The American Civil War broke out in the middle of a letter to Barbara Bodichon. “I wrote the above 10 days ago—very different is the state of things now,” Elizabeth told her friend on April 23, 1861. She had started writing just hours after the Confederate attack on Fort Sumter; now she resumed in a new reality. “Rebellion of the most formidable character threatens the subversion of the government and invasion of our very homes—everyone is up & doing.”
As far back as 1856, Elizabeth had been describing “the overbearing insolence & outrages of the pro-slavery party,” which called forth an equally fiery spirit in the North: “never were evil & good more strongly presented face to face for deadly strife.” Five years later she was more cynical. “I think it is much more of a fight for the tariff, than for principles,” she told Barbara. “I think the great majority of the country are perfectly willing to accept almost any compromise with slavery, if they could ensure safe commercial relations.” Her take betrayed a strengthening bias. There were more obvious causes for the war—the divisive election of Abraham Lincoln, disagreement over states’ rights, the widening cultural gap between the industrialized North and the plantation society of the South—but Elizabeth felt more than ever like an expatriate in America. In writing to her closest London friend, it was easy to slip into an attitude that cast Americans as boors driven by money. “Nevertheless this is a great country and I cannot but feel an interest in it,” she wrote, “although the people are strange to me, and their souls very shallow.”
The national emergency realigned the Blackwell sisters toward a single larger purpose, just as they had begun to diverge. In the year and a half since Elizabeth’s return from England—and despite a move to a new house at 126 Second Avenue spacious enough to hold both the infirmary and the Blackwell residence, exactly as Emily had recommended—Emily had lost her optimism about their joint venture. Elizabeth wanted to teach women the principles of both medicine and hygiene, but she hastened to place those subjects in “their true position, in which I believe the latter stands much higher than the former.” Women physicians, as Elizabeth now defined them, should be teachers armed with science. “I do not look on a good medical training as having power to make men of women,” she wrote, “but as a most valuable educator of their own natures.” Emily, increasingly skilled and confident both in the operating theater and in the labor ward, wanted to train women as surgeons and clinicians on a par with men—and when she considered the callow, untested medical graduates arriving at the infirmary for training, she despaired. “Doubt is disease,” Elizabeth had written, but when it came to the future of women in medicine, Emily had her doubts.
For Emily, the work had become toil rather than triumph. “She has taken an extreme dislike to it,” Elizabeth wrote to Barbara, “and though she performs her duties conscientiously, she only does in medicine what is unavoidable & no longer studies with any future object.” As soon as she saved enough to live on, Emily had announced, she would leave the profession. “Though I was bitterly disappointed,” Elizabeth wrote, “I have now accepted it as inevitable. I used what influence I could at first, but the subject is now never discussed by us.”
The war erased all thoughts of the future—there was only now. Emily’s crisis of confidence would have to wait. “We are compelled to direct the women who in a frantic state of excitement are committing absurdities in nursing talk,” Elizabeth scrawled hastily to Barbara. “I hurry this off, for a thousand engagements press.”
The wave of Union enthusiasm threatened to crash chaotically unless channeled and focused. Americans had only the dimmest understanding of the realities of war—the last large-scale conflicts on American soil had occurred long before most of the population had come of age. Already railcars bursting with poorly packed supplies were heading south. Wilting vegetables and fermenting preserves spilled over bales of unsuitable clothing, including thousands of unwieldy Havelock hats, meant to keep the sun off the neck, but mostly used by the men as coffee filters or cut into pieces to make the oiled patches used in muzzle-loading rifles. Eager, untrained would-be nurses were rushing to Washington to volunteer.
On April 25, Elizabeth and Emily called an informal meeting to discuss how best to help. They were astonished when more than fifty women and several sympathetic men crowded into the infirmary. The result was an appeal that ran in New York newspapers on April 28. “To the Women of New York and especially to those already engaged in preparing against the time of Wounds and Sickness in the Army,” ran the heading. Right-minded women were invited to the Cooper Institute, a short walk from the infirmary, in order to help “organize the benevolent purposes of all into a common movement.”
The next evening between two and three thousand women thronged the vaulted space of the Cooper Institute’s Great Hall, its fluted columns rising from a sea of bonnets and its floorboards invisible beneath jostling hoopskirts. Just a year earlier, Lincoln himself had stood at the same podium to deliver a speech—rejecting the expansion of slavery into the western territories—that propelled him toward the Republican nomination for president. Now cheers erupted as Lincoln’s vice president, Hannibal Hamlin, made an unexpected appearance: a testament to the well-connectedness of the infirmary’s allies, and also to the current administration’s need for help from any quarter. “God bless the women!” Hamlin finished, to tumultuous applause.
