A brief synopsis:
Dr. David Warner descends in a hospital elevator, and is transported in time to the Civil War, 1862.
In order to survive, he must gain the trust of Dr. Jebadiah Morgan, an old Civil War surgeon, who is as skeptical of David as he is intrigued. Demonstrating advanced surgical skills in difficult primitive conditions, he wins Dr. Morgan’s confidence and they soon become close friends.
David’s experience with such a brutal war is shocking and fearful. While in a desperate search to return home, David is thrust into the infamous Battle of Antietam. Overrun and greatly outnumbered, David reluctantly assumes command of his battalion and turns the tide of their capture.
Having narrowly avoided death at Antietam, David is forced into command once more: the Battle of Gettysburg. Alongside General George Armstrong Custer, the two develop and execute an ingenious plan to change the outcome of the battle and ultimately, the war.
As David nears the end of his journey, he is gravely wounded. With time running out, his survival depends on the future.
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Tear in Time
TT: Chapter 1
Alton Park region
June 8th, 2005
Life and destiny stood for one last moment, perfectly synced in time. Never again would the world see the past as they remembered, as one death would change the world’s destiny forever.
— — — — —
Trae Williams leaned to one side as he sat on his mother’s decrepit front porch and watched his sister play in their front yard. Lena Williams, an energetic eight-year-old, raced back and forth across the worn lawn as she chased after tiny moths that had hidden themselves on the blades of grass. With each swipe of her hand, she expertly snatched the tiny white targets out of midair, then released them back to the world safely.
“Oh yeah! Trae, did you see that?”Lenaasked proudly.
“Damn Le, you’re like a ninja or something,” Trae replied.
Beaming with pride,Lenareplied, “Too bad Mom can’t see my skills.”
“She’s working, Le. She’ll be home in a couple hours. Maybe you can show her then,” Trae answered.
“Mom’s always working,”Lenasaid disapprovingly, then added, “Too bad we don’t have a dad like Sharice’s, next door. Then Mom could stay home too.”
“Le, you do have a dad. He just don’t come around no more… and Sharice’s mom don’t work ’cause she’s lazy,” Trae replied as delicately as he knew how.
Lenastopped running and sat down next to Trae.
“Do you ever see your dad, Trae?”Lenaasked sincerely.
“Not for a long time. Not since before he went to prison. That was before you were born,” Trae replied.
“Oh,”Lenasaid simply. “Do you miss ’im?”
“Nah. He wasn’t around much, even before he got sent up,” Trae answered.
“Well, I miss my dad,”Lenareplied.
“Damn, Le, you never even seen ’im before. How could you even miss ’im?” Trae blurted out in quick reaction.
“I just do, Trae… I’m sure he misses me too,”Lenareplied.
Trae knew his sister was hurting from her father’s rejection. Hoping to take her mind off her pain, he searched for anything to distract her.
“Hey, Le: check out those moths over by the street. Bet you can’t catch ‘em all,” Trae said, with a challenging smirk.
“Bet I can,”Lenareplied, laughing.
Immediately,Lenasprang to her feet and darted to the edge of the road, both hands sweeping through the air as she lunged for more moths.
Trae watched her for a moment, then became distracted as an older Buick with faded paint slowly drifted toward the stop sign at the beginning of their street. Unremarkable at first, the long length of time spent at the stop sign made the old sedan a conspicuous sight.
Trae focused more of his attention on the car. Something just wasn’t right. He squinted hard as he tried to see through the darkened, tinted windows, but it was of no use. The occupants remained a mystery.
Trae began to feel uneasy. The old Buick was literally parked at the stop sign for what now felt like an eternity. He glanced over toLena, then back at the suspicious car. A knot in the pit of his stomach began to grow.
“Le, come here for a minute,” Trae said in nervous tone.
“Just a minute, Trae. I almost caught ‘em all,”Lenareplied, indifferent to the world around her.
Trae saw the brakes release from the old Buick, then quickly stop again, almost as if by accident. He looked up the street to see if the vehicle had intended on pulling out but reconsidered due to another passing car. Strangely, there were no other vehicles in sight.
“Lena, come here,” Trae said.
Hearing Trae use her full name,Lenastopped and stared at her brother for a moment. She could see the peculiar look spread across his face as he turned back toward the mysterious Buick.
“Trae, what’s the matter?”Lenaasked innocently.
“Dunno. That car’s been there a while. Maybe you should go in the house for a minute,” Trae replied, now feeling the anxiety of the moment.
“Ahhh,”Lenasounded out in protest. “I don’t want to go inside. It’s just a car, Trae. Besides, I can take care of myself,”Lenastated proudly.
“Uh huh, sure you can… just get in the house,” Trae responded bluntly.
“Just one more m.…”Lenabegan, but was cut short by the revving of the Buick’s engine.
“LENA, GET IN THE DAMN HOUSE NOW!” Trae shouted loudly.
Suddenly, aggressively, the old Buick released its brakes and stormed around the corner. With tires squealing and smoke billowing from behind the car, the old sedan charged up the street toward them.
“Oh no,” Trae murmured to himself, almost in sobbing tone.
With little time to react, Trae sprang to his feet and hurried toward his sister.Lenastood paralyzed in confusion. She knew something was wrong, but was too young and naive to fully understand Trae’s actions.
Trae watched in horror as the Buick’s dark tinted windows began to lower. In seconds, his worst fears were realized as the occupants extended their guns out from the windows. With deafening sound, their automatic weapons came to life.
As bolts of white light streaked from the ends of the gun barrels, Trae lunged forLena, knocking her to the ground. He instinctively rolled on top of her to protect her as a hail of bullets tore up the ground around them. As the faded Buick roared past, Trae andLenalay motionless on the front lawn, their minds and bodies unable to react.
As time seemed to slow, Trae could almost count the bullets as they exited the guns. One by one, each bullet miraculously missed it mark. Trae looked into his sister’s eyes. She had not been hit. Suddenly, he realized they both were alive and had made it through the drive-by shooting.
Quickly, Trae leapt to his feet, pullingLenaup with him. The sight of the two still alive spread quickly to the driver of the car. In an instant, he slammed on his brakes and brought the old Buick to a quick halt. Throwing it in reverse, he immediately roared backward down the street toward Trae andLena. Seconds later, the driver slammed on the brakes once more and brought the heavy vehicle to a quick stop.
Trae grabbedLenaaround the waist and sprang from the edge of the road. Like the stride of a gazelle, he bounded across the front lawn with amazing speed and agility, his adrenaline pumping at full capacity.
As the faded Buick came to a stop, all its doors were flung open and four young men exited the vehicle quickly. With their guns still drawn, they wasted no time in continuing their task. Trae leaped to the top step of his front porch and felt a sharp razor-like object strike his left side. Before the first bullet could even register, a second bullet struck him in the right shoulder, rendering his arm useless. Instantly,Lenadropped onto the porch, Trae collapsing beside her.
An eerie quiet spread over the neighborhood as the four thugs reloaded. Knowing this was their only hope of survival, Trae crawled to the front door and tried to wrap his fingers around the lower corner. With his hand covered in blood, they slipped off the edge of the door.
“Le, get in the house… stay low,” Trae ordered.
Lena, scared and crying, lay beside her brother, unable to move.
“Lena, get moving NOW!” Trae shouted.
“I’ll block you. Go now… hurry up!” Trae assured confidently.
Nodding reluctantly,Lenaquickly stood up and pulled the front door open as Trae moved to shield her from the four men nearby. Instantly, a roar of bullets unleashed a swath of destruction across the front of the house, breaking windows and knocking shingles from the siding. AsLenabegan to enter the house, another bullet entered Trae’s lower back, knocking him forward against the door, closing it momentarily acrossLena’s body. Trae rolled to his side and dropped down onto the deck of the porch once more.
“TRAE!”Lenacried out in fear and disbelief.
“Lena, get inside. GO, NOW!” Trae said, his voice now barely audible.
“No, I can help you,”Lenareplied with determination.
Before Trae could protest,Lenareached down and grabbed him by his shirt. She pulled with all her might as Trae pushed with his feet. Suddenly,Lenaexhaled abruptly and sounded a guttural moan, as a bullet struck her in the chest. Immediately, she slumped to the ground, then rolled over on top of Trae.
