Myths of Reconstruction: The Freedmen’s Bureau Medical Division

By Curtis Price

May 9, 2021


On the evening of January 31st, 2016, I heard a loud thumping on the door. It was the kind of ominous knock that makes your heart skip a beat. I was flooded with a sense of dread that something bad  was getting ready to be set off. And sure enough, something bad was about to unfold.

I opened the door. There, standing outside were two mean-looking, redneck Alabama sheriffs with a tense look on their faces and hands on holsters. They brushed me aside and did a quick sweep through the apartment. Then, they told me I had to come with them. I asked, “Am I being arrested and if so, what for?” They didn’t answer. Instead they escorted me to the waiting cruiser. But I noticed they didn’t handcuff me.

Driving down University Drive, one of the main drags in Huntsville, the night was starting to fall and all I remembered were the street lights blurring together like stars that had fallen from the sky, illuminating a path. Bur a path to where? The sheriffs still refused to tell me where we were going. They engaged in the hard-bitten banter of lawless law enforcers and I was the invisible, powerless,  prisoner under their control.  I thought to myself this is what it must have felt like in 1937 Soviet Union, with the GPU rounding people up without warning.

To me surprise, however, they drove past the county jail – an ugly, squat building known on the street as “The Blue  Roof Inn” because of its distinctive blue roof tiling. Instead, they pulled into the Huntsville Hospital ER. The sheriffs bundled me out of the car and escorted me inside a locked area, a mini-Panopticon with a staff desk in the middle surveying everything that went on. Right away, I heard an older woman who looked like Phyllis Diller with a shock of blond hair hanging over her face like a rooster, yelling “Get your motherfucking hands off me!” and swinging wildly. Then it dawned on me. I was in the Psych Ward.

No, dear reader, I hadn’t suddenly decided to fly over the cuckoo’s nest. As I soon found out, an involuntary petition for civil commitment had been filed against me for being “suicidal and homicidal.’ A former BFF who I had cut off contact because he went on a crack run had filed the petition in a fit of vindictiveness, because being drug-addled and being able to manipulate the system aren’t two mutually exclusive propositions. I would remain involuntarily committed until I saw a judge for hearing two days later. The staff placed in a holding room painted sickly, institutional green with the only furniture a cast iron bed. That would be my impromptu “home” until a bed opened up on the inpatient psych unit.

A nurse came in to interview me. I let her have it, in controlled outrage. How can people be picked up against their will just on hearsay, I said? Isn’t this what Third World dictatorships do, where anonymous complaints lead to incarceration?  Where were my rights? She remained calm, explained what was happening and what I could expect. I sat down on the hard metal bed while the older woman continued screaming next door. But at least they left my door open which was a sign they didn’t see me as a security treat.

I was due to work that night at 11pm so I went out to the desk and asked if I could use the phone to call my job. A yellowed sign said “No personal calls allowed.” But in one of the many instances that happened to me over the next two days, she broke the rules and let me call work. It showed me how even in the most bureaucratized and regimented situations, ordinary people will ignore the system and reveal some humanity if they think these rules unfair. They don’t do it because they consciously want to buck the system. They do it unselfconsciously from a personal sense of what’s right.

It wasn’t until 1 am that I was admitted upstairs to the locked ward, to a plain room with just a bed, one wooden chair, and a small desk.

I slept soundly. I don’t remember if I dreamed.

At 7 am, staff woke everyone up and sent us to the day room for breakfast. The day room was a large lounge with a communal eating table, a big screen TV, a jumble of worn but comfortable mismatched chairs- and the only reading material a few old, torn-up “People” and “Entertainment Today” magazines. I looked around at my fellow inmates. One woman, a small white woman in her late 30s with waist length, dirty blond hair, lay stretched out over a chair like a wilted flower, hair dangling, staring vacantly into space, dealing with who knows what inner demons. The whole time she was on the unit she never talked to anyone and held her head down while eating, avoiding all eye contact.

I recognized Phyllis Diller from the night before. We talked. She said she was here because she changed her will, cutting a daughter out, and the daughter filed commitment papers as retaliation. I asked the nurse later how often that happened. She said quite a lot. One party in a messy divorce would file a petition to prevent the other from getting custody. Wills were yet another common reason, like with Phyllis Diller. Swearing out an involuntary petition gets used to settle lots of scores.

