The Clara Barton Museum Blog

Marvel-ous Civil War Medicine

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You’re going to hear a lot about the “Civil War” in the next few days. However, what you hear won’t be about the American Civil War. No one will reference Grant and Lee. They’ll be talking about two different leaders: Captain America and Iron Man, as Marvel’s latest film Captain America: Civil War hits theaters across the country.

As we did for Star Wars, the staff of the National Museum of Civil War Medicine and the Clara Barton Missing Soldiers Office took some time to discuss the connections between the Marvel-verse and Civil War medicine. Here are some of our favorites:

Amputations and Agent Coulson

Let’s address the obvious first: Agent Coulson’s arm.

Agent Phil Coulson of SHIELD has his arm amputated.Amputation is one of the most enduring images of Civil War medicine, and with good reason. Over 60,000 amputations were conducted during the Civil War. After the war, the notion of “Heroes with Empty Sleeves” was perpetuated through illustrations, cartoons, and poems, celebrating these wounded veterans and fighting back against the Victorian ideal that amputees were less than because of their handicap.

Similarly, the Marvel universe is no stranger to amputation. Adam Holmes compiled this list:

In Iron Man 3, … Pepper Potts sliced off Aldrich Killian’s hand before he could kill Tony Stark, though it soon grew back thanks to his Extremis powers. This was followed by Loki cutting off Thor’s hand in Thor: The Dark World in from on the Dark Elves (which was proved to just be an illusion), a flashback of Bucky losing his arm in Captain America: The Winter Soldier, Gamora hacking off both of Groot’s arms in Guardians of the Galaxy (his also grew back) and Ultron angrily chopping off Ulysses Klaue’s arm in Avengers: Age of Ultron after the arms dealer compared him to Tony Stark.

So why talk specifically about Coulson’s? Unlike the examples above, Coulson’s limb isn’t severed in anger or by accident, it’s purposely removed to prevent the spread of “infection” (in this case, the terrigen crystals). Similarly, infection was a major cause of amputation during the Civil War. Infections like hospital gangrene were fast spreading and proved much more lethal than battle. Civil War surgeons would often cut of an affected limb to try and save the owner’s life. In many ways, this is what Mack is doing when he hacks off Coulson’s hand.

Prosthetics and the Winter Soldier

The Winter Soldier shows off this impressive prosthetic.After amputation comes prosthesis. Captain America: Winter Soldier presents a prosthetic arm which took the internet by storm. The arm allows for complete mobility and despite what must have been traumatic damage to a major muscle group. The Winter Soldier is not only recovered from the injury, he has become an assassin who is a legend in the Marvel cinematic universe’s intelligence community. This is the type of prosthetic which is still out of reach in reality, but we are at the beginnings of development. Johns Hopkins University has begun development of a robotic prosthetic controlled by thought. From the rough concept of a pegleg to soldiers completing marathons with double prosthetics, one of the first major advancements in prosthetics occurs after the Civil War. With sixty thousand amputations during the Civil War, the demand for improvements were strong.

James Edward Hanger has the unfortunate claim as having the first amputations of the Civil War. At the outbreak of the war, Hanger was a college student studying engineering. He left his education to join the Confederate army. A cannonball ricocheting through a stable struck Hanger’s leg and shattered the bones. His leg had to be amputated above the knee. Hanger was displeased with his prosthetic and decided to design his own. His patent would lead to the establishment of Hanger, Inc., one of the leading prosthetic manufacturers in the world today.  

The Aftermath of Battle: Daredevil and Agents of Shield 

While the Marvel films focus on specific battles, the shows Daredevil and Agents of Shield focus in part on the aftermath of violence, thus providing a unique insight into the Marvel Cinematic Universe and a parallel to the physical and medical impact Civil War battles have on the civilian population for months and even years later.

Headlines from Daredevil's New YorkDaredevil explores the impact of a major battle on the civilian population  While the Avengers establish a perimeter and contain the battle against Loki and the Chitauri, the citizens of New York within those blocks are still facing property destruction on a wide scale. Entire buildings are irreparably damaged. The total cost of the disaster was estimated to cost $160 billion, for comparison the cost of the September 11th terrorist attack was $83 billion. Who will be responsible for the recovery? Most buildings have insurance, but due to the involvement of Loki will the destruction be considered an ‘act of God’? The reality is that most people would be financially ruined if they were individually responsible for the cost. Daredevil looks at the people who come in to take advantage of this instability and the struggle of the individual against these greater powers.

Like the citizens of Daredevil’s New York, when the Civil War struck Sharpsburg, MD in 1862 families faced financial ruin. Phillip Pry and his family had lived a peaceful existence until the fateful day when a young officer in the Union Army rode up to their house and informed them their house and barn would be taken over for the use of the military. After the battle, the Pry Family submitted a war claim to the federal government totalling more than $9000. This claim included commandeered livestock, crops taken to feed cavalry horses, and rent for the barn’s use as a hospital. In 1865, the Prys would receive the first reimbursement from the federal government, but many claims had not been met by the 1870’s. The family never financially recovered from the battle, and eventually left Maryland to start a new life in Tennessee. The Pry’s story was not unique to Sharpsburg or across the country–hundreds of families would have faced similar circumstances.

