House surgeon

“ If the woman is living in a hospital where there is a resident surgeon with instruments ready, she has a better chance than if she is in her own house. Even if she has a surgeon within call the outcome of the case for her will depend largely on his skill, his presence of mind, the preparedness of his instruments, the general condition of the patient, and many other circumstances.
The instruments, ligatures, gauzes, solutions, dressing, etc., for coeliotomy are multitudinous, and all must be sterile, or the woman will be killed by septicaemia even if the hemorrhage is stopped. ”

“ Another little episode in the front surgery was when [Pg 87] a baby took us all by surprise by being born there! We should have sent it on to the Infirmary, but the mother was rather bad, so we had to take them in.
One Sunday evening I was in chapel when I heard some one come to the door, and then the porter came to fetch me, and at the door I found one of the dressers who told me there was a bad compound fracture in the surgery, and the house surgeon would be glad if I would come, as he wanted to give an anæsthetic. ”

“ Brock, the surgeon personally superintended the patient's removal to a quiet bedroom at the back of the house. Shortly afterward his clothes and his carpet-bag were sent downstairs, and were searched, on the chance of finding a clew by which to communicate with his friends, in the magistrate's presence. ”

“ Shall any man's misery prevail upon his credulity to make him more miserable? or will any Surgeon expose his patient? For your own sake, apply to some man of ingenuity and probity, who appears to justify his practice by his success; one of which invites you to his house, at the Golden-heart and Square-lamp, in Crane-court, near Fetter-lane. Ask for the Surgeon, who is to be advised with every morning till 11 o'clock, and from two till nine at night, in any distemper. ”

“ Every day a fresh surgeon or physician arrived to bind up legs and arms and heads, or revive the ladies from extreme prostration, pleurisy, inflammation of the lungs, heart-complaint, etc., till every medical man in Plymouth, Stonehouse and Devonport had been to the house of the spinsters. ”

“ In the hurry and confusion of a war, and amidst the pressure of hundreds of new cases in a day, what can the surgeons of the hospital be expected to do for science, or even for the improvement of medical and surgical practice?—The answer is seen in the new arrangements in England, where a statistical branch has been established in the Army Medical Department. Of course, no one but the practising surgeon or physician can furnish the pathological facts in each individual case; but this is what every active and earnest practitioner does always and everywhere, when he sees reason for it. ”

“ Any case that becomes infected through fault of the surgeon or attendants is no longer looked upon as a thoroughly successful operation, even though the patient recovers.
As in other branches of medicine, there are now many specialists in surgery. In the major operations it is best to employ a specialist, but in the minor cases the "family doctor" should be competent. If he does not care to perform the operation himself he can advise and direct you in selecting a competent surgeon. ”

“ I could command anything in the dispensary or store-rooms at any hour of the day or night, and carried many a man through the crisis of a night attack, when if he had been left until discovered in the morning, there would have been little hope for him; and when a surgeon could have done nothing without a key to the kitchen which none of them had.
I kept no secrets from any of them: told each one just what I had done in his ward; thankfully received his approval and directions, asked about things I did not understand, and was careful that my nursing was in harmony with his surgery. ”

“ On the following day, the 6th of November, the hospital was ready for occupation; the plumber and gas-fitter were ejected, the pantry became an operating theatre, the greenhouse was converted into a linen room and packstore. In the evening the ambulances met the trains, and the large ward on the ground floor filled up. Before very long all the beds were occupied, and the Chief Surgeon and her two assistants were kept busy with severe cases and heavy surgery. The pressure of work continued until January; and both doctors and nurses had their hands full. ”

“ Without dissection what can they know of anatomy? and unskilled in anatomy, how can they guide the knife healingly among the intricacies of the human frame? Yet all the operative surgery in this hospital is the care of the native surgeon, by whom the most formidable operations are successfully performed. ”

“ The surgeons connected with our hospitals, public and private, are doing a great work in relieving the ills of humanity, others in private practice are doing great work. Here and there one is found who operates only for the money, but persons who employ such a doctor are usually entitled to the results they receive. Your family physician, even if he is not a surgeon, is the best person to consult when an operation may be necessary. ”

“ Who will question, that there is more merit in saving one limb by superior skill, than in lopping off a thousand with the utmost dexterity?
To treat surgical diseases as they ought to be treated, the practitioner must be thoroughly acquainted with the healthy and morbid structure; he must also have a mind vigorous and firm from nature, well instructed in the best precedents, and matured by observation.
Years are not the measure of experience. It does not follow, that the older the surgeon is, the more experienced and trustworthy he must be. ”

“ Brinkley’s hospital, a beautifully appointed private residence, it is a comfort to women patients to have the doctor’s wife, herself a competent surgeon if necessary, at hand during the actual operation. ”

“ The front room was the rendezvous of the surgeons. In the morning they came to consult me about diet-lists or to talk to each other. In the evening the promenade of the ladies generally ended here, the surgeons always came, and I am proud to say that a circle composed of more cultivated, refined gentlemen and ladies could not be found than those who met in the rough linen-room of the Buckner Hospital. Dr. McAllister often looked in, but only for a few moments. He was devoted to his business as surgeon in charge of a large hospital. ”

“ There is in many of the great clinics a disregard of the patient's feelings, of his sufferings, and even of his life, which would be impossible in an English hospital. The contact of a surgeon with his hospital patients as individuals is largely through the nursing staff, and his point of view will be largely influenced by them. There is no one in our profession, from the youngest dresser to the oldest physician, who does not owe a great part of his education to Sister. ”

