The Surgeon: A Civil War Story

by Schwartz, Richard Alan

  Abbey addressed Melissa. “You’re welcome to join us but I must warn you, they are likely still taking fire.”

  “How can I help?”

  The doctor smiled. “Bring your new pharmaceuticals. For now, we’ll help load the wagons. Lt. Scharf will provide the supplies and we’ll estimate how much we’ll need…Um…Melissa, this may involve combat. Are you certain…?”

  Her new friend interrupted. “We may encounter a sucking- chest-wound. Imagine what I could learn from observing your treatment…not to mention observing other procedures.”

  * * *

  Abbey introduced herself to the Connecticut regiment’s chief surgeon. “Thank you for coming, Dr. Kaplan. We need to split your team as my helpers were wiped out by shell-fire last night,” Major Carracciola said while shaking Abbey’s hand. He stood just outside the field hospital’s main tent. Rows of wounded needing surgical intervention were arrayed on stretchers and cots.

  They walked among the injured and performed triage.

  “It smells like defecation over here,” Melissa said.

  Abbey explained, “Some lose control of their bowels when grievously wounded or the odor could occur when their intestines are split.”

  The major asked, “Dr. Kaplan, I understand you’ve successfully treated abdominal wounds.”

  “Only some. If the wound is near the surface and hasn’t torn too much of the intestine plus I am convinced I will be able to find and ligate all the bleeders, I’ll attempt repair. We use instruments rinsed in chloride of lime solution and utilize clean, dissolving suture material to repair the wounds or they quickly become diseased.”

  She bent over, lifted a soldier’s shirt and gently pulled up his bandages. “This type of wound is worth attempting repair.”

  Dr. Carracciola peered at the injury. “Survival chance?”

  “Roughly fifty-fifty…as opposed to one-hundred-percent fatal.”

  Dr. Carracciola nodded.

  “We’ll do our best for you,” Abbey said to the gut-shot soldier who whispered thanks and did his best to smile through his pain.

  Abbey returned his smile then continued, “More damage than this and the patient will likely bleed out during surgery or soon after.”

  “Let’s begin with him and with your permission, I’ll assist,” he said.

  They entered the surgical tent.

  “Dr. Neal,” the chief surgeon called out to his assistant surgeon, “please start the next patient without me.”

  With a nod from Dr. Kaplan, Cpl. Silver administered chloroform to the gut-shot patient.

  Melissa stood next to Abbey while the doctor performed and described the procedure.

  “Thank you, Dr. Kaplan. Most informative.” The chief surgeon of the Connecticut regiment moved to his own table.

  An hour later, a high-pitched whistling sound could be heard.

  “Incoming,” Lt. Smith screamed.

  Melissa, wearing a puzzled expression, turned to Abbey. The doctor grabbed the pharmacist by the shoulders and roughly pushed her to the ground then flattened herself to the soil as well. A tremendous, “Whump,” occurred, followed by the ground seemingly jumping up and slapping their prostrate bodies. Melissa noted, the men had learned to lay on their bellies but kept their family jewels out of harm’s way by keeping their hips slightly above the soil.

  Another projectile whistled its arrival. It exploded near the first, showering the medical team and patients with dirt and debris.

  After the second explosion, a spinning piece of pie plate sized, jagged-edged, cast iron came whirring through the tent. One soldier ducked at the sound of the explosion but didn’t flatten himself to the ground. Melissa watched as the flying debris neatly sliced his head from his body as if cleaved by a cutlass. Blood spurted up from the neck of the headless body. The head rolled to a stop near her; eyes still open as if they could see her. The head belonged to Dr. Neal, the surgical assistant. She jammed her eyes shut and curled into a ball with her hands over her loudly-ringing-ears. More whistling and explosions occurred which, mercifully, exploded beyond the medical tents.

  After a few minutes without further cannon fire, they began to stand and assess the damage. One side of the tent was shredded as well as part of the roof.

  Abbey sat up then stood. She helped Melissa to her feet. The pharmacist sputtered, “His head…it was sliced right off.”

  “I’m going to need your help, Melissa.”