I thought, “Isn’t this so typical of how America works?” People living disheveled on grates and baying at the moon can’t get help while perfectly sane people are rounded up against their will, wasting scarce resources that others in real distress are denied.

Phyllis Diller went around with a perpetual Bernie Mac “WTF?” expression on her face, cursing like a small battalion of sailors while  demonstrating a natural comedic flair with pitch-perfect timing .But quite honestly, I found her draining to be around because she was too high-strung and talkative. She told me she used to work in the chemical plants and when news came out about birth defects in children born to line workers, she stormed into the supervisor’s office with her work shears in hand and told the supervisor, “If my baby is born with no balls, I’m coming after yours.”

At meals, we were only served decaf, on the theory that caffeine over-stimulates the nerves of the mentally distressed.  I told the monitors, two young, hip, muscular black guys, I needed real coffee. One went off the unit every meal and brought me fully-strength coffee from another floor. Again, that spontaneous willingness to break the official rules.

People came and went continually while I was there because most patients had signed themselves in voluntarily and thus could freely leave on their own volition. Later that first day, a middle-aged black woman was admitted. She shuffled in, shoulders slumped, deeply depressed. But as the hours went on, she became more outgoing, as if being around the warmth of others’ company caused her to open up, the way a seed sprouts under the sun’s rays. She told me her story. She had married a man, who whisked her off to the deep country, where he isolated her from her family, and continually beat her.  Finally, she escaped to the local ER, threatening to kill herself and she ended up transferred here.

We hung out talking while watching TV, which was always tuned to Steve Harvey and Dr. Phil. Many times she would talk back at the TV, giving advice, and her advice contained more wisdom and insight than anything coming out of those two clowns’ mouths. I wondered what she would do when she was released. Would she end up, like so many battered women, back in the same situation she had escaped ? I got a hold of some napkins and borrowed a pen from a staff member, wanting to write down my impressions. I guess to outsiders I looked like the right madman, furiously scribbling away on napkins. But by this time, I was resigned to being held against my will and was determined to record all my thoughts.

Later that evening, a nurse brought me a mobile phone from the nurses’ station, telling me I had a call. It was the security guard from the job who had demanded – and won-  the right to speak to me. Again, that breaking of the rules, because patients were only allowed to use the communal phone in the day room. The security guard said that when the rest of the night shift heard what happened to me, they set up a prayer circle overnight. She and one of the other workers wanted to come to my hearing and testify on my behalf.  The nurse listened next to me, with a warm, concerned expression, obviously moved by this show of solidarity. But I told the guard she didn’t have to come because the hearing didn’t allow witnesses. (The security guard, by the way, was a hard-core Trump supporter and Christian fundamentalist, but pro-abortion, pro-gay and with many close black friends. We met for breakfast several times afterward and still keep in-touch occasionally years after I left the job.)

On the second day, I had my psychiatric evaluation. An elderly West Indian psychiatrist, very serious and official, speaking in a thick lilting accent, administered the test. I could tell from his eyes, because he wore the blank expression of professionalism, that he could obviously see there was nothing clinically wrong with me but he had to go through the motions anyway. He said nothing though to reveal his thoughts and left. I talked briefly with a new admission, a young white guy, rail-thin and heavily tattooed, with sores on his face – a tell-tale sign of heavy meth use. He told me he had just gotten out of jail and I thought him admitting himself was maybe a ploy for an upcoming court case. But he spent most of this time on the communal phone afterward and we didn’t talk any more. The rest of the second day went like a blur.

On the morning of my hearing, after consulting with my appointed lawyer, the psychiatrist came in. He asked if he could pray. Not wanting to be difficult and potentially causing him to change his evaluation, I agreed. He intoned a prayer, with his mournful, long face, for about 20 minutes. Of course, it should have been illegal to mix religion and public services. But I guess in the psychiatrist’s own way he was a rule breaker too. It was a fitting, concluding absurdity on top of already accumulated absurdities.

The hearing was over in 15 minutes. Of course, they found no reason for my long-term commitment and the case was dismissed and expunged.

