Book Review 412: Bad Doctors

BAD DOCTORS: Military Justice Proceedings against 622 Civil War Surgeons, by Thomas P. Lowry and Terry Reiamer. 126 pages. National Museum of the Civil War Medicine Press paperback.

In 1861 as the nation headed toward dissolution and war the surgeon general of the army lay in a coma, the result of a stroke. Such was the idiocy of the military mind that he could neither be retired nor replaced.

The tiny scattered army would've had difficulty in any event even with leadership. There were hardly any physicians, no field ambulance service, no system of procuring medical supplies, no hospitals -- really no nothing.

There was not even any agreed concept of standard care. In the United States of those days there were numerous competing systems of medical care, all of them more or less humbug.

By a curiosity of history, the small city of Frederick in Maryland was and is the center of the problems of Civil War medicine. In 1862 and '63, it was the closest considerable settlement to the south of the two bloodiest battlefields of the war, Antietam/Sharpsburg  and Gettysburg. The wounded were collected in Frederick to be treated in numerous buildings suddenly declared to be hospitals.

A small private museum, the National Museum of Civil War Medicine, is housed in an old building within walking distance of several of these hospitals. Its staff has compiled some studies along with the exhibits about the conflict. "Bad Doctors" (which seems to be available only at the museum store) presents a curious picture.

About 6% of the surgeons inducted into or hired by the Union Army were court-martialed. "Bad Doctors" presents a precis of the proceedings as well as a few short chapters on extraordinary cases.

Such is idiocy of the military mindset that the famous disasters of medicine in the Crimean War just a few years earlier had no impact on the thinking or preparations of American officers. Combat should have focused their minds, but they still were more concerned with the heinous offense of officers messing with enlisted men than they were with officers who neglected, starved, mistreated or otherwise abused the men they were supposed to care for.

Part of this indifference no doubt can be laid the lack of consensus on what a standard of care was. Thomas Lowry and Terry Reimer note that in one way the Confederate soldiers were better off than the Union soldiers. The Confederacy faced all the problems the Union faced with fewer resources. But that included lack of access to calomel and other poisons that were commonly used as medicines in those days.

Southerners tried to make do by turning to traditional herbal remedies and not far from Fredrick in Keedysville, Maryland, at a branch of the museum, the Pye House which was the headquarters of Gen. Meade at the Battle of Antietam, volunteers are recreating a medicinal garden of the war. Some of the remedies produced there were less dangerous than calomel but not necessarily safe either.

Somewhat surprisingly, despite so many factors working against success, the two American armies, although they were much larger than most armies of former times, managed for the most part to avoid the typhus and other epidemics that have decided so many previous campaigns. The work of the United States Sanitary Commission -- a Civil War innovation hardly mentioned in Bad Doctors presumably accounted for this.

Lowry and Reimer conclude that on the whole Union doctors did a pretty good job considering. The numbers court-martialed for eating with the enlisted men, drunkenness, thievery, treachery etc. was not out of line with the numbers involved in later supposedly more enlightened times.

Whether military medicine really did get better, as they assert, is a matter for debate. My uncle Hugh was badly wounded and France in 1918. The army doctors wanted to cut off his leg. He refused because they were all drunk and he got away with it because he was an officer.

Records of the courts-martials sometimes show that the defendants were heroes, dedicated healers accused of peculation and theft who were actually working outside failed army logistical protocols in order to get enough food or medicine to keep their patients from starving and dying.

At other times, clearly incompetent doctors were forced back on the army by state governors who had great influence on an army organized my regimental volunteers raised in individual states.

At other times it appears that courts martial were convinced that a surgeon was incompetent or ineffective but kept him on because there was no one else. The sample is too small to permit a statistical study but judging by the percentage of colored troops in the army against the percentage of doctors who were in colored regiments and court-martialed, it looks like black troops had a hard time finding even incompetent medical help.

Their death rates, much higher than those of white troops, suggest the same thing.

Here is the book's notation of a surgeon chosen at random: Jacob Quick of the 22nd New Jersey Infantry which shows the kind of information available in "Bad Doctors":

"Refused to attend a private suffering from a 'severe purging of blood,' cursed him, told him to wait until morning. Guilty. Fined one moth's pay. Second trial: cursed and attacked his colonel and stole meat and potatoes. Acquitted."

They had learned at the Museum was that by the Civil War you rock. Battlefield surgery had ended. Soldiers no longer had to bite the bullet Wally sawbones cut off a limb 95% civil War Battlefield surgeries use ether as an anesthetic.