With both victims down, the four thugs ran back to the waiting car and sped off. Once again, an eerie quiet swept over the neighborhood as the neighbors, one by one, ventured out into the warzone.
Further south, alongSignalMountain, Dr. Phineas Morgan stood on his wooden deck. Perched high above the valley floor, he stared out toward northernChattanoogaand tried to shut out the images of carnage that had just taken place. From his location a few miles away, he could not see the muzzle flashes, nor did he hear the gunshots; but strangely, he knew exactly where the shots were fired and who they were fired upon.
Sadly, he checked his watch:10:30am.
In a moment of solemn respect, he uttered a few simple words, “Forgive meLena. Your death will save thousands.”
Turning away, he stared out over the city and spoke. “The dominoes of destiny are now tumbling… Godspeed, David.”
T T: Chapter 2
June 7, 1862 – 8:30am
TheTennessee Riverquietly flowed south and west as it made its way pastMissionary Ridge, toward the city ofChattanooga. The April rains were now a month past and the wild and raging torrent that threatened to breech the swollen banks was now a gentle lazy river that quietly meandered its way through the valley. The muddy water that had angrily lapped the river’s banks receded some, leaving heavy, waterlogged brush and debris drying in the morning sunshine. Soft and tranquil, the water trickled past the fallen branches that scraped the surface of the river, catching any unsuspecting object that dared to tempt its grasp.
Flowing placidly south into the city, the river touched the edge of civilization, then abruptly changed course and headed north, pastSignalMountain. Several miles later, changing course once more, it looped around the mountain and continued its previous direction south, carrying with it the tiny bits and fragments of an industrialized city hard at work.
Sitting patiently on an elevated boulder, a young boy hung his makeshift fishing pole over the water in an attempt to catch his breakfast. Looking toward the city, he could see the tall smoke stacks that emitted the evidence of men toiling at work. A light, gentle breeze blew across the valley of high plains grasses, carrying with it the fragrance of fresh cut hay and wildflowers. The breeze brushed past his face, filling his tiny nostrils with the scent of nature, and sending warm contentment throughout his body as the sun shined down upon him. He reveled in his independence as he envisioned other boys suffering through school while he enjoyed his day of truancy.
Further up river, leaving the city limits, a raft made from hastily hewn logs of birch were haphazardly strung together with cord and vine, creating an unstable, yet functional mode of travel. Dirty and bedraggled, the two aged trappers floated downstream, extending into the water, long poles made from pine saplings, skillfully placed to navigate the many bends in the river on the way to their next destination.
Inside the city limits, at the sharpest bend in the river, a small force of Confederates guarded the main dock and prepared to unload supplies. In the morning sun, under the direction of the regimental captain, the men formed a human chain that led from boat to horse-drawn wagons. Hand over hand, they passed the goods and ammunition from one soldier to the next in sequence, until the final soldier arranged and stacked the supplies neatly in the back of the wagon. At this hour of the day, the sun sat lower in the cloudless sky, warming the temperatures to a comfortable seventy degrees. If it were not for their thankless duty to task, the soldiers would normally have enjoyed the balmy climate. As it was, their heavy labor created torrents of salty sweat that streamed down their faces, and soaked through their cotton shirts and heavy gray uniforms. When the wagon had been completely filled, the driver snapped the reins to the team of horses and started off to their encampment, whereupon the next driver in line took his place for loading.
Beyond the dock, a local merchant swept off the elevated wooden walkway in front of his General Store. A small cloud of dust rose in the air as he briskly cleared away the caked mud that had collected between the wide spacing of the wooden boards that ran the length of the street. At the rear entrance, a young man helped load heavy sacks and other supplies into a waiting wagon to be delivered to a local resident.
Further up the boardwalk, the blacksmith and livery were hard at work, attending to the needs of the community as well as those of the Confederate officers that had entrusted their belongings to their care.
At the center of the industrious town, off the open green, the one room schoolhouse bustled with activity and the sound of children’s voices, as they recited passages pulled from the important authors of the day, such as Twain, Thoreau, Dickens and Blake, each child’s voice as distinctive as the passage they read.
Beyond the main thoroughfare, on the secondary and tertiary roads, tiny houses dotted the roads leading out of town. Hung on public display, tiny diapers, socks, shirts, dresses and other freshly washed articles of clothing were draped over the makeshift clotheslines and pinned in place with wedges of wood, and allowed to dry in the brilliant sunshine as the matron of the home moved through her chores of the day.
This day began as any other day: monotonous and routine, men, women and children alike, functioning in their singular importance while contributing to the whole of their society. Unsuspecting and mostly indifferent to the violent world beyond their borders, they went about their lives, contented in their own daily struggles.
— — — — —
On the opposite side of the river, hidden in the dense thicket and underbrush, several companies of Union sharpshooters lay in wait. Quietly and undetected, they had moved to the river’s edge, sneaking in under the protection of darkness. Perfectly concealed, they laid on their stomachs and waited for their signal. They watched in anxious fascination as the Confederates on the opposite side of the river worked to unload their delivered supplies. With their rifles aimed at their targets, they whiled away the time by calculating windage and elevation. Time seemed to slow as they waited on their signal of death. At two hundred yards away, they were well aware of their ability to hit their mark. Spread out shoulder to shoulder, they presented a menacing sight.
The wait seemed to go on forever. Shifting their weight from side to side, they tried to alleviate their discomfort. As their arms and legs fell asleep, they shook them out, recirculating the blood through their extremities, gaining the feeling in their hands and feet once again. For an unlucky few, insects presented more of a distraction than the lack of feeling in their limbs. With regularity, ants returning to their nest would find their passage blocked by the hulking mass in blue. Upon investigation, the ants angrily attacked any bare skin, biting and pinching in a futile attempt to drive away the enemy. Their feeble assault was met with equal aggression as the soldier swatted and crushed his irritating attackers.
Time was their enemy. Waiting quietly in the underbrush, each soldier pondered his own fate. Any attempt to push the morbidity from their minds proved fruitless, as they watched the enemy in their sights, reminding them again of the possibility of their own forthcoming violent death. Searching for solace, they turned to their companions, whispering inquiries about families and future. In return, they received warm reassurance as the sound of their comrade’s whisper helped to sooth their deep worry. Having sat through the bite of cold as they crawled in under darkness, hunger pangs from lack of food, and the contemplation of death, the Union volunteers of the 79thPennsylvaniawere ready and determined to complete their task.
Up in the foothills, away from the edge of the river, the Union artillery waited on their orders from Gen. James Negley. High on his horse, barrel-chested and confident, he posed an impressive figure. He sat pensively and observed the scene below. Lifting his spyglass to his eye, he continued to look for weakness and opportunity. With an authoritative voice, he redirected cannons down the line to specific targets as he developed his impromptu battle plan.
As the Union soldiers manned their stations of artillery, they looked out over the valley at the Confederate soldiers drilling in formation in an open field far on the opposite side of the river. Several cannons were already directed toward them, but with a quick nod of his head, Gen. Negley ordered additional cannon support on that location. Feeling somewhat detached from the Confederates’ impending doom, they obeyed their orders and indifferently aimed the deadly weapons at the center of the field.
Standing by their designated cannon, each soldier mentally prepared himself for the battle. At their elevated position, and protected by the river, they all felt relatively safe: that is, safer than their comrades below by the river. They had survived the previous year’s battles, and were well seasoned in their trade. They knew there would be casualties, but felt relatively sure that with the element of surprise, the battle would be fairly one-sided. They looked down at their comrades who had crept up to the river’s edge just before dawn. A sense of sadness and anxiety come over them, knowing they were in harm’s way. Any retaliation by rebel forces would start with them. Well-hidden in the thickets, the Confederate soldiers would have a tough time distinguishing the exact locations of each Union soldier. The Confederates would hear the sound of the Union rifles and fire in that direction. Most of the boys in blue would be lucky, and escape the wild and harried volleys of lead. Some would not.
The previous day, June 6th, Dr. Jeb Morgan prepared one of the supply wagons as a makeshift operating table in preparation for the impending battle. As a commissioned medical officer in the regular Union army, he held the rank of Captain. Serving in the military for most of his life, he was no stranger to the horrors that warfare could bring. His battlefield experience was extensive, having served in the Mexican-American War of 1846-1848, various Indian campaigns, and now the War Between the States.
