We would love to hear your comments on the article from this month’s issue of Civil War News.

For the past several days, with each new hour, we are made more aware of the truly unthinkable horrors of the disaster’s aftermath.  I must assume that many of us are taken back to the tsunami disaster that occurred back in  2004.  Many are facing the same feeling of helplessness they did back then.  It is a good time for us to look to the past and see just how helpful everyone can be.  As a center for the study of the medical and relief efforts of the Civil War, we are keenly aware of just how great a difference we can all make.

In 1861, relief societies formed to help bring medical supplies and comfort to the soldiers at the front.  Over the course of the war, money and supplies were raised on both sides to bring humanitarian aid to the war torn portions of the nation.  Many of the donors never saw a single dead soldier, never witnessed the horrors of the battlefield and yet their influence was felt by countless thousands of soldiers and refugees.  We are called to follow in their footsteps.

The Museum and the Letterman Institute are proud of our contribution to the training of some who are currently on their way to the scene,  but this is not enough.  We encourage all who read these words to remember the deeds of those who supported relief efforts in the past.  To make this easier, we will be placing a donate now button on our Facebook page before the end of business on 3/15/2011.  We will also begin accepting donations in our Museum lobby today.  All proceeds will go to the efforts of the International Red Cross.  Please consider making a donation.  Our donations will all be designated for the victims in Japan in honor of Clara Barton.

There is no greater way to honor the past than to allow it to drive us to meritorious service in the present and the future.  I hope you will join us in this important effort!

Click to  DONATE NOW

Most everyone agrees that the number of men killed during the war is around 620,000. This number is known to be somewhat suspect since many of the Confederate records were lost. But there is mounting evidence that shows that this accounting is simply not sufficient in other ways. First, many men were sent home with wounds or diseases during the first years of the war AFTER being mustered out of service only to die at home. The effectively kept them out of the final tally. Next, most of those who died after 1866 were never counted! This is despite the fact that they may have died as a direct result of wounds or diseases that never healed. My own great great grandfather is among these. He died as a result of heart failure that was due to rheumatic contracted as a prisoner after the battle of Gettysburg

In the Medical and Surgical History of the War of the Rebellion, there is a significant section devoted to the Union Armies attempts to count the dead. There is an interesting footnote that many dead were counted despite the fact that, due to decomposition, they may have been black teamsters or rebel soldiers and therefore should not have been counted. This brings us to an interesting point. If a man is hired by the army, travels with the army and faces death with that army, like the teamsters, why would we not count them?

Today in Iraq (as one example) we know how many contractors have died in direct service to our troops. In the Civil War, these numbers were simply not kept. Contractors in those days would have been mostly seen in the fields of transportation and labor, but these individuals were still placed in harms way. Not all of these laborers would have been men and certainly they were not all African American. In addition to the teamsters, labors, cooks and dock workers, there were female laundresses, arsenal workers, nurses and clerical workers.

Laundresses in the hospitals were known to have significantly high mortality rates due to the handling of contaminated bandaging and linens. Nurses seemed to have faired somewhat better. Arsenal workers where also killed during the war in Pittsburgh, Washington and Richmond. Like their counterparts in the hospitals, these women were never counted among the dead. But these numbers are but the the tip of an iceberg.

It is estimated that in Missouri there were as many as 1,000 civilians killed during the war. While Missouri was certainly a hotbed of civilian conflict, it was not the only place where such tensions existed. Kansas, eastern Kentucky and Tennessee and norther Arkansas had similar violence. We will never know how many civilians died in these localized conflicts. We will also never have a good casualty number for those who may have served in irregular units that were never properly mustered into service. These men might be called “insurgents” today and as such we would have some accounting off them. We are also missing casualty numbers for some of the “90 day wonders” of 1861. Some of those early regiments never did properly report their casualties or even their muster roles.