Chitari HelmetIn addition to the the financial impact of a battle, another consideration is the medical impact on the civilian population. Season one of Agents of Shield introduces a related topic for consideration: an alien virus which can infect humans. One episode introduces a Chitauri helmet salvaged from the Battle of New York.  Humanity does not have a built-up immunity to the virus and it proves fatal to everyone who contacts it, with the exception of Jemma Simmons (spoilers). The idea of armies bringing new diseases into a population is grounded entirely in reality. After battles in the Civil War, civilian populations would face outbreaks of diseases such as typhoid fever and smallpox (despite a vaccine existing for smallpox at the time). Due to contaminated water, citizens could face disease outbreaks even months after a battle.

What Does a Government Owe Its Wounded Warriors?: Ethics in Agents of Shield and the Civil War

What Does a Government Owe Its Wounded Warriors? Not only was this a major ethical question for practitioners of Civil War medicine, it is at the heart of many of Marvel’s movies and TV shows. Take Agents of SHIELD  as an example–this question is integral to the show’s premise and drives the first season. Avid Marvel fans watched Phil Coulson die in Avengers, then sixteen months later he appeared on screen alive and well during the premiere of Agents of SHIELD. Apparently, Coulson received dramatic and involved surgery to keep him alive, at the order of SHIELD’s director Nick Fury. Through flashbacks, both Coulson and viewers learned that the agent begged to die rather than to go through the tortuous surgery.  Surprisingly enough, this has very real parallels in Civil War medicine.

Just because you can medically address a dire injury, should you? Do you owe it to a wounded warrior? Or is a wounded warrior owed a peaceful and honorable death? Ostensibly this is what the doctors who are operating on (fictional) Phil Coulson are asking themselves. It is definitely a question real-life Civil War surgeons faced on a daily basis. During the Civil War, doctors experimented with bone grafts to try to repair wounded limbs. However, while some repairs worked cosmetically, they almost never returned full function to the limb. In many cases, they instead, left the soldiers with a gangly, useless limb that caused more trouble than an amputated limb would have. Just because they could reconstruct a limb, should they?

Not only did surgeons face the ethical implications of grafting surgeries, like Director Fury they are making literal life and death decisions–whether to operate on someone or leave them to die. Triage is “the assignment of degrees of urgency to wounds or illnesses to decide the order of treatment of a large number of patients or casualties.” America’s triage system is first developed and instituted during the Civil War. Dr. Jonathan Letterman, the Medical Director of the Army of the Potomac, develops and institutes this system. Letterman literally has to decide what the degrees of urgent-ness are in the triage system. Which ailments do you prioritize over others? When do you decide that a soldier is too far gone to help, and not to waste the supplies and medical personnel on them? If Dr. Letterman were in charge of deciding whether Agent Coulson died or underwent incredibly intense, painful, and costly surgery to basically bring him back from the dead, I doubt he would make the same decision Director Fury did.

The theme of “What does a government owe its wounded warriors?” has continued throughout the run of Agents of SHIELD. When Fitz suffers severe brain damage, should he be kept on, despite his limited capabilities, out of loyalty?  What does the US government owe to those, like Andrew/Lash, who realize their Inhuman potential in the course of their duties? Training? Shelter? A vaccine?  Similarly this question of what the government owes its wounded warriors persisted through the Civil War (and continues today). An Invalid Corps was formed for soldiers who were injured but still wanted a way to serve. After the War, pension were awarded to Civil War soldiers depending on their rank, their service, and their injuries. $2 if you lost your finger. $4 if you lost an eye. $8 if you were “totally disabled.”

The difficult issues practitioners of Civil War medicine face daily, are not only central to the Marvel cinematic universe, they are at the heart of our medical, military, humanitarian, and political systems today. That’s why the staff of the National Museum of Civil War Medicine writes these blog posts. Not only are they fun to write, they highlight the connection between our past, present, and future. They underscore how understanding the history of Civil War medicine can provide insight on contemporary and future issues.

And with that, we’re off to see Captain America: Civil War.

The Cap understood that reference

About our Bloggers

Amelia Grabowski is the Education and Digital Outreach Coordinator at the National Museum of Civil War Medicine and the Clara Barton Missing Soldiers Office Museum. She confesses, she doesn’t know a lot about Marvel, she mostly watches Agents of Shield to see if Fitz and Simmons end up together.  

Katie Reichard is the Reservations Coordinator at the National Museum of Civil War Medicine. She knows much more about Marvel than Amelia.

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