“Dr. Kaplan,” Pvt. Silver called out. He stood next to a man who had just been placed in a bed.
She turned in his direction.
“This man’s clothing reeks of chloroform.”
Abbey approached then bent over the man. “It does. The last chloroform he received should have evaporated by now as it’s over an hour’s distance from the field hospital. This is a strong smell as if someone recently poured it on him.” She called to the soldier, shook him by the shoulders, then slapped the man. He was unresponsive. The doctor placed her ear near the man’s nose. “His breathing is quite shallow.”
“Maybe we should be checking all the men for the smell before they enter the ward?”
“I agree.”
Three-hours passed without another man smelling of chloroform. The stream of wounded slowed to a trickle.
“There’s a boarding house down the block from this hospital,” Abbey said. “A home-cooked meal instead of Army food might be a pleasant change.”
“I agree with you, Dr. Kaplan,” the private said with a huge grin.
As the restaurant’s owners were of German ancestry, the pair dined on Weiner Schnitzel, Spätzle and Rotkraut. Dessert consisted of Nusstriezel made with flaky dough, hazelnuts, apricot marmalade and honey.
“My grandparents make superb Dutch dishes,” Pvt. Silver said, “but this was one of the best meals I’ve ever eaten.”
Abbey smiled and sipped a cup of coffee. “I couldn’t agree more.”
They each paid their bill. Pvt. Silver pulled Abbey’s chair out as she stood then both spun their heads in the direction of the entrance.
“Smell the odor?” Pvt. Silver said.
“Chloroform,” she said.
They watched two ambulance drivers pass near them.
The drivers were seated at a table. Abbey and the private walked up to them.
She introduced herself, then said, “Pardon for interrupting but one or both of you smell of chloroform.”
“It’s from being near the wounded,” one man said.
The second added. “We just delivered a number of wounded right from surgery, Doctor. That’s probably what you smell.”
Abbey smiled, thanked them and left the establishment. “Pvt. Silver, please get the buckboard and we’ll head back to the field hospital.”
When they arrived, Abbey gingerly eased herself off the conveyance and thanked the private for his assistance.
“Anytime Dr. Kaplan,” he said. He paused briefly then said, “I was thinking…no…it doesn’t make sense.”
“What?”
“The ambulance drivers administering chloroform. How would they get it and why would they use it?”
“Good questions, Private. If you find answers, let me know.”
* * *
In the middle of camp disease treatment two days later, Pvt.’s Lawrence and Silver approached Abbey.
“Dr. Kaplan,” Pvt. Silver said. “Pardon the interruption but we’ve been discussing the chloroform problem. We have an idea.”
“I’m listening,” Abbey said as she sutured a laceration on a soldier’s palm.
“When I run low on the drug,” Pvt. Lawrence said, “I send a note to the recovery hospital and they send me a box with containers of chloroform.”
Abbey tied off the suture and a helper bandaged the injury.
She yelled, “Next.”
“The thing is,” the Pvt. continued, “I don’t always receive a full case. I always get enough to do my work but it never occurred to me I should be getting full cases every time.”
The doctor inspected a large abrasion on a soldier’s leg. “Keep it clean and it should be fine. If it gets red or hot, come back and see me.” She turned to her team members. “Who brings the supplies out.”
“Most of the time, they come in a freight wagon,” Pvt. Lawrence said.
“But occasionally they are sent with ambulances returning here to pick up additional after-surgery patients,” Pvt. Silver said.
“I’ll send a letter to the recovery hospital,” Abbey said. “Perhaps they can check the ambulances as they arrive.”
Lt. Smith approached and handed Abbey a note.
“Dr. Fellows wants me to meet a doctor at the recovery hospital to discuss emotional state.” She turned to Pvt. Silver. “I should be done here in an hour. Would you be available to take me over there?”
At the recovery hospital, Abbey faced an older-man with white hair on his temples and in his beard. A slim similarly- aged woman stood at his side.
