“It looks a mite better, don’t it?” said Mattie.
“No, it does not,” said I. “It’s still as morbid looking as before. Also remember we are only gazing at the surface now. We are not even considering the splintered bone inside. Now, one final admonition. If there is anyone here who does not feel capable of viewing this, let her leave us now. Alice? Emily?”
This time I didn’t even glance at my sister. There was no indication of retreat on the part of either Alice or Emily.
“Very well then.” I turned to the stand on which Mattie had placed the instruments, examined them carefully and finally selected one of my father’s ivory handled razors as the tool with which to begin. I opened it and tested its keen edge on my thumb as I had seen my father do many times. “Now then . . . above the knee or below . . . that is the question.”
“Whatever may be the state of his leg below the knee, there is absolutely nothing wrong with it above the kneecap,” said my sister flatly. “That seems obvious to me.”
“It may seem obvious because again you are only looking at the surface. You have no way of knowing how far the infection has spread beneath the skin.”
“Cut it off at the hip then, and be done with it.”
“Harriet,” I said sharply. “I will not tolerate this.”
She stared at me for a moment with an expression which a stranger, not knowing our relationship, could only have interpreted as absolute hatred. Then she lowered her gaze. “I’m sorry,” she said. “I apologize. I will make no more comments.”
“Very well. Then I will admit that I am inclined to agree that there is not enough evidence of spreading infection to justify amputating above the knee. The wound begins approximately three inches below the knee cap on the side of the leg and the discoloration begins about two inches below the cap on the front and back of the leg. Therefore let us cut just above the discoloration. Now, Harriet, what does it say in your text about the bones of the lower leg?”
Harriet peered at the book. “The calf bones are the tibia and the fibula. The tibia is situated at the medial side of the leg and, excepting the femur, it is the longest bone of the skeleton. The fibula is placed on the lateral side of the tibia, with which it is connected above and below.”
“The tibia is on the inside I believe, and the fibula on the outside—is that not correct, sister? And they are separated, I think, by cartilege—or something of the sort. Do you have a diagram there?”
Harriet found one for me and I studied it quickly and compared it with McBurney’s leg, identifying the area of bone through which I would have to cut.
“In the male,” Harriet continued, “the direction of the tibia is vertical and parallel with the bone on the opposite side, but in the female it has a slightly oblique direction, downward and lateral-ward, to compensate for the greater obliquity of the femur.”
“Fancy that,” marveled Alice.
“The femur is the thigh bone,” announced Emily.
“And that information is not at all important,” I stated, “nor is the oblique angle of the bone of any consequence to me. Now get on with what it says about the muscles. How many muscles will we have to sever?”
“The main muscles seem to be the gastrocnemus and the soleus which unite to form the tendon at the heel. Then there are the tibalis anterior and the digitorum longus in the front of the calf and the peronaeus longus and the peronaeus brevis at the sides of the calf and the biceps femoris at the back of the knee which from the diagram seem to be connected with some larger muscles above.”
“That is what I wanted to hear about,” said I. “Let me have a look at that diagram. Now do you understand the importance of finding the exact location of these muscles? Perhaps we ought to risk cutting a bit lower than our first mark in order not to take any chances on injuring the muscles of his upper leg and possibly giving him a stiff knee.”
“What difference will that make as long as the knee isn’t attached to anything?” asked Alice.
“That shows what you know about miltiary surgery,” said Emily “We can always make a wooden leg for him and it will be that much easier if he has the knee to manipulate it.”
“Be quiet, you girls,” I commanded. “Now Harriet, what about the veins and arteries?”
“Well it seems the main artery in the back of the calf is the popliteal. It is the continuation of the femoral artery which arises somewhere in the trunk of the body.”
“We are not interested in that.”
“Then the popliteal divides—apparently just below the knee—into the anterior and posterior tibial arteries.”
“How far below?”
“It doesn’t say, but on the diagram it doesn’t appear to be very far.”
“You will have to be more accurate than that. Let me see that drawing. It would help, I suppose, if we could cut above the popliteal division rather than below. That would give us less individual arteries to contend with.”
“Would you like to hear about the veins? The veins of the lower extremity of the leg are subdivided into two sets—the super filial veins and the deep veins. Then there are the sub-arteries, such as the branches of the popliteal which are the muscular sural and the muscular superior, the cutaneous, the medial superior genicular, the lateral superior genicular. . . .”
“Enough,” I said, “my head is whirling.”
“It seems you will have plenty of blood vessels to contend with no matter where you cut. If you want my advice, I’d say bind the tourniquet around his upper leg again and forget about the book. Tie each artery with a thread or something as you come to it.”
“I intended to do just that anyway, Miss,” I informed her, “but I thank you all the same for reminding me.” I took some of the strips of cloth from Emily then and bound them as tightly as I could above his knee. “And as for the book,” I added as I worked, “I think it has been of great help to us. We know now what to expect anyway. We’re aware now that our task will be a very complex one.”
“I wish you would stop saying ‘we.’ You are performing the task even though I’ve agreed the responsibility is partly mine.”