Dr. Morgan was a short, stout, older man of sixty, with a full head of white hair, a long, white, flowing beard, and piercing blue eyes. Having dodged Mexican bullets and fought hand to hand with Indians, he possessed an inner strength and courage, as well as intelligence, that were uncommon for most, distinguishing himself for his skill with a firearm as well as a scalpel. Recognized for his abilities, he had been offered lofty positions at comfortable hospitals of his choosing, yet rejected the honor, preferring instead to remain in the field, saving a greater number of lives; much to his superior’s dismay.
Far behind the Union front line, the doctor had searched for a suitable location to operate. In a protected grove of birch trees, he found a large flat area with lush green grass. As the principal surgeon for the brigade, it was his job to ensure a site that was far enough from the action to allow for undistracted work, yet close enough to the front lines for quick evacuation and treatment. Ordinarily, Dr. Morgan preferred the protected confines of houses and barns, commandeered from private citizens at the onset of battle. With the battle forChattanoogastarted from a location far removed from civilization in order to preserve the element of surprise, the wooded clearing would have to suffice.
The previous day, while Gen. Negley prepared his battle plan, Dr. Morgan scoured the foothills nearSignalMountainon horseback. As he rode up through the rolling terrain, the trees and vegetation became less dense, allowing him to catch glimpses of the city. Leveling off, he rode through the forest of white birch, weaving a path around the denser areas until he found the clearing. Immediately, he recognized the qualities of the find. He deduced the small field would allow for bright light to operate by, and the trees at the clearing’s edge would provide comfortable shade to the wounded as they recovered. It wasn’t perfect, but he felt he had worked in worse conditions while fighting in the west. This would certainly be more tolerable – as long as the good weather held.
After locating the medical encampment, Dr. Morgan quickly summoned a wagon to be used as an operating gurney and prepared his instruments. With the canopy removed, he neatly arranged his supplies on the right side, along the length of the wooden side-bracing. Within arm’s reach, he placed his instruments first; a basin and canteen of water next; then cotton batting and other bandages last. At the head of the wagon, he arranged the necessary supplies for the assistant, such as chloroform, bandages, and morphine in powder form, as well as opium as an analgesic. With the preparation for surgeries in place, he rejoined the front lines, offering his assistance where he could, leaving an assistant to watch over their makeshift hospital in his absence.
The following day, June seventh – the day of the battle – Dr. Morgan woke early after a restful night’s sleep under one of the many cannons aimed at the city. He was offered a tent for accommodation, but declined special privilege, electing to ‘rough it’ under a cannon instead of putting others out. A selfless man, he figured the boys that were fighting and dying should at least be granted the small pleasure of the comfort of a tent. After years of adapting to the rigors of warfare, he learned to sleep wherever he laid his head.
The dawn of the new morning created cool dew that had soaked through the unprotected parts of his body, mainly his legs and boots, producing mild discomfort. By8:30am, his clothing had dried out completely and he focused on his duties of the day. Filling up on hardtack, a hard, flavorless cracker, and some water, he administered various remedies to the soldiers that had reported for sick call while he ate.
Of the thirteen men reporting various symptoms, only one was deemed incapacitated. Suffering from acute dysentery, he was given a mixture of quinine and Dover’s powder, and sent to the medical encampment for recovery. Dr. Morgan was a compassionate and sympathetic older man, but tough nonetheless. His private philosophy was, “If you can walk, you can fight.”
With his duties accomplished for the moment, Gen. Negley ordered Dr. Morgan to ‘his station’ with a reverent nod. No words were exchanged. They both were seasoned military men who understood each other implicitly. With a respectful salute, the doctor turned and walked past the soldiers readying themselves at their own stations. He could now see the woeful anxiety on their faces as he made his way past, and he flashed them a courteous smile, trying to ease their worry. Locating his horse, a dark brown Canadian Stallion called Bill, named for an old friend that had died at the hands of an Indian ambush years before, he mounted the saddle, adjusted his boots in the stirrups, and with a quick snap of the reins, turned and rode off toward safety.
— — — — —
With his sword lifted to an exalted position above his head, Gen. Negley roared the order to commence firing. Loud and with great authority, he repeated his simple command over and over as he rode up the line. Instantly, his men responded and lit the fuses to their cannons. Like violent demons, the cannons came to life as they reported with a thunderous roar, shaking the ground under them.
Instantly, the fresh and clear morning air became a heavy cloud of smoke that stung their eyes and seared their nostrils with the foul stench of sulfur, as the powder quickly burned and discharged through the breech of the cannon. The deafening cacophony of cannon and soldier startled the birds and jarred other wildlife from their morning routine, instinctively sending them scrambling for cover.
The well-trained soldiers began their work. In groups of three, one loaded the powder and wadding, one loaded the shell or heavy ball, and the third lit the charge. They were as a machine, working in perfect sequence and timing to efficiently deliver unto the enemy, their deadly payload.
Whistling through the air, the shells and cannonballs picked up particulates of dust and small flying insects as they arced across the valley towardChattanooga, killing anything in their path before reaching their final destination.
The valley below became awake. The loud cannon fire from above signaled the sharpshooters below to unleash their own deadly volley of destruction. In reflex, they pulled their triggers and sent the tiny, yet deadly pieces of lead on their individual paths of doom, as they quickly reloaded their weapons with practiced speed.
They had only a second to think. With a startled jolt, the town and the Confederate soldiers both stood in place as their minds tried to quickly process the disbelief of their forthcoming death. Unable to move, they heard the whistle of air as the projectiles hurled toward them. Those with their backs to the volley waited and listened as the whistle grew quickly louder, into a thunderous rush of air. Those facing the volley watched in disbelief as they quickly trained their eyes on the direction of sound, watching the heavy ball and tiny bullets disrupt the air in front of them just before impact.
As fate and misfortune collided, so did shell and flesh. In the group of drilling Confederate soldiers, the first volley hit its mark with deadly accuracy. One unlucky private watched in horror as a shell found its mark in the chest of the unlucky companion marching in front of him. The shell tore through his uniform, flesh and ribcage, instantly killing him even before the shell’s internal mechanisms sensed the pressure of impact. With a great explosion, the canister fragmented into thousands of tiny projectiles, completely disintegrating the whole of the soldier’s existence. There would be no burial for him, as there was not a remnant left of his body.
Continuing on their way, the fragments of the now exploded shell found their next victim in the watching soldier. As the hot pieces of metal tore through his body, it severed his extremities, as well as buried molten metal into his own chest. Deflected, yet still deadly, the fragments found other victims all around the location of impact, sending blood, torn limbs and other shredded body parts into their fellow soldiers. For a lucky few who escaped the initial impact, the concussion from the shockwave of the explosion ruptured their eardrums, disorienting them and rendering them useless. As other shells exploded into and around the stunned, helpless soldiers, the same gory results affected the devastating loss of the entire company.
Along the waterfront, the Confederate soldiers that were unloading supplies met with the same fate as their drilling comrades. Shells fell around them, exploding into thousands of fragments and tearing through their bodies, killing the closest to impact while maiming and impairing others further away from the epicenter. Cries of agony could be heard as they fell.
As the Union sharpshooters unleashed their hail of shot, balls of lead sailed through the air with an awful shrill, telegraphing their intentions. The bullets found their mark, tearing through gray cloth, violently ripping through flesh and bone, and creating large, gaping wounds for germs and disease to enter the body unrestricted. Collapsing to the ground, many screamed out in agony, clutching their bleeding wounds in a desperate attempt to relieve the pain as death quickly overcame them. Others lay in torment as hypovolemic shock quickly enveloped their bodies from the loss of blood.
All around the city, that first barrage of munitions inflicted devastating damage. Not only was the Confederate encampment targeted: loading docks on the river, telegraph offices, livery stables and blacksmith shops were also targeted. Anything that could be used to further the Confederates’ cause was targeted in the first volley of Union fire.
Within seconds of the first discharge from the Union rifles and cannons, another round quickly sounded, followed by a third and fourth volley. The murderous fire seemed unrepulsed at first, but slowly, the Confederate soldiers that had not been wounded, and others that had not been targeted withdrew and regrouped to form a defensive line at various points around the city.
With determined anger, positioned behind a breastwork of wagons and supplies, a band of Confederates located both sources of gunfire coming from the opposite side of the river and higher up in the foothills, and unleashed their first of many volleys of retaliation and repel.
