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They Who Bear the Cost

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Humidity climbed as late summer claimed Alexandria, turning every room at the hospital into a rank oven no matter the efforts to air the space.  Windows were left open, fires banked, and the poor boys in the worst condition tended every minute with rags soaked in lukewarm water.  It was not the heat of August, but in a way it was worse.

Anticipation flavored every breath.  Dread, more like.  They could not hear the cannon, feel the ground shake, and the blood did not run in Alexandria’s streets, but it was near enough.   

Virginia had witnessed much bloodshed, would witness more, and here on the border, the clash would color the landscape.  In Alexandria they were still absorbing the news of South Mountain when word came that the two armies had begun to amass in Sharpsburg.  They had known it would come, they had only been able to watch and wait as Lee’s Army of Northern Virginia crossed the Potomac with bloody intent. 

The divide that some had begun to bridge in Mansion House seemed immeasurably wide.  Tempers flared, not just among the warring bedridden youth but among the staff.  Henry Hopkins took to sleeping outside the room Emma had claimed, on the floor, waking before she could discover him, because delirious soldiers had been known to wander the halls on occasion, some fighting the battle still, egged on and not tempered by dwindling supplies of morphine.

Foster was a veritable tyrant between surgeries, his patience gone and no Mary Phinney to interpret his clipped directives.  Hale’s confidence had reached a new high, and with that came irritation on Anne Hastings’ behalf, as she preferred a companion she could in some way direct.  The nursing staff suffered for McBurney’s demands on Anne’s time, and the few convalescent patients who lingered saw the difference. 

It was perhaps relief that spread through the wings of that establishment, when word finally came that the Army of the Potomac would wait no longer on the banks of Antietam Creek.


Around midday on September 17, a road-weary messenger appeared, looking for Major McBurney and finding Matron Brannan. 

Half-relieved at the sight of the man, she said, “Is there word?”  The words out before she could stop them, she prayed he did not hear.  But she stopped him with her lilt, his ears attuned to it, and he answered in a quiet brogue of his own.

“It began at first light,” he said.  He held her gaze for a moment, and the worldly-wise matron saw too much and had to turn away.  The messenger walked away to find the major.

Matron Brannan squared her shoulders, and saying nothing to any she passed, went to the kitchens to see that the fires were going, and sustenance made available for those that would require it.


“Fifty-five or so, on the road at present, sir.  More to follow.  The battle continues and I bring orders from General McClellan himself.”

The major stiffened, hoping it made him look more responsible, more impressive.  A practiced eye only saw his fear.

“We will be ready.  Nurse Hastings, if you please.”  His command was sharp if incomplete, and it was to his and the hospital’s benefit that Anne Hastings knew what this messenger was about.  She moved steadily from the room, and could be heard barking orders before she was five feet out the door.

The messenger swayed, standing at attention with no relief.  McBurney saw only weakness when others saw suffering, however slight, and he was caught offguard by the idea that the hospital was soon to be overrun.

He stared at his desktop and the messenger, a blue-clad sergeant, stared at McBurney.

Anne came back to the room, the matron in tow, and her list of demands was anathema to the overwhelmed officer.   The matron took hold of the sergeant’s arm, coaxing him from his stance to leave with her and find refreshment before going back to his post.  The most offensive of McBurney’s visitors gone, he felt equal to answering that no, Nurse Hastings could not enlist the help of Charlotte Jenkins or her colored helpers, and no, Nurse Hastings could not dispatch Samuel or anyone else to ask for help across the river.

“This hospital is well-staffed and equipped for just this sort of emergency, Nurse Hastings,” he blustered in a tone that came from an unacknowledged well of uncertainty.  “Make do.  Now, go, I have my own preparations.”

She narrowed her eyes and inclined her head, and left the room.  Anyone else, even Bullen at his drunkest, would have recognized the steel in her spine as defiance.  McBurney read no such thing, considering that she was well chastened.


“Make do,” she muttered, stalking down the hall and considering her plan.  The sergeant indicated he was only an hour, maybe two, ahead of the convoy.  As it stood, the hospital would be short beds as well as personnel. 

