Imagine putting in three days of Arctic night cutting off your own toes! From the frozen north there comes the attention-arresting story of trapper J. Omera who, though lacking surgical education and experience, was nevertheless forced by circumstances to amputate four of his own toes. While inspecting his trap lines in winter weather 60° below zero, Omera suffered frost bite in the toes of his right foot. After a few days in his isolated cabin, removed by more than fifty miles from the nearest human being, he noticed that infection had set in and decided that amputation was necessary.
We see him set about his surgery in a thoroughly business-like manner, taking care to sterilize with boiling water his entire outfit of instruments, which consisted of one kitchen knife. For three days he worked.
Eminent specialists of the medical profession undoubtedly can name a long list of complications which might result as after effects of such an unscientific operating procedure. One given to statistical and mathematical processes might even calculate the chances of the patient’s developing any one of a number of unpronounceable ills and perhaps leave him with only the tiny fraction of a single chance for complete recovery.
Yet, strange to relate, the tiny fraction won against heavy odds. Recently, on his return to civilization, Omera submitted to professional examination and was told that the operation was an entire success and that no further treatment was needed.
The story of Omera recalls the surgery of the old whaling days when it was no unusual thing for the captains of whaling vessels to do amputations of this kind.
Should we want to know more about this unexpected side of these hardy mariners, what is more natural than to turn to the records of the Coast Guard cutter Bear, that gallant ship which so often braved the ice of the frozen north and in both summer and winter carried hope and succor to freezing and starving whalers.
Through the courtesy of Admiral F. C. Billard, Commandant of the Coast Guard, I examined a surgical report made thirty years ago to the Bear by Captain George B. Leavitt of the whaler Newport.
It came about that at Point Barrow, the northernmost tip of Alaska, Surgeon S. J. Call of the Bear saw an Esquimo boy who had been operated on by Captain Leavitt. The surgeon was astonished at what he considered a remarkably successful outcome. Surgeon Call got in touch with Captain Leavitt and persuaded him to make the report from which we catch a glimpse of what was probably the most northern American operating establishment.
Fortunately Captain Leavitt happened to be one of those careful mariners who kept an accurate log. He committed to writing all that was interesting or instructive in his experience.
The first operation mentioned was the amputation of half the right foot of a man belonging to the Mary D. Hume in March, 1891.
How that table was scrubbed with sand and canvas, then washed with lye! Then the patient was placed on the table and wrapped well in blankets. To give additional warmth in that terribly cold room, whiskey bottles were filled with boiling water and wrapped with towels.
Speaking of this first operation, the captain says, “Putting the patient under the influence of chloroform was a slow process because it was entirely out of our line.” Not one of the operators had had any previous experience with chloroform or had ever seen it used.
The report continues: “We placed the bottle under the man’s nose, and after he had taken a whiff we would ask him if he was sleepy. This was continued for half an hour without any effect; he still showed a bright light.”
The consultations and discussions with suggestions and arguments waxed strong and were conducted in the presence of the patient, stretched out on the mess table in the officer’s quarters, “all shipshape as a schooner in drydock.” Professional jargon, so incomprehensible to the layman, being unknown to the company, they were forced by necessity to conduct the proceedings in that vernacular peculiar to the sea. Somebody recalled the case of a sailor on the China coast who committed suicide with chloroform by saturating a handful of rags with the liquid, then placing them over his face. This story furnished the basis for discussion because it was all that was known by these men about the use and effects of chloroform.
“Let’s try that system,” said Captain Tilton. “We’ve got to stop this backing and filling and get squared away.”
Protests and mumblings from the patient, who seemed to lack enjoyment in his un-' usual position of prominence.
Seeing that the discussion was getting on the patient’s nerves, and, fearing that if further pursued in his presence it might have the effect of dispelling that confidence in the surgeons which it is so desirable to retain in the mind of one who is about to be operated on, the conferees retired to the mate’s room and closed the door while they completed their plan. Down went the cook to the engine room to fetch a handful of waste.
“Then,” continues Captain Leavitt, “we made a paper cone, put in some waste saturated with chloroform, slapped it over the man’s face, like a thrummed collision mat over a hole in the side of a ship. He went right off.” There was no doubt of his being “off” because all swearing and protesting had stopped.
Meanwhile the cook had sterilized the surgical instruments by boiling them in the galley. They were brought in still in the pan of hot water. Their instruments consisted of two pieces. Simplicity and directness, basic elements of a seaman’s character, marked the common-sense preparations. One instrument was a butcher knife, sharpened until its edge was keen as a razor. The remainder of the outfit consisted of a hack saw that had done duty in the engine room and the stoke hole.
