Joshua L. Chamberlain is famously known as the “Hero of Little Round Top.” As commander of the 20th Maine, and placed on a hill called Little Round Top at the end of the Federal line at Gettysburg, he was tasked with holding it at all costs. Though he and his men held the hill against wave after wave of charging Alabamans and Texans, and then ordering his infamous bayonet charge, there is another reason I find Colonel Chamberlain majorly important. The face of medicine changed because of a wound he incurred.
Petersburg, Summer 1864
The Battle of Petersburg (more accurately the Petersburg Campaign), started June 9, 1864 and went through March 25th, 1865. Just 9 days into the campaign, Colonel Joshua Chamberlain and the 20th Maine led the Union charge on the Confederate line. At this time, officers led from the front, not the rear (unless you were a brigade or army commander such as Longstreet, Jackson, and Lee). This made them much more likely targets for the enemy. Another of the main people the enemy would aim for was the color-bearers. When the colors went down it was disheartening to the troops, it would cause confusion on the line if the colors could not be seen, and the regiment could not stay together or aligned properly.
During the charge, his color bearer was shot and killed. Chamberlain picked up the colors and continued forward. Now he was doubly a target for the Confederates, and indeed, they found him. A ricocheting .58 caliber Minié ball struck Chamberlain in the right hip, traveling up and through his pelvis and lodged in the inside of his left hipbone, ripping through organs as it went. Knowing that the wound was most likely fatal, but not wanting his men to know, Chamberlain thrust his sword in the ground for support as blood poured from his body, filling his right boot. He stood there commanding, until the blood loss made him so weak that he collapsed on the field as the battle raged.
Commanders at the rear saw Colonel shoulder boards lying on the field through their field glasses and realized the famous Colonel was down. They ordered men forward with a stretcher to retrieve him. When these four men arrived, Chamberlain begged them to leave him there as he believed the wound was fatal (over 90% of abdominal wounds were fatal at this time) and he did not want others dying because of him. Knowing their orders, and that they could not let the hero of Little Round Top die on that field, they told him that their orders out ranked him, placed him on a stretcher and dispatched him to the rear. By the time he reached the field hospital three miles to the rear he had been bleeding for hours and lost a significant amount of blood, not to mention having a fractured pelvis, punctured bladder, and severed urethra.
His brother, Tom, would hear of his brother’s severe wounds and come running with two of their physicians who would join with the doctors caring for Chamberlain. Finally finding him in one of the many field hospitals, they set about trying to figure out what to do. Gut wounds were nearly always fatal, but they couldn’t let the Hero of Little Round Top (and Congressional Medal of Honor recipient) die, but surgery on the abdomen was usually fatal as well. It would end up being the patient who made the final decision – Chamberlain himself asked them to try it. Now at the time, abdominal surgeries were almost strictly prohibited because the majority of the patients DIED, yet he was asking them to take a chance and try. At this point, what did they have to lose? He was certainly going to die if they left him there. So they agreed.
As many of you may remember from previous blogs, we did have anesthesia at this time, in the form of Ether and Chloroform, though Chloroform was the most commonly used agent due to it’s stability, and being less flammable. The thing with these early anesthetics is that they are heavy gasses, and if left under too long, the anesthetic to make one insensible to the pain would actually take their life. This happens by the heavy gas displacing the oxygen in the lungs. To prevent that, they would have to awaken the patient and get them taking big breaths to replace that oxygen and force the gas out. This means that they would have to awaken the patient every 15 minutes or less. Chamberlain’s surgery was going to take far longer than that, yet he persisted.
Therefore, on an operating table in a field hospital somewhere on the Virginia soil, four doctors and a brave man embarked on an unprecedented operation. Given morphine and chloroform, they opened his abdomen and began a surgery of exploration and restoration – tying off vessels, finding the bullet and removing it, having to rejoin his urethra to his bladder and repair the organ, during which they had to bring him out of anesthesia many times. Halfway through the surgery, the surgeons decided to stop, saying they could not torture him anymore. Chamberlain disagreed, and though in unimaginable pain, most likely held down to the table while they worked inside him, he gasped in pain and asked them, “I’m not dead yet. Please continue.” The incredible surgery would last FOUR HOURS. When they finally closed him, no one knew if he would survive. In fact, the exhausted doctors were incredibly skeptical that he would, but they had done their best. They nearly lost heart when they saw urine leaking from one of the wounds, knowing that most assuredly they had been unable to close everything and he would die, most likely from “ulcers” forming in the abdomen and causing death 1 (most likely they were indicating abscesses).
