Hospital Sketches

“As boys going to sea immediately become nautical in speech, walk as if they already had the ‘sea’ legs on, and shiver their timbers on all possible occasions, so I turned military at once, calling my dinner rations, saluted all new comers, and ordered a dress parade that very afternoon.”

The above passage exemplifies Alcott’s wittiness, one of the qualities that won Hospital Sketches praise. One characteristic of her humor is that it is often self-deprecating, as in this passage. She pokes fun at herself immediately adopting a military demeanor, using examples that escalate in their absurdity.

“Much of the Roman matron’s courage had gone into the Yankee matron’s composition, and, in spite of her tears, she would have sent ten sons to the war, had she possessed them, as freely as she sent one daughter, smiling and flapping on the door-step till I vanished, though the eyes that followed me were very dim, and the handkerchief she waved was very wet.”

Here, Alcott describes parting with her mother, Abigail May Alcott, an Abolitionist and suffragist. The passage illustrates two characteristic features of Alcott’s writing. One is her facility in weaving in allusions to the Bible, Roman history and mythology, and more, as she here compares her mother to a “Roman matron” to illustrate her stalwart demeanor. The second is her ability to acknowledge and express deep emotion with a light touch, such as when she describes her mother’s handkerchief as being “very wet,” suggestive of weeping.

“I am a woman’s rights woman, and if any man had offered help in the morning, I should have condescendingly refused it, sure that I could do everything well, if not better, myself. My strong-mindedness had rather abated since then, and I was now quite ready to be a ‘timid trembler,’ if necessary.”

Across the book, Alcott acknowledges biases against women. Here, she is unable to get the assistance she needs until her brother-in-law steps in to help her. As a staunch advocate of women’s rights, Alcott does not want to play into stereotypes, in this case by acting the “timid trembler.” At the same time, she appreciates her brother-in-law using his influence to benefit her and accepts it as a necessary step to achieving her larger goals. Alcott’s realization that sometimes she needs help speaks to her deepening understanding of The Dynamics of Care and Compassion.

“As travellers like to give their own impressions of a journey, though every inch of the way have been described a half a dozen times before, I add some of the notes made by the way, hoping that they will amuse the reader, and convince the skeptical that such a being as Nurse Periwinkle does exist, that she really did go to Washington, and that these Sketches are not romance.”

The above passage opens Chapter 2, when Alcott describes her journey from Massachusetts to Washington. Writing under a fanciful pen name might raise the question of whether the experiences she writes about are fact or fiction. Addressing the question helps Alcott establish her authorial credibility. Authority is also important to her larger goal across the Sketches: To draw attention to conditions at the hospital and to critique enslavement and its impact on her fellow human beings.

“Having heard complaints of the absurd way in which American women become images of petrified propriety, if addressed by strangers, when traveling alone, the inborn perversity of my nature causes me to assume an entirely opposite style of deportment […] I put my bashfulness in my pocket, and plunge into a long conversation on the war, the weather, music, Carlyle, skating, genius, hoops, and the immortality of the soul.”

Across the book, Alcott characterizes herself as reactionary in a number of ways, in this case providing another instance of how she pokes fun at herself. Here, she reacts against stereotypes about American women, and wanting to prove them wrong enables her to subdue her innate shyness. The episode displays Alcott’s playful tone, as she lists the wildly varying topics of conversation that she and her seat mate covered.

“Poor dear woman! how little she dreamed, as she read and rocked, with her cap in a high state of starch, and her feet comfortably cooking at the register, what fell designs were hovering about her, and how intently a small but determined eye watched her, till it suddenly closed.”

Several times in her Sketches, Alcott mentions her taste for the absurd, which she brings out in some of her more humorous descriptions, as in the passage above. Alcott pokes fun at herself keeping a close eye on the unwitting woman, who goes about her tasks completely unaware of Alcott’s intention.

