The Rangers Are Coming

by Phil Walker

  Rippert stepped into his room. It was a large room, with a table. Obviously, this was where Rippert would hold meetings. There was a bed in the alcove around the corner. There was a chest of drawers and a large bowl, with a porcelain pitcher of water. There was also a bucket that Rippert supposed he was expected to use as a toilet. At least the room seemed clean but had a musty smell.

  He unpacked his suitcase, and put away his clothes, after wiping down the drawers with a sanitizer. He also wiped down all the surfaces he might touch with sanitizer. Now, at least the room smelled fresher.

  After he’d unpacked he left, locked the door and wandered down the hall to the next room. When he knocked, Bob Peters opened the door. “I suppose you got a room of your own. I’m stuck with Eli here and we all know how he snores.”

  Eli walked over, “I thought I was being extravagant bringing so much sanitizer, but I bet I used half a bottle wiping down this place. Did you ever, in all your life smell such a rotten place as London? I thought half the people were going to die just by driving past them. And look here, I’ve got a bucket to crap in, and one lousy bowl to wash my hands.”

  “We can slip back to the Mississippi for showers when it gets so we can’t stand it,” said Don.

  “Really, Don, is this such a good idea? These guys are so ignorant and primitive, I’m not sure they will know what we’re talking about.

  “Not much we can do about it now but try and make the best of it,” said Don. “Let’s get the others and go down to lunch. Don’t forget your water bottles.”

  The team went down the stairs to the main floor and found Dr. Dobkins waiting for them. “Splendid,” he said, “my doctors have all arrived and are eager to meet you.” He led them down another hall and through big double doors to a dining room with one long table. Dobkins led the way to the head of the table and signaled Rippert to be seated on is right. The rest of the team were sprinkled down the table with British Doctors sitting next to them.

  Waiters entered the room carrying platters of food. The British doctors immediately started grabbing platters and starting serving themselves.

  “Excuse me, Doctor Dobkins,” said Rippert rising to his feet. “In America it is our custom and responsibility to thank the Lord before we begin eating a meal.”

  “Of course,” said Dobkins, forgive me and please proceed.”

  “All six of the Americans stood and put their hands together. “Heavenly Father, we offer you our praise and honor for a safe passage and an opportunity to meet with companions in science and medicine. We ask you to bless our efforts and for our work, here to be for your glory. We ask thanks for this meal in the name of our holy savior, Jesus Christ, Amen.”

  “Amen,” came a chorus of the men at the table. The Americans sat back down and began studying the food, trying to figure out what they could eat that wouldn’t give them dysentery.

  “I understand,” said a portly British doctor to Bob Peters that American Medicine has discovered the use of ether as an effective anesthetic?”

  “We have been aware of ether for some time,” said Peters, “However, today, ether is rarely used. The use of flammable ether was displaced by nonflammable anesthetics such as halothane. Diethyl ether was found to have undesirable side effects, such as post-anesthetic nausea and vomiting. Modern anesthetic agents, such as methyl propyl ether and Penthrane reduce these side effects.”

  The British Doctor blinked and cleared his throat into his napkin.

  Rippert caught the exchange and said loudly enough for the rest of the room to hear, “Actually, we have developed an entirely new and different procedure that provides us with a large number of options when we are conducting an operation. This is the reason we’ve made this trip to Europe. As you know, we have four other teams who are currently in, or arriving soon, in France, Germany, Spain, and Austria-Hungary.”

  “How soon will you be able to provide us with this demonstration,” asked Dobkins?

  “Has all our equipment been delivered to the hospital?”

  “Yes, it came with you this afternoon. We have placed it all in our largest surgical observatory.”

  “Then give us a day to get set up and we’ll be ready to start,” said Rippert.

  “I, uh, am reluctant to bring it up, but finding volunteers to undergo your experiments have been somewhat difficult to find.”

  “That won’t necessary,” said Rippert, “three of my doctors will serve as patients, and these are not experiments, they are standard procedures for all our operations in the United States.”

  “Well, that is very good news,” said Dobkins. “I notice Doctor that you are not drinking anything except water from those strange bottles. Is there a reason for that?”

  “Damned good reason,” said Eli, from the other end of the table. London is currently experiencing another outbreak of Cholera. Since Cholera is a water-borne disease, we are only going to drink water that we know is safe,”

  Rippert cringed at the other end of the table. He knew Eli was only speaking the truth, but the truth was that nobody in the world knew that Cholera came from drinking contaminated water. He hoped Eli had not opened a can of worms.

  “Are you saying that Cholera is caused by drinking water,” asked a shocked doctor sitting across from Eli.

  “Contaminated water,” said Eli,” when you mix fresh water with water that contains human or animal waste, or anything rotten you introduce the Cholera bacteria into the water. People drink it and die basically of dehydration.”

  “That is astonishing information,” said the British doctor. We have observed that Cholera does not spread from person to person.”

  “Of course not,” said Eli, “Cholera is not an air-borne disease.”

  “How do you prevent its spread, asked the doctor?