“I’m Doctor Kaplan. Dr. Fellows said Dr. Siegel wanted to see me.”
The man smiled and held out a hand. “I’m Doctor Bill Siegel. This is my wife Anna. She’s visiting from our home in Boston.”
Abbey shook hands with each of them.
“I have a patient I’d like you to see.”
“Have to walk slow, I’m still healing,” Abbey said, still using a cane to help her walk.
“Dr. Fellows told me of your wounds. Glad to see you’re getting around.”
They approached a man who was seated on a bed with his knees pulled up to his chest and his arms wrapped around his legs. He whimpered quietly and gently rocked his body.
“He’s awake but unresponsive. He was discovered like this in the middle of a field near his tent. He appears to stare into the distance but not see anything.”
“Is he a combat soldier?”
“Been on the nursing staff here at the recovery hospital…” Dr. Siegel paused to remove a note from his shirt pocket. He opened it then said, “for one-year and three-months.”
Abbey waved a hand in front of the man’s eyes. “He blinks but otherwise no reaction.” She put a hand on his shoulder then gently squeezed it. “No response.”
“Some seem to handle the horrors of battle but others aren’t even in battle like this nurse but are affected in the same way after dealing with numerous casualties.”
“How will you treat him?”
“There is no treatment we know of so we’ll continue hand- feeding him for another week then, if there’s no indication of improvement, arrange to have him sent to a military hospital near his home.”
“Why did you want me to see him?” Abbey asked.
“A couple of reasons. From what I’ve observed and heard from Dr. Fellows, you’re incredibly bright and a hard worker. Secondly, Dr. Fellows said you experienced nightmares after being in battle.”
“True about the nightmares. They cause me occasional loss of sleep but otherwise aren’t a problem.”
“Watch yourself. If the sleep deprivation worsens. Let someone know.”
“I will.”
Dr. Siegel sighed. “We have no clue how to care for problems like this. In general those afflicted may be in excellent physical health. Dr. Kaplan, while you’re working in the military, perhaps you might give thought to possible treatment.”
Abbey shrugged, raised her hands at shoulder height palms up. “I’m not sure where to begin other than collecting as much information on those with altered mental state.”
“Perhaps thinking about what causes your nightmares may help. There are no physical injuries but somehow…I don’t even know what the mechanism might be…I believe they’ve suffered trauma to their mind.”
Abbey stared at the doctor then the patient. She stroked her chin while considering the repeated nightmare concerning the soldier she’d shot. The doctor placed a lock of hair behind her ear then whispered. “Have to develop ideas for…trauma to their emotions.”
Dr. Siegel said, “I’m guessing. Don’t really know. I’ve found next to nothing in the medical literature. Somehow, we need to develop treatment for these poor fellows. The longer the war goes on, the more we seem to encounter.”
“I’ll keep an eye out for this type of patient.”
“We’re being advised to apply the scientific method in our medical practice. Perhaps we could begin by making observations on the patients with this phenomena an
d when we have enough information, begin to draw some conclusions…and send the information to Washington.” He handed her a notebook. “I’m doing it now; here are some of my notes. Perhaps we could compare information at some future date.”
Abbey perused his notebook. “I’ll make a list of this man’s symptoms and present them to you. Perhaps you’ll find some I’ve missed.” He offered her a sheet of paper. Abbey sat down at a desk and began writing.
Dr. Siegel reviewed her observations, smiled and said, “One day this war will end and we’ll return to civilian practice. This is my card with my home address. If you ever develop any ideas or just want to discuss mental trauma please visit. My wife and I live on the north side of Boston. I have a surgical practice there. We have enough room, you could stay with us.”
Abbey’s jaw dropped but she managed to say, “Thank you, Doctor.” She glanced at his wife.
Anna said, “We would be honored if you at least visited us.”
