Report of Dr. A. Monae Lesser
In response to a call from the president of the American National Red Cross, I left this city with Mrs. Lesser for Key West on June 15. On my trip South, a train of recruits commanded by First Lieutenant Heavey, First Infantry, joined us on their way to Tampa. There were a number of sick on this train; I offered my services to the lieutenant, which he accepted, and I attended the sick. Most of them had bowel troubles; either diarrhœa or constipation; several had fever, and some sore throats. One private was very ill, and lay on a short bench in a Southern Railroad coach. His temperature was high, and his condition somewhat alarming. I engaged a section in a sleeping car, saw that he was made comfortable, gave him medicine, and Mrs. Lesser nursed him until we arrived in Tampa. The lighter cases as well as the one special case were much improved when we arrived at Tampa, still I mentioned that the patient be taken in an ambulance which the lieutenant ordered by telegraph before we reached Tampa. We then proceeded to the steamer “Mascot,” bound for Key West. On board were a number of marines of the United States Navy, several of them suffering from the same troubles as Lieutenant Heavey’s recruits. Among them was one case of erysipelas, due to improper care of a vaccinated pox. We attended him, and left him and all the others comparatively well in Key West, where Mrs. Lesser and myself joined Miss Barton and staff on the steamship “State of Texas.”
The following morning, June 20, we started for Cuba, reaching Santiago after a six days’ journey. On June 26, Mr. George Kennan, vice-president of the American National Red Cross, interviewed Admiral Sampson for instructions, and the steamship “State of Texas” was directed to Guantanamo, where we remained over night.
The following morning, June 27, a correspondent of a New York paper boarded the “Texas” and informed Miss Barton that a battle had been fought at the front, and that there were a number of sick and wounded at Siboney.
Miss Barton gave orders for the ship to return immediately to Siboney (a little village between Santiago and Guantanamo), at which place we arrived at 9.20 p.m.
Work in the Field
Upon arriving at Siboney, although it was late in the evening, I was directed by Miss Barton to go ashore to inquire into the needs of the hospital, and if any, to present her compliments, and to make the following offer:—Although the “State of Texas” was sent to feed the refugees and starving Cubans, it carried some persons and articles that might serve for hospital purposes, and that the Red Cross considers its first duty to be to help those who are nearest.
There was a large barn to which I was directed when I asked for the hospital. I introduced myself and staff to the physician, extended the compliments of the president of the Red Cross offering the services of her staff, as well as needed supplies. The physician in charge very courteously answered that he had been ordered to go to the front the following morning, and not needing anything, thanked the Red Cross for its offer.
Westward from the landing place was a pond of stagnant water. Upon a little hill across a railroad track stood a number of wooden cottages. The first large one, which seemed to have been some kind of a store, and a barn westward from it was pointed out to me as another hospital. (It was the same house which later was used as a post-office, in which Postmaster Brewer contracted yellow fever, but which was never used by the Red Cross.) There were a number of sick soldiers lying around on the floor, Surgeon-Major Havard being in command. I made the same offer to the major as I had made in the first place, and the condition of affairs being apparent, I tendered him the services of the Sisters, as well as cots and blankets for his sick; for which he thanked me, adding that he would accept the cots and blankets, but that he did not require nurses. I invited him to the steamship “State of Texas” to see Miss Barton, so that he might select such articles or service as he desired. From there I went with the staff to Dr. Virano, surgeon-in-chief of the Cuban Hospital, making the same statement and offers to him. He introduced us to General Garcia and his staff, and thankfully accepted the offer of the Red Cross. His patients were lying on cots and on the floor, little care apparently having been given to put the house in fit and proper condition. This ended our duty of the evening, and we returned to the ship.
The next morning, June 28, Major Surgeon Havard visited Miss Barton on the “Texas,” as also did a Cuban delegation; the former made a request for cots, and the latter for the assistance of nurses, and food for the sick. Sister Isabel, Sister Minnie, Sister Annie and Sister Blanch under the direction of Mrs. Lesser went to the Cuban Hospital, taking with them proper nourishment for the sick, and utensils for preparing the same. The work of relief then began at the Cuban Hospital, and beds and blankets were sent on shore for Major Havard.
