# White-Jacket/Chapter LXIII

Chapter LXIII. The Operation.
Next morning, at the appointed hour, the surgeons arrived in a body. They were accompanied by their juniors, young men ranging in age from nineteen years to thirty. Like the senior surgeons, these young gentlemen were arrayed in their blue navy uniforms, displaying a profusion of bright buttons, and several broad bars of gold lace about the wristbands. As in honour of the occasion, they had put on their best coats; they looked exceedingly brilliant.
The whole party immediately descended to the half-deck, where preparations had been made for the operation. A large garrison-ensign was stretched across the ship by the main-mast, so as completely to screen the space behind. This space included the whole extent aft to the bulk-head of the Commodore's cabin, at the door of which the marine-orderly paced, in plain sight, cutlass in hand.
Upon two gun-carriages, dragged amidships, the Death-board (used for burials at sea) was horizontally placed, covered with an old royal-stun'-sail. Upon this occasion, to do duty as an amputation-table, it was widened by an additional plank. Two match-tubs, near by, placed one upon another, at either end supported another plank, distinct from the table, whereon was exhibited an array of saws and knives of various and peculiar shapes and sizes; also, a sort of steel, something like the dinner-table implement, together with long needles, crooked at the end for taking up the arteries, and large darning-needles, thread and bee's-wax, for sewing up a wound.
At the end nearest the larger table was a tin basin of water, surrounded by small sponges, placed at mathematical intervals. From the long horizontal pole of a great-gun rammer--fixed in its usual place overhead--hung a number of towels, with "U.S." marked in the corners.
All these arrangements had been made by the "Surgeon's steward," a person whose important functions in a man-of-war will, in a future chapter, be entered upon at large. Upon the present occasion, he was bustling about, adjusting and readjusting the knives, needles, and carver, like an over-conscientious butler fidgeting over a dinner-table just before the convivialists enter.
But by far the most striking object to be seen behind the ensign was a human skeleton, whose every joint articulated with wires. By a rivet at the apex of the skull, it hung dangling from a hammock-hook fixed in a beam above. Why this object was here, will presently be seen; but why it was placed immediately at the foot of the amputation-table, only Surgeon Cuticle can tell.
While the final preparations were being made, Cuticle stood conversing with the assembled Surgeons and Assistant Surgeons, his invited guests.
"Gentlemen," said he, taking up one of the glittering knives and artistically drawing the steel across it; "Gentlemen, though these scenes are very unpleasant, and in some moods, I may say, repulsive to me--yet how much better for our patient to have the contusions and lacerations of his present wound--with all its dangerous symptoms--converted into a clean incision, free from these objections, and occasioning so much less subsequent anxiety to himself and the Surgeon. Yes," he added, tenderly feeling the edge of his knife, "amputation is our only resource. Is it not so, Surgeon Patella?" turning toward that gentleman, as if relying upon some sort of an assent, however clogged with conditions.
"Certainly," said Patella, "amputation is your only resource, Mr. Surgeon of the Fleet; that is, I mean, if you are fully persuaded of its necessity."
The other surgeons said nothing, maintaining a somewhat reserved air, as if conscious that they had no positive authority in the case, whatever might be their own private opinions; but they seemed willing to behold, and, if called upon, to assist at the operation, since it could not now be averted.
The young men, their Assistants, looked very eager, and cast frequent glances of awe upon so distinguished a practitioner as the venerable Cuticle.
"They say he can drop a leg in one minute and ten seconds from the moment the knife touches it," whispered one of them to another.
"We shall see," was the reply, and the speaker clapped his hand to his fob, to see if his watch would be forthcoming when wanted.
"Are you all ready here?" demanded Cuticle, now advancing to his steward; "have not those fellows got through yet?" pointing to three men of the carpenter's gang, who were placing bits of wood under the gun-carriages supporting the central table.
"They are just through, sir," respectfully answered the steward, touching his hand to his forehead, as if there were a cap-front there.
"Bring up the patient, then," said Cuticle.
