My Name is Mary Sutter by Robin Oliveira

The novel opens with Mary Sutter, a tall, young woman with silvering hair arriving at the door of Dr. James Blevens' surgery. He is expecting the midwife, but Mary was not summoned by Dr. Bleven. She has come to request Dr. Bleven's help after waiting at the medical college to see Dr. Marsh. He refused and so Mary has come to Dr. Blevens for help. Dr. Blevens asks Mary, who is a midwife, to help the laboring young woman, Bonnie Miles on the surgery table. Mary quickly takes action, managing to turn the baby which leads to a successful birth of a baby boy. 

Mary then entreats Dr. Blevens to allow her to study and work with him but he refuses. Lincoln has called for men, after the Carolinians fired on Fort Sumter and Dr. Blevens plans to answer that call. Mary is desperate to become a medical doctor but the Albany Medical College won't admit her. She wants to learn more about anatomy and physiology and her hope is that by studying with Blevens she can accomplish this. But Dr. Blevens, who drives Bonnie and her baby along with Mary back to the Sutter home, repeatedly refuses. He tells her it just isn't possible and that she would see few surgeries, there would be no lectures and she would have no credentials to practice. 

As Dr. Blevens is about to leave, having been refused an invitation by Mary to stay for dinner, he encounters Mary's mother, Amelia Sutter along with their neighbour, Thomas Fall who is in love with Jenny Sutter, Mary's twin sister. Amelia has Jenny set another place for Dr. Blevens. During dinner they discuss the rally and Lincoln's call for men. James Blevens notes that Thomas is excited for war and believes that the North will win with its advantage of manufacturing and railroads. With the arrival of Mary's brother, Christian, the discussion turns to the importance of defeating Texas and ending slavery. As Thomas speaking of the railroad being built out to the orchards, James realizes that he is at dinner with the family of the late Nathaniel Sutter of the New York Railroad.

The dinner is interrupted by a maid who states that Bonnie is bleeding. Both Mary and James attend Bonnie and it is James who is able to treat the young mother, while Mary watches on, humiliated at her own lack of knowledge. 

Mary comes from a long line of midwifes from her mother Amelia back to her great-great-great-great-grandmother in France, who had delivered a dauphin. The La Croix family was gifted land near Versailles but fled to America during the Revolution. Amelia's mother married James Harriman and then Amelia married her childhood friend, Nathaniel Sutter. Nathaniel eventually became involved in the New York Railroad while Amelia continued the family tradition of midwifery. One night in 1842, after Nathaniel left their children alone so he could attend a railway meeting, Amelia began bringing Mary and Jenny and their brother Christian to her deliveries. It was Mary who was interested in being a midwife.

Nathaniel Sutter died and agonizing death in September 1860. The next day Mary wrote her first letter to Dr. Marsh requesting admittance to Albany Medical College and Thomas Fall and his family moved in next door to the Sutters. Two weeks after Nathaniel's death, Mary and Thomas met at a show at Tweddle Hall. Thomas was taken with Mary's self-possession, her intelligence and she liked his directness. While Thomas was uncertain about the direction of his life, Mary was determined to become a doctor, as her father had "... died badly. I never want anyone to die as badly again."  A week later, and no reply from Dr. Marsh, Mary wrote another letter, and allowed Thomas to drive her to Cottage Farm, to the Aspinwalls at Ireland's Corners to attend a birth. Afterwards, Thomas took Mary to a small lake where they sat and talked: Thomas was intrigued. But a week later, both of Thomas's parents were killed in a carriage accident. While Amelia made the arrangements, it was Jenny, whose calm demeanor that helped Thomas and they fell in love.