I walked out into the crisp, winter morning, closed my eyes and felt the sun hit my cheek, the first time I had breathed fresh air in two and a half days.  Now, I was free. But others weren’t. My fellow comrades in bad luck, misfortune and powerlessness were people taxed to their limits, isolated, unable to cope, and with no social support. Most would be discharged in three days  back into the same circumstances that sent them there. The system works, just as it was intended to.

Sick From Freedom: African-American Illness and Suffering During the Civil War and Reconstruction by Jim Downs (Oxford University Press, 2015

According to popular image, the end of slavery was an era of liberation, a happy ending to a bitter war, with jubilant ex-slaves embracing and flourishing under new freedoms denied in the regime of Southern chattel slavery. In this absorbing and well-documented book, Jim Downs questions this interpretation.

 The same troops that sung “John Brown’s Body” on marches, when confronted first-hand with disease and illness among slaves, closed down the informal settlements that had formed on the perimeter of Union camps, forcing newly free slaves away from Army bases.  Sometimes Union soldiers kidnapped escaped slaves and sold them back to their former masters. This continued after the war ended with military and Freedmen’s Bureau officials, obsessed with black bodies only as a source of labor, entering freedmen camps and communities, removing able-bodied men and shipping them to work on distant plantations.  (1)

As Downs notes, “many free slaves died once they secured refuge behind Union camps. Even after the war ended, they continually struggled to survive in a region torn apart by disease and destruction.”  (2) To Harriet Jacobs ,a northern aid worker comforting sick freewomen surrounded by the dead and dying in Washington, D.C., wrote how their eyes seemed to cry: “is this freedom?” (3)

These conditions continued in the post-war period, when the Freedmen’s Bureau set up by Northern authorities, prioritized ex-slave health only as a means to get ex-slaves to return to the fields they had just fled. The objective of the Freedmen’s Bureau Medical Division was to support the emerging free labor system in the South and, by restoring workers’ health, return the region to productivity while avoiding “dependency” on government largesse.

***

Toward the end of the Civil War, thousands of slaves abandoned plantations and escaped behind Union lines, what W.E.B. DuBois famously labeled “a general strike” against the plantation system. But they arrived sick and famished, having trekked great distances, and at considerable personal cost. Their forced mobility, always on the run, meant that freedmen lost community ties, ties that had nourished slaves throughout slavery’s harsh regimens.

As the collapse of the Confederacy accelerated, in large part because of a refusal – the second, yet unacknowledged general strike of the Civil War – by Confederate draftees to fight “a rich man’s war,” kinship bonds among slaves further eroded and families were thrown on their own resources. Medical care that slaves had gotten on plantations or through informal systems of folk medicine within the slave community vanished.

Although a sense of personal and collective agency had helped slaves flee bondage, the other side of the coin that hasn’t gotten attention, as Downs points out, is that ex-slaves faced obstacles “that could not be defeated, no matter how willing or independent they may have been.” Ex-slaves confronted multiple biological crises – the need of bodies for nourishment, shelter, and respite from illness – that even the keenest sense of autonomy could not vanquish. (4)

The Union army had neither the resources nor the political will to address this onslaught of mass suffering. To Union commanders, the presence of so many sick and debilitated slaves hindered war efforts. The Emancipation Proclamation carried no clauses governing Northern armies’ responsibilities towards escapees nor any funding to address their plight, in large part because the Emancipation Proclamation was conceived in narrow strategic terms as an economic weapon undermining the South’s plantation work force, not as a measure promoting social or human rights for African-Americans. (5)

The Union army saw escaped slaves only as a potential source of extra man-power for the war, to relieve grunt work falling on white Northern soldiers. Able-bodied male slaves either signed on voluntarily or were forced to enlist for rations and shelter. Sometimes raids were conducted in camps and freedmen’s communities (a practice that continued, although reduced, during the post-war period with a few local representatives of the Freedmen’s Bureau.)