  “Separate your fresh water supplies from your sewage, like not dumping your sewage into the river. It will make London smell better too.”

  “And how do you make suspicious water safe to drink,” asked the doctor?

  “Boil it,” said Eli, “that will kill all the pathogens in the water.”

  “Very interesting observations, Doctor,” said Dobkins.

  The meal finished with very little conversation.

  The team moved into the operating theater the next day.

  “Will you look at this,” said Bob, it’s nothing more than a classroom with auditorium seats. The doors go right out to the street, so much for a sterile atmosphere.”

  “We aren’t doing open heart surgery,” said Rippert, “all I’m going to do is poke you with a needle. I’ll still take all the precautions.”

  They rolled three tables into the open space at the bottom of the room. Rippert ordered that three large porcelain jars be brought in with boiling water in two of them. He sat these on another table across the room with a deep bowl in the center. He got out a frame that held the IV bags with the hook at the top. On this, he hung a bag of common saline solution and attached the bag to a plastic tube. The tube had a port in it to inject whatever drug they chose. At the end of the tube was a connector for a needle. He sat out some small bottles that contained a variety of anesthetics, and some syringes with covered needles. “I think that about does it,” said Rippert, bring in the audience. He and Eli put on the long white coats of doctors.

  Over a hundred doctors rushed into the room filling all the seats and gabbling as they sat down.

  Rippert turned to the audience and said, “Whenever you are working or operating around a patient, great care must be taken to insure no bacteria of any kind be introduced to the patient’s body. We take our first precaution by what is known as ‘the scrub’.” He walked over to the porcelain jars and poured boiling water in the basin, adding a small amount of cold water. “This water is as hot as I can stand. Ideally it should be running.” Rippert took the soap bar and a stiff brush and began to industriously, scrub his hands, and up his arms. He did this for several minutes, throwing out the water in the basin and adding
more. Finally, he washed off his hands and Eli handed him a towel to dry his hands. “This towel is from our supply and I know it is sterile. It was washed in boiling water and a strong detergent, dried and stored in this bag. I am now drying my hands.”

  Next Eli pulled out two plastic surgical gloves from a clear container and with gloves already on his hands; he held the gloves for Rippert to shove his hands into each of them. “There is powder inside the gloves to make them easier to put on.” He held up his hands to show the audience. “We now have taken the second precaution to maintain as sterile an environment as possible. More patients die of bacteria introduced into their system by the surgeon, than do from the reasons they came to the doctor in the first place.”

  Eli then placed a surgical mask on Rippert and tied it up. Rippert did the same for Eli. Then, speaking through the mask Rippert said, “A third precaution we take is to wear surgical masks. This keeps us from breathing or spitting any bacteria into the patient. Everything I have done should be standard procedure for any operation in which the patient’s skin is broken. It is a sacred rule of the oath we all took, ‘First, do no harm.’ Bring in the patient.”

  Bob Peters came walking into the room. He was wearing jeans and a short-sleeved shirt. He lay down on the table with his head facing the audience, which was a silent as a tomb. Rippert rolled the IV stand over to the edge of the table and pointed his gloved fingers to it. “This bag contains nothing more than a common saline solution. The human body is 90% percent water, the same as seawater. This plastic tube is connected to the bag. In the center of the tube is a port, by which I can inject anything I want into the patient. This is done by injecting the end of the tube, which has a needle attached to it, into the arm of the patient. This is a very sharp, thin piece of hollow metal that is sterile because of the covering on it. I will now remove the cover and pass some samples around the room. As you can see, the needle will allow the solution to pass through it into the patient’s body.”

  Rippert put a plastic band around Bob’s arm above the elbow, and said, “I am doing this to slightly constrict the blood flow and let me better see the veins in Bob’s arm here. We take the needle and insert directly into the vein.” He swabbed Bob’s arm with an alcohol wipe. “This is just alcohol to sterilize the skin where I am going to make the injection. It keeps any germs on his skin from going in with the needle.”

  Then he gently shoved the needle directly into a vein. He lifted the tube a little to show that blood was flowing. He then turned and picked up one of the small bottles. “This bottle contains our anesthesia. I am going to use this syringe and withdraw a small amount from the bottle. I don’t want Bob to sleep all night and miss dinner.”

  Rippert stuck the needle in the bottle and drew out a small amount of clear liquid. Then he injected into the port on the plastic tube. “Bob, start counting backwards from a 100!”

  Bob called out “100 -99-98-97-9 6 –nine.” And that was it.

  “Bob will out for approximately one hour. He will awaken feeling fine and ready for dinner. Can I have my next two volunteers? This is Doctor Clay and Doctor Harris. Which one of you brave souls is ready to come down here and do what I have just done?” Rippert waited for a bit, and then said, “Come, come, gentlemen. This is very basic medicine. There must someone willing to give it a try.”

  From about the middle a gallery a middle-aged man stood up. Dr. Rippert, I think I speak for us all when I say we have all just taken a giant leap into the medical future. I admit, I am afraid, but with your help, I’m willing to be taught.”

