A short distance away, a private pulling a horse-drawn ambulance heard the painful shriek of Corporal Fletcher over the thunder of war. This was his first pass through as he searched for casualties. Hearing the horrific screams, he snapped the reins to the team of horses and quickly located the suffering Corporal, barely conscious but still feeling his agony. He leaped down from the buckboard and ran to his side with a canteen of cool water. Kneeling, he placed the canteen to the corporal's lips and slowly poured a few swallows into his mouth.
In his grave state, Corporal Fletcher choked and coughed as the water entered his mouth, causing him to cry out in pain once more. Instinctively he pushed the private’s hand away and opened his eyes.
In a weakened voice, he said, “They've killed me. The Rebs have killed me.”
Looking down at Corporal Fletcher's blood, which had pooled under his leg, the private quickly realized the gravity of the situation. As he reached to lift the fading corporal, he replied, “Nonsense. Doc Morgan will have that leg off in no time. You'll be good as new in a just a few days.” He smiled as he spoke, hoping to lift the Corporal's spirits.
Even in the Corporal's deteriorated state, he knew the grisly torture that awaited him once back at the makeshift hospital. He stiffened a moment and looked down at his maimed appendage. He envisioned the painful procedure, then the disfigured remnant that would be left as a sad reminder of the reality of war. Disheartened, he slumped into the arms of the private, who struggled to lift him into the waiting ambulance. Moments later, laying in one of the hard, wooden gurneys, he was reminded of his agony as the private snapped the reins, abruptly jarring the wagon, sending excruciating pain through his gaping wound and up his spine.
“Sorry,” the Private responded sincerely, although there was little he could do to improve the comfort of the wounded.
Moments later, through his own screams of agony, he heard the cries of another wounded soldier being loaded into the wooden ambulance. He glanced over to see a young boy of sixteen, thin, with wavy yellow hair, being roughly hauled into the gurney on the opposite side of the wagon. With the ghastly wound in his stomach, he didn't have long to live. His blues eyes were sunken and dulled from the loss of blood, a good deal of which completely saturated his shirt and pants, as well as his hands, as he had tried in relieve the pain with pressure to his wound. Lying there in his agony, he cried out to God to end his suffering. Corporal Fletcher could almost feel the young boy's despair as he irrationally waited in vain for a higher power to answer his dying prayer. With the realization that he was all alone, he retreated into the far recesses of his mind, his last haven for solace. Rolling his head from side to side, he murmured under his breath, "Mama, mama." At the end of his consciousness, unable to speak, Corporal Fletcher mustered the last bit of his strength as he stretched out a weak, shaking hand, and gently laid it upon the private’s shoulder.
The young private’s eyes widened a moment as he quietly spoke in a receiving tone, "Mama. I love you."
As the corporal’s world went black, he slipped into unconsciousness, having brought some measure of relief to the poor dying boy beside him. It was all he could do, and it was enough. Shortly after losing consciousness, the young boy quietly died beside him, passing beyond the horrific end into peace.
--- --- --- --- ---
Dr. Jeb Morgan paced back and forth by the operating wagon, envisioning the dead and wounded with each report of the Union cannons. With each crack of a twig or an unusual sound of the wind, he craned his head to listen more intently, hoping for any advanced warning of the ambulances delivering their wounded. The minutes felt like hours as he reached into his pants pocket and pulled out his Elgin pocket watch. He pressed the tiny button of the gold timepiece and popped the cover, exposing the hands of time.
“Huh, only 10:30,” he said aloud, frustrated at how slow time felt during moments of anguish.
He snapped the cover closed and shoved the watch back into his pants pocket once more. Returned to his pacing, he gazed through the grove of birch trees, trying to view the battle at his protected location. Barely visible, columns of smoke and debris could be seen rising off the valley floor. The sight made him wonder how the Confederates were faring, and if their own surgeon was also nervously pacing.
It started as a low clicking sound, barely audible. At first, Dr. Morgan thought it might be cannon echoes reverberating off the mountains, but as the sound persisted, he recognized the distinctive repetitive sound. It was the hooves from a team of horses as they trotted. He strained his eyes in the direction of the sound, but still saw nothing. He spun on his heels and ran toward the operating wagon.
“Ok, men; we’re on,” Dr. Morgan called out in a deep authoritative voice. “Fetch my smock,” he ordered a nearby private, who was sitting on the ground, sunning himself.
“Yes sir,” the private quickly responded, hopping to his feet.
Moments later, the screams of pain could be heard as the driver hauled the wounded over rocks, logs and uneven ground as he made his way through the birch forest to the makeshift medical camp. He pulled into the clearing and rolled to the waiting operating wagon.
