The Surgeon: A Civil War Story

by Schwartz, Richard Alan

  “We’ll begin…without Dr. Fellows,” Abbey said in as confident a tone as she could fake.

  Abbey approached a table with supplies on it and unfolded one of her recently cleaned aprons. She smiled briefly. The words, Dr. A. Kaplan, were embroidered in two-inch-high black letters across the top. She said quietly, “Thank you, Mrs. Warshawsky.”

  Abbey glanced through the entrance of the tent. While cannon fire rumbled in the distance, a long line of ambulances were queued to unload their damaged human cargo.

  Trembling, she mumbled to herself, “It’s all on me until the bastard sobers up.”

  Sgt. Scharf, standing at her side, whispered, “One at a time doctor. We treat them one at a time.”

  Abbey took a deep breath to steady herself, turned to the Sergeant and nodded.

  She checked her medical instruments were complete and laid out the way she preferred. Abbey viewed the faces of her team.

  “Anyone feel they are unable to help repair the wounded by following a female Doctor’s orders?”

  Sgt. Scharf gave an angry expression to a few of the team members then said, “It won’t be a problem, Doctor.”

  “Pvt. Wilson,” Abbey said, “prepared to take notes as senior medical staff requested?”

  “I reviewed the directive you gave me so I’m prepared, Doctor.”

  “Sgt. Scharf,” Abbey said to the lead percussionist. “Your practice with pork belly was sufficient, in Dr. Fellow’s absence, I’d appreciate you assisting me.”

  “Yes, Doctor.” He moved from her side to across the table.

  “Ready Pvt. Lawrence?” she asked the man administering the chloroform anesthesia.

  In a barely audible voice he said, “Yes.”

  She glared at him until he added, “Doctor.”

  “We’re presented with an otherwise healthy soldier who is missing his left foot, severed just below the termination of his tibia.”

  Wilson wrote feverishly as she described her work. When the next soldier was placed on the operating table she examined his wounds and said, “We’ll be doing circular amputations today because these men will have to be transported a long distance to the recovery hospital. I’m amputating mid-thigh.”

  A tourniquet was secured by Sgt. Scharf where Dr. Kaplan indicated. Abbey began the incision at the top of the thigh and ran the scalpel down each side and below to the bone. As she cut, Sgt. Scharf pulled the lower muscle away from her work area. She left a flap of skin from the section to be removed which would serve to close the wound. Abbey picked up the bone saw and severed the femur. She picked up a file-type instrument and rounded the sharp edges of the bone so they wouldn’t penetrate the skin flap. Abbey ligated many blood vessels, instructed Sgt. Scharf to tie off a few then sutured the covering skin in place.

  Dr. Kaplan did her best to appear and sound confident but her tension was revealed when her voice quivered as, for the fiftieth time, she yelled, “Next patient.”

  The next amputation, a man’s right arm, had just begun when Pvt. Lawrence said, “He stopped breathing, Doctor.”

  “Damn,” Abbey cursed.

  The deceased man was removed and the next put on the table.

  “There is a bullet entry just inside his left shoulder joint.” She briefly probed for a bullet, didn’t find one so began closing the wound.

  “He’s not breathing,” Cpl. Lawrence said.

  “What? It wasn’t much of a wound.” She rolled the soldier onto his side…and saw the large exit wound. “Shit. He bled out because I didn’t check for an exit wound.”

  “All surgeons make mistakes,” Lt. Smith said.

  “This mistake killed someone.”

  “Next patient!” Lt. Smith shouted.

  Abbey stood unmoving with furrowed brow while contemplating the mistake which, in her mind, she caused.

  “Dr. Kaplan,” Sgt. Scharf said, “the next patient needs your attention.

  Abbey glanced at the sergeant then nodded. She closed a six-inch curved laceration on a soldier’s scalp.

  Three patients later, Abbey was closing an amputation when Pvt. Lawrence said, “He’s gone.”

  She checked for a pulse, swore under her breath, then shouted, “Next.”