As Union soldiers lay on their stomachs and reloaded, they heard the sound of lead crashing through the branches and thickets above them as the Confederates searched for their targets by trial and error. With the next round by the Union sharpshooters, more Confederates lay dead and wounded, but with this volley came a pinpointing of the Unions’ exact positions. With orders to aim low, the Confederates returned fire into the lower banks of the river. Cries of pain and agony testified to the Confederates’ skill, as several Union soldiers now lay dead and permanently maimed, slowly reducing their effective force. Just as with the Confederates, the Union soldiers now were on the defensive, and scrambled for a moment, regrouping into a smaller fighting force.
Unbeknownst to the Union command, out beyond the city limits, the Confederates loaded several cannons. Tucked away in a grove of tall oaks for protection from the elements, they were easily missed by their opposing force. Quickly, the three-man teams loaded their cannons and took careful aim at the Union battery. With the command to fire at will, the Confederates opened up on the Union forces staged in the foothills ofSignalMountain.
With visibility drastically reduced by the repeated cannon fire, the Union forces struggled to see targets. By the time the Union artillery brigade saw the heavy smoke from the Confederate volley, it was too late. As the scream of the fragmentation canisters telegraphed their arrival, the Union soldiers could only stand and watch in horror as the tiny projectiles grew larger in their vision, the speed leaving them little else to do but stand and watch their impending death.
The first of the four canisters roared into camp and impacted the ground between two cannon batteries, immediately exploding into tiny shards of twisted and molten metal. Instantly, the thousands of fragments traveled from the point of impact and found the first of their victims in the two Union soldiers that stood between the two cannons. Within a blink of an eye, their bodies absorbed most of the fragments, nearly obliterating any proof of their existence. Blood and bone splattered the two cannons in a characteristically horrific pattern of death and destruction. As the fragments deflected and ricocheted off objects human and metallic, their destruction was devastating, in all, killing and maiming nine Union soldiers.
A split second later, two more canisters roared in after the first, these two impacting the bluff just below theUnion’s cannoning. Although the projectiles embedded in the earth and exploded, their destructive intention would not be denied. The soil heaved and broke apart, sending large amounts of fast-moving granules of dirt and pebbles toward the Union battery, ripping into flesh, maiming several Union men hard at work, the force knocking them to the ground in agonizing pain.
The last canister rocketed over the heads of the Union soldiers and hit a birch tree high up in its trunk, exploding and instantly amputating its upper half from the lower. The crash of the tree as it hit the ground went unnoticed as the Union forces turned their destructive force onto the cloud of Confederate smoke far out beyondChattanooga.
With a wave of his sword, Gen. Negley bellowed the order to silence the cannons at the far edge of town. Quickly, the teams of three jockeyed their cannons toward the fading Confederate smoke, calculated the angle of trajectory, and lit their charges. The repositioned cannons came to life as their muzzles spewed fire, smoke, and metallic death, the recoil sending them reeling backward against their restraints. Seconds later, far out beyond the city proper, primary explosions could be seen as the shells hit their targets, followed by several secondary explosions, signaling the destruction of enemy ammo caches that had ignited as a result of the primary detonation.
Violently jolted from his lazy stare up river, the young boy sitting on the elevated boulder fishing for his breakfast nearly fell into the water in reflex to the loud explosions. He quickly gathered his things and jumped from rock to rock, desperately fleeing for cover. Still at the bank of the river, he found two large boulders to hide behind, giving him safe cover during the violent exchange.
Closer to the action, the two bedraggled trappers, upon hearing the deafening explosions that were killing their countrymen, quickly deduced that their only safe escape was to continue their poling down river. Any attempt to make land might expose them as combatants and draw fire from either side. They grabbed their poles even harder and strained to push the tiny raft faster down river. Hand over hand, they pushed on the flimsy poles, nearly breaking them as they rushed to evade harm’s way. Painful blisters formed and quickly broke, leaving fresh blood along the length of the poles as they continued to push for their lives.
Standing on the left side of the raft, without warning, a single stray bullet whistled through the air and impacted the back of the first trapper’s head. The lead ball mushroomed and shattered his skull, propelling bone, brain and blood down the front of his tattered clothes and into the river. Instantly, he fell overboard and floated downstream.
In shock from witnessing the death of his companion, the remaining trapper cried out in anguish as he helplessly watched his friend floating away, trailing behind him a path of red water. Reality snapped him back into focus as another bullet embedded into one of the logs of the raft, fracturing it and sending tiny splinters into the water. He looked back at the pelts of beaver and muskrat he and his now deceased friend had toiled over for the previous two months. He hesitated for a moment, then grabbed a handful of beaver pelts, his rifle, and a tiny strongbox of money, then quickly jumped into the water. Struggling to stay afloat with the weight of the rifle, he kicked his boots wildly under the water. As his head dipped below the surface, he was about to let go of the rifle when his feet touched bottom. He pushed off the muddy floor of the river and popped his head above the water, took a gasp of air and sunk below the water again. Finding the bottom of the river once more, he launched his waterlogged body above the surface and gasped for another breath of air. As he sank back into the water, his head now was above the water line. He had managed to move close enough to shore to now wade toward land with his handful of belongings safe.
Spotting a large boulder at the river’s edge, he made his way toward it, keeping his head mostly submerged for cover. At the boulder, he threw his pelts and strongbox onto higher ground and positioned his rifle for defense. With the powder wet and useless, he still aimed his weapon, hoping he would not be called on to bluff.
Shaking and scared, the young boy huddled close to the rock, having just witnessed the drama of the trappers unfold further upriver. At the tender age of seven, he had never seen a man killed before, and the sight of the old trapper’s violent death shook him to his core. His world had changed in an instant, the graphic vision imprinted in his memory forever. He openly wept as he watched the remains of the old man drift slowly downstream past him.
Union Corporal Amol Fletcher, part of a three-man team assigned to artillery, had been standing at his post when the first of the four Confederate shells exploded. Fighting two cannons away, the blast sent shrapnel through his team, decapitating one private and missing the other, while he himself took a large fragment to his lower leg, nearly severing his calf from the bone. Instantly, he dropped to the ground in agony. As he cried out in pain, he clutched the dangling flesh, irrationally trying to reattach it to the bone. In his delirium, his world seemed to slow. No one noticed him as he lay sprawled on the ground between the cannons. As bullets passed over his head, he heard their whistle, and for a moment forgot about his injury as a sense of self-preservation overtook him. He rolled on his belly and began to crawl. Pulling with his arms and pushing with his uninjured leg, he slowly worked his way through cannon and soldier, dragging a trail of blood behind him.
As hypovolemic shock began to develop from the loss of blood, the pain from his gaping wound became less noticeable. He moved faster and with more determination. Suddenly, a soldier lay in his path, face down. Corporal Fletcher grabbed his shoulder to roll him over as he felt the sting of hot lead graze his forearm and impact the back of the soldier’s head. Instantly, the soldier’s skull exploded, covering Corporal Fletcher’s face with blood, bits of brain and bone. He jerked away in reflex and cried out in fear, only to feel the mind-numbing pain of his own injury. As fear enveloped him further, he quickly crawled around the deceased soldier and continued on his path.
Up ahead, several yards away, he spotted a boulder for protection. Fear and anxiety coursed through his veins as he struggled to stay alive. Desperately, deliberately, he stretched his hands out in front of him, clawing at anything he could use to further his escape. As he crawled, the elevation dropped off slightly, allowing him more protection from the bullets passing above. With grass and mud embedded in his fingernails, he reached the larger boulder and pulled himself around it to safety.
Lying on his stomach, he rolled over and sat up against the smooth granite rock. He heard the sound of bullets ricocheting off the boulder and deflecting into the trees around him as he instinctively ducked from the sound. With his adrenaline pumping, he reached down to his grass- and dirt-stained shirt and ripped off a strip from its bottom edge. Taking the strip in both hands, he lifted the hanging flesh and secured it to the bone with the cloth, tying a loose knot to hold his calf in place as the pain caused him to scream in reflex.
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.
Corporal Fletcher, in his grave state, 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 hisElginpocket watch. He pressed the tiny button of the gold timepiece and popped the cover, exposing the hands of time.
