplunges into the fightâ€ going â€œs traight and swift â€ to the wounded. His descriptions express that the doctor is contentious about the work being done: work without know how, work on a whim, and work on a guess. Such guesswork creates a fraternal bond of surgeons diligently working away on groundup bodies and flipping
92 through worn out pages of bloodstained manuals without finding the answers they need. The words â€œstill on our ownâ€ signify their professional aftermath as they navigate the meaning of their roles so tested by war. They traversed â€œthrough untried roadsâ€ and tried myriad ways of moving the scalpel and passing the eye over the body in order to make an accurate diagnosis. The short line â€œambushes opponents linedâ€ suggests the unpredictability of what war does to the body and how the literature shows the doctorâ€™s confrontation with having to fix the unpredictability leaving him with â€œcrises, often baffled.â€ Baffled, he remains, with the pang of defeat and of not knowing enough or simply having enough hands to help. Whitman captures it thoroughly without saying it straightforwardly. His hospital scenes are not just about the wounded, but the ones charged with â€œunwoundingâ€ the wounded and making the unnatural natural to the home front eye. Without explicitly drawing the correlation, but making the parallel is clear, Whitman worked through the inner emotional labor of the surgeons he found himself surrounded by in Drum Taps . Thomas David Lisk creatively imagines Whitmanâ€™s experience with this labor: â€œWalt had worked to make himself i mperturbable, to inure himself to the pain of an uncertain knowledge that comes late at night sometimes with crushing certainty: no self endures, no thing is immortalâ€ (116). Whitman similarly came to terms with the crushing blows endured by the medical individuals charged with undoing the damage of war. He learned that, as did Drs. Reed and Winsor, not all could be saved and trying to save all was tough work. Lisk further imagines the result of observing and working within the war hospital, but I push his claim to compare Whitman with the doctor: both the poet and the surgeon emerge from the hospital in â€œtwo
93 fragments[with] an identity in tension, wounded, healed and scarred, [with] limbs reattached that they didnâ€™t want to be reattached and moved stiffly ever afterâ€ ( 114). The limbs of remembrance and of enduring involuntarily reattach and move stiffly ever after. Hinged knees. Such limbs are never quite the same. What Whitman as a surgeonscribe feels and narrates while observing pulls at every point of t he inverted Gross triangle: writer, artist, and doctorâ€“ all in medias chirurgia. His medical experience fashioned a way of writing about the warâ€™s aftermath: with visual incisions and surgical strategies. Notes 1. Frances Clarke does recognize Reedâ€™s memoir. For the most part, though, Reedâ€™s memoir is unjustly neglected in scholarly interpretation of Civil War literature. Clarke, in War Stories: Suffering and Sacrifice in the Civil War North, employs Reedâ€™s memoirs as an example of a writer who recognizes blac k suffering, but who does not grant the same intensive attention to such suffering as white Union soldiers. Clarkeâ€™s contention with Reedâ€™s lack of equal recognition extends to his chapter â€œColored Hospital at City Pointâ€ in which Reed does not write of th e black convalescent soldiers similar to white soldiers. Instead, a white nurse, Helen Gilson comprises the majority of written word for that chapter (64). 2. Some Civil War doctor memoirs such as John H. Brintonâ€™s Personal Memoirs of John H. Brinton, Civil War Surgeon: 18611865, Thomas Ellisâ€™s Leaves from the Diary of an Army Surgeon, and John Lettermanâ€™s Medical Recollections of the Army of the Potomac focus on the professional and administrative experiences associated with the managing the war hospitals. While these narratives are important to this study, the narratives included in this chapter are unique for their emotional tones as each engage with the feelings of performing and observing surgeon duties in dire circumstances. 3. According to Michael Fellman, the Siege of Port Hudson was a lengthy assault by Union troops upon the Confederates on the Mississippi River near Port Hudson, Louisiana. This siege lasted from May 22 to July 9 of 1863. Eventually, the Federals were victorious in taking possession of the riverâ€™s pathway (162). See Fellman, Michael, Lesley J. Gordon, and Daniel E. Sutherland. This Terrible War: The Civil War and Its Aftermath . New York: Longman, 2003. 4. Reed as a doctor scribe also employs a medical rubric for assessing the helplessness of wounded soldiers who are desperate for help but receive none. Reminiscent to the bodyâ€™s actual response to a wound, he describes the many
94 wounded waiting for care in a â€œsurging and concentrated mass of intense activity and sufferingâ€ (16). Like a wound that is at a crisis point, full of surging pain and blood with the body acting in intensity to save the skin, the muscle, or the bone, a remedy is needed. But, without hands to tend to the wound or medications to ease pain, the body languishes and remains in constant crisis. That is what Reed sees because that is what he knows as a doctor. He sees body upon body in crises, waiting for either care or death. In front of his m indâ€™s occupational eye, he imagines the countless prostrate men as one vast wound. Such a wound is one that he longs to diagnose, but he recognizes that he simply cannot. 5. He is able to understand the wounded menâ€™s pain because he allows himself to unders tand more than just the mechanics of the human body. He is in an element that engages with how the wounded men feel physically and psychologically, which in turn, illuminates how he feels. One example of this connection is when Reed describes riding in an ambulance from the battlefield to the hospital. He urges his reader to imagine â€œbeing violently tossed from side to side, of having of the four who occupy the vehicle together thrown bodily, perhaps, upon a gaping wound; of being tortured, and racked, and jolted, when each jarring of the ambulance is enough to make the sympathetic brain burst with agonyand then some poor stump would be jolted from its place and be brought smartly up against the wooden framework of the wagon, while tears would gather in the eyes and roll down over furrowed cheeksâ€ (5758). Reed carefully deconstructs the experience of riding in an ambulance while wounded to construct the feelings of the experience. The act of deconstructing to construct is surgical because he incises into ev ery aspect of the ambulance ride and examines each part of the experience only to put the pieces together to give a true account. Observing as a doctor instead of performing at the operation table, Reed writes of the formation of a psychic bond he has with patients that is forged out of bursts of the brainâ€“ bursts of knowing their pain that shatters mere sympathy and pieces together shards of empathy. 6. Near the conclusion of Winsorâ€™s recollection, he receives a letter from the colonel stating that the doctors he has seen since the field hospital quarrel over the best course of action to take about his hand. This speaks directly to the contention in the medical field about surgical practices necessitated by the war. The colonel states in his letter that he had to fold the envelope one handed. 7. Eakinsâ€™s relationship with the medical field bolsters his identity as artistic sketcher with the ability to unite art with surgery. He integrated himself into the medical field by studying anatomy while maintaining his i dentity as an artist. He made use of his anatomical knowledge in his artistic representations of the body. Though he did not confront the difficulties and impossible circumstances bestowed upon military doctors during the war, he still unwearyingly applied himself to learning about the inside of the body through performing dissections and surgeries similar to medical students and surgeons. 8. Interestingly, Eakins and Whitman shared a friendship in the latter part of the poetâ€™s life. Eakins painted Whitman and spent many hours with him. The connection
95 between them is that both were â€œsurgicalâ€ with their work â€“ seeing from the inside out â€“ to give a new narrative. Both were realists. Eakins felt his painting was a masterpiece because instead of painting the eminent doctor in his study behind a grand desk, he depicted him in his professional environment. Whitman felt that his writing granted access to a world never known before, a world that transformed the medical field and the meaning of literary representation. 9. Hutchinson discusses the aftermath of the Civil War in medical language: â€œin the nationâ€™s process of recovery from the trauma of war, much was left unspoken, undiagnosed, and unhealed in the heart of the democratic experimentâ€ (134). However, he does not engage with the medical realities of the war nor does he connect the medical metaphorical discourse to the work of doctors of that era. He does touch upon the theoretical idea of â€œsuturingâ€ that Robert Leigh Davis incorporates into his conversation of Whitm anâ€™s poetry, though. â€œWe see in Whitmanâ€™s work,â€ Hutchinson notes, â€œin this respect, and in the nation, an example of the sort of â€˜suturingâ€™ that has been described in recently within film and narrative theory. Surgical suturing reconnects torn or cut fles h after an operation or in the repair of a woundâ€ (146). While the language of suture is integral to medical metaphors that translate from specifically medical vernacular to literary texts, Hutchinson does not regard that before the flesh can be sutured, i t must be cut into and Whitmanâ€™s poetry also speaks to the surgery before the suture. 10. For example, Adam C. Bradford regards Whitman as a â€œrecollectorâ€ of human value. Confronted with an accumulation of corpses, Whitman collected information about the sol diers to undermine â€œthe deflation of human valueâ€ associated with such extensive loss of life (127). Therefore, Bradford provocatively argues that Drum Taps as a poetic project provided a â€œtextual means of reaching the deadâ€“ imaginatively recovering them and acknowledging their innate human valueâ€ (128). For more, please see â€œRecollecting Soldiers: Walt Whitman and the Appreciation of Human Value.â€ Walt Whitman Quarterly Review 27.3 (Winter 2010), 127152. Moreover, Daneen Wardrop discusses Whitmanâ€™s Memor anda During the War as a nursing narrative that grapples with erotic undertones. She argues that his memoir shares the same theme as female narratives such as Louisa May Alcottâ€™s â€œHospital Sketchesâ€ in which Whitmanâ€™s â€œmaternal and eroticâ€ tones create an â€œambient formula that approximates the expression of homosexuality in a culture thatresists itâ€ (41). See â€œCivil War Nursing Narratives, Whitmanâ€™s Memoranda During the War, and Eroticism.â€ Walt Whitman Quarterly Review 23.1 (2005), 2647. For more on Whit manâ€™s Civil War experience, please see Charles I. Glicksbergâ€™s Walt Whitman and the Civil War . Philadelphia: University of Pennsylvania Press, 1933; Roy Morris, Jr.â€™s The Better Angel: Walt Whitman in the Civil War . New York: Oxford University Press, 2000; and Robert Roperâ€™s Now the Drum of War: Walt Whitman and His Brothers in the Civil War . New York: Walker & Company, 2009. 11. On July 28, 1863, Whitman shares with his mother a quarrel he has with a doctor about a typhoid fever patientâ€™s need for care. In this situation, Whitman turns out to be right, thus exemplifying his informed medical knowledge. He writes, â€œDoctor F. here made light of his sickness â€“ said he would recover soon, &c.; but I thought very
96 different, and told F. so repeatedlyhe laughâ€™d, and wo uld not listen to meThe next day he changed his opinionâ€ (69). After this, Whitman remarks that he also brought to the boy the head surgeon of the hospital and that both doctors promised to aid the patient. 12. Ralph Waldo Emerson, in â€œThe Poet,â€ states that â€œthe sign and credentials of the poet are that he announces that which no man foretold. He is the true and only doctor; he knows and tells; he is the only teller of news, for he was present and privy to the appearance which he describesâ€ (263). The poet/ author as a doctor figure, or for my purposes, the doctor scribe, is, indeed, a teller of anew in Civil War hospital literature. Whitman exclaimed that the hospital opened a new world to him â€“ a world in which previous dramas, literature, and tragedies could not measure the magnitude of the war â€“ and this world he would make acquaintances with and endlessly describe. He embodied the reciprocal immediacy of the war hospital: the poetâ€™s war experience and the doctorâ€™s war experience resemble one another. For the entirety of Emersonâ€™s essay, see â€œThe Poetâ€ in Nature and Selected Essays . Ed. Larzer Ziff. New York: Penguin Books, 2003. 13. This is also outlined by Foucault as â€œthe medical gaze.â€ Louisa May Alcottâ€™s semi fictional nurse character, Tribulation Periwinkle, describes the same discontent as Whitman. 14. While Davis is concerned with the debates in nineteenth century medicine, I am concerned with how Whitman integrated witnessing surgery into his poetry. 15. Davisâ€™s study considers Whitmanâ€™s homosexual sense as the basis for interpreting his medical writings. In an â€œin betweenâ€ position, Whitman presents political oppositions fully, but he employs a â€œtherapeutic alternativeâ€ engraved as an intermediary space of the hospital that allows for a combination of rigidly opposed concepts (7). The combination is ultimately a vast vacillation that never claims one side or the other, but as Davis sees it, this vacillation was necessary for America to be democratic â€“ or, at least, Whitmanâ€™s version of democratic. 16. I agree with Lybeer that Whitmanâ€™s work integrated â€œthe body and its fluids into the lexicon of poetryâ€ (35). Lybeer also states that Whitmanâ€™s writing offers a â€œsurgical, impersonal recording of the warâ€ (35). Certainly Whitmanâ€™s writing is surgical; however, I disagree wi th his assertion that it is impersonal. Rather, Whitmanâ€™s poetry involving representations of surgery or surgical strategies for narration do what surgery does: sees from the inside out. Thus, surgical readings are deeply personal. 17. Lybeer quotes Michel Foucault from â€œNietzsche, Genealogy, History.â€ The Foucault Reader . Ed. Paul Rainbow. New York: Pantheon, 1984. 76100. 18. Mark Maslan examines Whitmanâ€™s letter writing initiative for convalescent and dying soldiers and the representational work of his poetry in â€œWhitmanâ€™s â€˜Strange Handâ€™: Body as Text in Drum Taps.â€ ELH 58.4 (Winter 1991), 935955. He argues that soldiersâ€™ bodies in his poems are represented through text with the broken lines and
97 terse phrases as wounds. For example, Whitman links the battlefront to the home front through his poem â€œCome Up from the Fields Father.â€ In this poem the family must open an envelope quickly to know their loved oneâ€™s fate. They open up the envelope to find a letter â€“ the â€œbodyâ€ of their young son and brother â€“ written in th e â€œstrange handâ€ of Whitman wrote the letter for the dying boy. The letter still represents his dying body through Whitmanâ€™s body that coalesces with the text. Moreover, the tornopen envelope, according to Maslan, is the same as the blanket folded around a soldierâ€™s body by Whitman in â€œVigil Strange I Kept on the Field One Night.â€ He enfolds two bodies, one literally, and one metaphorically, in separate poems. 19. Cristanne Miller, like Wry, also excises the same descriptions from Whitmanâ€™s letter, but she does recognize Whitmanâ€™s efforts â€œto affront the reader with scenes of agonizing surgery and dying and post traumatic stress nightmaresâ€ (191). See her complete arguments in â€œDrum Taps: Revisions and Recollections.â€ Walt Whitman Quarterly Review 26.4 (Spring 2009), 171196. 20. Interestingly, Whitmanâ€™s poems in Drum Taps are organized in such a way that reveals the trajectory of change soldiers of the war underwent beginning with the romantic, heroic notions then moving to seeing battle and feeling disillusionment. Whitman captures the soldierâ€™s experience enduring wounds , losing a sense of self or a body part, and spending time in the hospital. He then reflects on the larger national experience of accepting the dead and the impact of the dead on all of America. Drew Gilpin Faust discusses this extensively in This Republic of Suffering: Death and the American Civil War . 21. In December of 1862, Whitman went in search of his brother George, a volunteer for the Thirteenth New York Regiment, after receiving word that George had been wounded near Fredericksburg. Walt immediately t ook care to find him without knowing that during his travels his mother, Louisa, would hear from an alive and well, only slightly wounded George. This miscommunication fashioned a new opportunity for Walt that would perpetually alter his identity as a poet and individual. What is most important, though, for my purposes, is the fact that upon arriving in Falmouth, Virginia, Walt came across a sight that Edwin Haviland Miller poignantly states would â€œhover over his life and imagination for the next three year s, and it marked the beginning of a rite of passageâ€ (35). Waltâ€™s first sight of war was a pile of amputated limbs. This deeply touched him, but clearly did not deter him as he decided at the end of December to stay in Washington only to become the woundd resser that eventually emerged from his writing hand. 22. Two letters exemplify Whitmanâ€™s sentiments about observing surgery. Writing to Nathaniel Bloom and John F.S. Gray on March 19 and 20 of 1863, enclosed in parentheses, he places himself textually in the middle of the convalescent, cut up, diseased, and dying men. â€œI sometimes put myself in fancy in the cot, with typhoid, or under the knife,â€ he writes conveying how the sights of the hospital and his interactions with young men initiate him into a world unknown before (qtd. in Miller 52). Later on in May of 1863, he wrote candidly to his mother about the helplessness
98 that he felt â€“ undoubtedly similar to the doctor â€“ at not being able to keep the men alive. Specifically, he tells of a John Elliott who undergoes amputation surgery and â€œnever came alive off the amputating table.â€ Here, in this moment, Whitman explains how the man was â€œunder chloroformâ€ and that the doctors â€œtried their best to bring him toâ€ but he passed on. With the details that he describes, he observed this surgery as closely as the doctors and nurses. â€œI feel almost ashamed of being so well & whole,â€ he confesses to his mother after the fact. His sense of wholeness is the inversion of the amputeeâ€™s lack of wholeness and perhaps resembles what the doctors also felt at their failing efforts to help the soldier (qtd. in Miller 59). 23. The nation can never be remembered since, in my interpretation, the national body never underwent amputation surgery; instead the fracture was conservati vely resected as both sections were forced back together with the inevitable recurrence of diseases.
99 CHAPTER 4 BLOODSTAINED PETTICOATS, PROTESTING PANTALOONS, AND IMAGINING SURGEON EDUCATION FOR THE CIVIL WAR NURSE: RETHINKING LOUISA MAY ALCOTTâ€™S TRIBULATI ON PERIWINKLE Every woman is born a doctor. M en have to study to become one. â€“ Dr. Ella Flagg Young Louisa May Alcottâ€™s semi fictional Civil War era work, Hospital Sketches , begins with Tribulation Periwinkle stating, â€œI want something to doâ€ (3). Periwinkleâ€™s family members suggest teaching, marriage, or acting. None of these options spark her interest. Her father suggests writing a book, but she says she does not know enough about life yet to write. â€œGo nurse the soldiers,â€ suggests her younger brother. To this, she enthusiastically responds, â€œI will!â€ (3). Trib then comes home a few days later with her letter of commission and announces to her family, â€œIâ€™ve enlisted!â€ (4). Tribâ€™s use of militaristic language hints that she understands how the war will al low her to explore new vocational possibilities. She is sent to Hurly Burly House Hospital in Washington, D.C., and there she learns enough about life in a little over a month to take up the pen after she returns home. She learns the sights, smells, and fr ustrations of the hospital. She tends to many patients, most notably the blacksmith from Virginia, John, whom she closely befriends and soothes as he dies. With her constant care for ill, battletorn, and dying patients, Periwinkle succumbs to exhaustion and contracts typhoid fever after only six weeks of service. Her nursing duties subsequently end. Periwinkleâ€™s narrative is equivalent to Alcottâ€™s lived wartime nursing experience in early 1863. Alcott recorded the raw material of her experiences in her journal and then added fictional elements to comprise Hospital Sketches . Considered her â€œfirst successful literary work,â€ Alcott wrote and published Hospital Sketches as a series in
100 Bostonâ€™s The Commonwealth in 1863 (Showalter xxvi). The series contains six episodes. All of the sketches are important, but her last episode â€œA Postscriptâ€ is most important to my contentions because Trib responds to readersâ€™ questions about seeing surgeries. Readers ask her â€œif nurses are obliged to witness amputationsâ€ and she answers that she â€œwitnessed several operationsâ€ (Alcott 69). The fact that readers desired to know if she witnessed surgery speaks to the eraâ€™s novelty of women taking part in medical situations. Trib does not take on an active role in the surgeries or in dissections, but she remarks upon the possibility of surgeon education for herself. Tribâ€™s remarks are critically glossed over and deserve a closer look. Hospital Sketches shows us that Alcottâ€™s Tribulation Periwinkle is feisty and forward thinking. I ar gue that she embodies the possibilities for imagining a female doctor as a professional equal to male doctors forged out of war nursesâ€™ work. In the middle of the war, Alcott writes the nursing experience that will appear in future Civil War nurse memoirs and published journals. Trib is not only the semi fictional antecedent to the nurse authors considered in this chapter; she is also the semi fictional precursory model to the very radical and only female Civil War surgeon, Dr. Mary E. Walker. 1 With both these positions, Trib offers a commentary on how the war expanded womenâ€™s professional medical capabilities beyond nursing. This chapter rereads Alcottâ€™s Hospital Sketches through a lens constructed out of nineteenthcentury debates about medical education for women and Civil War nurse authorsâ€™ rhetoric.2 I emphasize that Alcottâ€™s Trib vocalizes in literature the broader logic that the set of Civil War nurse narratives tends to show: that wartime nursing is not only about becoming a nurse; it is about thinking of the possibilities of medical education and becoming a surgeon.
101 In this chapter I discuss two interrelated histories: Civil War nursing and womenâ€™s obstacles entering into the medical field. I begin by introducing an historical overview of how Civil War nurse authors thought about their hospital role in relation to surgeons. I do this to foreground the connection between Civil War nurse authorsâ€™ accomplishments and the larger history of women in medicine. This connection provides a new in terpretive context to reread the character of Trib and to reconsider Alcottâ€™s literary contributions with Hospital Sketches . The first section expands upon the womenâ€™s doctor education reform debates leading up to the Civil War. I then integrate Civil War nurse authors into this conversation because their actions correlate with antebellum education reformersâ€™ logic about womenâ€™s medical capabilities. The nurse authors move, in my view, within the following spectrum of action in their narratives: proving, r evising, and imagining. The narratives convey that many used nursing as a platform to prove their propensity for medical work, to revise male doctor centric attitudes through enacting patient centric therapeutics as an alternative form of care, and to imagine, more through action than words, the possibility of females as equal professional doctors and colleagues to male surgeons. The second section provides three â€œvisualsâ€ that correspond to each part of the nurse action spectrum that I outline in the fir st section. The visuals show, like Alcott shows, that the midnineteenthcentury hospital setting was a ripe environment for women to think about their occupational abilities. The visuals enact the linear narrative of events that Alcott includes in Hospita l Sketches and complete the foundation for the potential female doctor that Alcott imagines with Tribulation Periwinkle. In the last section I focus completely on Hospital Sketches . Indeed, Alcottâ€™s text
102 is infused with her real nursing experiences, and I do view her as part of the sorority of nurse authors. However, my intention is to emphasize the pathclearing work that Alcott accomplishes with her form and with Tribulation Periwinkle. Nurse authorsâ€™ historical narratives show the raw material of their experiences, but they do not weave together the larger meaning of their experiences in the refined way that Alcottâ€™s text achieves. Rather than just chronicling the events of her nurse work like the nurse authors do through memoir and journal entries, Alc ott expands on the possibilities of the meaning of her work by linear design and through Tribâ€™s words. The difference between Alcottâ€™s story and the nurse authorsâ€™ texts is that in Alcottâ€™s story, Trib enacts all parts of the spectrum of action discussed previously. She first proves herself as a nurse, then revises the usual course of care to her own standards, and finally imagines herself entering medical education. Such a claim requires that we reassess how Trib views her nursing role in relation to the doctors she encounters. Critics focus on Trib as a nurse only, though her interactions with doctors reveal that she does not perceive her nursing role as an end. She perceives her role as an opportunity. A more radical push is needed in favor of what Trib c ould be as a female nurse forging her own way in a professionalized masc uline space. I must note that Alcott and the nurse authors discussed here did not seek to replace the doctors they worked with in war hospitals nor did they do the amount of surgical work that the doctors did. Most, including Alcott, recollect performing conventional nursing practices such as managing diets, preparing meals, washing patients, and writing letters home. But, they felt strongly about what they did and what they could of fer the medical field. While nurses did not establish nursing schools or rush
103 off to medical school to become doctors after the war, clearly nurse authors thought about and wrote about their capabilities in comparison to male doctors, a notion that Alcott inaugurates and expands on in Hospital Sketches . It is also worth noting briefly how Civil War nurse narratives emerged. Most of the narratives were published during and immediately after the war by Northern women. Jane E. Schultz explains that â€œseventeen former relief workers published narratives between 1863 and 1870â€ (228). As noted previously, Alcott transformed her journal into Hospital Sketches in early 1863 and Georgeanna Woolsey Bacon followed with Three Weeks at Gettysburg later that summer ( 228) . Each sold well, as readers were eager for war stories. Between 1866 and 1870, seven more Union nurses published their narratives including Elvira Powers, Sophronia Bucklin, Sarah Palmer, and Jane Woolsey (230). Confederate nurse Kate Cumming published her Journal of Hospital Life in the immediate post war era, and P hoebe Yates Pember published A Southern Womanâ€™s Story: A Life in Confederate Richmond in 1879, but not many Southern nurses took up the pen (229). The years between 1870 and 1900 saw eight more accounts surface by former nurses such as Mary Newcomb, Adelaide Smith, and Susie King Taylor. Regardless of publication time or wartime loyaltie s, together these narratives reveal how women nurses underwent extensive medical education through immersion, observation, and practice. Nurse authorsâ€™ awareness of their unique qualities in comparison to the surgeons they encountered is vital to understanding the opportunity that they had to imagine a professional doctoring role for women.3 For example, Nurse Emily Bliss Souder shares with her husband a conversation she has with a surgeon. She writes,
104 I have a supply of paper and envelopes and can write letters without boxes and this also is much needed. A surgeon from Ohio, who is waiting for the Harrisburg train, says â€˜he can take a manâ€™s leg off, if necessary and not mind it; but when a man says, â€˜Canâ€™t you write to my wife and tell her how I died and tell her to kiss Mary ,â€™ that I cannot do. (13) The surgeon admits to Emily that he cannot do part of the required war hospital work. Female nurses took up this necessary responsibility with vigorous heart. They morphed into mother, sister, sweetheart, and lover at the deathbeds of countless soldiers in need of sending a message home or in need of a familiar hand to die by. The war allowed for women to take on fluid roles. History tells us that women acted as soldiers, cross dressers, spies, and nurses.4 What follows from this logic is that nurses had the opportunity to imagine themselves as vital medical actors, professional colleagues to the male surgeon, and as potential surgeons with the capacity to make informed decisions based on wounds and ailments.5 The professional medical possibilit ies for women discussed here stem from the widely conversed topic of womenâ€™s newly acquired wartime hospital role. Nina Silber contends that â€œfemale nurseswho found themselves doing grueling labor in wartime hospitals, on hospital transport boats, and som etimes on the fields of battle, learned important lessons in self assertion and professionalismâ€ (12). Their learned self assertion created confidence in their abilities to labor in previously unlabored masculine realms. Addressing the intersections of gender and professionalism in Civil War medicine, Schultz posits that â€œwomen rejected the values that formed the basis of medical authority as defined by surgeonsâ€ (389). This notion is central to the idea that the war gave women the opportunity to conceive of their own kind of caretaking and is important to my view of what women nurses did with their disagreement. Schultz emphasizes that the hospital was a site of struggle over authority and ultimately over
105 the care of soldiersâ€™ bodies (6). Many surgeons, suc h as John H. Brinton, for example, despised the presence of women nurses because of their snarky comments and disagreeing antics.6 Though Schultz recognizes how nurses found ways to disagree with the medical authority governing their work, she maintains that â€œfemale workers had little influence with surgeons to improve patient care and were often at odds with themâ€ (97). Her arguments that nurses and doctors often involved themselves in contentious relations and that the era did not catapult women into the medical sphere with open arms are correct. Yet, I contend that when the Civil War nursing narratives are situated in a context that considers the debates surrounding female medical education in general, women nurse authors comment on the larger cultural changes â€“ even if temporary â€“ that were at work during the war.7 The fact that, â€œby 1862, approximately two hundred and fifty women had managed to obtain a medical degree from a chartered college of medicine, and over half were graduates of sectarian schoolsâ€ cannot be ignored in relation to womenâ€™s nursing and medical participation during the war (More 20).8 Lisa A. Long further argues, â€œthe warmomentarily multiplied womenâ€™s vocational possibilities and revealed the capabilities of their fluid bodiesâ€ (184). Mi d nineteenth century women looking for a life outside of the home needed an arena to demonstrate their abilities. In the same way, antebellum medical education reformists advocating for womenâ€™s entrance into the field of medicine needed a practical showing of their rhetoric. The war allowed for women to display their abilities and for reformers to gather prov en evidence of their beliefs. The war also offered an opportunity for doctors to be visually assessed in the public eye. Civil War nurse narratives help to understand the eraâ€™s changing
106 conceptions of the doctor . Nurse authors demonstrate a critique of t he profession that is only touched upon in scholarship. The nurse authorsâ€™ perspectives and actions reflect the hopes of the antebellum, wartime, and late nineteenthcentury women studying medicine. Nurse authors envision the female doctor as a professional equal to the male doctor through an alternative course of care. Rather than reinforce the cultureâ€™s prevalent beliefs about women based on biology and emotionality, nurse authors instead show their natural emotional force and their ability to understand the realities of wartime medical care. In so doing, they reversed dominant ideologies and devised care that refused the logic that womenâ€™s capacities were only suited for nursing and highlighted how womenâ€™s sensibility improved and strengthened the medical field. Alice Fahs highlights how â€œthe Civil War took place within a sentimental culture that valued the expression of feeling and regarded women as the emotive center of the nationâ€ (1466). The narratives convey that nurses capitalized on the â€œfeelingâ€ context outside of the war hospital by ushering it into the wards and successfully integrating it with their medical care. What nurse authors like Alcott imagine is important because it echoes antebellum medic al education reformersâ€™ attempts to develop a more informed therapeutics based on maternal care. In fact, the nationâ€™s first female doctor, Dr. Elizabeth Blackwell, strongly believed that the best doc tor embodied maternal qualities (Morantz Sanchez 5758). So while a maternal role appears to be subscribing to the centuryâ€™s gender role conventions, the reformers and nurse authors take the absolute power given to them by the dominant culture and implement a singularly female strategy of medical care that is alternative: performing diagnostic and surgical tasks while
107 attending to patientsâ€™ needs. The recounting of loving and warm interactions with patients interspersed with the chronicling of wounds in doc tor fashion exemplifies the nurse authorsâ€™ patient centric attitude. Their rhetoric insists on maternal caretaking, healing, and an emphasis on feelings, not just the surgical procedure that the male doctors tend to focus on. Male doctors represent knowledge, and the women in the medical sphere represent both knowledge and care. The nurse narratives confirmed that women have a diverse set of skills â€“ including, for some, surgical tasks â€“ based on care that lend them to being capable, and sometimes better, doctors. As such, Elizabeth Leonard argues that nurses promoted a model of â€œfemininity redirected.â€ Leonard asserts, â€œthemajority of Civil War nurses and aid activists managed to stretch the boundaries of acceptable behavior for womenby effectively persuadin gmale coworkers that the work they were performing wasnothing more than traditional womenâ€™s work in a nontraditional settingâ€ (106).9 She also claims, â€œnursesposed a significant threat to the monopoly held by men at midcentury on medical practiceâ€ (22) . Redirected femininity and the threat that nurses posed underscore what I propose here. But, I make a more radical push to consider a new achievable goal found in nursesâ€™ redirected femininity. I argue that the Civil Warâ€™s spirit of fluidity and the centuryâ€™s debate about womenâ€™s role in medicine offered nurses the physical, psychological, and narrative spaces necessary to imagine the possibility of women as professional equals to male doctors, to bolster prewar medical education reformist sentiments, and to validate the pathclearing courage of women doctors such as Dr. Blackwell and Dr. Walker. Cleverly, nurse authors accomplished these goals by
108 maintaining their nurse role paralleling the rhetorical strategies of medical education reformers. Medical Education and the Civil War Nurse To study medicine, antebellum doctors demanded that women must have â€œan iron stomachâ€ and must be able to â€œcut like an executionerâ€ (Morantz Sanchez 30). The Civil War was an opportune occasion for women to prove they posses sed iron stomachs, iron wills, and cutting capabilities. The Civil War was also an occasion for women to prove their decisionmaking capabilities about the course of soldiersâ€™ medical care. This section examines Civil War nurse narratives in context of the social debates about womenâ€™s entrance into the medical field in order to create a new lens to reread Alcottâ€™s Hospital Sketches . The debates about entering the hospital during the war parallel the debates about educating women as medical doctors before the war, during the war period, and subsequently after the war. The rhetorical strategies of reformers in favor of women doctors res emble the language and examples employed by nurse writers to justify their value as individuals with the capacity to handle medical duties. Merging the conversations centralizes Alcottâ€™s short story as her work bridges the antebellum medical education debates with what will become the standard rhetoric in nurse narratives published during and after the war. Prior to the war, growing health reform efforts gave women a central role with the prevailing ideology that the health of the home equated with the health of society. Feminist domestic reformers â€œcontributed [to] the belief in the centrality of scientific hygiene to female emancipation and an evolving notion of womanâ€™s right to participate in the public world beyond the homeâ€ (Morantz Sanchez 50). Thus, medical education
109 for women became a major component of the debate concerning womenâ€™s role in private and public spheres. If women could study medicine, reformers thought, health, family, and motherhood could intertwine into a figure capable of aiding in the management of both spheres. Reformers employed the language originally meant to bolster separate spheres for men and women in order to justify womenâ€™s entrance into the medical field. The reformersâ€™ ironic strategy predates what Civil War nurse authors recall in their narratives: that their work as nurses allowed them to think about doing the doctorâ€™s work and often gave them access to doing the doctorâ€™s work. They gained access by utilizing the very qualities that were meant to confine them. Antebellum reformist rhetoric placed heavy emphasis on â€œwomenâ€™s moral superiorityâ€ and the perceived difference of women from men. Regina Morantz Sanchez explains that â€œwomen were indeed different from men, and their special abilities were much too important to confine to a narrow sphereâ€ (45). Historically, healing and caring belonged to women in the domestic sphere, especially in childrearing. Birthing children belonged to midwives and other women educated by experience, though â€œmale obstetricians sought to gain t he upper handâ€ as the century progressed (18). Regardless, as Morantz Sanchez emphasizes, in â€œwomenâ€™s natural abilities in matters of health lay the argument that women should study medicineâ€ (45). Designated as natural, maternal caregivers in the home, womenâ€™s work in family health served as a precursor for forging a path into the public sphere through medical education. The logical conclusion to educating women in medicine would be that they would simultaneously excel at their domestic duties while improv ing the health of society. Beginning in the 1840â€™s, women were allowed to study medicine at sectarian
110 institutions, but not at regular institutions that maintained a conservative position on medical education. Sectarian education, according to Mary Roth Walsh, focused on combining â€œsectsâ€ of medical philosophies. â€œHomeopaths, hydropaths, and eclecticsâ€ emerged from sect arian or irregular schools ( xiii).10 Ellen S. More notes the â€œdemocraticâ€ and â€œpreventativeâ€ quality of sectarian medicine that ultimately adhered to female sensibility (20). Regular institutions offered conservative education of â€œstandardized therapiesâ€ and were part of the professional and institutional framework involving hospitals and societies (Walsh xiii). However, More states that â€œthe qualitative differences between sectarian and orthodox medical schools before the 1880s were minor,â€ which contests the â€œdisreputeâ€ male doctors held for women doctors (9).11 The gender issue was of more concern than the medical. The first woman to attend medical college in the United States was Elizabeth Blackwell. Blackwell attended Geneva Medical College in upstate New York, a regular institution, though not without resistance from her male colleagues.12 She graduated in 1849. After Blackwellâ€™s success , Geneva once again closed its doors to women suggesting that Blackwellâ€™s education was a failed social experiment. Blackwell was not the only woman to attend medical school after her graduation, however. Within two years Mary E. Walker graduated from Cent ral Medical College in Syracuse, N.Y. along with two other women. Clearly, the medical profession was in transition on the eve of the Civil War, but this transition was not at the doing of the fraternity who were the essence of it. Resistance endured. Male doctors strongly believed that women were not intellectually capable of assuming a medical role. The prevailing consensus was that â€œwomen were impulsive and irrational,â€ Morantz Sanchez explains, and â€œdeficient in
111 judgment and courageâ€ (53). This line of thought concluded that women were emotionally, mentally, and physically too weak to handle the demanding act of surgery. Their nerves would render them incapable of cutting into flesh or performing any act that men claimed to be nerveproducing. Similarl y, male opponents â€œworried that teaching women the mysteries of the human body would affront female modestyâ€ ( 52). The â€œimproprietyâ€ of the dissecting room created an opportunity for female medical students to become acquainted with many naked bodies, and this was perceived as dangerous. Not only would acquaintance with the human body injure womenâ€™s reticence, the requirements of medical education would â€œhardenâ€ the hearts of women and â€œleave [them] bereft of softnes s and empathyâ€ ( 52). What can be gleaned from Civil War nurse narratives is that women washed male bodies and were no less proper. â€œSoftness and empathyâ€ were the foundations for the medical care that they provided. Their imagined doctor skills were a conglomerate of knowledge and tender care wit hout hardened hearts or disintegrated nerves. The fears about womenâ€™s hearts and minds stemmed from male doctorsâ€™ fears about the profession as a whole. Womenâ€™s entrance into the medical field would â€œfeminizeâ€ the profession when men had worked so hard to professionalize it as completely masculine. Doctors believed that only men possessed the constitution to take on the responsibilities of keeping the body healthy and intact. But, as stated previously, women were essential to public health through their modes of home care. Women kept bodies healthy. The underlying fears of medical men had to do with the fact that women were traditionally in charge of the body, and therefore in charge of their own bodies. Doctors worked to take this control away from them. T he work of Dr. J.