There were no “scrubbed” nurses with gauze over their heads and masks over their faces, to hunt down and destroy all bacteria. There were no autoclaves, nor steam- pressure sterilizers, nor digesters, nor rubber gloves.
Captain Tilton bossed the job. And a right good boss he was. If there were microbes in the operating room there was discipline also. The “seaman’s eye” compensated in a measure for the lack of anatomical knowledge. The skilled surgeon may be likened to a navigator sailing over well- known waters after carefully memorizing the chart. Captain Tilton and his assistants sailed into what was to them unknown regions. Bold Columbuses!
They whose hands had wielded the palm and needle in sewing a thousand sails, some of them wet and many of them frozen, found sewing up the wound “something in our line” which presented no difficulties whatever.
“It was,” runs the narrative, “a cut square across the foot. After the cutting, the edges were drawn together as far as they would come and gauze, well-greased, placed over the cut, followed by absorbent cotton saturated with Friar’s balsam. After four days the bandages were removed and fresh ones put on in the same manner. For a wash we used carbolic acid. It turned out well, but the bone the big toe moors to was a long time healing.”
Confidence and improved technique came to these surgical seamen with experience. The same month they amputated two large toes and three fingers; Tilton, head surgeon, and Leavitt and Bodfish, assistants. In the course of time we find little refinements introduced and a striving for exactness in detail to produce a shipshape job without loose ends or Irish pendants. It was the ambition to have the wound heal up “as smooth as the side of a racing yacht.”
We find in the report:
March 9, 1894—Both feet, or the best part of both feet, were amputated from a man belonging to the Norwhal. These feet were taken off well back, the same way as with other amputations, with the difference that after the foot was cut to the bone, a piece of canvas was put on and the flesh hauled back and the bones then cut off. In this way a flap was formed, and the whole business turned out as neat a job as anybody would want, something that reminded you of a new piece of rigging that had been wormed and parcelled and served.
December 9, 1894—Six fingers and three toes were amputated from a man belonging to the Thrasher.
This was the last operation credited to Captain Tilton as boss surgeon. All cases mentioned after this one were bossed by Captain Leavitt with Captains Bodfish, Cook, and McKenna assisting.
On December 28, 1895, Mr. Tilton, the second officer of the Alexander, had a finger removed from the right hand.
On February 3, 1896, a finger was amputated from a man belonging to the Jeannette.
With increased skill and teamwork the operators were soon able to work with surprising speed. Also, the technique of administering the anesthetic was so completely mastered that they could regulate the degree to which the patient “went off.”
February 17, 1896—Amputated part of one foot from a man belonging to the Beluga. From the time this man was put under the influence of chloroform until he came to, only thirty minutes intervened.
How many surgeons who have given a lifetime of study to the art can beat this performance?
My next big contract was taking off the right arm of Mr. West, the third officer of the Navarch on June 29, 1896. The arm was amputated a few inches below the shoulder, cleaning off all the burnt flesh. In putting a ligature on the large artery, gut was used. The small veins were touched with caustic. After bandaging the arm, a compress was kept on in case of accident until the ligature was removed. On June 28, I had to make a second operation, this time laying open the whole shoulder, and taking the bone off to within an inch of the joint. Disarticulation, as I understand it, means unjointing. Well, I did not do that, but left, I should say, one inch clear of the joint.
Another case of arm amputation was that of the Esquimo boy who came under the observation of Surgeon Call.
Summing up, Captain Leavitt writes:
Iodoform was the only antiseptic I used in all my surgery. After operations I used cocaine or morphine (whichever I happened to have) to deaden the pain, using from half to a full grain, as was necessary.
All the cases we worked on have turned out well, and some of them better than the case you saw. Chloroform was used in every case without a single bad result.
I have not studied medicine nor done any dissecting, nor had I ever seen anything of the kind done, until I was compelled to do it at Herschel Island.
So ends this extraordinary report. On it Surgeon Call placed the following endorsement: “Their fearlessness and the results are sometimes remarkable, and would call forth the praise of our most expert operators.”
It was a fearless breed who manned the whaling ships in those days. Resourcefulness and a more than full measure of common sense and good judgment often saved them from the jaws of death. What confidence the men had in their captains! They would never have submitted to an operation by a “landlubber” of similar inexperience.
Nothing seemed to daunt these men of the sea. Theirs was the spirit of Vasco da Gama, of Captain Cook, of Magellan, and Sir Walter Raleigh. The same spirit in Nelson broke the line at Copenhagen; in Farragut it damned the torpedoes in Mobile Bay; in Peary it conquered the North Pole.