“Huh, only10:30,” 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. Atfirst 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 private laying at the bottom of the wagon between the two gurneys. The young private 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 amputating 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, he 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 and 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 aggressively saw 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 looking on in fascination.
When he was done suturing, he 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 assistance, 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, then 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 laid down on their cots and fell quickly asleep.
TT: Chapter 3
June 8th, 2005
ElangerHospitalwas a bustling modern hospital with four branches spread out on each side of the city ofChattanooga; north, south, east, west, and one at the center of the city, accounting for five in total. Regarded as a teaching hospital, they developed and performed the latest cutting-edge medical techniques, producing some of the finest medical staff in the country; although all too often the advancements came as a result of the gang-related violence that erupted within the inner city, many times catching the innocent in its crossfire.
Dr. David Warner burst through the swinging wooden double-doors and headed to the scrub station.
“Ok, what do we have?” he asked as he turned on the water and pulled on the soap dispenser, releasing a large dollop into his hands. Vigorously he scrubbed from his fingertips to his elbows as he listened to his supporting staff inform him of the emergency.
“Doctor, we have a gunshot victim with an entry and exit wound between the seventh and eighth rib, entry through the abdomen. Her belly’s distended, must be filling up with blood. Her vitals are low, about eighty-five over sixty. Her Foley output is bright red and she’s hypovolemic from the blood loss. Triage has intubated her and already infused 2 liters of plasma,” replied surgical resident Kerry Stadler, as he too scrubbed in for emergency surgery.
“So she’s prepped?” Dr. Warner asked.
“Yes, doctor. Prepped and ready,” Dr Stadler replied.
“Films?” Dr. Warner asked in abbreviated speech, a function of his occupation.
Before he could receive an answer, surgical nurse Jill Edwards burst through the door. Pulling her mask from her face, she anxiously reported, “Doctors, you’d better hurry. Her vitals are dropping fast. BP is eighty over fifty-five, pulse ox is eighty-five.”
Without hesitation, Dr. Warner quickly responded, “Gloves and gown, now! And set up a thoracotomy tray, along with a laporatomy just in case.”
Both doctors washed the soap from their hands and arms quickly as the pressure and anxiety of the situation worsened.
“Should we get an ultrasound in here?” Dr. Stadler asked as he started to tie his gown.
“Yes, STAT!” Dr. Warner replied urgently.
As the two doctors quickly donned their attire, Nurse Edwards pulled on her protective mask and rushed back into the OR to prep the ultrasound equipment and set up the thoracotomy tray.
Moving through the double doors, Dr Warner heard the sounds of alarms as the medical equipment coldly reported a patient in crisis. He scanned the various devices as the patient’s levels continued to drop into the danger zone.
As he rushed to the patient’s side, Dr. Warner’s eyes widen in disbelief as he realized the age of the tiny victim. “My god, she’s just a baby. How old is she?”
“Eight years,” Nurse Edwards replied, her voice sadly exposing what her mask disguised.
“What’s her name?” Dr. Warner asked.
“The chart says Lena Williams,” Nurse Edwards replied.
Shaking his head in disgust, he listened as the cardiac monitor sounded slower beats and become erratic. Immediately, he reacted out of instinct.
“She needs volume NOW. Hang another two on the rapid infuser,” He said, his voice showing the strain as the youth of his patient weighed heavy in his mind.
“BP’s seventy over fifty and dropping, pulse ox is eighty-two,” Dr. Stadler informed his mentor and colleague.
“I just lost her pulse,” nurse Edwards cried out as the cardiac monitor sounded the unmistakable tone of ‘flat line’.
“Push an amp of atropine. Charge the paddles to fifty,” Dr. Warner retorted back.
Nurse Edwards quickly wheeled over the defibrillator and programmed the setting to Pediatric, while charging the external paddles to fifty joules. She quickly handed them to Dr. Warner, then injected an amp of atropine into the patient’s IV.
As Dr. Warner prepared paddles, Dr. Stadler scanned the young patient’s belly with ultrasound. Rotating the small metallic wand at various angles, images showed on the monitor, confirming their suspicions of the hidden trauma.
Having applied conductive gel, Dr. Warner placed one of the paddles to the upper right clavicle, and one just below and to the left of the young patient’s left nipple.
“Clear,” Dr. Warner called out.
Dr. Stadler broke off his examination just as Dr Warner depressed the buttons on the paddles, delivering a charge to the heart as well as other nearby organs.
The patient’s body convulsed from the current coursing through her. Her chest heaved and expanded, then fell and contracted back onto the table. The three medical personnel focused on the cardiac monitor for signs of activity. They held their breath in vain: the monitor continued to report a single monotone sound of flat line.
“Still in V-fib,” Dr. Stadler cried out. Desperation could be heard as he spoke.
“Fifty again,” Dr. Warner called out once more. He replaced the paddles in the previous locations and delivered a second charge. Again the tiny patient’s body convulsed. As the three waited for the electrical shock to dissipate and reset the heart, the cardiac monitor registered a single ‘beep’, then another and still another as the young patient’s heart began to return to its singular function, pumping life’s blood once again through her tiny body.
“Sinus tach,” Dr. Stadler cried out in relief.
Dr. Warner roughly placed paddles back on tray. “Ultrasound?” he asked Dr. Stadler, who had now resumed his examination, nervous sweat beading up on his brow.
“Belly’s full of blood. Looks like some major hemorrhaging where the bullet hit the spleen, pancreas and kidney. Eighth rib is broken too.” replied the Dr. Stadler, now regaining his composure.
“OK, eight blade,” Dr. Warner requested.
Instantly, Nurse Edwards handed him a scalpel from the tray of stainless steel instruments, butt end first, taking care not to slice her own hand as she pulled away.
Even with years of experience, the thought of slicing into the poor little girl that lay in front of him felt offensive. Dr. Warner strengthened his resolve and made his incision, cutting through the various layers of tissue as blood flowed freely from the opening. Immediately the unmistakable stench of blood and fecal matter wafted through their protective masks.
He finished the incision and called, “Clamp.”
Nurse Edwards placed the clamp in his hand. Dr Warner positioned the clamp, holding open the incision as he tried to examine the damage through the draining blood.
“Suction,” Dr. Warner called out.
Dr. Stadler inserted the probe into the incision and began to suck out the excess blood.
“Careful; watch the trauma. Work around the transverse colon. Clean out as much of that fecal matter as possible,” Dr. Warner cautioned as Dr. Stadler worked.
“Got it,” Dr. Stadler replied, carefully sucking up the blood and debris from the abdominal cavity.
With a better view, Dr. Warner could now see the damaged organs more clearly. It was apparent the spleen, pancreas and colon, as well as the left kidney had some form of trauma.
“I need a 4-0 prolene and an R.B.-1 needle, now. Anyone know the caliber of bullet?” Dr Warner asked, as Nurse Edwards handed him the needle and suture.
“Doesn’t look small, that’s all I know,” replied Dr. Stadler, still suctioning the colon.
“Looks like about a .22,” Dr. Warner informed. “Small entry wound, but heavy internal trauma from the shockwave as it passed through at the high velocity.”
“Shockwave?” asked Nurse Edwards.
While Dr. Warner worked to repair the damaged spleen, Dr. Stadler answered Nurse Edward’s question.
“As a bullet travels, it pushes the air out of the way, creating a field of turbulent air around the bullet. That air around the bullet, the shockwave, has almost as much destructive force as the bullet itself: so instead of a quarter of an inch bullet causing damage, you have to add the inch of shockwave to the problem too,” Dr. Stadler said.
“Awful, just awful,” Nurse Edwards replied sadly.
“Stats!” Dr. Warner called out as he quickly worked.
“BP seventy-five over fifty, pulse ox eighty,” replied Nurse Edwards
“She’s bleeding everywhere,” Dr. Warner complained. He turned to Dr. Stadler and instructed him to repair the transverse colon. “Looks like we have a small puncture in the transverse colon. Can you repair it while I attend to the spleen?”
“I’m on it. Eight blade with suction, and a 4-0 and an R.B.-1 standing by,” Dr. Stadler rattled off in quick succession to Nurse Edwards.
Like a gentle father teaching his son, Dr. Warner delicately cautioned Dr. Stadler, “One thing at a time,” he said, then added, “Work frantically in control.”