Dr. Siegel added. “Even after the war’s end, I fear we’ll still have work with casualties like this one.”
The woman turned to her husband who nodded. She cleared her throat. “Mental illness is a personal concern for us. Three-years-ago our only son, a fireman at the time, was slightly injured when a building collapsed. Unfortunately, he was the only survivor of a six-man squad. He seemed appropriately saddened initially, as I imagine anyone would. Six-weeks-later he began having conversations with the deceased men. Four-weeks of this, then not sleeping, and occasionally breaking out in tears. Ultimately, he tried to kill himself.”
“I’m sorry about your son, but remember, my experience is primarily physical injuries.”
“As is mine,” Dr. Siegel said. “We have zero treatment for, dare I call it, mental health illness. In my opinion, we have to begin investigations in an organized manner until we can determine a procedure to treat these poor fellows. Possibly, you can start by analyzing your own thoughts which lead to sleepless nights.”
Abbey nodded then turned to Anna. “Your son…”
The older woman interrupted. “Too late for him. He refused to eat until he’d starved himself to death.”
“How tragic.”
Anna continued. “Doctors treat those suffering trauma from bullets but must find a way to treat those with trauma which wounds their minds.”
Abbey shook her head. “We have much to learn.”
“As I’ve suggested to my husband, I believe a woman’s view of these patients may provide insight lacking in a man’s observations.”
“I’ll keep that in mind,” Abbey said.
“One positive observation concerning mental attitude and its affect,” Dr. Siegel said. “While observing the patients here at the recovery hospital, I’ve found those who believe they have a goal to complete, recover from their physical injuries quicker than those who don’t.”
“Suggesting a mental component to physical healing?”
“Only a general observation but something you may wish to keep in mind when you observe patients.”
“Dear Lord, when will we learn enough to repair them?”
* * *
Abbey met with Pvt. Lawrence and Pvt. Silver.
“I hear you two solved the chloroform problem.”
Grinning Pvt. Silver said, “If one of the ambulance drivers had a man who was in substantial pain, he put a chloroform-soaked rag over the wounded individual’s mouth; not knowing what damage he was doing by preventing enough air from getting into the soldier’s lungs.”
Abbey said, “You’ll each be receiving a commendation and a promotion to corporal for solving this. Please know, the results of your investigation will save lives. The head of the recovery hospital put you both in for a one-week-leave. Doctor Fellows signed off on it this morning.”
They exchanged grinning glances. Pvt. Silver then Pvt. Lawrence saluted Abbey.
She returned their salutes. “What diligent men,” she thought. “Lord, please keep them safe.”
* * *
Near the beginning of Abbey’s twelfth month of surgeries, the next soldier was placed on the surgical table. His entire face was covered in bandages. When they were removed, a number of her team gasped. His face was covered in blood, his eye sockets were empty his nose was missing and his right-side cheek bone had collapsed.
Dr. Fellows, performing duty as lead surgeon, froze.
“An object must have passed through his eyes and across his face,” Abbey said.
“I know him,” Cpl. Laurence said. “He’s our supply sergeant”
Lt. Smith said, “I barely recognize him.”
One of the helpers began vomiting. The young doctor yelled, “Get out.” The helper and Cpl. Laurence ran from the tent.
“Dr. Fellows,” Abbey said to the frozen-in-place doctor.
The senior doctor continued to stare at the patient’s face then took a few steps backward.
Abbey stepped in front of him and nodded to Lieutenant Smith who stepped to the head of the table and took over anesthesia duty.
Abbey put her ear over the area of the patient’s nasal passages then listened to his chest. “He’s still breathing but has a weak pulse. We’ll stop his bleeding and close as many of his wounds as we can.” She began ligations and suturing with Lt. Scharf assisting.
An hour of hard work and Lieutenant Smith said, “Doctor, he’s no longer breathing.”
Abbey verified his statement and checked for a pulse. “Shit. He must have had internal injuries or lost too much blood.”
