Prior to Hospital Sketches, Alcott had only published one book, a small print-run called Flower Fables in 1854 when she was 21 years old. This second book was, to the surprise of the author, a popular one. The Boston Transcript noted the sketches were "fluent and sparkling in style, with touches of quiet humor and lovely wit, relieving what would otherwise be a topic too sombre and sad." William Lloyd Garrison's newspaper, The Liberator, noted that "they are overflowing with genius, wit, humor, pathos, and womanly compassion and tenderness," concluding that "all who read them will greatly relish them."
The book format was published only months after the final magazine installment by James Redpath. Redpath promised to donate a small portion of each copy sold to children made homeless or orphaned by the war. Her father, the Transcendentalist philosopher Bronson Alcott, was proud: "I see nothing in the way of a good appreciation of Louisa's merits as a woman and a writer," he wrote.
Published under the pseudonym Tribulation Periwinkle, Hospital Sketches was not quite autobiography; one major change from the true story was that the narrator (Miss Periwinkle) does not join the Union cause because of a particular passion. Instead, she was merely looking for something to do. The book opens:
"I want something to do."
This remark being addressed to the world in general, no one in particular felt it their duty to reply; so I repeated it to the smaller world about me, received the following suggestions, and settled the matter by answering my own inquiry, as people are apt to do when very much in earnest.
"Write a book," quote the author of my being.
"Don't know enough, sir. First live, then write..."
"Go nurse the soldiers," said my young neighbor, Tom, panting for "the tented field."