An Irish Doctor in Peace and at War (23 page)

“I'll go there now, sir,” Paddy said, “and come down and let you know when the first surgical cases start arriving.”

“Good man,” Richard said, then, taking a deep breath, pursed his lips. “Those badly wounded for whom all we can offer is morphine…” Wilcoxson frowned and shook his head. “The poor devils will be made as comfortable as possible in the seamen's mess too. The chaplain's trained to give the medication and he'll stay with them and offer what support he can. He'll have two bandsmen/stretcher bearers to help.”

Fingal understood but hated what must be done. In wartime, brutal decisions had to be made, and the limited medical resources put to where they could do the most good. The hours of surgery spent on one patient who would still probably die were better invested in caring for men with lesser wounds who could be saved. Some men must be left to die. “I see,” he said, and his heart ached.

“Simpler cases, uncomplicated fractures, lacerations, minor burns, will be treated in the aft medical distribution centre by Davy Jones, the dentist, and their team, and,” he clapped Fingal on the shoulder, “the tougher ones will be brought here.”

“You're the most senior surgeon,” Fingal said. “I understand.”

“Paddy O'Rourke will assist me…”

And I'll give the anaesthetics, Fingal thought, and shuddered.

“Barker will assist you.”

“Me?” Fingal's voice rose. He was, he thought, between the devil and the deep blue sea. On one hand, he was still terrified at the prospect of having to give anaesthetics, and also relieved that it didn't look as if he was going to have to.

“You've had a year of gynaecological surgery training, you told me. The basic surgical priciples are the same in men and women.”

“I have.” But, Fingal thought, there would be a huge difference between performing a simple hysterectomy and treating someone with a belly full of shrapnel.

“You'll be fine.”

Fingal swallowed and said, “Aye, aye, sir.” Needs must when the devil drives. Fingal felt his stomach turn over.

“The two other SBAs can use the mask and ether like you did the day you arrived. We're going to need all the surgical hands we can get. Pity we're not connected to the mess decks by phone. The SBAs and us will be too busy between cases getting ready for the next one so we'll keep one stretcher bearer here as a runner to get his mates to take away each case back to the mess decks when we've finished. Have them bring the next one,” Richard said, “and we'll all pitch in to get the dirty instruments washed and resterilized.” He clapped Fingal on the shoulder. “It's going to be a long night and God knows when we'll get finished tomorrow—if then. If you think you're going to drop on your feet tell me. I have some benzedrine.”

Fingal had heard of naval surgeons and indeed deck officers keeping going on the amphetamine stimulants. “I'll ask if I need it,” he said.

Richard nodded. “Good.” Then he said to Paddy, who had reappeared, “Well, what have we got so far?”

“I spoke to the
Bedouin
's MO. He reckons that between them and
Forester,
the other destroyer, they're going to bring us at least two hundred casualties—”

“Bloody hell,” Richard said, and frowned.

It startled Fingal. He'd not thought anything could rattle Richard Wilcoxson.

“Only about fifty of those will need to be looked after, either here with us or by Lieutenant Jones and his crew. The rest aren't seriously hurt.”

“Still, that's fifty surgical cases, right?” Fingal said, and heard his voice rise. “Fifty?”

“Don't worry, Fingal,” Richard said, and his voice had returned to its usual unflappable tone. “With God's help we'll cope.”

The words were a comfort. Fingal had already learned that Richard Wilcoxson was a Christian who kept his faith to himself. Fingal, whose own beliefs tended much more to the agnostic, couldn't help but remember a remark he'd overheard a patient make at Sir Patrick Dun's. A nursing sister had been reassuring her patient that God loved him and that he would come through his operation with flying colours. “Indeed God
is
good, Sister,” the Corkman had said. “But a wise man never tries to dance in a shmall narrow boat, so.” In other words, don't expect the impossible under unreasonable circumstances.

All Fingal could hope for was that they would manage. And after all, he smiled to himself,
Warspite
was a very large and beamy vessel.

21

Thus Must We Toil

Barker, already gowned and gloved and ready to assist, faced Fingal across the operating table where his first case lay. Not AB Smith. Not CPO Jones. Not a real person, it seemed, merely a nameless case. Overhead lights glared down. The smell of ether mingled with the bitter aroma of Dettol and the coppery tang of blood. The SBA seated at the table's head lifted one of the patient's eyelids and said, “He's out, sir.”

