Jake picked up the hat Christian had knocked off in the scuffle and looked in the direction of Centreville. “So they’re doing it, are they?”
“They’re doing it,” Thomas said.
Jake sniffed and pointed his cap at a boulder down the bluff. “That’s where the colonel wants me, just in case,” he said, and loped toward his post as coolly as if he were a ten-year-old sent off to play by his exasperated mother on a fine summer morning.
After he left, Thomas kneeled into the dirt and said, “I’m not too sure about that kid.”
“Oh, he’s all right,” Christian said.
The noise of artillery reached even the streets of downtown Washington, and rumors began to run through the city’s streets, arriving in Georgetown via the canal boat captains and hack drivers. By two in the afternoon, reports came that the Union was winning; hills had been taken, the Rebels had been pushed back. By three, a rider raced through the streets proclaiming a Union victory. But by five, the telegraph operator at Fairfax Courthouse telegraphed the news that he had to abandon his post because the Rebels had overrun them and the Union army was skedaddling toward Washington. Stipp and Mary burned oil lamps waiting, and when the lamps ran low, true night fell, darker than dark. At dawn on Monday it began to rain, but not until the afternoon did returning soldiers begin to cross the Aqueduct Bridge and stumble up Bridge Street. At street corners, they told their stories: the Rebels were defacing the wounded, the Rebels were ruthless, the Rebels were legion, the ambulance drivers had abandoned five thousand dying men on the battlefield. By nightfall, the rain ended its drumming, leaving behind a haunted silence. That night, at the sound of every passing carriage, Mary leaped from bed, only to watch empty wagons rattle past, their ghostly lanterns bobbing in the dark. Five days of waiting had whittled her nerves to shreds; the beef tea the cook had steeped had spoiled, the egg puddings had curdled, all her preparations had been for naught.
It was not until Tuesday morning that the wounded began to descend on the Union Hotel. Most had staggered the full thirty-five miles from Centreville, ignored or missed by the roving ambulance crews sent back in after the battle under a flag of truce. Disoriented, feverish, a few had mistakenly stumbled into the tobacco warehouse across the street and expired on the drying floor. They continued to arrive for another two days, and by the time they reached the Union Hotel they were dirty, ravenous, and parched to the point of delirium. By midnight on Thursday, four days after the battle, Dr. Stipp had made full inventory: 254 wounded, most with extremity wounds from slow-moving musket balls that had entered their bodies but not exited. A few of the balls had managed to break bones: the right elbow joint of one man, the right shoulder of another, the femurs of perhaps half a dozen poor souls who had suffered torturous rides in two-wheeled jitneys that pounded into every rut and pothole in the ruined roads, two with missing jawbones, one with a broken hip, one whose feet had been crushed by a runaway wagon, and a dozen flesh wounds of the breast or shoulder or calf.
Three boys needed their legs off. And he had no idea how to go about it.
Chapter Eighteen
In the dining room, Stipp lit candles, assembled rags, and wrestled his amputation knife and bone saw from the velvet-lined case issued to him when he’d returned from the post at Davis Landing. In the days leading up to the battle, he had pored again over the surgery manual, but tonight his lethargic mind could remember nothing about amputating a leg. Across Washington City, it was the same in all the hospitals. No one knew anything about amputating legs or arms; all anyone knew had been gleaned from the government-issued manual. Now Stipp took a strong dislike to the dining room: it was a room of ghosts, of expired conviviality, the walls reeking of decades of sweat and stewed mutton and boiled oysters and spilled beer. Its view depressed: the dilapidated stable in the back fallen in on itself and the smaller tumbledown shed supporting a roof gone to thatch. But dislike would not dispel panic, which was beginning a serious incursion, tightening Stipp’s throat, shortening his breath, peaking as Mary Sutter, Mr. Mack, and one of the discharged dyspeptics who had limped back from the streetcar landing stumbled into the room carrying his first patient. Mary backed in first, supporting the boy’s shattered left leg, and the two men carried the patient between them in a sling of their joined hands. The trio grappled with the boy—he was a mere boy, but big, with a florid complexion and massive hands—and finally got him onto the cleared table. Though his left calf muscle had been torn to shreds, he did not display the terror that would overcome Stipp’s later patients, who would know what a wound like his portended; instead, the boy manifested only a sweating, confused fury, punctuated by shouts of pain.
