Tear In Time
Page 14
Gen. Negley scanned his field glasses across the northern plain and observed his fellow commanders engaged in the same function as he. With their own field glasses in hand, they too directed the battle from their elevated positions. Gen. Negley momentarily watched the exaggerations in body language as they hurried their couriers to deliver their battlefield orders to their subordinates. Usually on foot and occasionally by horse, the couriers received their verbal orders and quickly dashed off to deliver them to the next in command.
Turning back to the troops under his command, he noticed his left flank began to thin and waver as the front line atrophied due to the fallen men. He scanned the regiment of soldiers held in reserve behind him. Sighting Col. Theron McMasters, he immediately sent his courier to deliver orders.
“Private, tell Col. McMasters to send down a company of men to strengthen that left flank,” Gen. Negley ordered.
“Yes sir,” Pvt. Roberts replied, as he ran off to fulfill his duty.
Within minutes, a hundred men charged the battlefield, led by Lt. Parson as they dodged the stray bullets that missed the targets ahead of them. Moments later, as he watched through his field glasses, Gen. Negley observed his left flank surge forward as the added strength of men incited and inspired the front line. The greater numbers overpowered the now weaker Confederate right flank, and pushed them back further in retreat. At that early stage of battle, the Union army seemed to be directing control of the battlefield and inflicting horrific losses upon the enemy. For Johnny Reb, only a miracle could turn the tide of success.
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With the farmhouse nearly prepped and ready for surgery, David instructed the privates under him in proper hand-washing and sterilization of instruments as they waited for the wounded to arrive. His instruction was abruptly interrupted as they heard the sound of a fast-approaching wagon. Hurrying to a window, he could see the driver of the four-wheeled ambulance keeping a tight grip on the reins, while the three men that lay in back held on through desperate pain.
Dr. Morgan came up beside David and quickly peered through the window. He placed his hand on David’s shoulder and replied, “Ok, lad, this is our time. We won’t find a moments rest until we are finished. Is there anything you need?”
“Antibiotics?” David asked in jest.
“Hmm, quite right, lad, quite right,” Dr. Morgan replied, understanding the modern inference.
“Actually, I’ve been giving our lack of medical supplies some consideration. I really don’t think using the alcohol sparingly in order to make it last is our wisest course. I think it will do some good, but the vast majority will still have serious complications from infection. No, I’m thinking that to be the most effective, we will need to use it heavily until we run out, then accept the consequences in the patients that are treated without the use of alcohol. I’m guessing the overall cure rate will be higher,” David informed.
“Hmm, I see your logic, and it makes sense. The reality is the wounded are still receiving better treatment with the advanced medical techniques you’ve taught me, even without the proper disinfectant. On the whole, I believe they are still better off,” Dr. Morgan replied.
“One can only hope,” David replied.
Just then the stretcher bearer brought in the first of the three wounded men and quickly placed him on the makeshift operating table in the center of the main room. Joined by the other two regimental doctors, Dr. Morris Rogers and Dr. Jonas Weiss, the four examined the young private. With a large bullet wound to the abdomen, the young man’s hopes for survival were slim. Bravely, he ground his teeth as he tried to tolerate the pain, while slowly slipping in and out of consciousness. His moans of agony were low and nearly undetectable as Dr. Morgan and David conferred on the diagnosis, while the other two doctors, both second lieutenants and of lower rank, watched and listened to David as he quickly announced his findings.
“This boy is already in the latter stages of shock and his wound appears to have penetrated the colon, I’m afraid. A wound like this is difficult to repair, even in the best of conditions. I can smell the fecal matter from here,” David announced, looking between the three doctors. “Even if I can clean all that bacteria out of the abdominal cavity and resection the colon, not to mention repair any other damaged organs, I’m afraid in his physiological state he won’t survive the surgery.”
“Hmm. I hate to be so callous, but maybe we should reserve our resources for those that will survive,” Dr. Morgan offered as a suggestion.
“Sirs, you aren’t actually considering fussing with this man’s internals, are you? You might as well remove his heart while you are in there, for all the good it will do him,” Dr. Rogers stated in disbelief. Tall and trim, Dr. Rogers had a look of confidence as he made his case. “Isn’t it customary to set aside the abdominals and work the extremities first, as they have the greatest chance for survival?” he asked, using protocol for a defense.
“Lad, you will see some extraordinary medicine practiced here today. You are correct in reciting your protocols, but Dr. Warner here has experience in medicine beyond the limits of those protocols. I beg you to observe his skills and adjust your line of logic in order to gain benefit from his knowledge,” Dr. Morgan said, using rank and diplomacy to change the second lieutenant’s line of thinking.
Understanding his station among the four officers, Dr. Rogers replied with a simple, “Yes sir.”
“Doc, I’m afraid you are correct in your analysis. Our supplies are limited, and he just slipped back into unconsciousness again. There’s nothing I can do for him,” David said sadly.