Finally we need to consider those civilians who were killed as an indirect result of military operations. We know that many died of diseases that were unknown in rural populations until the armies came to an area. Pollution from camp garbage, communicable diseases brought by the soldiers and surface water pollution from the soldier’s poor camp hygiene all added to the suffering caused by the armies use of civilian food supplies. There are numerous reports of families loosing members in the weeks and months after battles. Typhoid fever and other “camp” diseases ran rampant in many towns in the aftermath of battle.

When all of these factors are added together, the death toll of war can only become even more grim. The currently held number stated above needs to be understood only as a starting point. The reality may never been known..but it is certainly much higher.

When Major Jonathan Letterman issued his orders to re-organize the medical department of the Army of the Potomac in 1862, little could he have known that 146 years later his ideology would become the basis of a management training program. The undeniable reality is that his methods were so well rooted in logic and human understanding that they have stood the test of time. His orders and writings lay out simple principles that can lead any organization to success.

These principles include:

• Solve all problems from the bottom up
• Always ask “why” when solving a problem – until you understand all of the “whys” you will formulate a truly useful solution
• Mission is the all-important ruler that must be used when measuring anything in an organization
• Keep your own ego in check, it will help you build stronger relationships and lay low the walls of resistance
• Give credit to those around you, don’t worry about getting credit yourself – after all – it’s supposed to be about the mission!

Remember, history has many lessons to teach. Some of those lessons are obvious while others take some some digging. It is those that take the most digging that often prove to be most valuable.

How many times have we heard this!?! A simple search on the Internet will confirm that most people really don’t understand what Civil War medicine was all about.

Please don’t get me wrong, Civil War medicine, like all battlefield medicine, is a brutal, horrifying, painful thing.  For that matter, so is most emergency medicine.  The problem with Civil War medicine is that popular depictions have replaced the reality.  Unfortunately, some of this popular misconception can be blamed on our Civil War ancestors.

In 1863 (the mid-point of the war) there was no unified germ theory, no antiseptic surgical technique and no sterilization of instruments.  While general hospital wards were kept clean and iodine and bromine were used to fight gangrene, it was not because we understood the germ.  These things were done because there was irrefutable evidence that these techniques saved lives-(despite a lack of evidence as to WHY they saved lives).  It would not be until the 1880′s that the infectious nature of wounds was truly explained.

Now put yourself in the mindset of an 18 year old soldier at Gettysburg who loses his arm.  As a 48 year old man you return to the doctor in 1893 for a simple procedure.  Once in his office you see his sterilized instruments, clean white garments, sterile bandages and a hand washing station.  As you reflect on the barn where you lost your arm so many years ago you have to wonder why those ignorant doctors would operate in such an unhealthy place! What were they thinking back then!  The fact is, science had changed medicine drastically in those 30 years.  It is not that the doctors were bad in 1863, they were just so much more advanced in 1893.

Think of it this way.  Do we blame Robert E. Lee for losing the Civil War because he failed to use his airplanes to bomb Washington?  Of course not!  The airplane wasn’t invented yet.  Well, neither was the germ theory.  We can even see this if  look back just a few years in our own lives.  When my grandfather had his hip replaced  he was kept in bed for several weeks before he could begin walking.  The surgery was very painful and the recovery was awful.  Last year my mother broke he hip and went through a similar major surgery.  She was walking within 24 hours!  The surgeon who did my grandfather’s hip was not incompetent, he simply did not have the advantage of the intervening years of technological advancement.

When we look at Civil War medicine, it is important that we look at the innovations they did accomplish rather than the blaming them for that which could not have been known.  Civil War medicine gave us many advances that did indeed change our world for the better:

• an organized evacuation system for the wounded
• improved transportation for patients (special ships, trains and ambulance designs)
• organized hospital administration for the effective use of manpower and supplies
• organized first aid
• organized triage
• improved supply methods
• improved methods to guarantee drug purity and potency
• widespread use of anesthesia
• better nursing care
• medical specialties (plastic surgery, neurology, prosthetics, etc)
• improved medical training for  military doctors

These are but a few of the improvements brought to us during the Civil War.  So, next time someone says that Civil War Medicine is icky, think of how much worse modern medicine would be if these innovations had never happened.