“ The organisation of the hospital proceeded rapidly, and the amount of heavy surgery and acute sepsis which came in taxed the energy and resources of the surgical staff. Dr. Garrett Anderson acted as chief surgeon and Dr. Gazdar took charge of the officers’ ward. Other workers fell into their places and a sort of routine was gradually evolved. The duties of administrator, or Médecin-en-Chef, fell to Dr. Flora Murray, and when she was not issuing stores or counting linen, she would be receiving the countless visitors who came to see the wards. ”

“ It is not so many years since a famous surgeon, who was fond of walking back from his work at the London Hospital along the Whitechapel Road, used to be pointed to with horror by the Aldgate butchers, whose opinion on such a subject was probably worth consideration. But now all that is changed. The surgeon can be a human being again, and indeed, except when he goes round his wards, his patients may never know, of his existence. They go to sleep in a quiet anteroom, and they waken up in the ward. Of the operation and all its difficulties they know no more than their friends at home. ”

“ See here. We've put in a little surgery up there in the north wing, it's a peach of a place. Come and see it."
He led the way rapidly back up to the house, in at the door and up the stairs. At the end of a long corridor he threw open the door of a small room, whose whole northern side was of glass. Its equipment was as complete as could be asked by the most exacting of operating surgeons.
"Good!" Leaver cried, quite forgetting himself for the moment. "I had no idea you meant to carry things so far as this. Fine!" ”

“ The operation was long, difficult, and dangerous, taxing both nerve and skill. The operating-room was very hot. One of the nurses fainted, and a young doctor, sick at heart and stomach, helped her away, glad to get out himself.
The operating surgeon, a keen, self-possessed practitioner, looked at the patient when all was over, with a deep breath of relief. ”

“ Another class of mistakes, to which the uneducated bone-setter is liable, have relation not to the mechanical principles of bone setting, but to what may be called the medical in distinction from the surgical, or operative part of the treatment. The mere operator, however skillful he may be, is not a finished surgeon. Very far from it. In order to be able to do his whole duty to his patients, the surgeon must in addition to his skill in operating, understand well the principles of inflammation and irritation, and must be in fact familiar with the whole range of disease. ”

“ He suggested that she should see her surgeon again, but she pooh-poohed the idea. “Why should a healthy woman see a surgeon?” At last her husband, gravely alarmed, insisted, and she did as he wished.
The surgeon, of course, saw the position at a glance. The disease had returned, and during the long weeks of concealment had made such progress that any operation or indeed any curative measure was entirely out of the question. Should he tell her? If he told her what would be gained thereby? Nothing could be done to hinder the progress of the malady. ”

“ If he's moved to another hospital his record and register go with him, so that the new hospital knows immediately he was invalided for a piece of shell in his leg, and no flurried or overworked surgeon tries to operate on him for inflammation of the intestines.
From beginning to end, the best specialists in the whole of the Union are at the disposal of any one who's unfortunate enough to get hurt. If it's eyes, ears, throat, abdomen, shell shock, mental derangement, or no matter what, one of the biggest men from home is on the job. ”

“ If I called for a basin of water to wash the face and hands of neglected men, one of these women would laugh insultingly and say, "Perhaps ye'll wait till I get a nagur to bring it to you, or a silver waiter." They would insist that the surgeon had ordered them to do this or that, and stop to argue against my directions, until I was fain to save the sick further noise and clamor by leaving the ward.
Not wishing to begin my work by complaining, or reporting to the surgeons these daily-recurring annoyances, I struggled to hold my own and to break down opposition by patient endurance. ”

“ Conditions past as well as present must be understood before one would dare prescribe remedies for the present threatened disintegration of the family. A surgeon, before attempting a certain operation, has his assistant spend hours with the patient, writing up the history of the case, as to heredity, environment, causes and effects, not only for his own benefit and the patient's benefit, but for the benefit of surgery in general. ”

“ A third kept open an ulcer on the leg, rubbing in a little antimonial ointment, which I bought at fifty cents, and sold him at five dollars a box.
A change in the hospital staff brought all of us to grief. The new surgeon was a quiet, gentlemanly person, with pleasant blue eyes and clearly cut features, and a way of looking at you without saying much. I felt so safe myself that I watched his procedures with just that kind of enjoyment which one clever man takes in seeing another at work. ”

“ The newly graduated surgeon is not as dangerous as the man who left medical school years ago, before the students received one-third of the surgical training that they do now. Many of these men have not taken a post-graduate course, have never been associated with a hospital, nor have they had even an opportunity for moderate surgical observation; and yet they are attempting to do the work that only a skilled specialist should undertake. I am not speaking of emergency surgery for which any man should try to prepare himself, and be brave enough to undertake when human life is at stake. ”

“ They showed no surprise, but were wont to develop amazing confidence in the ward doctors and to discuss the merits of the various surgeons in the square. Each man thought his ward the best ward in the hospital, and his doctor the best doctor on the staff; and many boasted to visitors and at tea-parties that the worst cases in the hospital were in their ward and under their doctor. The dental surgeon, whose skill in extraction was considered marvellous, never failed to thrill the men, and she was eagerly pointed out to friends or visitors. ”

“ He insists that surgeons must learn by seeing surgical operations, and watching them long and diligently. They must be neither rash nor over-bold, and should be extremely cautious about operating. While he says that he does not object to a surgeon taking a glass of wine, the followers of this specialty must not drink to such an extent as to disturb their command over themselves, and they must not be habitual drinkers. ”

“ His text-book of surgery is full of expressions that reveal the man and the teacher. He said the surgeon who cuts the human body without a knowledge of anatomy is like a blind carpenter carving wood. He insisted that men should make observations for themselves and not blindly follow others. He discussed operations on the head, the thorax and the abdomen. He said that wounds of the intestines would surely be fatal unless sewed up, and he described the technique of suture for them. His specialty was operation for hernia. ”