The same morning Miss Barton directed me to go to the front and find out if anything was needed at the camps, and accompanied by Mr. George Kennan and Mr. Elwell I started about 10.00 a.m. A large detachment of infantry which the night before had camped along the shore of Siboney, had gone on the road up the hill about a thousand feet in height, while another detachment of infantry and artillery took the lower road in the valley, being the only road for vehicles which leads from Siboney to Santiago. The men looked well, although the heat prostrated a number of them on the march. We walked along the latter road as far as the Camp of Rough Riders, which on that day was the furthest in front, a distance of eight miles from Siboney. It was several days after the battle between the Rough Riders and the Spaniards.
The next day, June 29th, I returned to the shore with the Sisters, whose work and value had been observed by others. Siboney with a large water supply and a sea breeze was selected for the Reserve Divisional Hospital of the Fifth Corps. Surgeon-Major La Garde, of the regular army service, was the chief of the department. His supply was small, and conveniences still smaller, which he said was owing to the fact that through military necessity medical and hospital supplies of the army were still on the transports, with no means of unloading. There were but few hospital tents, and the cots in them were occupied by a number of patients, in whom Dr. Fauntleroy took great interest. I offered the services of the Red Cross, as directed by the president. The major, a man with humane ideas, unable to get such supplies as were needed, accepted any reasonable aid that he could receive.
Our offer came at a moment when we could be of help. Surgeon-Major Havard with his staff had been ordered to the front and was unable to place the cots we had landed. His patients, who were suffering from typhoid fever, measles and other diseases, were transferred to Major La Garde’s camp. Battle was expected every day, and the major in order to be as well prepared as possible, accepted the offer of assistance made by the Red Cross, and placed a house at our disposal to serve as a hospital. He addressed a formal letter to Miss Barton, who answered at once in kind words and deeds. We also immediately sent word to Miss Barton, describing the requirements. The Sisters cleaned the muddy house, then disinfected it; Miss Barton sent from the “State of Texas” cots and bedding; food, stoves and utensils to prepare the same. In a few hours our house was disinfected and in order, and about thirty-nine patients were carried to it; most of them had typhoid fever and a few had measles.
The night of July 1, however, our work had to be changed. The major called for all assistance possible to attend the wounded who were arriving from the battlefield of Santiago. Large numbers of the wounded were brought down, many of whom walked miles. Men with bullet wounds through their lungs walked and crept for hours to get to the hospital. There were hospitals nearer to the front, but all seemed to have been overcrowded by the work of that day, and many soldiers had lost their way in the undergrowth and wandered about until they found the nearest road to a hospital. Many walked because they complained that the rough roads and heavy wagons increased their pains with every jolt. Surgeon-Major La Garde’s management can never be too highly praised. The wounded men that came down in the wagons were examined by him and laid somewhere to be comfortable until they could have attendance. By “comfortable” I mean as far as the situation would permit.
Every surgeon and nurse was put to work. Mrs. Lesser and the Sisters were called to assist at an operating table, and Sister Annie McCue and Mrs. Trumbull White were left in charge of the hospital building. At first I had the pleasure of assisting a very able army surgeon, Dr. Fauntleroy, but the same evening a table was assigned to me by Major La Garde. There were six tables in the tent, which were in charge of the following surgeons: Drs. Fauntleroy, Ireland, Nancrede, Munson, Parker, Howard and myself, some coming later than others. The work continued all night, each operator having one assistant and one of the Sisters at his table, continuing all of the following day. As the wounded came down in numbers, and there were not cots for them, they had to be left in any position around the ground. Major La Garde and Chaplain Gavitt were at all times kept busy having long flies put up to protect them in case it should rain.
Copyright, 1898, by Clara Barton.
The four sisters of the New York Red Cross Hospital of Dr. and Mrs. A. Monae Lesser, who nursed sick reconcentrados and their orphans in Havana, and afterward assisted the surgeons on the ships and in the hospitals of Siboney in dressing the wounds of Cuban, Spanish and American soldiers and sailors, until they fell victims of the fever and went into hospital themselves.
DIPLOMA OF GRATITUDE FOR MISS CLARA BARTON FROM THE RED CROSS OF SPAIN.
[Translation of Text.]