“Gotcha,” Dr. Stadler replied, slightly embarrassed by his over zealousness.
As they both worked frantically to repair the damaged organs, the flow of blood went on nearly unabated. Nurse Edwards kept a careful eye trained on the monitors as well as the doctors, anticipating their needs before their requests.
“Doctors, BP is dropping again, sixty-five over forty-eight. Pulse ox is very low: seventy-seven,” Nurse Edwards announced.
“Dammit, where is she bleeding from?” Dr. Warner asked rhetorically.
“We’re working the areas now, Dr. Warner,” Dr. Stadler replied.
“No, no, with this much blood loss there has to be a much larger source, like the vena cava or the aorta,” Dr. Warner speculated.
“We’re nowhere near those areas. The bullet exited out her back, through the kidneys,” Dr. Stadler replied.
“I know, but this much blood loss isn’t adding up. The bullet missed the renal and spleenic veins and arteries. This can’t be from just the organs,” Dr. Warner replied.
The two doctors worked feverishly to repair the damaged and bleeding organs as the patient’s vitals continued to fall. Having repaired the spleen and the transverse colon, the two moved onto the pancreas and left kidney.
“More suction, Kerry,” Dr. Warner instructed Dr. Stadler. He then glanced up and asked Nurse Edwards, “How’s our supply?”
“She taking blood faster than we can give it,” she retorted back instantly.
“Hang another two units,” Dr. Warner requested anxiously.
“Dr. Warner, do you see this?” asked Dr. Stadler. “Would you agree that the bullet entered the abdomen, broke the rib and continued through the spleen, pancreas and out the kidney?”
“It appears that way, why?” Dr. Warner asked as he worked on the kidney.
“There seems to be an abrasion heading up into the upper posterior peritoneum,” Dr. Stadler said, as he lifted the pancreas slightly and pointed to an abrasion that angled up toward the middle of the patient’s body instead of down and through it.
“Dammit, you know what that is? That’s another entry wound,” Dr. Warner replied. “Eight blade and sternal saw, STAT!” he said to Nurse Edwards.
“Two bullets? But there’s only one entry wound,” Dr. Stadler replied in disbelief.
“I know. Two bullets entered through the same location,” Dr. Warner responded as he accepted the scalpel from Nurse Edwards and began to make a long incision down the patient’s breastbone. “I knew something wasn’t right. A .22 caliber can’t break a rib, then have enough energy remaining to tear through all these organs. There had to be more than one bullet, and I’m betting it’s also the cause for the massive blood loss,” he explained as he finished his incision.
“What are the odds of that happening? I mean, two bullets with the same entry wound?” Dr. Stadler asked rhetorically, shaking his head now in further disbelief.
“Stenal saw,” Dr. Warner asked next, then added, “I never would have guessed it if I hadn’t seen it with my own eyes.”
Quickly, Nurse Edwards handed Dr. Warner the saw. Placing it at the base of the sternum, he began to cut through the breastbone, the smell of bone and blood penetrating through their masks and into their nostrils. Moments later, he was done.
“Rib spreader,” Dr. Warner requested.
Anticipating his request, Nurse Edwards handed him the instrument immediately. Inserting it directly into the incision, he turned the lever and separated the ribs enough to view the upper chest cavity.
“Probe,” Dr. Warner requested from Nurse Edwards. He then called to Dr. Stadler to begin suctioning the open areas. As he did, Dr. Warner examined the cleaned areas.
“More suction. I need more suction,” Dr. Warner asked with frustration. “Oh man, we have trauma to the inferior vena cava. I need a 4-0 and an R.B.-1, STAT!”
Working feverishly to repair the profuse bleeding, the needle contacted something hard. At first he thought it was a rib fragment, but upon closer inspection Dr. Warner realized it was the second bullet.
“There it is. Forceps,” Dr. Warner requested with an almost frantic tone.
He inserted the forceps into the cavity, gently pushing aside the still-bleeding vena cava and gently extracted the deformed and mangled bullet.
“Wow. The edges are like tiny razor blades. They sliced through the veins on contact,” he announced. “There must be a dozen fissures to repair.”
As he unceremoniously tossed the clamped bullet and forceps into a stainless steel container, he continued to suture the tears to the damaged vein and surrounding organs.
Moments later, Dr. Warner watched as the heart began to slow. Just then, the cardiac monitor sounded. He quickly placed his gloved fingers around the heart and began to squeeze, attempting manual heart compressions even before Nurse Edwards could speak.
“Doctor, she’s in PEA,” Nurse Edwards announced.
“Push another amp of Epi and charge the internal paddles to fifteen,” Dr. Warner demanded.
Handing him the paddles, they watch as he inserted them into her chest cavity and placed them on the still heart.
“Clear,” Dr. Warner called out he depressed the button and sent the shock directly into the young patient’s heart. As they listened for signs of life from the cardiac monitor, reality set in. There were none to be heard.
“Charge to twenty. Another 6 milligrams now. Clear!” Dr. Warner frantically called again.
He shocked the heart, sending the current deep within, but to no effect. The cardiac monitor continued to report its menacing tone – flat line.
“Asystole… God dammit.” Dr. Warner shouted out loud.
As he continued with manual compressions he called out once more, “Charge to thirty.”
Inserting the internal paddles again, he delivered a massive jolt to the patient’s heart. In horror and sadness, they watched the monitor register no change.
Dr. Warner frantically searched his mind for a solution as he continued manual compressions. Even with his years of education and training, the damage was too extensive for him to overcome. He pulled his hands from her chest and stood back. With his gloved hands dripping fresh blood onto the floor, he hung his head low.
“Call it,” he mumbled quietly.
As Nurse Edwards called the time of death, he stood motionless as he watched the lifeless body of the young girl. His mind raced as he stared at the carnage in front of him. He thought about the smiles she must have displayed just a few hours before. He thought about the hugs her mom must have given her that morning, and the pain the parents would be feeling forever. He thought about her violent death and the injustice of it all. Deeply saddened and sickened by the grievous sight, he could stand no more. He turned and walked out the OR doors, oblivious to all, in a state of shock and disbelief. With his gown soaked in blood and his gloves dripping a red path behind him, he made his way down the corridor toward the elevator. In a blurred and confused state, he was unable to hear his name being called as he walked.
Standing in front of the elevator, he pushed the button. Instantly, the doors sprung open. He looked back up the hallway to Nurse Edwards, who was calling his name, but heard nothing. As if in slow motion, he stepped in and the doors slowly closed behind him.
“Dr. Warner! Dr. Warner, stop!” Nurse Edwards called as she ran down the corridor toward the elevator.
Too late. She watched as the doors closed behind him. As she stared at the bloody footprints that seemed to vanish through the elevator doors, she caught a slight movement with her peripheral vision. Looking up, she watched with sadness as a droplet of blood pooled, then slide down from the elevator button. Reaching into her pocket, she pulled out a tissue and reverently wiped off the sad remains of the young victim, imprinting in her memory, forever the pain of the senseless tragedy.
In a daze, Dr. David Warner stood in the middle elevator and stared through an old photo hanging on the back wall. As the metal doors closed behind him, he felt a small shudder, then a slight drop as he momentarily became weightless as the elevator began to descend. Ignoring the fact that he had not pressed a floor to descend to, he felt any place but the OR was a good place. He just wanted to forget.
Slowly the elevator descended. As David struggled to free his mind of tragedy, his eyes began to focus on the picture in front of him. Slowly at first, then more detailed as he descended, the photo came into focus. He was no longer staring through the photo, but directly at it. Somehow it helped to soothe the pain that gnawed away at his soul.
The photo was an antique, a reflection of the past; a unique display of history that showed howElangerHospitalcame to pass. The photo was of a group of civil war doctors standing over a patient after a recent amputation. At its center was the patient, laying on a makeshift gurney built from an old wooden wagon, sedated and bandaged, with his lower right leg, a stump, resting and on display as a testimony to the doctors’ abilities. Standing behind the patient, dressed in uniform with their bloody smocks still fastened to them, several military doctors stood proudly for the photo. Hardened and determined, their faces were devoid of all expression, save for one – pride.