Women, children, the elderly, sick and disabled presented a special problem. In the eyes of Union commanders, sick slaves, women and children hindered mobility and used up scarce resources.  At times, escaped slaves were viewed only for their monetary value as chattel, such as when General Benjamin Butler wrote that “… more than $60,000 worth of them had come in” in describing an influx of escaped slaves behind Union lines.  Old slave pens from chattel days were re-opened by Northern troops as holding areas for escaped “contraband.” (6)

Without warning, Army officials sometimes suddenly broke up slave encampments, even after promising safety, and scattered escaped slaves elsewhere, even if this meant their risk of death from starvation or the spread of infectious diseases. Slaves, as Downs points out in his description of one slave family’s ordeals, “did not die from complicated medical illnesses or unknown diseases, they died because they did not have basic necessities.” (7)

The Army and, later, Freedmen’s Bureau officials wanted local authorities to take on responsibility for the welfare of ex-slaves, but local officials refused. Hostile to Emancipation, local officials in the South saw slaves as traitors getting their just deserts for abandoning the plantation. Ex-slaves were taunted over what they had lost from rejecting “benevolent” masters.  Many Southern officials found an opt-out by declaring since former slaves were never legally constituted as citizens, they were ineligible for local aid. (8)

This resistance to treating the medical conditions or providing basic social services of ex-slaves was a permanent feature of Southern official response from the end of the Civil War through Reconstruction – and beyond. To make matters worse, crop failures and drought swept through a South destroyed by war in the years after war’s end, making slaves’ survival even more precarious as available resources went to whites first.

Reacting to ground-level reports of the growing plight of emancipated slaves, the Federal government felt forced to act, setting up the Freedmen’s Bureau as a temporary stop-gaps to assist desperate slaves entry into the new world of free labor. The Medical Division of the Freedmen’s Bureau, one of several sub-departments of the Bureau, each tackling an aspect of ex-slave welfare, was established by the War Department. The Medical Division built over 40 hospitals to tend to freemen’s health and hired over a hundred doctors. But these measures were just a drop in the bucket in proportion to the growing need. Very quickly, the hospitals became de facto poor houses, providing housing, food and clothing to emaciated ex-slaves.

Contributing to high death rates among ex-slaves were the racialized concepts of African health that dominated U.S. medicine in the Civil War era. Because slaves were wrongly seen as immune to malaria because of their African heritage, malaria cases among black troops, for instance, were ignored. Northern doctors sent to practice in Medical Division hospitals thought people of African ancestry had weaker constitutions than whites and thus when fell sick were either under-treated or outright ignored.  Some Northern Medical Division doctors, even when sent, refused to treat freedmen. Charles Cox, an Illinois Democrat congressman speaking in opposition to the Freedmen’s Bureau legislation, no doubt spoke for many in the North when he said, “no government farming system, no charitable black scheme can wash out the color of the negro, change his inferior nature or save him from his inevitable fate.” (9 )

The passage of the Freedmen’s Bureau bill led to a drop-off in involvement of Abolitionist Benevolent groups as former activists felt – wrongly, as it turns out – that the Federal government was now taking over work that had previously been done voluntarily by Northern abolitionist groups. Aid workers remained, but were  sidelined and their observations ignored. At no point was any opportunity given by Northern authorities to freedmen to define their own needs. The anecdotes of suffering supplied by abolitionists were quickly replaced by the cold, impersonal calculus of raw numbers with no names attached.

The newly changed status from slave to freemen needing to making their way as workers in a free labor economy meant that health benefits that were formerly provided on the plantation now had to be introduced into individual labor contracts – if offered at all. Often the costs were too high for freemen to pay from meager wages, so health benefits stayed unused as new employers – often the same slave owners as before – now transferred the costs of reproduction to workers in accordance with the principles of the free labor system.

President Andrew Johnson, hostile to the Freedmen’s Bureau from the start, was determined to reinstate the old system of labor control inherited from slavery with power now shunted to employers. To Johnson, all Bureau activities cultivated a culture of “dependency” that had to be tenaciously fought.

 Instead of taking up care of freedmen, however, the ex-slave owners ignored their plight, leaving the stench of rotting bodies hanging in the air as corpses piled up in city streets. In Chattanooga, for instance, one Army official wrote that freed slaves were “dying by scores – that sometimes thirty per day dies & are carried out by wagon loads, without coffins, and thrown promiscuously, like brutes, into a trench.” (10)

O.O. Howard, then head of the Bureau, ignored Johnson and set up medical facilities anyway. But even Howard bucking the system was done with a commitment to the same goals. As Howard wrote, “the negro should understand that he is really free, but on no account, if able to work, should he harbor the thought that the Government will support him in idleness.” (11) When confronted with rising numbers demanding help, Howard concluded the problem was not unmet needs but instead a dangerous trend toward permanent dependence on state intervention.