The Supreme Assembly of the Red Cross of Spain Grateful for the powerful co-operation which you have given, contributing to the patriotic and humanitarian ends of the institution, has resolved to manifest its recognition thereof, by issuing to you the present diploma in the city of the Court of Madrid on the 31st day of October in the year M.D.C.C.C.X.C.V.I.I.I. (1898).
The President,
Marquis of Paloma.
The Secretary General,
Juan P.C. Domingues.
Every moment news of another battle was expected; the experience of the first, with no better means as yet at hand, was a matter of great concern and worry to all present. Suggestions were made and discussed. Finally it was agreed to request more Red Cross aid by telegraph. A call for one hundred Sisters was suggested, and Mrs. Lesser was consulted in the matter. We had fifty trained nurses and assistants on our lists, also women to act as matrons to distribute nourishment; we promised to send for that number immediately, as we had sent for twenty-five already. That morning Miss Barton, with Mr. Kennan and several of her staff, had gone to the front, and before leaving, Miss Barton instructed her secretary, Mr. C.H.H. Cottrell, that, at our request, he should cable in her name for such persons and material as should be needed in the Hospital Department. We cabled for fifty nurses, ten assistants, a number of immune physicians, complete hospital equipment, and a quantity of surgical material, sufficient to make at least five hundred patients comfortable.
The work was performed almost without intermission, every surgeon employing all his energies. The feeling in the hospital among the members of the surgical staff was an excellent one.
The night of the third we expected to be able to rest a few hours, but during the day the fleet had fought its battle, and a number of Spanish wounded prisoners were taken off by the various ships. Dr. Lewis, chief surgeon of the “Harvard,” who assisted in attending the wounded at the hospital at Siboney, invited Dr. Parker, myself and the Sisters to help him in attending the wounded Spaniards, to which we gladly responded and spent the night on the “Harvard.”
The wounded continued to arrive for four days, many of them telling that they had been shot on the first day of the battle, July 1, and as yet had received no care except from some comrade who had with him the little emergency package.
Permit me to say here that I believe the little emergency package has saved many a man from death through bleeding.
Most notable and commendable was the desire of the surgical staff to save limbs when at all possible; and I have seen and often joined Drs. Fauntleroy, Nancrede, Ireland and Parker in the work, spending an hour for resection of the part in order to prevent amputation. Of course all endeavored to do the same, and out of the total number of 1415 wounded treated in the Siboney Hospital after the battle, there were but three amputations of the thigh, two of the leg and one of the forearm, that I observed in the camp. The death rate was also very small, as most of the shots made clean wounds, and only when they affected most vital parts did they cause death.
The dressing of wounds and the operating upon the wounded, however, were not all the service required by the injured. Shelter, comfortable cots and blankets were needed, very few of which had been landed. Still, as the wounded came, and the needs became greater, I saw Surgeon-Major La Garde, most ably assisted by Chaplain Gavitt, hunt about for canvas or anything that would act as cover for a tent, and have it put up along the tents and flies. Their work was unceasing. In those days every officer and member of the medical staff gave up his cot and tent that the wounded might find some kind of shelter and proper resting place; but in spite of that they were inadequate. The largest number of wounded lay on the ground, some on blankets, others on canvas, or if very severely wounded, on a litter.
The steamship “State of Texas” had a number of cots (I believe 350) which were originally meant for Cuban relief, many of which we used in the Red Cross Hospital at Siboney; when I informed Miss Barton of the condition of affairs, all cots that were in the ship were unloaded and sent to the hospital, and the most seriously wounded received comfortable resting places.
The gauze, particularly the iodoform gauze, and bandages soon gave out. The “State of Texas” carried a quantity of surgical dressings. All that was necessary was to ask Miss Barton for them, who immediately sent on land any article needed if in her possession.
Among our patients were several cases of gunshot wound through the skull and brain near the eyes; the eyes were inflamed, and ice had to be applied continuously to relieve excruciating pain. Dr. Fauntleroy suggested that the cases be sent to the Red Cross Hospital, we had there the only ice in the field at that time; it also came from the “State of Texas,” from which we received a daily supply. The eye cases were carefully attended by Mrs. White, the wife of Dr. Trumbull White, of the Chicago Record, who deserves much praise for the constant attention which she gave them. It was necessary to make continuous application of ice every few minutes, which she did with constant and unceasing care. Mrs. White is not a trained nurse, but a gentle, wise woman. I agree with the remarks of Dr. Fauntleroy when he said that her attention and the ice relieved much suffering and saved quite a few from blindness. Captain Mills, who was one of the wounded in that manner, may tell of his own experience.
