When people ask that question, what they really want to know is “What would he have done at Gettysburg?” My answer is always “He would have never made it to Gettysburg.” (You can see an in-depth answer here and here.) So many people, it seems, want Jackson to get to Gettysburg. They want to talk about the Great What-If of the war.
Sometimes, the question comes up in a slightly different way: “What if Jackson had survived his wounding?”
This very question came up last week as I spoke to the Civil War Roundtable of New York. To my delight, there was a retired pathologist who happened to be in attendance—Robert Katz, M.D.—who asked if he could share some of his thoughts.
What sealed Jackson’s fate, said Dr. Katz, was when Jackson fell from the stretcher while being evacuated from the woods after his wounding. The fall seems to have severed the artery in Jackson’s left arm, leading to massive blood loss. According to some estimates, by the time doctors removed the arm, the wounding and surgery caused Jackson to lose half of his blood.
The fall also bruised Jackson’s right side. Those two injuries—the severed artery and the bruised side—proved a fatal combination.
“When a patient loses a massive amount of blood, we’ve discovered that it actually causes the body’s blood clotting system to malfunction and stop working,” Katz explained. “It’s a condition called Coagulopathy of Trauma.”
As a result, the bruise on Jackson’s side produced bleeding into the chest cavity, compressing Jackson’s lung— in addition to the upper respiratory infection Jackson was developing prior the battle ever beginning. “So you have an underperforming lung that is compressed by the blood, further impeding its function,” Katz explained.
Dr. Hunter McGuire, Jackson’s surgeon, diagnosed the cause of Jackson’s death as pleuropneumonia: that is, pneumonia in and around the lungs.
Treatments for pneumonia at the time called for, among other things, bedrest. As a result, Jackson’s lungs weren’t being exercised or cleared, so the congestion built up, leading to exhaustion and eventual death.
As Dr. Katz and I continued our discussion after the meeting, he offered a piece of insight that I found absolutely brilliant.
“One thing I did not mention last night, and you might want to use for further reference,” he told me in an email:
I would note that even if Jackson had recovered and returned to the army, he would not have been the same man. The physical debilitation and, perhaps as important, neuropsychiatric effects of such an injury are massive. Three examples of this are Richard Ewell, John Bell Hood, and Winfield Scott Hancock. Each survived a catastrophic injury (two injuries for Hood), each did eventually return to service, none ever performed as well as they did before their woundings.
“So,” Katz says, “there might have been some cracks in the stonewall if Jackson lived and returned to the ANV.”
Katz’s examples also suggest that, even if Jackson had survived his wounding, there’s no timetable that would have put Old Blue Light back with the army in time to make Gettysburg.
- Ewell, knocked out of action at Second Manassas when he lost a leg, didn’t return to the army for nine months.
- Hancock, severely wounded in the groin at Gettysburg, likewise stayed out for nine months.
- Hood, who permanently lost the use of his left arm from a wound at Gettysburg, was out for two months; wounded again at Chickamauga, he remained out for six months.
Similarly, there was James Longstreet, accidentally shot by his own men in the same Wilderness where Jackson had been accidentally shot by his own men just a year and three days earlier. Longstreet didn’t return to duty for five months.
“In one of those sad but ironic twists of fate and history,” said Katz, “Jackson probably died at the moment most favorable for his reputation and posterity’s view of him.”