Many would say that we should remember the past so that the efforts and sacrifices of those who proceed us are not in vain.  We could not agree more.  But, remembering the past is not enough.  If all we do is remember, then we are only scratching the surface.  How much greater is the honor we give to our ancestors if, instead of simply remembering them, we allow them to live with us still.  This is possible by carrying forward the lessons they learned and allowing those lessons to inform our lives today.

We must never forget that our ancestors were very much like us.  They had emotions, feelings, sufferings and triumphs just like we do.  To use their experiences to change our lives means that in a sense they can live with us today.  How could we honor them more?

The fact is, if history is studied just for its own sake then it is no more than a hobby.  There is nothing wrong with this but there is so much more.  If we study history to make our future brighter, then we are using history for the greatest of all reasons…for the betterment of humanity.

We hope that you will consider this as you begin to commemorate the great tragedy of the Civil War.  If we can do this as a people then as Lincoln said,  ”these honored dead shall not have died in vain.”

The Museum has been going through a number of changes in recent times.  We have updated several galleries, developed a new website, begun new leadership training programs and much more.  These are all quite significant but there is one event that truly stands above the rest.

In October, the Board of Directors of the National Museum of Civil War Medicine singed an agreement with the General Services Administration outlining a plan to open Clara Barton’s Missing Soldiers Office as a museum.  This historic office was first found over a decade ago by GSA employee Richard Lyons.  Since that discovery, it has been stabilized and is awaiting conservation.  Once the conservation is completed, the NMCWM will open the location to the public.

Clara Barton’s office (room #9 at 437 7th Street in Washington DC) provides the Museum with a unique opportunity to highlight and interpret the war-time career of one of America’s humanitarians.  Her work as a medical relief organizer and nurse is well known.  Unfortunately her work in locating missing soldiers is much less understood.

During the operation of the Missing Soldiers Office Clara and her staff answered over 66,000 pieces of correspondence!  This effort alone is remarkable until you consider that the same staff also raised funds to support the cost of the work and compiled and published updated lists of the missing for national publication. Her DC office has been credited with determining the fate of over 22,000 missing soldiers. In May of 1865 Clara left for a period of time to help locate and mark the graves of the men who died in the Andersonville prison.    She was accompanied by Mr. Dorence Atwater who, as a prisoner himself,  kept records of the dead for the Confederate commander.   Her work at Andersonville helped identify the graves of all but 460 of the nearly 12,000 graves.

Her accomplishments are not fully understood by most Americans today, but we hope to work with our partners to change that for future generations.  We look forward to developing  new leadership curriculums based on her work as humanitarian, organizer, manager and activist.  We also hope to use the new museum location to educate visitors on her incredible accomplishments. I hope that you will join us in honoring Clara Barton as one of America’s greatest leaders.

Original post date: December 15, 2009 on The Leading Edge ( http://gwunderlich.wordpress.com/)

A recent report claims that a Catholic relief services organization has become so fed up with the delay in supply delivery and a lack of security to protect supply lines that they have started a new tactic.,..surprise deliveries.  They are going out at night and simply setting up their operations when no one expects them.  they hand out the supplies to those who they find and continue to invite the local population to get supplies until they run out.  This method has everything going for it.  It is simple, effective, innovative and meets the mission goals of the organization while supporting the local population in need.  In short this was a stroke of brilliance.

You see, in 1862 when Jonathan Letterman was faced with a similar shortage of vehicles and logistical support, he simply invented a new system.  He used his ambulances to carry supplies after they had delivered their patients.  He also sent his subordinate officers out into the countryside to find medical boxcars which had been side tracked by officials of the B&O Railroad at the request of army officials keen on speeding ammunition and other supplies to the battle front.  By taking control over his own logistical destiny, Letterman carved a new path for himself and his department.  This new thinking helped him support his mission of medical support while it improved the lives of the soldiers that he would care for during the Antietam campaign.