Most of the cases of gunshot wounds gave very little work to the surgeons, as the bullet entered at one place and made its exit at another, thus leaving a clean wound. Even through vital parts of the body, such as the brain and abdomen, bullets passed without apparently giving the patient any great distress. The simple cases did not need much attention; cleanliness and a cushioned dressing well protected was all they usually required. In fact, many of the smaller wounds came to us bandaged with a little emergency pad, progressing in healing. These were always shots from the Mauser bullet. Many of the men that I saw were shot in the shoulder, the bullets making exits through the back. Some gunshot wounds had two places of exit and entrance in their course. For instance, I had cases in which the bullet had gone into the upper and lateral part of the cranium, come out behind the ear, went into the shoulder and came out behind and below the shoulder blade; or had made its course through the left arm, again entering the right chest and coming out at the back. It would perhaps be out of place to enumerate or describe in this report the many courses which the bullets have taken, but as stated, most of them required little attention. There were, however, some serious wounds, such as compound comminuted fractures, in the treatment of which great skill was shown by the various surgeons in the hospital. Those were the cases which in former years would have resulted in amputation, but drainage and cleanliness, plainly speaking, have given the patients the advantage of keeping their limbs.
In the simple cases one could work alone, with the assistance of a Sister or a hospital steward, but in the more difficult cases good surgical skill was required, and it was often a source of great gratification to see two eminent surgeons, of equally good reputation, assisting each other in a difficult case; one advising, the other acting; thus the greatest harmony existed among the members of the staff. The Sisters being required in the operating tents as also the stewards there were no nurses in the tents to care for the wounded.
No food had been prepared for the large number of wounded lying on the cots or on the ground on blankets or canvas; a great many of them were too helpless even to turn. Surgeon-Major La Garde did me the honor of consulting me in regard to the nursing, and I suggested that some of the Sisters leave the operating tables, which were by that time supplied with other assistants.
The major then sent for Mrs. Lesser, who suggested that the worst cases be brought into one or two rows of tents, as the small staff of Sisters brought into Cuba was not sufficient to take charge of all and do them justice. The rows of tents were then placed in her charge, and she portioned the work of caring for them among the Sisters assisted by hospital corps men. The soldiers were nearly famished; some had not received a morsel of food for two days. Oatmeal gruel, coffee and quantities of prune juice and other articles of relish were at once prepared at the Red Cross Hospital in big cans which had come from the “State of Texas,” and with the assistance of the ever active indefatigable Chaplain Gavitt, and several newspaper correspondents, the wounded soldiers received such food as their conditions allowed.
Unfortunately the surgeons lost track of the greater number of their cases. The patient marked for redressing was placed on any table, and the surgeon in charge of that table redressed the wound; thus it was hard to say what result one or the other had obtained, with the exception of a few cases, which by special request one was allowed to continue to observe. Some of the patients came down with their wounds dressed in some hospital at the front, and I may here mention that I saw excellent work coming from the hospital in command of Dr. Woods.
When the rush was over, I was called to the camp where the Spanish prisoners were located. I prescribed for their ailments, while the Sisters supplied their food. In addition, I answered the calls which came from Cuban families in Siboney. Some Spanish prisoners were wounded and others suffered from fevers. Those who were wounded had their wounds dressed at the scene of battle, and although some of the dressings were temporary, they feared to have any person touch them, until assured that they would be treated as gently as possible. The patients had now all been operated upon and attended; only some of the wounds needed redressing. They were taken to the transport hospital ships as soon as their condition permitted. It was about that time the hospital ship Relief arrived, bringing more food for invalids and more equipped cots.
Dr. Guiteras, who visited all the hospitals daily, informed me one afternoon that he had found a case of yellow fever in camp (not in our hospital), developed in a place near Siboney. There were two or more suspicious cases which he had watched, and he believed that yellow fever would develop very rapidly. I called the Sisters together, presented the situation to them, that they might decide whether to stay in the field or return to the “State of Texas.” Their unanimous decision to stay and face the consequences made them continue their work without any hesitation. The Red Cross Hospital building became crowded, one room was set aside for doubtful cases, while the other rooms were occupied with typhoid patients. The porch in front of the house, shaded with canvas, and a little isolated room to the right, sheltered the wounded.
