It seems customary for the Surgeon of the Fleet, when any important operation in his department is on the anvil, and there is nothing to absorb professional attention from it, to invite his brother surgeons, if at hand at the time, to a ceremonious consultation upon it. And this, in courtesy, his brother surgeons expect.
In pursuance of this custom, then, the surgeons of the neighbouring American ships of war were requested to visit the Neversink in a body, to advise concerning the case of the top-man, whose situation had now become critical. They assembled on the half-deck, and were soon joined by their respected senior, Cuticle. In a body they bowed as he approached, and accosted him with deferential regard.
"Gentlemen," said Cuticle, unostentatiously seating himself on a camp-stool, handed him by his cot-boy, "we have here an extremely interesting case. You have all seen the patient, I believe. At first I had hopes that I should have been able to cut down to the ball, and remove it; but the state of the patient forbade. Since then, the inflammation and sloughing of the part has been attended with a copious suppuration, great loss of substance, extreme debility and emaciation. From this, I am convinced that the ball has shattered and deadened the bone, and now lies impacted in the medullary canal. In fact, there can be no doubt that the wound is incurable, and that amputation is the only resource. But, gentlemen, I find myself placed in a very delicate predicament. I assure you I feel no professional anxiety to perform the operation. I desire your advice, and if you will now again visit the patient with me, we can then return here and decide what is best to be done. Once more, let me say, that I feel no personal anxiety whatever to use the knife."
The assembled surgeons listened to this address with the most serious attention, and, in accordance with their superior's desire, now descended to the sick-bay, where the patient was languishing. The examination concluded, they returned to the half-deck, and the consultation was renewed.
"Gentlemen," began Cuticle, again seating himself, "you have now just inspected the limb; you have seen that there is no resource but amputation; and now, gentlemen, what do you say? Surgeon Bandage, of the Mohawk, will you express your opinion?"
"The wound is a very serious one," said Bandage—a corpulent man, with a high German forehead—shaking his head solemnly.
"Can anything save him but amputation?" demanded Cuticle.
"His constitutional debility is extreme," observed Bandage, "but I have seen more dangerous cases."
"Surgeon Wedge, of the Malay," said Cuticle, in a pet, "be pleased to give your opinion; and let it be definitive, I entreat:" this was said with a severe glance toward Bandage.
"If I thought," began Wedge, a very spare, tall man, elevating himself still higher on his toes, "that the ball had shattered and divided the whole femur, including the Greater and Lesser Trochanter the Linear aspera the Digital fossa, and the Intertrochanteric, I should certainly be in favour of amputation; but that, sir, permit me to observe, is not my opinion."
"Surgeon Sawyer, of the Buccaneer," said Cuticle, drawing in his thin lower lip with vexation, and turning to a round-faced, florid, frank, sensible-looking man, whose uniform coat very handsomely fitted him, and was adorned with an unusual quantity of gold lace; "Surgeon Sawyer, of the Buccaneer, let us now hear your opinion, if you please. Is not amputation the only resource, sir?"
"Excuse me," said Sawyer, "I am decidedly opposed to it; for if hitherto the patient has not been strong enough to undergo the extraction of the ball, I do not see how he can be expected to endure a far more severe operation. As there is no immediate danger of mortification, and you say the ball cannot be reached without making large incisions, I should support him, I think, for the present, with tonics, and gentle antiphlogistics, locally applied. On no account would I proceed to amputation until further symptoms are exhibited."
"Surgeon Patella, of the Algerine," said Cuticle, in an ill-suppressed passion, abruptly turning round on the person addressed, "will you have the kindness to say whether you do not think that amputation is the only resource?"
Now Patella was the youngest of the company, a modest man, filled with a profound reverence for the science of Cuticle, and desirous of gaining his good opinion, yet not wishing to commit himself altogether by a decided reply, though, like Surgeon Sawyer, in his own mind he might have been clearly against the operation.
"What you have remarked, Mr. Surgeon of the Fleet," said Patella, respectfully hemming, "concerning the dangerous condition of the limb, seems obvious enough; amputation would certainly be a cure to the wound; but then, as, notwithstanding his present debility, the patient seems to have a strong constitution, he might rally as it is, and by your scientific treatment, Mr. Surgeon of the Fleet"—bowing—"be entirely made whole, without risking an amputation. Still, it is a very critical case, and amputation may be indispensable; and if it is to be performed, there ought to be no delay whatever. That is my view of the case, Mr. Surgeon of the Fleet."
"Surgeon Patella, then, gentlemen," said Cuticle, turning round triumphantly, "is clearly of opinion that amputation should be immediately performed. For my own part—individually, I mean, and without respect to the patient—I am sorry to have it so decided. But this settles the question, gentlemen—in my own mind, however, it was settled before. At ten o'clock to-morrow morning the operation will be performed. I shall be happy to see you all on the occasion, and also your juniors" (alluding to the absent Assistant Surgeons). "Good- morning, gentlemen; at ten o'clock, remember."
And Cuticle retreated to the Ward-room.
White-Jacket Chapter 62