(DuBois, in Black Reconstruction only mentions the Medical Division in passing but cites success stories such as the death rate among ex-slaves being reduced from 30% to 2.03%. Dubois couldn’t have been aware that the Medical Division’s statistics should be treated as suspect, inflated to make the Division’s work appear more successful than it was.

This, of course, was done to justify winding-down services and proving to Congress that the war against “dependency” had been won.  Federal Reconstruction officials as a whole needed to paint for Northern public opinion optimistic pictures of a booming South. To this end, Northern journalists were given tours touting the South’s rebirth under Northern tutelage, tours that showed happy freedmen working in fields and masked mounting black suffering offstage.) (12)

In many rural areas, where need was the greatest, overworked Division doctors lacked both time and resources to comply with the Division’s onerous bureaucratic reporting standards, leading to case undercounts. In the countryside, many ex-slaves died anonymous, unrecorded deaths from illness and starvation in bushes and forests without ever encountering a Medical Division doctor.

Yet even at their height, Medical Division hospitals could only treat an average of 20 patients at a time. Sometimes, hospitals and aid programs were forced off their sites so the land could be returned to former slave-owners.  Howard at first hoped to recruit doctors from the military to staff medical programs. But most Northern Army doctors left the South, with many openly expressing their lack of interest in treating black patients. (13)

Starved of funding, pressured by Northern officials to shut down as soon as possible, local hospitals were forced to improvise. Some Doctors hired patients to do menial work and were paid in food rations. Hospitals were told by Howard to grow their own vegetables on scraps of unused land to lower costs, A few defied Federal authorities and hired local workers anyway. Outside associations such as the Colored Benevolent Societies raised funds and provided food and clothing.

But Federal officials used this outside support as an excuse to further cut funding. The primary objective was to get fields back running again. As Downs notes, “ . . . Radical Republicans and members of Johnson’s administration who otherwise disagreed on the objectives of the Bureau – shared a view of ill-health as it related to one’s ability to perform arduous field labor.” (14) Later, in 1866, the Radical Republicans argued for able-bodied freedmen to be denied health care or assistance if they didn’t go back to the fields – a position indistinguishable from Johnson’s.

Left out in both Johnson and Radical Republican calculus was any acknowledgement of the role of war and internal displacement in stoking illness. Everything was narrowed to simplistic ideas of a “will to work” that was either present or not. The larger structural impediments to employment such as a ruined economy and infrastructure were never considered

During this period, dating roughly from 1862-1865, smallpox raged throughout the South, undoubtedly aided by freedmen’s forced dispersion. Smallpox carried a stigma of affecting the immoral, poor and promiscuous and carriers avoided public attention, making it harder to practice quarantine. Ex-slaves, for instance, hid evidence of infection from white eyes because they feared being told infection was God’s disproval of Emancipation. As smallpox spread up the Atlantic coast, military officials in D.C. pressured many freedmen to go back over the Potomac River, where they were warehoused in former slave pens in Alexandria; others were just abandoned to die. (15)

Smallpox was spread by large movements of freedmen, often forced out by local Freedmen’s Bureau to seek services elsewhere. Tragically, many freemen viewed freedom as the right to go wherever they pleased and thus unwittingly carried smallpox with them.

Susceptibility to illnesses such as smallpox for both Northern and Southern officials became one more sign confirming Africans’ inherent racial inferiority. The role of overcrowding and lack of housing escaped notice as a cause, even as both factors were acknowledged as exacerbating conditions when applied to whites. Instead, smallpox offered “proof” that blacks and whites had different biologies. Widely accepted as fact was the theory that African slaves were inherently doomed to die out, like Native Americans, and treatment was futile in stopping this inevitable outcome. As one religious leader spoke in 1863 about Africans, “Like his brother the Indian of the forest, he must melt away and disappear forever among the midst of us.”  (16)

These views were also held in the top leadership of the Freedmen’s Bureau Medical Division and officials refused to provide adequate funds to build separate facilities – pest houses – to house the infected. The logic was since freedmen were inevitably slated to become extinct, efforts to stem the spread of smallpox through basic sanitation measures and vaccination were futile. Thus Federal officials refused to follow long-known strategies for containing smallpox that had been standard practices for decades.