Standing in their clean white smocks stood Dr. Morgan, assistant surgeon George Fowler, Pvt. Douglas, who had been resting earlier, and Pvt. Cleveland. The horses came to a halt with the rear of the ambulance just past the operating wagon. Immediately, Dr. Morgan ran to the wounded and began his assessment. There were three soldiers lying with their feet toward him. He quickly saw Corporal Fletcher's leg and the pool of blood that had collected under it. As he climbed up into the ambulance, the private driving the wagon met him in the middle.
Pointing to the young boy of sixteen, he shook his head sadly and moved his gaze to the corporal lying at the bottom of the wagon between the two gurneys. The young corporal was still conscious and suffering terribly due to a bullet that had penetrated his leg just below the knee and smashed through the bone, leaving a gaping wound and shattered fragments embedded into the raw, mangled flesh.
Assessing the situation, Dr. Morgan quickly pronounced the young boy dead, and turned his attention to the two men still living. Feeling Corp. Fletcher had the gravest injury, he motioned to the two privates to carry him to the operating table. Immediately, the two lifted the gurney out of the ambulance and over to the other wagon.
As Dr. Morgan cut away a portion of the corporal’s pant leg, Asst. George Fowler prepared the chloroform. Dr. Morgan looked up while cutting and said, abruptly, “Save it. He's unconscious. I'll have his leg off well before he ever wakes up.”
Asst. Fowler stowed the chloroform and replied, “You think he'll ever regain consciousness after this?”
“I do.” Dr. Morgan replied simply, then added, “Once I tie off those arteries, I think he'll be ok; that is, if we can control the infection.”
Asst. Sgt. Fowler just nodded as he jumped down off the wagon and came around to the back. He stood for a moment and awaited further orders.
Looking at the gruesome sight, Asst. Fowler watched as Dr. Morgan placed the mechanical tourniquet just above the knee and over the femoral artery. With the strap wrapping around the leg, he pulled hard to tighten the cloth band around the skin. He then turned a large lever on the tourniquet to take in the excess slack. Moments later, the blood that oozed from the wound slowed to a slight trickle.
Dr. Morgan's hands were already covered in blood as he reached for his scalpel. With his pant leg gone, Corporal Fletcher's right leg was fully exposed. Starting at the top surface of the leg, Dr. Morgan began the amputation as he explained the procedure to Asst. Fowler while he operated.
“Right, I know this is your first time, so I'll try to explain as much as practicable. First, we determine the point of incision closest to the wound. We always try to leave as much of the amputated limb as possible. I'd say we could safely amputate about an inch or so behind the wound,” Dr. Morgan said as he placed the scalpel on the top of the leg.
Looking up
at his assistant, then up to Corp. Fletcher to ensure he was unconscious, Dr. Morgan was now ready. “Right then. Start at the top, here,” he said, pointing with the scalpel. “We pierce through the upper integuments – skin, that is – cutting through the fascia and just into the muscle. This really should be quite simple with him unconscious.”
As he explained, he pierced through both layers of skin and into the muscle as he sliced from the top and worked his way around to the bottom, blood and fatty yellow tissue immediately oozing from the laceration. At the bottom, he reached around the leg, coming up from underneath on the opposite side and continued to make his incision up the other side, ending at his first point of incision. The two incisions were so quick; Asst. Fowler barely had time to comprehend.
“Ok, I need you to pull back the first layer as I cut down to the bone. Just be careful of your fingers though. I'm moving pretty fast here and we don't want an accidental amputation of any of your digits, ok?” Dr. Morgan asked.
Asst. Fowler nervously nodded his head, placed his unwashed fingers into the incision, and began to pull back on the skin, opening it wider for Dr. Morgan. As he did this, he asked a question. “Sir, why don't we cut right down to the bone on the first pass? Wouldn't it be faster?”
Looking up at his assistant, Dr. Morgan replied, “Good question, lad. We could do this in one pass, but we lose the precision as we slice deep into the muscle. The remaining stump usually ends up grossly disfigured, more so than is acceptable, frequently leaving the appendage quite painful for use. The accepted practice is the double incision, as we are doing now. We will produce a stump that will retain more muscle tissue covering the bone, making it a less painful, as well as a more useful appendage.”
Asst. Fowler nodded, then turned his attention to his fingers as he pulled the incision open.
Dr. Morgan reached for a longer-bladed scalpel. He inserted it into the bloody tissue at the top, then angled the blade so that he would be cutting several inches up and underneath his assistant’s hand, effectively cutting out a cone shaped piece of muscle down to the bone. The first pass, the doctor sliced deeply into the flesh, slicing though vein, muscle and tendons, hitting the bone and increasing blood flow onto the table. As he was instructed, Asst. Fowler pulled back the freshly sliced muscle as the doctor worked quickly.
