Surgeon in Blue: Jonathan Letterman, the Civil War Doctor Who Pioneered Battlefield Careby Scott McGaugh
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Jonathan Letterman was an outpost medical officer serving in Indian country in the years before the Civil War, responsible for the care of just hundreds of men. But when he was appointed the chief medical officer for the Army of the Potomac, he revolutionized combat medicine over the course of four major battles—Antietam, Fredericksburg, Chancellorsville, and Gettysburg—that produced unprecedented numbers of casualties. He made battlefield survival possible by creating the first organized ambulance corps and a more effective field hospital system. He imposed medical professionalism on a chaotic battlefield. Where before 20 percent of the men were unfit to fight because of disease, squalid conditions, and poor nutrition, he improved health and combat readiness by pioneering hygiene and diet standards. Based on original research, and with stirring accounts of battle and the struggle to invent and supply adequate care during impossible conditions, this new biography recounts Letterman’s life from his small-town Pennsylvania beginnings to his trailblazing wartime years and his subsequent life as a wildcatter and the medical examiner of San Francisco. At last, here is the missing portrait of a key figure of Civil War history and military medicine. His principles of battlefield care continue to be taught to military commanders and first responders.
“With sensitivity and insight, Scott McGaugh presents the story of this fascinating figure and his legacy, which has saved uncounted thousands of lives of soldiers wounded in many wars.”
James M. McPherson, author of Battle Cry of Freedom
“Jonathan Letterman’s revolutionary medical innovations touch lives every time 911 is called for a trauma incident, a patient arrives at an emergency room, a medic treats a wounded warrior, or medical supplies are delivered to a disaster zone. Thanks to Scott McGaugh, Letterman can be introduced to a world that already benefits from his legacy.”
George Wunderlich, executive director, National Museum of Civil War Medicine
“This is an important book, whose author has thoroughly and ably researched the underside of warfare: namely, the travails of the wounded soldier from being abandoned on the battlefield to becoming the object of compassionate care.”
John S. Haller Jr., emeritus professor of history and medical humanities, Southern Illinois University
“In this eloquent and engaging portrait of the legendary medical strategist, Scott McGaugh reminds us that Jonathan Letterman’s spirit lives on today in every corpsman and medic, at every forward medical facility, and at every hospital in theater.”
André B. Sobocinski, historian, Office of Medical History, Bureau of Medicine & Surgery, United States Navy
“Stirring . . . In addition to being an incisive portrait of the great doctor and leader, McGaugh’s history is a testament to the brave men to whom Letterman dedicated his life.”Publishers Weekly
“Solid, well-researched . . . A nicely crafted biography that also offers Civil War buffs an unusual ambulance-wagon view of the great conflict."Kirkus Reviews
“Verdict McGaugh provides military history buffs, particularly those interested in military medicine, with a well-rounded picture of a man who greatly influenced our delivery of medical care for wounded warriors.”Library Journal
“Adds a sobering tone to the 150th anniversary of a conflict that advanced medical care at a terrible cost. . . . McGaugh provides telling details within a concise narrative to give Letterman's personal story the context necessary for appreciating his influence.”Associated Press
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Surgeon in Blue
Jonathan Letterman, the Civil War Doctor Who Pioneered Battlefield Care
By Scott McGaugh
Arcade PublishingCopyright © 2013 Scott McGaugh
All rights reserved.
NOT A LEARNED PROFESSION
In a sense, surgeon Jonathan Letterman's Civil War began when the enemy's guns fell silent. His planning and preparations for his first battle as chief medical officer of the Army of the Potomac had come down to this moment. Hundreds of surgeons under his command stood ready in primitive field hospitals as the moans from thousands of broken and dying men strewn across the battlefield replaced the whine of bullets splitting the air. "over here!" punctured the eerie calm when searchers came upon a man in agony or found a pulse in a body curled behind a rock or straddling rows of shredded cornstalks.
The gory, writhing battlefield at Antietam in western Maryland on September 18, 1862, appalled the survivors, including Benjamin Cook. "Rifles are shot to pieces in the hands of soldiers, canteens and haversacks are riddled by bullets, and the dead and wounded go down in scores. The smoke and fog lift; and almost at our feet, concealed in a hollow behind a demolished fence, lies a rebel brigade pouring into our ranks the most deadly fire of the war. What there are left of us open on them with a cheer; and the next day, the burial parties put up a board in front of the position held by the Twelfth (Massachusetts) with the following inscription: 'In this trench lie buried the colonel, the major, six line officers, and one hundred and forty men of the (13th) Georgia Regiment.'"