"Young gentlemen," he added, turning to the row of Assistant Surgeons, "seeing you here reminds me of the classes of students once under my instruction at the Philadelphia College of Physicians and Surgeons. Ah, those were happy days!" he sighed, applying the extreme corner of his handkerchief to his glass-eye. "Excuse an old man's emotions, young gentlemen; but when I think of the numerous rare cases that then came under my treatment, I cannot but give way to my feelings. The town, the city, the metropolis, young gentlemen, is the place for you students; at least in these dull times of peace, when the army and navy furnish no inducements for a youth ambitious of rising in our honourable profession. Take an old man's advice, and if the war now threatening between the States and Mexico should break out, exchange your navy commissions for commissions in the army. From having no military marine herself, Mexico has always been backward in furnishing subjects for the amputation-tables of foreign navies. The cause of science has languished in her hands. The army, young gentlemen, is your best school; depend upon it. You will hardly believe it, Surgeon Bandage," turning to that gentleman, "but this is my first important case of surgery in a nearly three years' cruise. I have been almost wholly confined in this ship to doctor's practice prescribing for fevers and fluxes. True, the other day a man fell from the mizzen-top-sail-yard; but that was merely an aggravated case of dislocations and bones splintered and broken. No one, sir, could have made an amputation of it, without severely contusing his conscience. And mine--I may say it, gentlemen, without ostentation is--peculiarly susceptible."
And so saying, the knife and carver touchingly dropped to his sides, and he stood for a moment fixed in a tender reverie but a commotion being heard beyond the curtain, he started, and, briskly crossing and recrossing the knife and carver, exclaimed, "Ali, here comes our patient; surgeons, this side of the table, if you please; young gentlemen, a little further off, I beg. Steward, take off my coat--so; my neckerchief now; I must be perfectly unencumbered, Surgeon Patella, or I can do nothing whatever."
These articles being removed, he snatched off his wig, placing it on the gun-deck capstan; then took out his set of false teeth, and placed it by the side of the wig; and, lastly, putting his forefinger to the inner angle of his blind eye, spirited out the glass optic with professional dexterity, and deposited that, also, next to the wig and false teeth.
Thus divested of nearly all inorganic appurtenances, what was left of the Surgeon slightly shook itself, to see whether anything more could be spared to advantage.
"Carpenter's mates," he now cried, "will you never get through with that job?"
"Almost through, sir--just through," they replied, staring round in search of the strange, unearthly voice that addressed them; for the absence of his teeth had not at all improved the conversational tones of the Surgeon of the Fleet.
With natural curiosity, these men had purposely been lingering, to see all they could; but now, having no further excuse, they snatched up their hammers and chisels, and--like the stage- builders decamping from a public meeting at the eleventh hour, after just completing the rostrum in time for the first speaker--the Carpenter's gang withdrew.
The broad ensign now lifted, revealing a glimpse of the crowd of man-of-war's-men outside, and the patient, borne in the arms of two of his mess-mates, entered the place. He was much emaciated, weak as an infant, and every limb visibly trembled, or rather jarred, like the head of a man with the palsy. As if an organic and involuntary apprehension of death had seized the wounded leg, its nervous motions were so violent that one of the mess-mates was obliged to keep his hand upon it.
The top-man was immediately stretched upon the table, the attendants steadying his limbs, when, slowly opening his eyes, he glanced about at the glittering knives and saws, the towels and sponges, the armed sentry at the Commodore's cabin-door, the row of eager-eyed students, the meagre death's-head of a Cuticle, now with his shirt sleeves rolled up upon his withered arms, and knife in hand, and, finally, his eyes settled in horror upon the skeleton, slowly vibrating and jingling before him, with the slow, slight roll of the frigate in the water.
"I would advise perfect repose of your every limb, my man," said Cuticle, addressing him; "the precision of an operation is often impaired by the inconsiderate restlessness of the patient. But if you consider, my good fellow," he added, in a patronising and almost sympathetic tone, and slightly pressing his hand on the limb, "if you consider how much better it is to live with three limbs than to die with four, and especially if you but knew to what torments both sailors and soldiers were subjected before the time of Celsus, owing to the lamentable ignorance of surgery then prevailing, you would certainly thank God from the bottom of your heart that your operation has been postponed to the period of this enlightened age, blessed with a Bell, a Brodie, and a Lally. My man, before Celsus's time, such was the general ignorance of our noble science, that, in order to prevent the excessive effusion of blood, it was deemed indispensable to operate with a red-hot knife"--making a professional movement toward the thigh--"and pour scalding oil upon the parts"--elevating his elbow, as if with a tea-pot in his hand--"still further to sear them, after amputation had been performed."