Reaching over the leg once more, the doctor continued his conical-shaped incision from the bottom and worked his way to the top. With his hands saturated in blood, he reached for a long strip of cloth a few inches wide. He worked around the bone, then pulled up on each end of the strip, lightly suspending the leg for a moment. He then pulled the cloth up the leg, which pulled the muscles higher up the bone.
“Ok, we've pulled the muscles higher up the bone. I'll cut through the bone as close to the cloth as I can without cutting through it – the cloth, that is. When we release the cloth, the muscle will spring back to its original position, covering the bone by a couple of inches, allowing for greater cushioning after healing,” Dr. Morgan elaborated.
He reached for his saw and placed his thumb on the bone as a guide. Resting the saw against his thumb, he pulled two times toward himself, leaving a small pilot slot to start the cut. He then began to saw aggressively through the bone. In seconds, he was nearly through the bone, as he began to slow. At the end, he only pulled the saw toward himself, insuring that the bone would not splinter. With the last pull of the saw, the lower leg completely detached from the upper leg. At the end of the table, the top-heavy foot rolled to one side under its own weight, and fell from the table into the grass below. The blood pooled around the end of the stump as the assistant released the cloth holding the muscle. Quickly reaching for a pre-threaded needle, the doctor began to tie off the various blood vessels, starting with the femoral artery.
“Right then. See those strands that look like tiny pieces of twine? They are the various blood vessels that supplied the lower leg with blood. Those all need to be tied off or he'll bleed to death,” the doctor said as he worked.
With the bleeding completely stopped, he slowly released the tourniquet and watched for leakages at the end of the stump. Seeing none, he then began to sew up the exposed wound. He quickly pulled the extra skin over the muscle and began to stitch across them.
“The ligatures should not be too close, as there needs to be room for drainage of any excess blood and pus while the appendage heals,” the doctor said as he stitched. His assistant looked on in fascination. When he was done suturing, the doctor allowed Asst. Fowler to bandage the end while he rinsed off his tools and threw the bloody foot into a basket to be carried away later. Turning to his assistant, he said dryly, “Let's hope there won't be too many of these today.”
Asst. Fowler just nodded. The whole bloody experience was almost too graphic for him as he tried to process the procedure in his mind.
“Right, let's have a look at the other fellow, shall we?” the doctor asked rhetorically.
Bandaging the corporal’s amputated leg, he looked up to see that Dr. Morgan was already cutting away the other soldier’s pant leg, presaging the next operative process. Moments later, the sound of distant gallops could be heard as more teams of horses began to arrive, pulling their wooden ambulances as they rushed the wounded to safety.
Faster than they could operate, the privates carried more wounded Union soldiers to the operating wagon. The basket of amputated limbs mounded over as the doctor disposed of the useless appendages, throwing them unceremoniously onto the bloody pile of flesh and bone that had already began to rot in the heat of the day. As each mangled limb landed on the bloody mound, swarms of flies darted away, escaping the falling limb. They quickly returned and continued their forage of filth and disease on their newly found real estate.
As the wounded flowed in, they were helped to the shady edges of the grassy clearing to wait their turn under the knife. Disheartening moans of agony could be heard everywhere as the injured men left one horrific world and entered another. Working quickly to overcome the numbers, Dr. Morgan set up another operating wagon for Asst. Fowler. Working side by side, Dr. Morgan monitored his assistant’s work. At first, the doctor assigned simple amputations to Dr. Fowler, but as the number of wounded mounted and Dr. Fowler began to grow into his newly acquired skills, Dr. Morgan allowed him to take on more complex surgeries. With two doctors working, the basket used to dispose of the limbs had long since disappeared under the carnage.
The stench of iron hung heavy in the air from the blood that spewed from the wounded. Through blank and pallor faces, some stared out into nothingness as shock deadened reality. Others winced and grimaced with each breath they took, and still others cried out in agony, each time dying a thousand deaths.
Hearing the suffering of their countrymen only served to stiffen both doctors’ resolve to save more men. Throughout the day and into the night, the two surgeons worked frantically to save the injured and the dying. As their exhaustion set in, and hysteria and despair overwhelmed them, they searched within themselves for the strength to continue. Eventually, their own bodies and minds began to fail them. They had pushed themselves to the limits of human endurance. With the battle not yet complete, they both knew that tomorrow would bring further death and pain. If they were going to be of service to the young men risking their lives for their country, they both would need some much deserved rest.
With the last flicker of light from the nearly spent oil lamps, the blood-soaked surgeons made their way across the other side of the clearing to their two canvas tents. With a quick change of clothing, they lay down on their cots and fell quickly asleep.
-ms-filter: grayscale(100%); filter: grayscale(100%); " class="sharethis-inline-share-buttons">share
Curse of Atlantis Page 29