Thousands of wounded men littered farm fields, stands of timber, and creek beds. Though few could possibly know it, an untested newcomer to their army had become responsible for their survival. Jonathan Letterman had held medical command of the sick and beaten Army of the Potomac for two months before facing his first major battle at Antietam. He had taken command shortly before the army went on the march in search of the Confederate general Robert E. Lee. The thirty-seven-year-old had learned of the battlefield's location only a few days in advance of the fighting. After a single day's battle, Letterman became responsible for half again as many wounded men as the total number of those wounded in the Revolutionary War.
Letterman had been born toward the end of the so-called Era of Good Feelings in our nation's early years. The son of a small-town physician, he had grown up in southwestern Pennsylvania. He joined the army upon graduation from a first-rate medical school. Thirteen years of outpost medicine subsequently bore almost no resemblance to the carnage at Antietam. Letterman would have to rely on his instincts, untapped talents, and basic medical training if the wounded now in his charge were to stand a chance of survival.
On November 3, 1824, more than 365,000 white Americans voted for their sixth president. None of the five candidates received a majority of votes, casting the country into uncertainty. Three months later, on February 9, 1825, the House of Representatives selected John Quincy Adams over Andrew Jackson. Although Jackson received more popular votes, the House elected Adams on the first ballot.
When Adams named Speaker of the House Henry Clay (who had been one of the five candidates for president) as his secretary of state, political opponents charged that a backroom deal had been made by Adams and Clay at the expense of Jackson. The controversy over the appointment marked a new chapter for a nation that had been created only forty-eight years earlier. It closed what Boston newspaper reporter Benjamin Russell had first termed the Era of Good Feelings, eight years of muted political bickering in a young nation finding its way. The raucous bipartisanship that returned was both divisive and sectionalist, influencing national debate and election results.
In the midst of this political turmoil, on December 11, 1824, Jonathan Letterman was born in Canonsburg, Pennsylvania, a young town that had been incorporated by the Pennsylvania legislature on February 22, 1802. Set at the bottom of a hill alongside Chartiers Creek, it lay about twenty miles south of Pittsburgh.
Its roots stretched back to the 1740s, when Peter Chartiers established an Indian trading post on a creek that fed the ohio River thirty miles to the north. The son of a French father and Shawnee mother, Chartiers trapped, traded with Indians, and supported the French. He was a harbinger of the immigrants who later arrived in western Pennsylvania, many of them coming from northern Maryland, Virginia, and Europe.
The pioneers settled in the heavily wooded and hilly region. Creeks meandered through isolated valleys. Dense forests held white-tailed deer, wolves, and bears. Forested slopes gave relief from hot summers punctuated by thunderstorms that occasionally drove creeks and rivers over their banks. Long and sometimes brutal winters brought snow as early as November.
Irish, Scot, British, and German pioneers carved farms from the forests and settled alongside rivers in communities that grew to become Pittsburgh, Wheeling, Wellsburg, and Brownsville. Celtic settlers tended to be farmers, while many of the English pioneers opened general stores. Some had fled political turbulence in Europe. Some northern Irish carried a price on their heads from opposing the Church of England before coming to America and establishing homesteads in its western wilderness. A settler could build a cabin, raise a crop of corn, grain, or vegetables, and apply for a four hundred-acre parcel of land as well as a preemption right to another one thousand acres. Many squatters simply settled a piece of land without bothering to check on or file for ownership. Self-reliance and sweat equity were critical to surviving isolation, disease, and unforgiving weather.
Sustenance farming, fishing, and hunting followed the seasons. Once a year, some settlers loaded their horses and traveled more than 200 miles east by pack train to Baltimore to trade their grain alcohol, wool, fabric, and pelts for gunpowder, lead, salt, iron, and other farm and living essentials.
Isolated pockets of farms spawned communities. Hardworking and frugal Scot and Irish placed a high priority on school and church. While most education took place in the home, sometimes itinerant teachers were hired to teach the children of several neighboring families that had settled along a creek or in a remote valley.
John Canon arrived in the late 1700s. Within a few years Canon owned twelve hundred acres on Chartiers Creek. An entrepreneur and officer in the local militia, in the early 1780s Canon built a flour mill and sawmill on the creek. He obtained a contract to provide rations to the local militia and turned his sights to creating what became Letterman's hometown. With Chartiers Creek as the southern boundary, Canon laid out a town on a portion of his property with the main street starting near his mill and proceeding north up a hill. Canon's first known plat of Canonsburg bears a 1787 date. It lists the names of lot owners but the date of the lots' sale is unclear.
For several years, Virginia and Pennsylvania had claimed the portion of America's western Pennsylvania wilderness that included Chartiers Creek. Both states issued property ownership rights for the same land. The Mason-Dixon Line established in 1781 to resolve the border dispute placed the Canonsburg area in Pennsylvania. Canon and other Pennsylvania residents found they held land patents issued by Virginia. Although it took Canon several years to obtain Pennsylvania patents for his town lots in Canonsburg, he continued selling lots. His conditions of lot purchase required the buyer to build within two years a frame or log house that was at least twenty feet wide across the front and had a stone or brick fireplace. Buyers also received free access to a coal outcrop not far away.
