Book Review: North Carolina’s Confederate Hospitals, 1864-1865: Volume 2

North Carolina’s Confederate Hospitals, 1864-1865: Volume 2. By Wade Sokolosky. Winston-Salem, NC: Fox Run Publishing, 2025. Hardcover, 260 pp. $32.95.

Reviewed by Sam Flowers

In 2023, Emerging Civil War reviewed Wade Sokolosky’s first volume on the Confederate hospital system in North Carolina. Now, two years later, a second volume continues the wartime story of the surgeons, nurses, and the growing challenges they faced as the conflict drew to a close.

In North Carolina’s Confederate Hospitals, 1864-1865: Volume 2, Sokolosky takes a deep dive into the growth and expansion of hospitals during the conflict’s last two years and describes the tense situation as the Union army began its campaigns to capture key coastal areas and their eventual push inland. This book heavily relies on primary sources, including newspapers, weekly and monthly medical reports, and correspondence between surgeons and those in charge of the system. The central character for this second volume is Surgeon Peter E. Hines, who by January 1864, was the recently appointed medical director of the Tar Heel State. As the overseer for over a dozen general hospitals in the state, Hines attempted to improve and expand what he had inherited. Although there were initial setbacks at new locations in Asheville and Salisbury, Governor Zebulon Vance believed Hines was still the man for the job.

Sokolosky does not write military history in exhausting detail, but instead weaves the consequences of battle during the war’s final year with how Hines reacts to the unfolding combat. The fighting around Plymouth in early 1864 not only yields a Confederate victory but also presents an opportunity for Hines to utilize his role efficiently. He activates the Reserve Surgical Corps and transfers Confederate wounded to interior locations via water or rail. Although successful, Sokolosky considers this as “an excellent dress rehearsal” (31) for what the rest of the year was going to look like for Hines. As the Overland Campaign rages in central Virginia, the hospitals in the Tar Heel State are flooded with wounded and sick from the fighting. Hines’ response was to aggressively expand the system by creating eight new hospitals across the state. These new locations gave the Confederate surgeons in North Carolina some breathing room when dealing with the influx of soldiers. Unfortunately for Hines, 1865 would be the beginning of the Confederacy’s collapse, and the hospital system in the Old North State would scramble to survive.

The second half of this volume focuses on the unraveling of North Carolina, starting with the 1865 Wilmington Campaign. As Fort Fisher is falling into the hands of the Union military, Hines reacts too late to evacuate the wounded along the coastal defenses and moves the patients within the port city into hospitals further away from the front lines. The action of evacuating further and further inland becomes a recurring theme for Hines and his surgeons for the rest of the war. For the next few months, hospitals are overcapacity and overwhelmed by casualties coming in from the battles at Wilmington, Wyse Fork, Averasboro, and Bentonville. This would, in turn, bring about the mass displacement of wounded and sick soldiers who not only wondered if the Union would capture them, but also how they were going to make it back home.

African Americans’ involvement in the hospital system was something that Sokolosky excelled at in the first volume. He continues to add in detail about their contributions, but not without its archival difficulties. For example, correspondence from March 1865 reveals that over two dozen enslaved persons were needed to handle the patient population, and that is all the information given. The author emphasizes, however, that despite the lack of voice from the records, enslaved individuals were a crucial component of North Carolina’s hospitals. Furthermore, he claims that the “system would have failed if not for the duties that African Americans performed side by side with Whites, such as cooking, laundry, and nursing.” (213)

While the content of Sokolsky’s second volume is heavily research-based, readers will find it offers a well-paced prose. Roughly the same page count as the first volume, Volume 2 is an informed and necessary monograph for anyone interested in better understanding an unfortunately underappreciated strand of Civil War history. With luck, we will see the third and final volume of this research in the near future.