A stream of illustrious speakers, all of them men, followed: ministers and physicians and even a surgeon who had witnessed the attack on Fort Sumter. Among them was Henry Whitney Bellows, the influential Unitarian—and husband of one of Elizabeth’s first patients—who had helped shepherd The Laws of Life into print a decade earlier. He attended the infirmary meeting and emerged from the massive Cooper Institute gathering as one of the leaders of a new organization: the Women’s Central Association for Relief. Led by a board of twelve men and twelve women, it was charged with collecting aid and comfort for the soldiers, managing a central depot of supplies for distribution, and selecting women to serve as nurses.
FIRST MEETING OF THE WOMEN’S CENTRAL ASSOCIATION OF RELIEF, COOPER INSTITUTE, AS REPORTED IN FRANK LESLIE’s ILLUSTRATED NEWSPAPER, MAY 11, 1861.
COURTESY NEW YORK SOCIETY LIBRARY
This last item, of course, was the chief preoccupation of the Blackwells. Elizabeth was named chair of the registration committee—the only female officer in the organization—charged with identifying and training the most promising individuals among the flood of women eager to do more than knit socks and roll bandages at home. Many of them had read Florence Nightingale’s recently published Notes on Nursing, with its thrilling exhortation: “Every woman is a nurse.” “There has been a perfect mania amongst the women, to ‘act Florence Nightingale!’ ” Elizabeth wrote with some exasperation. But the scope of opportunity for women to work as professionals in the field of health had suddenly widened dramatically—it was a powerful moment for the Blackwells to put their ideas into practice. Emily even traveled to Washington to meet with General Winfield Scott, the “Grand Old Man” of the Union Army, who at first opposed the very idea of women nursing the soldiers. He changed his mind.
The sisters quickly drafted a report, “On the Selection and Preparation of Nurses for the Army,” which became the template for the recruiting effort—a template modeled explicitly on “the printed records of Miss Nightingale’s invaluable experience in army-nursing.” Their first priority was to discourage frivolous interest; once the grim challenges of wartime nursing were made clear, they hoped, “much of the noble enthusiasm of women, whose sole desire is to serve their country in this momentous crisis, will be directed into other channels.” Likely candidates would be between thirty and forty-five years of age, possessed of a strong constitution, good references, and restrained manners, and amenable to taking orders. They would dress soberly, as dictated by the committee—no hoopskirts. Once chosen, they would submit to a course of medical training at approved New York hospitals and await the call to the front. Interested parties should come to the registration committee’s offices on the fourth floor of the Cooper Institute between two and four in the afternoon. Kitty liked to come and watch as Elizabeth and Emily interviewed prospective nurses. “Girls of eighteen came and swore themselves black and blue that they were thirty,” she remembered, “in order to get into the service.”
Through the late spring and early summer of 1861, Elizabeth and Emily poured themselves into war work. Women and men, working alongside each other for the collective good: it was a gratifying realization of Elizabeth’s youthful hopes. But in order to fulfill its mission, the Women’s Central needed to open a clearer line of communication with the architects of the war. In May, Henry Whitney Bellows took a delegation of board members to Washington, a city that was unfamiliar to him. In need of a savvy guide, he found his way to Dorothea Dix.
A generation older than the Blackwell sisters, Dix had built an international reputation on advocacy for the insane, working for asylum reform on both sides of the Atlantic as a lobbyist, not a medical practitioner. She was a passionate admirer of Florence Nightingale and her work with the British Sanitary Commission. When the war began, Dix made a beeline for Washington and was soon overwhelmed with inquiries from women eager to volunteer. She was a logical liaison for the Women’s Central: nurses trained in New York could be sent to her for deployment.
Touring military camps and hospitals at Dix’s side, Bellows and his colleagues began to envision a Washington-based entity that could not only oversee women’s relief efforts but also advise the military on sanitary issues. In mid-May they submitted a proposal to Simon Cameron, the secretary of war, outlining their ideas for a commission of philanthropists, military experts, and physicians to receive the goodwill of the people and direct it toward the health and comfort of the soldiers, as dictated by the latest scientific information. In England, this kind of effort had followed only after the Crimean War, its purpose to analyze past mistakes and recommend improvements. In forward-thinking America, Bellows’s proposal insisted, such measures must be taken immediately. The proposal was swiftly approved, and in June 1861 the United States Sanitary Commission was born, with Bellows as its president in Washington and the Women’s Central as its auxiliary in New York.
The informal April meeting at the Blackwells’ infirmary had led directly to the creation of the most important civilian organization of the Civil War. But as Bellows and Dix rose in prominence, the Blackwells retreated in frustration. “We shall do much good, but you will probably not see our names,” Elizabeth wrote to Barbara Bodichon, “for we soon found that jealousies were too intense for us to assume our true place.” The Sanitary Commission was happy to enlist the efforts of females and physicians, but not of female physicians.