By that time, a rudimentary, one-room log cabin had been converted into a school by Presbyterian minister John McMillan, a graduate of what is now Princeton University. He expected many of its graduates to establish schools to educate and prepare young men as candidates for the ministry. McMillan hired teachers to teach the classics while he taught theology. By the early 1790s, most of McMillan's graduates enrolled at an academy in Canonsburg. Canon gave the academy's trustees a 2.1-acre lot almost across the street from his house and built a new, two-story stone schoolhouse for them (Canon's son was a stone mason). Although Canon donated the lot, he gave the trustees the deed only after they had paid for the stone building in 1796. They soon began offering college-level courses after the state legislature chartered the school as the Academy and Library Company of Canonsburg.
By the late 1790s, Canonsburg was firmly taking root. It had become a market town on the weekly stage route between Pittsburgh to the north and Washington to the south. Property owners along the town's main street, Market Street, included weavers, tavern keepers, merchants, and lawyers as well as a doctor, tanner, cooper, hatter, brewer, miller, and shoemaker. Canonsburg was well on its way to becoming the college town where Jonathan Letterman, the son of a local physician, could prepare to become a doctor.
The paternal side of Letterman's family traced its American roots to September 27, 1727, when Letterman's great-greatgrandfather, Hans Lederman (a linenweaver), two brothers, and Lederman's nine-year-old son, Daniel, arrived from northern Alsace, Germany, aboard the ship James Goodwill. Daniel, Letterman's great grandfather, grew up to become a minister and lived in southern Pennsylvania and Frederick, Maryland. His son, also named Daniel, went by the name Leatherman and lived in Washington County, Pennsylvania. He settled four hundred acres along Pigeon Creek southeast of Canonsburg. Daniel and his wife, Elizabeth, married in 1772 and a year later their first son, Theobald, was born. The family grew quickly with the births of Jonathan (1775, Letterman's father), Elizabeth (1777), Hannah (1779), Mary (1781), and Joseph (1783). All were German Baptists, commonly called Dunkards at the time.
Letterman's father, Jonathan Leatherman, arrived in Canonsburg around 1815. By that time, the market town had become an established municipality. Incorporated as a self-governing borough in 1802, the town had grown to encompass four schoolmasters, four tavern keepers, four shoemakers, four carpenters, three distillers, three tailors, two millers, two harness makers, and two wheelwrights as well as a clockmaker, mason, and tanner. The same year, it issued a charter to the Canonsburg Academy to become Jefferson College, authorizing it to grant college degrees. Five young men received degrees the same year from a college whose leadership was dominated by Presbyterian ministers and elders.
Leatherman married Anna Ritchie on July 21, 1818. Anna's father, Craig Ritchie, had been one of the first purchasers of the town lots offered by Canon. Ritchie started a successful mercantile business, had fourteen children, and served as a legislator from 1793 to 1795, then as justice of the peace. On January 29, 1819, Ritchie sold the lot next door on Market Street to Leatherman and his wife for $300. Soon Leatherman lived next to his father-in-law and was building a medical practice.
Leatherman made an immediate impression on Canonsburg residents. Five years after his arrival, he served a two-year term as a borough burgess. He functioned much like a modern-day mayor but also had limited judicial authority and could levy fines and issue short sentences for relatively minor legal offenses. Both Leatherman and his father-in-law served on the borough council as well.
Two years later, Leatherman formed a partnership with Dr. George Herriott. On March 10, 1823, Leatherman announced the new practice in the local newspaper, offering services "in all the various branches of medical ... (and) likewise informs the publick, that he keeps himself supplied with fresh medicine, of the best quality, from Philadelphia."
Herriott had married Mary, another daughter of Craig Ritchie. That made Herriott and Leatherman brothers-in-law as well as business partners. As the practice grew, Anna Leatherman gave birth to the family's first child, Jonathan. By that time, his father had completed a medical apprenticeship and had received his formal medical degree from Jefferson Medical College in Philadelphia. The degree was largely honorary. Leatherman was not required to attend medical school and had been practicing as a physician as early as 1819.
Jonathan Letterman was born in a brick house on the southwest corner of Pike and Green Streets in the heart of Canonsburg. When he reached school age, a private tutor educated him, a common practice among financially secure and wealthy families at the time. Many families considered education a paramount priority, either in the home or in a one-room schoolhouse with a teacher hired by the community. Typically the teacher was a man and modestly educated. He focused on reading, writing, and arithmetic.
