Hospital Sketches

Hospital Sketches by Louisa May Alcott was first published between May and June 1863, serialized in the Abolitionist newspaper Boston Commonwealth and appearing under the pen name (a convention of the time) “Tribulation Periwinkle.” Well-received by both critics and the general public, the sketches recount her experiences serving as a nurse in a Washington D.C. military hospital during the American Civil War (1861-1865). The sketches explore The Dynamics of Care and Compassion, The Physical and Emotional Toll of War, and The Value of Humor in Stressful Times.

Alcott is best known for her novel Little Women and its sequels Little Men and Jo’s Boys. Born in Pennsylvania, she spent most of her life in Concord, MA and was known for her strong Abolitionist views and support of the Union cause. 

This study guide is based on the 2015 e-artnow eBook.

Content Warning: The source text and guide feature depictions of racism, weight-bias, gender discrimination, illness, and death.

Language Note: The source text uses the term “colored” and “black” to refer to Black Americans and includes racial slurs attributed to other speakers. This study guide reproduces this language only in quotations; elsewhere, it refers to Black Americans.

Summary

Hospital Sketches collects six of Alcott’s contributions to Boston Commonwealth covering her decision to serve as a nurse, her journey from Massachusetts to Washington, her portraits of a day and a night in her life as a nurse, her illness and decision to return home, and a postscript that responds to reader queries.

The first chapter, “Obtaining Supplies,” covers her decision to seek a nursing post. Though she is not assigned to her first-choice hospital, Alcott decides to take the post anyway, fueled by a determination to prove her younger brother Tom, who assumes she will not accept it, wrong. She sets out to secure a free travel pass to Washington with the help of her brother-in-law, who uses his authority and contacts to accelerate the process. With the documents in hand, her journey begins in earnest.

In “A Forward Movement,” Alcott travels by train to New London, CT, losing her hard-won documents. Though she is a shy person, she chats with her neighbor. As night falls, she observes her fellow passengers trying to get comfortable. In New London, she boards a boat to Jersey City. Despite anxiety about drowning, she manages to sleep. The following morning, she boards a train for Philadelphia, where she catches the next train to Baltimore, then another to Washington, where she is to take up her post. A kind gentleman assists her in locating the right transportation to her accommodations. The city impresses her, though she feels a bit forlorn and far from home.

In “A Day,” Alcott describes the work that nurses do during the day shift. When injured troops arrive, the nurses are called to wash, dress, feed, and comfort them. Alcott initially looks forward to the wounded arriving, but after a few days’ experience, she feels a longing for home and her quiet daily routine. Unpleasant smells are endemic to the hospital, which prompts her to carry a bottle of lavender water. Alcott feels compassion for wounded soldiers, who are processed and then given a bed. Alcott describes some of the soldiers she tended, including a cheerful Irishman and a Sergeant. She describes the soldiers’ daily routines.

“A Night” recounts her experiences on the night shift. It begins at nine in the evening and includes reading to and writing letters for the men, as well as attending to their medical needs. Affirming her belief in the healing power of laughter, she brings a cheerful mood to her ward, and the patients respond positively, filling her with affection and pride. She divides her ward into three rooms according to the needs of the patients. Studying the men as they sleep, she learns to recognize them by their snores and notes how differently they sleep, with some becoming sad or stern. She describes some of her memorable night patients, such as a Prussian, an injured drummer boy, and a man named John, whose death deeply moves Alcott.

“Off Duty” covers the period when Alcott contracts typhoid and has to rest, before reluctantly making the decision to return home. She describes problems with the hospital, such as the poor state of the building, the presence of rats and bugs, and the difficulty of getting to meals before all the food is gone. She explores Washington, visiting the Armory Hospital, whose warmth, cleanliness, and organization contrasts with her own hospital, where it can be difficult even to secure the necessary supplies. She also objects to the hospital’s tendency to allow patients to help, which endangers them and leads to the nurses being blamed for any problems. She also visits the Senate Chamber and Georgetown Heights. 

After the weather turns rainy and windy, she strives to help by mending garments and spends time watching the world outside her window. She reflects on the emotional impact of enslavement on Black Americans, which she believes has made them lethargic and servile. She respects their inherent good-heartedness and cheerfulness, despite the suffering they have endured. She records the racism that she has witnessed and celebrates the day the Emancipation Act goes into effect. Her father comes to Washington to bring her home. She leaves with gratitude for the experience, urging readers not to be afraid if they are inclined to serve.

The final chapter is “A Postscript,” which is a response to reader questions about various aspects of the nursing experience. Alcott also provides updates about patients whom readers asked about, including the Sergeant. Alcott declines to identify her hospital and emphasizes that any individual account will always be specific to the observer. To readers who objected to her at times humorous tone, she explains that cheerfulness is part of her personal religion. She closes by expressing her hope that she will be able to work in a hospital dedicated to Black regiments, who deserve admiration and respect, and so that she can begin to pay the debt whites have to them.