None But The Brave: A Novel of the Surgeons of World War II

by Anthony A. Goodman

  As in civilian life, there were rush periods and quiet times, though the quiet times were never long enough. Here they all grabbed snatches of sleep and quick meals, and then they went back into the OR at all hours of the day and night. It was a matter of need, and need ruled their lives.

  Hamm and Schneider were expecting the arrival of a few truck-loads of Women’s Army Corps nurses in a few days—the WACs. That would ease the load considerably, they knew, and brighten up the scenery, too. They had gotten pretty tired of looking at those unwashed, unshaved men day after day. Although they looked forward to the nurses’ arrival, at the same time they feared for the safety of the WACs so close to the front. Schneider didn’t know why he thought men were the only ones who should expose themselves to death in war, but he did. Chivalry came out in the most curious ways, and keeping the women safe at home had always seemed right. But the WACs were on their way, so the scuttlebutt had it, and the men weren’t all that unhappy about it.

  Hamm and McClintock came back to their quarters—a tent with a canvas floor close to the barn wall—after two in the morning. Both were looking pretty bad. They had been at it all day and much of the night. Their faces were grizzled and their eyes bleary and red.

  Schneider had been snoring loudly. “What’s up?” he said. He knew exactly what was up. He had slept only two hours, enough to make him groggy and cranky, but not enough for sufficient rest and refreshment.

  “You,” Hamm said. “You’re up, and you’re needed in the OR, stat.”

  “What is it?”

  “Chest and abdomen. Shrapnel. He’s stable right now. They’re just getting his blood volume up, so he’ll be ready to go in about fifteen minutes. You ready for an all-nighter?”

  “I have a choice?” Schneider said as he fumbled for his boots.

  No one answered. McClintock was asleep in his clothes already, and Hamm was off to the latrine before his nap.

  Schneider got back into some warmer clothes—the nights were chilly, even in June—and walked over to the OR tents. There were usually fifteen to twenty operations going on at any one time, day and night. All the operating tables and beds were full. There was never enough room at the inn. But, unlike the famous inn, the field hospital turned no one away.

  Schneider’s walk from his bunk to the OR tents felt surreal: A crisp June night in northern France, a starry sky above and a charming farmhouse at his back. Nearby, a creek made lovely, burbling sounds. Old poplar trees stood silhouetted by the starlight. Napoleon’s plane trees lined all the roads. It could have been heavenly. Instead, in the background, artillery whistled steadily, punctuated by the whoomph of mortars. Machine guns stuttered nearly nonstop. Occasionally, Schneider would involuntarily duck as low-flying German aircraft buzzed their position. It read like fiction, but it was all too real.

  Schneider fretted that he had yet to gain control over his fear. If he weren’t totally focused on a surgical case, his mind filled with the possibilities of sudden death or painful injury. Every wounded GI he saw could be him the next moment.

  He quit stargazing and made his way to the operating tents. The area was dark, but he knew the path by heart and didn’t risk the danger of turning on his flashlight.

  Snipers.

  The outside of the tents were the usual army khaki, with red crosses set in huge white circles painted four feet high on both halves of the slanting roofs and on each of the four walls. There was a little vestibule at the front door for several reasons. It made a good air trap so that contamination from the outside (like dust and flying insects) wouldn’t get into the operating room. It also helped maintain the heat inside the tent. But, most important, it provided a buffer for the lights which were kept bright inside the OR itself.

  Schneider pushed open the outer door and shut it before going inside into the OR area proper. The comparative brightness momentarily blinded him. He stood squinting for a few seconds. It was a noisy place, he noticed. Ten operating tables lined each side of the tent, with a walkway down the middle. Each team had a surgeon and assistant (usually another surgeon or a medic), an anesthesiologist, a scrub nurse, and a circulating nurse. They usually called them the sterile nurse and the dirty nurse, but naturally those names got misinterpreted and so reverted to scrub nurse and circulating nurse.

