The joint practice with Albert Miller failed precisely because the public was not ready. This was not a personal failing of Walker’s; it was a systemic condition. Even in a mid-sized upstate New York town, even at a moment when the small but real cohort of formally trained women physicians was beginning to make its presence felt in American medicine, the market for woman physicians was not yet developed enough to sustain a practice.
She absorbed this setback and kept working. The persistence she showed in the decade between graduating from medical school and finally securing a contract with the Army of the Cumberland is part of the same character that led her to refuse to surrender the Medal of Honor after the 1917 rescission. She did not stop when the institutional answer was no.
## The Patent Office Hospital and the First Year of War
The U.S. Patent Office Building in Washington, D.C., was opened in 1840 as one of the city’s grandest public buildings, a Greek Revival structure on F Street that housed the federal government’s rapidly growing patent archive. Within weeks of the Civil War’s outbreak, parts of it were converted to military use — a pattern that would repeat across public and commercial buildings throughout Washington as the city absorbed an influx of wounded soldiers that the city’s existing medical infrastructure could not handle.
Walker arrived in Washington in 1861 and began working at the Patent Office Hospital under Dr. J. N. Green. The conditions there were the conditions of an improvised wartime medical facility: beds arranged in the building’s great halls, inadequate supplies, insufficient nursing staff, and a constant influx of patients from the opening engagements of a war no one had expected to last as long as it did.