Fingal watched as Barker poured disinfectant on a shattered right thigh where a rubber tourniquet controlled the bleeding. There was no time for personal niceties. In the next few hours three doctors would have to perform more than fifty operations, and Fingal could feel the nausea of anticipation deep in his belly. The bone end, the femur, nacreous and jagged, stuck through the skin and muscle. The man had no foot and the lower leg and thigh were a mangled mess held on by a strip of skin.

“Right,” said Fingal, and bent to his work, concentrating on the surgical steps. Cut the remaining skin and drop the wreckage into a bucket. Take off the tourniquet and clamp the spurting blood vessels. Ligate the arteries and veins. Use a scalpel to create hemi-elliptical flaps of muscle and skin in front and behind the bone. Saw off the jagged bone and take a file to smooth off the femur's end. The rasping set his teeth on edge. Sprinkle sulpha powder on the insides of the flaps and sew them closed over the bone. Dress the stump. “Done,” he said. “Give him a quarter grain of morphine before he comes to, then wake him up.” He turned to the waiting stretcher bearer. “Please go and get your mate. You'll be taking this poor bugger to the seaman's mess then bringing the next patient.”

“Aye, aye, sir.” The man left.

Fingal began to strip off his glove.

“I'd keep them on, sir, if I was you,” Barker said. “Remember the boss said we all help out washing the instruments?”

“Of course.” Fingal looked over to where he could see Richard using a carpenter's brace and bit to drill a hole in the skull of a sailor who had been hit on the head and, according to
Bedouin
's medical officer on the basis of his clinical findings, probably had a blood clot on the brain. The senior surgeon's actions were rhythmic, unhurried. Fingal envied the man his experience.

“Good diagnosis,” Richard said, and Fingal could see the dark blood flowing from the burrhole. That patient now had an excellent chance of recovery.

Barker took the bucket with the shattered leg to a corner and deposited the contents in a large galvanised tub. Fingal bundled up his instruments in a towel and took them to a sink where he started to wash them. He was barely aware of the bustle around him, of tables being cleaned, stretchers coming and going.

“I'll finish off and pop them in the sterilizer,” Barker said. “Your next one is arriving. He's been shot in the guts.”

Bullet wounds to the bowel were not like a case of straightforward appendicitis. Fingal was trembling as he approached the table where a fair-haired young man was being strapped down. A plasma bottle suspended above his head was dripping into an arm vein and a narrow rubber tube for sucking out stomach contents disappeared up one nostril.

“Mutti. Mutti. Fur Die liebe Gottes. Mutti.”
He was moaning and trying to twist free from his bonds.

A German prisoner of war calling for his mother, for the love of God. It brought a prickling to Fingal's eyes. The wounded man couldn't have been more than twenty. He was a frightened child, but his mummy couldn't kiss a perforated bowel better. It wasn't clear that Surgeon Lieutenant O'Reilly could make it heal either.

“Bitte, wasser. Wasser zu trinken. Bitte.”

A drink of water was the worst thing to give such a patient.

“Come on, Fritz,” the SBA said, putting the mask in place. “Couple of deep breaths like a good Kraut.” He dropped ether on the gauze and said to Fingal, “I don't think much of the master race. 'Cepting they talk funny, they're not much different from us, are they, sir?”

Fingal nodded and thought, “If you prick us do we not bleed?” The pity was that none of this carnage should have been necessary in a so-called civilised world. God damn Adolf Hitler and his megalomaniacal crew, the Goerings, the von Ribbentrops, the Goebbels, and the rest.

Fingal went to scrub and met Richard, who had finished his first case. “What have you got, Fingal?”

“Man with a bullet in the bowels.”

“Can be a bit tricky. Call me if you're worried and I'll look over your shoulder and talk you through it, but remember it's quite easy really…”

Easy for you to say, but thanks for the offer of help, Fingal thought.