  Schneider walked over to the changing areas, exchanging nods with members of the various teams as he passed their tables. Although there were a lot of personnel there, he had gotten to know a lot of them. They did, after all, eat three or more meals every day in the same mess tents and changed their clothes in the same pre-op area; they did their laundry in the same washhouse and used the same latrines But, most of all, just hung out together when there was any hanging out to do. They were too near the front for movies, restaurants, or theaters. Their only entertainment was each other.

  Schneider hung up his khakis on a peg and put on some clean white scrubs. Then he walked over to the pre-op room to find his patient. It didn’t take a genius to figure out which one was for him. At the entrance to the pre-op area stood a cot surrounded with personnel. Three IV bottles hung from high poles fed whole blood into a patient, and a fourth ran plasma. The medics had raised the poles high to make them run faster. A medic was changing one of the empty bottles. No question the young GI had suffered much blood loss. Schneider made a mental note to be alert for clotting and bleeding disorders he might develop after so many transfusions.

  He walked to the bedside, where the little crowd parted for him. Antonelli was holding pressure on a Vaseline gauze pad wrapped around a chest tube protruding from the soldier’s left chest. The drainage bottle sat on the floor, quickly filling with blood.

  He looked at Antonelli and said, “You bring him in, Gene?”

  “Yessir.”

  “What’s he got?”

  “Well, he’s got a number of through-and-through wounds of the abdomen and the left chest. A large number!”

  When Antonelli said someone had a large number of bullet wounds, Schneider paid attention. Gene was no hothouse flower. Even though he was only eighteen, his last few weeks had pushed him right up there with the most experienced combat medics.

  “Anything else?” Schneider said.

  “No sir. Just the bullet wounds, but they’re enough.”

  “How we doing on the volume?” Schneider said to no one in particular.

  One of the pre-op team answered: “His BP is back up; he was in shock when he got here, though. Pulse is down below a hundred now, and the BP is about one hundred over fifty. Not great, but I don’t think he’s going to do better than that until you get in there and stop whatever’s bleedin’. Look at it running outta that chest tube!”

  “I see. Any urine output?”

  The same man said, “Yeah, about thirty cc’s since he got here—about a cc per minute. Not great, but it’s urine.”

  “OK,” Schneider said. “Where are his films, and where are we going?”

  “You’re at Table Six, with Major Page. He’s setting up now. He’s new. Just arrived, so he’s plenty fresh. Mahoney is scrubbed and waiting, and Dallas is circulating. Films are on the light box already.”

  “Great job, guys,” Schneider said as he started toward the OR. They did a great job every time, but Schneider never failed to thank them. “Let’s go.”

  The team followed, pushing the wheeled stretcher. Antonelli held one of the blood bottles high overhead, at the same time pressing on the dressing over the chest tube to prevent any air leak.

  They got to their space at Table Six and positioned the gurney next to the operating table. Page immediately took over, holding the GI’s head as the rest of them slid the unconscious man over from the gurney.

  “Hi, I’m Dan Page,” the anesthesiologist said. You Major Schneider?”

  “Yeah. Steve Schneider. Good to see you.”

  The two men reached across the patient and shook hands.

  The patient was already intubated—Page had placed an endotracheal t
ube in the pre-op area as soon as the man had arrived—so he transferred the tubing to his own anesthesia machine, which was pumping out pure oxygen. Since the GI was still unconscious, they wouldn’t need any anesthesia until they began to operate.

  Schneider looked around the table. “Who’s assisting?”

  Page shrugged. “We seem to be a little tight just now, Steve. Can you do this one alone, or should we send someone to go wake Major Hammer?”

  “No. Let him sleep. Hey, Gene, you want a battlefield promotion to surgical resident?”

  “Sir?”

  “Come on and scrub. I just need someone to hold hooks for me.”

  “Yessir!” And just like Marsh, Antonelli turned and literally ran from the OR area to get into a scrub suit, hat, and mask. When he came back, barely three minutes later, he had his hands out and waited for gloves.

  “Not so fast, pal,” Schneider said. “There’s the little matter of scrubbing.”