James Bleven is puzzled by Mary's determination to become a doctor. His medical journey began at the age of thirteen, with the deaths of his parents from diphtheria over a period of a few days. Puzzled, James was determined to learn why this had happened and at eighteen he was able to apprentice to Dr. Stipp, following him on his visits to homes and attending courses at the medical college. Impulsively and out of pity, James married a young Irish Catholic girl whose infant brother - a patient of Dr. Stipp - had died from tuberculosis but the marriage did not last. He did not want the tie of children and she soon left him. James still visited her once a year. With both Thomas Fall and Christian Sutter enlisted, James begins a letter to Colonel Townsend, intent on obtaining the position of regimental surgeon for the 25th Regiment from Albany but is interrupted by the arrival of Jake Miles. Jake is eager to retrieve his wife Bonnie and so James takes him to the Sutter home where he meets Mary and then is taken to Bonnie. Jake is adamant that Bonnie return home to him, but this is against Mary's advice. While Jake is with Bonnie, James attempts to smooth over things between himself and Mary by offering to speak to Dr. Marsh to convince him to admit Mary to the medical college. But Mary refuses this offer since she cannot see how it would help her.

Thomas and Jenny are married before he leaves for war. This is devastating to Mary who quietly leaves their small wedding celebration and weeps in her bedroom. Meanwhile Bonnie has returned, a week after she'd returned home, her baby dead. Thomas, Christian, and James all leave for war. Six weeks later in June of 1861, Dorothea Dix meets President Lincoln and is appointed the Female Superintendent of Army Nurses. When Mary reads Dorothea's first circular asking for nurses, she decides that in Washington she can better keep track of Christian and Thomas. She also views this as an opportunity to further her medical knowledge.

Arriving in Washington, exhausted, her clothes dusty and stained and without the required references, Mary meets Dorothea. But Miss Dix refuses to take on Mary as she is too young, has no references and has only worked as a midwife. On her way out of the house, Mary encounters John Hay, secretary to President Lincoln. Mary tells John that Miss Dix is turning away women who want to be nurses and he in turn tells Lincoln. However, the president is too overwhelmed at the death of his friend, Colonel Ellsworth who has died during a battle with the Confederates at Fort Monroe.

Meanwhile across the river in Albany, Jake Miles, Christian Sutter, and Thomas Fall are now sharing a tent along with Edmond Wellan, son of a bookseller. Along with thousands of men, they have been sent across the Potomac River and have been felling trees on Virginia soil so they can see the Rebels. They have been sent without food, the sanitation is nonexistent, and they have no proper shelter or blankets. The Union army is rife with cases of typhoid and malaria along with measles, mumps, and diarrhea. James is frustrated and infuriated with the conditions in the camp.

Now completely desperate, Mary manages to obtain a list of hospitals from the Surgeon General's office by pretending that she is acting on behalf of John Hay. She visits the Patent Office which has become a hospital for sick soldiers, the Capitol where sick are located in the basement, the New York Presbyterian Church, the medical college and finally the hospital at the Union Hotel. At all she is turned away except for the Union Hotel, in the village of Georgetown, where Dr. William Stipp reluctantly takes her on as a nurse/apprentice.

In the meantime, Mary's mother Amelia is distraught over her sudden departure and begs Mary repeatedly to return home. In Washington, the fighting begins in July and the Union Hotel is soon overrun with wounded: men with injuries from musketballs, broken bones and many needing amputations which Dr. Stipp, like most of the other doctors in the army, does not know how to do. In July, the Union loses the battle of Bull Run under the command of Major General Irvin McDowell. A discouraged Lincoln replaces him with General George McClellan.

After three months in Washington, Thomas and Christian along with the other seventy-five thousand men who first enlisted are being sent home. With Christian ill and struggling to breathe, Thomas leaves him in the care of Jake Miles and locates Mary at the Union Hotel. She refuses his request to return home and Mary does not reveal that his wife, Jenny is expecting. And so, Thomas reenlists, while Christian dies on the way home to Albany and Amelia. Meanwhile the men returning home from the first battles, return to fallow fields what were not planted in the spring.

Dorothea Dix visits the Union Hotel after having sent several nurses to Dr. Stipp and is furious to see Mary Sutter, the young woman she refused to hire, working there. She attempts to force Mary to leave but is unsuccessful. With a lull in the war after the Battle of Bull Run, Dr. Stipp also attempts to force Mary to return home as a comfort to her grieving mother, but Mary refuses. At this time she becomes an apprentice to Dr. Stipp, who teaches her during his "rounds".

