Jan 25, 201209:00 AMPoint of View


You can imagine women in petticoats down there twirling their bright parasols in the sun. Men jostle for position on the riverbank and children in britches tumble playfully in the grass. A breeze ripples across the water as a cheer goes up. Listing precariously, an overloaded boat rounds into view. The cargo is human wreckage. The wounded, fresh from the Civil War battlefront, have arrived in Philadelphia. Great sport, really. Something lively to do and see on a lazy summer afternoon… The paddle wheel boat churns in reverse, slowly pulling alongside a wooden dock, already dipping into the drink with the unbalanced weight of well wishers and gawkers. Now begins the unloading. Battered young soldiers wince at the slightest tilt of the stretcher, moaning in the sweaty discomfort of the languid summer heat. Crowds suddenly recoil at the rising vapor of fetid odors and draw quiet in the spectral presence of the War itself. Lemonade, fortified with rum, is dispensed from a silver tureen into a gleaming white, porcelain cup for each soldier--a gesture of welcome and to slake their thirst in a first line of treatment. Shortly, horse drawn ambulances arrive to spirit the wounded to massive, barracks-like medical complexes erected, hastily, to address the equivalent scale of trauma issuing forth from the battlefields...

Excised elbow joint from gunshot wound

“Anytime you see an ambulance, you're seeing civil war medicine,” says J. Nathan Bazzel, director of communications for the College of Physicians of Philadelphia, the oldest professional medical society in the United States dating back to 1787. The “Birthplace of American Medicine” they call themselves. The Mutter Museum of the College of Physicians of Philadelphia opens a permanent exhibit of Civil War medicine in the summer of 2013, coinciding with the Sesquicentennial of the Mutter Museum and the Battle of Gettysburg. Early in the Civil War, the United States government selected Philadelphia as the site for the sprawling Satterlee and Mower hospitals. This city was to be a central location for the care of sick and wounded Union soldiers and sailors. Though conceived and constructed in a rush, the hospitals touted modern principles of broad ventilation and daylight.

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Corridor at Mower Hospital, Philadelphia. Photograph by John Moran. Credit: Library Company of Philadelphia

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Entrance to Mower Hospital on 27 acres in Chestnut Hill, Philadelphia.. Photograph by John Moran. Credit: Library Company of Philadelphia

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Mower Hospital foldout from the hospital rule book. Credit: Historical Medical Library of The College of Physicians of Philadelphia

Robert D. Hicks, PhD, director of the Mutter Museum & Historical Medical Library, led me on a labyrinthine path to his basement office, surrounded by floating planets, a magic eight ball, a skull with a gold Halloween mask, a two-headed doll, a large-scale plastic model of a praying mantis and a fish tank with leeches, the type used for Civil War battlefield medicine. “They don't make the most interactive of pets.”

M5_DOCS_Hick's office

Dr. Hicks can't stand the harsh overhead fluorescent lights so always keeps them off. Somehow the inadequate lighting helps steep him in the milieu of the 19th century. Despite the anomalous presence of a flat screen computer, old wood filing cabinets, and spindled antique furniture complete the atmospheric effect. At his fingertips, extensive, animated knowledge of the many intertwining strands that will weave a cohesive, compelling human story for the upcoming exhibit “Broken Bodies, Suffering Spirits: Injury, Death and Healing in Civil War Philadelphia.” It will feature medical implements, surgery manuals, diaries and other documentary materials some of which have “never been seen before.” The exhibit cases themselves will be made from refurbished old-fashioned exhibit cases more appropriate to the 19th century.

M6_DOCS_Hick's window


S. Weir Mitchcell, pioneer neurosurgeon The Mutter Museum is small, a fraction of the 70, 000 sq. ft, College of Physicians, but it contains the potent stuff bad dreams are made of. It's an irresistible draw. Some 120,000 annual visitors gape at its medical oddities, skeletons, and formaldehyded human specimens of pathological anatomy. Hicks, though, is spearheading a transition to a broader medical humanities approach that examines human health within cultural perspectives over time. “Broken Bodies, Suffering Spirits” is an exhibit that will break the mold.

“The past is never dead. It's not even past.”

William Faulkner

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Desk of Dr. Hicks

To those of us from the north, the Civil War is important history, albeit history that most of us know far too little about. To southerners, “The War of Northern Aggression” never ended. Just ask them. That said, one struggles to comprehend the monumental scale of loss (still mounting in revised historical accounts some 150 years later) approaching 750,000 casualties – more than the combined total of all United States wars since. Proportionately, in today terms, that would represent seven to ten million war dead. “Every family would have been touched by this,” says Hicks, who numerous times spoke of getting “chills” from the inferences of his own Civil War research. There is an obligation, advises Hicks, to “respect the participants on all sides.” One can't be dismissive either of the medical care rendered at that time, he adds, since it became an incredibly well organized, systematized, and documented treatment juggernaut rendered on a mass scale. “The good records keeping came back to haunt the system,” says Hicks, alluding to the efforts of returning vets to gain the kind of government sponsored care, a uniform pension system, they had earned on the battlefield. Sound familiar? “It's sobering to think that the end of the Civil War was not all that distant...I was a kid at the time of the 100th anniversary and it registered with me then.” Hicks points out that the distance between the end of the Civil War and the beginning of World War I is roughly equivalent to the distance between the end of World War II and today. That's the point of this exhibit. The reverberations continue. There are medical treatments and examples from the Civil War battlefield that the United States military is now looking to for answers. The blunt, crater-like devastation of Civil War bullet wounds was, for a time, superseded by the clean exit wounds of modern projectiles. When improvised explosive devices (IED'S) cropped up in Afghanistan, all of a sudden Civil War medicine and records came to the fore, again.