She found Dr. Hale, who was making his rounds and checking stitches, a task easily left to someone else.  Dr. Foster was in surgery, and would have to be made aware of the situation.  They had not discussed the likelihood that the hospital might take in a significant number of wounded from so far away a battle, though the sheer number of participants had made it a possibility.  In truth, Anne wondered why they had not all been told to move closer to the field of engagement; her time on the front lines in the Crimea had prepared her for much more intimate contact with the realities of war. 

She shook off her thoughts and relayed the impending crisis to Byron, whose frown deepened as his face paled.

“Can we send for aid?”

“McBurney refused,” she spat, before slowing to consider that the refusal, born in ignorance, may have hit on a crucial truth.  “Byron,” she continued in a lower tone, “I don’t believe there is aid to be had.  Our supply requests have gone half-filled at best for the last month.”

Jed Foster came up behind Hale, causing him to jump imperceptibly.  “What’s this?”

“The battle at Sharpsburg.  We are to expect a large number of casualties, possibly within the hour, and we are woefully unprepared,” Hale said in a defeated tone.

Foster’s eyes widened and he stood straighter.  Anne’s own posture mirrored his as he countermanded McBurney’s orders.  “Nurse Hastings, find Samuel Diggs.  We need to move the convalescents as quickly as we can, and we will need to commandeer our shared supplies back from Miss Jenkins.  Go, hurry.”


Emma held the wrist of a wounded Yankee boy, who head was wrapped in such a way as to cover the eye he’d lost in a skirmish the week before.  He was healing, but his case was a sad one.

She looked around the room.  These were all sad cases, broken boys.

Dr. Foster came in, looking for her, anxiety pulsing through his skin to make him fairly shake.  He was not wild-eyed, but determined, and that sense of purpose filled the room.  “Nurse Green,” he said, something he rarely uttered, and she felt cold with dread, suddenly knowing what he was about to impart.  She saved him the trouble.

“These four boys can be moved immediately,” she said, pointing to them.  “This one here might be, but he will need attention, he cannot be left alone indefinitely.”  Emma placed her hand on the head of the steel bed where the boy with the missing eye lay. 

“I will allow you to accompany these boys to the makeshift ward outside, Nurse Green.  Find someone who can help him.  Samuel is out there now organizing a staff of sorts.  But I will need you in here.”

“Yes, sir.”  Her drawl was thick, the phrase sounding more like the “yas suh” of their similar childhoods, and Jed Foster took a moment to place his hand on her shoulder. 

“It will be hard, Emma.  They won’t all survive.  We must help those who can.”

She blinked back whatever tears may have threatened, nodded, and went to work.


Having seen the commotion surrounding the messenger, Charlotte had anticipated the orders, and was already making beds and giving her own orders when Samuel found her.

“They’re coming, aren’t they?” she said when she saw him, and they both knew she meant the boys of Sharpsburg as much as the wounded inside Mansion House.

Samuel nodded.  “I have to…we need supplies inside.”

She wanted to protest, she wanted to scream out the indignation that rose in her heart.  But she was realistic, she knew what was coming down the road through Maryland.  Destruction would not bow to her concerns, to the plight of these souls she had come to take charge of. 

Samuel had argued, it was in part for them that this was even happening.  She wanted more than blood for what she desired.  But today, it would keep.

“Over there, the blankets.  I have bandages, probably not enough, over there.  Hosea and Joshua will help you,” she said, waving over two of her most eager volunteers.  “And medicine.  I have some.  I have some that…. Samuel, you know what I….”

She of course had some supplies that had come from the north, shipped or smuggled by friends there.  Not everything she had came from the army’s stock, and she would never have shared it otherwise.

A rider on horseback flew by, yelling at those in his way.  “Here, here!” he seemed to shout, though the speed and exertion choked his words.

Charlotte pressed Samuel’s hand.  “Go,” she said, “and Godspeed.”


“Chaplain.  Chaplain,” said a weak voice.

He turned and laid a hand on the boy’s head.  This was one of those convalescents they could not, would not move, for he was not long for the earth.  Henry Hopkins was visiting them each in turn, in the small room where they had been moved, and preparing them and himself for what was to come.

This boy had been shot in the gut.  That one had a bayonet through his shoulder, and the wound had festered.  Another’s legs were gone, one taken by Dr. Hale and the other mouldering somewhere in the wilderness, and he had lost so much blood that his hands remained white and cold when pressed.  