Today the American military has its own medical schools operating within a scientific background that permits of an actual standard of care and a budget that is essentially infinite. It also has responsibility for the dependents of soldiers, which was not the case in 1861-65.

Military medicoes are only somewhat slightly better prepared to handle these responsibilities than in 1861 as anyone who has had to depend on Tri-Care will attest.

Trump speaks truth

According to The Washington Post:

 President Trump told two senior Russian officials in a 2017 Oval Office meeting that he was unconcerned about Moscow’s interference in the 2016 U.S. presidential election because the United States did the same in other countries

On CNN, one of the Post reporters on the story, Shane Harris, said that obviously is not true. But it is true.

No country has subverted more elections than the United States although its usual practice has been to allow elections to go forward and then if democrats are elected to destroy the democracy.

American interference in other countries' elections got going shortly after World War II in France and Italy. It continued under every administration except Carter's, but it wasn't just a matter of subverting democracy.

Democracy was not all that common so as often as not subversion of democracy took the form of supporting despotisms: Indonesia, Greece, Turkey, South Africa, South Vietnam, Spain, Portugal, Paraguay, many more.

From time to time brown people did attempt to start democracies. This usually caught America off guard since it does not believe brown people are capable of governing themselves.

When that happened democracies had to be overthrown in Haiti, Guatemala, Iran, Dominican Republic, Chile.

America didn't allow for democracy at home either. I came to political consciousness in the 1950s in Georgia which no one would describe as a democracy. Then or now although there have been some attempts in that direction recently there.

A few days ago I listened to most of Trump speech at the United Nations. He always speaks from the bully pulpit though in the common use of the word bully not Roosevelt's. He blustered about Venezuela. American policy has not been now or previously been to support democracy there. insofar as the current government has a policy it's the old familiar one of propping up a puppet with little or no popular support.

Imagine if the United States had supported democracy in Venezuela in the '50s or '60s. Perhaps it could have become a democracy by now. But actions have consequences and supporting the destruction of democratic movements makes it all the harder for any to break through subsequently.

The earliest international policy of which I have any clear memory was the 1956 Hungarian revolution. As Trump spoke about Venezuela I was mindful of what happened to the democrats in Hungry.

Hungry has never been a democracy. It was fascist and then it was occupied by Russians. At Our Lady of Perpetual Help church we prayed for the liberation of Cardinal Mindzenty in the name of democracy. Mindzenty was not a democrat, he was a reactionary Catholic.

Having failed to detect or support any genuine democrats, when the revolution broke out the United States was in an impossible position. Because of the McCarthyites and the Catholic lobby it could only support the reactionaries if it supported anyone. But the people in streets throwing Molotov cocktails against Russian tanks were -- at least some of them -- democrats.

 

The United States would not support them but Eisenhower had the Voice of America encourage their reckless resistance. With words only.

Today the United States talks about democracy in Venezuela but any actual democrats there have been hung out to dry.

Chock full o' nuts

Sykesville, the little town where I live, got its start with water mills for flour and lumber. Fire and flood put an end to that but in 1894 the state opened a lunatic asylum here.

This was the biggest employer until the '80s when most of the hospital shut down. Maryland has been trying with almost no success to find new enterprises for its 600-acre campus.

Today downtown has a feed store, a distillery, three saloons, two creameries and -- very unusually for such a small place -- a bookstore.  All very small businesses.

Over by the hospital there's a county lockup, a drug treatment center that looks more like the prison than the prison does and a huge building with a sign you can see from the highway: Northrop Grumman.

While it's not exactly a state secret what goes on there the company does not advertise it and nobody in town seems to know. I asked the mayor. He didn't know. I asked the man who runs the town museum. He didn't know. I asked te head of maintenance at the lunatic asylum next-door. He didn't know.

Visitors are discouraged:

When the building opened in 1997 it was announced that the company would work with electronic sensors whatever that means. Here's what it means now.

So it's still lunatics.

As the United States prepares to leave Afghanistan in defeat, it's worth asking ,was it reasonable to think that $10 trillion was sufficient to support a military operation in a country with 25 million people. One might have thought that was more than enough, but when you're spending $1 billion on mind reading and rail guns, $10 trillion doesn't go that far.

