Alcott’s family were ardent abolitionists. Her father, Bronson Alcott, was friends with William Lloyd Garrison, editor of the anti-slavery newspaper, The Liberator, and the Alcott home was at one point a stop on the Underground Railroad. One of Alcott’s earliest childhood memories was opening a stove and finding a runaway slave hiding inside. When the war broke out, Louisa was determined to contribute to the Union cause. On December 12, 1862, she arrived in Washington, D.C., where she had arranged to work as a nurse, an opportunity only newly available to women. Louisa spent six weeks working at the Union Hotel Hospital in Georgetown, not the assignment she had hoped for. The Union had a reputation for being poorly managed and in ill repair, and Alcott wrote home to her family about the rotting wood floorboards and the swarming rats.
Shortly after she arrived, the hospital received scores of wounded soldiers from the bloody battles at Fredericksburg and Antietam: “3 or 4 hundred men in all stages of suffering, disease & death” she later wrote. Although women had been nursing the sick since time immemorial, it was only in the nineteenth century that their work became professionalized—thanks in no small part to reforms introduced during the Crimean War by Florence Nightingale, whose book Notes on Nursing: What it is and What it is Not (1859) had helped ready Alcott for her service. Alcott also had some personal experience, having taken care of her sick sister, Elizabeth, whose death from scarlet fever was dramatized in Little Women. “Wonder if I ought not be a nurse, as I seem to have a gift for it,” Louisa wrote in her journal a year later in January 1859, after her mother also fell ill.
In letters home from Georgetown, Alcott recounted gruesome stories of amputations, disease, and despair that nevertheless conveyed both the author’s tenderness and, even more surprisingly, her sense of humor: “I took my first lesson in the art of dressing wounds,” she told them in a letter that appears in Hospital Sketches. “It wasn’t a festive scene, by any means.” Likewise, after telling her readers about the awful hospital food, including bread that tasted like sawdust and rancid-looking meat, she coyly added: “Another peculiarity of these hospital meals was the rapidity with which the edibles vanished.”
Louisa’s family would have encountered in these letters a new style from their daughter and sister, one refreshingly candid and earnest in expression, they encouraged her to publish them. In his journal, Bronson Alcott predicted the Sketches were “likely to be popular, the subject and style of treatment alike commending it to the reader.” They first appeared (with some fictionalization) in the paper Boston Commonwealth, but were eventually gathered together and published as Hospital Sketches (1863). Told from the perspective of a “Nurse Periwinkle,” the stories, much to Alcott’s surprise, were an instant hit. “When I wrote Hospital Sketches by the beds of my soldier boys,” she wrote (in a letter to an aspiring writer), “I had no idea that I was taking the first step toward what is called fame.”