ndersen er an - Gundersen Health System

successes and failures of medical leadership
Other forward-looking and successful Hammond initiatives
during the Civil War included the centralization of military
hospital authority; the initiation of a massive program for
building large pavilion-style hospitals, which were state-of-theart
in the 1860s; and streamlining and standardizing procedures
for discharging disabled men from the service. In between official
duties he found time to publish an extended treatise on public
health for the military, a book which quickly became a standard
text. 9 Hammond proposed a military medical school, an idea
which was not to reach fruition until 1893 as the Army Medical
School. Two of his ideas were far-ranging, indeed, and represent an
important legacy for medicine in general: The Medical and Surgical
History of the War of the Rebellion, a 13-volume set chronicling in
great detail the medical issues confronted during the war; 14 and the
Army Medical Museum, a collection of pathological specimens that
evolved into the renowned Armed Forces Institute of Pathology. In
1878, Hammond wrote, “There are few things in my professional
career in which I take more pride than that the ideas of the Army
Medical Museum and of the Medical and Surgical History… were
conceived by me.” 15
His early work was highly praised by soldiers’ advocacy groups.
As Reverend Henry Whitney Bellows (1814-1882), the first
President of the U.S. Sanitary Commission, wrote in 1862, “I am
more and more pleased with Dr. Hammond. His views are large,
his mind active & prompt — his action at present embarrassed by
almost insuperable difficulties. But he is cutting his way out.” 16
Such a positive view of Dr Hammond’s accomplishments was
not universal, however. Many critics found him abrupt, tactless,
and pompous. In May 1863 Hammond issued a memorandum
outlawing use of the popular medicinal compounds calomel (a
mercurial agent) and tartar emetic (an emetic) by military doctors,
and found almost universal disapproval of his actions. Political
wrangling over the composition of the newly formed corps of
Inspectors General further poisoned the atmosphere.
His biggest enemy was Edwin McMasters Stanton (1814 –1869),
the U.S. Secretary of War, who had opposed Hammond’s
appointment from the beginning. In late 1863 opposition to the
Surgeon General reached a critical mass within the War Department,
and Stanton engineered a subtle coup. He ordered Hammond on
an extended tour outside of Washington, and during Hammond’s
absence installed his own favorite, Joseph K. Barnes (1817–1883),
the head of the Inspectors General. On September 3, 1863, by
special order of the War Department, Barnes was “empowered to
take charge of the bureau of the Medical Department of the army
and to perform the duties of Surgeon General during the absence
of that office [ie, Hammond].” 17,18 Hammond was outraged at the
charges of fraud and mismanagement that were leveled at him and
demanded a court-martial, a move that proved to be a mistake.
The court was essentially hand-picked by Stanton and his allies,
and the testimony was flimsy and trumped up, if not perjurous.
Hammond was found guilty of “irregularities” in the purchase
of medical supplies and convicted of “conduct unbecoming an
officer” and given a dishonorable discharge on August 28, 1864. 18
While the New York Times opined that discharge was “too mild
a punishment… for utter villainy,” 5 for the most part the medical
community was supportive of Hammond and considered the
outcome a travesty. Barnes ultimately became the Surgeon General
on August 22, 1864, a position he held until 1882.
A Successful Private Practice
Dr Hammond’s life and career after the undeniable humiliation
of his court-martial and dishonorable discharge disproved the
famous maxim attributed to F. Scott Fitzgerald that “There are
no second acts in American lives.” Hammond’s finances were in
shambles, but friends helped him get established in New York City,
where he inaugurated an increasingly lucrative clinical practice
focusing on diseases of the brain and psyche (Figure 2).
In the 2 decades following the Civil War, Hammond’s medical
practice flourished, and in his best years he was 1 of the highest-paid
physicians in the country. He had a large house on West 54th St. in
New York City that was filled with antiques, rare books, and works
Figure 2. William A. Hammond in civilian neurological practice after
the Civil War. (Courtesy of the National Library of Medicine.)
of art where he frequently held court over exclusive dinner parties
and large soirees. At a time when general practitioners struggled
financially, Hammond’s estimated annual earnings of $60 000
($840 000 in current dollars) far surpassed almost all contemporary
physicians. As noted by fellow neurologist Charles Loomis Dana,
“Hammond put neurology in New York on its feet economically
by his amazing audacity of charging $10 [approximately $140 in
modern currency] as his fee, and showing the bills on his table.” 19
Not content with purely scientific pursuits, he turned his hand
to novels, publishing 9 works during his lifetime. They generally
represented typical Victorian melodramas, many referring to
scientific topics and 1 alluding to his professional crisis of 1863. 20
He was married twice, with 2 children who lived to adulthood.
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