Surgeon in Blue: Jonathan Letterman, the Civil War Doctor Who Pioneered Battlefield Care

  • Scott McGaugh
  • Arcade
  • 368 pp.
  • Reviewed by Charles V. Mauro
  • August 8, 2013

Innovations in US Army medical care began with one reserved Civil War doctor, Jonathan Letterman, who crafted and implemented vital policy on the care of our war wounded.

In Surgeon in Blue: Jonathan Letterman, the Civil War Doctor Who Pioneered Battlefield Care, Scott McGaugh tells the story of a quiet and reserved doctor who revolutionized the care of catastrophic numbers of wounded Union soldiers after the battles of Antietam, Fredericksburg, Chancellorsville and Gettysburg.

Letterman, born to a wealthy family in Pennsylvania, joined the Army after graduating from Jefferson Medical College in 1849, perhaps for the adventure. He was assigned to a string of harsh and isolated outposts where he learned of the Army system’s inadequacies in providing soldiers with a healthy diet, suitable living conditions and much needed medical supplies.

In West Virginia in April 1862, Letterman rose through the ranks, thanks to his connections, to become surgeon general under General William Rosecrans. General Rosecrans served under General George B. McClellan in the Army of the Potomac, and both generals respected the need for proficient medical attention to keep the troops prepared for battle. The carnage of the Peninsula Campaign forced Letterman to become a quick study in the care of soldiers from the moment fighting stopped. He worked to remedy poor logistical situations — and fast.

Shortly after the battle, McClellan issued orders, written by Letterman, to establish the organization of the medical department. The orders set forth the decision-making process used to determine whether a soldier would be admitted to a field hospital or shipped to the nearest city. Also included were mandates on providing soldiers with a regular supply of fresh vegetables, the proper bathing of soldiers, procedures for human waste disposal, as well as instructions on proper food preparation. Perhaps the biggest change was to move the authority for the medical department from the inefficient and segregated regiments to Army headquarters. The results led to immediate improvements in both Army health and morale.

In addition to working to improve the care of soldiers in camp and after battle, Letterman worked next to McClellan to prepare his department as battles drew near, ensuring there would be medical supplies close to the expected battlefield and establishing hospitals in nearby cities.

He then turned his efforts to the improvement, organization and flow of medical supplies within the Army. Following the Army’s debacle at Chancellorsville, Letterman sought and received permission to negotiate directly with Confederate General Robert E. Lee’s medical director for the removal of almost 1,200 Union wounded held as prisoners for almost a week after the battle. The Army’s path would lead to Gettysburg, where, once again, Letterman’s system quickly evacuated and treated the unprecedented 15,000 wounded.

McGaugh’s biography of Jonathan Letterman provides valuable insight into the improvement of Army medical organization, showing how it was as necessary to the fundamental order of battle as are strategies and tactics. Letterman was a detail-oriented man, and McGaugh provides a finely written account of what he accomplished.

The book is interesting — although not compelling. By the author’s own admission, the one thing missing is evidence of the feelings Letterman must have held during his years of service. McGaugh states that even in Letterman’s published recollections, “the frank, concise, and analytical treatise offered little in terms of his personal feelings.” It is a clinical exposition about a clinical man.

Perhaps it is Letterman himself who lets us in a little by way of what he wrote in the dedication to his Army colleagues in his recollections, stating that they performed their duties without hope of “promotion, or expectation of reward.” Maybe that is just the way Jonathan Letterman felt about his own duty.

Still, McGaugh shines a light on the inspired and truly innovative efforts of this remarkable man who greatly improved the quality of care given to soldiers. For readers interested in something more in-depth, beyond the stories of major Civil War battles, this well-written book provides insight into the efforts of one man working behind the scenes.

Charles V. Mauro is the author of six books and the producer of two movies on Civil War history in Northern Virginia. His work can be found at


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