112 Marion Sims who came to be the â€œFather of Gynecologyâ€ after his experimentation on slave women is one example. His work exemplifies doctorsâ€™ struggle in the nineteenth century to turn womenâ€™s know how into a profession that specifically s hut women out. Another example is the taking over of womenâ€™s bodies through medical texts.13 Stephanie A. Smith describes how â€œmedical theories concerning the radical instability of female anatomyâ€ forcibly linked women with â€œreproductive destinyâ€ (24). Doctorsâ€™ theories sought to connect women with â€œa biologically determined destinyâ€ that not only limited their role as females, but also limited their role as citizens. Women did not allow a complete takeover of their bodies and abilities to make decisions, though. Smith states that â€œmany women were beginning to take political action with regard to abolition, suffrage, and abortionâ€ (24). Likewise, women trampled on male doctorsâ€™ theories when the war gave them the opportunity to do so. When war demanded womenâ€™s work , the possibility of women becoming equal medical actors gained clout. But, womenâ€™s nursing work during the Civil War did not happen with ease and public agreement. According to Schultz, â€œthe nineteenth century belief that women were natural nurses did not translate into widespread appreciation of their relief servicesâ€ (44). The underlying tone of anxieties about womenâ€™s nursing work reflected the tone of earlier opponents to female medical education. The era lacked consensus about women keeping t heir propriety intact if involved in the medical field. Fears were not just about keeping women from being doctors, rather the fears were about keeping women from working in hospitals at all. Because hospitals were predominantly charitable institutions in this time period, Schultz notes, they â€œbecame associated with squalor and moral debility. Opponents feared that women would be subject to the whims of sexually
113 aggressive soldiers and that the air of moral laxitycould encourage romantic attachments and jeopardize reputationsâ€ (49). To combat this fear, the responsibility of keeping women nurses â€œsafeâ€ from lurking danger in the hospital fell on the women who were accepted as nurses. Spitfire Dorothea Dix demanded to control the influx of women into wartime hospitals and the garments they arrived in. Appointed to superintend nurses by Surgeon General R.C. Wood in 1861,14 Dix recruited nearly three thousand nurses under strict guidelines ( 15). She instituted a dress code and age requirement that excluded any woman eager to find a husband, or who might distract an ailing soldier, or who might create a sense that hospitals could provide solace behind closed doors. Her guidelines in Circular No. 8 of July 1862 called for: â€œwomen between thirty five and fiftymatronly persons of experience, good conduct, or superior education[ with] morality and integrityâ€ (qtd. in Schultz 15). Most importantly, women should dress (and look) â€œplainâ€ without â€œornamentsâ€ (15). In other words, women should not be noticeable. Their presence was strictly to help the sick and to provide spiritual and moral influence at deathâ€™s door or at the exit door back to the fight. The requirements called for by Dix did not bring passive women, however. Women actively learned the traits and methods of surgeons by working alongside them. This education offered women nurses the imaginative space necessary to think about the possibilities of female influence on the medical field. Nurse authorsâ€™ writings convey their intellectual and erudite capacities as well as their professional abilities. They assert through their actions and interactions with doctors and patients that women could not only nurse with maternal sensibility and be successful, but women could also perform doctorsâ€™ duties in a stressful environment and not succumb to their preconceived
114 â€œnerves.â€ Like the doctors, female nurses learned how to handle the new war wounds in the hospital. The new frontier of wounds forced surgeons to reevaluate their medical knowledge. Surgeons underwent practi cal reeducation simultaneously as women nurses underwent new education in wartime medical care. The following examples from the narratives show how nurses proved their abilities while working with and learning the traits of doctors, revised standard modes of care to include female and maternal sensibilities, and imagined the female surgeon while performing medical tasks. The body of narratives as a whole shows that women nurses sought to validate their abilities in the medical sphere, to emphasize how they influenced patient care, and to work professionally with men. The nursesâ€™ newly acquired professional sense conveys that the medical field in this era was not weakened because of womenâ€™s entrance into this sphere. Rather, the medical field was bolstered because of the specific qualities that women ushered in. Union nurse Sophronia Bucklin describes how women nurses learned the surgeonâ€™s steadfast demeanor needed to perform doctor duties as a way to prove that they could complete such tasks while not sacrificing their very feminine nature. She challenges the anxieties surrounding womenâ€™s work in the war hospitals and provides proof that public (male) fears were unfounded. â€œThere was no shrinking from contact with the bare awful reality,â€ she writes, â€œand womenâ€™s nerves learned the steadiness which controls the surgeonâ€™s hand, when bone and muscle and flesh feel the rasp of his remorseless instrumentsâ€ (30). Bucklin elucidates what Schultz regards as the development of â€œemotional fortitude.â€ Both doctors and nurses alike faced this impediment. â€œAlthough most had encountered sickness before,â€ Schultz explains, â€œnone
115 was prepared for the carnage that filled military hospitalsâ€ (74). So, not only did women nurses learn the acts and procedures of the medical sp here, but they also learned to be selective and subtle about showing their emotions. Bucklin does express growing â€œcallous.â€15 However, on the same page she confesses how difficult it is to hear dying men screaming for mothers and wives. She recognizes the necessary emotional shield that she must wear in order for her to perform her nursing tasks. Yet, that does not necessarily mean that she loses her capacity to feel entirely.16 Bucklin also engages in the proving part of the process when working along with a doctor on a wound. She describes meeting a soldier with â€œa pint of worms in his woundâ€ (270). She begins tending to his side wound and describes what she encountered: â€œhe had been struck by a piece of shell, and the cavity was deep and wide enough to insert a pint bowl. This cavity was absolutely filled withgreat black headed worms, which had grown on the living fleshâ€ (270). One by one, Bucklin picks the worms from the wound. The head surgeon comes by and pauses to observe her working. He says to Bucklin that picking out the worms is â€œtoo hardâ€ and he offers to â€œassistsome,â€ and â€œtaking the can of chloroformhe poured the entire contents of the can into the mass of creeping life, which for a moment fought the contest with the fiery fluid and then straightened outâ€ (270). After this, the surgeon tells Bucklin, â€œyou can dress the wound as you see fitâ€ (270). He leaves her to tend to the soldier with a course of care designed by her. She explains, â€œI took a full pint of the dead worms from his side, thoroughly washed out the wound, and filled it with soft lint, wet in cold water, then bandaged him about the waistâ€ (270271). Though the surgeon eases the process for Bucklin, he tr usts her choices. Bucklin and the surgeon are colleagues of equality in this scene. She
116 proves her capabilities with solid evidence. Confederate nurse Fannie Beers recalls showing her cooperation with a surgeon while proving that she has the endurance and fortitude necessary to do medical work. She describes her work with Dr. Jackson on a badly wounded officer. From the soldierâ€™s toes to above his knee â€œthe mechanism of the leg was entirely exposedâ€ and his heel rested upon a bandage that suspended his leg above the bed (135). Fannie intricately recounts the procedure emphasizing her relentless ability to help: every particle of the flesh had sloughed off[the unhealthy flesh] constantly [had] to be removed, either by the use of nitric acid (I believe) or by the knife. As may be imagined, it was horribly painful, and there was no chloroform. Day after day I was sent for, and stood by, while this terrible thing was going on, wiping the sweat from [his] face. (135 136) The officer survives this treatment and immediately after this anecdote, Fannie notes that she has become accustomed to seeing patient after patient â€“ hundreds â€“ with ghastly wounds that she must help care for. In short, Fannie proves her fortitude and medical abilities. In embracing their distinct form of care, women nurses acquired a sense of confidence by reinforcing their natural inclination for feelings. This allowed them to revise medical practices and dominant notions about their capacities. Many devised a course of care based upon tenderness in a way that doctors often did not do. Their revision of care often saved soldiersâ€™ lives and they were not shy about stating this fact. For instance, in 1864 an anonymous nurse author recounts her care for soldiers based on feelings. She boasts, â€œone day the surgeon came to me and begged me to try to cheer up Darlington, he was so downhearted, would taste no food, etc.; must certainly sink unless some change could be made in his feelingsâ€ (83). The important word here is â€œbegged.â€ She underscores the necessity of womenâ€™s distinct abilities in the hospital.
117 The positive effect of their value for feelings directly relates to antebellum feminist reformersâ€™ rhetoric about why women should be able to study medicine. Opponents argued that women did not hav e the emotional distance needed to perform medical duties, but the wartime nurse narratives propose that the emotional distance between caregiver and patient should be closed for effective medical care. Nurses opened their hearts to patients and often saved them with gentle, loving care in a manner that many doctors simply did not do.17 Nurses believed in their domestically infused, morality producing, and loveladen therapeutics. Maternal sensibility was a large part of their patient centric therapeutics .18 One of the conventions of Civil War nurse narratives is that nurses employed maternal language to infantilize patients . Daneen Wardrop argues that â€œthe nurse [saw] herself in a complex of relationships to some patients, in both maternal and erotic connection with a wounded and dying soldierâ€ (34). Schultz points out that familial metaphors and domestication of the hospital employed in nurse narratives defined the nursepatient relationship as strictly mother child. She contends, â€œthe infantilization of soldiers resulted from nursesâ€™ perception that soldiers were helpless, which in turn fed nursesâ€™ own need to be maternalâ€ (96). The â€œneedâ€ to be maternal excluded the need to be romantic.19 Unnoticed is that nurse authorsâ€™ maternal language also connects t o the rhetoric employed by supporters of female doctors and female education in medicine. Having a maternal sense, in context of both the medical education debates and war nursing narratives, was about seeing differently and caring in a way that male doctors could not achieve. Medical expertise, in this vein, was not just masculine. In the home, women passed down diagnostic expertise from mother to daughter solidifying an
118 inherent maternal power over the body and methods of care. The generational movement of information solidified a domestic connection to the medical field, thus opening a future for women to become true medical actors. The nurse authors discussed here imagine access to the medical field by working within its professional space, but they do s o with their homespun knowledge. Their domestic health education provided them with the upper hand in making diagnoses allowing some to treat patients with a maternal authority untouchable to doctors. Examples from war nurse narratives show that women further revised courses of care by asserting their know how of the physical and by integrating the moral into the medical. Fannie Beers, for instance, attends a convalescent who she is told has the measles, but she believes he has smallpox. She touches the patientâ€™s forehead, â€œand [feels] the dreadful pustules thickly covering itâ€ (183). She looks at the patient record book to â€œlearn what diagnosis his surgeon madeâ€ and â€œmeaslesâ€ is listed next to the patientâ€™s name (183). Fannie disagrees and takes it upon herself to right a wrong. She gives her diagnosis to Dr. Beatty, and both visit the patient again. Dr. Beatty confirms that Fannieâ€™s diagnosis is correct, not the surgeon who treated the man.20 Next, the author of an anonymous nursing account talks about making a â€œmoral diagnosisâ€ based on patientsâ€™ emotional needs. For each patient, she writes, she made assessments with her feminine eye and concluded â€œwhether [they] needed direct or indirect sympathy , â€ conceiving an alternative form of care based on female sensibility (202). Adelaide Smith also assesses patients with this perspective. Smith discusses a ward full of Ohio men who were diagnosed as â€œtyphoid casesâ€ by the doctors in charge, but â€œwere really suffering more from nostalgia than from feverâ€ (88). â€œN ostalgiaâ€ is the Civil Warâ€™s version
119 of homesickness or war stress. Attuned to the emotional tolls of war (and home), Smith, like other nurses, perceived that feelings were involved with diagnosis and she acted accordingly to aid in the recovery process. In another instance, a woman is called to perform the work of a surgeon. Mary Newcomb recalls in her 1893 memoir taking up the amputating saw in the absence of her hospitalâ€™s surgeon. She describes how a picket soldier came in with his forefinger shot and nearly severed. With a prideful tone she recalls, I told the boy I could attend to it, and I took the instruments and took off the finger at the middle joint. When the doctor returned he pronounced it a good job. That was my first performance in surgery; but I had occasion many times afterward to assist in operations, until I believe I could have taken off an arm or a leg without flinching. (116) Newcomb not only proves that she is able to perform amputation surgery and to assist in many operations without allowing her nerves to overcome her, but she also proves that she can work at the same caliber as the male surgeon in charge of her. If not performing surgical work, nurse authors still imagined assuming a ver y important role. They display their increasing authority through influence and disagreement. Though other surgeons were reluctant to listen to the advice of a woman, Mary Newcomb influenced a head surgeon to refrain from amputating a manâ€™s arm. The man subsequently lived without the amputation sur gery. Sophronia Bucklin expressed her disagreement with a manâ€™s amputation believing that his limb could have been saved with resective surgery: â€œI shall never outlive the feeling that his was an unnecessary amputation his wound was only that of a bullet t hrough the fleshy part of the armâ€ (108).21 Here, she shows her newly acquired medical knowledge that amputations are most necessary when the bone is shattered by a bullet. Unfortunately, the man passes away from infection leaving a wife, six children, and one on the way.
120 Bucklin sees this manâ€™s death as a medical failure and the prelude to a familial tragedy.22 Like Dr. Elizabeth Blackwellâ€™s philosophy that the best doctor is maternal, the imagined female doctor forged out of the experiences of the Civil War nurse is a doctor who has the saving ability to connect with the patientâ€™s home role. This kind of doctor possesses this saving power by embodying knowledge and compassion, two aspects that reformers believed medical care should offer. Bloody P etticoats, the Revision of the Woman in the Black Dress, and Protesting Pantaloons One purpose of this section is to provide an array of â€œvisualâ€ moments that serve as an alternative rendition of the nurse action spectrum â€“ proving, revising, and imagining â€“ I proposed previously. The first image suggests a proving event, the second image insinuates revising, and the third image embodies imagining femaledirected surgical work. Together, the images provide a visual tapestry that conveys the forward attitudes of women in regards to their participation in medical practice. Another purpose of this section is to consider the revolutionary context in which Alcott crafted Tribulation Periwinkle. All three images culminate in a commentary on the possibility of the female doctor and the potential integration of female sensibility into the medical field that Alcott brought to the foreground with Hospital Sketches in 1863. First, like the nurse authors considered above, a nurse appears in the following memoir and provides evidence that she is able to work with the doctor though the dominant ideology is that she cannot because of the link between her biology and emotionality. Her actions signify her imagining the possibility of what she is capable of and proving it to a m ale doctor figure. Confederate surgeon Dr. Ferdinand Daniel published his memoir, Recollections of a Rebel Surgeon; or, In the Doctorâ€™s Sappy
121 Days , in 1899. This Civil War doctor memoir is unjustly absent from both historical and literary scholarship. His memoir is divided into anecdotes and short stories narrated by an â€œOld Doctorâ€ who is presumably a manifestation of himself. For example, in â€œThe Doctor Takes Breakfast with the Yankeesâ€ is of interest. Dr. A. Flack, sees how hard a nurse works to prove that she is capable of what the hospital demands. In Danielâ€™s story, Dr. Flack requests to be placed in a field hospital for more surgery time. In the aftermath of a costly battle, Flack endlessly dresses wounds and operates. Exhausted, he looks for aid in a pending amputation operation. A young nurse asks if she can help. She says to the doctor, â€œâ€˜I helped Dr. Bateman amputate a manâ€™s leg just now; see?â€™â€ (69). The woman then lifted her skirt, he explains, and â€œshowed me where her underskirts were bespattered with the characteristic spirting of an arteryâ€ (69). Here, the nurse shows her bloody petticoats as proof that she has the emotional endurance to withstand operations and that she is a seasoned veteran of the amputating table. Her forward desire sugges ts that she understands the pedagogical and professional opportunities that a post next to the surgeon with a saw offers. In essence, this nurse is a reflection of Dr. Flack since he, too, realized that â€œoperative experiences afforded by the war were too r are to be wastedâ€ (62). The nurseâ€™s skirt lifting action coupled with the blood underneath also evokes womenâ€™s menstruation. This natural female cycle was of scientific and medical contention throughout the nineteenth century. Male doctors, according to Carla Bittel, â€œviewed menstruation as a symbol of female weakness, difference, and incapacityâ€ (27). Dominant ideologies underscored the notion that a womanâ€™s womb was intricately connected to her mind. This speaks to the reasons male doctors and opponents gave
122 for women to be kept from medical education and other professional paths. Likewise, the anxieties associated with womenâ€™s wartime hospital work stemmed from biological notions of the female body and female emotions. But, revi sions of these claims wer e certainly at work during the war. The assumption that women nurses went through menstruation while performing nursing and other duties is plausible considering the time that many spent in hospitals. Women proved that they could work alongside doctors, perform countless tasks, and do so against the predominant notions that they could not because of their bodily func tions. Their work, then, is equivalent to the memoirâ€™s nurse who lifts her skirt to reveal her bloodstained petticoats to Dr. Flack. See? Lik e reformersâ€™ strategy of inverting opponentsâ€™ reasons for disallowing women to advance into new professional realms, the nurse in Danielâ€™s memoir proves her abilities and her fortitude by inverting the idea that she cannot withstand amputations or blood. S he wears the amputation blood with pride. Menstruation is also a maternal sign. The maternal aura that nurse authors embrace and the revision of medical practices that they enact connect to the second image I consider: the only female present in Thomas Eakinsâ€™s The Gross Clinic , the central visual of this study. Art scholars fold her into the mother category.23 The reason she is considered the patientâ€™s mother or another female family member is because of the conventional read on her reaction. Dressed in black and faceless, she shields her eyes and turns away from the operation before her. Jennifer Doyle contends that the womanâ€™s â€œhysterical pos tureâ€ emphasizes her psychological feminine role as she anticipates the possibility of the patientâ€™s pain (5). She is appalled because she is supposed to be accor ding to gender strictures. R eading her as â€œhystericalâ€ confines the
123 interpretive possibilities of the womanâ€™s reaction to the very social conventions women in clinic spaces were trying to break down. What if this womanâ€“ dressed in plain drab clothes akin to the war eraâ€™s nurses â€“ had a say in what was to be done for the patient? Her say would be influ enced by her maternal sensibility. The sentimental quality of the woman that Doyle focuses on is important in understanding the context of the medical debates I consider (5) . Recall the arguments proposed by medical education reformers and Dr. Blackwellâ€™s claim about doctors and maternal qualities. The arguments were meant to revise the constricting notions about womenâ€™s abilities and to end the limited access to medical work and all professional work. If placed in this context, the woman in Eakinsâ€™ s painting symbolizes maternal medical care with feelings involved. Women desired to learn medicine with a patient centric philosophy. They disagreed when medical care took a completely doctor centric turn. The surgical scene portrayed could be viewed as doctor centric since Dr. Gross is the focal point and is teaching medical students how to perform the operation.24 If interpreted through this lens, the woman in the painting could easily be a nurse like Sophronia Bucklin or Tribulation Periwinkle.25 Eakinsâ€™s p ainting encapsulates a very rich medical history, thus the woman in the painting could be a nod to the insistence of women on gaining access to that pedagogical clinic space. The womanâ€™s reaction at first suggests that she cannot handle the scene before her eyes, and, therefore, embodies all of the reasons by male doctors why women should not be in that clinic space. Yet, when reformersâ€™ rhetoric and the adamant alternative philosophies and actions of war nurses are considered, the woman in the painting could be turning away as a form of subtle protest, a slight refusal, and a
124 differing attitude toward the patientâ€™s operation and the kind of care he should receive. Perhaps what is most unique about the image of the woman is that her clenched hand shielding h er eyes matches Dr. Grossâ€™s grasp upon his scalpel. This signifies not just a different way of seeing, but imagining a different way of doing. Mary E. Walker also embodied a different way of doing during the Civil War and her attire serves as the final v isual. Instead of lifting up her skirt like Danielâ€™s nurse during the war, Dr. Mary E. Walker hemmed her skirt up to show her steadfast pantaloons underneath. She did not need to show soldiersâ€™ blood to prove she could work with the surgeon; she was the surgeon. She enacted difference by her insistent attitude and by her appearance. By wearing pants beneath a shortened skirt, Walker donned a historically controversial outfit: the â€œBloomer Costumeâ€ that was first introduced by Amelia Jenks Bloomer in 1850. A ccording to Stephanie A. Smith, the Bloomer Costume was â€œregarded as a garment that could free a woman from the confinements of traditional stylesâ€ (1). The costume freed women from wearing heavy, dirt catching skirts and petticoats, thus allowing for a more hygienic lifestyle. The costume also freed women ideologically. Women bent on change, such as suffragettes, defiantly wore bloomers as a sign of â€œradical reformâ€ and â€œa sign that they sought freedom frombinding social and political constraintsâ€ ( 2). Though the Bloomer Costume declined in popularity around 1854 and did not resurface until the 1890â€™s, Smith explains that the ensemble stood as a threat against the â€œstabilityâ€ of gender and socially prescribed gender conventions. Donning bloomers suggested that a woman â€œmight work like a manâ€ ( 3). Walker did, indeed, work like a man. Leonard explains, â€œWalker recognized that the assumption by middleclass women of the centerpiece of
125 male clothing (like the assumption of a place in the male profession of medi cine) implied a renunciation of certain limitations on womenâ€™s behaviorâ€ (110). Walkerâ€™s choice to wear the Bloomer Costume ensemble was an outward display of her inward desire to transcend such limitations. Undoubtedly, as Leonard notes, she â€œembodied a t hreat to the â€˜naturalâ€™ social orderâ€ (110). But, really, she was more than just a threat in radical clothing. She managed to practice as a surgeon, even if briefly, thereby forging a pathway for women to imagine future medical work as equals to men. Walker imagined a career for herself as a surgeon. She took hold of this imagined life and made it a reality to the best of her ability by demanding access. She is the embodiment of the nurse authorsâ€™ imagined possibility by being the possibility against all impediments. Walker graduated from medical school in 1855 on the eve of the war. As early as 1861, she arduously requested commission as a military surgeon from the Army Medical Department (Leonard 112). By November of that year, she assumed a â€œtemporary, v oluntary, and noncommissioned positionâ€ at Indiana Hospital in the United States Patent Office in Washington, D.C. (117). Surgeon J.N. Green wrote on her behalf to Surgeon General Finely for an appointment and Finely refused her because of her gender.26 Wa lker decided to act as assisting surgeon regardless. At Indiana Hospital, Leonard tells us, â€œshe evaluatedcases (including diagnosing smallpox for purposes of quarantine), prescribed treatment, and assisted in operationsthe bulk of her time Walker spent doing work that simultaneously exercised her medical skills and alleviated some of the pressure on her colleaguesâ€ (117). She also attended various field hospitals set up for General Ambrose Burnsideâ€™s Union Army after the Second Battle of Bull Run, the Battle of Antietam, and the Battle of Fredericksburg.
