Antietam battlefield, seen from the observation tower. Photo credit: Lewis Sandy.

As it happens, this summer’s #1 best-selling book is Kristin Hannah’s The Women, which tells the story of Frankie, a young idealist nurse who volunteers to serve in Vietnam. This harrowing tale takes her fresh out of Army basic training to the Thirty Sixth Evac Hospital, where she and her fellow nurses triage the wounded, provide care for the dying, and stabilize soldiers for further treatment at other hospitals, while coming under attack.

Women at the front? The concept of battlefield triage? The idea of a “field hospital”?

All come from the Civil War, where Clara Barton became known as “the angel of the battlefield.”

Today our tour exploring the career and legacy of American Red Cross founder Clara Barton visited the Pry House Field Hospital Museum, the Antietam battlefields, and the National Museum of Civil War Medicine. As a physician, I can only marvel at the advances medicine and nursing have made since then—and note (with mixed feelings) that war often brings on great innovation and courageous action.

The ‘Bloodiest Day in American History’

Photo taken by the author at the National Museum of Civil War Medicine

In September 1862, Confederate general Robert E. Lee led 55,000 troops into Maryland, hoping to strike a major blow to the Union. Union general George McClellan prepared to meet him with 77,000 troops. On September 17, the battle began. Within three hours, Miller’s Cornfield changed hands six times with 10,000 casualties. By the end of the day, there were over 23,000 casualties. More Americans died at Antietam than any other day in U.S. military history.

What was Clara Barton even doing there?

Earlier that year, she worked in Washington, D.C., in the U.S. Patent Office. In April, the Sixth Massachusetts Infantry was attacked outside of Baltimore, and the wounded were taken to the Senate Chamber of the U.S. Capitol and personally cared for by Barton. She called them “my boys” since they were from the same area of Massachusetts she came from.

She’d already been raising money for troop supplies when she decided she was most needed on the battlefield. By August, she succeeded in getting the military to agree, and she cared for the wounded at several battles before Antietam.

On September 16, as the Antietam battle neared, she tried to get closer to the front. “Follow the cannons!” she prodded her teamsters, driving her mules all night to reach the battlefield.

As described by my old friend and colleague John Tooker, the CEO of the American College of Physicians:

At Antietam, Barton waited with Burnside’s Ninth Corps as the only woman. She arrived on the northern edge of Miller’s Cornfield around noon on September 17th with wagons of supplies while the battle was still being fought. The surgeons she personally assisted were astonished to see her but gratified, especially with all the much-needed supplies she brought and her determination to do whatever was needed in the moment.

The ‘Angel of the Battlefield.’

She worked 36 hours straight. While helping a wounded solider, a bullet went through her sleeve, killing the man she was helping. Clara Barton never sewed up that hole in her sleeve—she wanted it to be a reminder of what needed doing. In a letter from Brigade-Surgeon James L. Dunn to his family, he said of Barton:

“In my feeble estimation, General McClellan, with all his laurels, sinks into insignificance beside the true heroine of the age, the angel of the battlefield.”

And that title remained hers forevermore.

The Letterman System.

Barton worked alongside Dr. Jonathan Letterman, who as medical director for McClellan’s army had devised a new, more efficient system of mass casualty management:

  • first aid adjacent to the battlefield
  • an ambulance corps dedicated to the wounded
  • a field hospital system for urgent stabilization
  • and transfer to hospitals to receive further care

On our tour, we saw the Pry House Field Hospital Museum, a farm that became both General McClellan’s headquarters and one of the Antietam field hospitals. Barton herself worked at the field hospital just off Miller’s Cornfield, where the bloodiest battles occurred.

At Antietam, the system worked. A year earlier, at Manassas, it took a week to get 5,000 casualties off the battlefield. At Antietam, 23,000 dead and wounded soldiers were off the battlefield within 24 hours. The National Museum of Civil War Medicine in Fredrick showcases Barton’s courageous actions and the new Letterman System, and corrects the myth that Civil War amputations were done without anesthesia (they weren’t).

After Antietam, Barton returned to Washington in a wagon, exhausted, delirious, and suffering from typhoid fever. But she recovered and, as always, jumped back in to serve on the battlefield and beyond.

Both our visit today and the character Frankie in Hannah’s novel The Women demonstrate the heroism and courage of battlefield nurses. Thanks to innovators like Clara Barton and Jonathan Letterman (by the way, I sat for my medical boards at Letterman Medical Center at the Presidio in San Francisco) our troops can count on the best battlefield medical system, one that began at Antietam and is still in use today.

Barton’s story is for me a story of how one person—with vision, courage, and persistence—can make a difference.

Lewis Sandy, MD, is a physician and leadership/executive coach with a focus on health care. He is the co-founder of Sulu Coaching (www.sulucoaching.com). From 1991 to 2003, Dr. Sandy served as vice president and executive vice president of the Robert Wood Johnson Foundation. An internist with over 20 years in practice, Dr. Sandy was a faculty member, fellow, and RWJF Clinical Scholar at the University of California, San Francisco. He has served on the Panel of Health Advisors for the Congressional Budget Office (CBO) and the Special Medical Advisory Group for the Department of Veterans Affairs. 

(Read previous posts in this six-part Clara Barton tour series here.)