Frederick Law Olmsted's 1863 account of the Sanitary Commission's hospital ships during the Peninsular Campaign of 1862 is based on his (and his staff's) letters. It is part report, part diary including vignettes of praise, censure and trivia. He develops a well-oiled system as set out in the regulations in appendix B to relieve this "republic of suffering".

Olmsted, in charge of the Sanitary Commission, has to manage the rapid inflow of patients at White House Landing, organize their care and supply the necessary resources with a staff of doctors, dressers (2nd-year medical students), women volunteers ("active as cats"), male nurses and convalescent volunteers. Fighting for humanity means encroaching on the turf of the military, maritime and medical professionals who often neglected the basic needs (food, drink and shelter) of the sick and wounded.

To prevent overloading the ships, triage of the wounded was necessary, keeping some of them on land, some on a floating hospital and transporting the rest (8,000) via shuttles to Fort Monroe or the North (four days to Baltimore, seven to New York). Olmsted saw a lot of false economies: Many sick soldiers could have been returned to the front quickly if given a few days rest and proper nourishment. Instead, their health deteriorated and required a lengthy recovery up north.

Part marketing tool, part report, part history, it is a curious mix of small and large steps in the foundation of a medical service, of trivial and important acts of humanity and kindness in time of war. ( )