The nation in 1824 was less than five decades old and in transition, as it sought to assert its identity and position in the world. The previous year, in a speech before Congress, President James Monroe outlined what became the Monroe Doctrine, a warning to European powers to stay out of national affairs in the Western Hemisphere. He promised to stay out of Europe, although his promise must have rung hollow as America did not have a viable army or navy.
The Missouri Compromise of 1820 proved to be a temporary armistice between pro- and anti-slavery factions. It authorized statehood for Maine as a free state and allowed the voters of Missouri to opt for slavery. That kept the number of free and slave states the same in a nation whose 1820 census counted a total population of 9.5 million, including 1.5 million slaves.
Education emerged as a responsibility of government. In the early 1820s, local communities established school districts in Ohio, Indiana, Illinois, and New York. At the same time, America's leading colleges began debating whether higher education should be based on classic literature or focus on more contemporary subjects in the belief that learning should reflect the needs of modern life.
The fledgling nation was in a period of widespread expansion. In 1824, the Erie Canal neared completion. The canal was a commercial waterway that cost $7 million to build and would expand the nation's commercial base by reducing shipping times between the Midwest and northeastern states by one-third and cutting freight transportation costs by more than one-half. On the Mississippi and Ohio Rivers to the west, the gateway cities of Cincinnati, St. Louis, and New Orleans became portals to a vast, largely unexplored wilderness, with Chicago to follow within a decade or so. Stephen F. Austin recruited pioneers to settle Texas. Territories in the process of being settled included Missouri, Michigan, Arkansas, and Florida, in many of which Indian wars loomed on the horizon.
In 1825, the first steam locomotive appeared, and two years later the nation's first railroad, the Baltimore & Ohio Rail Road Company, utilized horse-drawn rail lines. As railroads began to connect cities and as small towns developed along post roads, turnpikes, and navigable waterways that provided transportation in remote regions, life in America evolved as well. Native authors such as James Fenimore Cooper (The Last of the Mohicans) and Washington Irving "Rip Van Winkle" became established. Families tended to entertain at home with games, music, and conversation. The minuet was gaining in popularity and the newest brass instruments, the coronet and French horn, were popular among musicians. Traveling circuses became popular.
Canonsburg evolved from a simple market town to a renowned college town. Jefferson College became one of the ten largest colleges in the nation, with a commensurably enhanced reputation. Leatherman joined its board of trustees in 1820 and remained a member for twenty-four years. Located on the corner of Main and College Streets, the college sat two blocks away from the Leatherman household after Leatherman bought a lot at the corner of Pike and Green Streets and built a home. There he likely saw patients and dispensed medicine between house calls.
His practice continued to grow. By 1830, Leatherman had the highest tax valuation in Canonsburg. At $2,636, his holdings included a $2,000 house, $500 in property, and $136 worth of horses and cows. Jonathan lived and was educated in that home until 1838, when the family sold the property for $3,100 and moved a few miles outside of town. Four years later he enrolled at Jefferson College in Canonsburg.
The college's admission requirements had stiffened in the late 1830s and early 1840s. By 1842, admission required Letterman to be familiar with arithmetic and geography, as well as possess a solid education in the classics. Letterman had to demonstrate knowledge of Caesar's Commentaries, Sallust, Virgil, the Greek Testament, and Greaca Minora, among others.
Since his family had moved out of town four years earlier, Letterman may have lived in one of several dormitories available in Canonsburg, including one on campus, or in one of several private boarding houses within a few blocks of campus. The most desirable, only a block from campus, was named for Mrs. Armstrong, who ran it, and nicknamed "Fort Hunt." Like many students, Jonathan may have kept a horse at his grandparents' stable a few blocks away in order to visit his parents, whose house was about two-and-a-half miles outside of Canonsburg.
College tuition totaled $30 a year. Student housing costs ranged from $1.25 to $2.50 per week. Some landlords charged extra for coal to heat tenants' rooms, typically about three cents per bushel. Overall, parents anticipated their child's annual college expenses to be less than $100.
Letterman and others typically arose at 5:30 a.m. Breakfast was served at 6:00 a.m. and classes ran from 8:30 a.m. to noon. In his first year at Jefferson, Letterman took classes in Roman and Grecian Antiquities, Cicero's Orations, Algebra, and Latin Composition.
Excerpted from Surgeon in Blue by Scott McGaugh. Copyright © 2013 Scott McGaugh. Excerpted by permission of Arcade Publishing.
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Meet the Author
Scott McGaugh, the marketing director of the USS Midway Museum, is a veteran journalist and the author of Battlefield Angels and several books on the USS Midway. His television appearances include the History Channel, Discovery Channel, and Fox TV, and he gives public speeches and travels regularly for the museum.
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I love history – the more obscure the better. Most of what I know about battlefield medical care comes from watching MASH as a child. Surgeon in Blue provides a very well versed description of the career of Jonathan Letterman. The book is very well researched and extremely educational and interesting.