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As an historian, Dr. Ira Rutkow was amazed at the lack of medical training doctors received and the unsanitary conditions that existed in hospitals prior to the start of the Civil War in 1861. As a practicing physician, he is grateful for the many innovations in the treatment of medicine as a result of the battle between the Northern Armies and the Southern Confederacy. His fascination with the war had less to do with the political circumstances and more to do with the savageness of battlefield deaths and injuries. 
“For me, as a physician and medical historian, something was always missing—an understanding of the brutality and medical realities inherent to war,” Dr. Rutkow explained to the crowd of more than 60 history enthusiasts.
Dr. Rutkow, a surgeon and author of several books on American medical and surgical history including Bleeding Blue and Gray: Civil War Surgery and the Evolution of American Medicine (2005), presented the first of three NYAM lectures highlighting the impact of the Civil War on American medicine on January 18. The event was covered nationally by C-SPAN.
In his talk, Dr. Rutkow provided an overview of the practice of medicine prior to the Civil War in which medical students often paid a doctor who would then study with and mentor them until they were able to practice on their own. Medical training was, as he explained, more of a process of paying to secure a license to practice rather than an in-depth study of anatomy or the treatment of life-threatening diseases.
Dr. Rutkow also explained the purpose of hospitals not as places to get better but as filthy and germ-ridden destinations for death.
“Prior to the Civil War, you did not go to hospitals to get well; you went to die,” Dr. Rutkow said. “Those who could afford to, avoided hospitals at all cost.”
Dr. Rutkow went on to explain that conditions for medical treatment had actually not gotten better during the war; it was the lessons learned from treating battlefield injuries that would forever change the practice of medicine.
He went on to describe the emergence of new ideas in every aspect of treating wounded soldiers, including an organized ambulance corps, the use of hospital trains, and better management of large hospitals. More importantly, Dr. Rutkow said, Civil War doctors came to understand that patient well-being depended on adequate cleanliness, controlled sanitation, sound nutrition, and natural ventilation.
“Physicians’ dedication to a military medical objective imposed much-needed comradeship and discipline,” Dr. Rutkow said. “As a result, the profession became more cohesive and forward-thinking on a national level.”
The remaining two lectures in the series are “Of Wards and War: The Importance of Good and Bad Medical Care in the American Civil War” on February 8 and “Hired to Care: Civil War Nurses and the Military Body” on March 15. For more information and to register, visit www.nyam.org/events.
Posted on January 19, 2012
Contact:
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Reporters: to arrange interviews with NYAM medical and urban health experts, contact
Andrew J. Martin, Director of Communications
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Community Benefit: Innovative Models and Opportunities for New York
On March 1, 2012, the NYAM Section on Health Care Delivery will present a panel discussion on the Community Benefit standard, the legal standard for determining whether a nonprofit hospital is exempt from federal income tax, moderated by Ellen Rautenberg, President and CEO of Public Health Solutions.
Vimla Patel, Director of NYAM's Center for Cognitive Studies in Medicine and Public Health is part of IOM Committee report on Health IT and Patient Safety: Building Safer Systems for Better Care, a consensus report that outlines how health IT can help improve health care providers' performance, better communication between patients and providers, and enhance patient safety. Please click on link to read the full report.