The Catholic relief organization in Haiti showed the same type of innovation.  They assessed their assets, analyzed the need, took note of the obstacles in their way and then took the action needed to meet their mission goal.  It sounds so easy and yet it is very difficult to do.  There is always the temptation to say:” That is not how we do things here.”  It is hard to step out of our comfort zone and do things differently. If we fail then we are no longerLe protected by our past successes.  We can no longer claim that it had always worked before.  When we break the mold and take a bold new direction we are out on a limb and there is no safety net.  If we fail in our efforts we do so for all the world to see…or do we?

The great Leonardo da Vinci saw failure in a different light.   For him it was better to try unsuccessfully than not try at all.  The only failure was failure to try.  By learning from all of his unsuccessful endeavors he was able to plan and predict for future efforts.  His brilliance lay not in the fact that he never failed, but that he learned from his mistakes and then changed his future plans accordingly.

Late night food deliveries in Haiti could have been a disaster.  The question is whether the disaster would have been any greater than the  earthquake itself.  Like Letterman before them, our relief agency saw that their mission was not being met by status quo thinking and therefore they decided to risk an innovative plan to meet fulfil their mission.  Like Leonardo, they saw that the only failure was to do nothing and allow the people to continue in their suffering.  In this case history, and humanity, were on their side.

This is a perfect example of using the past to lead in the modern world.  I am sure that Letterman and da Vinci would be proud!

Please feel free to leave your comments below, we want to hear what you think!

The news of the recent earthquake in Haiti has sent a flood of assistance and money to that impoverished and now critically stricken country.  Who cannot be moved to action by dire needs of our close southern neighbor?  It further saddens me to hear of the continued suffering of those injured as they struggle to find adequate care in the face of complete destruction of their country.  Medical relief workers, who are dealing with a lack of infrastructure and supplies, are accused of practicing “Civil War” medicine.

Unfortunately, it is not Civil War medicine that is the problem.  The problem is the failure of our society to understand the lessons that Civil War medicine can teach.  When we think of Civil War medical treatment, we correctly see unsanitary conditions, antiquated instruments and a general lack of the technology we expect today.  What we fail to see is that our modern emergency response systems and protocols were born of this now distant war. Understanding the true lessons of the Civil War could relieve the sufferings of thousands if the popular myths could only be left behind.

The Civil War gave us our first system of medical logistics, modern emergency room organization and management structures, triage, medical records, medical communications and intelligence, organized first aid and evacuation procedures.  Our Civil War caregivers gave us a system that would become the ambulance and 911 communications networks of the current day.  Faced with unthinkable numbers of wounded and sick in an environment where modern communications and transportation did not exist, our ancestors devised innovative low-tech solutions to our most critical medical problems.

Recently the Bagram Air Force Base in Afghanistan named the medical dormitories after Major Jonathan Letterman who commanded Union medical staffs at Antietam and Gettysburg.  A bronze plaque located there is a testimony to the lessons learned from the man whose “Letterman Plan” became the basis for much of our modern emergency medical system.  This honor is not a hollow one.  Letterman’s writings have been instrumental in plans to improve medical communications systems in Iraq and even lower airframe maintenance and fuel costs of Air Force medical transportation flights.   Civil War medicine has a broader reach than most would expect.

These seemingly ancient protocols have proven themselves not only on the battlefields of Iraq and Afghanistan but also in the aftermath of Katrina and the recent tsunami.  Over 3,500 military and civilian caregivers have been trained in these Civil War systems and processes over the last four years and have achieved great things around the world.  Numerous citations have been awarded to these professionals who are using the past to push innovation forward.  Unfortunately, as Haiti reminds us, we still have a great number of organizations and caregivers who have not yet heard this lifesaving message.

We need to change our opinions of the past.  If we continue to look at history as a frightening era to be mocked and avoided, then we will never learn the lessons needed to improve our future.  Those who are using the lessons of the past are now reaping the benefits.  More importantly, their patients and those they assist are reaping the true benefits.  We need to wake up and see that Civil War medicine is not something to be mocked and feared, but contains lessons for the future that can improve the quality of emergency planning and medical care.