"He is fainting!" said one of his mess-mates; "quick! some water!" The steward immediately hurried to the top-man with the basin.
Cuticle took the top-man by the wrist, and feeling it a while, observed, "Don't be alarmed, men," addressing the two mess-mates; "he'll recover presently; this fainting very generally takes place." And he stood for a moment, tranquilly eyeing the patient.
Now the Surgeon of the Fleet and the top-man presented a spectacle which, to a reflecting mind, was better than a church-yard sermon on the mortality of man.
Here was a sailor, who four days previous, had stood erect--a pillar of life--with an arm like a royal-mast and a thigh like a windlass. But the slightest conceivable finger-touch of a bit of crooked trigger had eventuated in stretching him out, more helpless than an hour-old babe, with a blasted thigh, utterly drained of its brawn. And who was it that now stood over him like a superior being, and, as if clothed himself with the attributes of immortality, indifferently discoursed of carving up his broken flesh, and thus piecing out his abbreviated days. Who was it, that in capacity of Surgeon, seemed enacting the part of a Regenerator of life? The withered, shrunken, one-eyed, toothless, hairless Cuticle; with a trunk half dead--a memento mori to behold!
And while, in those soul-sinking and panic-striking premonitions of speedy death which almost invariably accompany a severe gun-shot wound, even with the most intrepid spirits; while thus drooping and dying, this once robust top-man's eye was now waning in his head like a Lapland moon being eclipsed in clouds--Cuticle, who for years had still lived in his withered tabernacle of a body--Cuticle, no doubt sharing in the common self-delusion of old age--Cuticle must have felt his hold of life as secure as the grim hug of a grizzly bear. Verily, Life is more awful than Death; and let no man, though his live heart beat in him like a cannon--let him not hug his life to himself; for, in the predestinated necessities of things, that bounding life of his is not a whit more secure than the life of a man on his death-bed. To-day we inhale the air with expanding lungs, and life runs through us like a thousand Niles; but to-morrow we may collapse in death, and all our veins be dry as the Brook Kedron in a drought.
"And now, young gentlemen," said Cuticle, turning to the Assistant Surgeons, "while the patient is coming to, permit me to describe to you the highly-interesting operation I am about to perform."
"Mr. Surgeon of the Fleet," said Surgeon Bandage, "if you are about to lecture, permit me to present you with your teeth; they will make your discourse more readily understood." And so saying, Bandage, with a bow, placed the two semicircles of ivory into Cuticle's hands.
"Thank you, Surgeon Bandage," said Cuticle, and slipped the ivory into its place.
"In the first place, now, young gentlemen, let me direct your attention to the excellent preparation before you. I have had it unpacked from its case, and set up here from my state-room, where it occupies the spare berth; and all this for your express benefit, young gentlemen. This skeleton I procured in person from the Hunterian department of the Royal College of Surgeons in London. It is a masterpiece of art. But we have no time to examine it now. Delicacy forbids that I should amplify at a juncture like this"--casting an almost benignant glance toward the patient, now beginning to open his eyes; "but let me point out to you upon this thigh-bone"--disengaging it from the skeleton, with a gentle twist--"the precise place where I propose to perform the operation. Here, young gentlemen, here is the place. You perceive it is very near the point of articulation with the trunk."
"Yes," interposed Surgeon Wedge, rising on his toes, "yes, young gentlemen, the point of articulation with the acetabulum of the os innominatum."
"Where's your Bell on Bones, Dick?" whispered one of the assistants to the student next him. "Wedge has been spending the whole morning over it, getting out the hard names."
"Surgeon Wedge," said Cuticle, looking round severely, "we will dispense with your commentaries, if you please, at present. Now, young gentlemen, you cannot but perceive, that the point of operation being so near the trunk and the vitals, it becomes an unusually beautiful one, demanding a steady hand and a true eye; and, after all, the patient may die under my hands."