The one on the end, closest to the window so that he might see the sky, no longer saw anything at all.  In his hands was clasped his Bible, and Henry took it up.  It opened naturally to the Psalms, so bent was the spine, and across the top of the page was scrawled a phrase.  He squinted and read aloud, "'We hope and pray that you may be permitted by kind Providence, after the
war is over, to return."

He reached down and closed the boy's eyes.  Providence had not been at all kind.

This was a room of death.  Henry tried not to feel at home in it.


This voice pierced his heart like none other.  Feminine, and injured only by his own actions.  He closed his eyes and prayed for the boy before him before turning to the woman behind him.

Her hands were clasped behind her, and her face shone.  With exertion, with anticipation, anxiety?  He neither knew nor cared.  She was beautiful, still.

“Henry,” she said in a different tone, a commanding one.  “You are needed.  Leave them.”

He did not wish to move, but if she would only look at him like that for the rest of her life, he would fly.

Henry followed Emma out of the room, into the melee that had arrived, the storm of blood and torn flesh and rage that was but a fraction of what lay to the north.  He pushed his sleeves up and knelt beside the first broken body he saw, immediately murmuring the Lord’s Prayer, and Emma left him there with a ghost of an approving smile. 

Forcing down the urge to follow her and beg forgiveness, he simply worked alongside the doctors and the more numerous nurses, helping where possible, praying always.  He stopped only to wipe his face and realized as he went that he had not thought of that night by the creek since dawn.

The war for his soul was not yet won, he was forced to admit.


The first wave was closer to one hundred, of which only thirty survived the day.  The second wave was more, the ratio of the dead to the living much worse, but by the third wave, and the fourth, life began to win out.  There was injury – devastation, really.  Whereas many if not most of the wounded who came into the care of the staff here were routinely discharged back into active service, hardly any from that day would fight again.

Both sides claimed the victory.


“Dearest Mary,


If my handwriting is indecipherable, it is because my hands shake from the effort of saving lives. 

That is an uncharitable sentence and I shall cross it out ‘ere I send this, if I send this.  But it is truth, and despite our faults we have been honest with one another, I hope.  I might have been better, and so I say now, here, that I am weary, Mary, and I have done little good.

The room spins, but I must tell you, the war is real.  It arrived today at Mansion House and we are the worse for it.  Of course, this is not news, we both have seen what has been wrought in the name of Union, in the name of secession.  You will scold and remind me of the greater good, but Mary, Mary, the dead know no greater good today.  They grow cold and their faces, their faces….

We are not angels but butchers, said one soldier to me today.  A Union boy, a Yankee with an impenetrable accent, of stock and breed with which I am unacquainted.  He is right.  Ezra would say so.  And he is wrong – you would say so, I hear your voice just now in my ear, whispering and caressing and Mary I need, I need….

This is a maudlin ramble and it must stop, I must stop.  I need to take this hour and rest, for more men await.  The field hospitals are overrun, they are telling us.  Hale and I are the only surgeons present, for any colleagues we might call upon are out there (do not ask about the Major, you know where he is and in what state without me spelling it out).  Anne has risen to the occasion as one might expect her to, and your pet is even now administering salve and morphine where possible.  And it isn’t possible much longer, for our supplies….

All these words and I have not inquired after your health.  But there, I know how you do, for you are in my dreams nightly and I mourn that I am unable to come to your side.  My consolation is that you are there, because if you failed to walk the corridors of my mind I feel sure that it would mean….

I cannot.  This letter goes to the fire.  My darling, I think of you.  I think of you, when I should not.  Be safe, be well.  I will see you soon.”


“Estimated casualties are well above ten thousand.”


“On our side.  The Yanks suffered more.”

The conversation was whispered between men whose names are lost, but who lay in Mansion House under cover.  Neither wore a uniform that had belonged to him at any point.

Neither wore the uniform of the army to which they had sworn allegiance.


Major McBurney opened his door and listened.

The melee had passed, indeed the flood of wounded had stopped altogether.  The hospital buzzed with activity, a surgery in one room, various medicinal applications in others. 

He strained his ear to ascertain whether he was needed.

Determining that he was not, he retreated, and went to bed.