“Fish out the small bowel, run it through your fingers like you would a bicycle inner tube looking for punctures. Any you find, sew shut in two layers. Large bowel. Same thing. I don't think you need worry about damage to the great vessels. If they'd been torn, he'd not have made it here. But if anything else like a kidney or the spleen's been hit, there'll be a fair bit of blood so you'll have to search for the source, fix it or take it out…”

Fingal shuddered. He'd be asking Richard for help if such were the case.

“When you've got everything repaired or removed, wash out the belly cavity with saline, dump some sulpha in. If you find the bullet take it out, but if not just leave it. Once he's got over this operation and we've got him to facilities where they have time to do X-rays and the like it can be removed then…”

Another reminder of how everything under battle conditions had to be done in a rush, Fingal thought.

“Then bring a loop of bowel at a level closer to the stomach than the highest perforation out through the abdominal wound and shove a glass rod between the loop and the belly wall. Sew up the bullet wound and your incision. Incise the loop so the contents can leak into a bag. That'll rest the gut and give the inner gut wounds a chance to heal until he's better.”

We hope, Fingal thought.

Richard shook water off his hands and said, “Good luck. Yell if you're stuck.”

“Thank you, Richard.” I'll need all the luck I can get, Fingal thought, and stared at the PMO's departing shoulders. That's where the man carries the medical woes of the whole damn fleet. Thank God he's here.

Fingal did have good luck. By the end of the arduous procedure, the young German had been patched up satisfactorily and the bullet removed.

And so it went case after case; bodies on and off the table, groaning men being anaesthetised, yelling men awakening. The Germans weren't the only ones begging for their mummies. Blood had flowed in rivers—thank the Lord for plasma. He must have stitched enough to have, under different circumstances, woven a Persian rug, and used enough dressing to stuff a mattress.

Fingal knuckled his eyes. It was as if the entire sandy beach at Ballyholme had crept under his eyelids. He put a hand in the small of his back, which was knotted from bending and felt like all the eight forwards of the Welsh rugby team had trampled on it. “Wake him up and bring the next one.” He'd finished another amputation, this time of a foot only. It was an abhorrent procedure, he thought, turning a healthy young man into a cripple, but it was better than letting him die. At least Fingal was becoming more skilled in removing limbs.

*   *   *

“Begging your pardon, sir, but Commander Wilcoxson says we've dealt with the most urgent cases. It's ten to three in the morning,” Barker said.

“Is it, by God?”

“Yes, sir, and the boss's sent for sandwiches and hot cocoa. We've all to take a breather. And don't worry about these instruments. I'll see to them.”

“Thank you, Barker.” Fingal stripped off his gloves and gown and went to sit at his desk. His war diary lay where he'd left it after making his last entry about coming into Westfjord at noon. Not now, he thought, but later, later he'd try to record his feelings for what he'd been doing for—he did a quick calculation—the last nine hours. Pity, revulsion, anger were there, and so was pride. An enormous pride in the medical branch of HMS
Warspite
and their complete dedication. And what about Fingal O'Reilly, who had always tried to think of his patients as individual human beings, not bullet wounds or amputations? Was he becoming hardened? Inured? He shook his head. He didn't know, and while he'd never burden her with all his worries, at that moment Fingal wished Deirdre were here so he could tell her about his fear, and be comforted. He'd write it all down later so when next they were together, he'd be able to remember, at least tell her some of it. She was a nurse. She'd understand.

Someone knocked on the door and Fingal saw a mess steward appear and hand Barker a steaming tray. “Here you are, mate, K-eye and dorks.”

Which translated meant cocoa and sandwiches.

“Ta very much,” Barker said. As he neared Richard, the SBA paused while the PMO tipped something from a bottle into each mug.

Barker offered the tray to Fingal, who gratefully accepted the first grub he'd had since noon yesterday. Tonight the tinned Uruguayan salted beef would taste very good, and the cocoa? He sipped and looked up to see Richard Wilcoxson, smiling with his mouth and eyes, their crinkling for a moment smoothing the deep bags beneath.

“Ah,” said Richard, “I keep a little something for moments like this. The malt whisky will give us all a boost, because we're not done by a long chalk.” He plumped down on a chair beside Fingal. “Once we're finished, we'll go and take a look at our recent handiwork and what else needs to be sorted out.”