Submitted to the press on Jan. 31, 2010

On Thursday afternoon I was able to aid in the development of a new training day for the Uniformed Services University of the Health Sciences on the Antietam battlefield.  This day-long course will help motivate and prepare first year medical students in all branches of federal medical service.  By using the plan and example of Maj. Jonathan Letterman and walking the battle that transformed his leadership legacy, we will assist these students in developing their own legacy of leadership and medical professionalism.  While this is the third year of our participation, this is our first year developing the course from the ground up.

This weekend I have the privilege of presenting leadership training to the West Virginia Lions Leadership School in Sutton, WV.  Once again I am surrounded by dedicated community leaders who are continuing their leadership development as part of their personal commitment to the service of others.

It has been a very busy week.  Some might think that it would be tiring.  Indeed the opposite if true.

To see so many people eager to dedicate themselves to the service of others is exciting and invigorating.  Like all human endeavors, leadership must be practiced, learned, and re-learned over many years.  It is not a “once and done” event but rather a lifetime dedication.  To be in close proximity to over three hundred is almost too good to be true! I think that I am learning more from these groups than I could ever hope to teach.

Their lesson is simple.  Practice is required if we wish to improve in any activity and leadership and service are not accepting.  They also show us that acting, even practicing, is better done in some form of community rather than is solitude. Even for the most introverted among us, the ability to gain new insights and feedback from others is a gift.  Even if it means taking time alone to digest and assimilate the information.

I encourage all of you to dedicate yourselves to similar activities when the opportunity presents itself.  You will be richer for the experience and so will the world around you!

Original post date:  January 29, 2010 from http://gwunderlich.wordpress.com/

I do have one observation that can help us all in such disasters….be prepared for everything  in mind and body.  Some of the greatest military campaigns in the history of mankind were planned by people living in tents and meeting under trees.  Major Letterman evacuated and fed tens of thousands seriously sick and wounded in a day when offices were not provided and telephones were decades away.  If you can operate in such primitive conditions (as the relief workers in Haiti are doing right now!) then how much more effective can you be with your technology in place?

Do not become too reliant on technology.  It can and will fail.  Become more reliant on the human mind, spirit and body.  They are the most resilient machines known to the world.  Imagination can overcome the loss of a machine, BUT, no machine can replace imagination.

Use the past as a guide to understand what is possible and then prepare for the day when you find yourself in Haiti or when your home becomes a Haiti.  Do not forget the lessons of Katrina, the recent tsunami, Haiti or Antietam.  If you learn the lessons well you can benefit your fellow-man by being part of the solution….if not you will drain your fellow-men by being part of the problem.  The choice is yours.

What would a true leader do?

Original post date:  January 24, 2010 from http://gwunderlich.wordpress.com/

Think of a great person that you admire and that exemplifies some leadership quality for you. After you think of this person think of the leadership quality that most strikes you about that person.

When I ask this of groups I nearly always get similar answers: Jesus, Gandhi, George Washington, Mother Teresa, Florence Nightingale, Eleanor Roosevelt, Oprah Winfrey, Nelson Mandela, the Dali Lama, Abraham Lincoln and Bono.  Certainly there are many more, but, this list represents some of my most common answers.

When I ask the respondents why they chose as they did the answers remain strikingly similar as well.  Their chosen “leaders”  all represent a selfless quality (or qualities) and served others before self in the opinion of the respondents.

Who you choose and why you choose them says something about you.  It means that you too see selfless servant leadership as an admirable quality.  I ask this both as a learning tool for those who visit here and as an excercise for myself to learn more about others.

Thanks for participating!

Original post date: January 19, 2010 from http://gwunderlich.wordpress.com/ on http://gwunderlich.wordpress.com/ from http://gwunderlich.wordpress.com/ from http://gwunderlich.wordpress.com/