Gilpin observer., 1918-07-18
Twenty
Minutes
Difference
~ WILLIAM HAMILTON OSBORNR
Of Ihs Vigizontes

In . hospital in New York there were
two clever surgeons, each of whom had
earned worldwide renown by his re-
markable specialized knowledge. Only
the most desperate cases, those requir-
ing intricate surgical knowledge, were
brought to them. 1t was noted by a
close observer of these two men, that
the subjects operated on by one Of
them almost invariably succumbed-
while those operated on by the other
surgeon almost invariably survived.
The curious observer was a confiden-
tial friend of the resident physician
Of the hospital. He wanted to know.
"Just what" he Queried, 'is the diff
ference between these two distinguish
ed Operators?"
1.-THE difference" returned the house
physician, "oh. about twenty minutes,
! should say"
There was the secret-twenty min.
utes difference in the time of perform
ing an operation. One man was deft,
swift, sure. The other was sure, but
slow. His too deliberate methods kept
the nervous system of the patient un-
der too long strain, and the system
frequently could not survive the shock.
The other man was like fiash-he cut
and slashed-in jiffy he was through.
Through twenty minutes sooner than
his brother surgeon. That twenty min
utes meant life on the one hand-death
on the other.
II you've got friend or relative in
the trenches, there is one picture that
keeps recurring to your mind. A thou
sand times you see this boy meeting In
stant death. Your young friend hasn't
ono chance IN ten thousand Of being
instantly killed. The number Of bull
lets that find their mark in the brain,
or that pierce any vital organ, is ex-
tremely limited. The great loss of life
upon battlefield does not result from
wounds Immediately fatal. The great
danger in this war as in all wars, Is
from wounds, not in themselves imme-
diately fatal, but wounds that become
serious only with the passage Of time.
Flesh wounds may be entirely super
6cial, and yet may become terribly
fatal. The victim may bleed to death,
he may suffer exposure. infection, fe-
yer, pneumonia-from his enforced ex-
posure = gangrene, modification -
death.
The Answer Is-Tlme.
In such a case, why does he live and
get well, If he lives? Why does he die,
II he dies? What is the difference2
The answer is, time. The answer may
be, twenty hours or twenty minutes.
Suppose 1t were possible to pick up
every wounded man the instant that
he's hit. to remove him swiftly from
the battlefield or the trench to a first
class hospital, to give him the immedi-
ate attention of nurses and surgeons.
II that picture were true, the fatalities
in our armies would be almost in
6nitesimal.
Look in the darker picture. Your
young friend goes over the top in big
allied drive. He Is wounded in the
leg. It Is q big drive-hundreds Of
thousands Of men engaged-hun-
dreds killed nstantly-thousands up
On thousands suffering with wounds,
most Of them superficial and SEEM
lngly unimportant. Your young
friend is disabled but for the present
he feels no unusual discomfort. Shock
Bustains him. He feels that very short
ly he will be picked up and taken in
to an emergency hospital where his leg
can be fixed up. He Is disappointed
no one comes. Terrific pain sets in
with the Inflammation a heavy fever.
Twenty-fOur hours go by. Finally he
is picked up. He is rushed to a hos
pital as fast as possible, considering
the number Of ambulances. He reach
es the hospital. The nurse looks at
his leg-she calls doctor. They both
shake their heads-they ought to have
had the man hours ago. All right, he
thinks to himself, they'll take care Of
him now. But ahead of him Is waiting
list Of groaning, wounded men. There's
nothing for 1t, he's got to wait his turn.
Hours pass. The wounded come in by
dozens. Medical supplies give out
medicine gives out. Dressings give
out. There are not enough surgical in
struments to go around. Finally, with
your man at the height of raging fe-
YER they get to him and operate. Twen-
ty hours before an operation would
have been unnecessary. They remove
the leg-a leg which had suffered n
superficial wound, not dangerous In
itself but which became dangerous
only with the passage of time. But
gangrene already has set init is fol-
lowed by modification. The boy suf-
fers the tortures of the damned. He
dies-is glad to die.
Now. what's the answer? Would
twenty minutes have saved him? Pos
sibly. Would an hour and twenty
minutes have saved him? Quite likely.
Would three hours and twenty minutes