M9_DOCS_William W Keen copy

William W. Keen was the only physician to serve in uniform in both the Civil War and World War I. Though he found himself on the early battlefield with only nine months of training and faced a chaotic lack of military and medical command, he stayed the course. “I did not know whether to order six ounces or a gallon of laudanum, an ounce or two or a pound or two of opium.” He participated in and embraced the transformation of American medicine and therapeutics into the 20th century. See: “Frontline Pharmacies” (Chemical Heritage magazine Summer 2011) by Robert D. Hicks, Director of the Mutter Museum and Historical Medical Library of the College of Physicians of Philadelphia At the time of the Civil War, Philadelphia had the highest concentration of medical facilities north of Washington, DC, upwards of 20 hospitals and two major medical complexes, Satterlee and Mower, where modern battlefield medicine was virtually invented on the spot. Ambulances, triage treatment strategies, trauma (PTSD) awareness (then called  “Soldier's Heart”), phantom limb syndrome and the birth of American neurology (in 1864), all sprang from the agony of the Civil War. The city of Philadelphia must have fairly swarmed with “Civil War docs in town” who were unlicensed, hardly trained by today's standards. The college itself had about 150 members at that time but other contract physicians were mobilized, too. Residences were sometimes converted into treatment centers. Don't forget, there was no medical imaging in those days, either. In order to trace the trajectory of a bullet through the body one had to either see surface evidence...or poke ones finger inside. You could have done it yourself. A long instrument called the Nelaton probe was eventually developed during the Civil War and was used as late as World War II.


Ford's Theater draped in black, mourning Abraham Lincoln's assassination in 1865

If ever the expression “a country torn asunder” applied it would be to the United States during the Civil War. The country, literally, tore itself itself apart as doctors labored feverishly to close the gaping national wound. Despite the horrific fratricide on the battlefield it was not unusual for Union doctors to treat Confederate soldiers and vice versa.

Hicks and I spoke about the potential “So what?” reaction to his planned exhibit. We're war weary as it is with recent foreign engagements. Though interest and exposure will grow during this 2011-2015 Civil War anniversary period his challenge is still to wrestle the incomprehensible scale of war and destruction into something concrete – individual human experience. We can't take a ho-hum attitude towards such history and expect to make progress as a country. Martin Luther King Day cannot be a day at the beach if we expect sacrifice to equate with progress. I suppose that's my own bias but consider this – a country will never be whole if it is missing a limb, a portion of its populace – Northern or Southern, black or white, male or female. The Mutter Museum was about to close but Hicks reached into his files to give me an astonishing, moving facsimile document of a typewritten letter in a Courier type font addressed to Dr. S. Weir Mitchell (pioneering neurosurgeon) dated February 10, 1906, by a Civil War commander recording testimony of his lost limb, its phantom presence: “I was 24 years old when I lost my arm, and now I am 67.  Almost two-thirds of my life has passed without thought of the possible use of my right arm, and yet never have I dreamed once that I was not without two arms...I am now fond of writing with a pen, fond of the mechanical skill which writing requires, and I often write in my dreams, but always with t he right hand I used over forty years ago... Thus, in my dreams, I remain a man with perfect frame, but while awake, I never think of myself otherwise than a one-handed being.” Joseph G. Brin is an architect, fine artist and teacher based in Philadelphia, PA. He is writing a graphic novel on Al Capone to be published on Kindle. Brin is also collaborating with Jordan Gil, exhibit designer, on a new project harnessing the power of art and strategic design for a bully-free Philadelphia called “B. Free.” (http://bfreephiladelphia.wordpress.com). Brin’s fine art rowing poster site is at: www.brushstrokesrowing.com/gallery Twitter: @AncientGlass Links: COLLEGE OF PHYSICIANS: http://www.collphyphil.org/Site/The_College_of_Physicians_of_Philadelphia.html LIBRARY COMPANY OF PHILADELPHIA: http://www.librarycompany.org/ Credits: Photographs of Dr. Hick's office and desk: Joseph G. Brin Vintage photographs and Mower foldout: The Historical Medical Library of The College of Physicians of Philadelphia Photographs of Mower Hospital (interior and exterior) -- Library Company of Philadelphia METROPOLIS: "Civil War Vet Builds on River"

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