Carbuncle of uncertainty

Meanwhile in Buffoonistan;

the president warned that hurricane Dorian was going to hit Alabama hard. Apparently the National Weather Service is part of the deep state because less than 20 minutes later it tweeted that hurricane Dorian was not Alabamy bound.

You have to follow Trumps tens of thousands of tweets pretty intently to have noticed this and I certainly don't and didn't. Trump the master manipulator ensured that the world did pay attention.

He went on television with the map showing the projected track of the storm. It included an odd final bulge that reached to the area around Mobile Bay. (His accomplice was Kevin Macaleenan, previously in charge of starving prisoners in concentration camps and kidnapping babies. Now we have a project thåt might keep both of them out of prison: they can spend the next wet afternoon with some of Trump's many dollar bills, drawing mustaches the the portrait of Washington.)

The map had been altered. It should not take detectives too long to pin down the culprit. It was someone who is addicted to the use of very large black Sharpies and who hasn't ever noticed that each successive segment of a cone of uncertainty is larger than the one before, like the segments on a nautilus.

The Alabama  map looks more like a pimple.

It turns out that although falsifying and publicizing an official weather map is not an impeachable offense, it is a low crime and misdemeanor. Judging by the penalty, less serious then molesting a Coast and Geodetic Survey benchmark.

Perhaps Trump can mount a defense based on the fact that the map that was altered was not a weather map but a water district map.


I have a low opinion of Trump's followers but not as low as Trump's opinion of Trump's followers.

Splinter group

Christian monarchist Nazis.

At the time, neoreaction (also known as “NRx”) was a largely unknown internet phenomenon. Even now, defining it is tricky. At its core, neoreaction is anti-egalitarian and anti-democratic, and many of its proponents advocate a return to monarchy or other autocratic forms of government. Yet even its central tenets and thinkers, like most internet movements cloaked in onion-like layers of irony, are ambiguous. It feeds off of self-importance, as well as the impossibility of pinning it down.

Which was also  thing with the original Nazis. Even the would-be Hohenzollern crown prince put on the brown shirt.

A long piece in Splinter exposes these Nazis and their influence on today's rightwing.

I had never heard of Splinter but was led to it by an interview by conservative Joe Scarborough with conservative Tim Carney. This led back to Carney's piece at the Washington Examiner where he summed up;

Conservatives ought to make it a priority to fight for the fundamental dignity and equality of racial minorities who have been denied that dignity and equality. It will require overcoming decades of injustice, and so won't happen quickly. We won't disabuse the Left of their self-satisfied smears and conceits, but that's not the point. Conservatives will be able to take solace in the fact that we're fighting the good fight and pissing off the racists.

They are very late to this party. My racist uncles joined the John Birch Society in the '60s.

For individual antiracist conservatives, I have a suggestion: Join the left. It hasn't had a Nazi problem since July 22, 1941. That will be a lot easier than remaking the Republican Party.

George Orwell comes to Maryland

Bandit visits us from New York

Maryland, where I live, has a new law forbidding the retail sale of dogs, cats and rabbits.

I do not know why these animals are more equal than all the other animals. Or perhaps less equal.

I'm sure that the dogs will prefer being sold, while the cats will be indifferent. I don't know what the rabbits will think.

Spirit of Drancy V

The gods are smiling on Trump today. Another shooting in Texas and a Category 5 hurricane heading for Florida have pushed the child execution news out of the public eye just when it was about catch attention.

Numerically, the plan to execute children would not have had any impact on immigration one way or  the other, but it was one of those things that tends to grab the public by its emotional ears and give it a good shake.

WBUR in Boston broke the story almost a week ago and although in some respects it was almost unbelievable it was quickly confirmed in Florida by the Miami Herald and has since been admitted to by the administration. Nobody else except maybe Rachel Maddow paid much attention. She got quite worked up about it and even begged her 'friends at FOX News" to mention it so that Trunp would become aware.

So far as I know her friends let her down.

The moment is passed. The news tht the government is preparing to execute immigrant children would never impress the right-wingers anyway for whom killing brown people is kin to sport, but it might have had some effect on general public opinion for whom immigration isn't really much of an issue.

Instead we get wall to wall weather and ordinary murder.  The only thing really newsworthy about either of those stories is it Gov. Greg Abbott in Texas did not offer either thoughts or prayers for the people going down in Odessa. Presumably he has exhausted his stock of both.

It was impressive though how the Odessa killer managed to kill seven people by hitting them with a hammer while driving down the highway at 55 miles an hour.