“As you wish, sister. I will say ‘I,’ then. I am ready. Is everyone else?”
“We been ready for fifteen minutes,” said Mattie.
“Be silent, you!” I half shouted.
“Yes’m. My feet’s gettin sore is all, standin here.”
“Your back will be sorer than your feet, I guarantee you.”
“For God’s sake, Martha, begin,” cried my sister. “If you’re going to do it, then go ahead with it.”
“Very well.” I marked the new place on his leg with my forefinger and laid the edge of the razor on it. Then—a mistake—I looked up again to make sure he was still unconscious. He was, but that momentary glance cracked the edges of the detachment I had maintained until then. McBurney looked suddenly, not like a problem to be solved, but like a person about whom I had some feelings—not always liking, perhaps, and probably on some occasions even disliking, but always something, some very personal interest. I couldn’t ignore him as a person any longer—especially now that I had remembered a resemblance to someone else.
“Take one of those sheets, Mattie, and put it over him,” I said.
“He ain’t cold.”
“Do as I say. Cover him down to the knees. Put it over his face, too, but fold it up a bit around his head to let the air in.”
“There is some frailty in you, after all, isn’t there,” observed my sister as Mattie took the sheet and put it over him.
“I have never denied it,” I told Harriet. “I do deny myself the pleasure of giving in to my weaknesses. What I have done now is not to spare myself, but to prevent a possibly dangerous distraction.” And I began to cut Corporal McBurney’s leg.
I will not describe the following half hour in detail beyond saying tha
t it was the worst such period in my life. There were later unfortunate and unpleasant events in this house, which to the participants may have seemed like worse times than the thirty or so minutes it took to amputate McBurney’s leg, but to me those moments were the most agonizing I have ever experienced.
And yet, they seem so only in retrospect. I recall them vividly, I dream about them constantly—and yet while they were occurring, the urgency and physical effort involved permitted me to think of little else but getting the job finished. Even when he awakened and screamed, I was still able to concentrate on the task itself. I even remember what I was thinking about at that moment. It was . . . “Mattie can hold him . . . what a mess we’re making . . . is the tourniquet tight enough . . . it is a pity Mattie couldn’t find a better saw.”
Alice crumpled to the floor and was left there. Emily walked rigidly out to the kitchen and didn’t come back. Mattie earned her keep that day, as she always does in any such emergencies. My sister comported herself remarkably well throughout the entire ordeal. When McBurney awakened, for example, she pulled the cork on another bottle of wine and held his head up and poured half the bottle into him, whispering words of comfort to him all the while.
He wasn’t awake long, thank God. The wine or the shock and loss of blood soon rendered him unconscious again, and then my sister took a drink out of the bottle herself and afterwards extended it to me. I looked up and nodded my acceptance and she held it to my lips while I took a good draught of it. Then she passed the bottle on to Mattie who finished it.
Mattie at one point in the proceedings had gone out to the kitchen and obtained a garden basket. She waited with this now and when the blade cut through to the table she took the separated portion of McBurney and put it in the basket, then covered it with a cloth—gently. I noted, and neatly too. Two more irrelevancies crossed my mind. One was . . . “I’ve gashed the walnut table” . . . and the other . . . “I might have thought to remove his stocking.”
My own work was neat enough, too. I think if a surgeon inspected it, he would have agreed that I had made a very tidy job of it. I tied all the major blood vessels off with some of Harriet’s silk thread and then, having left a sufficient flap of skin all around the stump, I folded this together and sewed it as tight as a drum against the bone.
“There,” I said, backing off. “There we are.”
“Yes, there we are,” said my sister.
“What do you want me to do with this?” asked Mattie.
“Bury it somewhere. Get a spade and dig a decent place for it. But first you’d better see to Miss Alice here.”
“What are you going to do with him?” asked Harriet.
“Take him back to the settee, when I’ve caught my breath.”
“I mean later . . . if he lives.”
“He’ll live.”
“I’m told that in the armies, it is seldom that the men recover from this kind of surgery.”
“You didn’t mention that before.”
“I thought you knew it.”
“Well, it doesn’t matter. He’ll live—I know he’ll live. And then he can stay here, if he likes. He’ll always have a home here for as long as he likes.”
I don’t know why I said that, but I did. I think I must have been half out of my mind from the strain at that moment and capable of saying anything. I was in a state, it seems now, of something close to exultation. I felt a sense of triumph—of having won a great victory against overwhelming odds. I have said that I know those thirty minutes now to have been the worst ones of my life, but I also know I didn’t feel that way then. Then, if you had asked me, I might have called those moments my best.
“All right,” I said then. “Let us take him back to bed. Raise him gently . . . so . . . and slide the sling under him. Now, Harriet and Mattie, take the head poles, while I carry the bottom.”
“It’s too heavy for you alone,” said Mattie.
“Nonsense,” said I as we moved out. “I could carry twice this weight, if necessary.”
In the hall we found the sullen Marie Deveraux sitting on the bottom step of the stairs. When Harriet called to her she arose and took one of the poles from me. Then we continued across into the living room and put Mister McBurney back on his settee.