Although Amelia is also a midwife, she feels that she will not have the skill necessary to deliver Jenny when her time comes. But Mary, in her determined quest to become a surgeon and because her intense heartbreak prevents her from facing Jenny, delays until the last possible moment to travel home to help her sister Jenny -with disastrous results. The ensuing tragedy causes Mary to have a crisis of faith in her desire to become a surgeon and she vanishes into the maelstrom of the Civil War, only to resurface at the battlefield months later.

Amid the disorganized carnage of the early Civil War, Mary, William and James struggle to cope not only with their own loss and personal demons but with the blood, gore and exhaustion as they attempt to minister to the overwhelming numbers of injured and dead. Mary and William work amid the chaos to save the lives of soldiers while James believes that if they only knew more, doctors could save the lives of many of the wounded. All three men, Thomas Fall, James Bleven and William Stipp find Mary Sutter an utterly  remarkable, if not incomprehensible woman. None of them quite understand her but are drawn to Mary by her courage and her intelligence.

Discussion

My Name is Mary Sutter is a well-written historical novel set during the United States Civil War. Although the title character, Mary Sutter is fictional, the novel is populated with many historical figures including President Abraham Lincoln, his secretary John Hay, Dorothea Dix, 

Mary Sutter is likely a compilation of the many women who served as nurses during the Civil War. In her Acknowledgement, Oliveria writes that "Nearly twenty women became physicians after their experiences nursing in the Civil War; it is to honor them and their collective experience that Mary Sutter lives." 

In the mid-19th century, nursing was not considered a respectable profession suitable to women of good character. However, this attitude would change with the United States Civil War. Prior to the Civil War, women were limited to caring for ill family members at home or as midwives helping women birth their babies. At the start of the Civil War in April 1861, men were preferred as nurses and when there weren't enough of them, soldiers with minor injuries or those recovering from illness were put to use caring for their fellow soldiers. However, as the number of wounded soldiers began to dramatically increase, the military along with other agencies began to recruit women nurses. Dorothea Dix, Superintendent of Nurses for the Union Army set the standard at the time for a woman to volunteer as a nurse: she had to be over thirty years of age, plain looking, of good character and had to wear black, unhooped skirts and no jewelry.  White women and freed and enslaved African American women worked as nurses in hospitals. A Civil War nurse's duties included bandaging wounds, administering medicine, washing and changing patients, praying with them and writing letters for them. Many of the women found the experience of dealing with the wounded soldiers emotionally and mentally challenging. The work was also physically challenging. Nurses themselves also became ill with typhoid, smallpox and other diseases. At this time, germ theory - the theory that many illnesses are caused by "germs" or bacteria, viruses, and other agents- was only beginning to be understood. As a result hand washing, cleaning of surgical instruments and wearing gloves and masks was not yet in place. 

Oliveria begins her story at the beginning of the Civil War in 1861, establishing the backstory of the two major characters, Mary Sutter and James Bleven and how they were drawn to medicine by the deaths of parents: for Mary it was the painful death of her beloved father Nathaniel, and for James it was the death of both his parents from diphtheria. In this backstory is the overriding and determined refusal of society to admit women to any role other than that of wife and mother. Mary's determination to become a surgeon is met with obstinate refusal even by those like James Blevens who might have been more open to such a possibility. Mary is refused admittance to the Albany Medical School and is unable even to obtain a position as an apprentice to a doctor. 