“Can’t you even get a man properly drunk?” Stipp shouted at Mary. He had told her to give the boy as much as he could handle, and Mary had given him the better half of her flask; she pulled the silver container of whiskey from her skirt pocket and waggled it at Stipp, who fought the urge to swipe it out of her hands and down the rest of it.
The steward was not a man the doctor admired, but tonight Stipp needed the wily and resourceful lieutenant. Two assistants would be better, but the dyspeptic, who until the other day had been bedridden for two weeks, had already crawled into a nearby room and collapsed on the floor. Mostly though, Stipp did not want Mary Sutter in the room. It was not pride, he told himself, it was not that he did not want her to witness his ignorance; no, he needed to maintain discipline. Yes, he told himself, discipline and a sense of command; these were vital. He was vaguely aware that he wished he could sit down.
“I’ll need you to hold this boy’s leg,” Stipp said to the steward.
But Mr. Mack was already at the door, his skin a sickening shade of gray.
“God damn it, man,” Stipp said, “I order you.” But the steward vanished, leaving Stipp alone with Mary, who, with a possessive hold on the boy’s shoulder, showed no sign of retreat. Instead, a mixture of anticipation and something Stipp could only think of as voraciousness flared across her pale face.
“Get out,” he said.
“I’m staying.”
“I don’t need you.”
“Don’t be a fool. You need someone.”
“Not you.”
The boy lifted his head from the table. “Don’t you talk like that to this nice lady,” he slurred.
Stipp forced the boy’s head back down and inverted an open cone over his face, the larger opening hovering just above his nose and mouth. Into the smaller opening, Stipp stuffed a ball of cotton, onto which he dripped the clear chloroform, which he had kept in a cupboard to avoid exposing it to the light. Averting his own head to avoid the fumes, he couldn’t remember how much to give, but he remembered the process, how the body seized and shuddered as it went under. The boy did struggle, but soon he began to breathe rhythmically and fell asleep, and Stipp lowered the cone, watching the boy’s corneas slowly dilate. When they contracted, Stipp lifted the cone from the boy’s face and set it far away so as not to be overcome himself.
Now he considered manhandling Mary out the door. Why wouldn’t she leave? He could not let her see that he didn’t know what the hell he was doing. If the prospect of blood wouldn’t run her off, then . . . he peered at her, trying to think of something, anything, to get her out. It would take an extreme measure, he thought, and then he knew. In a single flourish, he undid the boy’s pants and stripped them off, exposing him. Lifting his head in triumph, he expected fury or at least embarrassment to have washed across Mary’s face, but she did not flinch. Instead she crossed her arms and said, “I have a brother.” And then she said, “You don’t know how to do this, do you?”
“Don’t be ridiculous,” Stipp said, but a warm flush of blood was rising in his face. Despite all their preparations, he had never thought that it would come down to the two of them standing opposite one another over real need. He, along with everyone else, had not feared this moment in the way they ought to have done. And now the boy’s leg was rapidly taking on a bluish asp
ect. Twilight was seeping in on the edges of the candlelight.
“Just leave me be to do this right,” Stipp said, and then feared what would happen if she did. How he would falter; how the boy would die. Mary tilted her head to the side: her face was a shining sphere, as warm as the Texas sun. It was then he suspected she might reach out and touch him. He wished she would. He was terrified. A drop of wax from the burning candles spat onto his arm. Stipp glanced at his knives.
