“He does. He had his lawyer with him this afternoon and he’s remade his will. But he’s hopeful that you’ll be able to save him.”
George took out his watch and glanced at it. “So it’s been almost nine hours since he was shot.” He sucked air between his teeth and then took a final gulp of coffee. “Gentlemen, I think it’s time I saw the patient.”
* * *
Dr. John Handy was lying back against a bank of pillows looking exhausted and in considerable pain. He had a full head of black hair and a full beard. His face was bathed in perspiration and his eyes seemed sunken into their sockets.
“George…thank the Lord… that you’ve come.”
“I came as soon as I could, John. I was shocked to hear that you had been shot.”
“That cur of a lawyer Frank Heney killed me, George.” He pointed weakly at the three other doctors who had come in after George and stationed themselves at the end of the bed. “That’s what I and our friends here think.”
“You’re not dead yet, old friend. That’s why I’m here. We’ve got to get you back on your feet so you can get on with healing the sick.”
George saw the glimmer of hope flash across his colleague’s face. He tried to be as positive as he could, despite the fact that he was concerned about the time that had elapsed since the shooting.
“If you get me back on my feet, George Goodfellow, I’ll buy you a crate of the best whiskey in the world. To tell you the truth…it’s…it’s my youngsters that I’m more concerned about than my patients. They…need me.”
George turned to Hiram. “So you and Michael removed the bullet. What caliber was it?”
“It was a .32,” Hiram Fenner replied.
“That is the first piece of good news,” George said with a nod. “As I’m sure you will all know, if you read my paper on the management of gunshot wounds in the Southern California Practitioner, a couple of years back, the caliber of the weapon is crucial in abdominal wounds.”
“I read it, George,” Dr. Handy said, weakly. “But the bloody fool shot me as I was trying to take the gun from him. It…it was pressed up close to me when it went off.”
George sat down and gently pulled back the bed covers and removed the thick dressings. He maintained a professionally calm countenance even though he was aware Handy understood that a close-up wound would bring additional problems.
And as he inspected the wound his suspicions were confirmed. There were significant burns around the entry wound in the lower abdomen. The wound was already tumescent, red and swollen.
“There is a second good bit of news, John,” he said reassuringly to Dr. Handy. “It’s a lower abdominal wound. That makes it less likely to have damaged the liver or the kidneys.”
“Or the spleen,” offered Dr. John Green.
“If the spleen had been hit then death would have been damned near instant,” George replied without looking around. “The spleen hemorrhages catastrophically.”
He laid a hand on Handy’s abdomen and gently palpated, all the time watching the pain that it elicited on the patient's face. Then he placed his left hand flat on the abdomen and percussed the back of the middle finger with the tip of his right middle finger. He nodded as he listened to the sound that it produced.
“Let’s see what I can hear now,” he said, pulling out his stethoscope and uncoiling the rubber tubing. He placed the earpieces in his ears and listened at several points on the abdomen as he moved the funnel around.
“There are not a lot of borborygmi there. That might mean that the intestine that isn’t damaged is already paralyzed. And on percussion it is clear that there is a lot of blood in the abdomen. We’re going to have to operate on you, John. And as soon as we can.”
“Good…but I can’t say that I…re…relish being put to sleep with chloroform.”
“I’ll happily see to the anesthetic, Dr. Handy,” John Green volunteered. “I’ve used it a lot and I have a Chisolm chloroform inhaler, which means I can reduce the dose that you need to a single drachm. That will be an eighth of the dose that you need by the traditional method. The benefit is that you won’t get any of the suffocative side effects that you get with the old way of dripping onto a face mask.”
Handy gave a nod of relief. “I thank you, John. The Chisolm inhaler is the finest medical invention to come from the days of the Confederacy.”
“Right then, gentlemen,” George said, as he stood up. “The anesthetic is settled. Dr Green will do it. Are you happy for me to operate?”