At the left side of the photo sat an old man on a rickety stool. With his white flowing beard and hair, he looked much older than his more distinguished-looking colleagues. He too wore a bloody smock, and his face also carried the expression of pride. Yet something else shone through in the old man’s eyes – wisdom. While the others looked into the camera, he looked beyond it, as if deep in thought and oblivious to its presence. He appeared somewhat accidental to the photo’s purpose. At the bottom of the photo, David read the inscription: Original site ofElangerHospital, 1862.
David gazed upon the doctors in the photo. He looked at the bandage, bulbous and barbaric on the poor soldier’s leg. A feeling of contempt swept over his body.
“Huh. A hundred and fifty years of progress and we still can’t save ’em,” he shouted out irrationally, his fists clenched in anger and still encased in bloody gloves.
Then, in a fit of rage, he punched the picture on the wall, the glass shattering and dropping to the floor of the elevator, cracking the cheap plastic frame. The sound of shattering glass and cracking plastic snapped him back to reality. He bent over and picked up the old photo, leaving the broken shards of glass still at the floor of the elevator. He began to replace the picture on the bent hook when he felt his knees begin to buckle slightly as the elevator began to slow to a stop.
A moment later, David heard the sound of a bell as the elevator settled into its floor. Suddenly, he saw his gloved hands, sticky with drying blood, holding the framed picture held out in front of him. He looked down at his gown and realized he was covered in blood, a fact that had escaped his attention moments before.
As the mechanized sound of the heavy metal doors signaled their opening, he felt a light balmy breeze brush by his neck. The air suddenly felt dense, as if the relative humidity dramatically increased. A strange yet familiar odor drifted from behind him and penetrated his nostrils. Turning around to investigate, he stiffened and froze in place.
As his eyes took in the sight before him, his mind struggled to make sense of the scene beyond the doors of the elevator. His heart began to pump wildly and his whole body shook. He felt he was dreaming: but never before had a dream felt so real.
“Hey, you. Come here. I need you to hold his leg,” David heard just outside the door of the elevator.
David squinted at first, then rubbed his eyes and refocused on the vision before him. There, several yards away, he watched as a man dressed in a blue military uniform stood over another man laying on a wooden gurney. The man standing looked familiar to him, and he searched his mind to make the connection.
“Hey, come here. I need your help now. I’m almost finished,” the voice called again from beyond the elevator door.
David looked around inside the elevator, then over to the control panel. At the bottom of the panel, a circular button labeled “G” was highlighted. He thought it strange that he ended up at the ground floor, as he had not pushed any of the buttons on the panel. He turned back to the scene that was unfolding in front of him. The light, balmy breeze was still blowing in his face, and the strange odor, now foul and offensive, still penetrated his nostrils.
David watched in fascination as he realized the military man beckoning him was, in fact, a doctor performing crude surgery on the other man laying unconscious on the wooden gurney. Suddenly it dawned on him. The man standing before him was the same man in the picture. David looked at the picture in his hands, then back at the man beyond the elevator. He was indeed the doctor; the older-looking man with a white flowing beard and hair.
“Wow. This is one strange dream,” David said out loud.
He felt confused by the vision.
“Whoa, I’m seeing color in this dream. How is this possible?” he asked of no one in particular.
“Are you just going to stand there or are you going to help me?” the old doctor called out to David in frustration.
David thought about answering him, but thought it to be silly. ‘It’s just a dream,’ he thought to himself. Then, reconsidering, he rationalized to himself, ‘What would be the harm?’
David called to the old man, “What do you want me to do?”
“Tear that cloth into strips,” the old doctor responded immediately, pointing to a mound of cloth on the grass at the foot of the wagon.
At first, David hesitated. Something in his gut was telling him not to go. He felt paralyzed with indecision, but then, throwing caution to the wind, he stepped forward. As he passed through the doorway of the elevator and stepped out onto the grass, time seemed to slow for a moment. He heard voices and sounds as if they were being played to him at half speed. He turned and looked back into the elevator, but strangely, he saw only its interior: the hospital he expected to see housing it was not there.
David turned and took a step onto the grass. Time seemed to resume its normal speed. He suddenly heard the deafening sounds of thunder and recognized the foul stench of rotting flesh. He turned to look back at the elevator, but it was no longer there: only grass and birch trees, which partially obstructed the war that raged off in the distant valley.
“What the hell?” David said out loud, as a wave of fear and confusion spread through his body.
“Son, I really need your help here,” David heard, as the old voice shouted from behind him.
David turned and looked at the old doctor, then back at the spot of grass that used to be the elevator. Suddenly, a loud clap of thunder sounded just beyond the birch trees, shaking the ground under his feet. He heard screams of agony and realized that the sounds he’d been hearing were not thunder after all, but were in fact artillery explosions.
Instinctively, David ran toward the old doctor, frantically searching for cover as he closed the distance. The old doctor, seeing the intense fear in David’s eyes, quickly recognized the developing problem. He pulled away from his patient and moved quickly to intercept David in flight.
“Whoa, son! Steady. You’re in no danger,” the old doctor called to David as he ran to him and grabbed his arms, reassuring him of his safety.
“Those are bombs. They’re trying to kill us,” David replied, almost hysterical.
The doctor casually looked beyond David at the raging war, then back into his eyes, and replied, “Well, I suppose they are, but we’re out of range of their artillery.”
He scratched the top of his head with his bloody fingernails and continued, “I guess a wild bullet could accidentally find us up here, but it’s not likely,”
He then took a long look at David’s clothes. A confused expression crossed his face as he spoke. “That is quite an unusual uniform you have on. What outfit are you from?”
“Outfit?” David replied, still in a deep state of shock.
“Outfit, lad. What outfit are you from? Who’s your commanding officer?” the old doc questioned with a bit of suspicion, then added, “Don’t tell me you’re gray?”
David was about to speak when another shell hit a bank just beyond the birch trees, startling both he and the old doctor. With a quick look over David’s shoulder, then back to his patient on the wooden wagon, the doctor refocused on his duty.
“This way, lad. We have work to do,” the old doctor said, as he extended his hand in the direction of the patient as an invitation for David to follow him.
Quickly, they walked back to the wagon, with the doctor leading the way. Once at the patient’s side, the old doctor instructed, “I need you to tear those rags into thin strips so I can finish bandaging this poor lad’s stump before he comes to. Lord knows he’ll be suffering enough when he wakes without us fidgeting with his bandage, so be quick with your work.”
David pulled off his rubber gloves and tucked them into his pocket. With his mind struggling to make sense of the situation, he reached down and begin to tear the cloth into strips in an effort to buy himself time to sort through the complexities of his dream. His mind raced from one topic to the next, never answering his questions as each problem became a Pandora’s Box of other unanswerable questions, distracting and derailing him from solving anything. As he looked around, he could hear the cries of agony, the sounds of war, the smell of death, and suddenly he realized that this was no dream. This was real. He was now existing in another era in time: the Civil War – the 1860s.
As he tore off each strip of cloth, he handed it to the old doctor, who used it to secure the amputee’s bandages in place. As he worked, the old doctor began to interrogate his new assistant.
“I see you’ve been in surgery already. I don’t recall another medical unit around here. Where did you come from?” the old doctor asked casually as he worked.
David searched his mind for an answer that would be suitable for the old man. He knew he couldn’t say he was from the future. Quickly he devised a cover story until he could make sense of his dilemma.
“I have medical training and thought I could be of use,” David replied, hoping his answer would suffice.
“Uh huh, and where did you come from? Allow me to be more direct. Are you gray or blue?” the old doctor asked without breaking his concentration.
“Doctor, I am neither. I am just a medically trained individual who wants to lend a hand to these poor boys,” David replied.
“Young man, are you a deserter?” the old doctor asked bluntly.
“No, sir. I am not in the military,” David responded.
He knew the questions would keep coming and that he needed to find a better reason for his presence. He then had an idea.
“Doctor, the truth is I need a job. I’d like to join the military to in order to practice medicine. I am a very skilled practitioner and feel I can be of real use here,” David finished, hoping he hadn’t overplayed his abilities.
“Hmm, skilled practitioner you say? Where were you trained? Are you a doctor?” the old doctor said, continuing his interrogation.
“Yes, I am a doctor. I was trained inNew EnglandatHarvardUniversity. Have you heard of it?” David asked, unsure if his Ivy League alma mater wouldn’t raise even more suspicion.