  After seven-hours, a man was placed on the surgical table with bandages on his left shoulder and missing his left arm. Sgt. Scharf removed the bandages. A couple inches of his humerus remained but had torn loose from the shoulder socket. The tissue surrounding the area reminded Abbey of raw ground beef covered in a thin layer of tomato sauce. “I’ll remove the dead tissue and humerus bone.” She did then watched Sgt. Scharf as he followed her directions while closing the wound.

  Dr. Fellows appeared at her side. He was unsteady but took over as lead surgeon. She moved across the table from him to assist. The stench of bourbon and cigar smoke caused her to regularly bring the back of her hand up to her nostrils. She decided it was better to breath shallow breaths to avoid the disgusting odor. His bourbon scented belches still assaulted her nose.

  “His work is rapid but sloppy,” Abbey thought. And he didn’t describe his work so Pvt. Wilson could record it. The private glanced at Abbey. She shrugged.

  Two-hours later, Dr. Fellows nodded to Dr. Kaplan to perform another amputation. He observed for a while then said, “Fast counts, Doctor. Not goddamned pretty.”

  “The patient is no longer breathing,” Cpl. Lawrence said.

  “Your slow work killed him,” Dr. Fellows said, giving Abbey a disdainful gaze. In a contempt filled voice, he added, “That’s why a man is needed to do this work. Continue to lead…Doctor.”

  Another patient was placed on the table. Abbey closed a laceration across his pectoral muscles then set his broken lower leg bones.

  The hot, humid conditions caused sweat to form on her brow. Beads of sweat ran down her back and chest. She noted her clothing sticking to her skin. Salty droplets stung her eyes. She kept wiping with her shoulders until Sgt. Scharf wiped her forehead and cheeks. Abbey nodded a thank you.

  “Next,” she yelled.

  Dr. Fellows took over as lead again.

  “You and you, raise the tent sides,” Lt. Smith shouted. The men scrambled to comply.

  Mercifully, a cool breeze wafted across the medical staff.

  As if it wasn’t sufficiently humid, a light rain began.

  Five more surgeries and Dr. Fellows noticed his staff staring at his trembling hands. Just prior to making an incision, he dropped his scalpel. “Dr. Kaplan,” he growled, “finish here. I…I…hurt my wrist last night. I’ll be in my tent if you need me. And try not to kill anyone else.”

  Through gritted teeth she replied. “Yes, Doctor Fellows.” He spun on his heal and hurriedly left the medical tent. Sgt. Scharf moved across the table from Abbey and assisted as she completed numerous surgeries.

  Seven-hours since she’d begun and three-hours since the shooting died down, Abbey addressed her team. “Seems to have slowed down. Get something to eat and rest for a bit. We’ll return in sixty-minutes or sooner if casualties needing surgical intervention arrive.”

  They were exiting the medical tent when a shell whistled into the area and exploded fifty-yards beyond the tent.

  Abbey flattened herself to the ground, copying the example of the others. A few minutes silence ensued.

  “Is it over?” Abbey asked.

  “I suspect so,” Sgt. Scharf said. He helped her to her feet.

  “Why would they fire at a medical tent?”

  He shrugged. “Not sure. The Confederates are good about respecting medical facilities; even trains with wounded. They most likely didn’t know what they were aiming at. I think it’s called probing.”

  Abbey held up her trembling hands. “The explosion shook me up almost as much as being lead surgeon.” She brushed off her clothing. “Wonder how many soldiers I killed today?”

  “Don’t be hard on yourself, Doctor. We always have patients die on the operating table. Some are just too torn up to ma
ke it.”

  “My mistake in not checking for an exit wound cost someone his life today. I always like to think there was more I could have done and there certainly was for that poor man.”

  The Sergeant moved directly in front of her and stared in her eyes. “Don’t kid yourself. There wasn’t anyone else in the tent who could have done what you accomplished.”

  She turned away briefly then said, “I appreciate your support…and assistance, Sergeant.”

  “Thank you, but it’s become part of my job since you’ve been training me.” He became pensive for a while then said, “Rumor is, this battle will be continuing.”