  “Good show, old man!” said Rippert, Come on down here and walk into history.”

  Rippert got fresh boiling water and supervised while the doctor, whose name was Crane, scrubbed up. He had to do it three times before he passed Rippert’s inspection. Then Rippert handed him a towel to dry his hands, put on a new pair of gloves, and held another pair instructing Dr. Crane to push his hand into the glove smartly to make sure of a good fit. He tore up two pairs of gloves getting the hang of it. Then Rippert put on Cranes’ surgical mask and one of his own, explaining as he did that you always use new gloves and new masks every time.

  Dr. Clay came into the room, smiling, and lay down on the table. Rippert rolled the new IV bag over to the edge of the table with a new plastic tube, port, and a shielded needle at the end.

  He had Crane, tie the elastic round Clay’s arm, and swab him with alcohol. Then both of them got close and Rippert pushed gently on Clay’s arm. “See the vein,” said Rippert, “Put the needle right in the middle of it.”

  Dr. Crane would be forever grateful his hand was steady and he hit the vein on his first try. Then he got the second syringe, inserted the needle in the top of the bottle, and drew out the exact amount Rippert said to take. He pushed the needle into the port and said, “Count backwards from a hundred.” Crane only got to 98 before he was unconscious. “This anesthetic is for use when time is short, like you have a man with a belly wound and he’s about to bleed out on you.”

  He held up the syringe and said, “Whose next?” This time there were several volunteers. Ripley picked a young man and sent him through the entire routine until Dr. Harris came into the room and went out cold, right on schedule.

  “I don’t think you will have trouble getting volunteers now,” said Rippert, “tomorrow we will begin again, and each of you will do this routine until it becomes like second nature.”

  Rippert was mobbed by applauding doctors who wanted to get their hands on all that strange equipment they’d seen. They asked a hundred questions, oblivious to the three sleeping men on the tables.

  The stiff British reserve was gone. Dr. Don, as he came to be called and the rest of his staff worked diligently for two weeks to insure that no less than 200 doctors had mastered the technique and learned to wash their hands before they operated. They worked in harmony and an air of the unknown. Exactly what was the nature of medicine in the United States if the docs could answer any question put to them, no matter what the subject? It gave the British physicians a profound respect for what America must be doing in other areas if they had come so far in medicine.

  The American Ambassador to England dropped by one day to say that the results in the other countries was much the same.

  When the mission was over, a great party was held. One of the highlights of the party was Dr. Don drinking a glass of water Dr. Dobkins gave him. He said that it was part of a batch of water that was boiled especially for the occasion. The water wasn’t cold, and there were no ice cubes in the glass, but it was a very satisfying drink for Dr. Don.

  The team left ample enough supplies to conduct several hundred operations. The British government ordered an entire shipload of the things they needed to keep the anesthesia running. All the other countries did the same, and a pharmaceutical company in Virginia had a windfall of profits.

  40

  Washington, D.C.

  Arcadia sat at her computer in her big Georgetown house. The computer was transferring the image onto the big monitor that covered most of a wall in her large office. The other walls were mostly a collection of photographs of the important events of America, going back to 1770. Now, in 1850, Arcadia was reviewing the land use planning maps she and her urban designers conceived when the North American continent was secure.

  The nice thing about having a big empty space like she did with Alaska, Canada, the original United States, Mexico, Central America, and the Caribbean as a palette was that the planners could make the most efficient use of the land for all the purposes that would emerge in a modern country. In the original United States, growth had produced a hodge-podge of land uses that put industrial areas too close to residential areas, did not make the best use of the agricultural lands, or provide for the proper growth planning that would emerge with population growth.

  The states had mostly the same boundaries as before, with some major differences. California, for example, became two states, north, and south. Of course
, the state of Sioux had wiped out North and South Dakota and Nebraska and increased the size of Kansas. The National Parks and Federal land in forests and unique geographical places were kept clear of all development, except the service centers for visitors. Transportation corridors for rail, and highways, were also planned for expansion and growth as the population increased. The electrical power grids were interconnected and all buried in steel pipes. The dams that were built, took into consideration the environmental impact along with the commercial uses in hydroelectric power, and the land that could turned into agricultural uses, along with their natural flood control component.

  As immigrants were admitted to the country, they could be disbursed to the regions, most like their former homes. They were kept in large enough groups to help maintain their culture, but not big enough to dominate a region.

  Thus, when the flood of Irish began to arrive because of the potato famine, they were divided by their work skills and transported to that part of the country where that activity was underway. Farmers went to farmland and received free land, factory workers went to the one of the many assembly line production centers. It was not unusual for groups of Irish to end up in the state of Alberta for farming, or Guadalajara for work in an aircraft plant.

  The school system was completely accustomed to bringing in illiterate people or those who did not speak English and transform them into useful workers, farmers, or students in just a couple of years. At the heart of all things in America was the Christian ethic that asked people to live their lives as much as possible as Jesus did, with love, charity, and moral integrity in regards to honesty and strong family units.