Moments later, the two stretcher bearers brought in the next patient, Pvt. Mitchell. Removing the previous soldier from the table, Pvt. Mitchell took his place with a painful and worried expression spread across his face. He suffered from a wound to the leg. Once again the four doctors examined his wound: a bullet hole to the thigh. Although the wound was extensive, no bones had been impacted.
“I can have that leg off and bandaged in about ten minutes,” Dr. Rogers announced proudly.
“I’m sure it can be done quickly, but I believe the region would require a bit more time due to the nature of its location,” Dr. Weiss added.
“What is your analysis of the wound, David?” Dr. Morgan asked, hiding his anticipation of the answer.
“Well, I’m quite certain I can repair his leg in about half an hour without the need for amputation, although with the amount of trauma I see, I’m afraid he will probably have a severe limp when he recovers,” David answered.
“No amputation!?” Dr. Weiss exclaimed in doubt. “Sir, this man most certainly will require amputation. The extent of his injury is too great to consider anything else. I fear anything short of that will result in gangrene before the day’s end. We must amputate at once,” he said, exaggerating to emphasize his point.
Before David could respond, Dr. Morgan spoke, “Nonsense, lad. I have been witness to Dr. Warner’s surgical skills for some time now. He is a brilliant surgeon. If he claims he can heal this man’s wound, we must trust his word,” Dr. Morgan stated proudly. Continuing, he added, “Now, lads, while I operate on the other wounded man, I want you two to observe Dr. Warner. In particular, I want you to pay special attention to his care in cleanliness. If I’m not mistaken, I’m sure he will explain the details as he works,” he finished, now giving an all-knowing smile to David.
“Doctor, are you going save my leg?” Pvt. Mitchell asked nervously.
“What’s your name, private?” David asked with genuine interest
“I’m Jackson Mitchell, sir, but everyone calls me Rat,” Pvt. Mitchell replied.
“Rat? Why would they call you Rat? Do you eat a lot of them?” David asked, now curious.
“No, sir. Its account of how many I’ve kilt so far,” the young private answered.
“I don’t follow you. Why is that so noteworthy?” David pressed.
“I’m a sharpshooter, sir. I’ve kilt off m
ore Rebs in my company than anyone else,” Pvt. Mitchell replied proudly.
“I see. So a rat is a Confederate soldier. What are Union soldiers called?” David asked.
“Squirrels, sir. Johnny Reb calls us squirrels,” Pvt. Mitchell answered.
“Interesting. I’ve never heard those terms before. I wonder if historians have either,” David asked rhetorically. Returning his focus to the young private, he said, “Anyway, Rat, I’m going to try and save your leg. I need to ask you a favor though. When I’m finished, I need you to stay off it until it heals and keep it clean with soap and water. Do you think you can do that?”
“Why, yes, sir,” Pvt. Mitchell responded with surprise in his voice. “Sir, what if I can’t find soap and water?”
“Then it will surely become infected and will have to be amputated,” David replied bluntly, looking back over at the two doctors.
“I will find soap directly, after we whoop them Rebs, that is,” Pvt. Mitchell answered back resolutely.
“Are we winning?” David asked. For a short time, he had forgotten his fears, but with the private’s response, David was once again reminded he was in the middle of a war.
“Well, sir, just before I was rode from the field, we was pushing Johnny Reb further back toward the mountain. For a spell they had us on the run, but ole Gen. Banks is a wily one. He sent in a company of regulars around our own right flank, far into the woods. When they popped out of the woods, they was behind them Rebs and fired on them directly,” Pvt. Mitchell said proudly, although in obvious pain. He shifted his leg a bit to find relief and continued, “You shoulda heard the hollering and a-squealing from them rats as we cut them to ribbons in a murderous cross fire. Our boys really showed ’em,” he said, beaming with pride.
“Private, our boys were behind enemy lines. Were they able to get away?” David asked with intensity.
“I reckon they did, ’cause we poured on the lead and they ran scared. The Rebs, that is. I think that’s when I heard the bugler sound our boys’ retreat,” Pvt. Mitchell replied. Looking forlorn, he continued, “I kinda lost track on account of a ball tearing across my leg. I must have went out, ‘cause when I woke, our boys were far ahead, down the field; that is ’cept Gen. Negley’s boys. They had straggled a bit behind on our left flank, but then I saw a bunch of our boys running from reserves and push them Rebs back, straighten’n out our whole line,” Pvt. Mitchell stated.
He looked down at his leg again. Worry swept across his face as he spoke, “Doc, you will be able to save my leg, won’t you?”
“I'll do my best, but if I run into complications once I'm inside, I might have to amputate,” David replied in cautionary tone.
With a grim look, Pvt. Mitchell laid his head down and closed his eyes.
As Dr. Morgan worked on his wounded patient in one of the other makeshift operating rooms, David applied chloroform to the nervous private and began his own preparation for surgery. Instructing his less than enthusiastic students, David meticulously observed sterilization practices as he explained in detail their purpose.