“We are,” replied Hiram Fenner. “And we are both happy to assist you at the operation.”
“Well, in fact I’d like just one of you to assist and one to operate my carbolic spray. We need a fine spray onto the operation site throughout the procedure. I have a small portable machine that I had built according to Professor Lister’s design.”
“Hiram is your assistant then, George,” Dr. Spencer said. ‘I’ll do the spraying.”
“And we have the kitchen table already scrubbed and ready,” Dr. Green announced.
* * *
It was ten past ten that night before the four doctors had the kitchen transformed into an operating theater.
Dr. Handy shook hands with each of them and said a prayer before Dr. Green administered the chloroform via the Chisolm inhaler that consisted of a small brass box with two tubes, one of which was inserted up each nostril.
“Just breath in and out through your nose, John,” he urged the patient. “If you get a tightening feeling in the back of the throat, just open your mouth and breathe in and out. That’ll take away any unpleasant sensations.”
And within a few moments Dr. John Handy was asleep.
George instructed Michael Spencer on the operation of the carbolic spray, which consisted of a metal cylinder containing a water bath above a spirit lamp, with tubes leading to and from a bottle containing carbolic acid. The water was boiled to produce steam, which was then pumped by hand into the carbolic acid, which was taken up by the steam and emitted into the air as a spray.
“Keep it topped up and just keep that spray above the operation.”
Then George and Spencer washed their hands in carbolic and soaked all of the instruments.
“Now gentlemen,” George said, as he pointed his chin at the clock. “It is precisely 10:20 pm. Let us proceed with as much haste as we dare.”
Before he operated on a gunshot wound George always made it a point to try to work out the track of the bullet, thereby having a good idea of what anatomical structures could be damaged.
In John Handy’s case the wound had entered one inch below and to the left of the umbilicus. The wound on his back, from whence Drs. Fenner and Spencer had extracted the bullet, was almost directly opposite it. This, George deduced, meant that the gun had been pointing directly at his abdomen, which was better than had it been pointing upwards, for that would surely have hit major organs and probably been fatal already.
He made an extended incision parallel with the linea alba and just an inch lateral to the swollen and inflamed wound.
Immediately, blood started to spurt from the abdomen and together, George and Hiram Fenner started to soak it up and remove blood clots and intestinal contents from the cavity.
“Keep that spray going, Michael,” George urged. “With this much intestinal ooze we’re going to have to make sure that we get his peritoneum as clean as possible.”
Then slowly and methodically George started to examine the small intestine. He found eighteen separate perforations.
The three Tucson doctors watched with admiration as he skillfully worked on the damaged intestines.
“I always use the glover’s stitch on intestinal wounds,” he explained as he executed a continuous lock-stitch suture by each time passing the needle through the loop of the preceding stitch.
“Whereas interrupted stitches are fine for other tissues, because the intestine is so vascular, you have to make sure that you have as hemostatic a closure as pos
sible. That way you are also less likely to get further ooze of intestinal fluid into the abdominal cavity.”
None of the three doctors raised an objection to George’s lecturing manner, for they were all too well aware that he was the expert in gunshot surgery and was pushing back the frontiers of surgical practice all the time. Even some of the forceps that he was using to control bleeding were instruments of his own design, made for him by Tiemann & Co of New York.
They had been operating for almost three hours and all had seemed to be going well. George was enjoying the surgical challenge and was starting to feel a glow of satisfaction as he approached the end of the operation.
He had just closed the very last perforation when Dr. Green cursed and held his small mirror close to the patient’s mouth. There was no misting of its surface. Then he felt for a pulse.
“I am sorry, Doctors,” he said, shaking his head. “Our patient has just died.”
It was quarter past one in the morning.
Chapter 5
FRUSTRATION
George barely slept that night. Like the other three doctors he was frustrated and felt that he had failed his colleague.