  “Help…?” She watched, wide-eyed, as two men respectfully placed the body and head on a stretcher and left the tent.

  Melissa wobbled slightly. “His severed head…it looked right at me…”

  Abbey steadied her then shook her by the shoulders.

  The pharmacist slowly shook her head. “I’m sorry, Dr. Kaplan but I’m not made for this.”

  “This is war and we do what is needed to save these soldiers. Therefore you’ll find the necessary strength and do, goddamn, what I tell you.”

  Melissa used both hands to briskly wipe her hair out of her face. “Yes…you manage the horror…” she swallowed hard “…so will I…” she stood tall and said, “We…save these men…I will, Dr. Abbey.”

  “Listen to me. Clear your head. My assistant will be working with Dr. Carracciola. I need you to assist me.”

  “Assist…,” the new acquaintance muttered in a quivering voice while her entire body trembled. She strained to remain standing tall. Melissa bowed her head and whispered, “I’m needed here, Jesus. Please give me strength that I might help these brave soldiers.”

  The doctors and their teams began treating those wounded in the tent. Medical helpers continued to remove the dead and stage the injured.

  Melissa followed Abbey as she evaluated the soldiers and helped bandage many.

  Abbey helped her into a surgical apron then directed her to rinse her hands in the bowl of cleaning solution.

  Dr. Kaplan yelled, “Next.”

  A soldier was placed on the table.

  “Cut open his clothing so we can see the damage,” Abbey directed her new assistant.

  The soldier’s foot was missing and his ankle was crushed. Abbey felt along his lower leg bones. “Crushed up to mid- calf. We’ll amputate just above.” Abbey demonstrated applying the tourniquet strap. “I’ll amputate just below this but leave a flap of skin from the lower section to close the wound. I need you to grip below the location of the amputation and gently pull down on the tissue, away from the cut I’m going to make.”

  Melissa put her shaking hands on the injured leg. “Oh no. It’s still warm…and it’s covered in sticky blood.”

  “Steady Melissa. This man needs our help.”

  Melissa nodded but continued to tremble as Abbey began a circumferential cut into the leg muscle. Melissa didn’t watch but felt the tissue she held moving slightly downward as Abbey sliced. A quick glance revealed only the bones attaching the upper and lower calf; the tissue she pulled on had moved away from the incision in a cone shape.

  Abbey put the bone saw to work.

  “I feel the vibration of the saw’s teeth,” Melissa whispered. “What an awful sensation.”

  A moment later and the severed limb was free.

  “Place it in the wheelbarrow,” Abbey said.

  Melissa didn’t move but stared at the bloody remains she held.

  “In the wheelbarrow behind us please, Melissa,” Abbey repeated in a louder voice.

  As if in a daze and still staring at the severed limb, the chemist turned and slowly walked to the wheelbarrow. She placed it on top of other previously severed arms, legs, hands, feet and fingers.

  “She’s going to vomit,” Cpl. Silver said.

  Sure enough, Melissa turned pale then wretched numerous times.

  Abbey used a tenaculum to pull arteries to the surface so she could tie them off then used a file to round and smooth the end of the bone. Last, she began suturing the flap to close the wound. She nodded to Cpl. Silver then indicated Melissa. The corporal
approached the chemist.

  He put a hand on her shoulder. “Happens to most their first surgeries, Ma’am. Don’t feel bad.”

  “Hoped I was stronger than this.”

  “You’re doing fine but Dr. Kaplan still needs your assistance.”

  Melissa took a few deep breaths then repositioned herself across the surgical table from Abbey. She straightened. “Ready, Dr. Kaplan.”

  Around midnight a number of children were brought in.

  “We’ll suture this laceration,” Abbey said, indicating a shoulder wound. “I need you to pull the tissue together while I sew.”

  “Yes Doctor,” Melissa said. She brought the edge of the child’s wound together, gritted her teeth and mumbled to herself, “I’m doing this. I won’t get sick. This child needs me. I refuse to get sick.”

  When she’d placed the last suture, Dr. Kaplan said, “Next,” then whispered to Melissa, “You’re doing great.”

  A soldier was placed on the table. His skin tone was blue.