“Soon after their departure we had an accident; for no long journey in American would be complete without one […] Hats flew off, bonnets were flattened, the stove skipped, the lamps fell down, the water jar turned a somersault, and the wheel just over which I sat received some damage. Of course, it became necessary for all the men to get out, and stand about in everybody’s way, while repairs were made; and for the women to wrestle their heads out of the windows, asking ninety-nine foolish questions to one sensible one.”

Alcott’s appreciation of the absurd and The Value of Humor in Stressful Times is exemplified in the above passage. Describing the effect of the crash, which apparently did not injure anyone seriously, she layers example upon example of the accident’s effect, painting a vivid picture of the event in a way that draws on physical humor. The portrait of the men hampering repair efforts with needless hovering and the woman similarly asking pointless questions heightens the effect.

“My heart beat rather faster than usual, and it suddenly struck me that I was very far from home; but I descended with dignity, wondering whether I should be stopped for want of a countersign, and forced to pass the night in the street. Marching boldly up the steps, I found that no form was necessary, for the men fell back, the guard touched their caps, a boy opened the door, and, as it close behind me, I felt that I was fairly started, and Nurse Periwinkle’s Mission was begun.”

Alcott closes Chapter 2 with a moment of suspense: She has arrived at the hospital, and her work will now begin. The technique of ending with a cliffhanger reflects that the chapters were initially published serially, with each installment inviting curiosity to hear what would come next in her experiences. Acknowledging her trepidation contributes to the dramatic tension.

“Having a taste for ‘ghastliness,’ I had rather longed for the wounded to arrive, for rheumatism wasn’t heroic, neither was liver complaint, or measles; even fever had lost its charms […] [N]ow unloading their sad freight at our door, I recalled sundry reminiscences I had heard from nursers of longer standing, my ardor experienced a sudden chill, and I indulged in a most unpatriotic wish that I was safe at home again.”

Alcott was serving as a nurse in the aftermath of the Battle of Fredericksburg, Virginia, some 50 miles from Washington (See: Index of Terms). The Confederate army routed the Union, which suffered approximately double the casualties. Many of the wounded who arrived had suffered gruesome injuries and had experienced limb amputations under desperate circumstances in field hospitals. Alcott does not present herself in an idealized way but depicts her naïveté here, which creates a growth arc for her across the collection as she develops her sensitivity to The Dynamics of Care and Compassion.

“In they came, some on stretchers, some in men’s arms, some feebly staggering along propped on rude crutches, and one lay stark and still with covered face, as a comrade gave his name to be recorded before they carried him away to the dead house.”

Alcott’s description of the soldiers arriving from Fredericksburg create a verbal tableau that captures The Physical and Emotional Toll of War, which she builds on across the sketches. Characteristically, she uses physical description to suggest emotion. In this case, she speaks of men carrying their comrades into the hospital, speaking to their care for one another.

“This comical tableau produced a general grin, at which propitious beginning I took heart and scrubbed away like any tidy parent on a Saturday night. Some of them took the performance like sleepy children, leaning their tired heads against me as I worked, others looked grimly scandalized, and several of the roughest colored like bashful girls.”

The “comical tableau” Alcott refers to is her experience washing the Irishman’s feet. His good-nature soothes any anxieties she carries about her work, illustrating The Value of Humor in Stressful Times, and her spirits rally so that she energetically throws herself into her task. The passage also highlights The Dynamics of Care and Compassion in the different reactions of the soldiers to being undressed and washed. Each response is unique to the dynamic between the individuals involved.

“He lay on a bed, with one leg gone, and the right arm so shattered that it must evidently follow: yet the little Sergeant was as merry as if his afflictions were not worth lamenting over; and when a drop or two of salt water mingled with my suds at the sight of this strong young body, so marred and maimed, the boy lookup up with a brave smile.’”

All three of Alcott’s central themes come together in her interaction with the Sergeant. The Value of Humor in Stressful Times is evident in the way his good humor helps Alcott manage her emotions, which are evident in her reference to “salt water,” meaning tears, mixing with the soap she is using to wash him. The severity of his injuries and his quivering lips suggest The Physical and Emotional Toll of War, as he struggles to contain his emotions in the face of his physical suffering. The interaction between them and their ability to rally each other speaks to The Dynamics of Care and Compassion.