As with the Great War which would come some fifty years later, the American Civil War was deemed to be a short conflict that would be over in a matter of months. Even Lincoln believed the war would be short, initially calling for volunteers for three months. By the end of August a second callup would be for three years. And as with the Great War, the misplaced enthusiasm for war is portrayed as Thomas Fall describes the Albany filling with the volunteer militia from Buffalo. " A crowd had gathered this afternoon at the Capitol, and a band was still playing in the park near the medical school, and the whole city was seething with excitement." Jenny tells Mary, "You should have seen it, Mary, it was glorious.I think even you would have declared it a spectacle worth seeing.... "  Oliveira portrays the initial excitement for war which the Union or North believes will be short and painless. "There was so much vibrant feeling, a wilful ignorance of what was to come. It had been almost a hundred years since Albany had been taken up with a war, and in between there had been years in which to forget the consequences...."  This initial enthusiasism would lead later on to wealthy men paying the Irish and the Italians, the poor of America, to fight. The foreshadowing of the death that is to come is shown through the character of Christian Sutter. While he is sitting outside the laying-in room, Christian begins to feel fear. "For all his eagerness, he was frightened suddenly....He was frightened of being afraid, frightened of dying." It is a foreshadowing of his future, but he will not die from the war, but from illness. Many soldiers would die not just in battle and from their wounds, but also from dysentry, measles, and typhoid.

The glorification of war by people who had forgotten its reality and the belief that victory would be swift led to a lack of preparation by the Union in every way imaginable. Soldiers were ill-trained and poorly equipped, their commanders lacked courage and an understanding of battle strategy and the medical knowledge of the time was so lacking that thousands died. Oliveira captures the sheer brutality of medicine in this era: the amputation of limbs by doctors who did not know anything about amputation, the administration of chloroform, nor about germ theory and infection. The Civil War occurred just prior to most of the major discoveries in modern medicine including basic knowledge about surgical hygiene. Surgeons treated severe compound fractures by amputation, doctors believed suppuration and fever healed wounds. Water to clean wounds was used over and over again and the wounds were stuffed open with lint. Patients where regularly treated with whiskey and/or quinine.

After the Battle of Bull Run Mary and Stipp do not know what to do with the amputated limbs, with the dead for whom they have no coffins, they don't know the names of the wounded and those who die on the surgeon's table, or who to contact to take them home. "The army had thought of nothing. They needed coffins, a dead house, a way to let headquarters know who had died and who had not died. But none of this was in place. How do you forget coffins? How do you forget to supply tourniquets? How do you forget that people might die?"  Readers will find Stipp's directions to Mary on how to treat various ailments and injuries to be both horrific and indicative of just how little was known a mere one hundred and twenty years ago. Stipp writes Blevens telling him, "...this is nothing compared to the injuries I have seen. I seem to be able to save only those who sustain gunshot wounds to their limbs, while the rest die...."  Amidst the first night of horror, Mary believes that this will be the end of the fighting, that "No one will allow this to happen again. No one wants this."  Stipp reminds her that men are not "reasonable".

Mary Sutter, her sister Jenny and brother Christian, her mother Amelia, and Jenny's husband, Thomas Fall are all tragic figures and portray the suffering that the Civil War brought to many.  Mary ends up in the horrors of the Civil War in an attempt to escape the loss of Thomas to her sister Jenny. "Now she would admit it, as she had been unable to ever admit it to herself before; she had come to Washington because of the baby.She had come because she couldn't watch Jenny grow large with Thomas's child. "  Her letters home to her mother Amelia portray the pain she continues to experience at the loss of Thomas whom she still loves. She is in deep conflict between her obligation to her twin sister Jenny and her desire to be a surgeon. Mary delays until it is the death of a young soldier that pushes her home during a blizzard. She is too late to save her beloved sister, but in time to save Jenny and Thomas's baby, a girl named Elizabeth. Mary, blamed by her mother for Jenny's death, leaves Albany, as well as the Union Hotel hospital and Stipps and works in the Capitol, in the War Department as a clerk. Mary returns to the war as a nurse but it is at Fairfax Station, with the thousands wounded that she must make a choice. There she meets up with Dr. Stipp who tells her that they cannot save all of the wounded, that the men with stomach, chest or head wounds will not survive. He orders her to "sort" or what is today called "triage" the men and make sure only those they can save are placed on the trains to Washington. To Mary, this is a horrific task, to choose who must live or die, and she refuses. But Stipp tells her, "You want to be a surgeon? To be a surgeon is to look a man in the eye and tell him the truth. If you can't do that, then get out of here. Go home...Choose who you are...Choose who you'll be." Mary's wish to be a surgeon comes to happen at the Battle of Antietam where she is put to work amputating limbs, including that of Thomas Fall, the man she once loved. Even though she is now a successful surgeon, Mary watches as men die from infection. Only a few years later, she and William Stipp will come to understand through the work of Joseph Lister, that "If they had just washed their hands between patients, then all those deaths could have been prevented."