“Harvard you say? Hmm. We are short-staffed here, to be sure. My assistants mean well but are bumbling country boys, if you understand my inference,” the old doctor said as he winked at David.
“Completely, doctor,” David replied back with a smile of understanding.
“Well, doctor, do you have a name?” the old doctor asked, now warming to David a bit.
“Yes sir. My name is Dr. David Warner. May I ask what your name is?” David responded in kind.
“Certainly. My name is Jebadiah Morgan,” Dr. Morgan replied, his modesty eliminating fancy titles from his name.
He tied the last bandage and lifted his head. With piercing eyes, he stared directly into David’s. Slowly, he extended his hand in greeting.
“I’m pleased to make your acquaintance, David. Now, if you will indulge me a while, I’d like to see your abilities. I have a young man waiting amputation I’d like you to attend to. If you prove your skill, I will consult with Gen. Negley regarding employment. Is this accord satisfactory?” Dr. Morgan asked with blunt sincerity.
“Where’s the patient?” David replied, trying to contain his confidence.
Dr. Morgan signaled to the private to bring up the next patient. As they waited, he showed David to his station, pointing out the instruments he’d be operating with, as well as suturing materials and bandaging. David viewed his crude operating environment with shock. He hadn’t thought about it until that moment, but he was trained to operate in a highly technical environment. This was as primitive as he could imagine. He wasn’t sure he could do it.
Dr. Morgan sensed David’s apprehension and said, “Son, are you sure you’re up for this?”
“It’s a bit more primitive than I’m used to, but I can manage,” David replied.
“Son, I don’t want you to manage. I want you to perform as a trained operator. These young men deserve more than a butcher or a charlatan. If you are either, please speak the truth,” Dr. Morgan stated boldly and with conviction.
“Doctor, I can assure you my skills as a surgeon are more than adequate. I just need a moment to acclimate myself to an environment I’m not accustomed to,” David replied with a bold and confident tone, in an effort to reassure Dr. Morgan.
As the assistants laid the next patient on the wooden wagon, David could see the agony of the young soldier and immediately began his assessment.
Without the basic equipment to understand the patient’s vital signs, David could only make limited observations. He quickly took the patient’s pulse and determined it to be weaker than normal. Next, he checked pupil dilation and reaction with a match. Satisfied, he then examined the patient’s mouth, tongue and skin for dehydration and color. He observed that his skin color was pale and felt clammy. In addition, the young man seemed somewhat withdrawn and lethargic. Trying not to move the traumatized leg too much, he moved it only slightly, cutting away the pant leg. He observed that a large caliber bullet had indeed passed through the calf, but had left a gaping wound upon exiting. David determined that with careful cleaning and repair, the leg could be saved, although without antibiotics, the post treatment would be problematic.
David immediately bent the young man’s undamaged leg at the knee, leaving the traumatized leg laying flat. He then moved to the front of the wagon, grabbed a blanket, and draped it over the patient.
“Dr. Warner, what is your assessment?” Dr. Morgan questioned with concern.
“The patient is suffering from mild hypovolemic shock. I am making some effort to stabilize him before invasive surgery. The large bore bullet has indeed left a great deal of trauma to the calf, but I believe I can save the leg.”
David recalled from his courses in school that the anesthesia of choice during this period was chloroform.
He continued, “Do we have the chloroform ready?” David asked.
“Doctor, I must protest. His leg is too badly damaged. We must remove it before gangrene develops,” Dr. Morgan said.
“I’ve examined the wound and feel it is relatively clean, thanks to his pant leg protecting the trauma. After a proper cleaning, I can repair the muscle, veins and arteries, but will need a strong cleansing solution and freshly boiled water. I believe he will have some degree of infection, but the chance of gangrene is much lower than you might think,” David replied.
“Repair the veins and arteries? Is this possible?” Dr. Morgan asked incredulously, then added with great concern, “And what if the infection spreads and gangrene develops?”
“We’d amputate, but then he’d be no worse off than if we had amputated now. At least we give him a chance to save the leg,” David reasoned.
“Hmm. You really think you can do this? Save his leg?” Dr. Morgan asked, now intrigued by David’s plan.
“I can only assure you he won’t die under my care, though saving his leg under these conditions isn’t going to be easy,” David responded.
Dr. Morgan coifed his long white beard as he contemplated the procedure. He looked over at the patient, then back at David, deep in worry as he struggled to trust this mysterious doctor who appeared just minutes before. David could see the old man’s forehead furrow as he thought. A moment later, David saw the worried expression leave the old man’s face. He now began to smile a bit as he came to grips with his decision.
“Ok, son. Tell me exactly what you need,” Dr. Morgan finally replied.
“Two pots of boiling water, distilled or grain alcohol, soap, and clean dressings,” David replied.
“It’s going to take some time to collect these things. Is every operation like this?” Dr. Morgan asked.
“Keeping the water boiling is the only time consuming consideration,” David responded.
A fire had already been smoldering from early morning usage, so Dr. Morgan tossed more wood on the coals. Twenty minutes later, two pots of water boiled wildly as David sorted through Dr. Morgan’s limited instruments required to perform the surgery. Resigned to his selection, David placed the instruments into the boiling water for sterilization. He then poured off some of the boiling water into third pot and began to scrub his hands and arms with the soap, as well as the rubber gloves he had in his pocket. Satisfied with his cleansing, he slowly washed away the soap.
Dr. Morgan looked on ill-amused with the display by this strange doctor. A man of medicine for more than thirty-five years, he regarded the prep work as shenanigans reserved for roadside carpetbaggers as a means to disguise their lack of content. David looked over and could see the contempt in Dr. Morgan’s eyes. He knew the old doctor was losing his patience, and with that lost, he too was losing what little credibility he might have had.
Quickly, David set up next to the young soldier. With the help of the old doctor, the patient was anesthetized in a matter of minutes. With the patient out, Dr. Morgan looked on closely. David put on his now-sterilized gloves, and then applied a generous amount of the ‘moonshine’ he obtained from the old doctor to the area around the wound in an effort to sterilize it.
“Ok, doctor: as you can see, the patient’s leg is torn up pretty badly. I’m going to make an incision through the back of the calf to inspect and then repair any damage I might find,” David started.
With the patient’s legs bent at the knees and rolled to one side so he had a clear view, he made an incision across the entry wound large enough to view inside when spread apart. As if on cue, Dr. Morgan moved in for a closer look.
David then brought out a pair of retractors used to hold open an incision. He delicately placed the instrument in the incision and expanded it, giving him a good view of the wound. Next, he rinsed out the incision with a salted water solution he had prepared before the surgery. Dabbing the excess blood, he was able to see the damaged muscle tissue and a torn vein. Using his scalpel, he cut away the torn and mangled muscle tissue. Again, he rinsed out the interior of the wound with ‘moonshine’ and his makeshift saline solution. With the smallest needle from the old doctor’s bag of instruments, David began to sew the reconstructed muscles as well as the arteries, using very few sutures to accomplish his task.
“Now, the sutures will remain there forever, but the body will adapt to them. I believe this should take care of this side of the wound,” David replied softly, completely engrossed in his work.
He closed the entry wound and move onto the more extensive damage on the other side of the calf.
Dr. Morgan looked on in total fascination. Never before had he seen or even heard of surgery so delicate and so complicated performed with such ease and skill. Eagerly, he waited for David to attempt the more difficult area of the operation. After watching the first phase of the operation, David had indeed proven himself to be a quite gifted surgeon. Dr. Morgan now watched as any spectator would watch a professional in his element. He was in awe and excited to observe even greater feats of medicine.
Once again, David did his best to rinse and clean the wound with the salted water solution, and then sterilize it with the distilled alcohol. Pulling the scalpel from the hot water, he began to work the damaged muscle tissue on the exit wound. The damage was much more extensive, but manageable. As he removed tissue, he would temporarily close the wound to ensure the proper shape of the reconstruction. Working quickly, he then began to suture the arteries and muscle as he had done on the previous side, using very few stitches to accomplish the task. He then closed the wound as he had done on the other side. When completed, he rinsed again and sterilized the entire area with the alcohol.
With the operation over, he began to bandage the wound. A few minutes later, as the patient was gaining consciousness, David had tied the last bandage. The operation was now over and David felt confident he had done his best to inhibit infection. In a day’s time, the results of his work would be evident. All he could do now was to wait.