  * * *

  Dear Mom,

  It’s late August as I write this. The second Battle of Bull Run ended ten-hours-ago.

  Despite the lack of battle, the acrid scent of burned gunpowder still hangs in the muggy, hot air. Twelve-hours prior, I was sitting on a bench and leaning my exhausted body against a tree. I could barely lift my arms. After thirty-six- hours of surgery, I was desperate for sleep but knew, even as exhausted as I was, it wouldn’t come easily as my mind still functioned at the breakneck pace needed to devise surgical interventions for the seemingly endless stream of casualties.My right hand was, and is, sore when I flex it. The palm is red and still pulses from the exertion of gripping a bone saw while its teeth chatter their way through the bone of, yet another, soldier’s appendage. I can’t count the number of limbs I’ve removed from these brave young men. Prior to their loss of consciousness due to the chloroform anesthesia, they beseeched us to repair but not remove their torn appendages. At some point my dominant hand was cramping. I tried placing sutures with my other hand. It didn’t work.

  Like two boxers having savaged each other, the two armies retired to their corners to assess their own and their opponent’s damage before eventually re-engaging.

  I’ve learned, initially, most believed the Civil War would last but a few months. Governor Sam Houston of Texas, just before secessionists forced him from office, predicted a long and bloody struggle.

  Sadly, he was correct.

  We discovered two soldiers walking around aimlessly. They didn’t respond to questions but babbled unintelligibly. I suspect their emotional balance was altered after participating in numerous battles. We need to know more about what causes this. Any ideas?

  My ankles, knees and hips ache when I stand. I regularly arch forward to stretch my sore back muscles then rotate my shoulders. This helps relieve tension besides loosening my musculature.

  Before I forget, I’ve been told it may be difficult for the post office to find me if you send letters so don’t concern yourself with a reply.

  As I write this, just after dinner and outside my tent, I see a two-wheeled, covered cart rumbling toward our three medical tents. Two similar units trail it. A nurse has just examined the first wagon’s contents and is yelling for me… ironically, this is the same nurse I’d overheard speculating as to what type of woman could perform the removal of limb after limb with “an utter lack of emotion.”

  I’m needed.

  Love to all, Abbey

  Directives

  “Dr. Kaplan, this is my daughter, Talia. She’s fourteen,” Mrs. Warshawsky said with a proud grin.

  The doctor said, “Pleased to meet you.”

  Talia held out her right hand but kept her left in front of her mouth.

  “Let me examine that.”

  Talia was embarrassed but let Abbey examine her hare lip.

  “New techniques are discovered all the time. If I learn of a way to repair the opening, I’ll let you know.”

  “Please Lord, that should happen,” Mrs. Warshawsky said while stuffing Abbey’s laundry into a canvas bag.

  “Soon, I hope,” Talia whispered.

  * * *

  “Dr. Kaplan,” a young corporal called out. He was helping remove a man from an ambulance. “This one is pleading to talk to a surgeon.”

  Although sunny, the brisk air of a cool fall day whipped around them.

  Abbey, performing triage, approached the man’s stretcher as it was placed near the entrance to the medical tent. The man wore a large bandage on his left hand. His face was dirt- smudged and tear-streaked.

  “Are you a surgeon?” he asked. She nodded. “My name is Lawrence Solomon. Remove the contents of my left pocket. You must help me.”

  Abbey nodded at the corporal who removed a rag from the pocket, opened it and showed three fingers to Abbey.

  “You have to replace them,” the wounded soldier said. “I’ve spent my entire life studying piano. I need my fingers. You must re-attach them.”

  “I’m sorry. We’ll do the best we can so the rest of your hand can heal but we’re not able to re-attach fingers.”

  “My ability to share Bach and Mozart gives my life meaning. I have no head for business or technical pursuits. Music is the gift God gave me and playing piano is my gift to Him.”

  Abbey kneeled at his side and put an hand on his shoulder. “I’m sorry. You need to discover other ways to use your musical gift.”

  The soldier’s eyes filled with tears.

  Abbey noted his mezuzah. “You’re Jewish.”

  He nodded. Abbey showed him her mezuzah.