Amelia who blames Mary for the death of Jenny eventuall comes to regret her actions and words that drove her daughter away. "What mother chastises one twin for the death of another?" She comes to realize that without Mary, Jenny's daughter Elizabeth would not have survived. "Thank you, is what she would say now. For trying. For coming back when you didn't want to. And I am sorry your heart was broken."

Christian never returns home having become ill and dying alone on the train back to Albany. Jenny dies an excrutiating death in childbirth, her pelvis too narrow to birth her too large baby. And Thomas, distraught with grief, abandons his regiment, only to be caught, returned and put on public display and to finally collapse from his grief. He fights in numerous battles: Chickahominy, Malvern Hill, the Seven Days, and Chantilly. And Antietam. He survives the last battle, losing his left leg after being shot in the shin by a musket ball, but unlike so many others, survives the infection from the amputation. 

James Blevens struggles with the abandonment of his young Irish wife and the obvious attraction he feels towards Mary Sutter, the loss of the use of his hands as a doctor. From his work with his microscope, Blevens comes to believe that there is an unknown bacteria making the soldiers in camp ill. Eventually he is commissioned to do research into the problem but he leaves Antietam to find his wife,  having realized that Mary cannot love him.

Ms Oliveira is able to weave significant figures of this time period into her narrative, making them believable and three-dimensional. Lincoln seems extraordinarily vulnerable, suffering terribly and undergoing a crisis of faith when his son Willie dies of typhoid. He struggles with the issue of slavery that is dividing his beloved country. After only a year of bloodshed, Lincoln considers, "...to warrant the last year and a half of misery. Something good to come of all this, the very least of which, if he were successful, would be an unsundered union. But it was not just this that drove him. There was a certain decency that had to be imposed. A righting of wrongs. Yes, just as he had shut down the Maryland legislature, so he would shut down slavery."  Lincoln realizes that the "Rebel intransigience  regarding slavery must be dealt with firmly through change and emancipation. He is at a loss to understand the Rebel mindset. "Lincoln could not understand a man who could not see his own fallibility. Irony lost in the blind pursuit of cacophonous righteousness. I wish to be free, but you may not be free. What he hated most was that they could not see the inherent cruelty in their economy. Their slaves' skin might be black, but it was not as black as the souls who might enslave them." Eventually Lincoln crafts his Emancipation Proclaimation, reading it to his Cabinent, five days after the Battle of Antietam.

Considering the amount of  historical detail in the novel,  it is evident the author did considerable research involving both primary materials (journals, lectures, diaries newspaper articles) as well as consulting historians and  librarians. Among sources consulted, The Library of Congress for Dorothea Dix's letters, Interlibrary Loan of the King County Library for books, The Special Collections at the University of Washington Medical School Library for information on midwifery, the online librarian at the Library of Congress who directed Oliveira to Clara Barton's War Lecture and as well as a number of books on Civil War Medicine, Civil War hospitals and Civil War surgeons and doctors.

For such a dark novel, My Name is Mary Sutter ends on a somewhat hopeful tone: after skipping over the end of the Civil War, by 1867 Mary is a doctor working in Manhattan City having graduated from Elizabeth Blackwell's School of Medicine and is living with Amelia, Elizabeth and Thomas. William Stipp also a surgeon in Manhattan visits Mary after receiving her letter, hopeful to begin again, the friendship that was also filled with love. The fate of Bonnie and Jake Miles, and James Blevens is left unresolved. (It should be noted that Elizabeth Blackwell, the first woman to receive a medical degree in America did not have her own school of medicine.)

My Name is Mary Sutter is historical fiction, attentive to detail, with realistic characterization amidst the tragedy of the American Civil War. Because of the graphic descriptions and some sexual content, this novel is recommended for adult readers.

Book Details:
My Name is Mary Sutter by Robin Oliveira
New York: Viking Press  2010
364pp.