And then, just as he had thought, Mary laid her hand on his wrist. It felt like a caress. He did not know how long they stood there together. It was as if time had swallowed them; all that mattered was her generosity. Over the last month, he had seen her employ this elixir of womanhood, a trick that transformed misery into pleasure and made the men do things they would not otherwise do: walk when they wanted to rest, live when they wanted to die. But in that moment of intoxication—a second, a minute?—he began to believe he could do the job; he told himself that what he was about to do was little more than basic butchery. Any farm boy could cut up a chicken or a hog. Was this really so different? He reached for the small knife and whispered, “On the table beside my cot is a book called The Practice of Surgery. Would you get it for me, please?”
Mary withdrew her hand. “My God, you really don’t know how.”
“If you faint on me,” Stipp said, “I will personally take you to the train depot and buy you a ticket home.”
Mary drew herself up. “And if this is a ruse—if you lock that door behind me, I swear to you I will get a ladder and climb through the window.”
“I need that book,” Stipp said. “I have, if I am lucky, half an hour before this boy wakes up.”
Mary regarded him for a moment, no more, and then she was gone. An eon passed in which Stipp feared that Mary had deserted him, but then she surged through the door, riffling through the dog-eared pages of his surgery manual.
“Above the knee?” she asked. “Is that what you want to do?”
Desire for her swelled. Quixotic, passionate, it fogged his mind. He turned to assess the boy’s mangled calf. It would have to be above the knee. That would be best, because then there would only be the one bone to manage.
“Yes,” he said. “Above the knee.”
“Then it says to apply the tourniquet mid-thigh.”
“We don’t have a tourniquet,” Stipp said.
Another drop of wax fell on his arm. He flicked it away before guiding Mary’s thumb to the fold between the boy’s left thigh and hip. “Femoral artery,” he said. “Press hard.”
“Will it stop all the bleeding?” Mary asked.
“It will stop some of it. Now read me the instructions.”
She read, “An assistant is to firmly grasp the thigh with both hands and to draw upward the skin and muscles with some force while the surgeon makes a circular incision as quickly as possible, through the integuments, down to the muscles.”
“Fuck,” Stipp muttered, worried now because Mary couldn’t do all three: read, apply pressure to the artery, and draw back the muscles as well. After a moment of dread, in which he contemplated with great affection his lazy days in the gentle sunshine of his beloved Texas, he leaned over, placed his left forearm against the boy’s thigh, and drew back the muscles as well as he could. He then put knife to skin above the knee. Though the flesh resisted like a tough steak, he managed to make a series of awkward cuts, working the blade in a sloppy, imprecise manner. There was no telling how long it took. Time was its own meter, stretching to magnify his incompetence.
At the first sign of red muscle, he pulled back. It was one thing to cut skin, another to sever muscles. Would they snap back? Disappear under the flesh? To what would he anchor them afterwards? Oh, curse his medical training! Six months of courses at Yale; not one surgery performed under anyone’s auspices. In New York, little surgery, more management of epidemics. Any latent skill he possessed was merely guesswork augmented by common sense. What would a cut muscle do?
Into these rampaging thoughts came Mary’s wavering voice. “It goes on and on about muscle dissection. I can’t find a single direction that is clear.”
“Read down, read down!”
Turning the pages with her thumb, Mary skimmed, flying past words like flap and oblique division and vastus internus. Finally: “Many excellent surgeons, whom I have seen operate, do not cut at once obliquely down to the bone, after the integuments have been divided and retracted; but so far adopt the principles of M. Louis, as to divide the loose muscles first, and lastly, those which are intimately attached to the bone, taking care, with a scalpel, to cut completely through the deep muscular attachments, about an inch higher up, than could be executed with the amputating knife itself. This last measure causes very little pain, and has immense effect in averting all possibility of a subsequent protrusion of the bone, or of a bad sugarloaf stump.” She looked up. “Why can’t he say something straight out?”