“He seemed asleep; but something in the tired white face caused me to listen at his lips for a breath. None came. I touched his forehead; it was cold: and then I knew that, while he waited, a better nurse than I had given him a cooler draught, and healed him with a touch. I laid the sheet over the quiet sleeper, whom no noise could now disturb; and, a half hour later, the bed was empty.”

While Alcott frequently draws on humor and the absurd, she does not allow it to distract from The Physical and Emotional Toll of War, which she depicts in somber but gentle tones. The above passage exemplifies this technique: By the time she returned with water to fulfill the patient’s request, he had quietly died. The “better nurse” who had “healed him with a touch” presumably refers to the angel of death, which bestows a rest that “no noise could now disturb.”

“By eleven, the last labor of love was done; the last ‘good night’ spoken; and, if any needed a reward for that day’s work, they surely received it, in the silent eloquence of those long lines of faces, showing pale and peaceful in the shaded rooms, as we quitted them, followed by grateful glances that lighted us to bed, where rest, the sweetest, made our pillows soft, while Night and Nature took our place, filling that great house of pain and the healing miracles of Sleep, and his divine brother, Death.”

As Chapter 3 takes readers through a day nurse’s duties, it closes with the end of the shift, which follows with her fourth chapter depicting the duties of the night nurses. The passage illuminates that The Dynamics of Care and Compassion flow in both directions: As the patients need treatment, the nurses need to feel that their work is making a positive difference in their patients’ lives, however long those lives may be. Importantly, under the circumstances, the nurses (and surgeons) are not necessarily in control of whether their patients survive. They cannot always save the patients from death, but they can cultivate peace and rest. Thus, seeing the patents sleeping peacefully or transitioning peacefully into death is the needed “reward for that day’s work.”

“More flattering than the most gracefully turned compliment, more grateful than the most admiring glance, was the sight of those rows of faces, all strange to me a little while ago, now lighting up, with smiles of welcome, as I came among them, enjoying that moment heartily, with a womanly pride in their regard, a motherly affection for them all.”

The above passage highlights The Value of Humor in Stressful Times, as Alcott documents the effect of her good cheer on the soldiers she tended on her night shifts. While she is often hard on herself, she also acknowledges the positive impact her approach has on her patients. Though some readers would criticize her levity, throughout the book she documents its power to lift soldiers’ spirits and to forge emotional bonds between herself and her patients.

“The vivid dream had wrung the childish heart with a fresh pang, and when I tried the solace fitted for his years, the remorseful fear that haunted him found vent in a fresh burst of tears, as he looked at the wasted hands I was endeavoring to warm.”

The above passage describes Teddy, the 12-year-old drummer boy who came to the hospital suffering fever and shivering. His case illustrates The Physical and Emotional Toll of War: While his body burns with fever or shivers from cold, his heart grieves the loss of Kit and wrestles with guilt at the role he believes he played in his death. Though Alcott attempts repeatedly to reassure him, he must come to terms with what has happened himself.

“Never on any human countenance, have I seen so swift and beautiful a look of gratitude, surprise and comfort, as that which answered me more eloquently than the whispered—

‘Thank you, ma’am, this is right good! this is what I wanted!’”

Alcott here describes John, the patient who seemed strong but whose injuries will prove fatal. Alcott had been so impressed by his fortitude and forbearance that she had failed to intuit his reluctance to voice his needs, lest he distract her from other patients. Through this moment, Alcott realizes that she had been neglecting him in favor of more vocal patients, and strives to make up for it in future. The passage illustrates her evolving understanding of The Dynamics of Care and Compassion across her experiences.

