Jane E. Schultz. Women at the Front: Hospital Workers in Civil War America. Chapel Hill: University of North Carolina Press, 2004. xiv + 360 pp. $35.00 (cloth), ISBN 978-0-8078-2867-0.

Reviewed by Megan Seaholm (Department of History, University of Texas at Austin)
Published on H-CivWar (February, 2006)

"Are we not all soldiers?"

Jane E. Schultz, associate professor of English, American studies, and women's studies at Indiana University-Purdue University-Indianapolis, makes an important contribution to social history, women's history, and Civil War studies with her recent book, Women at the Front: Hospital Workers in Civil War America. The title and subtitle are descriptive and suggestive. Hospital relief workers often worked at or near the battlefront. In addition, they often experienced their service as a war against death and disease; against loneliness and fear; against military and medical hierarchies; and against demeaning ideologies of gender, class and race. As Anna L. Beers wrote to the famous Civil War nurse Mary Ann Bickerdyke in 1886, "Are we not all soldiers?" (p. 183).

Women at the Front is an inclusive scholarly study history of Civil War women hospital and relief workers. Schultz's subjects include northern and southern women; elite, middle-class, and working-class women; Catholic nuns; slave women, free black women, and "contraband" women; cooks and laundresses, as well as the often-noted nurses. In other words, "Female hospital workers were as diverse as the population of the United States in 1860" (p. 12). Noting that the 1875-88 twelve-volume Medical and Surgical History of the War of the Rebellion devoted a mere two hundred words to female hospital workers, Schultz believes that the labor of twenty thousand women requires greater attention (p. 8).[1] She accomplishes this ambitious expansion after consulting dozens of manuscript collections in fourteen states and Washington, D.C., numerous documents in the national archives, over one hundred published narratives, and an impressive list of secondary sources. Professor Schultz has done her homework. In an appendix, Schultz provides a helpful historigraphical essay in which she commends the work of George Rable, Drew Gilpin Faust, Victoria Bynum, LeeAnn Whites, Leslie Schwalm, Catherine Clinton, Laura Edwards, Elizabeth Leonard, and many others.

Schultz's inclusivity is more than breadth of coverage. She is eager to deflate the myth that women war workers were all white and middle class and that they worked primarily as nurses. Those who were middle class, and literate, left more of a paper trail, and their stories are, therefore, more prominent than those of other hospital workers. At the same time, Schultz has not written a hagiography. She is unflinching in identifying the class and race biases that did not disappear despite the extremity of war, and she is equally clear-eyed in analyzing the mixed motives of war memorializing.

Schultz presents her findings in two parts, "On Duty" and "The Legacy of War Work." She begins by emphasizing the heterogeneity of the female hospital workers and the related variety of motives for involvement. Hospital workers, not unlike the soldiers they tended, sought hospital relief work because of patriotism, idealism, a sense of duty, a lust for adventure, the desire to be near relatives, and because they needed a paycheck. As male breadwinners went to war, many sought hospital relief work out of financial necessity. Regardless of motive or need, many met great resistance. Nineteenth-century gender ideologies both beckoned women to and discouraged them from war work. Women were viewed as natural nurturers, but the military was, initially, opposed to female nurses: they had no medical training and their presence would be a nuisance and a distraction. Middle- and upper-class women were discouraged from hospital work because of the impropriety of being around so many men, because the horrors of the military hospital would overwhelm female delicacy, and because hospital work was considered lower class. As the war continued, longer than anyone in 1861 had imagined, the need for hospital workers begat public support and encouraged military acceptance. Thousands of women entered hospital service, some for years and some for only a few weeks. Some worked for particular regiments. Many became involved through various relief organizations; others were appointed to nursing jobs by Dorothea Dix, head of the Office of Army Nurses. Some showed up after a battle to lend a hand and were immediately swept up in the enormity of providing for hundreds of wounded men.

Life in the military hospitals was difficult and often dangerous. Women relief workers experienced the hardships of the front: food shortages, inadequate shelter, squalid conditions, enemy fire, and the same diseases and conditions that afflicted the soldiers--typhoid, smallpox, lice, and dysentery. Wages were low, and women routinely received less than male relief workers. Working-class women and black women were additionally vulnerable to sexual harassment and abuse. Schultz enlivens her narrative with first-person accounts like this one from Helen Eaton at Chancellorsville: "I rode up to a house, found it crammed full of wounded soldiers … There was not even standing room, but the doctor managed to find me a corner long enough to lie down, in an old attic, full of old rubbish & wounded soldiers [where] I rolled myself up in a corner, after one o clock and lay in the dark" (p. 82).

Despite these hardships, Schultz reports on the "staying power" that allowed hundreds of women relief workers to stay on their jobs for several years (p. 108). In becoming more skilled and confident, some women became more assertive in their advocacy of better treatment for the wounded. They complained about inadequate or substandard food, inhumane or improper care, corruption and mismanagement. More often than not, however, the bottom line was defined by gender. Elite women may have shared the same class status as surgeons, but, being female, they were neither military nor medical professionals. That "problems with hospital authorities were located in gendered relationships" was surely the case (p. 140), but here Schultz misses a step. The Civil War was a tsunami for military medical practice. Poorly organized, ill-prepared, and most significantly, lacking knowledge of bacteriology and the importance of antisepsis, physicians and surgeons were fighting a losing battle.[2] In acknowledging the concerns that women hospital workers had for soldier patients, she too hastily generalizes about the indifference or professional interests of physicians.

