by Zina Abbott
Our patients? Penelope smiled in response to him including her as part of his surgical team. So far, she had not done much except put water on to boil and change into clean clothes. She interlaced her fingers in front of her and straightened her posture as she realized he studied her. It felt good—albeit, after a year and a half, strange—to once again wear her cotton work dress from before her husband died. She hoped the large apron she put on over it would protect it.
Marcus cleared his throat. “Thank you for changing, Mrs. Humphry. What you have on is far more appropriate for what we will be doing tonight. The fact it hasn’t been worn since it was last laundered is a plus as far as preventing infection.”
Penelope accepted the two shallow crock bowls nested together he pulled from his medical chest and unwrapped. They were supper plate size. She met his gaze as he spoke his instructions.
“Please fill these bowls with about an inch of boiling water and find a place on the counter but out of the way of your laundry.” He pointed at a folded square of white cotton inside the top bowl. “Take it out first and use it to cover the bowls. We can use the cloth later to dry our hands. For now, I just want to keep dust and bugs out. Also, please see the two privates emptied the pan they washed up in. I’ll need it and a second pan cleaned with soap and filled a few inches deep with boiled water for handwashing and rinsing. I’ll need a third smaller bowl with about an inch of boiled water set to cool we’ll use for a carbolic hand rinse.” He offered her a teasing smile. “I don’t know about you, but I’d rather the water has time to cool before I wash for the surgery.”
After Penelope did what he asked, she returned to find the large table moved next to a wall that was opposite the kitchen. The wall had been cleared of all furniture, maps, and pictures. Two hooks that held lighted lanterns remained. Three additional unlit lamps rested on the floor next to the wall and beyond the end of the table.
The captain tugged one end of a large oiled cloth spread over the top of the table to pull it smooth. When he finished, he stood straight and placed his hands on his hips as he studied the covered surface. “Good. It looks like the cloth didn’t crack at the creases while folded inside the chest. Hopefully, between that and the oiled cloth the cook found for me, nothing will leak onto the wood underneath. I don’t want to do permanent damage to Capt. Conyngham’s prized furniture.” He turned to Penelope. “How are we doing on boiled water?”
“I found enough pans and bowls to wash and fill with boiled water to cool. The lieutenant sent a couple men to check all the barrels throughout the station to find more water for you. He…um…seemed concerned about having enough for the stock. I now feel guilty that I washed all of Jeremy’s clothes. I should have only washed enough for two days and waited to do the rest after I arrive in Pond Creek.”
Upon seeing the frown that appeared on the captain’s forehead and how he turned his head to the side, Penelope clenched her back teeth. What did she say to annoy him this time? The concerns about choosing between his patients and livestock when it came to the available water? Or was he still annoyed with her going to Pond Creek? Could he not understand that she had no other good options for providing for herself and Jeremy? And could he not accept that she had prayed about the matter and felt she needed to travel west, not north?
Marcus turned to face her once more without making eye contact. He shook his head and kept his voice low. “I do not wish for animals to suffer from lack of water. On the other hand, I need the water now to perform the surgeries in a manner to keep these men alive by preventing as much infection as possible. The way I see it, the captain can use every man at this post not needed to escort the stagecoach to collect water from the river.” He turned his back and walked to his medical chest he had placed on a chair. He turned back with a bottle in one hand and what appeared to be a stack of folded muslin squares, only they were more the size for washing one’s face as opposed to diaper size. “Mrs. Humphry, I’ll be getting my instruments out now. Let’s see if the handwashing water is cool enough. If so, we’ll both wash and rinse. Next, I’ll carry the two shallow bowls out I’ll use to clean my instruments and swab the patients’ wounds.”
Penelope eased a silent sigh past her lips. He had not again tried to persuade her not to continue her journey. She rolled up her sleeves in more ways than one as she followed his directions for washing and rinsing her hands and forearms and then dipping them in what she understood to be a ratio of one part carbolic acid to twenty parts water solution. Without touching anything, she shook her hands as dry as possible.
