The bucolic endeavors of that summer were disrupted on the fifteenth of September when Margie injured her forearm. It happened early one morning while she was splitting some kindling for the cook stove, in preparation for the day’s canning operation. Working with a short-handled mine ax to split the kindling, she was momentarily distracted by the sound of the TA-1 field telephone clacking on the C.Q. desk. Taking her eyes off of her work for only an instant, Margie brought the ax down at an angle and it bounced off of the piece of wood that she was attempting to split. The ax blade struck the inside of her left forearm, making a deep, ugly gash. She let out a cry, but waited until it became clear that the call on the TA-1 was just a regular commo check.
Then, applying direct pressure to the wound, she called for help. The cut only bled a little at first, and Margie was not overly alarmed. By the time Mary was examining it a few minutes later, however, the capillary bleeding had begun to increase. To Mary’s dismay, she also found that Margie had nearly severed two tendons.
Mary quickly applied a bandage to the wound and had Margie move to the kitchen. Mary put on one of her light green “scrub suit” uniforms and a surgical mask. Then she thoroughly washed her hands and forearms with Phisoderm and put on a pair of sterile surgical rubber gloves. Meanwhile, Rose washed down the kitchen table with rubbing alcohol. Throughout all this, Margie sat patiently at the table, with her arm raised above her head to help control the bleeding. By the time Mary was done scrubbing up, the bandage was soaked, and a thin rivulet of blood began to trickle down to Margie’s armpit. “Please hurry, Mary dear,” she said.
Mary was finally ready to begin after she had pulled a selection of surgical instruments from her bag and out of their sterile wrappers. She then paused to wash her hands yet again. “It’s starting to really hurt. It’s throbbing,” Margie said with a groan.
Mary had Margie lay down and elevated her injured arm and her feet, to lessen the risk of going into shock. Soothingly, she said, “Don’t worry. I’m going to give you something for the pain.” Picking up a 20 c.c. hypodermic syringe, Mary quickly filled it with Lidocaine H.C.L. After tapping the sides of the syringe and briefly depressing its plunger to displace a few small air bubbles, Mary inserted the needle subcutaneously to three sites around the wound. She said soothingly, “The pain will start to subside within a few minutes. Just be patient, my patient.” Looking toward Rose, who was by now also wearing a surgical mask, she said, “I’ll need more light. Bring the reading lamp from the living room, and put it here on the edge of the table. There’s an outlet right over there.” A minute later Rose returned with the lamp. Mary chided, “No, no, not so close, that thing’s hardly sterile. Set it up farther down the table, but tip the shade so that I get the light over here. There, that’s it.”
Mary then picked up a pair of her black handled bandage scissors and cut away the now sodden bandage from the wound. Working with a blunt-tipped probe, she gauged the extent of the wound. For the benefit of Margie and Rose, who was looking over Mary’s shoulder, she said, “The cut is ten or twelve millimeters deep, at its deepest point. There is considerable capillary bleeding and there are four small arterial bleeders. The bluish-looking one here is a vein, not an artery. It’s a pretty big one, and luckily it still has its integrity. If it had gotten cut, there would already be a puddle of blood, so that’s a piece of luck. The bad news is that we’ve got two tendons that have been nearly cut through, and another that’s been nicked.”
By now, four other militia members were hovering at the far end of the kitchen, whispering to themselves. Looking over her shoulder, she said to them, “You can make yourselves useful if one of you were to go out to the shop and get the electric soldering iron, the small one.” Lon turned from the doorway of the kitchen and dashed in the direction of the shop. “What does she need a soldering iron for?” Della whispered to Doug, who was standing next to her.
Doug leaned over until his mouth was nearly touching Della’s ear and whispered, “Cauterizing, I think. You don’t have to stay and watch this unless you want to. It could get pretty gross.”
Della whispered back, “No,I want to stay.I won’t get grossed out.Besides,this is pretty interesting. I might have to do this someday.” Doug nodded in agreement.
Mary continued on with her monologue. “I’m going to start by stitching up, or at least trying to stitch up, these four little arteries. I’m afraid to say that they are about the same size as the ones that I had trouble with when I worked on your gunshot wound, Rose. I’m going to use the smallest of my absorbable suture material. Anything larger, and I’d probably end up with an artery that was patched together, but that would leak like a sieve.”
Just then, Lon returned with the soldering iron. Mary tossed her head to gesture toward the lamp. “Plug it in over there,” she said.
“What about sterilizing it?” Lon asked.
“We don’t have to concern ourselves with the tip, that will sterilize itself as it heats up. It’s just the handle that I have to worry about. I’ll just do all of the cautery at once, and then change gloves.”
Mary spent the next twenty-five minutes suturing together the four small, severed arteries, muttering the occasional epithet. It was painstaking, frustrating work. To control the bleeding during this stage of the operation, she had Rose briefly put a sphygmomanometer cuff on Margie’s upper arm, and slowly pump it up to pressure. Once the bleeding had slowed to the point where she could once again see her work, Mary told Rose to stop pumping. Mary had to suture one of the arteries closed because it was badly damaged. She managed to successfully rejoin the other three. After the suturing was done, Mary told Rose to release the pressure in the cuff, for fear of restricting Margie’s blood flow for too long.
Throughout the operation, Margie remained calm. Mary occasionally asked her if she was feeling pain. She always answered no. Margie could not bear to watch the operation. She kept her head turned toward the wall throughout the procedure.
When full blood flow was restored, the patched together arteries showed no sign of leakage, but steady capillary bleeding resumed at both sides of the wound. Turning toward the kitchen doorway, Mary said, “Lon, Rose, I’m going to need your help.” The two approached and looked at her expectantly.
She said, “I need you to hold Margie’s arm in place.”After instructing them on how she wanted the arm held, Mary picked up the soldering iron. She said to Margie, “Now this might hurt, despite the Lidocaine, so try to hold still.”
Mary rolled the tip of the soldering iron across spots of the flesh that had shown the worst of the capillary bleeding. The soldering iron made a hissing noise throughout this process. Margie said that she couldn’t feel a thing, but that she didn’t like the smell. “It smells like a barbecue,” she said.
After she was done cauterizing, Mary donned a fresh set of gloves and took another look at the damaged tendons. She said, “I wouldn’t know how to begin to work on these tendons, so we’re going to have to hope that they heal themselves. The best we can do is immobilize your hand, wrist, and lower arm for two months to allow them a chance to heal themselves.” Mary then began the slow process of closing the wound with nonabsorbable three-zero silk sutures.
When she was finally done, Mary daubed the area of the wound with Betadine solution. Then she lightly wrapped Margie’s lower arm in two-inch wide sterile gauze and pulled down her mask. A few minutes of consultation with Lon yielded a plan for making a splint. Lon returned from the shop five minutes later with a pair of heavy pliers and an eight-foot length of one-eighth-inch diameter steel fencing wire. Laying the wire directly against his wife’s arm, Lon eyeballed a measurement for the splint. Then, with the help of the pliers, he began bending the stiff wire. After taking a few more measurements, he had the splint bent into shape within a few minutes. By the time he was done, Lon was sweating profusely from the exertion.