On 8 September 1942, the USS Seadragon (SS-194) was on patrol in the South China Sea when Seaman First Class Darrell D. Rector first reported to Pharmacist's Mate First Class (PHM1C) Wheeler B. Lipes said he was not feeling well and had a pain in his abdomen. Several hours later, with the patient's temperature above normal and rising, Lipes was confident the diagnosis was acute appendicitis. The vessel was then in enemy-controlled waters.
With Rector's symptoms growing worse and medical evacuation impossible, the only alternative was surgery. Failure to intervene could result in rupture of the appendix and eventual death. But there was no medical officer on board to do the appendectomy.
Lieutenant Commander William E. Ferrall, the Seadragon's commanding officer, and lieutenant Norvell G. Ward, her executive officer, went to the crew's quarters to talk with Rector. The seaman said whatever Lipes decided to do was okay with him.
After further consultation, Ferrall asked Lipes if he could do the surgery. He could, he said, but under the circumstances, the prognosis was not favorable, and he was very reluctant. Lipes recalls his skipper telling him, "I'm out here every day, and my job is to sink enemy ships. I fire torpedoes and sometimes I miss. But I keep at it because that's my job."
Lipes replied, "Sir, I can't fire this torpedo and miss, but if you order me to do the operation, I will certainly do it."
Ferrall nodded his assent, and the 23-year-old corpsman went to work assembling his operating team. Lieutenant Ward acted as assistant surgeon, and Lieutenant Franz Hoskins performed duties as anesthetist.
Because major surgery on board was. not contemplated, surgical instruments, anesthetics, or even rudimentary equipment such as anesthesia masks and retractors were unavailable. The only antibiotics in use by the Navy in 1942 were the sulfas—sulfanilamide, sulfathiazole, sulfadiazine.
Lipes had no access to a laboratory. There was no microscope, no blood pressure apparatus, no means of determining clotting time or blood count. Nevertheless, Lipes had been a laboratory technician, had assisted in several appendectomies, and was innovative and highly motivated.
The wardroom mess table served as the operating table. An inverted tea strainer lined with gauze became a makeshift anesthesia mask, and teaspoons with bent handles served as retractors. Lipes sterilized the pajamas and rubber gloves worn by his operating team with alcohol normally used to fuel the Seadragon's torpedoes. Instruments were sterilized by boiling.
Ferrall ordered the Seadragon down to 120 feet to give his young corpsman a stable operating platform. Although ether was not carried aboard U.S. submarines, Lipes had obtained several cans of the anesthetic while in port and now instructed Lieutenant Hoskins in the drip method of administering it.
With a scalpel blade gripped by a hemostat as a handle, Lipes made the incision. The location and removal of the appendix were anything but routine. It was hidden under the caecum-the blind gut-adhered to the intestine, coiled, and buried at the distal tip, which was turning black. The corpsman had to detach the appendix from the caecum, being careful not to cut or puncture it. Such an event would flood the lining of the abdominal cavity with pus, ensuring peritonitis. He tied off the appendix in two places and then amputated and removed it. Once that difficult task was accomplished, he cauterized the stump with phenol-carbolic acidand then neutralized the phenol with torpedo alcohol.
Prior to the surgery, Lipes had ground sulfa tablets into a powder, which he heated in an oven to kill any spores. The powder was now sprinkled in the peritoneal cavity and on each layer of tissue during closure. Seaman Rector was soon back on duty.
Although this selfless and heroic act earned Wheeler Lipes the recognition of a nation at war in 1942, then-Surgeon General Vice Admiral Ross T. McIntire considered preferring court-martial charges against Lipes for performing a procedure that he was neither credentialed nor qualified to perform. But the enormously positive response to Lipes's story in the Chicago Daily News conspired against punishment, and the event became one of the most famous in the annals of Navy Medicine.
Many years have gone by without the formal recognition Wheeler Lipes deserved. Last year, now former Surgeon General of the Navy Vice Admiral Michael Cowan initiated the paperwork, and a Navy Commendation Medal was approved. But before the ceremony could take place, the now 83-year-old lieutenant Commander Lipes, MSC, USN (Ret.), became gravely ill. When he is strong enough to travel, Lipes and his wife look forward to coming to Washington for a formal award ceremony.
"I certainly wasn't out there to be a surgeon," Lipes notes. "I wasn't being heroic. I was there to do whatever it took to alleviate pain and suffering and save a life if I could do so."