Each year, first year medical students from the Uniformed Services University of Health Sciences (USUHS) gather in Sharpsburg, Md., for the Antietam Road March.
"This is an opportunity for students to learn the principles of military medicine, and the foundations of where these innovations came from," said Navy Lt. Brian Andrews-Shigaki, USUHS assistant professor of emergency medicine, who organized this year's march. Students had originally participated in a march through nearby Rock Creek Park to break in their new boots, but the event took on a deeper meaning when it was moved to Antietam in the 1990s.
During the annual event, students walk a seven-mile route around the park, volunteers dressed in period clothing demonstrate Civil War surgical procedures, and USUHS professors discuss battle tactics and the logistics of military medicine.
"It all started here," explained Andrews-Shigaki. "As the students see this battlefield and hear about the experiences of doctors in the past, they gain a better understanding of what they are learning in school now."
The Battle of Antietam on Sept. 15, 1862, resulted in more than 23,000 casualties, leaving approximately 4,000 dead. It marked the single bloodiest one-day battle in American history, but many lives were saved thanks to changes implemented by Dr. Johnathan Letterman, a surgeon appointed as medical director of the Union army in June 1862.
Known as "The Father of Military Medicine," Letterman was the first to organize a system for the evacuation of wounded from the battlefield. He established mobile field hospitals, connected them by an efficient ambulance corps and implemented a system for the distribution of medical supplies.
Kyle Wichtendahl, director of interpretation and programming at The Pry House Field Hospital Museum, said Antietam marked a turning point in the development of military medicine. "It's common sense today, but it was revolutionary at the time - you can't re-supply a hospital you don't know is there," explained Wichtendahl.
In addition to the logistical improvements introduced by Letterman, the Civil War brought about advances in first aid procedures and surgical techniques.
"The Civil War is considered to be the beginning of modern military medicine," said Dr. John Rathgeb, a retired orthopedic surgeon and volunteer with the National Museum of Civil War Medicine. "Was it primitive? Yes. But the Wright brothers didn't fly a 747. They had to start somewhere."
Rathgeb explained to the student group that German and French surgeons were considered the best in the world in the early 1800s, but by the conclusion of the Civil War, American surgeons were considered on par with their European counterparts. Rathgeb said patients continue to reap the benefits of these advances nearly 150 years later.
Explosive Ordnance Disposal Technician 1st Class Todd Hammond, a wounded warrior and patient at Walter Reed National Military Medical Center, spoke to students about his experiences in the care of military doctors, and described how his treatment compared to the care soldiers received during the Civil War. Hammond had his right leg amputated below the knee after he was severely injured by an improvised explosive device while serving in Afghanistan in 2011.
"A military doctor is not always in a hospital setting - their patients won't always be put on a table in front of them," said Hammond. "It's important that the students get a glimpse of what goes on outside the hospital, out on the battlefield."
Seated on a bale of hay in a barn similar to those used as makeshift hospitals during the Civil War, Hammond described how he was treated and transported from Afghanistan to Germany, then brought to Walter Reed National Military Medical Center. He showed students his scars, and explained how tourniquets were used to reduce the bleeding from the wounds to his legs.
"Tourniquet theory has changed over time, but what they did for me is actually quite similar to what they did back then," explained Hammond.
"Nowadays we put them higher up on the limb without worrying about tissue damage, as we know there won't be as much time elapsing between injury and treatment in a hospital," explained Hammond.
Hammond said he feels grateful to the military doctors for their service, and that this trip gave him a greater appreciation of the heritage of military medicine.
"Quite a few doctors who've worked on me are so skilled and talented and knowledgeable, they could go wherever they wanted. Any major trauma hospital in the country would snatch them up in a heartbeat, but they're here at Walter Reed because they want to be here and work on wounded warriors," said Hammond. "I feel lucky to have received such excellent care."
Air Force 2nd Lt. Elizabeth Kim, a first-year medical student at USUHS, said hearing descriptions of the conditions Civil War soldiers endured and learning about the logistics of battlefield medicine was both moving and enlightening.
"It shows how much we can learn from the past," said Kim.