A military man, Letterman understood that troop's lives are not saved just by the expedited treatment of their wounds, but, also, by their expedited travel and positioning. "The expediency of the order I, of course, do not pretend to question, but its effect was to deprive this department of the appliances necessary for the proper care of the wounded". He appreciated that command had to make hard decisions when allocating transport vehicles for the best overall benefit of the Army's operations and soldiers. Still, Letterman was somewhat discouraged by command's lack of support for his organization at the Battle of Gettysburg and through the Mine Run Campaign.