The title of Drew Gilpin Faust's book, This Republic of Suffering, is derived from a quote by Frederick Law Olmsted, who described the nation in that way as he encountered thousands of wounded men at an Army hospital.
Essentially, Faust argues that the death, destruction, human misery, and loss affected the United States in unprecedented ways. She writes that the suffering resulting from the war was truly staggering—more than 600,000, or two percent of the American population overall, died in the conflict. Extrapolated for today's population, that total would equal over two million deaths. Thus, the Civil War marked a "new relationship with death" on the part of the American people and the nation as a whole. For one thing, "sacrifice and the state became inextricably intertwined." The existence of the Republic, in the wake of the war, was defined by bloodshed. Service to the nation in this time of crisis became a trope in politics, as African Americans in particular staked a claim on political participation by stressing their willingness to die to preserve the nation.
As Faust writes, the aftermath of the war also imparted new obligations of the people of the United States and the nation as a whole. The bodies of the dead and the wounded had to be cared for, and no infrastructure existed for doing this. Faust points to the construction and maintenance of national cemeteries, and, crucially, a federal pension for soldiers as fundamental changes in the relationship between the government and the people, "shaping national structures and commitments."