The Blackwells’ infirmary was pointedly excluded from the list of New York hospitals approved to train nurses, those hospitals having made it clear that they would refuse “to have anything to do with the nurse education plan if ‘the Miss Blackwells were going to engineer the matter,’ ” Elizabeth quoted with disgust. These were the same hospitals that continued to prohibit female medical students on their wards—they were not about to partner with female physicians now. And it wasn’t just the male medical establishment that objected; several lady managers of the Women’s Central, Emily noted, expressed concern “lest our name should make the work unpopular.” With casualty figures growing daily, it was unpatriotic for the Blackwells to argue. “Of course as it is essential to open the hospitals to nurses, we kept in the background,” Elizabeth wrote in resignation. “Had there been any power to support us, we would have fought for our true place, but there was none.”
To compound the insult, the most prominent role in the nursing effort—Matron General and Superintendent of Women Nurses—had gone to Dorothea Dix. “Miss Dix, though in many respects an estimable & sensible woman, is deficient in the power of organization, and has no idea of the details of Hospital management & the requisitions for this peculiar service,” Emily wrote. “I think there cannot fail to be much confusion.” Elizabeth was less restrained. “The government has given Miss Dix a semi official recognition as meddler general,” she spat. “A showy false thing has more success than an unpretending truth and it is very difficult to make truth pretentious, it does not puff up nearly as readily as falsehood.” Emily might have been accustomed to following another woman’s lead, but Elizabeth was incensed by Dix’s appointment, especially when her own medical qualifications were so much stronger.
Elizabeth and Emily continued to work long hours for the Women’s Central during the first year of the war. But a year was as much as they were willing to give. In June 1862, Elizabeth told her brother George, “We completed the 100 nurses that we have sent on to the war—wrote up the annual report, made up the treasurers accounts, and then resigned our place in the Registration Committee.” Not only had their male colleagues left them behind as the Sanitary Commission in Washington grew, but the ladies of the Women’s Central Association for Relief had disappointed them as well. “They were inclined as summer came on to do as they did last year,” Emily wrote in exasperation, “all go out of town and leave the whole work of the Committee on our shoulders.” Wartime philanthropy was no match for the swampy heat of a New York summer, at least for those wealthy enough to escape it.
Elizabeth and Emily had diverted enough energy from their own work, especially given the implacable chauvinism with which their tireless efforts had been received. From this point, they let the war go on without them. Intermittent and incomplete engagement was not unusual on the Union home front. Sam, Henry, and George, now in their thirties and a decade older than the average Union soldier, stayed home; Henry was among those who opted for “commutation,” the practice of paying cash—about $300—to avoid military service. Older men with wives, children, and professional responsibilities tended to see enlistment bounties as a form of patriotic contribution. “I have given up reading the newspapers and following politics, for it all seems such an unsatisfactory muddle,” Emily confessed to George. “I see no issue and as I can’t do anything I don’t allow myself to be so absorbed in public affairs as people are generally.”
The sisters turned their attention to the project of building a small cottage on a wooded ridge in Bloomfield, New Jersey, using the money Madame de Noailles had earmarked for a sanatorium. The retreat would provide therapeutic fresh air and greenery for the infirmary’s patients, and much-needed relief for their exhausted doctors. The house was still under construction in January 1863, when President Lincoln issued the Emancipation Proclamation—followed in March by a national draft to replenish the Union forces. “Our carpenter & mason will put no heart in their work till drafting day is over, they are so afraid of it,” Emily wrote.
In New York City, white working-class resentment—sparked both by the draft and by the fear that emancipated Black workers would soon flood the labor market—resulted in several days of lethal violence in 1863, known to history as the Draft Riots but quickly devolving into white-on-Black terrorism. Kitty and Elizabeth were in New Jersey when they heard news of the violence, and immediately headed for the city: Elizabeth to protect her patients, and Kitty to protect Elizabeth. Leaving the ferry at Cortlandt Street and unable to find a carriage, they walked the two miles to the infirmary in the July heat, warily skirting a muttering mob on Broadway.
At the infirmary, they found the patients in a state of panic, clamoring to turn out the single Black woman on the ward lest she draw the attention of the rioters. As Kitty remembered it, the white patients were tersely informed that they were free to leave; the Black patient would be staying. No one left.*
Once the Bloomfield house was ready, Elizabeth spent every weekend there, gazing over the hills and picking out the ships in New York harbor with her telescope. “The green flickering light, the rustling leaves, and moss & flowers, charm all my senses,” she wrote. “If I am anxious they soothe me, if sad they cheer, if worried they calm.” Though she brought ailing patients along to recuperate, the cottage’s salutary properties were most enjoyed by Elizabeth herself. (Despite Emily’s love of the natural world, there is less evidence that she spent much time there. For her, its most salutary property might have been that it provided a break from Elizabeth’s company.) “You will wonder at my hopes & plans, while the country is in such a state,” Elizabeth acknowledged to Barbara. “But strange to say, business never seemed more flourishing, and every sort of undertaking seems to go on as usual. I think [this] a hopeless war, which I trust Providence will bring good ends out of—I cannot approve of either side—so I work on.”
