Dr. Henry Janes’ lecture certainly stood out. While other speakers at the annual meeting of the Vermont Medical Society in 1903 addressed more conventional topics like “The Treatment of Effusion from the Chest” and “Some of the Cardinal Points in Diagnosis of Abdominal Tumors,” Janes had another idea.
He titled his talk “Why is the Profession of Killing More Generally Honored than that of Saving Life?”
Four decades earlier, Janes had served in the Union Army, first as a surgeon and later as the director of large military hospitals. Now in his early 70s, Janes had become one of Vermont’s leading doctors. His hair had gone white and he’d shaved off the thick beard he’d worn in the Army. A walrus mustache that covered all but the center of his lower lip now dominated his face. The mustache and the pince-nez glasses perched on his nose lent him an air of authority.
Janes used his allotted time before a roomful of doctors at the Vermont Medical Society’s annual meeting to express his fervently anti-war beliefs, which had grown out of his Civil War experiences.
“An army marching past in well aligned platoons, with colors floating, bands playing, the men with freshly cleaned accoutrements, arms polished and shining in the sunlight … affords a costly pageant well calculated to enthuse an unthinking populace,” he told the assembled physicians. “But come with me over the field, after a hotly contested battle, or still better, because the attention is not distracted by the hosts of mangled corpses of the men more mercifully killed outright, help me to receive the wounded at the field hospital during and after the battle, as they are brought on the long lines of stretchers and ambulances.”
Despite the horrors he saw, Janes had reenlisted during the war, serving for essentially its entire duration. The Union cause was lucky to have him. Skilled doctors like Janes were precious commodities.
Having grown up in Waterbury, Janes attended school at Morrisville and later at St. Johnsbury Academy before studying medicine at Woodstock College. He left the state to finish his studies at the College of Physicians and Surgeons in New York City, part of Columbia. He worked as a house physician at New York’s Bellevue Hospital before starting a practice back in Waterbury.
Antietam and Gettysburg
When Janes first enlisted, he was made surgeon of the Vermont Third Regiment. His education in the savagery of war started in earnest in September 1862, when he was put in charge of the military hospital at Frederick, Maryland. The Battle of Antietam had just produced the single bloodiest day of the war. More than 3,600 men were killed that day, Sept. 17. It was Janes’ job to oversee care for the 9,540 wounded Union soldiers and any wounded Confederate captives.
Less than a year later, Janes was in charge of military hospitals scattered around Gettysburg, Pennsylvania, during and after the war-altering battle that took place there. Janes’ staff of 250 surgeons and countless assistants cared for roughly 20,000 wounded men, both Union and Confederate.
From his experience, Janes had learned that he could sometimes save a badly damaged limb, particularly a gunshot wound to the thigh that had fractured the femur. The common treatment was amputation, but Janes taught his surgeons what he knew and as a result many wounded soldiers owed their lives, and legs, to him.
Janes spared his audience at the Vermont Medical Society annual meeting little of the nightmarish scenes he had witnessed, instead detailing what he had seen while making rounds after battle: “This man in the deep coma has concussion of the brain; see the pitiful expression of this boy with both eyes shot out; the horrible appearance of this officer whose nose, jaw and almost whole face has been torn off by a shell; here is a boy with both legs torn off by a round shot; and another with both arms completely shattered…” His descriptions went on for pages.
Why did Janes go to such lengths? Why did he detail the effects of gangrene, the heartrending sight of a man shot through the spine and paralyzed, or the slow but inevitable death of victims of tetanus? After all, his audience was made up of medical men; they had witnessed suffering and death. Perhaps he hoped his audience would share his outrage about the barbarity of war, even if most had never experienced anything like Janes had.
Perhaps he hoped his speech would reverberate and reach a larger audience. Or maybe he was merely venting his moral indignation. Given what he had experienced, who could fault him?
Gettysburg wasn’t the end of Janes’ military career. Late in the war, in the fall of 1864, he was placed in charge of Sloan General Hospital in Montpelier, one of three facilities established in Vermont to treat soldiers strong enough to survive the journey from the battlefield.
As part of his practice, Janes’ used an innovative technique being adopted by some other doctors at the time. He used photographs of his patients to record their wounds and treatment. Janes also arranged for patients to be offered classes in arithmetic, bookkeeping, writing, grammar and oratory.
Sloan and Vermont’s other military hospitals had a strong record of success. Most of their patients were later able to return to duty. Records show that 66 percent of soldiers treated in Vermont hospitals rejoined their comrades, compared to the 25 percent of soldiers treated at Philadelphia and Washington-area hospitals. That record reflects the care given by doctors like Janes and to the fact that only patients in better condition were deemed fit enough to be treated at distant hospitals.
‘The flood of thoughts’
Janes returned to Waterbury after the war and resumed private practice. But he remained interested in what we might call emergency medicine.
Though his experience was on the battlefield, many lessons he learned were presumably applicable to farming and industrial accidents. At state and national medical conventions, he read papers on the treatment of gunshot-related fractures, particularly to the femur, the treatment of gunshot wounds to the abdomen, the effects of amputations and his study of treatments that avoided amputation.
He continued to practice and perform surgeries both at Waterbury and at the new Mary Fletcher Hospital in Burlington; he also taught at the University of Vermont’s medical school.
But Janes’ wartime experiences never left him.
Forty years later, at the Medical Society’s annual meeting, he asked: “Is the profession of killing men and mangling them so that their lives are ever after a burden to themselves and to the community, so much more noble than that of curing and restoring them to usefulness, that all the honors should be given to the former and none to the latter?”
Doctors, he argued, had years of training, while many soldiers had almost none; and military doctors’ mortality rates were higher because they braved both gunfire and the infectious diseases that spread rapidly through hospitals. But still, Janes protested, a doctor wouldn’t be promoted above the rank of major, “even if he has under him a major-general’s command.”
When Janes argued that doctors should be accorded higher respect, and, yes, rank, he wasn’t just thinking of himself. He felt a deep bond with his fellow military surgeons. Years earlier, in the 1880s, he had written a moving obituary for another Army doctor, Charles Chandler, whom he had met in 1861 during the Civil War.
“From that time on,” he wrote, “we were much thrown together; we camped on the same cold and soaking ground; we marched through nights seemingly interminable, when human endurance was stretched to its utmost; we walked through the same miasmatic swamps, and rivers of mud; we were near each other in the same shower of hissing bullets, and screaming shells; during the horrid nights after the battles we worked together among the same crowds of mangled and dying humanity; we toiled side by side for many long days among the festering and gangrenous wounds of the soldiers hastily gathered up from the battle fields or famishing in the enemy’s lines; and we were together among the fevered and infected sick, in the more permanent hospitals.
“Will you wonder then, that ‘the flood of thoughts rushing o’er me’ prevents adequate expression by words? He had become to me more than a brother.”