126 Despite her lack of a commission, Walker stayed in Washington in 1863 in hot pursuit of a commissioned surgeon position. Secretary of War Edwin Stanton refused to let her raise her own regiment in order to become acting regimental surgeon (Leonard 128). She was refused by the surgeonin charge in Chattanooga after the Battle of Chickamauga though she had a letter of recommendation from Assistant Surgeon General R.C. Wood (Leonard 129). In January of 1864 she was then refused by President Abraham Lincoln with the excuse that he did not want to interfere with the â€œMedical Department hierarchyâ€ (129). But even President Lincoln could not stop her. General Thomas of the 52nd Ohio Volunteers appointed her as a civilian contract surgeon. The victory was small because the contract surgeon medical board did not take her seriously. They were concerned about her â€œintrusionâ€ and the â€œhybrid costumeâ€ that she donned (131). This language registers the fears of antebel lum opponents of women in medical education. Morantz Sanchez explains that opponents had anxiety about women â€œimitating menâ€ and becoming â€œintellectual and moral hermaphroditesâ€ (50). The idea was that women could not be both of anything. But, the reality is that they could be both intellectual and moral, and female and professional. Women were pushing into the medical sphere before the war by embodying this â€œbothness.â€ The war just illuminated and occasioned for a practical showing of their efforts. Even w ith resistance, Walker was assigned to the 52nd Ohio for a few months until her capture as prisoner.27 Her incessant efforts still did not win her a commission. Yet, what she was able to accomplish speaks to the opportunity that the war offered women. S he viewed herself as a medical professional and she protested with her individualistic pants against any person who did not see her as a doctor. In fact, she
127 wrote that she, unlike her â€œmedical and surgical brothers,â€ opposed always resorting to the knife in cases of potential amputation (Leonard 124). With this sectarian philosophy, Walker was not so far from the tender sensibility and mentality nurse authors conveyed. Like nurse author Sophronia Bucklin, Walker â€œdeveloped the same repulsion for unnecessar y amputations that many female nurses sharedâ€ ( 123124). She urged soldiers to protest amputation if the possibility of saving the limb was probable. With the same pride, Walker stated, â€œmany a man today has for it the perfect and good use of his limbs who would not have had but for my adviceâ€ (qtd. in Leonard 124).28 Even with access into the medical field by nurses and Dr. Walker, women attending medical schools faced continued resistance in the postwar era. More tells us that â€œmany male physicians (and men in general) considered [women doctors] unsexedâ€ (2). Opponents still believed womenâ€™s access to a predominantly masculine profession took away their essential femininity. The same old fears had survived the war, but that did not stop the wartime medical women from writing about their experiences and future women to forge paths into the medical field. Walker did not let the postwar opposition deter her from embracing her beliefs, her credentials, and her attire either. Nurse Adelaide Smith recalls in her memoir seeing Dr. Walker recently after the war in her â€œsemi masculine garbâ€ (244). She sees Walker again in 1908. More radical than ever, Walker proudly strolled along the street in full manâ€™s attire â€“ without any skirt to be seen. Tribulation Periwink le (Future M.D.) Though Tribulation Periwinkle does not trot through hospital wards in pantaloons in Alcottâ€™s 1863 Hospital Sketches , she is a literary manifestation of the real and
128 imagined possibilities that Dr. Walker and so many of the nurses discussed in the previous sections embodied. She is bold like Walker and very direct. Tribulationâ€™s traits come directly from the real inspiration for her character: the author herself. Alcott was a tomboy. She strongly adhered to the notion that writing was her profession and that she could profit from literary production. She was alternative. She came from a family of reformers and philosophical thinkers. Ralph Waldo Emerson provided her the gift of entrance into his library to read, peruse, and borrow books as she pleased. Educated and tough as nails, she felt like â€œa soldier going off to warâ€ when she embarked on her journey to the Union Hotel Hospital in Washington, D.C. in December of 1862. Had Louisa not fallen ill from typhoid fever and calomel poisoning, perhaps she may have become quite the force to be reckoned in her assigned duties as nurse (and a s oldier and so much more). I reread Trib with Louisa May Alcott and her radical sensibility in mind. Alcott, through Trib, thought about professional possibilities beyond the Civil War because she engaged in circumstances that allowed her to do so. Trib proves, revises, and imagines out loud in Hospital Sketches . She finds her voice as she transforms into an independent woman surviving beyond her home in a conventional male environment. As I stated in the beginning, Trib teaches what the nurse memoir examples above show: that women are capable of being surgeons and undertaking medical education. Nursing is only the start. My assessment of Alcottâ€™s work begins with Longâ€™s notions of â€œwomenâ€™s vocational possibilitiesâ€ during the Civil War because Alcott seized these possibilities as a nurse and author. What we learn from the body of nurse narratives is that many events described by the nurse authors speak back to Alcottâ€™s Hospital Sketches . Alcott
129 was the innovator with her form. She envisioned a new function of fiction that relied on her journal entries. She added semi fictional elements to her journalâ€™s narrative, and by doing so, she refined her experiences into a narrative about a woman who is transformed by her new wartime vocation and then realizes the pos sibilities of that transformation. Civil War nurse narratives give countless examples of how many women were profoundly influenced by their experiences. But none present nursing as a pathway to proving medical abilities, revising medical care with a more patient centric approach, and imagining a professional surgical role for women in one narrative like Alcottâ€™s series achieves. Alcottâ€™s forward thinking in form and style created the context for her to envision a potential female surgeon in fiction. Alcot tâ€™s use of inversion also bolsters how Hospital Sketches is a narrative about the possibilities of vocational rule breaking. Inversions matter in the Civil War hospital. We know from the nurse narratives that roles were fluid and prewar social rules were b ent. Alcott capitalizes on the role fluidity first with the name of the hospital that Trib nurses in: the â€œHurly Burly House.â€ The hospital lives up to its unstable name as a chaotic setting that flips convention on its head. Next, Alcott includes the wide ly noted gender exchange between masculine and feminine emotion with the nursepatient relationship. Soldiers took on more sentimental, emotional traits as patients while nurses hardened their emotions in a typical masculine way to get through their work. Further, Tribâ€™s moniker is a paradox that speaks to nursesâ€™ vacillation between hiding emotion or breaking down. â€œTribulationâ€ represents resilience and â€œPeriwinkleâ€ exudes softness and sympathy. Lastly, Tribâ€™s comment on surgeon education reveals a new in version: nurse and doctor. Trib as the nurse figure arrives at the conclusion that she
130 could be the doctor. With the constant role inversion between men and women going on in the war hospital, it is logical that Trib realizes she could become a more promi nent medical actor regardless of the masculine confines surrounding the profession. Scholarly assessments of Tribâ€™s character mostly focus on her maternal and domestic qualities, but do not correlate these qualities with a more active medical role. Lyde C ullen Sizer notes that â€œTribulation Periwinkle sets out to make the Hurly Burly Hotel a comforting home for the wounded, and in her depiction is a justification for womenâ€™s place in wartime hospitalsâ€ (97). Justification through maternal qualities ultimate ly leads to the trope of soldier infantilization. Laura Laffrado expands upon this trope by thinking about Alcottâ€™s narrative choice: â€œthe form of the hospital sketch frees Alcott â€“ as the hospital frees the woman nurseâ€“ to handle male bodies and male/female physical contact without directly invoking male and female sexuality for herself or her nineteenthcentury American readershipâ€ (71). Though Alcott cleanses the text of sexual connection, the insinuation is still there through Tribâ€™s close relationship wit h one soldier in particular, John. Mary Cappello and Sizer agree that Alcott reinforces traditional notions of home while nudging up against traditional boundaries. Cappello views Alcottâ€™s work as â€œher attempt to intervene into social processes in order to see and say things that she as a woman was not allowedâ€ (63). This coincides with Sizerâ€™s notion that Trib â€œdemonstrates the transgressive nature of her work as a nurse,â€ which critiques conventional acceptable r oles for women (97). Even as scholars agree on the fluidity of Tribulation â€™s character, none extend this fluidity to see Trib as a protodoctor. Long argues, â€œTrib refers to herself in the third person, suggesting her essential multiplicity: she is both in and out of the scene, at once
131 enacting and transcribing the events , â€ and â€œshe is at once fiery soldier and soothing mother, indignant protofeminist and reliable palâ€ (186). This â€œessential multiplicityâ€ provides a pathway into thinking about the interpretive possibilities of what Tribâ€™s charact er represents. Schultz describes Trib as â€œone of Alcottâ€™s ambidextrous narrators,â€ a â€œspinsterâ€ who explores â€œmasculine rolesâ€ (104). Trib adopts a â€œmilitaristic voiceâ€ while also embodying domesticating qualities. Elizabeth Young considers role fluidity w ith Tribâ€™s â€œaccess to masculine agencyâ€ (71). However, Youngâ€™s assessment of access always aligns Trib with wounded soldiers, not the doctors she works with. Young does note that Trib is impatient with some surgeons, but she keeps quiet thereby yielding to male authority. The only recovery of authority that Young perceives is â€œin [Alcottâ€™s] subsequent Civil War fiction [when] she gets to play doctor, offering several related versions of a revitalized body politicâ€ (93). Youngâ€™ s assertion that Alcott â€œplaysâ€ doctor undercuts the sincere, radical work of the author and other women in the wartime medical sphere. The conversation surrounding Trib focuses intensely on gender dynamics and role fluidity, as it should, but how does Trib nod to what she could accomplish postwar? How does her role fluidity speak to possibilities in the medical field? Considering these questions, there is a lack of focus on what Alcottâ€™s feisty character thinks about in terms of her relationship with the surgeons she works with. While Trib is an imagined character, the fact is that she is real. The access that she obtains to the work she does is because of Alcottâ€™s lived experience and because of the nationâ€™s fracture. She comments on her education as a nurs e, but more importantly, she comments on how nursing creates a pathway to becoming a surgeon.
132 In the spectrum of action that continuously reappears in wartime nurse narratives, Trib first proves that she is able to withstand the demands of the hospital and wartime medical treatment. She arrives prepared in her â€œcavernous black bonnet,â€ dressed in Dix fashion ( Alcott 6). For my purposes, she is also eerily akin to the bonnet wearing woman in Eakinsâ€™s painting. The trajectory that Trib embarks on is pathcl earing for nurse authors like Bucklin and Beers. She is immediately initiated into what she will be dealing with: the cost of the war made visible on soldiersâ€™ bodies. She recalls, the sight of several stretchers, each with its legless, armless, or desperately wounded occupant, entering my ward, admonished me that I was there to work, not to wonder or weep. So I corked up my feelings, and returned to the path of duty, which was rather â€˜a hard road to travelâ€™ just then. ( 22) She never loses her feeli ngs, but she understands what she must do in order to help the legless and armless. Trib learns very quickly the steadfast demeanor of doctors. Though she is capable of taking on such traits, she learns not to eradicate the best of her emotionality. Tribâ€™s awareness of her natural qualities allows her to assume a more effective caretaker role. Especially with her patient, John, she closes the emotional distance that medical men fervently believed to be necessary. Tribâ€™s close friendship with John, a black smith from Virginia, allows her to revise typical medical care according to her own standards. Johnâ€™s doctor tells Trib to inform John of his impending death. Trib takes on the responsibility of the doctor by delivering this tough information, but she does so with a sentimental touch. She nurses him until he finally succumbs to his wounds, promising to help him â€œbear it.â€ Sitting on his bed, she holds his hand as he passes away, but does not let go right away. Periwinkle describes, â€œDan helped me, warning m e that it was unsafe for dead and living flesh to lie
133 so long togethermy hand was strangely cold and stiff, and four white marks remained acros s its backâ€ ( 45). Refusing to let go of Johnâ€™s hand leaves a physical imprint of his hand upon hers, but this si gnifies a metaphorical imprint of Johnâ€™s identity upon her heart. The text enacts Periwinkleâ€™s emotional state as Alcottâ€™s tone is one of hardening though the sympathetic connection is still present. Alcottâ€™s Nurse Trib is the doctor that Blackwell foresees as the most caring and effectiveâ€“ maternal, loving, and alternative. She also thinks of the possibility of alternative care that is not doctor centric through her disagreement. Trib expresses her indignation at an insensitive surgeon, Dr. P, who is able to separate wound from patient.29 Periwinkle derisively remarks that Dr. P whips â€œoff legs like an animate guillotineâ€ (71).30 She recognizes Dr. Pâ€™s lack of sensitivity and reveals that she has witnessed this doctor in a painful surgical interaction with a patient. Dr. P asks his patient, Fitz G., to hold his wounded arm with his healthy one so he can easily dig around his bone and muscle causing this young man incredible pain. Trib looks at the doctor enraged and with â€œa strong desire to insinuate a few of his own disagreeable knives and scissors into him, and see how he liked itâ€ (7071). Dr. P acts like â€œan accomplished surgical seamstressâ€ that makes Tribâ€™s â€œteakettle boilâ€ (71). Though she keeps quiet in the moment, just by her disagreeing thoughts s he conceives of an alternative way of doing this procedureâ€“ one where the patientâ€™s feelings are considered. Tribâ€™s imagined doctor role is forged out of what all nurse authorsâ€™ imagined doctor role is forged out of: distinct womanly qualities proven neces sary for effective medical care. Trib confirms her role as a nurse while thinking about the possibility of more medical education. She states,
134 our work begins afterward, when the poor soul comes to himself, sick, faint, and wandering; full of strange pains and confused visions, of disagreeable sensations and sights. Then we must sooth and sustain, tend and watch; preaching and practicing patience, till sleep and time have restored c ourage and self control. (69) However, the most powerful line that Tribulation Periwinkle states is this: â€œDr. Z. suggested that I should witness a dissection; but I never accepted his invitations, thinking that my nerves belonged to the living, not to the dead, and I had better finish my education as a nurse before I began that of a surgeonâ€ (70). Trib verbalizes thinking about and imagining a future in medicine for herself. S he realizes that her nursing experience is educational as she learns and proves her capabilities through practical display. Like both reformersâ€™ rhetoric and nurse authorsâ€™ recollections, she maintains her role as a nurse with all of her â€œfeminineâ€ qualities â€“ even â€œnervesâ€ â€“ but she thinks about the possibility of surgeon education. She thinks about the fact that she has the ability to begin the education of a surgeon with her propensit y for alternative care. She offers no comment on societal and professional constraints. Instead, Trib feels confident enough to make a seamless connection between what she is doing in the hospital as a nurse and what she could be doing in the hospital as a doctor. Here, Tribâ€™s nursing experience is a precursor for moving forward in her medical education. Alcott further explores the possibility of medical education for women in her childrenâ€™s story, â€œNellyâ€™s Hospital.â€ Rarely con sidered in connection with Hospital Sketches , â€œNellyâ€™s Hospital,â€ written in 1865, is one of Alcottâ€™s best commentaries on giving very young girls the idea of a potential future in the medical field. Nelly is a child of about six or seven years old. After Nellyâ€™s brother returns from the war with a wounded foot, she decides that she would like to be a nurse and â€œhave a little hospital all my ownâ€ (29). She tends to â€œsick birds and butterfliesâ€ from around her yard, makes a
135 hospital ward out of the summer house, and crafts an â€œambâ€™lanceâ€ for her patients. She treats all patients the same with love and tenderness â€“ even the â€œrebel snakeâ€ and â€œthe winged contrabandâ€ (36 and 38). Though she enlists the help of her male friend, Tony, as a surgeon, Nelly also designs a course of treatment on her own terms for Tony to follow. Other children in the neighborhood observe Nelly and â€œcopy her designâ€ (39). My contention is that Alcott wrote Nelly into existence to provide postwar little girls the opportunity to think about medical education. Nelly is the future of little girls who want to work, who want to be useful, and who might achieve those goals by enrolling in medical school. What Tribulation Periwinkle and little Nelly, as well as the sorority of Civil War nurse authors, tell us is that before the female doctor appeared in late nineteenthcentury literature, she appeared in a surrogate sense in nurse narratives and Alcottâ€™s short fiction. She appeared ready and capable for education in wartime medical treatment. And she appeared steadfast with her alternative care infused with prewar domesticity and war wrought confidence. A more in depth study is needed to assess the relationship between Civil War nurse narratives and the emergence of women doctors in late 19th century fiction. But what is clear is that male doctors had fears about womenâ€™s entrance into the medical profession and fears about the woman doctor in the (male) literary medical space. Dr. S. Weir Mitchell, neurologist and novelist, comments on Sarah Orne Jewettâ€™s A Country Doctor , William Dean Howellsâ€™s Dr. Breenâ€™s Practice , and Elizabeth Stuart Phelpsâ€™s Dr. Zay in Doctor and Patient . He regards Howellsâ€™s novel as a â€œremarkable attemptâ€ and Phelpsâ€™s novel as â€œabsurdâ€ because a â€œyoung woman doctor, a homeopath, sets a young manâ€™s leg, and falls in love with him after a therapeutic courtshipâ€ (81). He is
136 quick to note her sectarian education and her inability to keep her relationship with her patient as professional. Mitchell further contends, â€œthe woman doc tor is, I suspect, still available as material for the ambitious novelist, but let him beware how he deals with herâ€ (82). Indeed, his warning rings true for she is formidable, intimidating, and feisty as Civil War nurses showed surgeons in the hospital. D r. Mitchell no doubt encountered this type during the war. With his comments, he genders the novelist as male and regards the novelist who does write about a female doctor as lofty. How can the female doctor as a respected member of the medical community be imagined if there is no basis for her to exist? Mitchell misses that the possibility of the female doctor was thought about and imagined during the Civil War. Before the novels above, she was imagined and sometimes, whether by nursesâ€™ subtleties, by Dr. Mary Walkerâ€™s persistent pants, or by the thoughts of Alcottâ€™s fiery Trib, she existed. Notes 1. The body of Civil War nurse narratives is expansive and rich. I investigate a selection of the narratives and employ many as examples. Some examples I have placed in the notes below. I wish I could discuss all of the narratives in this study as each is important in thinking about the diverse dynamics at work in the medical sphere during the war. For more, please see: Cornelia Hancockâ€™s letters in South After Getty sburg: Letters of Cornelia Hancock, 18631868. Ed. Henrietta Stratton Jaquette. Lincoln: University of Nebraska Press, 1971., Phoebe Yates Pemberâ€™s journal, A Southern Womanâ€™s Story: Life in Confederate Richmond. Ed. Bell Irvin Wiley. Jackson: McCowat Merc er Press, 1959., Amanda Akin Stearnsâ€™ The Lady Nurse of Ward E . New York: The Baker & Taylor Company, 1909., Susie King Taylorâ€™s Reminisces of My Life in Camp with the 33d United States Colored Troops Late 1st S.C. Volunteers. 1902., Julia S. Wheelockâ€™s T he Boys in White; The Experience of A Hospital Agent In and Around Washington. New York: Lange & Hillman, 1870., and Jane Stuart Woolseyâ€™s Hospital Days . New York: D. Van Nostrand, 1868. 2. During the Civil War, the term â€œnurseâ€ was applied to convalescent m en who were employed in the hospital while recovering. My argument about women imagining a professional medical role could be applied to the possibility that women imagined a professional nursing role. The governmentâ€™s Medical Department did devise a
137 syste matic way to integrate women into hospital work during the war. However, my goal is to make the more radical claim that women could see beyond assuming an inferior position to male doctors. To be sure, Civil War nurse writers reiterate tremendously their k een nursing abilities. They insist that they should be valued in the medical world as competent medical actors. The subtle hints to doing the doctor or surgeonâ€™s work is what is of importance to this study. Their subtleties illuminate how the physicality of medicine and surgical work commented on the ongoing debate about womenâ€™s role in the nineteenth century. 3. Lyde Cullen Sizer takes up a similar notion in terms of writing. She argues that â€œin the postwar years, nursing narratives became alternative hist ories. Replete with conflict and reflecting the shift in language from a mainstream antebellum romantic style toward a more accepted postbellum realism, these narratives mark a transitional moment. The war heightened these womenâ€™s awareness of the limits t hat society imposed on their work and their authorityâ€ (215). While the war heightened womenâ€™s awareness of societal limits, it also heightened their awareness of the singular qualities they had. Nursing narratives are, indeed, alternative histories. At th e same time, they outline a course of alternative medicine highlighting their awareness of societal constraints and their abilities to overcome these constraints. 4. See Sarah Emma Edmondsâ€™ Nurse and Spy in the Union Army: The Adventures and Experiences of a Woman in Hospitals, Camps, and BattleFields . Hartford: W.S. Williams & Co., 1865. Other sources include: Peggy Caravantesâ€™ Petticoat Spies: Six Women Spies of the Civil War . Greensboro: Morgan Reynolds Publishers, 2002., Elizabeth D. Leonardâ€™s All the Da ring of a Soldier: Women of the Civil War Armies . New York: W.W. Norton & Co., 1999., and David D. Ryanâ€™s A Yankee Spy in Richmond: The Civil War Diary of â€œCrazy Betâ€ Van Lew . Mechanicsburg: Stackpole Books, 1996. 5. â€œA narrow entry separated our room from the one where twenty men laid upon the floor,â€ nurse Anna Morris Holstein recalls in her memoir, â€œin one corner, was a graduate of Yale College; his opposite neighbor, a young lawyer, from near Pittsburg, who was an only son; next to him, upon the floor, t he son of a Presbyterian clergyman; the rest of the occupants, Eastern and Western men, indiscriminately mingledâ€ (24). Holstein and her skirt clad colleagues join these professional men, as well as the hospitalâ€™s doctors, and administer care as the vessel s of their future health. Therefore, the narrow entry Holstein speaks of symbolizes a threshold into the possibility of imagining and reconsidering womenâ€™s entrance into the medical field. A narrow entry is just enough room for to conceive of an alternativ e mode of administering care better than the set structure. The cultural, military, and professional structure dictating what women should be doing within and without war did not offer a space for womenâ€™s complete participation in medicine. See: Anna Morri s Holsteinâ€™s Three Years in Field Hospitals of the Army of the Potomac . Philadelphia: J.B. Lippincott & Co., 1867. 6. It makes sense that the entrance of women nurses into the hospital would feel like an â€œinfiltrationâ€ to many military medical men because their model of care was not
138 based on female sensibility or female eyes. Female eyes see in a different way than men do. 7. Schultz focuses on contentious interactions between doctors and nurses, or the untying of the â€œred tapeâ€ by nurses to overcome stifling medical and military authority. She also views the narratives as memoirs of relief and commemoration. I agree with her notion that the Civil War was not an era of progressive medical institution work, however I believe that the war occasioned for progressive medical thinking in terms of who could be part of the institution. 8. Sectarian education coupled with gender strictures prevented women from performing as paid and welcomed surgeons in the Civil War. Mary E. Walker managed to do work, but women simply were not allowed to participate as contract civilian surgeons. Military surgeon rank was certainly out of the question. 9. Patricia L. Richard agrees with this notion. She likewise asserts that â€œthe war caused shifts in the gender system, wherein women expanded their sphere, utilizing their roles as moral agents to justify their bold behavior but stayed within it as they used the traditional method of moral suasion to influence the soldiers whom they cared forâ€ (2). See Busy Hands: Images of the Family in the Northern Civil War Effort. Bronx: Fordham University Press, 2003. 10. Elizabeth Leonard succinctly describes the difference between regular and nonregular medical schools. Regular medical schools adhered to traditional philosophies of â€œdramatic intervention,â€ mostly adhering to the work of Benjamin Rush (108). Nonregular schools, however, believed in â€œmilder forms of treatmentâ€ such as â€œhomeopathy, which discouraged the use of massive doses of medicine), hydropathy (which focused on various forms of water therapy) , Thomasonianism (which promoted dietary reform and herbal remedies), and eclecticism (which combined the teachings of the other three its opposition to orthodoxyâ€ (108). 11. More describes the perceived tension between sectarian and regular medical education: â€œthe high proportion of women whose medical degrees were awarded by â€˜sectarianâ€™ schools over an approximately thirty year period contributed to the disrepute in which many male â€˜regularsâ€™ held all women graduatesâ€ (9). 12. Blackwell caused quite a stir. Other women refused to speak with her and often stopped to stare at her. â€œI had so shocked Geneva propriety,â€ she recalls in her autobiography, â€œthat the theory was fully established that I was a bad woman, whose designs would gradually become evident, or that, being insane, an outbreak of insanity would soon be apparentâ€ (6970). See Blackwellâ€™s Pioneering Work in Opening the Medical Profession to Women. London: Longmans, Green, and Co., 1895. 13. See Dana D. Nelsonâ€™s National Manhood: Capitalist Citizenship and the Imagined Fraternity of White Men.
139 14. Later in the war, Schultz explains, Surgeon General William Hammond allowed surgeons to decide on female aid because of the immense need for help in the hospitals, which â€œcircumvented Dixâ€™s powerâ€ (15). This transition in power from Dix to medical officers emphasizes that need eventually dismissed prewar public fears temporarily. 15. The callous quality appears again when she recalls eating with her medical comrades. â€œWe used for a table an old stretcher which was dirty and bloodstained,â€ she notes, â€œno one could tell how many dead and dying had been borne upon it, as it gave evidence of having done considerable serviceâ€ (285286). Kate Cumming notes a similar experience in her journal. She recalls surgeons eating breakfast in the same room that they performed amputations (151152). See: Kate: The Journal of a Confederate Nurse by Kate Cumming. Ed. Richard Barksdale Harwell, 1959. Originally published in 1866. 16. Her â€œcallousâ€ nature is pacified again when she comments on the amputating tent. What she sees there is a sight she has become acclimated to: â€œabout the amputating tent lay large piles of human fleshâ€“ legs, arms, feet, and hands. They were strewn promiscuously about â€“ often a single one lying under our very feet, white, and bloodyâ€ (268). Her description is straightforward and seemingly unfeeling, yet she concludes by noting how â€œthe stiffened members [seemed] to be clutching ofttimes at our clothingâ€ (268). With her heart both shielded and on her sleeve, she suggests that the limbs clutched at her physical and emotional garments. Her compassion is not lost, but selective. Her recollection of such scenes illustrates what she learned through immersion: to handle the scenes like the doctors do. In short, her nerves were touched, but she learned the necessary steadiness of medical work. 17. One example of this: Bucklin comes across a Rebel with typhoid fever. He could not endure a cleansing because â€œhe was literally alive with crawling vermin.â€ Determined to save this man, and â€œon the refusal of the men to cut his hair, or shave his face, which had not known a razor for three years,â€ she explains, â€œI took the revolting task upon myselfâ€ (165166). Bucklin takes on a task that the men refuse to do and she does it with tenderness. 18. F or example, C.E. McKay labeled her mollifying abilities as â€œwomansuasionâ€ (53). This theme of persuasion based on femalesâ€™ ameliorating presence is consistent in the body of nurse writing. McKayâ€™ patients are grateful for her. The men repeatedly tell her: â€œyou are so much like my wife, my sister, or my motherâ€ (103 104). See: C.E. McKayâ€™s Stories of Hospital and Camp. Philadelphia: Claxton, Remsen, & Haffelfinger, 1876. 19. Another reason why nurse authors may have framed their narratives with a maternal sense was to appease the reader. During the war, many had apprehensions about womenâ€™s propriety and hospital work. The constant reiteration of a maternal role in the narratives ameliorates any cultural criticism.