By the time Penelope returned to the main room, Mr. Pierce had been moved onto the table. She noticed her black silk sash was gone and replaced by a dark cloth tied around his upper arm. The sleeve of his shirt from about three inches below the shoulder had been cut away to expose his entire arm. She blinked and swallowed at a sense of how improper it was for her to see so much of a man. Stop being a ninny. You’ve seen Jamie and Papa without shirts on. When Jeremy became so sick, you saw more than that. It is seeing the wound that would put most women into a dither.
Off to the side stood Lt. Ezekiel and one of the black soldiers who recently joined the group to help with the wounded. Both men had removed their coats and had their sleeves rolled up. Evidently, the captain had put them through the same handwashing procedure he outlined to her.
As she approached the table, Penelope saw the two shallow bowls, one on each side of the patient. The bowl on the side closest to the wall where Marcus stood held several instruments submerged in the solution. Next to it, she saw a stack of the muslin squares and other items she did not recognize. Likewise, squares of cloth were stacked next to the bowl on the side where she now stood. She watched the captain look up until his gaze met hers.
“Now you’re here, we’ll get started. Please stand next to the table opposite to me. I’ll let you know what I need as I go.”
The smile that followed almost took Penelope’s breath away. Why did he have that effect on her? During the first two days they journeyed together, he had been so disagreeable and critical, she could barely stand to be in his presence. Now, she looked forward to working with him and serving as his assistant.
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Chapter 14
~o0o~
M arcus turned to his patient. “Are you ready, sir?”
“Yes…” Mr. Pierce offered the captain a tentative smile. “Not sure if I should call you captain or doctor.”
Marcus smiled. “You may call me either. Technically, I’m a surgeon. I started out as an apothecary but helped my local doctor with surgeries before I joined the Army as an assistant surgeon. I haven’t received formal medical education.”
Mr. Pierce responded with a weak laugh. “Out here, anyone can hang out a shingle and call themselves a doctor. As long as they get people well, most folks don’t worry about how much training they’ve had.”
“That might be so. However, sir, you’re in need of a surgeon. Fortunately, I’ve had quite a bit of experience at that. First, I’ll give you something to put you out so you won’t feel the pain of me working on you.” He lifted a tool that consisted of a handle and a metal mesh cone-shaped basket on one end out of his medical chest. He lined the basket with a cloth and reached for a bottle different in appearance than the one of carbolic acid. “I’ll put a few drops of chloroform on this cloth and place the basket over your nose and mouth. Once you’re asleep, we’ll get you sanitized and ready to remove both that wood and the bullet.”
Mr. Pierce eyed the basket with suspicion. “You sure I won’t suffocate with that over me like that?”
Marcus shook his head. “No. I’ll remove it before it comes to that.” He glanced at Penelope and grinned. “Don’t worry we’ll end up falling asleep from the fumes, Mrs. Humphry. I have a box that seals fairly tight I keep it in between uses.” His gaze never leaving hers, he grimaced and tapped his front teeth together. He reached for the box
in which he kept the infuser and walked it over to a second chair across the room. “Just in case, though, I’ll ask you to stand by the door to the kitchen until the infuser is safely in its container.” He returned his focus to his patient. “Mr. Pierce, first, I’ll remove this chunk of wood. If my guess is correct and it cut into the vein, I’ll get it sewed up before I pull the bullet out of you. It angled into your muscle, but, as long as it missed the bone, you should heal fine.”
With the lieutenant and one private standing back from the foot of the table and the woman who occupied far too many of his thoughts standing across the room by the kitchen door, Marcus administered the chloroform. After he placed the infuser in its box, handed to the private and pointed toward the kitchen door. He inhaled deeply to rid himself of any fumes that he might have inhaled and returned to his patient.
The private returned and reassumed his position.