My work at the Red Cross Hospital became continuous, as a large number of patients came from the various camps to receive attention, and still a larger number from our camp came for consultation and treatment. The number of such consultations I discontinued to write down after three hundred were attended, Americans, Spanish and Cubans together.
Every case of typhoid fever and other disease which was placed in our charge from the day we opened the hospital, has recovered. The last of them were brought home well on the “Concho;” those that came later were on the way to recovery when I left for the fever hospital. Among our patients were two who had measles, complicated with pneumonia, and there was a large number of patient suffering with Cuban malarial fever. I also wish to state that not one patient in our hospital became infected with yellow fever; the cases that had it came there with the disease, but were closely observed, and as soon as the first positive sign was noticed, they were isolated and brought to the fever hospital. The total number of sick permanent and transient thus attended was 234. Most of the medicines we had brought with us, but received some from army stores.
When the “State of Texas” left for Jamaica to get ice, in order to save time we took a dwelling in one of the houses at Siboney, which was believed by experts not to be infected. The family living in it was very clean, and it appeared that the house would serve as well, and perhaps better than any other. Our tents, in which we should have preferred to live, had not arrived, nor did we have any cots, all having been given to the sick and wounded.
When the houses at Siboney were ordered to be burned down, we left for the yellow fever camp. Before leaving I requested Dr. Senn to operate upon two Spanish prisoners whom I had not seen for several days.
On the seventh day after our arrival at the camp we were able to return to Siboney. Our ailments, although not prevented, had been made light by prophylactic methods, and our recovery was consequently rapid. After our return to Siboney I again offered to serve.
In the meantime word from Assistant Surgeon-General Greenleaf was received at Siboney, stating that forty-five Red Cross nurses, surgeons and other assistants, had arrived at Guantanamo, waiting to come to us, and as we returned the same day from the fever camp, Surgeon-Major La Garde telegraphed and telephoned repeatedly for them to come, but he received no reply.
Feeling that under the existing circumstances and exhausted from work and illness we could not continue to work without more assistance, I applied for our return. Surgeon-Major La Garde upon this placed me in charge of the steamship “Concho” which left for the North on July 23, of which voyage a special report has been presented.
Before my departure from Siboney, Surgeon-Major La Garde handed me a document, a copy of which I herewith present:
Reserve Divisional Hospital, Fifth Corps,
Siboney, Cuba, July 23, 1898.
This is to certify that Dr. A. Monae Lesser, surgeon-in-chief of the American National Red Cross, offered his services to the Medical Department of the army on the twenty-ninth day of June. From the latter date to the present day Dr. Lesser has been connected with this hospital as a surgeon and patient. When the wounded commenced to arrive on July 1, and during the rush of work which lasted four days in the care of the wounded, Dr. Lesser was assigned one of the six tables in the operating room. His work was skillful and most continuous. His suggestions to me on more than one occasion, concerning administration details, were of the highest value. After the rush of work in the operating room Dr. Lesser continued to take charge of a hospital, a building which was pronounced free from infection, in which he treated wounded and sick soldiers. His work was the admiration of every one who had the good fortune to be under the watchful care of himself and the Sisters under him. Unfortunately the building—in which they lived—soon showed signs of yellow fever infection. Dr. Lesser, his wife and four of the Sisters—his entire staff—were taken one by one with the fever. They were removed to our yellow fever hospital. They are now convalescing, though weak; they leave us for the North to-day for a much needed rest. I have no words at my command which could in any way express my appreciation of the work of Dr. Lesser and his heroic staff. Had it not been for their assistance and the quantities of supplies furnished by the “State of Texas,” the sufferings of the hundreds of wounded would have been magnified more than I can now venture to express.
In commenting on our lack of supplies, attendants, etc., I desire to state that our unprepared condition to meet the rush of work which came with such surprising rapidity was due to those military conditions which often transpire in war when blood, suffering and death seem to be inevitable, or beyond the scope of man to anticipate.
May God’s blessing be with him and his.
Louis A. La Garde,
Major and Surgeon, U.S.A.,
Commanding Hospital.