140 20. Nurse Elvira J. Powers records a similar situation in Hospital Pencillings. She diagnoses a man with measles and the doctor in charge disagrees. He sends the soldier to a quarantined smallpox hospital where the doctors there come to the conclusion that he has the measles (171172). The patient dies. See Hospital Pencillings; Being A Diary While in Jefferson General Hospital, Jeffersonville, Ind. And Others at Nashville, Tennessee, as Matron and Visitor . Boston: Edward L. Mitchell, 1866. 21. Having the maternal sense means that women nursesâ€™ view of the amputation table strikingly incites images of the kitchen tableâ€“ often with a vacant chair. The nurse views that table as serving up loss of limb or life in an American tragedy tearing familial ties asunder. Confederate nurse Kate Cumming reinforces this point. In one journal entry she notices blood dripping down from the amputation table in a room above the kitchen. This image of blood dripping down onto the kitchen table is a literal image that captures the impact of the war on the home front. With their natural maternity, the nurses think about the home and who is left behindâ€“ wife, mother, child, or unborn child. 22. Schultz also conveys this difference in perception. She argues, â€œfor many surgeons, the human being was principally a medical specimen, not some â€˜poor motherâ€™s son,â€™ as nurses might have viewed himâ€ (135). 23. See Jennifer Doyleâ€™s â€œSex, Scandal, and Thomas Eakinsâ€™s The Gross Clinicâ€ in Representations 68 (Autumn 1999): 133.; Michael Friedâ€™s Realism, Writing, Disfiguration: On Thomas Eakins and Stephen Crane. Chicago: University of Chicago Press, 1988; Elizabeth Johnsâ€™ â€œThe Gross Clinic, or Portrait of Professor Grossâ€ in Reading American Art . Ed. Marianne Doezema and Elizabeth Milroy. New Haven: Yale Universi ty Press, 1998. 232263; and Amy Werbelâ€™s Thomas Eakins: Art, Medicine, and Sexuality in NineteenthCentury Philadelphia. New Haven: Yale University Press, 2007. 24. The eagerness of the nurse in Danielâ€™s memoir to partake in another amputation scene seems to fit in with doctor centric thinking. However, her motivation is to prove her abilities in that space. She is not eager to help simply for the sake of witnessing a body cut up or participating in a dissection. At this point, she only wishes to prove. Once s he has done that, it is likely, based on the rhetoric of Civil War nurses, that she would probably begin to think about revising modes of treatment and care. 25. Bucklin similarly conveys her disagreement when she finds out about the exploratory surgery the head doctors undertake. Her blood boils at the â€œmanglingâ€ of a wounded soldier as the doctors â€œ[hold] him under chloroformâ€ (177). After, â€œthey removed him to the amputating room, where they paused a while to have their photographs takenâ€ (177). She recalls waiting three hours while the patient was â€œheld under the knife.â€ Bucklin remembers the patient possessing an overall appearance of strength except for his shoulder wound before the surgery. Post surgery he is placed back in his bed looking like death. The doctor gives him into Bucklinâ€™s â€œspecial chargeâ€ with the hopes of her raising him and she does save him. Perhaps the doctorsâ€™ surgery fixed
141 his wound, however Bucklin takes credit for undoing the â€œcrueltyâ€ upon this manâ€™s body and soul that she witnessed. Most likely, the woman figure in the clinic cared tenderly for the young boy patient after the procedure. 26. Walker also appealed to Assistant Surgeon General R.C. Wood and he could not overturn Finelyâ€™s decision of deference. 27. Walker was captured as a pris oner of the Confederacy on April 10, 1864. Schultz notes how she caused a stir when she arrived at Richmondâ€™s Castle Thunder: â€œDressed in trousers and a surgeonâ€™s uniform, the twenty five year old made such a sensation when she rode into camp that several Confederate soldiers and visiting wives mentioned the incident in their letters and diariesâ€ (178). After being released, she became â€œSurgeon in Chargeâ€ at Louisville Female Military Prison housing Confederate women for spying in September of 1864 (Leonard 142). She was never commissioned or paid for her work, though she did receive the Congressional Medal of Honor on November 11, 1865 (Leonard 155). 28. Not all nurses were averse to amputations. C.E. McKay, for example, writes in her narrative the dangers of deferring amputations or performing resective surgery when an amputation surgery may fare better (118). 29. Michel Foucault theorizes the meaning of how doctors separate wounds from patients in The Birth of the Clinic. Foucault describes the separation of the patientâ€™s body from the patientâ€™s identity as the â€œmedical gazeâ€ (9). Essentially, the doctor must â€œabstract the patientâ€ in order to figure out the patientâ€™s problem and to diagnose a course of treatment. Alcottâ€™s description of Dr. P speaks to Foucaultâ€™ s examination of the evolution of medical perception throughout the nineteenth century. Many examples from Civil War medicine fit with Foucaultâ€™s medical gaze. This makes sense because of the sheer numbers of wounded bodies that doctors encountered. Perhaps what is most important is that while the male doctors see the patientâ€™s body, the nurses see the patientâ€™s identity, thus women justify that the medical gaze should include both. 30. Alcott situates Periwinkle in another situation in which she finds a doctor â€œin a state of bliss over a complicated amputationâ€ (52). In attempting to dress a gunshot wound a soldierâ€™s shoulder, she realizes that she does not have the necessary materials. Therefore, she angrily goes to retrieve some but is refus ed by the individual in charge of supplies because she does not have an order form the surgeon of her ward. She demands to see the surgeon in charge and finds him working on an amputation in his glory. Periwinkleâ€™s indignation and Alcottâ€™s fiery tone is ak in to many nurse authors and Dr. Mary Walker who disagreed with amputation after amputation.
142 CHAPTER 5 CONSERVATIVE RESECTION: RECONSTRUCTION AND MARK TWAINâ€™S MEDICAL COMPLAINT History becomes defiled through lapse of time and the help of the memories of b ad men. â€“ Mark Twain Life on the Mississippi â€œThe Lost Episode,â€ also titled â€œJim and the Dead Man,â€ from Mark Twainâ€™s 1884 novel , The Adventures of Huckleberry Finn deserves a closer look .1 If in the text that we now read today, â€œThe Lost Episodeâ€ would be in chapter nine. Sitting in a cave, Jim tells Huck about his past. When Jim was sixteen, his master, a medical student, asked him to go to the medical college and warm up a dead manâ€™s body for dissection. He tells Huck, â€œone nightyoung Mars. William he tole me to go to de college, en go up stairs to de dissectinâ€™ room on de second floâ€™, en warm up a dead manen git him soft so he can cut him upâ€ (Twain 63). Jim then recalls his experience w alking into the dissection room: â€œdat room was sixty foot long en twenty five foot wide; en all along de wall, on bofe sides, was de long black gowns ahanginâ€™, dat de stugents wears when deyâ€™s achoppinâ€™ up de dead peopleâ€ (63). In the process of warming the man, Jim becomes entangled with the corpse. While Jimâ€™s chore is to make the body more lifelike so that the medical student can cut into it with ease, the more important aspect is that the body â€œenlivensâ€ and â€œawakensâ€: He was a layinâ€™ on round sticks â€“ rollers. I took de sheet offâ€™n him en rolled him along feet fust, to de enâ€™ er de table befoâ€™ de fire place. His laigs was apart en his knees was cocked up some; so when I upended him on de enâ€™ er de table, he sot up dah lookin pretty natural, wid his feet out en his big toes stickinâ€™ up like he was warminâ€™ hissef. I propped him up wid de rollers, en den I spread de sheet over his back en over his head to help warm him, en den when I was a tyinâ€™ de corners under his chin, by jings he opened his eyes! I let go en stood off en looked at him, feelinâ€™ might shaky. (63)
143 What Jim tells Huck opens up a part of slaveryâ€™s history that the rest of the novel does not. The space of the medical college evokes the oppressive medical history and inhumanity against blacks for the profit of white people. Jimâ€™s purposes for being there symbolize the horrifying historical relationship between doctors and slaves: the treatment of slaves and the use of slaves and freed black people as instruments in medical study. Looking at Tw ainâ€™s work through the lens of this episode illuminates a new way to understand his complaint about the failure of politicians and citizens to remember the monumental changes brought on by the Civil War. Huck Finn is predominantly a commentary on how America decided to no longer have a conscience about race inequality during Reconstruction. The novel , Christine MacLeod explains, expresses â€œTwainâ€™s profound engagement with American racial attitudesâ€ and with â€œthe failed promises of Emancipationâ€ after the Civil War (6). MacLeod reads Miss Watsonâ€™s ultimate emancipation of Jim as a â€œdramatization of Twainâ€™s bitterness at the self righteous and limited gestures of commitment his society had made towards the true meaning of black liberationâ€ (9). Miss Watson, the equivalent of â€œwhite supremacist hegemony,â€ controls Jimâ€™s fate as a slave and as a freedman, while her conscience appears to be wiped clean of her slaveholding ways (9) . This illustrates the problem of forgetting Emancipation in the postwar era. Instead of implementing equal, democratic principles after the war, the nationâ€™s opposing sections reunited and crafted a dominant narrative of the warâ€™s meaning without remembering the inhumanity that was perpetrated by slaveholders and racists. With â€œThe Lost Episodeâ€ in mind, I argue that t he reanimation of the dead bodyâ€™s limbs in Jimâ€™s arms could signify making the meaning of the Civil War dead â€œaliveâ€ in the
144 consciousness of America. After all, Jim encounters four bodies in the dissection room and each body could represent one year of the war from 1861 to 1865. The last year had much at stake for what would become of the nation. The last body is the one that opens its eyes to Jim and looks him square in the face, but this look does not last long. Moments later Jim thinks he sees the corpseâ€™s limbs reanimate in the lantern light. Jim tries to maneuver the corpse in an awkward embrace, but the body rolls off of the table and kicks the candle out leaving him completely in the dark. Jim is left in the dark without any connection to the dead, which parallels the national narrative of forgetting about what slaves endured and about what the massive death of the war was supposed to rectify and change. Twainâ€™s frustration about the irresolution of race issues in R econstruction is illustrated by the episodeâ€™s removal. Twainâ€™s complaint is that the medical component of slavery and the inhumane treatment of slaves should not have been taken out of national consciousness during postwar memory making. Ironically, his co mplaint is exemplified by his own actions: Twain removed this part and put the text back together again. He removed the episode in the same way that he shows that it should not have been removed from the larger picture of the Civil War and Reconstruction. In the context of this dissertation, the text undergoes conservative resection surgery signifying how this type of surgery on the nation and the national narrative of war was the wrong choice. Without the episode in the novel, a telling part of Jimâ€™s history is lost. If, as Jocelyn Chadwick Joshua points out, Jim represents â€œAmericaâ€™s greatest unfinished social issue,â€ then not only is Jimâ€™s history lost, but an important part of all enslaved blacksâ€™ history is lost (8). 2 This is why the novel enacts what it does: Huck forgets about
145 what he has learned with Jim at the end, and all of the Tom Sawyers of America keep antebellum views of black people alive after the war. I do not claim that the removal of the episode was deliberately done by Twain to show hi s frustrations in a medical way.3 Rather, I contend that the removal performs the problem that Twain seeks to underscore in his work. Therefore, this chapter is not just about Huck Finn. I illustrate how Twain is concerned with blacks in medical history and how this history was forced out by the dominant white cultureâ€™s ease of forgetting about the horrors of enslavement in The Gilded Age: A Tale of Today , Life on the Mississippi , and A Connecticut Yankee in King Arthurâ€™s Court . The first section pairs exam ples of medical mistreatment in slavery with similar Civil War medical moments to show the persistence of antebellum thinking into Reconstructionâ€“ the type of thinking that frustrates Twain. The second section adds another dimension of interpretation to my discussion of Thomas Eakinsâ€™s The Gross Clinic . The Jefferson College medical students in the painting represent the history that Jim opens up in â€œThe Lost Episode.â€ Lastly, the third section rereads Twainâ€™s novels. Pre Op Persistence William Dean Howells knew Mark Twainâ€™s feelings about the Civil War. Twain â€œwas entirely satisfied with the result of the Civil War, and he was eager to have its facts and meanings brought out at once in history,â€ Howells writes (31). Twain scoffed at the majority of A mericans who believed that the time was not right â€œto philosophize the events of the great struggle;â€ he warned that the widespread â€œimbecilityâ€ of forgetting the warâ€™s accomplishments until a later time would ultimately turn the warâ€™ s meaning into â€œfableâ€ ( 31). Twain foresaw that the writers of such an American fable would be racists and forgetters.
146 Twain â€œbecame an ardent champion of African American rights [and] a proponent of Radical Reconstructionâ€ (Fulton 171 and 175).4 He kept his ear close to the walls of the government and angrily stood by as President Johnson took over as head surgeon to the wounded national body and, along with the efforts of racists and reconciliationists, conservatively resected the nation, or resectioned North and South, bac k together.5 Johnson pardoned many Confederate politicians, which gave the impression that tearing apart the national body by force was not an act for which one should be punished. He outraged Republicans because they saw that he chose to forget about E mancipation. Johnson sacrificed the health of the nation to reattach the limb, the South, and doing so without radical changes created the conditions for race inequality to recur. In other words, Johnson remained an antebellum surgeon with antebellum thinkin g. The continuity between antebellum surgeonsâ€™ and wartime surgeonsâ€™ thinking is a synecdoche for the larger cultural refusal to change social dynamics and beliefs about race that took place from the antebellum period through the war and into the last hal f of the nineteenth century. Four traits make up what I term the antebellum surgeon mentality: selective memory, medicine without humanity, lack of conscience, and blunted moral perception. This mentality is mostly tied to Confederate surgeons according to Southern Civil War hospital narratives; however, the Unionâ€™s experimental measuring of black soldiersâ€™ bodies during the war speak s back to antebellum racial practices and emphasizes how Northern hypocrisy about African Americans found its way into Civil War medicine. Most importantly, this mentality is important for my assessment of Twainâ€™s novels. Much of Twainâ€™s literature exemplifies how the political
147 choi ces and social beliefs of white victors in crafting the national memory of the warâ€™s meaning proved that antebellum thinking about race survived the war like a virus and once again pulsed through the veins of the postwar national body. Nineteenthcentury American medicine advanced because doctors had selective memory about their role as practitioners. Doctors, especially in the South and in the business of using slaves as clinical material to learn from, depended upon beliefs about blacksâ€™ inhumanity so that they could conduct experiments without guilt. In doing so, doctors conveniently forgot to abide by the professionâ€™s foundational Hippocratic promise: to do no harm. One might assume that because many doctors believed black people could not feel pain and were of an entirely different species â€“ i.e., not humanâ€“ that they were not doing any harm.6 However, the irony of antebellum surgeonsâ€™ practices, as noted in depth by Harriet Washington, is that the impulse for experimenting upon slaves was to find cures and treatments for white people, thus automatically placing slaves in the human category and making their choices and practices hypocritical. William Wells Brownâ€™s Clotel; or, The Presidentâ€™s Daughter reveals how antebellum surgeons were â€œlicensedâ€ to kill â€“ the exact opposite of the saving and curing their profession demanded. In the text, a young Northern Christian, Carlton, visits the Peckâ€™s Southern plantation. While there, Carlton shows the patriarch, Mr. Peck a schoolâ€™s advertisement for sick slaves that he is curious about. Mr. Peck explains to Carlton that doctors use slaves in their medical lectures. Carlton then reads a column boasting about the available bodies for instruction and â€œproperâ€ anatomizing at a school: â€œNo place in the United States offers as great opportunities for the acquisition of anatomical knowledge. Subjects being obtained from among the coloured population in
148 sufficient numbers for every purpose, and proper dissections carried on without offending any individuals â€ (101). Here, Car lton concludes that slaves are used for dissection, and he asks Mr. Peck whether or not the doctors wait for the slaves to die to begin clinical instruction. Peck responds that the doctors accrue and hold slaves until needed for anatomy lecture. Then, they choose one to bleed to death. Carlton observes that such an act is murder, and Mr. Peck replies, â€œdoctors are licensed to commit murder, you knowâ€ ( 101). In t his example, Brown argues that doctors in this time period had no limits to the harm that they could cause. Antebellum slavery gave them the limitless environment to do anything and everything to human bodies for their own gain without regard to how much physical and psychological pain they inflicted.7 What follows from this kind of behavior is a Ci vil War hospital narrative with a surgeon who forgets to put his patients before himself and to do no harm. In Confederate nurse Phoebe Yates Pemberâ€™s journal, A Southern Womanâ€™s Story: Life in Confederate Richmond, Pember is called to a patient who is â€œsuffering intensely.â€ Before this point, the patient came in with a crushed ankle, he was attended to, and then the surgeon ordered for him to be left alone. â€œHe had a burning fever, and complained of the fellow leg instead of the injured one,â€ Pember recall s (124). She gives him a sedative, but this does not work, so she investigates further despite being told not to. She looks at both of his legs, and â€œit was the most shocking sight â€“ swollen, inflamed and purple â€“ thesurgeon had set the wrong leg!â€ (124). The surgeon conveniently forgot to abide by his oaths and hospital protocols in order to drink the stock of the operating roomâ€™s liquor supply, and then he performed a very serious procedure that he botched on a grand scale. Because of the surgeonâ€™s actions, the man with two crushed
149 ankles subsequently dies. Selective memory and practicing medicine without humanity go hand in hand. The trait of practicing medicine without humanity involves historical prewar and wartime examples of doctors using medicine, rem edies meant to make the body heal, as punishment tools. In slavery, doctors and slaveholders alike used medical treatments to punish slaves for feigning illness. This legacy was brought into the Civil War hospital. Wartime surgeons used their knowledge and power to determine the veracity of soldiers feigning sick to escape the battlefield. Fugitive slave Henry Bibbâ€™s Narrative of the Life and Adventures of Henry Bibb, An American Slave, Written by Himself recounts acts of medical punishment. Bibbâ€™s slaveho lder acts as the doctor to his slaves. If a slave fell ill, Bibb describes, the diagnosis and remedy administered by his slaveholder was always the same. The treatment would consist of â€œstrong red pepper tea, boiled till it was red. He would make them drink a pint cup full of it at one dose. If [the slave] should not get better very soon after it, the dose was repeatedâ€ (60). Dose after dose of the treatment was given, and if nothing prevailed in curing the slave then the slaveholder would add chimney soot to the concoction and force the slave to consume a quart of it. The result of ingesting this concoction â€œwould operate on the system like salts, or castor oil,â€ Bibb explains (61). In other words, the slaveholder forced his slaves to consume â€œmedicineâ€ that created a purgative and diarrheal effect. The slaveholderâ€™s goal was meant to accomplish one of two outcomes: if the slave was indeed ill, then the medication would cure them, and if the slave was not truly ill then surely they would be cured of feigning illness again. The medical tools of punishment in slavery effectively translated into the Civil
150 War hospital. Putting possible malingering soldiers to the test by doctors achieved the same outcomes sought after by slaveholders. If the soldier was truly i ll, he would be cured, and if he were not truly ill, he would give up his ruse and never malinger again. In her memoir, Memories; A Record of Personal Experience and Adventure During Four Years of War , Southern nurse Fannie Beers mentions the methods surgeons used to test malingering. She explains, some soldiers, knowing â€œthat the blistering, purging, and nauseating process pursued in [malingering] cases by surgeons was intended as a punishmentâ€ would instead shoot themselves through the hand, finger, or foot to get out of battle (96). Beers is not entirely sympathetic to malingering soldiers. She refers to them as â€œhospital rats,â€ however her listing of surgeonsâ€™ punitive practices evokes the practices used by slave doctors and slaveholders. We learn from F annie that wartime surgeons were capable of channeling their medical k nowledge into harmful punishment tactics. Stuffing hot pepper tea, chimney soot, and castor oil down oneâ€™s throat or blistering skin are forms of torture, not just acts of medical inhumanity. Inflicting torture involves a lack of conscience. Countless examples of torture exist in antebellum slave narratives, and such instances are not linked with Civil War hospital literature. But they should be. The reciprocal relationship between the Civil War hospital and slave torture is best exemplified by shared rhetoric. As mentioned previously, cure is usually associated with medicine; however slaveholders and overseers tortured slaves in order to â€œcureâ€ them of their intractable behavior. Likew ise, â€œbuckingâ€ and â€œgaggingâ€ are associated with slave punishment, yet these forms of torture appear in the Civil War hospital setting. The shared thinking signals a lack of conscience because the
151 perpetrators in both the narratives I consider inflict thei r punishments to â€œcureâ€ and feel no sense of indignity in doing so. Fugitive slave John Brownâ€™s 1855 narrative, Slave Life in Georgia: A Narrative of the Life, Sufferings, and Escape of John Brown, A Fugitive Slave, Now in England, describes bucking and gagging. Brown is forced to watch his friend, John Glasgow, endure this kind of punishment. Stripped naked, Glasgowâ€™s hands were fast and tied and brought down over his knees doubled up under his chin. A stout stake was thrust under his hamsIn this posi tion he was turned first on one side then on the other, and flogged with willow switches and the cow hide, until the blood ran down in streams and settled under him in puddles. ( 337) After three hours, his wounds were washed with salt, water, and red pepper. Here, the heat of the red pepper jolts us back to the ingestion of pepper tea and chimney soot forced upon Henry Bibb. The fact that slaveholders thought carefully about and devised more than one type of punishing tool embodies the lack of conscien ce associated with their institution. Glasgowâ€™s torture scene is also a medical scene because of the puddles of blood. Early medical practices instructed surgeons to use bloodletting to cure patients. Bloodletting was thought to draw out the disease or bal ance the bodyâ€™s â€œhumors.â€8 Considering the torture connection between slaveholders and surgeons, I contend that such a scene with so much blood suggests a kinship to the image of a Civil War surgeon in midoperation. Such a scene further suggests a kinship to the image of a Civil War surgeon who prescribes bucking and gagging to punish soldiers in his hospital. Just shy of ten years after Brownâ€™s narrative, Confederate nurse Kate Cumming recorded in her journal, A Journal of Hospital Life in the Confederate Army of
152 Tennessee from the Battle of Shiloh to the End of the War , an incident of punishment similar to Glasgowâ€™s prescribed by a surgeon in the hospital she nursed in: Mrs. Newsom tells me that Dr. Hawthorn, the surgeon, i s one of the best managers she has ever been with; but I have been told one thing about him , that proves that he is not a humane man; I refer to his method of punishing the men by bucking and gagging; sometimes he puts a bayonet in their mouth instead of a stic k, and ties it so tightly that the blood gushes out. Many a time he has made the men stay in this position twenty four hours, giving them neither food nor water. (105) Cumming, from a slaveholding family, recognizes that what Dr. Hawthorn orders is similar to methods of punishment upon slaves when she identifies the doctorâ€™s preferred type of punishment. The gushing blood she sees parallels with John Glasgowâ€™s puddles. Most importantly, Cummingâ€™s description shows how Dr. Hawthorn, with all of his professional clout, managed patients who bent the rules with a mentality akin to enslavement practices. Dr. Hawthorn assumes the language, actions, and thinking of a slaveholder or slave doctor in an environment meant to heal and save lives. One can only look beyond what Cumming recorded and conjecture the damage that this surgeon inflicted on bodies â€“ acts clearly counter to the point of his profession.9 â€œBlunted moral perceptionâ€ is Twainâ€™s phrase. The Yankee uses it in A Connecticut Yankee in King Arthurâ€™s Court to describe slaveholders and how morality and slavery are severely at odds. No other example in antebellum slave narratives illustrates blunted moral perception more than the medical experimentation perpetrated on slave bodies by doctors. The measuring of slave bodies by antebell um doctors eerily matches the measuring of African American soldier bodies during the Civil War. Union doctors (and the government) viewed a medical opportunity with the new set of freed black bodies, and in making African American soldiers a science project, the North undermined the ideological reasons it stood for in wartime.
