Louisa May Alcott, author of Little Women, had the briefest of nursing careers: about six weeks, from start to finish. Alcott being Alcott, she effectively morphed the experience into grist for her literary mill.
Alcott was not a Big Gun in nursing history. Her musings are not technically significant, like Florence Nightingale’s contemporaneous Notes on Nursing. Her service does not resonate through Civil War history like that of her influential contemporaries, Dorothea Dix and Clara Barton. The product of Alcott’s nursing experience was Hospital Sketches (1863), the story of a bedside army nurse at a time when the bedside army nurse was also, typically, a Victorian spinster. Alcott’s tale of grit and grace is as compelling now as it was in the nineteenth century.
Louisa May Alcott, daughter of philosopher Bronson Alcott, grew up in New England with prominent Transcendentalists such as Thoreau, Hawthorne, and Emerson as family friends. Unfortunately, Bronson Alcott’s philosophical proclivities often got in the way of his better judgment, and his family suffered real poverty and instability as a result. Louisa evolved from the chaos as her mother’s mainstay in keeping the family going. Thus, she learned service and selflessness early and perhaps a little too well.
“Decide to go to Washington as a nurse”
The Alcott family took human rights seriously; their home was a stop on the Underground Railroad, the means by which slaves were helped on their escapes to freedom. Inevitably, Louisa felt called to serve when, in 1861, the Civil War broke out. The pioneering work of Florence Nightingale in the Crimean War (1853-1856) had paved the way for a female army nursing service in the United States, and a personal epiphany on her own thirtieth birthday cinched the deal for Louisa. She wrote in her Journal, “Thirty years old. Decide to go to Washington as a nurse if I could find a place.”
On December 11, 1862, Alcott was deployed to the Union hospital in Georgetown, outside of Washington, DC. Although not formally trained, she was an adept nurse by dint of her personal experience in caring for sick family members. This was good enough for Dorothea Dix, Superintendent of Army Nurses for the Union Army. Dix only required that her nurses be sober-minded, mature (over thirty), and plain-looking. ‘Flighty’ or attractive women who wore stylish clothing and jewelry were not appropriate candidates for duty. Spinsters were. Alcott was considered “…the prospect of a really good nurse, a gentlewoman who can do more than merely keep the patients from falling out of bed.”
Georgetown Hospital was, like most army hospitals at the time, an inherently unhealthy place. It was damp, stuffy, and stinking, inadequately supplied, crowded, chaotic, and filthy. Germ theory had yet to be embraced by the medical community, so surgery and wound dressings were done without benefit of soap and water, and antibiotics were unknown. Epidemiology was poorly understood, and preventable diseases such as typhoid and dysentery were rampant.
Days after Alcott’s arrival at Georgetown, the Union troops suffered a major debacle at the Battle of Fredericksburg. As the wounded poured in, Alcott’s own baptism of fire began.
“No time for nonsense”
The sheer magnitude of human suffering that she saw initially sent Louisa into hiding behind a pile of clothing. She was soon chivvied out, however, and put to work washing the blood and filth from a dozen men. The New England spinster decorously described the prospect as “really—really—.” “However,” she continued gamely, “there was no time for nonsense.” Readers of Alcott’s semi-autobiographical Little Women will recognize Jo/Louisa in this quick recovery, and in the vignette that follows it.
One of Alcott’s patients was much amused at being bathed by a woman; at this time, female army nurses were a very new phenomenon. Alcott, again, being Alcott, soon saw the funny side of the situation. Before long, she was laughing right along with her patient.
Alcott’s nursing skills and sense of humor inspired her patients. The fortitude, courage, and dignity of her soldier patients, maintained against all odds, inspired Louisa to write about what she, and they, were living. This style of writing would become her trademark; she would pilot it with Hospital Sketches, and would later bring it home, literally, with the amazingly successful domestic novel Little Women.
Nurse Alcott assisted with semi-barbaric surgeries, dressed hideous wounds, bathed and fed invalids, and eased the final moments of the dying. Civil War army nursing was particularly difficult. Advances in the technology of warfare had created weapons that were very efficient. Advances in medical science, unfortunately, had not kept pace. In the absence of any other treatment, wounded limbs were amputated, frequently without the benefit of chloroform, the only known anesthetic other than a strong shot of whiskey. Treatment was excruciating, and often introduced infections more dangerous than the wounds themselves.
“I guess I’m moving on, ma’am.”
A Night, the story of a fatally wounded Virginia blacksmith, is the best remembered chapter in Hospital Sketches. It fell to Alcott to tell the dying man of his imminent fate, and to pen the man’s final letter home to his family as he dictated it. The man died squeezing Alcott’s hand. Deeply moved by his courage, she recounted his words in Hospital Sketches… “I knew you’d come! I guess I’m moving on, ma’am.”
In January 1863, Alcott fell ill with typhoid pneumonia. Her comrades in arms did all they could for her; Dr. John Winslow, with whom Louisa had a special friendship if not a romance, was especially attentive and diligent. Nevertheless, her life was in danger, and Dorothea Dix herself sent for Bronson Alcott to bring his daughter home.
Back home in New England, Alcott’s life hung in the balance for some time. In the delirium she suffered at the height of her illness, the impact of the harsh realities of army nursing on a sensitive Victorian spinster became all too discernible. Once, she was found collapsed on the floor by her sister May; a delirious Louisa chastised May for leaving her alone with so many men, and said she had fallen trying to get away from them. She also dreamed of having to nurse hundreds of sick men who never recovered, and never died; they just stayed sick. She even dreamed that she was tempted by Dr. Winslow to ‘worship the devil.’
Louisa survived the typhoid, but her health was destroyed by the lingering effects of the mercury-based calomel used to treat it. She would suffer pain, weakness, and neurological and digestive problems for the rest of her life. Thankfully, she brought away something other than ill health from her war service; the key to her success as an author. In her own words, Hospital Sketches showed her what she called “her style”, the telling, with heart and humor, of life as she lived it.
Visit JoAnn’s blog: stillanurseblog.wordpress.com
See also Uncle Tom’s Cabin