  The pianist pleaded, “You’re sure there’s nothing you can do?”

  “We’ll give you the best care possible but are unable to do what you ask.”

  His heart-rending sobs filled the air.

  On her way to the surgical tent, she encountered a soldier wearing captain’s bars sipping a cup of coffee. “I need a favor, Captain.”

  The warmly smiling officer stood. “Yes, Doctor Kaplan,” he said, after reading her name from her apron. “I’m Captain Ascari. How may I be of assistance?”

  “One of the casualties I’ll be working on shortly was a pianist. I used the word ‘was’ because he lost three fingers today.”

  “How tragic.”

  “If possible, can you send word to have a Jewish chaplain report to me? I believe it may help the soldier if he speaks to clergy.”

  “I’ll ask around, Doctor.”

  * * *

  “Dr. Kaplan, Thank you for asking for me.” He stood in line next to her while mess soldiers served coffee late the same day. The term bookish would have described the man who addressed her; short, on the chubby side, with thick lenses in his glasses which sat half way down his nose, his face surrounded by a dark, curly full beard.

  “You’re welcome, Rabbi. How was your conversation with Pvt. Solomon?”

  “Difficult. He mostly cried but we did recite a few prayers.” He gazed at Abbey for a while but then said. “You are a woman working in a sea of men in what is, considered by most, a man’s profession.”

  Abbey stiffened. “But more importantly, I’m a surgeon repairing a sea of wounded soldiers.”

  “Yes, of course. For certain you are.”

  Abbey motioned him to sit across from her at a mess table.

  He took a sip of dark brew. “If I may ask, what goals have you set for yourself?”

  “Become a skilled surgeon…and learn to exist in a man’s profession.”

  “How do you relate to your superiors?”

  “With difficulty. My immediate superior resents my gender, speaks to me disrespectfully, and continually reminds me I’ll be replaced soon.”

  The rabbi cleared his throat and said, “How do you manage such a difficult situation?”

  “I bury myself seven-days-a-week in medical work including research, reading and writing reports. Haven’t considered much else; although I try to light Shabbat candles on Friday night and Havdalah Saturday evening as long as I’m not performing surgery.”

  The Rabbi smiled. “What do those simple acts do for you?”

  “Reminds me of my family and allows me to feel a sense of home for a few minutes.”

  “That’s all?”

  “The light reminds me, as a Jew, I have a responsibility to use the gifts the Lord ga
ve me even if my environment tries to prevent their use.” Abbey thought for a while then added, “My spiritual self takes a beating on a regular basis.”

  “How so?”

  “I’ve been thrown into a wartime environment, where I must work at the limits of my, admittedly, beginner surgical ability while acquiring new techniques…all the while enduring daily reminders, most believe I should be home raising a family.”

  “You are a contract surgeon?”

  “Yes.”

  “You can leave.”

  “As a doctor…and a Jew…I have a responsibility to the wounded whether they approve of my gender or not. And my goal is to become an accomplished surgeon and learn as much practical knowledge about disease as I can.”

  Rabbi Schulman folded his hands and leaned toward her, saying in a quiet voice, “You’re putting immense pressure on yourself.”

  “My job and my future as an accomplished doctor require it.”

  “Your mental balance may suffer.”

  “How?”

  “Irrevocable sadness. Also depression, difficulty sleeping, becoming easily provoked.”

  “You’ve witnessed this?”

  “I served with the British during the Crimean War. Those with altered emotional state may also injure themselves or commit suicide.”

  “Injure themselves? Such as?”

  “Shooting themselves in the foot or hand, even shooting off a trigger finger…all to get out of combat.”

  “I’ve treated wounds that, I suspect, were self-inflicted.”

  “I believe you are to report them to your superiors.”

  “Yes, but I had no way to be sure.” Abbey became pensive, taking long sips of coffee then asked, “Did the British discover methods to treat injuries of the mind?”

  “None I’m aware of. A soldier’s altered mentality isn’t even considered a disease, let alone a treatable one.”

  “According to my chief surgeon, strong men don’t commit suicide.”