153 Fugitive slave John Brown chronicles unspeakable torture by a doctor who experimented upon his body.10 A local doctor, Dr. Hamilton, chooses Brown for experimentation. Hamiltonâ€™s objective is to find remedies for severe sunstroke in slaves and to discover the thickness of black skin. Hamiltonâ€™s objective is not surprising since, as Gretchen Long notes , â€œslave owning was structured around physical labor, any management of slavesorbited around the work each slaveâ€™s body could do,â€ and the medical â€œstructured slavery,â€ especially â€œlabor expectationsâ€ (21). Hamilton knew that he could make money if he found a way to make slavesâ€™ bodies work more. For nine months, Brown is forced to submit to Dr. Hamiltonâ€™s whims. To measure how much heat the slave body can handle, Brown is repeatedly placed in a hole dug in the ground and heated by fire. Brown faints from the intense heat, but Dr. Hamilton revives him and puts him through the experiment again. He is also put through other experiments: I was put on a diet, and then, during a period of about three weeks, he bled me every other dayAt the expiration of that time, he set to work to ascertain how deep my black skin went. This he did by apply ing blisters to my hands, legs and feet, which bear the scars to this day. He continued until he drew up the dark s kin from between the upper and the under one. He used to blister me at intervals of about two weeks. He also tried other experiments upon m e, which I cannot dwell upon. (340) Brownâ€™s silence reveals Dr. Hamiltonâ€™s limitless drive and self fashioned authority. Washington details how Southern doctors felt authority over blacks â€“ that anything could be done to them for science and medicine â€“ because â€œ they lived in proximity to blacksstudied them, and understood their medical and intellectual characteristicsâ€ (32). The white antebellum surgeon mentality has strong roots in Southern enslavement, but as this chapter touches upon as wel l, the North is a ccountable for wanting to forget about slavery during Reconstruction and beyond. The following
154 examples of Union doctorsâ€™ blunted moral perception speak to the larger problem of racism in the North that survived the war â€“ a racism that was coated with hypocr isy. Margaret Humphreysâ€™ work uncovers medical racism exacerbated by the war.11 Humphreys informs us about doctors who viewed the recruitment of black soldiers into the Union Army as an experiment or an opportunity to scour over and measure their bodies. S he also describes the outright neglect of black soldiers by surgeons. Long before African American soldiers encountered battle, sustained a wound, became ill, or entered a hospital, their bodies endured Union doctorsâ€™ scrutiny in the recruitment stage. The Sanitary Commission requested doctors to record their findings regarding black soldiersâ€™ bodies. â€œBlack soldiers were measured, weighed, and tested,â€ Humphreys explains (x). Union doctors desired to measure masculinity, strength, and the impact of racial diversity on physicality. Before black men could don a Union uniform to gain or convey their freedom or manhood, a doctor had to measure it.12 Humphreys signals the fine line of medical connection between the Confederacy and the Union: â€œnorthern [doctors ]dissected the black body for clues as to its distinctiveness. And they had many bodies to explore, for poor treatment led to high rates of disease and death among black troopsâ€ (x). Especially for the doctors who had never encountered a black body before, the war occasioned for dissection opportunities. Moreover, inadequately trained surgeons were purposefully assigned to black regiments. Humphreys explains how insufficiently educated doctors who populated black regiments held positions â€œof surgeon and assistant surgeonâ€ and â€œwere filled by medical students just shy of earning the M.D. degreeâ€ (59). The black soldier emerged from a situation of experimentation for educating medical students and reinforcing racial
155 inferiority, encountered an assembly line of experiments in the recruitment process, endured war and either succumbed to illness or a ghastly wound, and was then ushered into the hospital â€“ another experimental space riddled with racial inferiority. â€œIn their letters,â€ Long writes, â€œblack soldiers frequently deplored their medical treatment and living conditions that led to illnessâ€ (77). The medical apparatus of the Civil War did not offer reprieve for these men who desired so much to guide the Union on the road to a victory that promised freedom f or their identities, but ultimately did very little to keep that promise. The Clinicâ€™s Medical Students The antebellum surgeon mentality has much to do with one surgeon passing along his knowledge to another or to medical students. Recall the second ch apter in which I discuss the passing along of faulty ideologies from â€œexperiencedâ€ surgeons to green medical students on the eve of war. This section interprets Thomas Eakinsâ€™s The Gross Clinic from within this perspective, but I now focus closely on the m edical fieldâ€™s history of passing along faulty race ideologies that became scientific facts to doctors and the social standard for believers of race inequality. Though The Gross Clinic does not depict medical torture against a black person, the history of the space and the observers of the procedure in the painting summon up the medical beliefs that formulated the components of the mentality that I outline above. At first glance, a masterpiece paint ing and a recovered lost episode of Huck Finn appear to hav e nothing in common. But, I contend that The Gross Clinic ties together Dr. Gross with Mark Twain, and, more importantly, the painting shows the surgery that the novel, when â€œThe Lost Episodeâ€ is considered, performs. Art scholars tend to overlook the rac ist element of the medical legacies and
156 history attached to the setting of the painting, the Jefferson Medical College clinic space, and the medical students in the audience. Attention is given to the fact that the paintingâ€™s lighting favors Dr. Grossâ€™s em inence, knowledge, and contribution to medicine. Dr. Gross is spotlighted and in midlecture because the painting is meant to revere his leadership in surgical work and the passing along of his knowledge to students in one of the finest medical schools. El izabeth Johns notes that â€œlighting is Eakinsâ€™s most dramatic tool;â€ that the â€œdusky roomâ€ and the â€œemot ion charged lightingâ€ represent â€œactual conditions in Jeffersonâ€™s surgical clinicsâ€ (234). The dusky room obscures the medical students, and what is not seen so clearly suggests that there is an alternative read to be made about the medical history that the painting depicts. The light o f Dr. Grossâ€™s eminence forces the eye to focus upon him and his pat ient, not the audience. This is the paintingâ€™s main narrative. One point of sharp contrast denotes that there are two narratives involved, though. The darkness of the audience coupled with the crisp white bed linens soon to be stained with blood from the doctorsâ€™ hands signifies a contrast between what the painting intends to show and what it cannot help but show. I perceive the darkness of the audience paired with the soonto bestained bed linens as representative of nineteenthcentury medical historyâ€™s underside: medical racism in the form of dissection, anatomization, forced experimentation, graverobbing, and medicine as punishment upon black individuals by white doctors and their students. The darkness of the audience, and the â€œfew brush stro kes,â€ Johns points out â€œ[convey ] the many attitudes of [the] studentsâ€ (237). While Johns argues that she sees â€œmany attitudesâ€ among the audience members, she does not elaborate on what these attitu des are. But, clearly, one attitude is a historical mentality that permeated from the
157 medical clinic out into social constructions of difference, prejudice, and ideologies of race. The racist roots of the clinic space and of medical studentsâ€™ training reach farther back beyond the Civil War and slavery. In the early republic, for example, Dr. Benjamin Rush examined the racialized body in a cultural context that demanded specific race and gender categories. Blackness was equated with disease and difference, and therefore in need of a cure for social stability (Nelson 58).13 Dr. Samuel G. Morton preached polygenesis in terms of racial difference between blacks and whites. Morton studied the skulls from individuals of various races to â€œproveâ€ differences, whic h were ultimately, according to Dana D. Nelson, â€œscientific calculations of racial hierarchyâ€ meant to forge â€œprofessional spaces of white, scientific manhoodâ€ (113). Nineteenthcentury scientists such as Josiah Clark Nott, Louis Agassiz, and George Robins Gliddon believed in ethnology, or that â€œthe enslaved black [is] inherently debased and immutably so: no amount of training, education, or good treatment could make him the equal of a white manâ€ (Washington 35). Melissa Stein discusses â€œthe sciences of di fferenceâ€ at length in her work, and how scientists enmeshed the needs of the dominant culture into their theories. â€œRather than the strictly objective disciplines they often purported to be,â€ she reveals, â€œ[nineteenthcentury] scientific endeavors on race took their cue from the reflected existing cultural ideologies and hierarchiesâ€ (6). Scientists and doctors â€œinterpreted black bodiesâ€ as â€œdesigned for servitudeâ€ in order â€œto naturalize slaveryâ€ (7).14 As the century progressed, the clout that these beliefs gained intensified among the medical field and the general public . The medical fieldâ€™s obsession with anatomical study came along with these
158 widely held â€œscientificâ€ ideologies. The dissecting room was the space for initiation into professional medicine. As Michael Sappol explains, â€œin dissecting the cadaver, the student penetrated, surveyed, and appropriated the interior of the bodyâ€ (3). Gaining this knowledge brought students into an authoritative fraternity with the power to shape medical practi ces, scientific theories, and social beliefs. Sappol describes how doctors and students argued that â€œa knowledge of anatomywas needed to educate and morally uplift the northern working class, young women, black people, savages, and American youthâ€ (6). A knowledge of anatomy also kept women, black people, and economic â€œothersâ€ out â€“ unless they were being experimented upon, of course. As Nelson discusses at length, anatomical study was linked to national white manhood and forged an imagined fraternal connect ion between doctors. The imagined bond produced and reproduced their â€œpower to objectify, to identify, [and] to manageâ€ bodies and social categories while obscuring their professional insecurities (3). Here, the teaching aspect of the antebellum surgeonâ€™s mentality and the connection of medicine to enslavement reemerge. Washington states that newer doctors â€œleft their medical school training with a deeply ingrained habit of looking upon blacks as demonstration material and experimental subjectsâ€ (11). This kind of thinking was taught, which bears a striking resemblance to how racist attitudes were passed from one generation to another in slaveholding families. Instead of receiving the hickory rod or whip, medical students took the scalpel and sunk it into bl ack flesh. American medical education for doctors in the nineteenth century progressed and developed along with and because of the institutionalization of slavery.15 R acist medical thinking was also integrated into the larger American cultural
159 consciousness through literature before the Civil War. Sharla Fett explains, â€œso common was the medical exploitation of black bodies that the theme of dissection crossed over from medical practice and entered white antebellum print cultureâ€ (153). One example is an obscure set of sketches published in 1850, Odd Leaves from the Life of a Louisiana Swamp Doctor , written by Henry Clay Lewis under the name of Madison Tensas, M.D. Lewis was an actual doctor in the South who practiced in the marshy swamps on the Tensas River. Classified as Southwestern humor, Lewisâ€™s sketches are overtly racist and grotesque.16 Kenneth S. Lynn describes Lewisâ€™s work as a display of â€œferocious humorâ€ because â€œto Lewis, theNegro was a carnal animal whom it was fun to torture under the guise of medical treatmentâ€ (104). Of all the medical situations that Lewis writes of, the sketch â€œStealing a Babyâ€ brings the reader into the clinic lecture hall, and in the words of Lynn concerning all of Lewisâ€™s work, â€œfurnishes a significant insight into the psychology of the slavocracy on the eve of the Civil Warâ€ (104). â€œStealing a Babyâ€ shows medical student Madison Tensas to be an anatomy obsessed young man who fantasizes about stealing a black baby from his schoolâ€™s postmortem room so he can perform his own personal dissections at home. During lecture one day, he sneaks out, finds and steals a black infant cadaver (from the arms of its dead mother), places the infant inside of his coat, and attends the rest of the lecture as normal. After the lecture, Tens as leaves school only to slip and fall on ice and have the dead infant roll onto the street in front of his fiance and her father (illustration included by Lewis). Looking at the painting after considering this kind of work, one might wonder if Madison Tensas were sitting in Dr. Grossâ€™s painted clinic with a dead black infant stuffed in his coat. Twain knew a lot about medicine, and I concur with K. Patrick Ober that this
160 influenced how he wrote about national issues. Ober argues that Twain must have lea rned about the intricacies of medical education through secondhand experience. He writes, â€œskeletons, cadavers, and autopsies recur throughout his work,â€ and Twainâ€™s â€œawareness of anatomic issues probably reflects his knowledge of the instructional course at McDowellâ€™s Medical College â€“ if medical schools of the era had any focus of excellence, it would be anatomy, and there is no question that McDowellâ€™s was a leader in this subjectâ€ (90). Founded by Joseph Nash McDowell in 1847, Missouri Medical College in St. Louis, or McDowellâ€™s Medical College, was in earshot of Twain. Likewise, Dr. McDowell was known throughout Twainâ€™s boyhood home of Hannibal. Based upon Twainâ€™s accuracy concerning anatomy and the process of acquiring cadavers, Ober concludes he must ha ve engaged in conversations with an actual doctor, or at least a medical student. Further, Jim Lampton, Twainâ€™s uncle, was a student at McDowellâ€™s Medical College. Concerning Jimâ€™s cadaver episode in Huck Finn, Ober asserts that â€œthis incident may well hav e been taken from a real medical school experienceas hinted at in a short entry made by Clemens in his 1866 notebook: â€˜Jim Lampton & the dead man in Dr. McDowellâ€™s Collegeâ€™â€ (90). Two Jims in a medical school dissection room do not appear to be completely coincidental. And the connections do not end there. Though vague, Twain was inadvertently tied to Gross through shared knowledge: Gross knew McDowell, McDowell could have taught Lampton, and Lampton told stories to Twain. Moreover, the paintingâ€™s conserv ative resection surgery shares a relationship with Huck Finn and how I interpret the removal of â€œThe Lost Episodeâ€ in relation to the larger picture of Twainâ€™s work. Recall my descriptions of conservative resection surgery
161 throughout this study: this surgery favors saving a limb instead of complete amputation by removing the infected part of the bone and suturing the limb back together. This surgery was considered less drastic than amputation. However, before the Civil War, during the war, and up until the development of bacteria theories, conservative resections had a high rate of reinfection. My point here is not to focus completely on the mechanics of the procedure. Rather, my point is to underscore the philosophical element of this type of surgery i n connection to the painting. Eakinsâ€™s painting was so radical that it made spectators ill, but, ironically, the man he painted embodied conservatism. Dr. Gross is dressed in dark clothing as if he walked in from his nearby professor office, and he is not wearing any protective cover (a practice that was gaining popularity in the 1870â€™ s). So, the main man in the scene is wearing the garb of yesterday by the time this painting was produced, and this is the kind of garb that many Americans could not part with in the postwar era. Lastly, the painting was produced in 1875 as Reconstruction was on its deathbed. Considering the nuanced history that the painting captures, it participated in national memory negotiation at the same time the nation was attempting to piece together a narrative of enslavement and war at the expense of emancipated peoples. The historical medical mentality fraught with racism in antebellum slave narratives, Civil War hospital narratives, and subtly embedded in The Gross Clinic , is a way o f thinking that Twain disliked. Re Section Complaint Twain processes the nationâ€™s choice to forget the enslavement and the subsequent emancipation of African Americans as part of what the Civil War accomplished in The Gilded Age , Life on the Mississippi , A Connecticut Yankee in King
162 Arthurâ€™s Court, and Huck Finn . When these works are placed side by side, a narrative emerges about what happens to black bodies in slavery and in medicine and how this component is neglected in postwar national memory making. In the broader sense of this chapter, pre op, antebellum surgeon thinking survives the Civil War into Reconstruction. The appearance of medical racism, hypocrisy, selective memory, lack of national conscience, and choosing to forget in the texts show Twain â€™s criticism, or in my view, medical complaint of the dominant white cultureâ€™s role in resecting the nation back together with the same problems it fell apart with. Historian David W. Blight describes the postwar conflict over memory, race, and the meani ng of the Civil War in Race and Reunion. My arguments hinge on Blightâ€™s outline of the three visions of contested Civil War memory during Reconstruction because Twain comments on selective remembering in his postwar work. The three visions were: emancipati onist, reconciliationist, and white supremacist. The emancipationist vision arose after 1863 when the dead demanded meaning and President Abraham Lincoln gave a higher significance to â€œthe causeâ€ of abolishing slavery by war. The reconciliationist vision w as a BlueGray, brotheragainst brother narrative of soldiersâ€™ heroism in battle to which self congratulating white Northerners and forgetful Southerners subscribed. The problem with this view is the problem that Reconstruction could not solve: trying to r econcile and maintain the ideologies that brought each section of the nation to war with one another in the first place. Southerners who embraced the white supremacist vision were hell bent on remembering the war through the lens of the Lost Cause tradition. Reconstruction politics and the reconciliationist vision tried to mesh together racial equality with white
163 supremacy and the radical changes the war brought with lenient policies for reattaching the South (or the diseased limb) to the Union. As Blight s tates, Americaâ€™s â€œsegregated society demanded a segregated historical memoryâ€ (361). Aside from bad business deals, lofty monetary goals, self centered choices, and greed, Twain and Charles Dudley Warner expose hypocrisy and medical racism in The Gilded A ge: A Tale of Today , published in 1873. Justin D. Kaplan contends that this novel fueled Twainâ€™s â€œanger at American democracyâ€ and the failure of democratic principles (xxii). Scholars have yet to focus on how the medical narrative in The Gilded Age also c omments on the failure of democratic principles during Reconstruction. Susan K. Harris does argue that this novel â€œtargets American types that have corrupted the countryâ€ (142).17 One of the storylines in Gilded is that of Ruth Bolton, a female medical student.18 Though she is far from a nefarious, corrupting character, Ruth turns a blind eye on pressing race issues with her lack of action (which proves to be just as damaging as direct racism) in the same way that many Americans did in the postwar era. Ruth is introduced as the love interest of Philip Sterling. The novel shifts from its focus on the Hawkins family and their land speculation debts to the aspirations of a young Yale graduate after fame and fortune. To try and achieve his goals, Philip goes off on a railroad operation as an engineer. Philip writes to Ruth to tell her of his expedition to Missouri, but her focus is on attending medical school. She first convinces her Quaker family that she is capable of medical study, and then she goes on to attend a small medical college in Philadelphia. Though the name of the college is withheld, the fact that she is in Philadelphia calls to mind Dr. Gross and his clinic at Jefferson Medical College, and we know the possibilities of what can happen there.
164 Stud ying one evening, Ruth and a fellow student come across anatomical information that they cannot understand without visual demonstration. She persuades her friend â€œto go down to the dissecting room of the college, and ascertain what they [want] to know by an hourâ€™s work thereâ€ (Twain 107). Once at the school, â€œthe janitoradmitted the girls, not without suspicionand without other remark than â€˜thereâ€™s a new one, Miss,â€™ as the girls went up the broad stairsâ€ (108). The janitor figure is symbolic. Washington explains that â€œanatomical dissection had become key to [surgeon] training, but because the procurement of cadavers, and often dissection itself, was illegaldoctors and their porter had to employ a macabre creativity leavened with criminal force to secure bodiesfor dissectionâ€ (118). Porters, or janitors, of medical college clinics were usually African American and notoriously employed by the faculty to do the dirty work of cadaver acquisition. It makes sense that the janitor in the novel tells the girls that the body is new because, historically, he would know. The dissecting room is very dimly lit with â€œtwo long and several small tables,â€ â€œa couple of skeletons hanging on the wall,â€ and â€œthe mortal parts of the unburiedâ€ ( 108). Both women approach a long table in the center of the room knowing that the cadaver beneath the white sheet is the â€œnew oneâ€ the janitor mentioned. Ruth slowly pulls back the cover, and finds â€œa negro [with a] black face [that] seemed to defy the pallor of death, and asserted an ugly life likenessâ€ (108109). Both women are frightened at what they see: â€œtheblack face seemed to wear a scowl that said, â€˜Havenâ€™t you yet done with the outcast, persecuted black man, but you must now haul him from his grave, and send even your women to dismember his body?â€™â€ (109). Twain emphasizes the persistence of antebellum racist ideologies coupled with the forgetting of enslavement. Havenâ€™t you
165 done enough to me already? Ruth recovers the cadaver (notably, with a white sheet), and she and her companion begin work at two other tables, but â€œnot without an awful sense of life itselfâ€ (109). To be sure, their appalled reaction is very different from the racist sociopathic medical students in Madison Tensasâ€™ work. However, the actions of Ruth and her companion are akin to facile Abolitionists. Ruth and her companion feel bad, but that does not stop them from continuing their work and effectively adding a hypocritical element to their medical study. Moreover, cutting into black bodies for white medical profit evokes the painful underside of medical history: medical racism and what Washington calls â€œpostmortem racismâ€ (118). â€œFor blacks,â€ Washington goes on to say, medical di ssection â€œwas an extension of slavery into eternity, because it represented a profound level of white control over their bodies, illustrating that they were not free even in deathâ€ (125). So, the black man on the table is really saying that if Ruth and her friend choose to forget the relationship between medicine and slavery, then they should be reminded because every person that chooses to forget about the inhumane acts of enslavement and racist medical practices have their hands mired in whipscarred or s calpel cut black flesh. Gretchen Long describes, â€œAfrican Americans, in their memories of slaverytended to remember medical care asinherently connected with the ways their bodies functioned as laboring and reproductive organismsâ€ (42). Certainly, African Americans could not forget about the medical inhumanity perpetrated upon them. This inhumanity obviously extended past the war. Jim Downs elaborates on the obstacles of emancipated slaves during Reconstruction and beyond.19 Downs conveys how emancipated slaves struggled to acquire proper healthcare and to meet basic
166 human needs. He explains, â€œthe outbreak of epidemics and sickness compounded by the inability to secure clothing, shelter, and food left many freedpeople dead and caused inordinate suffering among those who survivedâ€ (6). They starved. They fell ill. And they were victims of improper, racist medical treatment. The treatment of blacksâ€™ health and bodies resembled care given to them, if any, in enslavement. The lack of health in this population ultimately slowed their fight for equality and rights. In the postwar era there was â€œan aggressive assertion of racial superiorityâ€ by racists and proslavery advocates and this included superiority in regards to medical care according to Martin Griffin (3). The Freedmenâ€™s Bureauâ€™s doctors did not help matters either. Like antebellum medical views of slaves, â€œmany Bureau physicians seemed to harbor beliefs that black people were inherently inferior and susceptible to certain illnesses and immune to othersc onsequently, their diagnoses often reflected stereotypes about the South and black peopleâ€ (Downs 11). These doctors are perfect examples of the antebellum surgeon: practicing medicine without regard to humanity. Life on the Mississippi is Twainâ€™s 1883 sem i autobiographical account of how Samuel Clemens came to be Mark Twain as a steamboat pilot and then surveyor of society on the Mississippi River.20 He captures river life as he comes to terms with the nationâ€™s changes. Lewis P. Simpson argues that this novel shows Twainâ€™s â€œpersistent, deeply empathetic relationship with the Sout hâ€ (153). On the contrary, the novel explores two topics that reveal Twainâ€™s complaints about the nationâ€™s postwar selective memory: steamboat piloting and Vicksburg, Mississippi. H is steamboat piloting descriptions read doubly as a commentary on Northernersâ€™ choice to forget about the warâ€™s ro le in E mancipation. His Vicksburg episode reads doubly as a commentary on
167 Southernersâ€™ choice to reinterpret defeat and reinstate racial inequality. Both allude to t he struggle for blacks to keep E mancipation in the national war narrative. Twain spends a great deal of time talking about piloting steamboats and the acute memory skills needed for this vocation. The chapter â€œA Pilotâ€™s Needsâ€ is an ode to the power of memory and how steamboat pilots are experts in remembering. He writes, â€œthere is one faculty which a pilot must incessantly cultivate until he has brought it to absolute perfection. Nothing short of perfection will do. That faculty is memoryâ€ (60 61). A steamboat pilot must remember every inch of the Mississippi River to navigate it without disaster. This is no easy task and takes time to learn, yet once navigating the irregularities of the river by memory is learned, the pilot cannot f orget. In fact, Twain states that forgetting â€œwas simply impossibleâ€ (62).21 Twain discusses piloting with â€œa romantic viewâ€ and a sense of â€œnostalgia,â€ Brian McCammack contends (1011). Twainâ€™s romance for piloting signifies a longing for something no longer attainable. He reiterates throughout the narrative that human memory can be powerful if it is used like a steamboat pilot. â€œAstonishing things can be done with the human memory if you will devote it faithfully to one particular line of business,â€ he teaches (61). A fidelity to memory is what postwar Americans eager to forget about the moral and racial components of the national conflict abandoned. This abandonment set the stage for a recurrence of the problems that put the cataclysmic crack in the nation to begin with. All along the river, Twain notices how the war put steamboats â€œto sleep.â€ Aside from the rise of railroad travel, â€œthe war came and almost entirely annihilated the steamboating industry during several years, leaving most of the pilots idle, â€ he states (79). Pilots no longer needed to use their memories, and apparently no one else moving along the
168 Mississippi or anywhere else i n the nation needed to either. Twainâ€™s intense focus on memory is coupled with race in a scene where he compares hi mself to an emancipated slave. Lawrence Howe views this scene as Twainâ€™s work to â€œ[make] his river life stand for national experienceâ€ (423). Twainâ€™s apprenticeship under an older pilot, Brown, is one of torment and constant criticism. Brown is the master figure with the worst memory for piloting and a goal to dominate. McCammack explains, â€œrather than negotiate and harmonize with the river, Brown attempts to overrun and control the Mississippiâ€ (4). He also tries to overrun his cub. When Twain reaches his limit for how much brutality he can take, he smashes his fists into Brownâ€™s face and tames the tyrannical pilot: â€œIpounded him with my fists a considerable time. I do not know how long, the pleasure of it probably made it seem longer than it really was; but in the end he struggled free andsprang to the wheelâ€ (99). From this point forward, Twain was the dominant one in the pilot apprentice relationship. â€œI knew how an emancipated slave feels,â€ he writes, â€œfor I was an emancipated slaveâ€ (99). The conflict between young Twain and Brown is so reminiscent to Frederick Douglassâ€™s pivotal tussle with Edward Covey, the overseer.22 Douglass endures Coveyâ€™s beatings until he resolves to fight back. The resistance terrifies Covey, and Douglass is never again whipped. The captain of the boat does not punish young Twain for his actions. The scene then takes on allegorical meaning. Howe writes, â€œthe captainâ€™s leniency subverts Brownâ€™s authority and is a metaphor of abolition. And Brownâ€™s ultimatum, that either the capt ain dismisses the cub or Brown himself will go ashore, is a metaphor for secessionâ€ (425). What is essential to my interpretation is that Twain links emancipated slaves with steamboat pilot memory. Twain â€œwinsâ€ against
169 Brown, which allegorically suggests t hat the link he makes is the link that America needs to make. Even though he wins, what he struggles against speaks to the larger impossibility of the emancipationist vision of the war to overcome the dominant, forgetful, white narrative. The episode â€œVi cksburg During the Troubleâ€ further underscores Twainâ€™s attention to postwar national forgetting. He describes his encounter with this once embattled city. The great battle that ensued at Vicksburg occurred between May 18 and July 4, 1863. The Union Army of the Tennessee led by Major General Ulysses S. Grant held the Confederate Army within its defenses for days until they surrendered. Grant captured control of the Mississippi River, which aided in securing victory in 1865. â€œSigns and scars still remain, as reminders of Vicksburgâ€™s tremendous war experiences; earthworks, trees crippled by the cannonballs, cave refuges in the clay precipices, etc.,â€ Twain describes (165). He sees how the war is still present in the geographical landscape, but as he soon finds out, the people no longer see it. Twain retells the story that he heard during his visit: each day the morning would be quiet until the rumble of battle shuffled the people to shelter in a nearby cave. One couple told him their story rushing off to safet y. At first it was all anxiety, but then the bombing became commonplace. And so, Twain discerns, â€œleft to tell their story in their own way, those people told it without fire, almost without interestâ€ because â€œthey got used to being bombshelled out of homeâ€ (167). The war wore them out, and the war wore out their memories. These people that Twain spoke to could be reconciliationists if not Lost Cause subscribers. No wonder the townspeople chose to forget about the barrage of cannon fire upon them; rememberi ng would reassault them with defeat.23
170 At the end of this episode, Twain meets a black man with an unexploded shell in his yard. Like his steamboat piloting discussions, Twain again couples race with remembrance and brings the differences between how the war was remembered by blacks and whites together. â€œOn the road, a quarter of a mile townward,â€ he writes, â€œan aged colored man showed, with pride, an unexploded bombshell which had lain in his yard since the day it fell there during the siegeâ€ (169). This man cannot forget the war because it is literally embedded in his front yard and his psyche. He shows the traveling group â€œwith pride,â€ which alludes to the possibility that the battles (both combative and governmental) may have freed him from enslavement. If he was born free and never a slave, then the fact that he is â€œagedâ€ suggests he is aware of the constant racial conflict before, during, and after the war. The unexploded shell could be read in two ways. The shell could be viewed as a reminder of liberation for all to see. This is the kind of remembering that emancipationists hoped would be part of the national narrative of the warâ€™s accomplishments. Or, the unexploded shell could be viewed as leftover tension from the war that could bust at any time. Though the man feels proud to show the shell, the fact that it is an unexploded shell means that it still carries the power to disrupt, that its trajectory is not fully executed, and that the fight for equality expected by liberated men and women is simply not over. So while the people of Vicksburg were eager to forget, Twain came across this man who was eager to remember. Twainâ€™s frustration at Americans who believe in democracy, yet do not have a conscience about the historical mistreatment of African Americans is evident in A Connecticut Yank ee in King Arthurâ€™s Court . Satire is the hallmark of this novel, and the narrative follows Twainâ€™s usual mode of foregrounding his current political and social
171 issues in past settings.24 Hank the Yank from nineteenthcentury Connecticut is transported back in time to the kingdoms of Arthurian lore and passes himself off as a magician with the power to fix what will be the problems of the future. He teaches King Arthur about the plight of the poor and enslaved by getting them thrown into slavery, and then he squares off with the powerful Merlin only to finally be beat by the sorcerer. The novel is really about the North and South and Northernersâ€™ attitudes about antebellum slavery and the Civil War. Twain accomplishes a scathing commentary of wartime Abolitio nists and emancipationists who do nothing in the postwar era through the Yankeeâ€™s choice to do nothing though he feels for the enslaved. Having a conscience is a burden to the Yankee. Hank comments on how difficult it is to feel guilt: â€œI have noticed my conscience for many years, and I know it is more trouble and bother to me than anything else I started withâ€ ( Twain 93). The Yankee admits that it is easier to forget rather than yielding to the conscience and doing the hard work of making right. In fact, he states that if he could remake man, he would cut the conscience out because it is â€œmuch better to have less good and more comfortâ€ (92). What the Yankee iterates here is that personal comfort is more important than doing good for the whole of humanity. This reasoning speaks back to the drunk surgeon in Pemberâ€™s narrative who comforted himself with whiskey and then set the wrong leg on a patient. More importantly, this view matches how many Northerners and Southerners felt after the war. In Life on the M ississippi , Twain compares how Northerners and Southerners talk about the war: the former completely forget all things war and the latter refuse to stop talking about their (white) version of the war. Both methods of remembering the meaning of the national conflict ultimately relied upon a lack of
172 conscience. The Yankeeâ€™s awareness of slaveryâ€™s inhumanity makes his choices so frustrating. He notices the passing of inherited ideas from one generation to the next about inequality similar to how slaveholders taught their children racism: â€œthose people had inherited the idea that all men without title and a long pedigree, whether they had great natural gifts...were creatures of no more consideration than so many animalsâ€ (39). He terms this â€œidiotic training.â€ He notices the brutality perpetrated upon slaves. The novel includes scenes of slaves young and old moving in chains and compared to animals as they are â€œbundled together like swineâ€ (113). One of the most gut wrenching moments he describes is when a chil d is torn from its motherâ€™s breast so the mother can be beaten: the slave driver â€œsnatched the child from her, and then made the men slaves who were chained before and behind throw her on the ground and hold her there and expose her body; and then he laid on with his lashâ€ (113). He notices the blunted moral perception of aristocrats and he compares this perception to that of slaveholders because of the superiority that aristocrats feel over others. â€œThe blunting effects of slavery upon the slaveholderâ€™s moral perceptions are known and conceded, the world over,â€ he states, â€œand a privileged class, an aristocracy, is but a band of slaveholders under another nameâ€ (140). This comparison is significant because the antebellum South was essentially an aristocrati c society unto its own deluded rules and beliefs. These rules did not evaporate with the gunfire and cannon smoke of 18611865. Regardless of his awareness, the Yankee fails at becoming the heroic Northerner with the chance to go back in time and eradicate slavery once and for all and prevent
