Today, November 6, 2014, President Obama awarded First Lt. Alonzo H. Cushing of Wisconsin the Medal of Honor for heroism. Cushing kept to his post despite horrific wounds in his shoulder and abdomen, leading his men for ninety minutes until a bullet to his head killed him. What makes this story unusual for a Medal of Honor recipient is that the engagement in which Cushing died was the Battle of Gettysburg, 151 years ago.

Cushing could, in fact, have been awarded the medal immediately, for Congress created the Medal of Honor during the Civil War. In July 1862, President Lincoln signed a law that authorized the president to present in Congress’s name a Medal of Honor “to such noncommissioned officers and privates as shall most distinguish themselves by their gallantry in action and other soldier-like qualities during the present insurrection.” The following year, the law was expanded to include commissioned officers. Awards were not determined by Congress, but by the president and the secretary of war. The medal was given in Congress’s name to make sure that military honor did not become a way for a president to surround himself with a military guard.

The first six recipients of the Medal of Honor were survivors of a foiled Union plot to commandeer a Confederate railroad train in 1862. In April of that year, twenty soldiers from the Ohio Volunteer Infantry had infiltrated a Confederate troop train. While the genuine Confederate recruits disembarked for breakfast, the Union spies uncoupled the locomotive and baggage cars from the passenger cars and set off for Union lines in Tennessee, burning bridges and cutting telegraph lines as they went. Caught within days, eight of the men were hanged; twelve were imprisoned. Six of those later escaped, and the remaining six were exchanged for Confederate prisoners a year later. When those exchanged six arrived in Washington, they were greeted by Secretary of War Edwin M. Stanton with a handful of medals. “Congress has by a recent law ordered medals to be prepared,” he told them, “and your party shall have the first.”

But Congress had established no criteria for earning the medals, and by the end of the nineteenth century, they were available almost for the asking. Veterans who flocked to fraternal organizations wanted the medals; presidents eager to court the veterans vote in an era when it made up a large part of the electorate had no incentive to deny such awards. Presidents between 1891 and 1897 gave more than five hundred medals for Civil War service; Benjamin Harrison controversially awarded twenty to soldiers who had participated in the Wounded Knee Massacre.

In 1897, the secretary of war announced that future awards would require “incontestable proof of the most distinguished gallantry in action.” Later, the army established that evidence of heroism must come from official reports, and that officers, rather than the honoree, must request the medal. A military panel convened in 1916 stripped medals from 2600 recipients, including William F. Cody, known as Buffalo Bill – who had received one for his work as an army scout – and the only female honoree, Civil War surgeon Mary Walker, who refused to turn her medal in, continuing to wear it conspicuously on her coat. (In the late twentieth century, Cody and Walker were reinstated as recipients.)

In the twentieth century, Medals of Honor were hard to come by. Only 95 were awarded to soldiers of World War I, 324 to soldiers of World War II. Korea and Vietnam combined saw 240 Army recipients. Only three soldiers have been honored for their heroism in Afghanistan or Iraq.

Alonzo Cushing came to Congress’s attention in 2002, when Margaret Zerwekh discovered his story after buying his family’s Delafield, Wisconsin farm. At her urging, Senator Russ Feingold of Wisconsin nominated Cushing for the award that year, and in 2010, the Secretary of the Army recommended that the medal be awarded. Three years later, Congress voted to approve the recommendation, and today, 151 years after he stemmed the tide of Pickett’s Charge, Alonzo Cushing became the recipient of the nation’s highest military honor.