Stipp began his assault. He nearly closed his eyes. He had no idea if his attempts at division would make any difference for the boy in the end. There were moments ahead that he did not want to think about: how best to cover the bone afterwards, whether his stitches would hold; recovery, if the boy didn’t die now.
When knife hit bone, his hand jerked to a stop. He held the knife up for a moment, hardly able to believe what he had accomplished.
It was his first but not his last amputation. One by one, he would grow adept with a knife, skilled, quick, efficient, in conditions much worse than these. In time, he would wield that blade as an extension of himself, grow to love its heft, its curves, the way the blade caressed and then sliced a portion of a man away. And he would grow to love himself: how he would know just what to do and how to do it, could do it, would be forced to do it for days on end, his knees buckling with fatigue, his heart numb to all but necessity. By the end of the four years the war would take, he would perform this operation in under five minutes, his record being nine legs in one hour in a drafty barn in Gettysburg beside a welling stream that would flood one stormy night and carry away all his surviving patients. In the end, he would perform 607 amputations, though he would lose count at fifty and cease caring at a hundred. By that time, loss would be a mere fact, mourning an extravagance he would not indulge. But he would have compassion. It would swell inside him, not for his patients, but for the inept, flawed human being he had once been and was now on a muggy night in Georgetown, mosquitoes diving into the rivulets of blood that percolated from other arteries buried in the boy’s thigh with names like profunda femoris and deep femoral , names that resurrected themselves from his sun-addled brain when he had only a few minutes, ten maybe, before this boy lost so much blood that nothing he did now would matter.
Mary was fumbling, trying to turn the pages.
“Find where it says something about a retractor,” Stipp said. He was beginning to remember whole paragraphs, not the details but the gist. “Hurry,” he said, tying off the arteries he could separate from the muscle.
“I can’t find it—” But finally she lit on it, joy rising in her voice as she read the instructions and Stipp, following them, tore a rag into a strip and ringed the upper flesh and pulled it out of the way. He was remembering, he was remembering, oh the joy of memory, but it was memory of a peculiar nature, as if his competent future self had returned to help his present fearful self. He turned and seized the saw from the buffet table behind him. The danger, Stipp remembered—how could he?—was splintering the bone with too much force.
“I’ll need you to steady the leg,” he said.
Mary shook her head.
For the first time, her eyes glistened with indecision. He had infected her with his uncertainty; he would remember never to do that again.
“I know what to do now. Cradle his thigh in your elbow and steady it against your shoulder.”
To what did she respond? The confidence in his voice? His sudden, alloyed briskness? But with her left thumb still pressed on the boy’s
artery, she obeyed. It was the first time she had ever done anything he had asked without an argument. She thrust her right shoulder into the flesh of the boy’s thigh and slipped her right arm underneath to hug the limb tight against her upper arm. Her hair curled and twisted against the pallid flesh.
Stipp brushed it away. He was glad her head was turned. He did not want her to witness his inexpert thrusts and parries. After several swipes, the saw stuck. He removed it and shook free the bits of bone, then wiped it against his thigh and reinserted the saw.
The break came clean. He had a moment to contemplate what a pristine thing a cut bone was. Then he thrust the severed limb aside.
“Now release the pressure,” he said.
Mary lifted her finger. The stump reddened slowly, from intact top to mangled end. Stipp held his breath. His ties needed to hold. He willed them to hold. Sweating, fighting, trembling, he watched that stump grow plump and bright, and the ties tighten against the resurrected arteries and flesh, and when he was certain that the boy had not died, not yet anyway, he began to sew a flap and said, “Bring me the next one.”
Ten hours later, a silvery dawn threw shafts of pale light into the hallway outside the dining room where Mary Sutter sat slumped against the sweating plaster walls. Throughout the hotel, feeble cries for water drifted through the crevices of the ceiling and walls, though in this place in the last few days since the battle, calls for water were unceasing.
Last night, uncharacteristically, they had gone unanswered.
My Name Is Mary Sutter Page 17