Marie Deveraux
I wonder if when Miss Martha thinks about the afternoon when she cut McBurney’s leg off, she ever remembers the pretty vile way I was treated on that occasion. I’m talking about being sent out of the room like a leper or a person with the pox without even being given the opportunity to explain that I had no intention of interfering with the business of the operation or distracting the lady surgeon in any way. I was not even permitted to tell how I had spent one entire afternoon at home, when I was only seven, watching Doctor Bonnard probe for a bullet in my uncle Georges’ chest which my uncle, who was normally a very expert duelist, had obtained as the result of an unfortunate slip on early morning grass. Admittedly, I was trying to hide behind a certain but Doctor Bonnard knew I was there because at one point when he had paused to come over to the window for a breath of air and a sip of brandy, he turned and winked at me. Also, to return to the present case, there is always the question of why, if I was old enough and sensible enough to watch the repair work on McBurney’s leg, I couldn’t be allowed to watch the cutting off of it.
Well I bear no grudges. McBurney’s leg is past history now. I have been subjected to a thousand fresh indignities since that time but I have learned to live with them. It’s all a matter of deciding what you want and then making the little necessary adjustments which will enable you to get your wish. What I wanted very much that day was to see McBurney’s amputation and naturally I did. Through the keyhole. Or rather, at first through the keyhole and then later around the edge of the door, which I opened very quietly.
And, not to brag about it but only to be accurate, I was the only student here who did see the whole thing from start to finish, because Miss Emily Stevenson ran off, sick to her stomach, and Miss Alice Simms gave one heave of her marvelous bosom and fainted dead away. Of course Edwina Morrow and Amelia Dabney were not present for any part of the proceedings.
I might add that I helped carry him back into the parlor. Miss Martha didn’t need me to assist with the surgery but when those two shining example of beauty and intelligence turned out to be complete failures, why then Miss Harriet was very glad to call on your obedient servant to assist in getting Johnny back to bed.
Well after we had unloaded him, Miss Martha felt his brow and his pulse and put her head on his chest and listened to his breathing—all in the best medical manner, I assure you. For a while there, as I later told my roommate, I was very much afraid this surgery idea would become over popular and we might be faced with a regular epidemic of cutting people’s legs off. “We had better sleep with our legs tucked under us in future,” I jokingly told Amelia sometime later, “or else we may wake up some morning and find we have sacrificed them to Miss Martha’s new enthusiasm.” Of course Amelia didn’t think this was very funny because she took a very personal exception to Johnny’s operation and she was terribly upset for a very long time after it.
As Miss Martha was too, I can tell you. She didn’t reveal any emotion in the dining room but once she had McBurney tucked in bed, she just became absolutely hysterical, and ranted and raved and went on in the wildest fashion ’til she just about drove us all right out of the room.
I think Miss Harriet started her off by making some innocent remark about Johnny’s not looking much like her and Miss Martha’s brother any more. As I recall Miss Harriet said that she had considered Johnny’s resemblance to her dead brother quite striking at one time, but that this resemblance seemed to be gone now.
“I suppose you think I cut off his leg to change his appearance,” Miss Martha practically shrieked.
“No, no . . . of course not,” Miss Harriet said, trying to ca
lm her. “I wasn’t referring to his leg at all. I just meant that his face seems changed now. It seems more drawn and older looking than before. But I suppose that’s only a natural reaction to the shock and all.”
“Of course. That’s been your reaction too, Harriet. You look years older than you did this morning.”
“I imagine I do,” Miss Harriet answered. “I certainly feel that way.”
“And what about me?” Miss Martha persisted. “Or has the ordeal left me unchanged. Do you think it was just another day’s work to me—or maybe you’re under the impression that I did it for enjoyment.”
“Not for enjoyment, Martha, but possibly for something else . . . satisfaction.”
“Of course I’m satisfied,” Miss Martha shouted. “I admit it. I’m satisfied that I have done my best to save a boy’s life! Is there something wrong in that?”
“Nothing, sister. If you can honestly take pride in this accomplishment, then I envy you. I envy you your peace of mind.”
“Do you really, sister? Wouldn’t it make you just a trifle happier if you thought I was feeling some remorse?”
“This talk is foolish, Martha. It doesn’t make any difference now what either of us feels. The thing is over now and whether you are sorry or glad about it won’t change anything. Your remorse wouldn’t restore this boy’s leg any more than it brought Robert back after you drove him away.”
Well whatever the meaning of that remark it evidently had great significance for Miss Martha because I think she was about to attack Miss Harriet physically then—if she didn’t perish from apoplexy first—because she turned in her tracks and started for Miss Harriet with her hands upraised and clawed, ready to scratch Miss Harriet’s eyes or pull her hair out. And Miss Harriet just stood there, not even preparing to defend herself, but just waiting calmly as though the onslaught was something she had been expecting for a long time and now that it was finally coming, she rather welcomed it. Or at least that was my impression of her attitude when I thought about it later.
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