Hospital Sketches
louisa

Louisa May Alcott
chronicles her experiences as a nurse


Illustration by Malcolm Garris/PhotoDisc

by Elizabeth Foxwell
June 23, 1998

Six years before the creator of Meg, Jo, Beth, and Amy carved out her literary niche with the publication of Little Women, Louisa May Alcott traveled to Washington, D.C., to take up a more demanding post: as a nurse in the Union Hotel Hospital, caring for wounded soldiers. Alcott wrote a book, Hospital Sketches, about her experience; 135 years later, it’s still in print. It provides a poignant and immediate window into the suffering of Civil War soldiers and their loved ones and vivid insight into their care.

First serialized in the Boston newspaper Commonwealth, then published in book form in 1869, Hospital Sketches launched Alcott’s literary career. With part of its profits donated to war orphans by the publisher, the book drew praise from many readers and critics including Henry James Sr. (father of the novelist), who wrote of his delight in Alcott’s "charming pictures of hospital service." Hospital Sketches rather vehemently disproved the wisdom of publisher Henry Field’s advice to Alcott to "give up trying to write and stick to teaching."

A love of nursing

Alcott was the regular nurse for her family’s illnesses, and she decided at age 30 to take up nursing as a means of war service since as a woman, she could not fight. "I love nursing, and must let out my pent-up energy in some new way," she wrote in her journal.

Written in the form of letters to her family, the book begins with Alcott’s departure from Concord, Massachusetts, in early December 1862, and ends with her contraction of typhoid pneumonia and doleful return home in late January 1863. Alcott hid behind the persona of "Tribulation Periwinkle," changed the names of her family members, and uses the Victorian device of initials for her fellow nurses and physicians. She refers obliquely to "our Florence Nightingale," whose real-life identity was Dorothea Dix, superintendent of female nurses for the U.S. Sanitary Commission. Dix, who was also a social reformer, hardly enjoyed widespread popularity in her superintendent role, but Alcott felt grateful for her personal kindness. Alcott also omitted more scandalous episodes from her book, saving them for letters. One nurse, for example, "sung hymns and prayed violently while stealing the men’s watches and money."

An honest account

With characteristic humor and keen observation, Alcott vividly described typical shifts of day and night duty, the starkness of gaping wounds and amputations, the nurses’ meager accommodations and poor meals, and the frustrations of an understaffed and undersupplied hospital. There are a few glimpses of the Capitol, of a glittering White House with carriages rolling in and out. She describes several deaths, including the prolonged battle of a beloved patient.

"I sat down by him," reads the account, "wiped the drops from his forehead, stirred the air about him with a slow wave of a fan, and waited to help him die. He stood in sore need of help—and I could do so little; for, as the doctor had foretold, the strong body rebelled against death, and fought every inch of the way, forcing him to draw each breath with a spasm, and clench his hands with an imploring look, as if he asked, ‘How long must I endure this, and be still!’ "

Alcott also emphasized her abolitionist views in talking about run-ins with "rebs" and in cuddling a black child—a "baby Africa"—before an affronted Virginia matron. As an advocate for women’s right to work, Alcott’s scorn for the typical Victorian woman was made clear.

"One funereal lady came to try her powers as a nurse," she wrote, "but, a brief conversation eliciting the facts that she fainted at the sight of blood, was afraid to watch alone, couldn’t possibly take care of delirious persons, was nervous about infections, and unable to bear much fatigue, she was mildly dismissed. I hope she found her sphere, but fancy a comfortable bandbox on a high shelf would best meet the requirements of her case."

No regrets

Alcott’s matron, Hannah Ropes, headed an overworked staff of 10 nurses caring for 400 patients and later died of typhoid pneumonia contracted at the hospital. Alcott also contracted the disease, which finished her Civil War nursing career, turned her into an invalid, and ultimately ended her life in 1888.

Yet Alcott did not regret her short period of war nursing. After she returned home, she kept in touch with some of her "boys," as she called them, was bemused by the attention for Hospital Sketches, and remained grateful for her war nursing career. "I never have regretted that brief, yet costly experience," she wrote in a letter, ". . .for all that is best and bravest in the hearts of man and woman comes out in times like those, and the courage, loyalty, fortitude and self-sacrifice I saw and learned to love and admire in both Northern and Southern soldiers can never be forgotten."

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