On the other hand, Schultz's analysis of class, race, and gender is particularly astute. She explains that work assignments were usually based on race and class: poor white and black women were dispatched to custodial work while middle-class white women were assigned to nursing duties. Though the female hospital workers, whatever their assignment, were a sexual minority, gender solidarity did not follow. Middle- and upper- class white women were eager to maintain class and race boundaries vis a vis the rest of the female staff. Further, as middle-class women were snubbed by the medical staff, class and race barriers between them and the soldiers disappeared: "Middle-class women, who would have eschewed contact with laboring men at home, now had an opportunity to celebrate their nobility" (p. 97). Class and race trumped gender among the women hospital workers; however, gender trumped class when it came to military and medical rank. "The hospital hierarchy under which nurses labored was analogous to soldiers' position in the broader military arena" (p. 140).

In the second part of the book, "Legacy of War Work," Schultz focuses on the postwar work of Civil War hospital workers, the campaign for and implementation of the Nurses Pension Act of 1892, and the ways that these women remembered and memorialized their war work. As she follows the hospital relief works in postbellum America, Schultz provides scores of fascinating examples but they defy generalization. Working-class women and freed slaves sought work in the rapidly industrializing north or in the racist economic arrangements of the New South. Some middle-class women were able to leverage their war work for secure employment, and some focused on postbellum reform. Schultz claims that "the war encouraged a reunited U.S. labor force to receive [women] more readily after 1865" (p. 180), but this claim is not persuasive. That more women were hired for extra-domestic work after 1865 more frequently than before is more likely a consequence of the pace of industrialization and the need for laborers than changed views regarding gender.

Similarly, Schultz argues that women could "contribute to the public life of the nation with greater impunity than they had before the conflict" (p. 181). She provides examples of women who distinguished themselves as reformers after the war. Given the vigor of women's involvement in antebellum reform, however, it is difficult to credit Schultz's claim. War work and involvement in postbellum reform may have been more continuous with trends already in place than the occasion for change, even for women whose reform vocation did not begin until after 1865.

Schultz's chapter on "Pensioning Women" is a signal contribution to the history of U.S. social welfare policy. In a smaller way, Schultz follows the lead of scholars like Theda Skopol when she recounts and analyzes the passage of the 1892 Nurses Pension Act.[3] As a pension for Civil War nurses, thousands of the lowest paid hospital worker--the cooks, laundresses, housekeeper--were overlooked. Still, the act was a significant departure in that it recognized the propriety of pensioning women for their service independent of marital status and presumed need.

Schultz concludes with an analysis of how her subjects pursued the work of war memorializing. As individuals who published narratives of their hospital work and as members of memorial organizations such as the Women's Relief Corps and the United Daughters of the Confederacy, women hoped to "gain a national foothold in the chronicle of war" (p. 216).[4] The women writers, many of whom published because they needed the money, had to be careful to craft their "triumphal narratives" according to contemporary gender conventions. Their tone was often self-effacing and their accounts of contributions or self-sacrifice were couched in praise of the soldiers they served. Still, "[t]hey molded narrative to their own uses, demonstrating the malleability of memory as they celebrated their religious and domestic work among soldiers and carved a niche for themselves in a hostile arena" (p. 244).

The scope of Shultz's work--her subjects, their experiences during and after the war, and her careful analysis of gender, race, and class--makes Women at the Front a valuable and unique contribution. We learn much less about the working-class or African-American hospital workers than we do about the white, middle- and upper-class workers. In this, Schultz promises more than she delivers. To her credit, though, Schultz never lets her readers forget these women even if it is only to point out that in the hospitals and after the war their options were severely constrained. The oppressions of race and class were such that their stories could not be told as fully of those of more privileged, literate women. Nonetheless, Schultz has provided scholars and serious readers a well-researched, well-conceptualized, and well-written study of female hospital relief workers during America's Civil War.

Notes

[1]. The Medical and Surgical History of the War of the Rebellion, 12 vols. (1875-88; reprint, The Medical and Surgical History of the Civil War, Philadelphia: Broadfoot, 1990-92), p. 958.

[2]. Ira Rutkow, Bleeding Blue and Gray: Civil War Surgery and the Evolution of American Medicine (New York: Random House, 2005).

[3]. Theda Skocpol, Protecting Soldiers and Mothers: The Political Origins of Social Policy in the United States (Cambridge, Mass.: Belknap Press of Harvard University Press, 1992).

[4]. Joan Marie Johnson's study of South Carolina clubwomen includes an excellent discussion of ways in which the United Daughters of the Confederacy championed the "Lost Cause" and "shaped the culture of a newly segregated South" (p. 3). Joan Marie Johnson, Southern Ladies, New Women: Race, Region, and Clubwomen in South Carolina, 1890-1930 (Gainesville: University Press of Florida, 2004).

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Citation: Megan Seaholm. Review of Schultz, Jane E., Women at the Front: Hospital Workers in Civil War America. H-CivWar, H-Net Reviews. February, 2006.
URL: http://www.h-net.org/reviews/showrev.php?id=11411

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