Yes. I was handing him a retractor. Not something simple and pure like a scalpel or a lancet. After all, they call that journal The Lancet. No one would ever call a journal The Retractor. A retractor’s the turnip of surgical instruments. Anyhow, for him and for me it was a case of “eyes across the retractor.”
Other women would be reticent about mocking such events—the weight of engagement. And of breaking it.
The hollow ship was ringing with the shouts of healthy men delivering the maimed. At last Fellowes accompanied a case carried in—the man yelping like a dog. Head wound—that was why. As with Lieutenant Carradine, the loss of the hold on language but not on the impulse to make one. Orderlies either side of him held swabs to the skull. The journey from barge to deck or from deck to ward must have somehow moved bone and brought on this frenzy. Orderlies dumped him—in his shirt and bandages—from the stretcher onto the theatre table. They held him down and called for reinforcements to help them restrain him in his demented state. Big enough to hold a bull out to pee, she heard an orderly wheeze. Quick, Nurse, said Fellowes. One of the dressings fell away and Sally saw through blood the occipital lobe and the cerebellum. The square-headed, sturdy boy looked up at Sally with the eyes of a demented animal and though two orderlies managed to hold his arms, their strength might not last. Sally felt that her movements were heinously slow but took up the anesthetics dispensing bottle and the mask and poured chloroform on the pad without letting any of it too close to his thrashing face. Near enough, however, for the fumes to dope him down and to numb that frantic brain and render him drowsy. The chloroform filled the theatre with its sweet, heavy fumes as she clamped the pad inside the mask. Fellowes—beside her—spoke urgently to an orderly. Hold him. And to Sally, Mask down now. Mask down.
She forgot dosages as she dripped further chloroform onto the mask which, for the first seconds of its tenure, needed all the force of her left arm to keep it in place. Then the patient made a bleat like a child and was under and the orderlies drew back panting, before leaving for more stretcher work. Sally flicked open the young man’s left eyelid. The pupil was appropriately dilated and she felt grateful to the numbing chemicals.
Now she placed the airway device in between his teeth. They were a bush kid’s teeth, with some gone and some fixed with fresh amalgam—for he had been to the army dentist in Egypt. His respiration was ragged. But what was to be expected? She moved to one side of the body to let in Fellowes and Freud and placed the cuff of the blood-pressure device on his arm, pumping it up. She saw a low diastolic and then felt his pulse, which was thready and leaking along the artery. She reached for a thermometer but Fellowes said briskly, Don’t bother. For what if he somehow woke and filled the theatre with chaos before she could get more chloroform on the mask. Fellowes did his work. Retractors were involved, the unglamorous tools Freud had mocked. And the rest of the armory, which Fellowes nominated calmly and Freud passed to him. Sally took notice only of pulse, which maintained itself at its present unsatisfactory level.
The blood pressure had fallen, she saw. She called out the figures. Ninety over fifty. Her dread was the two figures meeting. Fellowes cried to the surgical orderlies, Elevate the table six inches. They got six-inch blocks from the corner and one lifted the end of the table. Gently, cried Fellowes and there was despair at their lack of skill in his voice. You could not get men to stay in the theatres and wards and become proficient at one thing. They thought it feminine work. They would prefer to lump the wounded or supplies around the ship. She wondered about her amenable old ally—Wilson—from the last trip. For he had not seemed humiliated to work with women. These fellows finally propped the blocks under the end of the operating table to stop the blood fleeing the abused brain. The scrub nurse received bone fragments in a bowl, Fellowes saying, I want some of that back, Nurse.
He would in part rebuild the skull with suitable pieces. He asked for blood pressure again. It was not a good tale—the number for the heart under pressure falling to meet the measure for the heart at rest was a lethal union occurring one instant before the final heart fibrillation.
It happened. A tremor through the body. Oh damn, said Fellowes softly. And no adrenaline on board. Take him away.
Somewhere was an ammonia-refrigerated place where such men went. There he would be stored for an Egyptian burial amongst the other children of shock and hemorrhage—until it filled and the sea again became an option.
No sense of failure delayed things in the theatre. Orderlies washed down the surface of the table with soap and water and briskly dried it off. There was at once another boy. He had a shattered femur wound and was brought straight to her with a splint of dowel stick tied with rags from thigh to foot. He could smell the fumes and obviously feared anesthesia. Sally put the mask down and could hear him beneath it bravely counting numbers. When the putrid bandages were gone, there proved to be two wounds, one made by a bullet, the other by the upper end of the fractured bone showing itself jaggedly through the bloody hole it had made an instant after the bullet struck. After probing the wounds, Fellowes ordered the upper leg lifted and dragged by an orderly and the scout nurse. A traction splint was strapped on, and this man-boy was now destined to walk crookedly for a lifetime.
Amputations occurred at times on the Archimedes—in spite of the rocking of the sea—and when an overhopeful surgeon ashore had cut the limb off below the knee of another man brought onboard, the sutures were cut and the stench of the wound competed with the chloroform. A new and graver amputation must be done above the knee. With the big strap tourniquet around the thigh, Fellowes’s lancet went cutting decisively through fascia—vastus lateralis and hamstring and quadriceps. A good flap left. And the wound irrigated and sutured up around a rubber pipe. And then the bandaging. Here was a surgeon! Imagine had it been Dr. Maddox, with his confident cack-handedness.
The Turkish guns exchanged their metal with the warships offshore, and the shudders of the Archimedes were something those on board dealt with without a thought. Fellowes would raise whatever instrument he held when a shell seemed near and start again once the jolt conveyed through the water to the Archimedes ended.
The timeless session in the theatre ended. Noon had eaten all time, and what was left was devoured by midnight. They were to have three hours’ sleep. At subsequent meals—when they were taken—there was no conversation of any length. Salt was pointed to. Worcestershire sauce lay untouched. They could have been an order of silent nuns.
They slept for a full afternoon before a ship’s steward—a man left over from the days of peace when the Archimedes took sane people to sane places—knocked on the cabin door and told them he had left a tray of tea for them. The bugles had sounded ashore. More barges on their way. More sweepers.
Nearly eight hundred men were on the Archimedes when the anchor was again raised—another battalion of men treated brutishly by metal but better accommodated now on new cots crowded in. This time more were dysentery and typhoid cases and so a hasty readjustment had to be made to the ship to create a contagious ward. It was a short run this time, a matter of four or five hours. From the ship they saw arid mountains in the sun—the harbor of Mudros on that island of Lemnos whose myths Kiernan had explained but which Sally had forgotten. Tales of man-murdering women and the furnaces of gods had become thin and tame, even here. Military tents filled the valley between the two great heads of the port. Hospital tents had begun to colonize the headlands as well. The camp’s roads were marked out in brown earth by prim, white-painted stones. The olive and orange orchards grew inland—on hills—and meadows beyond the coastline were green. The hills looked enduring and real—whereas the camp looked like a giant and hasty misconception. A new order was to land the urgent cases here. Egypt for the walking wounded, the stable, the uninfected wounds. Lemnos for the rest.