173 Americaâ€™s most cataclysmic war. Like Ruth Boltonâ€™s feelings, the Yankee watches the scene â€œhurtto the heart,â€ but does not act upon his principles: I wanted to stop the whole thing and set the slaves free, but that would not do. I must not interfere too muchIf I lived and prospered I would be the death of slavery, that I was resolved upon; but I would try to fix it so that when I became its executioner it should be by comm and of the nation. (113 and114) He carried so much clout as the â€œBossâ€ of the land, but he puts himself first. He cannot act upon the ideologies that he stands for. This Yankee is an Abolitionist who has more in common with the moral perceptions of the aristocratic slaveholder than he would like t o believe. He is full of talk and no walk. He wishes he did not have a conscience, when really that is what all Yankees in postwar America truly needed. To be sure, the Civil War was on Twainâ€™s mind when he wrote Yankee.25 The Battle of the SandBelt at the end of the novel, as Scott Dalrymple has noted, reads like a narrative of the Civil War. Dalrymple argues that the Yankee is a parallel to General Grant, and the battle clearly represents â€œthe bloody war between Union and Confederacy: a clash between a chivalric, slave owning, agrarian society and a modern, technologically advanced republic led by a general presidentâ€ (9). Dalrympleâ€™s assessme nt is compelling and well taken; however, he does not consider the entire ending of the novel and how the Battle of the SandBelt and what happens to the Yankee comment not only on the war, but on Reconstruction and the lack of change. Yes, the industrialized side (the North) appears to win, yet, the industrial machinery produces a ton of dead bodies, and in this massive pile of bodies the meaning of the war is lost because people want to forget. The forgetting opens the door for the old aristocratic man with his usual tricks (the South) to control the outcome: no change. This is best shown when the Yankee is put int o a long sleep by old Merlin and wakes up
174 1,300 years later. The Yankee confirms that nothing has changed because he cannot tell the difference between where he is and where he came from. Turning back to Huck Finn, the novel also blends the past and pres ent to make a point about the Civil War and the nation that would become Reconstructed America. â€œThe Lost Episodeâ€ and Huckâ€™s decision near the conclusion of the novel reveal Twainâ€™s consistent complaint throughout much of his work. The novel as a commentary on the failure of Reconstruction to secure liberties and equality for blacks in the post Civil War period really begins with Neil Schmitzâ€™s critical interpretation.26 Jim is at the center of his argument. Schmitz explains that â€œJimâ€™s situation at the end [of the novel] reflects that of the Negro in Reconstruction, free at last and thoroughly impotent, the object of devious schemes and a hapless victim of constant brutalityâ€ (60). He goes on further to note that, immediately following 1876, during â€œthe period [Twain] worked on the novel, Reconstruction was nullified, the ambitious programs of the Radical Republicans abandoned and the fate of the Negro restored to the keep of his former masterâ€ (60). Schmitzâ€™s contentions speak to the national memory negotiation that was underway during Reconstruction and the latter half of the nineteenth century. Jimâ€™s plight signifies how the emancipationist version of war remembrance desperately needed by blacks lost ground. Though Huck and Jim figure as equals on the raft implying that equality is possible, Twain pulls them from the raft right to the Phelpsâ€™s farm a nd concludes the novel ( 60). Twain remarks in Life how he knew as a pilot that the Mississippi River could subtly change its geography and still flow with force. He could see how the river of the 1880â€™s was different than the river of the 1840â€™s. The keyword involved with the river is â€œchange.â€ The Mississippi River always changes, but the war conveyed that no matter
175 the political weather, the land surrounding one of the nationâ€™s most integral arteries never does. No raft, no equality. No steamboat, no memory. Richard Gollin and Rita Gollin build from Schmitzâ€™s notions. Goll in and Gollin focus on the Phelps farm episode. In this oft noted episode, Jim is held as a runaway in Silas Phelpsâ€™s shed. To look for Jim, Huck takes the opportunity to act as Tom Sawyer so Tomâ€™s Aunt Sally Phelps will invite him in. When the real Tom Sa wyer arrives to visit, Huck explains to him the situation with Jim and Tom agrees to act as a William Thompson from Ohio. The boys find that they have the power to easily free Jim. But, Tom convinces Huck to play along with his shenanigans to make freeing Jim more â€œstylish.â€ Jim agrees to do as the boys say and go along with the obstacles they create, though we soon learn that he is actually free all along. Gollin and Gollin read this episode as â€œa satire on enlightened white attitudes toward the free blac k manâ€ (6). Put differently, they perceive the â€œevasionâ€ that Tom and Huck â€œstageâ€ as â€œa paradigm for the condition of the emancipated Negro at the time Twain wrote the novel, legally free but nevertheless imprisoned by his ignorant need to trust in white good willâ€ (10). First, Tom and Huck as children reinstate the racist attitudes that precede them. As stated previously, racism was taught to children in slavery; they were not born with it. Since the episode is an 1880â€™s satire, Tom and Huck are perceived to be the children that come after the war who are taught old attitudes. Secondly, though Tom and Huck are â€œbest intentioned,â€ they put Jim through the ringer to â€œfreeâ€ him. He moves from one form of enslavement to another regardless of the laws of the land on which he treads. Gollin and Gollin emphasize this phenomenon: â€œwe see [Jim] subject to more arbitrary tyranny, and more helplessly independent upon white
176 good will, than when he was the docile and unquestioned property of Miss Watsonâ€ (10). They clearly imply that the 1880â€™s are no different than the 1840â€™s, and that many of the people who do not believe in slavery are the ones perpetrating perceptions of difference between whites and blacks. The evasion scene speaks to Huckâ€™s decision to forget about Jimâ€™s humanity. I put blame on Huck for forgetting, whereas MacLeod states that Huck does not take part in Tom Sawyerâ€™s plans â€œwillingly,â€ and that his â€œpassivity, therefore, must be understood as the result of practical powerlessnessâ€ (11). It does not matter if Huck still knows somewhere in his being that there is a human at the center of their game, his lack of action suggests a conscious decision. In fact, Huckâ€™s recognition of Jim as a human being and then decision to go along with Tom Sawyer paralle ls Hank the Yankeeâ€™s decision not to act though he knows slavery is wrong in Connecticut Yankee. The pivotal moment in the novel is when Huckâ€™s conscience fills with fond memories of Jim as he struggles with whether or not he will tell Miss Watson about Ji m. He realizes, â€œsomehow I couldnâ€™t seem to strike no places to harden me against him, but only the other kindâ€ (Twain 273). He feels for Jim. His conscience urges him to do what he thinks is best, not what society would want him to do so he resolves to â€œgo to hellâ€ even though he makes the moral choice. Then, the Phelps Farm incident changes everything. Huck forgets about the revelation he came to about Jimâ€™s humanity and the power of his individual conscience. He does not act on Jimâ€™s behalf with any reso lve. Laurel Bollinger argues, â€œHuck cannot recognize Jim as an equal or a friend and yet allow Tom to amuse himself at Jimâ€™s expenseâ€ (34). Huck cannot have it both ways. He chooses Tom. The nation could not have it both ways either, but that is the direct ion that Reconstruction
177 went in until finally the nation chose Tom, too. Recall the conservative resection metaphor I posed about the removal of â€œThe Lost Episode.â€ Twainâ€™s complaint is that the medical component of slavery should not have been taken out of national consciousness. If the episode were in the novel, then Huck would have had a more visceral understanding of slavery. Jimâ€™s smile, protective nature, and talk about his daughter that Huck remembers does not do enough to pull Huck into his histor y as a human being to make a last ing impact. Victor Doyno states that the fact that Jim runs away from the dissection room after being frightened might undermine Huckâ€™s â€œgrowthâ€ in him learning how to respect a black man (373). However, I contend that Jimâ€™ s pulling of Huck into an experimenting room at a medical college and all that space entails like the episode does might have done more to influence Huckâ€™s choices later on. Huck would have seen even more that black people are not just superstitious â€œniggersâ€ with paternalistic white owners who need help farming their plantations. Though the novel is an example of conservative resection, buried deep within the text is a book about amputation. Ober notes that Twain â€œskillfully blended the world of medicine into the larger picture of life in the nineteenth century,â€ especially in Huck Finn when he â€œdescribes some of the reading material that could be found in the homes of the Mississippi Valleyâ€ (7). Huck comes across â€œâ€˜Dr. Gunnâ€™s Family Medicine, which told you all about what to do if a body was sick or deadâ€™ (qtd. in Ober 7).â€ Written in 1830, Dr. Gunnâ€™s Domestic Medicine, or Poor Manâ€™s Friend, in the Hours of Affliction, Pain and Sickness advises that â€œeven surgical procedures such as amputations of arms and legs could be done by any man following the simple instructions in the bookâ€ ( 7). Only
178 â€œfirmness and dexterityâ€ were needed to perform an amputation. Knowing when to amputate was the most di fficult task for surgeons ( 7). Huck finds this book, later â€œamputatesâ€ Southern societyâ€™s view of slavery by deciding to â€œgo to hellâ€ to save Jim at the right time â€“ what all postwar Americans should have done. Yet, by the time he gets to the Phelps farm he forgets this book and plays along with Tom (subsequently resecti ng to his mind the old views he previously cut off) . Huckâ€™s forgetting reinforces the postwar eraâ€™s trend of forgetting, not a trend of holding firmly to the radical changes instigated by the war. What is important here is that, hidden away, buried beneath the layers of the novel, is a text expressing some sort of direction on how to amputate a limb. Mark Twain grew more radical as time went on. Perhaps if he were the surgeon in charge that Abraham Lincoln viewed himself to be, he would have amputated South Carolina (and the entire Confederacy) when the problem started. Twainâ€™s work shows us that the South may have lost the war in battle, but it won in keeping its mentality embedded in national thinking about race and change. In his 1894 novel, The Tragedy of Puddâ€™nhead Wilson, Twain reinforces how the fluidity of race relations undermines any rigid social strictures that perpetuate racial prejudice. Twainâ€™s novel underscores the human inability to discern oneâ€™s racial heritage by appearance, yet appearance is what social beliefs were (and still are) rooted in. Nine years after Wilson , in The Souls of Black Folk , W.E.B. Du Bois wrote about â€œthe vast soreâ€ of â€œsocial separationâ€ and racism (64). He warned that if the â€œhealingâ€ of the problem appeared to pr ogress on the surface of society, but â€œsubtly and silentlyâ€ the races remained apart on truly important issues such as â€œhuman intimacy,â€ then â€œsocial
179 surgeryâ€ would be needed (64). The only way that America could ever live up to its ideals of freedom and equality, he said, would be because of the efforts of â€œbroadminded, upright men, both black and white.â€ Du Bois called for surgeons without the antebellum mentality that continued to plague race relations at the turn of the century. But, this call would go unheard. Sixty years after Du Boisâ€™s call, Martin Luther King, Jr. reminded the nation that blacks were still not free and equal. A s Blight has noted, Americans like a history of progress, not a history of tragedies, so the problems go unsolved. Fifty years after King, on the sesquicentennial anniversary of the Civil War, America still does not celebrate the Emancipation Proclamation as a nation. Notes 1. â€œThe Lost Episodeâ€ was found in a manuscript of the novel that was tucked away in an attic until about 1992, and is not published in its original intext location in todayâ€™s prints of Huck Finn, but is appended as a facsimile. The contents of the episode rather than the discovery of it are of importance here. 2. Although the Civil War is absent from the novel if one only looks for battles or reads with a literal perspective, Huck Finn is critically viewed as a Civil War novel. David Madden and Peggy Bach believe that Twainâ€™s novel could â€œbe considered one of the great Civil War novelsâ€ because the novel contemplates America before the war as a way to know the â€œAmerica to come,â€ or the nation shaped by war and not entirely changed (10). For more, see â€œIntroduction.â€ Classics of Civil War Fiction . Jackson: University of Mississippi Press, 1991. 322. Lewis P. Simpson further argues that the novel is â€œan exploration of the southern society that fought the Civil Warâ€ (156). Surely, Twainâ€™s intention was to examine his present societal problems through the landscape of the antebellum era and the role Southerners played in the Civil War and after. More importantly, Simpson states that Huck Finn as a Civil War novel presents â€œa history you canâ€™t resign from,â€ and that history, in my view, is slavery (156). 3. Victor Doyno presents multiple reasons why Twain might have r emoved the episode from Huck Finn. First, he argues that the episode would have added to the pile of bodies already in the novel: the episode â€œwould have added four more bodiesâ€ though it does the meaningful work of emphasizing the novelâ€™s â€œmotif of unburi ed corpsesâ€ (373). Secondly, Twain may have removed the episode because of its similarity to Henry Clay Lewisâ€™s work. It is possible that he may have read Lewisâ€™s literature as it was popular. Next, we hear Jimâ€™s voice and perceive his history in the
180 epis ode, and if it were kept in the text, then it may have taken away from the story belonging completely to Huck. 4. Twainâ€™s writing, Fulton contends, â€œproduced during the years leading up to the Civil War, the war years themselves, and Reconstructionreveal the reconstruction ofTwain, a personal reconstruction that paralleled and responded to what transpired on American battlefields and in American politicsâ€ (xi). 5. Johnson feared the expansion of federal power so he vetoed essential legislation such as the Freedmanâ€™s Bureau Bill and the Civil Rights Bill that would secure the hardwon liberties for blacks (133). Congress overrode Johnsonâ€™s veto on the Civil Rights Bill. 6. For more on African Americans and the issue of pain, see Debra Walker Kingâ€™s African Americans and the Culture of Pain. Charlottesville: University of Virginia Press, 2008. 7. An historical anecdote Washington provides is another example of doctorsâ€™ license to do harm without repercussion. She shares one story (of many) about the work of Dr. J. Marion Sims. The story is of Dr. Sims and Sam, a slave whom he purchased for demonstrating surgery to his students because Sam has a cancerous growth on his jawbone. Sims forcefully operates on Sam (sans anesthesia) in front of medical students. Washington describes, â€œthe barberâ€™s chair into which Sam had been welcomed had been surreptitiously fitted with wooden planks, and as soon as Sam was seated, five young physicians bounded forward to restrain him with straps about his thighs, knees, ankles, abdomen, chest, shoulders, arms, wrists, elbows, and headâ€ (102). Like punishment tools devised by slaveholders to destroy flesh and souls, the medical students here carefully fashioned a surgical procedure contraption meant to hold down a slave for their benefit. 8. The teachings of Dr. Benjamin Rush shaped antebellum and Civil War doctorsâ€™ standards of practice. Rush believed that removing blood and other fluids from the body could draw out illness and disease. Ira Rutkow explains, â€œcopious bloodletting, administering drugs to induce diarrhea, salivation, sweating, and vomiting, and drawing out bodily fluids by blistering the skin served as mainstays of Rushâ€™s approachâ€ (45). The goal was to balance the bodyâ€™s â€œelementalor personality affecting humors: black bile (melancholy), blood (sanguine), phlegm (phlegmatic), and yellow bile (choleric)â€ (45). Civil War doctors, in particular, used calomel to perform the drawing out of illnesses up until they realized, at about midway through the war, that they were doing more harm than good with that treatment. See Rutkowâ€™s Bleeding Blue and Gray: Civil War Surgery and the Evolution of American Medicine. 9. Kate Cumming writes about a hospital fire in late August of 1864 caused by a â€œsmall piece of lighted paper, thrown down by a l ittle negro boyâ€ (231). She is â€œconfidentâ€ that the fire was an accident. Perhaps the fire was an accident, however, I perceive the fire as an act of resistance. Not only did the hospital burn, but a thousand stored
181 cotton bales in a nearby barn went up in smoke. All in one act, the young boy destroyed a war hospital and a product of slave labor â€“ both physical manifestations of two interdependent institutions. The burnt cotton reads as a precursor to Shermanâ€™s March to the Sea and the burning of Atlanta near the end of the war. The young boyâ€™s lighted piece of paper could be viewed as a slave narrative in another form: a powerful act of undermining the mentality that sought to craft social standards based on racial inferiority. Put differently, he published h is power in flames. 10. John Brown also describes how he and others under Stevensâ€™ direction were forced to consume cotton seed as sustenance. Stevens concocted ground up cotton seed with mush in order to see how much actual food he would not have to give to his slaves in order for them to function. â€œThe seed is crushed and mixed up in the â€˜mushâ€™ that is given to the negroes,â€ Brown explains, â€œbut it is unwholesome, and soon brings them out in sores. I have been made to eat it, thus mixed, in my food, until I broke out in great ulcers, from my anklebone upwards. Experiments have been tried to ascertain what quantity a â€˜niggerâ€™ could bear to swallow in this mannerâ€ (384). 11. Humphreysâ€™ most recent work on Civil War medicine focuses on the problem of widespread ill ness on the battlefront and home front. She discusses the limitations and advancements in medicine that were dealt with and made before, during, and after the war. See Marrow of Tragedy: The Health Crisis of the Civil War . Baltimore: The Johns Hopkins Univ ersity Press, 2013. 12. The experiment of accruing these bodies for data leads directly back to ethnologists who curiously peered at the black body for intellectual capital. On the issue of freedom and manhood for African American soldiers, please see J. Matt hew Gallmanâ€™s â€œIn Your Hands That Musket Means Liberty: African American Soldiers and the Battle of Olustee.â€ Wars within a War: Controversy and Conflict over the American Civil War . Gary W. Gallagher and Joan Waugh, eds. Chapel Hill: University of North C arolina Press, 2009. 87108. 13. For more about race and social categories in the early republic, please see Elizabeth Reisâ€™s Bodies in Doubt: An American History of Intersex . Baltimore: The Johns Hopkins University Press, 2009. Reis makes a fascinating case for doctorsâ€™ and scientistsâ€™ drive for racial and sexual certainty. For example, she metaphorically describes how, â€œin the nineteenth century, as Northern blacks figuratively turned white through emancipation, women threatened to turn into menâ€“ again, figur atively â€“ as they claimed the political rights of citizenship reserved for white malesâ€ (40). The chaos that ensued created fear, and those in power, i.e. white men, worked to keep classification systems that favored them intact. 14. Dr. Samuel A. Cartwright wrote an important medical text detailing symptoms and treatments of diseases specific to slaves. Published in 1848, The Diseases and Physical Peculiarities of the Negro Race included made up conditions such as â€œDysthesia Aethiopica,â€ or blacksâ€™ penchant for destroying their slave ownersâ€™ property (Washington 36).
182 15. Todd Savitt discusses the theories of difference that white Southern doctors believed in when examining and treating slaves, the kinds of diseases slaves suffered from, the relationship between blac k health and white society, and antebellum medical practice and beliefs. Savittâ€™s approach is a biomedical one with descriptions and charts about diseases in the South that afflicted the slave population. Sharla Fett similarly focuses on the power dynamics between the doctor and the slave. She asserts that â€œantebellum medicine and health care was a veritable freefor all, characterized by experimentalism, skepticism, and contesting claims to scientific legitimacyâ€ (4). While Fett examines the medical practi ces of white doctors upon slaves and their reasoning, she also uncovers a vast history of enslaved healers who created an alternative form of medical therapy. See Savittâ€™s Medicine and Slavery: The Diseases and Health Care of Blacks in Antebellum Virginia. Urbana: University of Illinois Press, 1978. 16. In the postwar era, Andrew Silver argues, â€œa national humor of resignationâ€ and a â€œnational fatalismâ€ arose regarding race reform and womenâ€™s rights; during and after Reconstruction â€œa sense that social problem s are better left for someone else to solveâ€ became the norm and the time periodâ€™s humor reflected that (8 and 9). For more on race, reforms, and humor in the nineteenth and early twentieth centuries, see Silverâ€™s Minstrelsy and Murder: The Crisis of Southern Humor, 18351925. Baton Rouge: Louisiana State University Press, 2006. 17. Harris focuses on the inscriptions of Laura Hawkins in The Gilded Age. She describes Laura as a â€œrebelâ€ who â€œgrasps the male prerogative, actively seeking to create and control her own lifeâ€ (145). Harris does not include Ruth Bolton in this conversation even though the young medical student is a strong female character who chooses to pursue a path that is predominantly male. 18. Ruth appears as a competent female medical figure in li terature before William D. Howellsâ€™ Dr. Breen, Elizabeth Stuart Phelpsâ€™s Dr. Zay, and Sarah Orne Jewettâ€™s Nan Prince. 19. Longâ€™s study addresses the problems outlined by Downs, but she also shows how the racist ideologies that barred the African American com munity from gaining medical education could not stop them from taking â€œmatters into its own handsâ€ (139). In the late nineteenth century, the community â€œbegan to assemble the structures necessary [to] train a new generation of formally educated [African A merican doctors]â€ (154). Establishing medical education for African Americans was a political act because it reinforced their right to American citizenship. 20. For more on race and Life on the Mississippi , see Stephanie LeMenagerâ€™s â€œFloating Capital: The Tr ouble with Whiteness on Twainâ€™s Mississippi.â€ ELH 71.2 (Summer 2004): 405431. 21. Thomas M. Walsh and Thomas D. Zlatic point out that, â€œthroughout his life Clemens had a notoriously poor memoryâ€ (214). Perhaps this may be the case, however I argue that pairi ng steamboat piloting with Twainâ€™s remarks about national memory
183 do not depend on the quality of his memory and how he was often â€œlate for appointmentsâ€ and got lost when trying to follow directions (215). Rather, he comments on the need for memory about i mportant cultural issues in his work, not necessarily his own need for better memory. For more on Life on the Mississippi and memory, see Walsh and Zlaticâ€™s â€œMark Twain and the Art of Memory.â€ American Literature 53.2 (May 1981): 214231; and Edgar J. Burd eâ€™s â€œMark Twain: The Writer as Pilot.â€ PMLA 93.5 (October 1978): 878892. 22. Twain was very familiar with slave narratives. Chadwick Joshua mentions that â€œhe knew some runaway slaves. He and Frederick Douglass, for example, were friendsâ€ (17). 23. Twain noticed Northernersâ€™ and Southernersâ€™ selective memory in how they discussed the war. â€œIn the North,â€ he writes, â€œone hears the war mentioned, in social conversation, once a month; sometimes as often as once a week; but as a distinct subject for talk, it has long ago been relieved of dutyâ€ (201). In the South, Vicksburgers are not too keen on talking about the defeat of their town and war, but most Southerners took to talking about the war in their own way. â€œMention of the war will wake up a dull company and set their tongues going when nearly any other topic would fail,â€ Twain writes, â€œin the South, the war is A.D. is elsewhere; they date from itâ€ (201). 24. For more on race and the Civil War in A Connecticut Yankee in King Arthurâ€™s Court , see Lawrence I. Berkoveâ€™s â€œM ark Twainâ€™s Hostility Toward Joseph.â€ CEA: An Official Journal of the College English Association 62.3 (Summer 2000): 3947. 25. Dalrymple tells us that Twain wrote A Connecticut Yankee in King Arthurâ€™s Court between 1885 and 1889. In this period of time, especially during 1885, Twain undertook the publication of Ulysses S. Grantâ€™s memoirs and also published â€œThe Private History of a Campaign That Failed,â€ a narrative of his brief stint as a Confederate soldier (2). Clearly, Twain took this opportunity to thi nk through the Civil War on both personal and national levels. 26. For more on Adventures of Huckleberry Finn and medicine, see Walter J. Friedlander, M.D.â€™s â€œMark Twain, Social Critic, and His Image of the Doctor.â€ Annals of Internal Medicine 77.6 (December 1972): 10071010. On the role of Reconstruction in the novel, see Stacey Margolisâ€™ â€œHuckleberry Finn; or, Consequences.â€ PMLA 116.2 (March 2001): 329343.
184 CHAPTER 6 CONCLUSION: UNSEVERED: THE REIMAGINED CIVIL WAR SURGEONâ€™S LESSONS IN E.L. DOCTOROWâ€™S THE MARCH To conclude, I move from nineteenth century texts to a contemporary novel to underscore how, even one hundred and fifty years after the war, surgeons and surgical scenes in Civil War literature explain and negotiate American social issues and deeply rooted cultural problems stemming from that era. This phenomenon is best noticed in the endless amount of amputated limbs that often appear in Civil War literature. The paradigmatic, recurring image of severed limbs is ironic becaus e America, as a culture, is unsevered from the warâ€™s problematic legacies â€“ racism, regional differences, divisive politics, and new warfare that challenges combat medical treatment.1 As Susan Mary Grant explains, many Americans do believe in â€œthe conviction that [the warâ€™s] lessons continue to have meaning todayâ€ (5). Robert Penn Warren noticed the endurance of the warâ€™s meaning long ago. He wrote, â€œthe Civil War is urgently our war, andreaches in a thousand ways into our blood stream and our personal presentâ€ (101). Still, the Civil War is part of our identity as Americans. Even more so, the Civil War is part of our bodies, and there seems to be an undying need to understand that part of our bodies. SusanMary Grant explains that the attraction to the war era â€œis surely tinged with the recognition that the warâ€™s legacy was a divided one, which left many issues unresolved,â€ and that these issues â€œare as alive in thetwenty first century as they were in the midnineteenth centuryâ€ (5). The feeling of the warâ€™s present â€œalivenes sâ€ als o speaks to the nationâ€™s recent war situation. Stephanie A. Smith draws a poignant parallel between now and then. She states that we are involved in â€œtwo wars that share with the Civil War an imperfect yet horrifying symmetry, the symmetry that moder n warmust share: people, torn to shreds by inventions both
185 technological and ideological, shipped home in body bags, coffins, or in (battle) piecesâ€ (1). The symmetrical relationship between now and then is ironically captured in an asymmetrical image: pi eces, or bodies with missing limbs. The amputee is a simultaneous holder of tragedy and renewed life. The loss of a limb is no doubt tragic, but the purpose is to keep the life of the body healthy. What would remain if that body still had the damaged limb? As we know from the previous chapter, the damage would remain, intensify, and worsen the life of the body. Concerning the sesquicentennial anniversary of the war, SusanMary Grant and Peter J. Parish quote David Maddenâ€™s telling hope about fixing cultural problems: the ideal outcomewill be the reconciliation, at long last, of North and South based on factual, imaginative, and spiritual recognition by each citizen that his or her personal identity and destiny are grounded in the historical event that most crucially shaped our national character. (1) At long last. Maddenâ€™s words reiterate the longstanding discordance of societal beliefs about the warâ€™s meaning. Michael Kammen also notices this lack of reconciliation that has persisted throughout Americaâ€™ s history. He describes the Civil War as â€œrememberedâ€“ but unreconciled,â€ and Dr. Wrede Sartorius in E.L. Doctorowâ€™s The March would no doubt agree with Kammen (101). Dr. Sartorius would climb on top of his operating table and shout out this lesson if only s omeone would listen. Standing in the middle of the medical aftermath of the warâ€™s battles, Sartorius knows that in the future the Civil War will certainly be re membered and painfully unsevered from American historical memory. The Civil War, he teaches, wi ll always be an open wound for Americans with irreconcilable differences concerning the warâ€™s meaningâ€“ never reconciled, never recovered, and never healed no matter what. Published in 2005, Doctorowâ€™s The March is a contemporary reimagining of
186 General Tec umseh Shermanâ€™s 18641865 March to the Sea. Doctorow sets the reader into a winding, contracting world of change leading to the conclusion of the war. His reimagining forces the reader to grapple with implied current political and social issues within the historical context of the war. The March is a conglomerate of fact and fiction. This processing of events from reality matches the work of the nineteenthcentury predecessors who are part of this project: Ambrose Bierce, Walt Whitman, Louisa May Alcott, an d Mark Twain. One major component that ties these authors together along with Doctorow is that, often, the semi fictional, processed literary piece speaks the truth concerning human dynamics and social issues more forcefully than the raw material of histor ical chronicles. Doctorow uniquely achieves this in The March as a historical piece that processes the past and the present simultaneously. Moreover, Jim Cullen notes that popular culture mediums help to explain why things are the way they are in American society. Doctorowâ€™s novel surely teaches lessons about how the legacies of the Civil War influence why things are the way they are now in American society. The novel accomplishes teaching lessons about the warâ€™s legacies through the renowned Union Army surgeon, Dr. Sartorius.2 This conclusion seeks to contemplate the function of Dr. Sartoriusâ€™s role as a reimagined Civil War surgeon. What is the purpose of a reimagined surgeon conveying what can be learned from the Civil War? My initial response to this question is quite simple: tough answers. By occupational and cultural expectations, doctors are supposed to have answers about life, our most precious possession. The historical doctors of the Civil War often did not have answers about how to save lives (see second and third chapters). But Dr. Sartorius does. He tears up national beliefs of â€œrecoveryâ€ with his logic. He reminds us
187 that giving in to imagined recovery covers the fact that the nation is actually, to echo the words of Walt Whitman, still in â€œone vast central Hospitalâ€ trying to figure out ways to cure and surgically repair the social consequences of the war and its aftermath. And there the nation will always remain.3 Surprisingly, Dr. Sartorius has not captured much scholarly attention. Instead, one focus on the novel attends to the function of photography and contrived vision connected to historical narrative construction. Eric Seymour and Laura Barrett argue that the staged quality of Civil War photography is a metaphor for the process of history making. In other words, the â€œpossibility of passing off a fiction as a convincing truthâ€ that photography provides is analogous to the selective perception of history making that excludes and marginalizes specific ideals, experiences, and groups of people (55) . Real wartime photographers such as Mathew Brady and A lexander Gardner â€œmanufacturedâ€ historical scenes, or, in Timothy Sweetâ€™s words, â€œcomposedâ€ narratives by staging battlefield p hotographs ( qtd. in Seymour and Barrett 54). Brady and Gardner desired to capture both the terrifying and sentimental aspects of the war: bloated bodies after battle and a dead young boy appearing to dream quietly upon his knapsack though undeniably dead. The fictional photographer in the novel, Josiah Culp, who is â€œattached to General Shermanâ€™s campaign, shares [this] selective vision[and] is more concerned both with how convincing an image appears and how well it conveys a particular message about the war than with the dispassionate cataloguing of eventsâ€ (52 and 55). The work of Culp, so reminiscent to Bradyâ€™s and Gardnerâ€™s, shows how the â€œmanufacture of â€˜pictorial recordâ€™â€ is analogous to the manufacture of historical record (53). Seymourâ€™s and Barrettâ€™s commentary on extracting truth from fi ction is pivotal to
188 my assessment of the reimagined Civil War doctorâ€™s function. If photographers and snapshots capture illusions, then Dr. Sartoriusâ€™s medical perspective captures the reality of the illusions. His view is the opposite of Culpâ€™s. Instead of seeing with â€œsingle vision,â€ Sartorius sees with double vision â€“ his present and what will be the future present â€“ and comments on the need to acknowledge the contrived stability of history making in order to see the chaotic lie that it is. Scott Hales, without much regard to Sartoriusâ€™s perspective, comments on the â€œdisorienting effectâ€ that Doctorow creates by â€œblend[ing] fiction with factâ€ (149). Hales claims that â€œhistorical fiction, therefore, often works to strengthen its readersâ€™ historical conscious ness and memory through narratives of imagined history â€“ at the expense, of course, of actual historical factâ€ (148). But what if the imagined history tells the reality that the â€œfactsâ€ ignore? Doctorow surely rewrites the past, and in doing so, he reveals p ersistent and ineradicable truths about the impact of the Civil War on the present through Dr. Sartoriusâ€™s medical observations. Dr. Sartoriusâ€™s medical perception is critical to the novel. His perspective provides a new way to think about how Civil War me dical thinking and practice comments on the legacy of the decisions made upon the national war body. Therefore, Dr. Sartorius pulls together two narratives: the Civil War medical narrative and the national narrative of the war. His surgical procedures and beliefs about injuries assume double meaning. When placed in a context that considers the symmetry between the Civil War historical moment and the present, Sartoriusâ€™s medical perception could be read with an undertone of national commentary. As, what I term, the doctor of the future in the past, he teaches what is to come for the medical field and