"Quick, Steward! water, water; he's fainting again!" cried the two mess-mates.
"Don't be alarmed for your comrade; men," said Cuticle, turning round. "I tell you it is not an uncommon thing for the patient to betray some emotion upon these occasions--most usually manifested by swooning; it is quite natural it should be so. But we must not delay the operation. Steward, that knife--no, the next one--there, that's it. He is coming to, I think"--feeling the top-man's wrist. "Are you all ready, sir?"
This last observation was addressed to one of the Never-sink's assistant surgeons, a tall, lank, cadaverous young man, arrayed in a sort of shroud of white canvas, pinned about his throat, and completely enveloping his person. He was seated on a match-tub--the skeleton swinging near his head--at the foot of the table, in readiness to grasp the limb, as when a plank is being severed by a carpenter and his apprentice.
"The sponges, Steward," said Cuticle, for the last time taking out his teeth, and drawing up his shirt sleeves still further. Then, taking the patient by the wrist, "Stand by, now, you mess-mates; keep hold of his arms; pin him down. Steward, put your hand on the artery; I shall commence as soon as his pulse begins to--now, now!" Letting fall the wrist, feeling the thigh carefully, and bowing over it an instant, he drew the fatal knife unerringly across the flesh. As it first touched the part, the row of surgeons simultaneously dropped their eyes to the watches in their hands while the patient lay, with eyes horribly distended, in a kind of waking trance. Not a breath was heard; but as the quivering flesh parted in a long, lingering gash, a spring of blood welled up between the living walls of the wounds, and two thick streams, in opposite directions, coursed down the thigh. The sponges were instantly dipped in the purple pool; every face present was pinched to a point with suspense; the limb writhed; the man shrieked; his mess-mates pinioned him; while round and round the leg went the unpitying cut.
"The saw!" said Cuticle.
Instantly it was in his hand.
Full of the operation, he was about to apply it, when, looking up, and turning to the assistant surgeons, he said, "Would any of you young gentlemen like to apply the saw? A splendid subject!"
Several volunteered; when, selecting one, Cuticle surrendered the instrument to him, saying, "Don't be hurried, now; be steady."
While the rest of the assistants looked upon their comrade with glances of envy, he went rather timidly to work; and Cuticle, who was earnestly regarding him, suddenly snatched the saw from his hand. "Away, butcher! you disgrace the profession. Look at me!"
For a few moments the thrilling, rasping sound was heard; and then the top-man seemed parted in twain at the hip, as the leg slowly slid into the arms of the pale, gaunt man in the shroud, who at once made away with it, and tucked it out of sight under one of the guns.
"Surgeon Sawyer," now said Cuticle, courteously turning to the surgeon of the Mohawk, "would you like to take up the arteries? They are quite at your service, sir."
"Do, Sawyer; be prevailed upon," said Surgeon Bandage.
Sawyer complied; and while, with some modesty he was conducting the operation, Cuticle, turning to the row of assistants said, "Young gentlemen, we will now proceed with our Illustration. Hand me that bone, Steward." And taking the thigh-bone in his still bloody hands, and holding it conspicuously before his auditors, the Surgeon of the Fleet began:
"Young gentlemen, you will perceive that precisely at this spot--here--to which I previously directed your attention--at the corresponding spot precisely--the operation has been performed. About here, young gentlemen, here"--lifting his hand some inches from the bone--"about here the great artery was. But you noticed that I did not use the tourniquet; I never do. The forefinger of my steward is far better than a tourniquet, being so much more manageable, and leaving the smaller veins uncompressed. But I have been told, young gentlemen, that a certain Seignior Seignioroni, a surgeon of Seville, has recently invented an admirable substitute for the clumsy, old-fashioned tourniquet. As I understand it, it is something like a pair of calipers, working with a small Archimedes screw--a very clever invention, according to all accounts. For the padded points at the end of the arches"--arching his forefinger and thumb--"can be so worked as to approximate in such a way, as to--but you don't attend to me, young gentlemen," he added, all at once starting.