Marcus offered a confident smile as his gaze surveyed those around the table. “Everyone step forward please. Gentlemen, be ready to hold his body still should he flinch or start moving about. Mrs. Humphry, when I give the word, please dip the threaded needle in your bowl of antiseptic and hand it to me.” He nodded at the curved needle on Penelope’s side of the table before he turned his attention to disinfecting the area around the wound.
Marcus pressed one hand next to the wood sliver and slowly pulled it out. Blood quickly filled the open wound. “It is as I thought.” He reached for an instrument in the bowl of diluted carbonic acid. “I’ll use this to clamp the vein while I stitch it shut. Mrs. Humphry, once I get it in position, please hold the clamp for me. It will free up my hands.”
“Certainly. If you don’t mind my asking, what is this you have threaded through the needle? I can tell it’s not cotton or silk thread.”
After Marcus placed the clamp, and Penelope held it in place, he eased his fingers away, leaving both hands now free. “No, it’s called catgut. I have been known to use silk to sew surface wounds. During the war, when just about everything was scarce, we were known to use the hairs from horses’ tails for surgery. Catgut works best, especially in a situation like this where I’ll be closing the wound over the stitches in the vein. It dissolves and can be absorbed by the body, whereas other fibers like silk won’t.”
“Why it called catgut, suh? It come from a cat?”
Marcus responded with a quick laugh. “What’s your name, Private?”
“Pvt. Samuels, suh.”
“That’s actually a good question, because many people don’t know what it’s made of. The surgeon I first worked for had to explain it to me. It’s fibers that come from the intestines of sheep, mostly, but it can come from other large animals, too. The ‘cat’ is short for cattle.” He shook out a cloth and laid it on the table. After pulling his surgical instruments from the carbolic acid solution, he dipped a cloth square into the liquid and wiped the skin and opening of the wound free of blood. He tossed it aside. Without looking up, he held out his hand. “The needle, please, Mrs. Humphry.” He glanced up and smiled. “I told you I need more hands. I’ve already tied up both of yours, and I’m just starting to fix this vein.”
Once he repaired the puncture to the vein and removed the bullet from Mr. Pierce’s arm, Marcus smiled with satisfaction. He had been right about Mrs. Humphry. She quickly followed his instructions and only needed to be told once what to do. She handed him instruments, wiped away blood, and cleaned the area where he worked.
He followed Pvt. Samuels and the other freshly-recruited orderly to direct them in settling Mr. Pierce on his pallet and what to watch for as he regained consciousness.
“Captain, you need to see Pvt. Colby. He’s not doing good, sir.”
Marcus crossed over to the man with the infected arrow wound and dropped on his haunches. As the private with him followed and held the lantern so Marcus could see better, Marcus realized the man had worsened. He pivoted on the balls of his feet as he turned to the wounded sergeant. “Sorry, Sgt. Mulroney. I’m going to put you last. Pvt. Colby’s infection is getting the best of him. I need to take him next. In the meantime, I’ll have my newly recruited orderlies help you take your pants and drawers off. Do you have any clean ones for after I remove that bullet?”
Sgt. Mulroney brushed the back of his hand across his forehead. “Sure it is I had clean drawers and a shirt in my gear bag, sir. Seeing the Cheyenne took my horse, they be wearing them now.” He flashed a grin, and then sobered as he turned his head, and his gaze sought out Mrs. Humphry. “With a woman helping you, sure you’re needing them off, Captain?”
Marcus held back a smile as he stood. He understood the sergeant’s concern. “We’ll keep you well-covered, sergeant. All she’ll see is a few square inches of flesh around where the bullet went in. I’ll see what we can do about getting your own clothes washed and mended. If you need something for the pain, I can give you a little laudanum to hold you until it’s your turn.”
“I’ll not be turning it down, Captain.”
Marcus nodded and turned to the private tending the men. “As carefully as you can, I need you to get Pvt. Colby’s shirt off and be ready to carry him to my table as soon as I get it prepared. Thank you for alerting me to his condition.”