Abbey checked around for Dr. Fellows but didn’t see him. “Next patient.”
“He was the last,” a helper said. Abbey removed her apron.
“We’ll clean up and get organized in case more casualties come in,” Lieutenant Smith said.
“Thank you, Lieutenant,” Abbey said.
Their trumpet-playing, chloroform administrator approached her as she left the medical tent. “I apologize for running out, Doctor.”
“Don’t feel bad. Those were ghastly wounds. Even Dr. Fellows experienced difficulty.”
Cpl. Lawrence gazed at the ground while speaking, “How do you do it, Doctor Kaplan?”
“Do what?”
“With all due respect, Ma’am, my mother and sisters are strong folk but they couldn’t do what you do…view ugly injuries day after day and month after month without flinching.”
“I’ll bet they could do it if their children’s lives were at stake.”
“Maybe…but they’d show some emotion, some feeling.”
Abbey peered skyward and threw her hands in the air as if asking for divine assistance. “Corporal Lawrence, we don’t all show emotion the same way.”
He responded with a glance which Abbey thought would have been appropriate if she were an alien lifeform. “Anything else, Corporal?”
“No, Doctor.”
Abbey walked to the officer’s mess area.
“Tough day, Dr. Kaplan?” Captain Williams, an infantry officer, asked.
“More like a typical day…except for the last patient who sustained facial injuries which a number of my team experienced difficulty observing.”
“Two men from my company received severe burns.”
“I saw them. There was nothing we could do for them. In my experience, people with burns like those live for a while but their lungs seem to quit functioning within a few hours and they die of suffocation.”
“Then neither made it?”
“I’m sorry.”
“If you don’t mind my asking…”
Abbey’s pulse began pounding in her temples. She spoke through gritted teeth. “I do mind and I’m tired of people asking how I endure the horrors.” She saw the other officers turning toward her.
“I didn’t mean to offend…”
Her exasperated voice interrupted him. “You’re in combat. You kill people. How do you manage?”
“It’s not the same.”
Abbey put clenched fists on her hips. �
��Because you’re a man?”
“Well…” He spooned more food into his mucket.
“In your first battle, I’ll bet you grieved over the men you killed but now it has little effect on you.”
The captain stiffened and turned to face her. “I still grieve for the dead…on both sides.”
“I can’t afford the luxury of grieving or I fear I’d do little else.”
She filled her mucket and sat at a table. Captain Williams took his and left the area. Not one of the other officers sat near her or acknowledged her presence.
* * *
The next patient was placed on the operating table.
“Abbey, I came to visit you and this is what happened,” her brother William said. He held up bloody, handless stumps. Horrified, Abbey stood back and put a hand up to cover her mouth. She stared at the patient’s injuries and then said,
“I can’t work on him. He’s my brother. Find Dr. Fellows.”
“He’s indisposed,” Lt. Smith said.
Lt. Scharf said, “There’s no one else. You have to operate on him.”
“I can’t,” she shouted and ran out of the tent. The doctor was horrified to see her father and other brother with bloody injuries waiting for her surgical intervention. She heard Lt. Scharf and her brother William pleading for her to begin surgery.
Lt. Scharf grabbed her by the shoulders and shook her while yelling, “Dr. Kaplan. Dr. Kaplan.”
* * *
“Dr. Kaplan, are you all right?” she heard Lt. Scharf yelling.
Abby sat up with a start and rapidly gazed around her dimly illuminated tent. He stood at her side.
“Dr. Kaplan,” he said again. “Do you need help?”
“I’m fine,” she said. Her heart beat wildly and she was short of breath.
“I apologize for entering your tent but you were shouting something about William.”
“Thank you, Lt.” Abbey whipped her head side-to-side trying to dislodge the memory of the nightmare. “Just a bad dream. You can go now.”
The Surgeon: A Civil War Story Page 12