  Antonelli laughed and reddened a little. He was so excited at the thought of playing surgeon, he forgot to scrub. He actually wanted to get started before a real surgeon arrived and bumped him off the case.

  Schneider and Antonelli stood at the scrub sink together and washed their hands with soap and wooden scrub brushes. The soapy water ran off their elbows, making wet spots on the canvas floor.

  “You take off your wedding ring when you scrub, Doc?” Antonelli asked, pointing with his chin at the gold band on Schneider’s left ring finger. Strictly speaking, it should have come off before he scrubbed.

  “Nah. I’m afraid I’ll lose it one day, and if I do that, I may as well not even go home.”

  “Your wife wouldn’t like that, eh?”

  “No, she wouldn’t. Nor would I.”

  Schneider did not elaborate. He was thinking that the ring was not what might keep him from going home. For a long time since he’d left, he felt as if he were always walking on eggshells. Nothing he could do was right with Susan. If he fell asleep after dinner on the floor of the den, she’d be on him for not playing with the girls. Never mind that he had been up for forty-eight hours. He felt whipped, and he didn’t like it. None of that helped their sex life either. It was hard to be passionate and loving when he was on the verge of a fight all the time.

  When he left for basic training, Susan had not even seen him off at the station. She barely looked at him as he hugged his little girls goodbye. Now he wondered if Emily and Anna were all that was holding his marriage together. If they’d had no children, would he stay with Susan?

  “What’s your wife’s name, sir?”

  “Hmmm? Oh, Susan.”

  “You miss her?”

  “That, I do, Gene.”

  They finished scrubbing and walked to the table. Mike Dallas, the circulating nurse, opened a pack of towels and dropped them onto the sterile field. Pete Mahoney, the scrub nurse, draped one over Schneider’s hand and another one over Antonelli’s. They dried and gowned, and Dallas tied them in. Schneider stepped to the right of the table, as Antonelli took his place at the patient’s left. The GI was already positioned and draped; Dallas had washed and disinfected the skin while they were scrubbing. Mahoney had made a window in the draping towels along the midline of the abdomen and another over the left side of the chest, exposing both the bullet wounds and the incision area.

  “Everything stable, Dan?” Schneider said, looking at Page.

  “Yes, you can start,” he said.

  Schneider was glad to see a calm and confident anesthesiologist at the helm, just like McClintock. That was where the likeness stopped. Page didn’t have any of the slow, North Carolina drawl emerging as it always did when McClintock sought to slow and calm the waters in the sometimes frenetic operating room. Page was all business with a definite speedy clip and efficiency. His accent had no regional giveaway, but Schneider bet on somewhere in the Midwest. Page was short and stocky with wisps of curly blond hair peeking out from under his knitted surgical cap. He looked very athletic, with arms that bulged tightly into the short sleeves of his scrub suit. He had deep blue eyes. Schneider would have to wait until after surgery to see the rest of his face, now hidden under the surgical mask.

  Schneider made a quick catalogue of the wounds, and then opened the chest. Sure enough, the left chest cavity was full of both liquid and clotted blood. Schneider placed a self-retaining retractor and spread the incision wider. Then he began scooping out the blood with cupped hands. It wasn’t very elegant, but it was fast. The suction apparatus would have become clogged with blood clots. Schneider plopped the clots into a basin, which was quickly filled to overflowing. Then, when he was down to liquid blood, he asked for the suction and handed it to Antonelli.

  “Suck this stuff out and keep sucking until I find the bleeder.”

  Page deflated the lungs slightly to give Schneider more exposure. Schneider knew he would enjoy working with the New Guy.

  Antonelli was busy sucking out the blood and enjoying himself greatly.

  Who knows, Schneider thought, after the war, this kid too might just be inspired to go to college and then medical school. Wouldn’t that be nice?

  “Hold this,” Schneider said to Antonelli, handing him a wide flat malleable metal retractor covered in gauze to protect the lung. Antonelli retracted the lung and exposed the hilum where the major vessels were and where the bleeding seemed to be coming from.