Being more interested in the active proceedings of Surgeon Sawyer, who was now threading a needle to sew up the overlapping of the stump, the young gentlemen had not scrupled to turn away their attention altogether from the lecturer.
A few moments more, and the top-man, in a swoon, was removed below into the sick-bay. As the curtain settled again after the patient had disappeared, Cuticle, still holding the thigh-bone of the skeleton in his ensanguined hands, proceeded with his remarks upon it; and having concluded them, added, "Now, young gentlemen, not the least interesting consequence of this operation will be the finding of the ball, which, in case of non-amputation, might have long eluded the most careful search. That ball, young gentlemen, must have taken a most circuitous route. Nor, in cases where the direction is oblique, is this at all unusual. Indeed, the learned Henner gives us a most remarkable--I had almost said an incredible--case of a soldier's neck, where the bullet, entering at the part called Adam's Apple--"
"Yes," said Surgeon Wedge, elevating himself, "the pomum Adami."
"Entering the point called Adam's Apple," continued Cuticle, severely emphasising the last two words, "ran completely round the neck, and, emerging at the same hole it had entered, shot the next man in the ranks. It was afterward extracted, says Renner, from the second man, and pieces of the other's skin were found adhering to it. But examples of foreign substances being received into the body with a ball, young gentlemen, are frequently observed. Being attached to a United States ship at the time, I happened to be near the spot of the battle of Ayacucho, in Peru. The day after the action, I saw in the barracks of the wounded a trooper, who, having been severely injured in the brain, went crazy, and, with his own holster-pistol, committed suicide in the hospital. The ball drove inward a portion of his woollen night-cap----"
"In the form of a cul-de-sac, doubtless," said the undaunted Wedge.
"For once, Surgeon Wedge, you use the only term that can be employed; and let me avail myself of this opportunity to say to you, young gentlemen, that a man of true science"--expanding his shallow chest a little--"uses but few hard words, and those only when none other will answer his purpose; whereas the smatterer in science"--slightly glancing toward Wedge--"thinks, that by mouthing hard words, he proves that he understands hard things. Let this sink deep in your minds, young gentlemen; and, Surgeon Wedge "--with a stiff bow--"permit me to submit the reflection to yourself. Well, young gentlemen, the bullet was afterward extracted by pulling upon the external parts of the cul-de-sac--a simple, but exceedingly beautiful operation. There is a fine example, somewhat similar, related in Guthrie; but, of course, you must have met with it, in so well-known a work as his Treatise upon Gun-shot Wounds. When, upward of twenty years ago, I was with Lord Cochrane, then Admiral of the fleets of this very country"--pointing shoreward, out of a port-hole--"a sailor of the vessel to which I was attached, during the blockade of Bahia, had his leg----" But by this time the fidgets had completely taken possession of his auditors, especially of the senior surgeons; and turning upon them abruptly, he added, "But I will not detain you longer, gentlemen"--turning round upon all the surgeons-- "your dinners must be waiting you on board your respective ships. But, Surgeon Sawyer, perhaps you may desire to wash your hands before you go. There is the basin, sir; you will find a clean towel on the rammer. For myself, I seldom use them"--taking out his handkerchief. "I must leave you now, gentlemen"--bowing. "To-morrow, at ten, the limb will be upon the table, and I shall be happy to see you all upon the occasion. Who's there?" turning to the curtain, which then rustled.
"Please, sir," said the Steward, entering, "the patient is dead."
"The body also, gentlemen, at ten precisely," said Cuticle, once more turning round upon his guests. "I predicted that the operation might prove fatal; he was very much run down. Good- morning;" and Cuticle departed.
"He does not, surely, mean to touch the body?" exclaimed Surgeon Sawyer, with much excitement.
"Oh, no!" said Patella, "that's only his way; he means, doubtless, that it may be inspected previous to being taken ashore for burial."
The assemblage of gold-laced surgeons now ascended to the quarter-deck; the second cutter was called away by the bugler, and, one by one, they were dropped aboard of their respective ships.
The following evening the mess-mates of the top-man rowed his remains ashore, and buried them in the ever-vernal Protestant cemetery, hard by the Beach of the Flamingoes, in plain sight from the bay.