189 the nation. His medical acts and observations on Shermanâ€™s March indirectly reinforce that long after the last gunshot and field operation of the war, future political and social choices about how to put back together the national body will have a perpetual impact on American society. Because of his revolutionary medical perception, he shares traits of his historical counterparts, but he is further able to see and understand parts of bodies and parts of the war that his fellow doctor colleagues do not. His advanced medical knowledge and penchant for instruction forge what he is known for on the March. He teaches lessons to others in the novel, and, in doing so, t eaches us two major lessons that speak to his function. The first lesson he teaches is that the war is an open wound, not a healed and recovered wound only in the past. The second lesson he teaches is that the war will always be now for all of us. By this statement, Sartorius notes that we will always explore the injury and the open wound that the war is. The perceived reality is that we think we have fixed this injury, but Sartorius, the fictional reimagined Civil War doctor speaking the hardest truth, rem inds us that we have not and will not. Because Sartorius stands with one foot in the Civil War moment and one foot in the future present, our â€œnow,â€ the structure of this analysis constantly pairs a historical war surgeonâ€™s beliefs with the reimagined contemporary qualities of Sartorius to exemplify his radical abilities and the accuracy of what he knows. I first pair John H. Brintonâ€™s historical war doctor narrative with The March to show that Dr. Sartorius as a reimagined doctor is very much like his hi storical counterparts, but his enhanced qualities allow him the insight to teach his two lessons about the future impact of the Civil War. Secondly, I pair Dr. Grossâ€™s teaching of a conservative resection surgery in
190 The Gross Clinic with Dr. Sartoriusâ€™s te aching of a conservative resection surgery in the novel to show Sartoriusâ€™s lesson that the Civil War is always an open wound. Lastly, I pair Sartorius with Brinton again to comment on historical and reimagined interpretations of the warâ€™s temporal influen ce from Sartoriusâ€™s medical perspective. I conclude with Doctorowâ€™s reimagining of President Lincolnâ€™s medical treatment after he was shot by John Wilkes Booth. Doing so underscores how Dr. Sartorius not only teaches lessons, but he also fulfills historical fantasies of what could have been. The Reimagined Civil War Doctorâ€™s Perception Civil War surgeon Dr. John H. Brintonâ€™s historical memoir, Personal Memoirs of John H. Brinton: Civil War Surgeon, 18611865, offers us an interesting lens through which to read the medical narrative in The March. Brinton spent a great deal of time on his memoir and finished the manuscript in 1891, though it was not published until 1914. His memoir is important for my purposes because of his curator role during the war and because he contemplates the impact of the war on he and his colleagues. I pair Dr. Brintonâ€™s Army Medical Museum goals and his perception about the medical opportunities of the war with Dr. Sartoriusâ€™s reimagi ned qualities to exemplify Sartoriusâ€™s transcendent perception about his medical role and the nationâ€™s future. Sartorius thinks like Brinton, which ultimately binds him to the traditional conception of the Civil War surgeon. However, Sartorius extends Brintonâ€™s vision because he has insight that the war periodâ€™s surgeons do not have. He has what will be their future retrospect in the historical moment when they could have used it. This quality, along with his â€œforeignâ€ nature, serves as the foundation for his perception that allows him to teach his lessons. First, Dr. John H. Brinton was the wartime medical fieldâ€™s main limb digger.4 He became the collector of both freshly severed and long buried arms and legs for
191 pedagogical material. He assumed this rol e because the war changed the professional needs of nineteenth century medicine. As we know, wartime doctors were forced to confront situations that they were wholly untrained for as antebellum education was not designed to respond to the demands of military medicine on such a grand scale. Alfred Bollet notes how â€œvery little surgery of any kind was done before the war, and hardly any of the new militarized surgeons had any training or experience treating woundsâ€ (3). To remedy the lack of surgical knowledge among the eraâ€™s doctors, on June 4, 1862, Brinton was selected to prepare the Medical and Surgical History of the War of the Rebellion at the request of Surgeon General William Hammond (169). Bollet explains that this surgical history â€œ[contained] six huge volumes [of] majorinformation about Civil War medicine: approximately 6.5 million diagnosed episodes of illness and the treatment of approximately 250,000 men. The volumes also [contained] descriptions and photographsof specimens submitted to the medi cal museumâ€ (23). The making of this volume required Brinton to undertake his vast collecting mission, which led to the idea of constructing a museum. Surgeon General Hammondâ€™s idea of creating an Army Medical Museum came later when he sent a letter to B rinton asking him to be curator in August of 1862.5 Brinton delighted in this opportunity. He describes in his memoir that â€œby [the museum] the results of the surgery of this war would be preserved for all time, and the education of future generations of m ilitary surgeons would be greatly assistedâ€ (182). Brinton was aware of how the war influenced the field of medicine for the better. He believed that the museum was â€œnot for the collection of curiosities, but for the accumulation of objects and data of las ting scientific interest, which might in the future serve to instruct
192 generations of students, and thus in time be productive of real useâ€ (186). To accomplish his goals with writing and with his curatorship, Brinton procured bullets and projectiles in order to accurately understand gunshot wounds, and of course, he collected amputated body parts. Brinton â€œdug out of the trenchesâ€ infected heaps of limbs (187).6 Like Brinton, Sartorius also views the war as â€œpracticumâ€ and an opportunity to gather learning material. Sartorius digs into limbs in the novel rather than digging them up. He believes that â€œif there was any compensation for the barbarity of war, it was an enriched practice. The plethora of casualties accelerated the rate of learningâ€ ( Doctorow 272). He feels â€œaloneâ€ in this thinking, but clearly Brintonâ€™s memoir proves that the war was viewed in historical context as a giant laboratory and medical school clinic for learning. Sartorius also teaches inexperienced surgeons how to do amputations. Sa rtoriusâ€™s method of amputation is a work of art to his doctor cohort: â€œhe had the most beautiful hands, squared and strong but with long slender white fingersâ€ (58). Perhaps hands like Sartoriusâ€™s would have made a fine display in Brintonâ€™s museum. His renown, though, is for his rapidity among his colleagues â€“ a quality that many Civil War era doctors (and soldiers) thought to be extremely valuable. Sartorius was known for â€œremoving a leg in twelve seconds. An arm took only nineThere was never enough chlorof orm to go around, and so given onlybrandy a soldier would have reason to bless the doctor who did the job as quickly as possibleâ€ (58). Young surgeons look to him for guidance, though he notes later on that not all take to his instructions. This further u nderscores how Sartorius is a parallel to Brinton. However, his reimagined qualities create a point of departure from his likeness to an eminent historical medical
193 figure like John H. Brinton. Wrede Sartorius possesses the power of foresight and he is â€œforeign.â€ These traits forge his transcendent ability to envision a connection between his surgical work and the national and cultural consequences of the war. As I noted earlier, Sartorius is the doctor of the future in the past. His presence in the novel ushers in a futuristic foresight of what is to come for the medical field. Unlike historical Civil War surgeons, Sartorius is extremely experienced with surgery upon entering the war. He reveals, â€œwe know so little. Our medical service is no less barbarous than the war that requires itâ€ (59). The possibility of a more sophisticated system of practice is within grasp to this reimagined doctor. Terming the medical service as â€œbarbarousâ€ is an enduring (and popular) critique that tends to defy more positive in terpretations of the eraâ€™s hospital practices. â€œSomeday we will have other means,â€ he notes, â€œwe will have found botanical molds to reverse infection. We will replace lost blood. We will photograph through the body to the bones. And so onâ€ (59). Here, he thinks of antibiotics and x rays. These thoughts are regular to him. Southern nurse Emily Hamilton listens to these words and wonders if she hears him correctly. To the eraâ€™s learned woman or common doctor, Sartorius thinks on the fringes of madness. To co ntemporary listeners, he sees the problems of Civil War medicine before hindsight will forge them as the inherent flaws that plagued treatments of the eraâ€™s wounded: the lack of understanding regarding bacteria and infection transmission, the unknown benef its of blood transfusion, and the inability to see inside of the body without slicing into it.7 Civil War surgeons were always limited by what they could see on the outside of the body. This is where much of the medical failures during the war stemmed from . But, as the reimagined doctor, Sartorius realizes that this will eventually change. He has to have
194 this ability to conceptualize what is to come for the medical field in order to have the foresight he does about the impact of the national crisis on the f uture of the nationâ€™s body. His multifaceted foreign estrangement adds to his advanced insight. Sartorius is foreign by citizenship as he is a German national. Most importantly, he possesses an â€œemotional estrangement from the medical communityâ€ that he works with (272). This places him in a sphere unto himself outside of his medical cohort. The doctors he works with infuriate him with their refusal to let go of old practices and their old thinking. Unlike the eraâ€™s doctors, he does not constantly grapple with what he lacks. Instead, he grapples with what he knows: that no matter how much he offers his advanced knowledge, his brilliance, and his renowned skill, his colleagues will not take to what he teaches. â€œHe had become intolerant, passionately intoler ant, of traditional medical thinking,â€ Doctorow writes, â€œit did not change; it did not advance but looked dumbly upon the disasters it devised for the poor broken and mutilated boys that were its responsibilityâ€ (272). The reimagined doctor blames his coll eagues for the â€œdisastersâ€ they design with their own hands. Their responsibility is to heal and yet they employ methods that exacerbate the healing process. Sartorius, then, embodies a warning about adhering to old ways that could be read doubly: in one w ay, he speaks to the medical decisionmaking about how to treat wounded bodies, and in an extrapolated way, he speaks to the political and societal decisionmaking about how to best heal the wounded nation. Sartoriusâ€™s insight, foreignness, and, finally, transcendent ability to connect his work with the national crisis solidify his reimagined Civil War doctor perception. As he
195 works to keep so many alive, he appears above the other doctorsâ€™ nightmare of not knowing what to do. For example, in the aftermath of Sherman sending cavalry into the fray near Waynesboro, Sartorius sets up operative shop in a railroad depot. There, he was viewed with: his transcendent attentions to the war wounded. North or South, military or civilian â€“ he made no distinctions. Even now, some gray uniforms were among the bluecoats lying on their pallets. He seemed above the warring factions, Wrede Sartorius. He was like some god trying to staunch the flow of human disaster. (58) He was staunching the flow of human disaster â€“ not creating it like most of his colleagues. He staunches the outpouring of blood by plugging a bullet hole with a finger or two. Here, he performs the same procedures of his colleagues. Many wartime field surgery manuals instruct doctors to plug and probe gunshot wounds with fingers. But for Sartorius, there is more significance to the action than just keeping a body from bleeding out and dying. His actions speak to underlying national concerns about the human cost of war. He knows what is to come so he works to miti gate the tragedy. As the doctor of the future in the past, he has the vision to understand the weight of his responsibility as a surgeon in the moment and how this responsibility extrapolates to the cataclysmic ravaging of the nationâ€™s body (and bodies). E very time he cuts off a limb or resects a limb successfully back to a body or makes a decision about a life can be read metaphorically in relation to the national body. Once again considering Brinton, regardless of their perceptive differences, both he and Sartorius share an interest in what can be learned from the wounded and severed limbs of the war. Both teach that limbs and wounds can be learned from for the advancement of the medical field in the postwar era. But Sartoriusâ€™s reimagined qualities allow him the perception to see how injured limbs, severed and unsevered,
196 assume symbolic meaning. He informs us in the novel that limbs and wounds capture how the problems of the warâ€™s aftermath will impact the future recovery of the national body. For Brintonâ€™s pedagogical purposes and Sartoriusâ€™s national commentary purposes, the lessons are where Civil War doctors encountered problems but could not fix them: in the bones. Lesson One: Open Wound â€œâ€˜Somewhere in their bones,â€™â€ David Blight quotes Robert Penn Warren, â€œmost Americans have a storehouse of â€˜lessonsâ€™ drawn from the Civil Warâ€ (171). If Thomas Eakinsâ€™s The Gross Clinic is viewed as an untold visual narrative of Civil War surgery (see this projectâ€™s introduction), then the location of the lessons War ren speaks of would be in the femur of the patient Dr. Gross is operating on, diseased with infection, and desperate for remedy. If The March is examined alongside the painting, then a scene in the novel also shows that the location of the lessons would be in the â€œlong leg boneâ€ (presumably the femur) fractured from battle, producing pus like symptoms of infection, and desperate for remedy. The visual scene of the painting and the textual scene of the novel both exhibit a similar open wound to be examined and learned from. Therefore, this section pairs Dr. Samuel D. Grossâ€™s pedagogical act of teaching a surgical procedure to medical students depicted in the painting with Dr. Sartoriusâ€™s pedagogical act of teaching a surgical procedure to field surgeons depic ted in the novel. The two scenes comment on the connection between the historical Gross and the reimagined Sartorius in regards to the conservative resection surgery that they both perform. The purpose of tracing the connections between the resection operation scenes is to further underscore Dr. Sartoriusâ€™s reimagined doctor perception and the lessons he teaches in the novel. The qualities that forge his medical perception allow him to teach with his
197 actions and beliefs his first lesson, which is visually s hown in the painting, that the war is an open wound that is neither recovered nor healed. The painting scene and the novel scene are nearly identical in three ways. First, both Drs. Gross and Sartorius perform a conservative resection surgery.8 This kind of surgery was considered â€œconservativeâ€ because â€œthe procedure took much longer than amputationâ€ and required observation before action unlike the more radical removal of a limb with a procedure that â€œgenerally lasted two minutesâ€ and forever altered a s oldierâ€™s life ( Bollet 147). Dr. Gross â€œidentified â€˜conservativeâ€™ surgery as one of the professionâ€™s most importantdevelopments,â€ according to Elizabeth Johns (250). Similarly, Sartorius feels that â€œthe accepted viewthat resections usually led to postoper ative complicationsâ€ is â€œnonsenseâ€ (Doctorow 153). Like Gross, Sartorius believes in more conservative procedures. However, the caveat for him is that conservative surgery should be done with newer postoperative care methods that stem recurring infection.9 In other words, resections should be done his way. But he knows no one will listen to him. By novelâ€™s end, amputation becomes the operation that he must perform to clean up the botched resections done by inadequately trained surgeons, which draws a parall el between how the nation was put back together and how it may have fared better with newer resection practice or amputation to begin with.10 Second, both scenes involve medical colleagues observing and learning from the operation. In The Gross Clinic , Dr. Gross lectures to a group of medical students in the amphitheater of the Jefferson Medical Collegeâ€™s school clinic. He is slightly turned away from his patient â€“ presumably in midsentence â€“ with a bloody scalpel in bloody hands. Colleagues of his surround the operating table either assisting in the procedure or
198 observing closely. In The March, Dr. Sartorius stands at one of the three operation tables assembled near a field hospital. The hospital is overloaded with wounded in need of surgery, but his colleagues gather for his instruction because he â€œwas the only surgeon in the corps who did resections in the fieldâ€ (Doctorow 153). Surgeons, assistant surgeons, and army nurses congregated â€œaround the openair operating tablethe scene wasgrim, with men lying about on their litters calling for water, cursing God, screaming in pain. Yet the doctors had left their patients to observe Wrede Sartorius at workâ€ (153). Instead of lecturing while working, Sartoriusâ€™s hands move swiftly and accurately incising into â€œ the leg in two places,â€ applying â€œforceps to the major arteries,â€ and â€œpassing the threaded needle under the boneâ€ to â€œ[attach] it to a flexible chain handsawâ€ (153 and 154). His accuracy denotes extensive practice and his advanced understanding of the procedure demonstrates his medical estrangement and his futuristic know how. He moves quickly without lecturing during the surgery to keep the possibility of infection minimal. Lastly, and most obviously, both scenes involve a male patient under anesthetic w ith an open wound. Grossâ€™s patient has an infection of the femur, or osteomyelitis. The patient is a young boy laying on his right side as the left thigh is the location of the problem . â€œHis head is at the far end of the table under the anesthesiasoaked gauze,â€ Johns describes, with â€œhis sock clad feet at the near endâ€ of the table (232). The boyâ€™s face is completely obscured from sight representing a lack of identity that connects to the surgical operations done by Sartorius and historical Civil War doctors: one patient after the next, one boy after the next. Gross prepares to remove â€œa piece of dead boneâ€ in h is â€œlast stageof treatmentâ€ ( 250). The wound in the boyâ€™s leg is viscerally shown: it
199 is stretched open with retractors and the bone is slightly vi sible as it is encircled with deep red muscle tissue and blood. In the novel, Sartoriusâ€™s patient is similarly anesthetized under chloroform. This patient has a â€œsuppurating fractureâ€ in his leg, or a fracture with the presence of pus caused by infection. Unlike what is portrayed in the paintingâ€™s scene, Sartorius shows how to complete the operation. To his observers he â€œdisplayed the offending bone section aloft in forcepsâ€ and demonstrated how to complete a â€œrejoinment and closureâ€ of the wound ( Doctorow 153). He bandages the leg and places it in a box splint. Because of The Gross Clinic â€™s â€œsnapshotâ€ characteristic, the outcome of G rossâ€™s operation is unknown, and the wound is perpetually open. We do not know his methods for bandaging or closing the wound. What we do know is that based on the dim clinic setting and Grossâ€™s clothing that he is conservative not only in his surgical philosophy , but also in his entire medical treatment philosophy: he resisted changes in the 1870â€™s concerning new ideas about contamination. This highlights the possibility of vastly different outcomes between the surgical choices of the historical Gross and the reimagined Sartorius. Sartorius knows the outcome of his teaching will be what The Gross Clinic depicts: an open wound s usceptible to reinfection.11 Sartoriusâ€™s reimagined informed perception allows him the insight to see t hat, though he has completed the surgery successfully, his colleagues will resort to their old surgical practices. He thinks to himself, they are still using collodion dressings on woundswhic h almost assures inflammation. I have written papers arguing for light and air as the healing agents, but they do not listen. They do things the way theyâ€™ve always done them, because thatâ€™s the way theyâ€™ve always done them. (154)
200 If, as Warren says, Americans have the Civil War in their bones, then the visual representation of surgery in The Gross Clinic when paired with Dr. Sartoriusâ€™s operation and commentary in The March reinforces the presence of t he injury in the national body that is perpetually infected. Lesson Two: Always Now for All of Us Dr. Brintonâ€™s memoir shows that he does not have the same awareness about the impact of the war beyond the medical field that Dr. Sartorius has. Brinton does reflect upon the warâ€™s stagnant temporal feeling for doctors that is crucial in what Sartorius teaches, though. He recalls the all encompassing effect of the war on him and his fellow surgeons: for you must know that then, the War, to all of us, was ev erything, it was all in all. The past was forgotten; the future we scarcely dared to think of; it was all then the grim present, in which everyone tried to do his best. (11) The difference between what Brinton realizes and what Sartorius teaches is that â€œ the grim presentâ€ means something else entirely for Sartorius. The â€œgrim presentâ€ for Brinton is the war itself with the past gone and the future nonexistent. What Brinton describes is how scholars interpret Sartoriusâ€™s patient Albion Simmsâ€™s phraseâ€“ how â€œi t is always nowâ€ for him â€“ and that the past feels severed from the present, which is dangerous (274). Sartorius expands what Simms feels and sees beyond the injured manâ€™s perspective. The â€œgrim presentâ€ for Sartorius is a conflation of the war and what will be Americaâ€™s future: our present. Thus, he emphasizes the influence of the war and how it will always be â€œthe nowâ€ of the war no matter how time progresses. Sartoriusâ€™s insight about the temporal impact of the war is best illustrated with his treatment of Corporal Albion Simms. Simms comes to Sartorius with an iron spike in his skull, which â€œpenetrated the cranium above the ear at an angle of 180 degreesâ€ (269).12
201 Simms sustains this wound from an accidental explosion caused by unloading powder into the Saluda River in Columbia. Sartorius assesses Simms at South Carolina Collegeâ€™s hospital and finds that the corporal has extensive memory loss though he is able to answer questions. Simmsâ€™s answers tell that he has no recognition of who he is. Other surgeons, jaded by routine surgeries, rush to Sartorius and his new patient in hopes of observing a new skull operation. Knowing of their envy, Sartorius elucidates to his cohort the mechanics of Simmsâ€™s injury: If you look closely, you will see no impact fracture. It is a clean four sided penetration. Some six centimeters protrude, which means seven centimeters of iron have traversed the parietal occipital areas. And there is bone in front of it. A trepan is not possible, nor can you expect to extract the spike as you would a splinter from your finger . (269270) Sartorius disappoints the doctors by his refusal to operate. Instead of surgery, he takes Simms on the march though he knows that it is ethically wrong to do so. This speaks to his belief about the practical nature of war medicine and the opportunities for hands on learning; â€œthe possibility of learning something about the brain from the affliction of this soldier was an opportunity he was not willing to forgoâ€ (270). Sartorius knew â€œthe mind would recede in the manner of an outgoing tide. But that would be a process. Albion Simms would deteriorate under studyâ€ (270). Sartoriusâ€™s study of the deteriorating Simms yields the doctorâ€™s toughest lesson. Like Sartorius expected, Albion Simms begins to slowly deteriorate. He loses more memory, he perceives color when he hears sounds, and he randomly remembers a song that he sings over and over again though the words change. With no past and no future, Simms speaks to Sartorius in circles. He has no past and he has no future, like Brinton elucidates, but Sartorius reads into his words more. Here, Simmsâ€™ answers comment repetitively on how he understands time:
202 Yes. That is why my head hurts. Itâ€™s always now. Thatâ€™s what hurts. Who did you say I was? Albio n Simms. No, I canâ€™t remember. There is no remembering. Itâ€™s always now. Are you crying? Yes. Because itâ€™s always now. What did I just say? Itâ€™s always now. Yes. Albion, in tears, held his bar and nodded. Then he rocked himself back and forth, back and forth. Itâ€™s always now, he said. Itâ€™s always now. (274) Simms captures critical attention because of the loaded phrase he cannot stop repeating. Seymour and Barrett argue that Simms â€œembodies the loss of access to the past effected by the war; having had an iron spike driven into his skullhe is only capable of living in a perpetual present in which â€˜[t]here is no rememberingâ€™â€ (62). This understanding of Simmsâ€™s perception is similar to Brintonâ€™s feelings about the warâ€™s effects on time. Brinton felt the loss of the past as well as the loss of the future in the middle of the warâ€™s throes. Hales reads Simmsâ€™ phrase as a case of â€œhistorical amnesiaâ€ (159). He argues, â€œin many ways, Simms seems to be a symbol of twenty first century America and the hist orical amnesia it exhibited in the wake of its own massive headwound, the terrorist attacks of 9/11â€ (159). For Hales, Simmsâ€™s â€œalways nowâ€ is a commentary on the risks of living in the present without any regard to the past. His interpretation of Simmsâ€™s phrase certainly speaks to Doctorowâ€™s subtle implications of current societal issues. However, he does not consider Simmsâ€™s context. Hales detaches Simms from the Civil War. In making Simms a twenty first century symbol, Hales undoes his own argument by d etaching Simms of his historicity and forgetting who Simms is, how he was injured, and who tends to him. In this vein, Hales does not consider Dr. Sartoriusâ€™s thoughts to what Simms says. If we only consider Simmâ€™s point of view, then Halesâ€™ interpretation is
203 based on injured perception, not Sartoriusâ€™s insightful medical perception that can see beyond Simmsâ€™ view and beyond the historical moment of their exchange. Essentially, scholars fail to consider who Simms is conversing with when interpreting his phrase, and they fail to consider what the doctor concludes immediately after Simms laments that â€œit is always now.â€ Sartorius listens to the injured man and subsequently thinks, â€œmy poor fellow, itâ€™s always now for all of us â€ ( 275). Like Hales, Seymour and Barrett underscore the interpretation of historical forgetfulness. They remark that â€œ The March is making a statement about our own problematic relationship to the past, suggesting that â€˜itâ€™s always now for all of usâ€™â€ (275). Seymour and Barrett refer to Sa rtoriusâ€™s thought but do not attribute this powerful notion to him. Disregarding the entire exchange between Simms and Sartorius as well as Sartoriusâ€™s thoughts obscures a more meaningful interpretation of the conversation and the doctorâ€™s perception. I agree that any war can have the effect of severing the past from oneâ€™s perspective. I also agree that forgetting the past is dangerous because of historyâ€™s cyclical nature. Yet, when the entire scene in the novel is considered, and when what the doctor says is considered, I believe that Dr. Sartorius teaches that it will always be the Civil War for all of us. His lesson is that the war will never dissipate from our identities and our consciousness and our bones. Even when seemingly lost in historical memory, the warâ€™s legacies will always be lurking under the surface of any imagined reconciliation. One important aspect of Sartoriusâ€™s thoughts is who he references: â€œall of us.â€ Who comprises the â€œall of usâ€? I claim that Sartorius simultaneously nods to three groups. First, Sartorius refers to his medical cohort. The â€œnowâ€ of the war for them will
204 be the tragic medical legacy of the war: the lack of knowledge concerning infection. Recall how he realizes on the march that wartime medicine did not change. Instead, it â€œlooked dumbly upon the disasters it createdâ€ and looked dumbly upon the tragedies it had a hand in (literally). Second, Sartorius includes individuals who will reshape historical memory of the war into a national victory narrative. He knows that many will hold tightly to â€œrecovery attitudesâ€ in relation to the truth of the warâ€™s unsolvable problems. The â€œnowâ€ for them will be the use of the warâ€™s conclusion to cover the truth with imagined beliefs about overcoming fratricidal and racial conflict. Thi rd, Sartorius recognizes the individuals who will investigate the â€œaliveâ€ quality of the war that SusanMary Grant describes, the feeling of the war in â€œour bloodstreamâ€ that Robert Penn Warren explains , and the â€œimperfectâ€ and â€œhorrifying symmetryâ€ between now and the 1860â€™s that Stephanie A. Smith notes. Sartorius belongs in this category. He regards people like him: people who actually think about the problems that stem from the nineteenth century and how these problems perpetually permeate American identity and societal crises. Dr. Sartoriusâ€™s lessons teach that the Civil War will always be grappled over. Blame will be contemplated, but never concluded upon. Who is there better to make such a claim about the warâ€™s impact on the national body than a doctor? After all, Dr. Sartorius is the only one in the novel who gives answers about bodies. He teaches that the wounds of war were operated upon, but not quite fully closed. The war will always be open for all of us. Doctorowâ€™s revolutionary surgeonâ€™s fi nal moments with President Abraham Lincoln in the novel are worth noting because what he does and what he says solidify
205 his function as a reimagined Civil War doctor: to imagine and fulfill historical fantasies. The historical narrative of President Lincol nâ€™s assassination is well known. On April 14, 1865 at Fordâ€™s Theatre he was shot in the head from behind by John Wilkes Booth. Lincoln was taken across the street to the Petersen house and placed in a bed too small for his lanky frame. He passed away the next morning. Perhaps the most striking part of President Lincolnâ€™s assassination is that the first doctor to reach the president after being shot was a twenty three year old young man ripe out of medical school. Dr. Charles A. Leale had responded to an audience memberâ€™s call for a surgeon. Six weeks previous to this moment Leale had completed his studies at the Bellevue Hospital Medical College in New York. Youthful, yet trained, he reached the theatre box occupied by the Lincolns and began an assessment of the prostrate president. In a recently discovered first draft copy of Dr. Lealeâ€™s medical report written on April 15, he describes, when I reached the President he was in a state of general paralysis, his eyes were closed and he was in a profoundly comat ose condition, while his breathing was intermittent and exceedingly stertorous. I placed my finger on his right radial pulse but could perceive no movement of the artery. (3) He then held Lincolnâ€™s head and shoulders and came into contact with a clot of blood. He removed the clot and felt inside the bullet hole. This caused for the wound to release blood, which improved the presidentâ€™s breathing. Brandy and water were then admi nistered to Lincolnâ€™s mouth, and he was moved and warmed with heated blankets at the request of Leale. Leale abdicated his main role when Dr. R.K. Stone, the presidentâ€™s personal physician, arrived. Leale notes in his report that Stone â€œapproved of the tre atmentâ€ (5). The Surgeon General arrived moments later. The doctors present in the upstairs bedroom of the Peterson house desperately
206 tried to figure out what to do with the revered man. They probed the bullet hole in his head with fingers and instruments. They repeatedly removed clotted blood from his wound. They felt his pulse and listened to his breathing slow, quicken, slow, and finally cease. No matter their reputation or experience, all of the doctors that treated the president, in that moment, wer e as green as Charles Leale. Minutes before 7:20 a.m., the time of Lincolnâ€™s last breath, Leale recalls, â€œthe Surgeon General now held his finger to the carotid artery. Col. Crane held his head, Dr. Stone who was sitting on the bed, held his left pulse, and his right pulse was held by myselfâ€ (6). They watched the president die beneath their hands. That was it. They could do nothing. Leale recounts this moment as he and his medical colleagues held history in their hands â€“ a history that America cannot let go of. E.L. Doctorow rewrites the above scene from the perspective of Dr. Sartorius as a bitter surgeon who knows more than the doctors surrounding the dying president. Sartorius arrives to the Peterson House and examines Lincolnâ€™s head wound. At that moment, another doctor reaches to the wound and removes a blood clot. Wrede notices, but says nothing. Doctorow writes, â€œthis and the mistaken application of brandy to the Presidentâ€™s lips, causing him almost to choke, and the placing of hot water bottles at hi s feet, andrecording his vital signs, were all that thesedoctors in attendance were able to doâ€ (351). Wrede does not probe the wound. He kneels next to Lincoln and finds that the presidentâ€™s pupils are dissimilar with the pressure of blood behind one ey e. Frustrated, he â€œstood and was suddenly enraged at the number of doctors in the small roomâ€ (351). Coolly he announces, â€œhe is finished, he will not last the hour. Your medicine is uselessâ€ (351). He rushes out infuriated. Sartorius, estranged from the
207 medical men around him, says your medicineâ€“ not medicine in general, and perhaps most telling, not our medicine. This statement, once again, places him outside of the eraâ€™s medical cohort and in a category unto himself. Based on his assessment of the president and the words of contempt he speaks to them, he is most enraged at how all of them have failed. Sartorius disappears from the novel into the fog of the early morning just as Lincolnâ€™s last breaths expire. Dr. Sartorius evokes reimagined fantasies of what could have been on the night of April 14, 1865, but then confirms the tragedy of Lincolnâ€™s death. What if a seasoned veteran surgeon far beyond his ti me had been there in the theatre and not the young Charles Leale? If Sartorius had been the one to make it to President Lincoln first after Boothâ€™s gunshot, perhaps Lincoln may have lived and Reconstruction may have produced a very different outcome for the nation. As we know, Lincoln viewed himself with the responsibilities of a surgeon. Imagining the po ssibility of his survival, even for a moment, opens up the fantasy that Lincoln could have resected the national body without the old reasoning that was ultimately used, which, as is shown in the previous chapter, resulted in a perpetual reinfection of rac ism and ideological difference. After all, Lincoln was poised to usher the nation in a progressive direction. Lincolnâ€™s 1862 message to Congress echoes the urgings of Dr. Sartorius to his medical colleagues: â€œthe dogmas of the quiet past are inadequate to the stormy presentas our case is new, we must think anew, and act anewâ€ (Warren 18). Think anew. Act new. But, this does not happen. Thinking anew did not gain much ground in the postwar period as the meaning of the war was negotiated in favor of forgetti ng E mancipation. I n The March, the seasoned veteran surgeon far beyond his time was not in Fordâ€™s Theatre, and even
208 though he existed, he appears at the moment of Lincolnâ€™s death to confirm that no amount of modern medicine could save the eminent man. The tragedy of his death is what Sartorius affirms throughout the novel: he knows what is to come for the nation, and the medicine that will be used to doctor America back together will only do more harm than good. Dr. Wrede Sartorius teaches us that perhaps America is like Dr. John H. Brinton, Dr. Samuel D. Gross, and Dr. Charles A. Lealeâ€“ arriving to the crisis again and again â€“ hanging on to old curriculums and old ways. We will not be able to reconcile the â€œsurgicalâ€ decisions made by hasty postwar surgeons who refused Lincolnâ€™s dogmas of anew. We just do not know how to use the tools in our operating bag of analysis and negotiation. But, we will try anyway knowing all along the inevitability of the outcome: unsevered limb of historical memory with a sensit ive open wound. Some refuse the â€œhistorical realism and self criticismâ€ that only â€œ[compounds] old inherited delusions,â€ Warren tells us (76). Many believe that the â€œdiseasesâ€ of the war â€“ racial, ideological, and regional differenceâ€“ have long been eradicated. Assessments of the historical trajectory from Reconstruction onward, the current social politics that entrench our country in struggle and division, and the medical narrative of The March exemplify that the nation will never pulsate to one heartbeat. The reimagined Civil War doctor, this doctor of the future in the past, with his advanced medical knowledge, his foreign nature, and his transcendent qualities in the war moment, teaches us the hard reality that the nation never did pulsate to one heartbeat and never will .