“It was John’s letter, come just an hour too late to gladden the eyes that had longed and looked for it so eagerly! yet he had it; for, after I had cut some brown locks for his mother, and taken off the ring to send her, telling how well the talisman had done its work, I kissed this good son for her sake, and laid the letter in his hand, still folded as when I drew my own away, feeling that its place was there, and making myself happy with the thought, that, even in his solitary place in the ‘Government Lot,’ he would not be without some token of the love which makes life beautiful and outlives death.”

Alcott’s interactions with John in the above passage exemplify both The Physical and Emotional Toll of War and The Dynamics of Care and Compassion. Several times across the book, she describes a patient’s death not only with dignity and restraint but also deep empathy and a sense of personal loss. Her depictions show the emotional toll of war on nurses and on the families who were bereaved.

“Constant complaints were being made of incompetent attendants, and some dozen women did double duty, and then were blamed for breaking down. If any hospital director fancies this a good and economical arrangement, allow one used up nurse to tell him it isn’t.”

Across the book, Alcott draws attention to the importance of nurses’ contributions and the challenges they face, as reflected in the above passage. She speaks plainly and directly about how hospital administrators seem to expect nurses to compensate for their own mistakes or shortcuts. Alcott herself will become an example of the physical toll on nurses, as she contracts typhoid in the course of her service.

“I never shall regret the going, though a sharp tussle with typhoid, ten dollars, and a wig, are all the visible results of the experiment; for one may live and learn much in a month. A good fit of illness proves the value of health; real danger tries one’s mettle; and self-sacrifice sweetens character. Let no one who sincerely desires to help the work on in this way, delay going through any fear; for the worth of life lies in the experiences that fill it, and this is one which cannot be forgotten.”

Chapter 5 concludes with Alcott being compelled to return home after just six weeks of service, due to illness. Across the chapter and the book, she is honest and forthright about unhealthy conditions at the hospital and the emotional and physical toll of caring for the patients. Nevertheless, she also emphasizes the importance of the cause and the personal rewards that come with serving it. For Alcott, these are not material but spiritual and emotional rewards, as suggested above in her belief that illness, danger, and self-sacrifice benefit the development of character.

“‘I’d rather laugh than cry, when I must sing out anyhow, so just say that bit from Dickens again, please, and I’ll stand it like a man.’”

The speaker of the above passage is the Sergeant, whom Alcott introduced in Chapter 3 and whose fate readers asked about. Alcott describes brushing his hair and gossiping with him while Dr. P. “poked and strapped” (67) his arm, His declaration that he would “rather laugh than cry” affirm Alcott’s own belief in The Value of Humor in Stressful Times. She reports that since she returned home, she received news that he did as well.

“Speaking of the surgeons reminds me that, having found all manner of fault, it becomes me to celebrate the redeeming feature of Hurly-burly House. I had been prepared by the accounts of others, to expect much humiliation of spirit from the surgeons […] Great, therefore, was our surprise, when I found myself treated with the utmost courtesy and kindness.”

Earlier in the book, Alcott drew attention to the way nurses tended to be blamed for errors that resulted from poor decisions by hospital administrators. Here, she balances her assessment of the hospital by affirming the respect and care the surgeons showed for nurses. Her acknowledgment of their respectful treatment offers an additional perspective on The Dynamics of Care and Compassion: For it is not only the relationship between staff and patients that matter in hospitals, but also the relationships among staff members.

“As no two persons see the same thing with the same eyes, my view of hospital life must be taken through my glass, and held for what it is worth. Certainly, nothing was set down in malice, and to the serious-minded party who objected to a tone of levity in some portions of the Sketches, I can only say that it is a part of my religion to look well after the cheerfulness of life, and let the dismals shift for themselves.”

Alcott is forthright that her experiences are her own, and while her colleagues and readers have responded positively to her sketches, she acknowledges that they are individual, unique to her. Likewise, her belief in The Value of Humor in Stressful Times is part of her personal belief system, an extension of her religious belief that, as she quotes Sir Thomas More, “it is wise to ‘be merrie in God’” (72). This emphasis on the personal and individual is evident across the book in the way she focuses her descriptions on what she personally has seen and heard, rather than focusing only on generalizations and judgments.