  “Look at that, Doc,” he said.

  Right at the place where the major vessels entered the pleural cavity from the heart was a tear in the left main pulmonary artery. The artery was the size of Antonelli’s thumb and bleeding out fast. It was a tribute to the laws of evolution that the GI had survived this long.

  Schneider put his thumb against the tear in the vessel and the bleeding stopped. “How are we doing on volume?” he asked Page. He could, if necessary, wait with his finger in the dyke until the blood volume was restored.

  “We’re just about caught up, Steve. Don’t wait for me, I’ll take care of his pressure and volume. Just go on ahead and sew him up.”

  Schneider took his finger off the artery, and placed a small vascular clamp across the edges of the tear. The bleeding stopped again. Then he took some fine vascular sutures and closed the tear.

  When the tear was closed, he irrigated the chest cavity with several liters of saline solution until it was clean and shiny and good as new; that is, as good as it could be with about a dozen bullet holes visible in the chest wall. However, none of them were bleeding, and the pre-op x-rays showed no evidence of any bullets or fragments left in the chest or the lungs or the heart. There were a few holes in the lung itself, but they were easy to repair with some fine sutures.

  When everything was the way he wanted it, Schneider asked Mahoney for a chest tube and some stay-sutures for the closure. Gene had begun to take out the self-retaining chest retractors, as Schneider instructed him, while Schneider made a hole between the ribs for the chest tube.

  The kid was stable now.

  Schneider had just said to Page, “We’re closing the chest and going to the abdomen,” when their whole world imploded.

  Schneider didn’t hear the noise itself. There had been so much background war noise since D-Day that no one paid any attention to what went on outside. So, when he felt the shock wave, he had no idea what was happening. There was a terrible pressure and pain in his ears, and the room went dark at the same instant his hearing went away. Then he was swept to the ground as the entire operating tent came down.

  Buried beneath the tent, he couldn’t tell whether or not the generators had gone out. Whatever was happening, Schneider was helpless beneath hundreds of pounds of canvas and tent poles. He couldn’t breathe, and, in his panic, he struggled like a swimmer trying to get to the surface. But, there was no surface. It was like drowning under the ice with no place to escape. Instead of calming himself and breathing slowly to conserve what air he had, he lost all control over reason and began to struggle and thrash and use up what
little oxygen was circulating in his blood.

  His head ached, feeling as if it were growing larger, as if it might explode. He grew more confused and thrashed frantically, clawing at the canvas, trying to tear his way to the surface with his fingernails.

  A temporary rescue came as something knocked him closer to the overturned operating table, where a small pocket of air had been trapped under the canvas. Somehow, he was on his hands and knees again, and in this position he had accidentally established a small air space beneath his body.

  Schneider used all his strength to stay up on his knees, to preserve that precious volume of air beneath him. He had visions of a malevolent tent willfully pressing him into the ground as the air seeped from beneath its folds to be wasted on the outside of the canvas.

  He might have been in that position a few seconds or a few minutes. However long it was, he felt himself losing the battle, slowly sinking beneath the unremitting weight of the surgical tent.

  His precious air was slipping away.

  As he lost the last few inches beneath his abdomen, his face pressed into the rough canvas floor, there was a sudden pressure on his back, strong enough to hurt like hell. It was as if someone was walking across him with boots on. And that was just what was happening.

  Schneider wanted to cry out for help but could not. He wanted to shout to them to get the fuck off his back! But he could not. He found himself losing all grip on reason, slipping into helplessness, giving way to the coming of death by suffocation.

  And he began to cry.

  Suddenly there were more boots stomping on his back, driving more air out of his lungs. He became angry and afraid at the same time. He wanted them to leave him alone, to get the hell off his back so he could breathe again.

  But there was nothing to breathe. There was no air left in his world.

  He opened his mouth to cry out, to scream at them, but nothing came out of his mouth. There was no air left in his lungs. He could not even call for help.