Occasionally, freedmen organized to demand better protection. In New Bern, North Carolina, a group of freedmen successfully approached a commander alleging the Freedmen’s Bureau superintendent committed “oppression and outrages.” In Columbia, SC, ex-slaves demanded an end to the unsanitary conditions at the local smallpox hospital. At other times, freedmen, not trusting the Northern military with their health and exercising what they felt was their new freedoms, refused to cooperate with Union army campaigns for mass vaccinations. (17) But such protests were rare.

By the time the Freedmen’s Bureau Medical Division was shut, few of its hospitals remained. Although a handful of dedicated doctors and Northern volunteers continued to provide health care to newly emancipated slaves, these scattered efforts could never meet the overwhelming need. From then on, freedmen’s would be at the mercy of employers or their own wits and the first experiment with government-sponsored health care consigned to history.

***

In many ways, the end days of the Confederacy saw a horizontal shift in suffering as Union troops and later Freedmen’s Bureau officials, confronted with the immense suffering of escaped slaves, refused to respond, leaving tens of thousands to die of hunger, exposure, and disease. Why are these circumstances unknown? As Downs points out,

“The few and scattered references of freedpeople suffering from the challenges of emancipation have been overlooked because these episodes do not fit into the patriotic narratives of the Civil War. Frozen feet and starvation complicate accounts dominated by heroic black soldiers or freedwomen in Union camps caring for both freed slaves and Northern troops. These carefully cast representations of freedpeople were often created by white authors in the late nineteenth century who strove to highlight the happy outcomes brought by emancipation. Recounting the hardships endured by former slaves during emancipation risked sending the erroneous message that the institution of slavery was no wholly cruel – inadvertently supporting the argument of antebellum pro-slavery advocates in response to the abolitionist movement” (18)

Alongside the exalted phrases of the Emancipation Proclamation and stirring accounts of black freedom during Reconstruction, we also need to center the experience of an anonymous freedwoman living in a dump cart in Montgomery who passed out while giving birth, only to find when she woke that hogs had devoured her baby. (19 130) She too is a face of Reconstruction and her baby’s death a case of social murder, perpetrated by the indifference of both Northern and Southern authorities alike, when confronted with the mass suffering of ex-slaves in the Civil War and Reconstruction eras.

Notes

1) Jim Downs, Sick From Freedom: African-American Illness and Suffering During the Civil War and Reconstruction (New York: Oxford University Press, 2012), 37, 123.

2) Downs, Sick From Freedom, 6.

3) Downs, Sick From Freedom, 162.

4) Downs, Sick From Freedom, 6.

5) Downs, Sick From Freedom, 38.

6) Ibid.

7) Downs, Sick From Freedom, 21.

8) Downs, Sick From Freedom, 68.

9) Downs, Sick From Freedom, 61.

10) Downs, Sick From Freedom, 27.

11) Downs, Sick From Freedom, 73.

12) Downs, Sick From Freedom, 144.

13) Downs, Sick From Freedom, 83.

14) Downs, Sick From Freedom, 93.

15) Downs, Sick From Freedom, 99.

16) Downs, Sick From Freedom, 103.

17) Downs, Sick From Freedom, 109.

18) Downs, Sick From Freedom, 6.

19) Downs, Sick From Freedom, 130.

Further Reading

Harris, Paul. “How the end of slavery led to starvation and death for millions of black Americans. “ The Guardian, January 16, 2012. Retrieved from https://www.theguardian.com/world/2012/jun/16/slavery-starvation-civil-war?fbclid=IwAR1Zv08337Uwv090IoP_RWnWTYcEWVt6F3hcsjwj-rADQR13hWGoQtaM6Sk

One thought on “Myths of Reconstruction: The Freedmen’s Bureau Medical Division

  1. On Myths of Reconstruction: Regardless of the perils that may lie ahead, the price and promise of freedom is immeasurable, even when paid in disease, starvation, insane charges of genetic inferiority, and death.

    Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.