Marcus returned his attention to the sergeant. “One last thing, sergeant, before the laudanum fogs your brain. We will stay here a day or two until I’m sure all you men are on the mend. When we leave, you will be returning to Fort Hays in the ambulance. Even if you say you prefer to ride, you have no mount. You will technically remain in command of your men, but I need one of them in charge under you who can direct the others with the day-to-day and should we have trouble on the way back. Any recommendations?”
The sergeant hesitated. “I’d be choosing Pvt. Belton, sir, but I’d be keeping him away from the whiskey. With him being a corporal and a sergeant a time or two in the past, I’d be putting my money on him keeping his head should the Cheyenne be attacking us again.”
“Thank you, sergeant. I’ll speak to Pvt. Belton tomorrow.” Marcus returned to the table to begin the process of scrubbing the oiled cloth with soap and water, followed by a carbolic acid solution final rinse. One down and three to go. He stretched his neck side to side and rolled his shoulders. During the war, surgery on four men in one day would have been nothing. However, doing it this evening following a day of traveling, fighting off the Cheyenne, and tending those wounded in the attack, he already felt fatigue setting in.
As he approached the table, Marcus noticed the used swabs had been removed. He turned to the woman who had proven herself to be an excellent surgeon’s assistant. She spoke before he had a chance to open his mouth.
“I already put the used cloths in cold water to start soaking. I assume you want them washed and boiled so you can use them again.”
“Yes. I’ll take care of that later. Time for you to wash your hands and use the antiseptic rinse again, Mrs. Humphry.”
“I already have.”
“Good. I’ll follow behind you as soon as I prepare for Pvt. Colby. It will then be time to put more boiled water in the wash pans to cool.”
“What about you, Captain? I noticed a blood spot on the clean shirt you put on. Were you also struck by a bullet or arrow?”
“Yes, but it was only a scratch. From what I could feel, it didn’t even need stitches.”
“And you gave it the same sanitary care you are giving your patients?”
Marcus sighed. Confounded woman. I’m fine. He scooped a small amount of the carbolic acid solution in his hand and slapped it against the wound on his shoulder. He knew if there was a blood spot there, the added moisture would make it spread across the fabric of his shirt. However, if it kept peace with his surgical assistant, it would be worth it. “That should hold me until later. Mrs. Humphry? You did well. I cannot thank you enough for your help tonight.”
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Chapter 15
~o
0o~
I nstead of being repulsed by the surgery on Mr. Pierce’s arm, Penelope found it fascinating. By focusing on what the doctor did to fix the vein and remove the bullet, she kept her mind off seeing the blood and muscle below the skin. Before she knew it, all four men had been operated on.
What had really been a revelation was the patient who did not need a bullet removed. When Marcus pulled a bloodied piece of what looked like frayed skin from Pvt. Colby’s infected wound, he held it up to the light.
“Part of his shirt that the arrowhead forced inside him. That, along with the dirt on the arrowhead itself, was what caused the infection. Fortunately, he didn’t hit any intestines or major organs. He’s lucky he didn’t tear his flesh and chest muscles any worse than he did when he yanked the arrow out.”
Penelope recalled making an effort not to react at his words. Of course, she knew about intestines. She had helped clean and prepare animal intestines for making sausages. Still, it was uncomfortable thinking about intestines belonging to a man. Genteel ladies did not discuss body parts, especially those beneath the sections of skin expected to stay beneath clothing. If my mother was still alive, she would rail at me about how unseemly this is. However, the more Penelope thought about it, she did not feel she behaved unseemly assisting the surgeon. Even if she were seeing parts of a man’s anatomy that most women might only see on their own husbands or young sons, how could helping to save men’s lives be improper?
When the captain finished removing the bullet from Sgt. Mulroney and stitched the wound closed, she realized he must feel just as fatigued, or perhaps more so, than she did. She watched as he ran his fingers through his hair.