Floating hospitals innovate Civil War medical transport
The challenges of medicine on the battlefield
Imagine Union leaders discovering a new process that would speed up the evacuation of wounded soldiers from battlefields that would reduce suffering and save lives. Eager to solve a pressing problem quickly, they request approval and emergency funding.
After a lengthy wait, the request is inexplicably denied. After some investigation, the generals and engineers are shocked to learn that a special interest group, the Wagon Wheel Trade Organization (fictitious dramatization!), has managed to kill the request because it would hurt sales of wagon wheels and parts.
Although this scenario is fictitious, powerful special interests are often a real and present danger in many areas of public life, including healthcare. If this had actually happened during the civil war, many more lives would have been lost.
Defeat leads to opportunity
The leaders of Confederate troops on the Mississippi River had a choice to make, be captured by Union forces or abandon and burn their vessel. They burned their vessel.
The Battle of Island Number 10 (the Kentucky bend on the Mississippi River) ended in defeat for Confederate forces on April 8, 1862. It also left a charred ship. The timing could not have been better for the Union.
Transporting the wounded
The Battle of Fort Donelson in February 1862 resulted in thousands of wounded on the Kentucky-Tennessee border. They needed to be moved off the battlefield and to hospitals to receive professional care and hope to live. Transporting them by wagon over land was difficult, took time, and would likely result in more deaths or permanent disabilities.
The nearby Cumberland River provided an answer. The federal government leased private steamboats to transport the wounded along the river systems to Cairo and Mound City, Illinois, and sometimes other points north.
An estimated 15-25 commercial steamboats were jammed with the battle wounded. Although it resulted in more rapid transport, it was a disaster. Wounded soldiers were everywhere: decks, cabins, improvised bedding. The boats were not equipped to provide medical care, only transport. With overcrowding, lack of sanitation and medical care, many soldiers became sick and died before reaching a hospital.
The Battle of Shiloh in April 1862 resulted in even more casualties. The battle was near Pittsburgh Landing on the Tennessee River in southwestern Tennessee. It is important to note that the Tennessee empties into the Ohio River only miles from the Mississippi.
Steamboats were again used to transport the wounded, but with similar results to Fort Donelson. Not only were the wounded dying on the battlefield, but also during transport. The rivers often became clogged, delaying medical care for the wounded by days, even as long as a week.
Innovation in medical transport is born
In April 1862, Union leaders decided to convert the charred hull of the Confederate vessel into a hospital ship. It was outfitted not only to transport wounded, but also to treat them. It was commissioned in December 1862. From idea of transforming a burnt ship into a state-of-the-art medical facility to a functioning floating hospital took only eight months.
The USS Red Rover
The Red Rover had separate wards for patients, ventilation systems for disease control, onboard laundry and other hygiene methods, along with ice storage for preserving food and medicine. In addition, this floating hospital had Navy surgeons, nurses, including the Sisters of the Holy Cross (Catholic sisters), and other workers to care for the sick and keep the ship clean.
Critically, the hospital ship was not just a transport method like the steamboats; it evacuated the wounded and treated them on the way to land-based medical facilities. The staff onboard was able to stabilize and treat gunshot wounds, amputations, and treatment of infectious diseases, such as dysentery, malaria, and typhoid, along with providing comfort.
By early 1863, the Red Rover was active along the Mississippi River during Union campaigns. Other floating hospitals were commissioned soon after. The Mississippi and its connecting waterways functioned as a well-oiled evacuation chain.
The Wagon Wheel Trade Organization
If a powerful special interest had intercepted the creation of floating hospitals because they would cost them market share, we may not have seen the developments during the Civil War, or they may have been too little, too late. Obviously, this is an exaggerated and imperfect example, but it is meant to make a point.
Perhaps they would have released a press statement resembling this:
“The wagon is a safe, proven, and effective form a transportation for the wounded. We care deeply for the wounded and their families, as well as the safety of medical personnel. A hospital ship is unproven and risky. There are too many unknowns.”
The next story will discuss the massive Civil War medical operation in Paducah, Kentucky, a strategic city at the intersection of the Mississippi, Ohio, and Tennessee Rivers.
J. Steven Bromwich founded 1690 Media to explore the soul of healthcare. He tells the stories of heroes and villains of historical healthcare, connecting these moral lessons to modern medicine. He is a bioethicist, criminal investigator, and RN.