209 Notes 1. For more on the medical challenges of new warfare, see Dr. Ronald J. Glasserâ€™s Broken Bodies, Shattered Minds: A Medical Odyssey From Vietnam to Afghanistan. New York: History Publishing Company, 2011. 2. Surgeon John Julian Chisholm was one of the first doctors to publish a military surgical manual in 1861 after the beginning of the Civil War. In his manual he refers to the course of disease and the path of a bullet through the body as â€œthe marchâ€ (210). H ow fitting that Chisholmâ€™s choice of medical words matches the title of Doctorowâ€™s Civil War novel. See J. Julian Chisolm, M.D. A Manual of Military Surgery for the Use of Surgeons in the Confederate Army; With an Appendix of the Rules and Regulations of t he Medical Department of the Confederate Army . Richmond: West & Johnston, 1861. 3. Historically, the aftermath of Civil War battle could be viewed as the most devastating because that was when the reality of the consequences came to light for both combatants and noncombatants. The most important individuals in the aftermath of battle for the surviving wounded were the doctors. Charged with making assessments, performing procedures to save life or limb, and diagnosing, doctors gave the final word on the futur es of countless identities. The stereotypical Civil War doctor remains strong in historical imagination, along with the amputation scene that is paradigmatic to all narratives of the war. He carries calomel in one hand and a saw in the other, one for disease and one for amputations. Doctorowâ€™s Dr. Sartorius carries these tools. But, he carries with him a perceptive vision that allows him to see beyond the usual procedures. And that makes all the difference. 4. John H. Brinton graduated from the University of Pennsylvania in 1850 and from the Jefferson Medical College in 1852. He was commissioned as a brigade surgeon (U.S. Volunteers) in August 1861. When under General Grant at Cairo he became his trusted medical director. Brinton was a man of high places. He regularly conferred with General Grant and Surgeon General Hammond. Interestingly, Brinton is connected to both Dr. Samuel D. Gross and artist Thomas Eakins. In 1882, Brinton became professor of surgery at Jefferson Medical College. His antecedent was Dr. Gross. Thomas Eakins also painted a portrait of Brinton. 5. According to Bollet, â€œHammond brought several capable young physicians into the Surgeon Generalâ€™s Office, including John H. Brinton, Joseph J. Woodward, George Otis, and John Shaw Billings. They wer e instructed to establish a â€˜medical museum,â€™ in which research would be conducted on the medical and surgical problems of the war and illustrative specimens would be collected. This museum was, in fact, a research institute that evolved into an internationally respected research organization, the Armed Forces Institute of Pathologyâ€ (22). 6. Not only did Brinton dig up limbs and other materials for display, but he also disseminated his surgical expertise by performing operation instruction for green surgeons. He recalls, â€œthe surgeons under me wereinexperienced, and I had to do
210 many operations, and also teach them how to do themâ€ (90). Brinton believed that the war provided an opportunity for practice that would refine surgical skills. Not all of his students followed his example though. One young Illinois surgeon, for instance, implored Brinton to show him how to do an amputation as he had never done one before. Brinton explained to him how to do the surgery and forced him to perform it on his own to build his confidence. Later on in the war Brinton came across this surgeon again. This time, he met him at the end of a trail of blood. Told that a regimental surgeon was amputating away in an upstairs room of an abandoned house after a battle near Fort Donelson, Brinton rode to ascertain the identity of this experienced man. He recalls what he found after walking up bloodsoaked stairs: â€œamputated arms and legs seemed almost to litter the floor; beneath the operating table was a pool of blood, the operator was s meared with it and the surroundings were ghastly beyond all limits of surgical propriety. â€˜Ah doctor,â€™ said the new fledged surgeon, â€˜I am getting on, just look at these,â€™ pointing to his trophies on the floorâ€ (91). Overzealous surgeons appeared to be a l ess desirable byproduct of the practical nature of war medicine that Brinton truly believed in. Not adhering to instruction is a problem that Dr. Sartorius similarly grapples with in The March. 7. Bollet notes that after hearing a lecture by French surgeon Dr . Charles douard Brown Squard on â€œblood transfusions to treat lifethreatening hemorrhage, mostly for obstetrical patients with massive postpartum bleeding,â€ Union surgeons tried transfusions in two documented cases (185). One case was successful, the ot her was not. 8. See previous chapter. 9. Doctorow situates Sartorius in the culture of medical debate concerning wartime amputations and resections. The medical field underwent a great conversation about how to best handle the new frontier of gunshot wounds that the war occasioned. Dr. Frank Hamilton, in his manual for example, tersely notes that â€œresectionpresents feeble ground for hopeâ€ (166). In fact, Hamilton does not include a chapter on resections in the manual at all. See Frank Hastings Hamilton, M.D. A Practice Treatise on Military Surgery . New York: Ballire Brothers, 1861. 10. As the war comes to a tumultuous close, Sartorius comes to terms with his colleaguesâ€™ methods when assigned to Washingtonâ€™s U.S. Army General Hospital. There, â€œadditional surgery had to be performed in the cutting away of gangrenous tissue, or the removal of limbs that had failed of resectionâ€ (350). Sartorius is the doctor who must fix failed resections with amputation. Instead of being the surgeon who makes decisions about the cour se of treatment upon wounded soldiers, he becomes the surgeon who must fix the consequences of the operative and postoperative decisions made by other surgeons. He must save the integrity of patientsâ€™ bodies knowing all along that if the surgical operation went differently or different bandages were used the gangrene would not have set in and the limb could have been saved without infection.
211 11. In the war moment, Sartorius knows that for the future the consequences of the war will never be fixable because of t he obdurate nature of powerful ideologies â€“ both medical and political. He knows the nation will be put back together with old beliefs after warâ€™s end. Just like the eraâ€™s doctors often stuck to their old methods, Sartorius infers that the national body will be resectioned with conservative force. 12. The fact that Simmsâ€™s injury does not kill him right away certainly nods to one of the nineteenth centuryâ€™s most famed occurrences, Phineas Gageâ€™s accident. On September 13, 1848, while working on a railroad, a tam ping iron about three feet long impaled into Gageâ€™s face and skull. The accident did not kill him or impair him right away. In fact, he lived for eleven years after the removal of the iron. For more on Gage, see John Fleischmanâ€™s Phineas Gage: A Gruesome but True Story About Brain Science . New York: Houghton Mifflin Company, 2002. C HAPTER 7 AFTERWORD: REHINGING LIFE/SCALPEL TO TEXT: NARRATIVE MENDING IN DR. DAVE HNIDAâ€™S PARADISE GENERAL1 Iâ€™ m here to pull bodies out of a sausage grinder, if possible, with out going crazy. Period. â€“ Dr. Hawkeye Pierce M*A*S*H 4077th The bodily results of war still continue to serve purposes beyond the battlefield hospital. During the 2012 presidential election, President Barack Obama used amputee imagery to make his point about the nationâ€™s status trying to forge ahead after economic devastation. He said, And I think about the young sailor I met at Walter Reed hospital, still recovering from a grenade attack that would cause him to have his leg amputated above the knee. Six months ago, I would watch him walk into a White House dinner honoring those who served in Iraq, tall and twenty pounds heavier, dashing in his uniform, with a big grin on his face; sturdy on his new leg. And I remember how a few months after that I would watch him on a bicycle, racing with his fellow wounded warri o rs on a sparkling 1 Reprinted with permission from Sarah K. Traphagen. â€œRe hinging Life/Scalpel to Text: The Wounded War Doctor and Narrative Mending: A Surgical Analysis of Experience in Paradise General: Riding the Surge at a Combat Hospital in Iraq by Dr. Dave Hnida .â€ The Journal of Military Experience Vol. 2 (July 2012): 256 270.
212 spring day, inspiring other heroes who had just begun the hard path he had traveled. He gives me hope. (8) The hope that President Obama feels can surely be attributed to the resiliency of this individual and because of new technologies t hat replace limbs. Like this project shows, wartime medical discourse does a great amount of conceptual work in capturing the reality of national circumstances. At the core of this discourse, however, is the actual experience of where the discourse emerges from and what this project hones in on: the war surgeon in the hospital performing operations and coming to terms with his own limitations and his own miracles. As we ponder the sesquicentennial anniversary of the American Civil War, the horrifying blunders in that eraâ€™s medical and surgical practices, and the very fact that this nation has been at war for many years, we recognize how different war has become over time. We also realize how different combat medicine is because of the devastating necessit y caused by changing warfare. Confronted with the medical realities of Iraq and Afghanistan, the treatment of wounded military service members is vastly more advanced, and, because of this, the impact on lives is a delicate combination of the physical and psychological. Dr. Ronald J. Glasser states an unfortunate and blatant truth concerning this impact: there have been 1.9 million soldiers and marines deployed to Afghanistan and Iraq over the last decade, with over 5,000 killed, some 300,000 wounded, anot her 250,000 diagnosed with PTSD and over 300,000 with traumatic brain or concussive central nervous system injuries, along with amputees approaching l evels not seen since our Civil Wary ouâ€™d think that so many wounded, if not dead, would be hard to ignore. But they are. (11) Acknowledging the sincerity of warâ€™s traumatic impact upon these military servicemen and women, the memoir discussed here reorients the focus of psychological â€œwoundingâ€ to the individuals charged with the excruciatingly painful and infinitely rewarding work of
213 saving military service members from war injuries. First, let us consider the medical realities of todayâ€™s combat surgeons. What war doctors confront today is complex and requires an advanced capacity for accuracy as well as ingenuity. Being a war doctor demands undeniable resilience, fortitude, and acceptance. Because of the nature of new wounds sustained in combat, surgeons now accept that not everything can be fixed. As a result, doctors practice what Dr. Glasser regards as â€œDamage Control Surger yâ€ in which they rarely see wounded individuals longer than a few hours. Within that short amount of time they do what they can to keep patients alive in order to send them along the medical chain of survival. The reason for this type of surgery and movement â€œis because our troops are no longer being shot at; th ey are being blown upâ€ ( 82). IED injuries signify a point of change in how the human body sustains war wounds as these injuries come from every angle and inflict devastating damage. Glasser further delineates that, because the wounds are of this nature, the accompanying suffering is that much more intenseâ€“ for the person who sustains the wounds and any person administering care. He explains in succinct terms what new warfare equals: â€œnew weapons â€“ new treatments and procedures â€“ a new kind of sufferingâ€ (83). The impact from this agonizing novelty is telling: many doctors and other medical participants have published memoirs and narratives about their experiences in Iraq and Afghanistan. In the combat hos pital literature of today, doctorsâ€™ and nursesâ€™ knowledge is tremendously advanced, the technology is progressive, the rapidity and movement of handling wounded bodies is organized, and the survival rate is positive. But, the experience of working to mend wounded bodies in a setting meant to wound
214 them is the same as it ever was in any war because traumatic impact is timeless. In fact, as these narratives exemplify, war is timeless. Even with this truth, Elaine Scarry theoretically poses that â€œwhile the central activity of war is injuring and the central goal in war is to out injure the opponent, the fact of injuring tends to be absent from strategic and political descriptions of warâ€ (12). An outpouring of combat hospital literature provides a remedy for this absence with description after description of the inevitable consequences of injuring in war, which begs the questions: what does war do to those who work tirelessly to fix these consequences? And how might they overcome the impact of this work? So m any years after the reflective Civil War narratives of Dr. William H. Reed and Dr. Frederick Winsor, Dr. Dave Hnida contemplates the answers to these questions . Medical Autopilot After an unannounced medevac chopper brought in a young soldier with injur ies sustained from an IED blast to the 399th Combat Surgical Hospital in Tikrit, Iraq, Dr. Hnida went into lifesaving mode. Quick at his skilled work, he noticed the soldierâ€™s swollen abdomen, mangled arms and legs, deep tissue shrapnel wounds, and peaceful untouched face. Dr. Hnida was reminded of his own children looking at the soldier, and he immediately shut out images of home at that moment so he could work. Then he and his team spent approximately â€œtwenty eight minutes of medical improvâ€ to stabilize this patient for surgery. Hnidaâ€™s uniform, soaked in the soldierâ€™s blood, felt warm and reiterated to him his purpose: â€œthere was a young man who belonged to that blood, and now he belonged to meâ€ (92). He and his colleague, Dr. Rick Reutlinger, scrubbed i n for surgery and worked diligently to keep the young man alive so he could be moved. The
215 soldierâ€™s condition was beyond critical and both Dr. Hnida and Dr. Reutlinger were forced to confront this fact. Informing the soldierâ€™s unit anxiously waiting outside of the hospital of his critical condition silently wounded the doctors charged with putting back together â€œhuman jigsaw puzzles.â€ After speaking with the unit, they exchanged glances that expressed a hurt they could only share with each other. Surgeons s ave. And war constantly works against that axiom. Most likely similar to all of the lives that came before Dr. Hnida, this life that now belonged to him carried a photograph of his family in his wallet. Looking at the photo, he recognized, â€œI was one st ep from losing my sanity. The photo had blown a giant hole in my protective armorâ€ (94). An integral part of his daily routine, Hnida and his colleagues donned their uniforms and boots, secured their pistols, wielded their scalpels, and positioned their mental armor as protection against the wounds waiting for their care. For this case that he describes, Hnida felt the wounding of a life that he could not save, though he and his colleague saved him long enough to be sent home so his family could say goodbye. Hnida was concerned about the lives he went there to save long before he walked through the CSH doors. Before he left for deployment, he asked himself about the good he could do by going: â€œcould I and would I make a difference?â€ (16). There is no quest ion that his story tells us that he did. With every turn of the incoming medevac blades he heard standing in the trauma bay waiting, he thought about a life coming to him in need of his care. Every patient he encountered had a history, memories, families, perhaps life beyond their own, and photographs in their wallets or uniform pockets to prove it. But, what about the life of Dr. Hnidaâ€™s mind? In his efforts to make a difference,
216 his memoir candidly shares moments that indicate he felt inner wounding from his experiences. Of the young soldier he worked to keep alive knowing all along the inevitable loss, Hnida reveals, â€œI felt Iâ€™d never truly wash his blood off my skin, just like I could never get the pungent odor of charred flesh to leave my nostrils; they were my scars of his battleâ€ (95). My scars. What we learn from Dr. Hnida is that he engaged in his own inner battles in his efforts to save lives. His memoir offers a unique view of how he tends to his wounds and scars through writing. From a literary perspective, what Dr. Hnida does through poignant and illuminating narration of his experiences is similar to his wartime medical work: careful analy sis through textual surgery. About 150 years ago, in the middle of the chaotic, bloody, and gory atmosphere of a Washington, D.C. Civil War hospital, another man engaged in textual surgery as he wrote of the visual traumas taking place before him: Walt Whitman watched surgeons at work, tended to the dying, and poetically noted, â€œI myself become the woundedâ€ (1898). Whitman was a keen observer of the tragedy of Civil War surgeonsâ€™ work. As this study discusses, Civil War surgeons were limited in treating wounded soldiers only by what they could see, and they often did more wounding than healing. Whitman felt deepl y anguished by what he witnessed, and the eraâ€™s doctors likewise felt the impact of what they could not do. Dr. Hnida tells us that during the Civil War a phrase was coined by surgeons â€œto describe the process of a body rapidly going into shock, or, a condition where blood ceases to clot, the blood pressure plummets, and the heart exhausts itself to a standstill: the rude unhinging of the machinery of lifeâ€ (89). Whitman no doubt stood close by observing perplexed surgeons witness this unhinging and desperately try to figure out a way to rehinge the machinery of the failing lives in front of them. Hnida
217 shares that he and his colleagues likewise â€œreluctantly joined the centuries old fraternity,â€ side by side with Civil War surgeons, watching the rude unhing ing (89). In writing his memoir of the hospital, like the writing of Whitman, Hnida joins an array of historical voices analyzing and narrating warâ€™s medical traumas. Traumatic situations for Dr. Hnida appear as such in narration because of his internal contemplation that accompanies description. These two aspects in his writing enlighten us to his analytical method, which resembles his skills as a surgeon. Surgical procedures require a seamless informed relationship between thinking and doing, and his writing and narrating exemplify this seamlessness. His hands (writing) and his mind (thinking) coalesce to deconstruct and reconstruct each experience, similar to employing surgical skills, in order to identify the most traumatic of wounds. He conflates the past and present in his memoir by describing fast paced action at the same time as thinking and examining his feelings in those rapid moments. He alternates paragraphs between action and thinking, and he conveys pulsing thoughts and movements through quic k, terse sentences. For example, his â€œAnatomy of a Traumaâ€ chapter is most representative of what his memoir accomplishes. His writing places us not only in the trauma bay with him, but also within his perception while he does exploratory surgery by memory of the situations he endured. In this chapter, over a period of nine minutes that are listed by thirty second intervals, Hnida retells and retraces his steps, thoughts, and movements. He anatomizes the situation, which is compacted into a short period of time, yet speaks voluminously of the impact of what he did and how he works through it suturing and learning. Writing this anatomy, Hnida explains, â€œit took nine minutes from front door to OR
218 for my patient. Nine minutes where I became a short story in this soldierâ€™s life. I realized he probably wouldnâ€™t remember me and we would never meet againâ€ (148). Until now in this memoir. Looking back while writing as if in the present, his memoir does what Whitmanâ€™s speaks of about the wounded soldiers he could not forget: â€œeach linehas its history. Some pang of anguish, some of tragedyOut of them arise active and breathing formsâ€ (4). Indeed, active and breathing forms to be mended. Scalpel to text. Every Slice, Every Stitch In Paradise General , out of each li ne is a form to be mended. But the forms are not just patients; the forms are also moments. These moments that arise in remembering and writing the text allow for Dr. Hnida to resituate himself from looking at the patients who came to him to looking at him self and how he felt during these moments. With this reoriented scope, two important elements emerge that suggest wounding from the war surgeon experience and healing through textual surgery. The first element is a recognition and retelling of the demands of the war doctorâ€™s experience, specifically impossible expectations, the ethics of decision making, and loss. And the second element is the psychological subjectivity involved with that experience, or what he does in conflating his surgical/writing abilit ies. Essentially, the medical field and expectations go hand in hand. According to Dr. Glasser, â€œthere is a new normal inmilitary medicine [which] has become the norm for battlefield care. It is no longer expertise in medicine or surgery that is expected, that much, for better or worse, is simply assumedâ€ (79). Assumptions about expertise in battlefield medicine create expectations and stress far beyond what can be fathomed outside of combat zones. Dr. Hnida shares the vast difference between how he prac ticed medicine at home in the safe confines of America and how he practiced
219 medicine in the middle of a space designated for injuring on a scale only known to war. Narrating from a distance of these expectations and stresses, Hnida explains that he learned to interpret severely wounded bodies under impossible pressure. Though pressure and expertise are evident aspects of any doctorâ€™s occupational experience, combat medicine is different in the most intricate of ways. He reveals that he had to â€œsign forms th at authorize giving unmatched blood, a signature that would be medical malpractice back in the Statesâ€ (148). War medicine grants a license to do what is necessary because saving lives â€“ quickly â€“ is what is most important. War medicine demands surgeons to mak e choices about lives only known to the combat hospital setting, therefore increasing the possibility of needing to reexamine potentially traumatic situations. Hnida and his colleagues were constantly forced to make decisions based on gut instincts and ex perience rather than technologically advanced measurements, and they had to do it in the matter of seconds. Only having seconds to determine the trajectory of a personâ€™s life weighed heavily especially with the pressure of expectation so readily bestowed u pon them by their superiors, patients, and circumstances. Of course, they succeeded so often with their decisions, however the experience of making those choices and dealing with moments of failure is what is important here with Hnidaâ€™s self reflective nar ration of being a war surgeon. His self reflective narration reveals that making decisions in a combat hospital setting can be psychologically wounding because the most critical of cases forced him to decide without a great amount of contemplation. How he conveys this is he first writes of his immediate reaction as a surgeon in medical expertise mode. Then, he
220 writes about how he later internalized the situation through reflection on the chaos and how he felt making decisions. Through Hnidaâ€™s poignant wri ting we feel the pressure he felt making a decision about how to treat a wounded soldier followed by his anxiety of wondering whether or not his decisions were right when a patientâ€™s life hung by a thread. Sometimes by his threads. The tying of every stitc h. Often the dreaded medical reality of a life â€œhanging by a threadâ€ for Hnida was all he had to hold onto laying in his bed at night thinking through every move of his gloved hands. Moves that were always, at least on some level, decisions that would impact more than just the patient. Making choices about the lives of wounded individuals requires extensive knowledge and experience. Hnida shares an instance when making a decision demanded a reexamination of medical ethics. War tends to reshape and reorgani ze ethical questions and problems, but for those with the occupation of fixing warâ€™s consequences, when a battle of ethics ensues, the beauty is that Hippocrates always wins. Dr. Hnida and his trauma team, as well as each medical member of this memoir, exe mplify working to save all without prejudice because, as he so movingly states about treating an insurgent, â€œthe X rays on the OR viewbox didnâ€™t list nationality, the scalpel didnâ€™t cut differently into flesh that was hostile, and the blood pooling inside the pelvis was just as red as what flowed through our veinsâ€ (87). Yet, in this case of warâ€™s irony, Dr. Hnida questioned his ethical decisions and wondered about the life he worked desperately to save knowing all along that life had just wounded American soldiers. A few hours after the American wounded were rushed in with severe injuries from a nearby IED blast, the insurgent who had dug and planted more than one bomb came into the trauma unit with gunshots to his body. Regardless if the scalpel did not cut
221 differently into hostile flesh, Hnidaâ€™s internal battle while treating the enemy is evident in the text by his designation of â€œAmericanâ€ to bullets sustained in the insurgentâ€™s pelvis and blood pumped into this body. Though he works to save with his doctor knowledge, he also remembers the military uniform he wears and what that means to him. Here, we see that the combat hospital demands an altogether different kind of duty for the war surgeon where the patients are equally deserving of care, but do not share ideological loyalties. Within these dividing circumstances the right decision for each doctor and medical member is to act and save without thought, but the inevitable thoughts are there just the same. â€œWhat kind of doctor walked away from his own GI s to try to save an enemy bomber?â€ Hnida asked himself after scrubbing in to the OR (87). Clearly, the memoir as a whole answers this question and that is the kind of doctor that Hnida intended on being before he left for deployment: one who put forth ever y ounce of his being to save each wounded individual that came into his trauma bay. And, yet, he understandably struggled with the ethics of his duties. He reveals his conscience and his struggle between how he felt and how he thought he should feel â€“ a stru ggle that war initiates but does not resolve. After this particular case, he was â€œnot sure whether it was good that a bad person had died or sad that this bad person had diedâ€ because he shares that this insurgent was a fifteen year old boy who probably dug those holes for money, but still he was the enemy (90). With this thinking, he demonstrates his awareness of his actions during his work and how he navigated his feelings after (and then again while suturing up this moment in text). He ends this particul ar episode with ambiguity suggesting that often making the right choices does not always yield the right answers. Even after time had passed for him, Hnida rethinks and understands the
222 awareness he had while treating this particular patient by reliving every slice of his (American) scalpel. Losing this patient made him question how he should feel about saving lives with differing loyalties, however as we have seen previously, losing any patient resonated far beyond the sands of Iraq. Loss is inevitable in war and in the medical field. Perhaps the most wounding decision for Hnida and his colleagues to make was to let go of soldiers that they desperately tried to save but could not. Like the instance mentioned previously about saving the soldier with the phot ograph long enough to be sent home, Dr. Hnida reveals the trauma of losing a patient in a way that literally slices to the core of his memoir with him standing over an unhinged body needing to fix wounds â€“ his patientâ€™s and his own. In this text he works thr ough the moments where the consequences of war simply cannot be fixed, and by working through these moments his narrative suggests self healing from the wounds of losing. One of the most devastating episodes that Hnida conveys in his memoir is underscore d by the following question: â€œDoes everyone agree we canâ€™t do anymore?â€ (182). What began as a seemingly routine injury ended in a reminder of simply what cannot be achieved despite doctorsâ€™ best efforts. An incoming soldier was at first alert after sustai ning wounds from an IED blast, but suddenly went into cardiac arrest as the chopper landed at the hospital. Hnida recalls the medics rushing him into the hospital while performing CPR. He articulates this experience by noting the collision of fast paced ac tion with slow motion sensory overload from where he waits for the patient. Narrating, he recognizes the chaos but remembers that he was able to hear the clock ticking on the wall, the wheels of the stretcher moving toward him, as well as the clear
223 commands for blood, and he could see the pale white young man without a pulse and no outward wounds to be found. Hnida and his team worked on this soldier until they realized that his spinal cord had disconnected from his legs because of a shattered pelvis. Nothi ng more could be done. At this moment, each person involved with this patient had to answer the impossible question about continuing lifesaving. Each person had to nod in the affirmative to stop their medical autopilot. Hnida shares that, though he had t o shut off his autopilot and walk away, this young soldier would forever stay in his mind as a wound to revisit and mend in a textual space not bent on injuring. He emphasizes his hurt the most after losing this soldier with his recognition of the traumati c impact of his work: the death of the young soldier hurt with a pain none of us could put into words. We are not gods. Sometimes we make mistakes. And even when we donâ€™t, we suffer because we are not able to undo the damage one human can inflict on another. Each of us would see this young manâ€™s face for the rest of our lives. (182183) The most important part of this recognition for him is the fact that he and his medical colleagues do, indeed, suffer for not being able to fix what war creates and demands. Not being able to undo the damage one human can inflict on another is a reality Hnida confronted when working, and undoing the damage upon himself of confronting this reality is what he does in writing. Further, Dr. Hnida teaches us once more in this moment about the novelty of what current combat doctors confront, and in his case, reconfront. The new wounds this young soldier sustained were completely internal and caused by the shock waves of an IED blast. In another twisted case of historical war irony, Dr. Hnida and his colleagues once again joined the fraternity of Civil War surgeons about the wounds from that war:
224 â€œthe problem is often what you cannot seeâ€ (181). What cannot be ignored here, too, is that this problem is eerily reminiscent of the invisibility of psychologically traumatic wounds carried home by so many veterans of war. In writing this memoir, Hnida makes visible the invisible. The surgeon as writer emerges so clearly: when a wound is seen or uncovered from not being seen right away, a decision can be made, and the probability of failure in healing diminishes. Recall the questions posed earlier about those who fix the consequences of war and how they might overcome the potentially traumatic circumstances and wounding of such wor k. The answer to the questions is to do in another way what they are so beautifully skilled at: mend. Dr. Hnida shows us the possibility that every wound the war surgeon encounters becomes his or her own in a quick, poignant process of working to save a severely injured life. He carefully explains that by saving a life, a doctor saves the memories of that wounded individual. And, in turn, by saving a life, a doctor internalizes his or her own actions, feelings, and wounds, which then become memories. Savi ng a life strengthens his medical expertise and his ability to retain his memories of healing so that he might later on heal his own wounds from encountering the inevitable loss of wartime medical practice. In a way, this dual saving described by Dr. Hnida forms his ever present effort in the narrative to place his scalpel/pen to the past and to the metaphorical body of his mind. This act of textual surgery transcends his writing moment and allows him to surgically analyze the experience of being a war doct or piece by intricate piece, and then subsequently mend any opened wounds through narrative healing. Or, in other words, to rehinge the machinery of life of what was experienced. With each circumstance and his analytical consciousness in view, Dr. Hnida
225 works through the intense realities of the combat hospital and confronts how he navigated such realities by exploring the meaning of the hospital space in war. The hospital concentrates the physical and emotional traumas of combat, the aftermath, the cost, and the impact of witnessing into one confined space. What he and his fellow war surgeons come to realize very quickly is that despite rigorous training and hours in practice, nothing could have adequately prepared them for the impact and the lasting results of combat medical work. Dr. Hnida shows us that the war surgeonâ€™s experience as a doctor in America facilitates a translation of knowledge into the war hospital, but the feelings accrued in the war hospital spaceâ€“ feelings that are more powerful, intens e, and moving because of the setting and circumstances â€“ do not translate back into their home lives, town practices, or city hospitals when deployment is over. However, he attempts to translate the weight of war medical expectations upon him and his colleag ues through narration. He states that his memoir is really more about life than loss. Narrative mending. The Final War Body While reading this memoir one cannot help but notice quips and perfectly delivered humor so reminiscent to Alan Aldaâ€™s character Dr . Hawkeye Pierce from M*A*S*H . In an episode that pushes Pierce to the edge, he succinctly describes his purpose for enduring the traumas of war: to save kids from the sausage grinder. He notes that he must do so without going crazy, which suggests the evi dent notion that what he is doing, what he encounters, and his environment constantly work to shred that sanity. Humor and an everlasting bond forged in bloody gloves, OR masks, and incoming wounded save Pierce and his motley crew. Humor in the combat hospital setting is another necessary surgical tool to keep the life of doctorsâ€™ minds from
226 completely unhinging. Hnida writes of both severely traumatic moments while offering a portrait of his camaraderie with the other doctors he saved lives with. Undoubtedly, they helped save one another. Near the end of his narrative, Dr. Hnida ties up the last sutures of his experience by sharing an oft noted truth for any individual who has experienced war: â€œyou may leave the war, but it never leaves youâ€ (276). He may have left his mended (and lost) patients to the past when he boarded the plane to go home, but their wounds and the wounding of his work never left him. Every day as a combat doctor he prayed that he could do well what he went to war for: to fix the consequences. He was so concerned about this that he made flashcards outlining medical procedures in case he came across a wound he did not know how to mend. He never used them. His power to save always remained firm in his surgical ability. And we know that this surgical ability emerges so intricately in the text of his memoir. In writing Paradise General the final war body that he mends is his ownâ€“ wielding his scalpel, wielding his knowledge, and his pen, he mends through the text with each word and sentenceâ€“ sewing up and understanding that no matter how long each wound heals, some scars of knowing and experiencing will remain. But, amid those scars, he proves his lifesaving abilities on a multitude of levels in writing this memoir. Dr. Hnida rehinged so many lives, and what he achieves in narrating his experiences is carefully connected to the daily hope and most important goal he carried with him while in the middle of a war constantly trying to unhinge and then again at home answering the call of need as a doctor in his community. Therefore, this memoir is a life saved or a life re hinged. His life.
227 APPENDIX THE GROSS CLINIC BY THOMAS EAKINS Figure A 1 . The Gross Clinic (1875) by Thomas Eakins. Courtesy of the Pennsylvania Academy of the Fine Arts, Philadelphia. Gift of the Alumni Association to Jefferson Medical College in 1878 and purchased by the Pennsylvania Academy of the Fine Arts and the Philadelphia Museum of Art in 2007 with the generous support of more than 3,400 donors.
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239 BIOGRAPHICAL SKETCH Sarah K. Traphagen completed her Bachelor of Arts in English with minors in History and Womenâ€™s Studies at Niagara University in 2008 and her Master of Arts in English at the State University of New York at Buffalo in 2010. She received her Doctor of Philosophy in English in the summer of 2014.