Three years into the war, Elizabeth at last traveled to Washington herself—as a tourist. Though her train rolled through “villages of tents & shanties & baggage waggons” on the outskirts of the capital, she described what she saw with a blithe cheer that belied the bloodshed just a hundred miles to the south; more than ten thousand Union soldiers were dying at the Battle of Cold Harbor, and no one could yet know that this Confederate victory would be General Lee’s last. “We have had charming weather,” Elizabeth wrote gaily to Kitty. “I am certainly seeing Washington under the best possible auspices.” Her upbeat observations were likely intended to spare her ward’s tender teenaged sensibilities, but they may also have reflected her own detachment from the conflict.
Escorted by her old Philadelphia friend William Elder, who now held a position in the Treasury Department, Elizabeth took in government buildings and monuments, the city’s avenues and squares, the wonders of the Library of Congress, and the lavish fare at her hotel, from mock turtle soup to strawberries and cream. She paid a call on Dorothea Dix, “making acquaintance with the lady, and watching her style of working.” But Dix was hardly the most notable of her encounters.
Dr. Elder had brought Elizabeth to see the public reception room at the President’s House, and she was admiring the view of the Potomac from its windows when Judge William Darrah Kelley, a congressman from Philadelphia and close friend of Lincoln’s, happened upon them. “Why don’t you go up and see the President?” he asked them. “He is all alone, it is a good chance for you.” The visitors were startled, but as Elizabeth told Kitty, “Dr. Elder & I are always ready for any deed of daring.” Shepherding them upstairs, Kelley “swept aside the usher & opened the door of a large comfortable square room on the second floor.”
Elizabeth was surprised at the sight of the “tall ungainly loose jointed man” who stood before her. “I should not have recognized him at all from the photographs—he is much uglier than any I have seen,” she wrote. “His brain must be much better in quality than quantity, for his head is small for the great lank body, and the forehead very retreating.” Phrenologically speaking, Lincoln was underwhelming—an impression that was reinforced when he perched himself on a corner of his worktable and “caught up one knee, looking for all the world like a Kentucky loafer on some old tavern steps.” It was hard to credit this gangling character as the brilliant writer and thinker she knew him to be.
A more gregarious or aggressive woman—Marie Zakrzewska, say—might have seized this rare opportunity to engage the president of the United States on health policy and the future of women in medicine. But Elizabeth’s disappointment in the Sanitary Commission was still fresh, and face-to-face confrontation had never been her style. After a brief exchange of pleasantries with the president, she excused herself. “Altogether it was a most characteristic little peep, immeasurably better than any parade glimpse,” she wrote, “so I considered myself quite in luck.” In her memoir, the chronicle of her own campaign, she neglected to mention the meeting at all.
Elizabeth’s account of her visit to Washington did not edit out the war entirely, but even when confronting the brutal reality—some of the wounded were quartered at her hotel—she sounded more like a sightseer. She was disappointed in the Department of the Navy—no model warships or rebel flags to see—but perked up at an invitation from a young army doctor to tour the four-hundred-bed Douglas Hospital, a few blocks from the Capitol. In one ward full of wounded men, she paused by the bed of a “handsome dark eyed young man” who, with his elderly father by his side, seemed “comfortable though weak”—a peacefully poignant tableau that was unfortunately ruined by a sudden “torrent of red blood pouring from a hole in the middle of his thigh.”
Elizabeth soon took her leave, with “a very cordial greeting from the excellent young Doctor,” who gave her a souvenir photograph of the hospital. She had always been more interested in institutions than in individuals. And though the national crisis was not yet over, she and Emily had a new institution in mind.
* In her old age, Kitty dictated her memories to various family members. An earlier version of this story is slightly different: upon reaching the infirmary, Elizabeth and Kitty found the wards empty except for the Black woman. When the staff refused to turn her out, the white patients had fled. In both versions the infirmary staff is honorably protective of the woman in peril. In the earlier one, they are unable to influence their racist patients, who leave en masse; in the revision, their principled stance inspires their patients to swallow their prejudice and stay. Elizabeth pledged her life to raising humanity to a nobler plane, and Kitty was her most devoted acolyte. It seems in keeping that Kitty might have revised her memory to show the Blackwell example in the noblest and most successful light.