They had tended to Dr. Handy’s body then arranged for one of the attendants who had been waiting to sit with the patient after the operation to go and fetch the undertaker.
Then they had returned to Dr. Fenner’s house where they drank a toast to their dead colleague.
“We were too late!” George said as they sat around Dr. Fenner’s dining room table, with a decanter of whiskey in the middle. “It was just as I said in my paper, any abdominal wound with a caliber of .32 or more should be operated on within an hour.”
“That wasn’t possible, George,” said Hiram. “We got you here as soon as humanly possible. None of us had the expertise to perform an operation like that.”
George grunted and struck a light to his pipe. “Do any of you gentlemen enjoy poetry?”
“I do,” replied Michael Spencer. “Have you a poem in mind to help think about John Handy?”
George blew out a thin stream of smoke. “No, I was thinking more about how I feel about not saving him. There is a line from Endymion, by the English poet John Keats. It goes: ‘There is not a fiercer hell than the failure in a great object.’ That is how it feels to me, gentlemen. This feels like hell. We tried and we failed to keep one of our own profession alive.”
Hiram Fenner sighed and looked at the crestfallen faces around the table. He reached for the decanter. “I think we could all do with another drink, gentlemen.”
He poured each a generous measure then raised his glass.
“I propose another toast – to John Handy, who knew that we were all trying to do our best for him.”
* * *
George had always been able to hold his liquor and still work the next day. Drs. Green and Spencer were not so sure that they had a similar capacity. Nor did they have much inclination to drown their sorrows at having lost a colleague.
Hiram Fenner had one final drink with George before retiring to join his wife in their marital bed. Before he did, he showed George the guest room where it had been arranged for him to stay.
“My house is your house, George. Help yourself to anything you want to eat or drink. I’m hoping that we’ll all feel a mite better in the morning.”
“We are professionals, Hiram. That is the nature of our profession, you win some and you lose some.”
George sat in the parlor smoking his pipe while he drank the rest of the decanter. Then feeling only partially satiated he found a bottle of brandy in a cabinet and a box of cigars.
It was four o’clock by the time he finally went to bed having consumed half the bottle and smoked four of Hiram’s cigars. Unfortunately, neither the spirits nor the tobacco had made him feel a bit better.
Inevitably, he barely slept at all, for his mind kept berating him for failing to keep John Handy alive.
“You are a damned useless fool, George Goodfellow,” he mumbled to himself as he lay alone in the darkness. “Tucson has lost one hell of a good doctor, thanks to you! Why the hell didn’t you ride faster or get that darned train to really travel? And then you sat down and filled your stomach with bread and cheese instead of seeing the patient and operating straight away.”
And then he fell into a doze, a fitful slumber wherein his mind kept replaying the journey on El Rosillo, then the hell-for-leather train journey from Benson to Tucson.
“Too slow,” he mumbled in his sleep. “Too darned slow.”
With which he woke himself and punched the pillow in frustration. “Tarnation! John Handy had no chance of surviving because of those ten hours between the shooting and the moment I made the incision at the start of the operation.”
The one question that never occurred to him was whether any of the Tucson doctors should have operated on their colleague. He was too well aware that none of them had the surgical skill to perform such a procedure.
“Damn it! I was so close. So close!”
* * *
El Rosillo had been happy to see him when he arrived back at Benson. He nuzzled George’s shoulders when he turned to lift his saddlebags up. Then he nickered.
“And I am sure pleased to see you, too. It’s been a tough and sad time and I am pleased to see a familiar, happy face.”
Although he was conscious that there was a lot of work waiting for him when he got back to Tombstone, yet he was feeling less than enthusiastic. The slight muzzy hangover from his drinking the night before was no problem, for it was something that he often had when he over imbibed at the Crystal Palace Saloon or one of his other regular saloons where whiskey seemed to be a natural accompaniment to poker or Faro.
