Although Louisa May Alcott was only an army nurse for a month, she had the good luck to arrive just in time to treat the mass of casualties of the Battle of Fredericksburg, a bloody disaster for the Union. Alcott wanted to see service, so for her this was good luck. Her first chapter of actual hospital work is about the first day the wounded poured in to be cleaned, re-bandaged – their bandages had not been changed for days – and stitched up.
Alcott first published Hospital Sketches, or most of it, in a New England anti-slavery newspaper. She was writing for an audience desperate for news, and likely with family in the army. A patriot and abolitionist, Alcott might well have avoided criticism and protected her readers from unpleasant subjects. That book would not be worth reading.
She steers a middle course, openly critical of the bad food (coffee “like mud soup, scalding hot, guiltless of cream, rich in an all-pervading flavor of molasses, scorch and tin pot,” III, 43), the unhygienic conditions, and the indifferent or thieving staff, and writing in an open-eyed but careful manner about the blood and wounds. Anesthetic-free amputations are routine – “whipping off legs like an animated guillotine” (VI, 88) is her description of a particular doctor – and much of a nurse’s job involved treating horrible wounds, and Alcott does not conceal any of this, yet I believe the book is readable by almost anyone. A “six foot New Hampshire man” has “a leg broken and perforated by a piece of shell, so large that, had I not seen the wound, I should have regarded the story as Munchausenism” (III, 35), and a “rough Michigander” has “an arm blown off at the shoulder, and two or three bullets still in him – as he afterwards mentioned, as carelessly as if gentlemen were in the habit of carrying such trifles about with them” (III, 33). She uses words to describe but also to conceal.
Hospital Sketches is at its core about death. Ten pages of the short book, the longest single episode, are given to a single death and life. John the Virginia blacksmith is the character who stands in for all of the others.
I thought him nearly gone, and had just laid down the fan, believing its help to be no longer needed, when suddenly he rose up in his bed, and cried out with a bitter cry that broke the silence, sharply startling every one with its agonized appeal:
"For God's sake, give me air!"
It was the only cry pain or death had wrung from him, the only boon he had asked; and none of us could grant it, for all the airs that blew were useless now. (IV, 56-7)
Alcott divides her wards into “’my duty room,’ my ‘pleasure room,’ and my ‘pathetic room.’" John is in the pathetic room. Alcott means the word in its older sense, not inferior but evoking pity or sympathy, and she uses her book to create pathos as well. I believe we again see the influence of Dickens, the master of elevated sentimentality – not that he never succumbs to the cheap stuff!
He never spoke again, but to the end held my hand close, so close that when he was asleep at last, I could not draw it away. Dan helped me, warning me as he did so that it was unsafe for dead and living flesh to lie so long together; but though my hand was strangely cold and stiff, and four white marks remained across its back, even when warmth and color had returned elsewhere, I could not but be glad that, through its touch, the presence of human sympathy, perhaps, had lightened that hard hour. (IV, 57)