Yet, for several days he continued to fight and live. With no antibiotics (there were none until the 20th century), non-sterile conditions, unclean instruments with which the operation had been performed, lying in a field hospital surrounded by death and disease, no significant pain medication to deal with the tortuous agony he was enduring, and only able to void via a catheter they had placed (either made of metal or wood, most likely metal at this time), he endured. Due to concern that he might contract a disease on top of his wounds in his weakened state, eight litter bearers were ordered, and carried him 16 miles until he could be placed on the hospital ship Connecticut which was at City Point.3 The ship carried him to Annapolis where he was placed in the naval hospital for care. They say he arrived, “booted and spurred, blood soaked and smeared, hair and beard matted with blood and earth, pale as death and weak as water.” 1 One can only imagine his condition when they were operating on him! Probably laying right there on the table still in the blood and filth, and operated upon still in uniform.
But God and Chamberlain had other plans. Miraculously, for that is all that can be said about it even by his doctors, Chamberlain began recovering. Six weeks after his surgery, the doctors had to admit that he was recovering so well that his chance of survival was nearly certain. Indeed, he would recover, but with several prolonged issues. He developed a fistula (tunneled opening) from the urethra that opened just in front of his scrotum due to the prolonged use of the catheter. It was unforeseen, and most likely unavoidable, but made things difficult the rest of his life. Due to this fistula and his issues voiding, he would have chronic urinary tract infections the rest of his life. In a day and time where there were no antibiotics, this was quite terrible and painful, taking him out of commission for sometimes weeks at a time. The pelvic fractures were (thankfully!) not unstable fractures – which is a serious medical emergency and often fatal – but would cause him continued issues, making him unable to mount his horse, Charlemagne, without help, or to sit in the saddle or even walk for very long.
Yet, all of these things did not stop this formidable man. He would return to command his troops in November 1864 as a newly promoted Brigadier General and would finish out the Petersburg campaign. He would, in fact, finish the war, being chosen by General Grant to receive the final surrender of arms from Confederate General John B. Gordon just three days after the armistice signing at Appomattox, VA. After the war, he returned to Maine and wrote extensively about his time serving in the Army of the Potomac and his experiences during the war. He returned to teaching for a time, and would serve as President of Bowdin College from 1871-1883, during which time he founded a Scientific Division and the establishment of a military drill at the college.2 At the urging of many, he ran for Governor of Maine and won, serving not one, but four terms in office.
Strangely, it would be the War Between the States that took his life, but this would not happen until 1914. Complications of his wounds and multiple surgeries later, he continued to be plagued with problems and chronic infections. On his death in 1914, his doctors listed one the death certificate, “Bacteremia, probably secondary to a urinary tract infection.” 3 In other words, he got a urinary tract infection that went systemic, causing sepsis, and then death. He had survived heat stroke, malaria, typhoid, tuberculosis, smallpox, having his horse shot out from under him 5 times (twice on Charlemagne), being shot a total of six times. He engaged in 24 major battles, who knows how many skirmishes, captured 2,700 POWs and 8 battle flags.3 He accepted the final surrender and retired from military service a Major General. He went on to have quite a significant career in education and public life for 50 years, contributing much to this country, and yet in the end, the devastating wounds he incurred on Virginia soil would ultimately take his life.
I personally find Chamberlain an amazing man, one from whom we can learn much. But what I find most exciting about this tale, is that because of him, and his valor and fortitude, the first successful abdominal reconstructive surgery was performed on American soil!
- Nesbitt, M., Chamberlain, J.L., and Chamberlain, J.J.: Through Blood and Fire: Selected Civil War Papers of Major General Joshua Chamberlain. Mechanicsburg, Pennsylvania: Stackpole Books, 1996. Quoted in Harmon, W.J., McAllister, C.K. (2000) The Lion of the Union: The Pelvic Wound of Joshua Lawrence Chamberlain. The Journal of Urology, Vol 163, p 713-716.
- Harmon, W.J., McAllister, C.K. (2000) The Lion of the Union: The Pelvic Wound of Joshua Lawrence Chamberlain. The Journal of Urology, Vol 163, p 713-716.
Other reading you may enjoy:
- Trulock, A.R., Nolan A.T. (1992). In the Hands of Providence: Joshua L. Chamberlain and the American Civil War. Chapel Hill, North Carolina: University of North Carolina Press.
- Wallace, W.M. (1988). Soul of the Lion: A Biography of General Joshua L. Chamberlain. Gettysburg, Pennsylvania: Stan Clark Military Books.
- McAllister, C.K. (1998). Fire, Blood, and the Lion of the Union: Joshua Chamberlain’s Civil War Ailments. The Paros of Alpha Omega Alpha, 60: 40.
- Medical and Surgical History of the War of the Rebellion: U.S. Surgeon General’s Office 1861-1865. 3 Vols., 6 parts. Washington, D.C. (1870).