  “Found a sucking-chest-wound as requested,” Cpl. Silver said. “We’ve kept him on his side per your instruction. He’s the last of the wounded for now.”

  Dr. Carracciola’s eyebrows went up. “You can treat a perforated chest?”

  “First time but with a new pharmaceutical, courtesy of Miss Morgenthau, who also brought me a description of the technique we need to implement,” Abbey said.

  “May I observe?”

  Abbey nodded. She kept her hand over the soldier’s chest opening, allowing better airflow to his lungs.

  Dr. Carracciola, Lt. Scharf and other members of the surgical team, all gathered around Abbey as she performed the new procedure with Melissa assisting.

  “The soldier’s skin color,” Dr. Carracciola said a few minutes later, “is steadily improving.” He turned to Abbey and Melissa. “Brilliant work by the female medical team.” He shook each of their hands but seemed to have a special smile for Melissa. “Miss Morgenthau, when can you supply me with collodion.”

  I have extra,” Melissa said, “but, if you’ll direct me to the communications tent, I will send a telegram to my company. You’ll have it within a day.”

  “As we’re done here and with your permission, I’ll take you myself.” He offered his arm.

  The following morning, Abby and Melissa walked around the men waiting for transportation to the Connecticut regiment’s recovery hospital.

  She encountered a man with a distorted face. His right-side cheekbone and a segment of his upper jaw had been ripped off but healed. The poor man was alive but left with a ghastly facial expression.

  He noticed their stares. “I can scare kids with this kisser.”

  Melissa whispered to Abbey, “I’ve read of surgery to replace bone with material used by dentists.”

  “As have I,” the doctor said. She turned to the soldier. “We know of a procedure which will attempt to replace some of the missing bone. Would you be willing to let us try?”

  “Hell yes, Ma’am.”

  “We’re going to take some measurements, then craft the missing bone and perform a surgical procedure to place it below your skin.”

  “Measure away,” he said.

  Abbey did while Melissa made notes of the measurements, then sketched a dimensioned drawing.

  With the assistance of a dentist, the twosome crafted the shaped material and fasteners then a discussion followed with how he used implants.

  The following day, Abbey led the surgical team with Dr. Carracciola assisting and guidance from the dentist. Melissa and Lt. Scharf made notes as the surgery progressed.

  “A tremendous bit of surgery,” Melissa said after the last bandage was applied. “But will it work?”

  * * *

  The following morning, back to her own unit, Abbey noted a tall, broad shouldered man of dark complexion and grey flecked hair waited at the medical tent next to a wagon pulled by two large mules. He wore overalls and held a wide brimmed sun hat which he nervously fingered. His hands were rough and callused. A young boy stood at his side. Four bushel-baskets, each covered with a cloth, were adjacent to the wagon.

  The man talked to a corporal then approached Abbey. “I’m Trent Booker, Ma’am. Got a truck farm a few miles up the road. That corporal said I should talk to a Dr. Kaplan. Word reached me, there’s a surgeon by that name from the 222nd Massachusetts who repairs hare lip.”

  “I’m Doctor Kaplan and I perform that procedure.”

  He seemed shocked. “You?”

  “If it’s a problem I’m female…”

  The tall man quickly interrupted. “No Ma’am! Just surprised.” With a twinkle in his eye, he added, “Hell… long as you can help my son, I wouldn’t really care if you was mule from the waist down.”

  Abbey chuckled and glanced at Melissa whose laughter filled the air.

  Mr. Booker asked, “You don’t mind working on folks like us?”

  Dr. Kaplan pointed to the soldiers waiting to be transported to the recovery area. “As you can see with your own eyes, we perform surgery on everyone needing it.”

  “Bless you, Doctor.” Mr. Booker put his hand on his son’s shoulder. “Matt is ten. Any chance you can help him?”

  “Let me see your lip, Matt.” Abbey ran her finger on his lip and examined the gums behind the lip. “I can repair this.”

  “Will it hurt?” the boy asked.

  “You’ll be asleep during the work I do. Afterward, the area will be sore for a few days. But if you and your dad follow the instructions I give you, your lip will heal just fine. Can you put up with pain for a few days?”

