"Commissioned by God: Mother Bickerdyke during the Civil War

Military Medicine, Oct 2003 by Sartin, Jeffrey S

Bickerdyke struggled throughout the war with a hierarchical, male-dominated, and all-too-often inefficient system. Women nurses in the Union army numbered less than 20% of the total and were poorly trained, if at all.4 Many of them had no official appointment in the Army hospitals, which meant they received no pay and could be dismissed at will. They were often assigned menial tasks, such as dishwashing, in lieu of meaningful patient care responsibilities. They were, according to "Superintendent of Female Nurses" Dorothea Dix, "objects of continual evil speaking among coarse subordinates," and "looked at with a doubtful eye by all but the most enlightened surgeons" (p 179).4 Dix, well known for her reform of institutions for the mentally ill, had attempted to improve the status of women as military nurses, but she hurt her own cause by insisting on rigid standards of propriety: the woman must be over 30 years old, healthy, "plain almost to repulsion in dress, and devoid of personal attractions" (p 177).4 She also harbored a strong antiCatholic bias and discouraged Catholic orders from sending nuns to the war, an admonition that was fortunately ignored. Despite these difficulties, a number of women distinguished themselves by their contributions and became well known, including Clara Barton, Louisa May Alcott, Mary Safford, Eliza Porter, and Mary Ann Livermore.

The more numerous male nurses were drawn chiefly from the ranks of convalescents, formalized as the Invalid Corps in 1863.4 They were poorly trained and supervised and participated in many cases of theft, abuse, and neglect. Civilian volunteers often contributed their services and included the poet Walt Whitman, whose "Specimen Days" remains a stirring account of the daily struggles against the consequences of projectile injuries and bacteria.5 The toll of death and disease during the 4-year war was indeed staggering with approximately 400,000 Union deaths (from a total troop strength of 2 million) and over 200,000 Confederate deaths (from 750,000 troops).6 Only one-third of the deaths on either side were caused by combat: the majority of disability and death was brought about by infectious diseases. At any given time, an average of 20% of each Army unit was unfit for fighting because of disease. As malnourishment and poor hygiene were the rule, and effective medical treatments were lacking, the provision of attentive, compassionate nursing care became an absolute requisite.

When Grant's western army moved to take control of Kentucky and western Tennessee in February 1862 by assaulting Fort Henry on the Tennessee and Fort Donelson on the Cumberland, Mother Bickerdyke followed on board the Sanitary Commission steamer, City of Memphis. The battle at Fort Donelson produced almost 700 dead and 3,000 casualties on both sides, shocking the complacent publics of both sides and earning Grant the nickname "Butcher Grant." These casualty figures, although later to be dwarfed by those of Shiloh and Antietam, overwhelmed the rudimentary evacuation and field hospital system. Bickerdyke tended the wounded on the ship, and then, dismayed at the numbers still unevacuated, began to assist men on the field. The image of Mother Bickerdyke going from figure to figure in the cold night, silhouetted by her lone lantern while looking for survivors, was picked up by the war press and made her a celebrity of sorts (Fig. 2). Bickerdyke was unimpressed; the end of battle was just the beginning of her work, and she related later that she toiled around the clock and did not sleep in a bed or change clothes for 10 days after the Donelson battle.3