“Germs? Sir, forgive my insubordination, but do you have proof of these so-called germs? How are we to believe that these tiny creatures exist? And furthermore, how are we to believe that they are of greater consequence than the wound itself? This whole notion seems too fantastic to believe,” Dr. Rogers responded in disbelief.
“Agreed,” Dr. Weiss added, “We may be newly trained doctors, but we are not new to medicine. In our two years of medical training, we were instructed in the most advanced techniques presently known. Never has anyone uttered a single syllable about germs. I am compelled by logic to discount this new idea,” he finished, arms folded in defiance.
“Let me see if I can explain it in terms closer to home,” David replied patiently. “In farming, blights that kill crops are caused by tiny insects or some form of fungus. You can see these killing agents with your own eyes, and that is why you believe in them, but before they grow to a point that you can see them with your naked eye, they begin in a state so small they are undetectable. Is it correct to say that because you can't see them, they don't exist?” David asked rhetorically, then answered the question himself. “Of course not. They do exist, and their killing affects can be seen as the plants die further in time.”
David poured some alcohol onto a clean rag and began to sterilize the gaping wound. Occasionally releasing pressure from the tourniquet, he worked quickly to control the bleeding as well as clean the wound. As he worked, he calmly continued his instruction. “So, just as a blight kills living plant tissue, so too germs kill living human tissue.”
David paused a moment as he concentrated on the worst areas of the wound, then continued, “And how do we kill germs? In the simplest form, we can use alcohol,” he said, holding up the jar of moonshine and the now bloody rag. “The key word here is cleanliness. If we can keep the instruments and the wounds clean, we can vastly improve the post-operative results. No germs, no infection. No infection, no amputation.”
“And that is why you and Dr. Morgan believe you can save this young man's leg?” Dr. Roger asked, now beginning to see some logic in the lesson being taught.
“Yes, doctor. Complications from infection can be minimized with simple sterilization techniques. Oh sure, there will still be some infection during the healing process for a variety of reasons, but most certainly, if you have done a good job at controlling germs during the operation, you will dramatically change the success rate of your surgery,” David answered.
“But, Dr. Warner, even if you control the germs in this poor private’s leg, that is a horrific wound. Half the muscle tissue has been shot away. The wound has rendered his leg useless. Isn't it better to amputate and leave him with a stump that can be fitted with a prosthetic limb, then to drag that useless appendage behind him forever?” Dr. Weiss asked, shaking his head discontentedly.
“I plan on reconstructing the damaged tissue. When I'm done, he won't be able to run, but he will be able to walk again, albeit with a limp. It will be a better life limping with his own limb than to walk with a fake one,” David reasoned.
“Reconstruct the muscle!?” both doctors cried out in shock.
“How in the name of the Lord do you intend on doing that?” Dr. Rogers asked in astonishment.
David chose not to respond. Instead, he pulled the hot scalpel from the boiling water and began to make his incisions to repair the damaged tissue. As the sounds of war rang out in the distance, David began cutting away the mangled flesh. He carefully reconstructed the remaining muscle tissue, working quickly to minimize exposure to the unsterile air. Having reshaped the tissue, David began to reconnect veins, arteries and connective tissues as best he could. As he worked, he explained the concepts of his techniques to the two bewildered doctors. While he closed and bandaged the wound, he noticed the astonished look on their faces turn to blank stares as they struggled to comprehend the operation they just witnessed.
Dr. Weiss was the first to speak. “Dr. Warner, I am humbled. Never in my imagination have I dreamed of something so complex, although I must admit, I make perfect sense of your procedure. It is quite logical, I think,” he said, as he looked off into space and pondered his statement.
“Dr. Warner, Dr. Morgan was correct in his analysis. You are a brilliant surgeon. Could you teach me your techniques?” Dr. Rogers asked in an unpretentious tone.
David was about to speak when he heard the sound of another wagon arriving. The three rushed to the open front door of the farmhouse to observe the visitor. The bedraggled ambulance driver pulled up to the porch and jumped down from the buckboard, tossing the reins over a worn hitching post.
The moans of agony were low and subdued, as the soldiers’ bravery hid the extent of their wounds. David ran from the door and down to the edge of the wagon to examine the wounded men. There, in a grisly state, lay three more wounded soldiers, one whose left leg had been blown off just above the knee, and was bleeding profusely
in spite of his tourniquet.
“Dr. Rogers, this man leg needs immediate treatment. He's in shock from blood loss and trauma. Can you take him first?” David asked in a polite but firm tone.
“Yes sir. In the name of expediency, shall I forgo the use of sterilization on this case? I fear time is slipping away on this one,” Dr. Rogers replied.
“Absolutely not, doctor. At all times do we maintain cleanliness. The effort is well worth the time spent,” David replied resolutely.
Dr. Rogers nodded in submission and hurried to prepare his station. David took note of the remaining two and decided that both could be treated more efficiently if operated on side by side due to the advanced techniques he alone would need to administer.
“Dr. Weiss, grab a few men and move your operating table next to mine. Both men have leg wounds that need special care. We can work together and I can guide you through it, ok?” David ordered.