  The young man straightened and nodded. “Yes, Ma’am. I’ll manage.”

  “I have two-bushels of sweet potatoes and two-bushels of carrots for payment,” the man said.

  “Not necessary. The Army pays me. I’ll need an hour to perform the repair.”

  “Excuse me, Dr. Kaplan, but I pay my own way. Always have. I’m sure the soldiers ‘round here would enjoy these carrots and tubers.”

  “That’s most kind of you, Sir. I’m certain the men will appreciate your produce,” Dr. Kaplan said. She reached out and shook the farmer’s calloused hand. “Cpl. Silver, notify the mess sergeant then please assist Mr. Booker and get these provisions to the mess area.” She turned to the man’s son. “Matt, come with me,” then called to the father, “Mr. Booker, would you have basil leaves? I could use some for their medicinal qualities…upset stomachs and the like.”

  “I’ll gather a pound or so when I return to my farm…one more thing Dr. Kaplan. My niece just graduated from medical school. She’s going to setup a community practice in our town. Would you mind teaching her your hare lip technique?”

  Abbey thought for a moment. “I can teach her a number of techniques useful to a community doctor. If possible, have her here in two days at seven in the morning and tell her to bring enough clothing for a few day’s stay. I’ll schedule appropriate surgeries.”

  Another day later, Abbey walked Melissa to the train station.

  “It was proper of the mess sergeant to pay for Mr. Booker’s produce.”

  “All but one-bushel of carrots…which was declared payment for his son’s surgery.” Abbey giggled. “So if anyone asks the value of our surgical skills, you tell them we’re worth precisely one-bushel of carrots.”

  Melissa laughed then said, “How’s the bromine working?”

  “The inflamed area is obviously healing.”

  “What about the soldier with the implants?”

  “Much better. Not perfect but won’t scare anyone.”

  “Thank the Lord.”

  They walked in silence for a few minutes.

  Melissa seemed sullen. She sighed. “I feel like I’m leaving a sister behind…even though we’ve only known each other for a handful of days…a sister who’s going to be in grave danger.”

  “Such is the price of war. I knew what I was in for when I volunteered for this assignment.”

 
; “I don’t know how you manage.”

  “Our discussions on pharmaceuticals were most beneficial and your help with the surgeries was a Godsend. You should be proud of yourself. I’m sure it wasn’t easy.”

  “Truthfully, it was hell. Pure and simple, it was hell. Even now, I have many varied emotions swirling around which are empowered by ghastly visual and tactile memories. I’m certain the wounds those poor soldiers endured will haunt me for years to come.”

  “But you did it. You’re tougher than you previously thought…sister.”

  Melissa turned and briefly embraced Abbey. “At one point, I felt like I couldn’t go on. In my estimation, the only reason I found the inner fortitude, was the strength the Lord suddenly provided me.” She sighed and nodded. “It was a blessing meeting you, Abbey Kaplan. When I have research on new pharmaceuticals, I’ll write or send them with instructions on their use.”

  The loud hissing sound of the approaching train blowing down its boiler, shattered the air.

  Melissa smiled at Abbey and said, “Thank you for allowing me to work at your side. I’ll pray, sister, you remain safe and we’ll meet again.”

  “When we meet again, we’re going to work at gaining respect for the field of pharmaceuticals,” Abbey said. With a twinkle in her eye, she leaned toward Melissa and said in a quiet voice, “And getting women the vote.”

  Second Leave

  Abbey was spending the day examining soldiers at a nearby recovery hospital. She stopped at the bed of a patient whose head was wrapped in bandages. Only his face was exposed. He smiled at her, but only one side of his lips formed the smile.

  “He was my assistant surgeon.” An older man approached wearing captain’s insignia. “Walked out in the middle of an amputation, returned to his tent and shot himself in the head.”

  “Surprising he wasn’t killed.”

  “Poor aim. Dented the side of his skull though.” The older man held out his hand. “I’m Paul Brantley, chief surgeon of the 209th Ohio Infantry Regiment.”

  “Abbey Kaplan, assistant surgeon with the 222nd Massachusetts.”