It was late afternoon by the time he arrived back in Tombstone. He took El Rosillo straight to the Dexter Livery Stable on Fremont Street. Old John Dunbar ran it now and had a real way with horses, which George liked. He had never really cottoned to Dunbar's former partner John Behan, who had been a part-owner until he became first the undersheriff and then sheriff before he left Tombstone for Yuma in 1887. As a friend of the Earps, George didn’t care much for the way he had sided with The Cowboys, or for the way that he supplemented his income by siphoning off money from the numerous gambling joints and brothels.
From the livery he walked along a block and dropped into the Tombstone Epitaph offices, where he found Stanley Bagg overseeing his hard-working printers, while filling the air with his inevitable cigars.
Stanley beamed when he saw George, before punching a worktop when he saw George’s melancholic shake of the head.
“I was too late, Stanley.”
“Darn it! I was hoping I’d have good news about your surgical skills two days running.” He picked up and handed George a fresh copy of the Epitaph from a pile on the floor. “Take that and have a read later on. Now tell me exactly what happened.”
George followed him into the editor’s office, placed his G W Elliott saddlebags on the floor by the desk then sat down and filled and lit his pipe. He told him everything, including details about the operation and Handy’s death just as he was closing up the wound. Stanley made rapid notes with the practiced ease of a well-seasoned journalist.
He struck a light to his cigar, immediately provoking a fit of coughing. He noticed George’s raised eyebrow.
“I know, you told me off about the cigars. But go on; tell me what’s happened to the fellow who shot him? What was his name?”
“Francis J. Heney, a Tucson lawyer. He submitted himself for arrest and there’ll be a trial. A long one, I imagine.”
Stanley shook his head. “I deal in news, George, as you well know. In my experience, all news sells papers, but I can’t say that I ever enjoy making money out of bad news. Handy’s death is bad news indeed.”
George leaned forward and tapped the ashes out of his pipe. “I’ve lost the taste for that smoke. It’s bad news, all right and I feel bad that I couldn’t help him. It was just too long before t
he cutting started.”
“That’s not your fault, George. You can’t be everywhere.”
George stood up. “I know that, but it still rankles, Stanley. He was a colleague. And he was a good doctor, even if he had his faults.”
Stanley’s eyes enlarged. “Faults, George?”
George smiled for the first time and gripped the lapels of his coat. Stanley watched his jaw rise and knew what was coming next. He recognized the George Goodfellow mannerism that indicated a burst of pomposity was about to erupt.
He was right.
“Well, I’m afraid that you’re going to have to do some digging elsewhere if you want any dirt on the subject,” George said. “He was my patient, Stanley, and as you know, I am therefore bound by my Hippocratic Oath. I cannot and will not divulge anything else.”
Stanley tossed his pencil on the desk. “Of course, George. I’ll write all this up and have it in the next issue.”
George grunted and picked up his saddlebags. “Well, I’d better go see Edith and Stella. With any luck they’ll have some food. I must say that my stomach is feeling like my throat was cut.” He smiled again as he picked up the newspaper and tucked it under his arm. “Like that miner I operated on yesterday, actually. Did you know that he absconded from the hospital before I could tend to his wound. Damned fool pulled his tracheotomy tube out.”
Stanley winced. “That must have hurt.”
“It would have done. And the damned fool hadn’t paid me for saving his life.”
“Some folks are just plumb ungrateful, George.”
“He sure was. Apparently he left saying that he was going to kill me.” He harrumphed as he put on his hat. “I’ll be seeing you, Stanley. Maybe some cards and a drink sometime?”
Stanley watched his friend leave the office. He was well aware that George was hurting. It wasn’t that he believed he was a saint, as the good folk of Sonora thought and called him. It was just that he hated to lose a patient.
* * *
Stella and Edith were baking and after telling them the sad news about Dr. John Handy he sat at the kitchen table and ate a generous portion of apple pie and drank a pot of coffee.
West of the Big River: Boxed Set of Eight Western Novels Page 72