James McGee - Resurrectionist

A movement on the floor caught Hawkwood’s eye and prompted a buzz of chatter, but it was short lived when the crowd realized it was only the dressers bringing in linen and towels and a pitcher of hot water. Nevertheless, the air of expectation remained as it was now apparent that the operation and lecture were only minutes away. The two dressers appeared unconcerned at the reaction their appearance had caused and went about their business calmly and unhurriedly, placing the linen on the centre table, and the towels and pitcher on the oak cabinet next to an enamel basin. Another small square table was positioned near the main operating table. On top of it sat a deep-sided wooden box and a small tin bowl. One of the dressers began to transfer a selection of surgical instruments from box to tabletop. When they had finished laying out all the equipment, they moved to the side of the room and stood in silence, hands behind their backs, waiting.

Suddenly the level of conversation dropped. Hawkwood felt the students on either side of him tense. Three men entered through a door in the corner of the theatre, their footsteps resonating on the wooden floor. Two of the men were dressed in dark tailcoats, and the younger one was holding the arm of a third man, who was wearing a white calf-length nightgown and slippers. The young man ushered the nightshirted individual to the table and invited him to sit, leaving his companion to take the floor.

So this was the great man, Hawkwood thought.

Carslow had presence, there was no denying it. Tall, well built, with a bearing that was almost military and a high forehead crowned by swept-back hair, his elegant stature and steady, unflinching gaze reminded Hawkwood of Arthur Wellesley.

A hush fell over the lecture room.

“Lithotomy, gentlemen. Cutting the stone. From the Greek: lithos — stone — and thomos — cut. The removal of one or more calculous formations that cannot exit through natural channels and must therefore be extracted by means of surgical incision.”

The speaker turned and indicated the man in the nightgown. “The patient is a forty-three-year-old male and a merchant by trade. His symptoms — abdominal pain and acute discomfort while urinating — indicate the presence of a stone in the bladder. This afternoon I will be operating to remove the offending object.”

The spectators turned their heads towards the patient seated on the table. His brow was bright with sweat. Dark stains were visible under his armpits. There was a noticeable tremor in his right leg. The man looked terrified.

“The operation to remove a stone or stones is one of the most important a surgeon can perform. It requires not only a detailed understanding of anatomy, but also a mind that never wavers and a hand that never shakes.” Carslow paused in his address and ran a stern eye over the faces of the onlookers.

Then the surgeon turned to the waiting dressers and removed his coat. “Let us begin.”

A dresser stepped forward to take the surgeon’s coat, exchanging it for an apron that had been hanging on a hook next to the door.

Carslow addressed the room once more. “There are only two safe routes to enter the bladder; the first is from directly above, through the lower abdomen. This is referred to as the high operation. The second is by way of the perineum, known as the lateral operation. It is the latter that I shall be performing today. However, before I begin the procedure, I shall require the services of two more assistants.”

Carslow placed a forefinger to his lips. His eyes swept the encircling tiers. Hawkwood, watching from above, had the impression this was a charade enacted before every operation. He could see students nudging each other and grinning as if it were a contest where the team captain got to pick his right-hand man.

The surgeon’s gaze settled on the second tier down, to the left of where Hawkwood was standing. He pointed. “You, sir, and the young gentleman to your right; if you’d be so kind as to join us. Your names, please? Mr Liston and Mr Oliver, is it? Very well, if you would attend my colleague Mr Gibson, he will instruct you.” Carslow ushered the two students in the direction of his companion, who was still standing by the table, his hand placed reassuringly on the patient’s shoulder.

“Now, gentlemen, if you’d kindly prepare the patient by placing him in the lithotomy position.”

The audience watched as the hinged headboard was raised to form a shallow angle and locked. A linen cloth was placed over the table. The patient was then laid on his back, hands by his sides, with the back of his head resting against the slanted board. His legs extended out beyond the end of the table, above the tray of sawdust.

The patient’s nightshirt was lifted and rolled back over his chest. Beneath the gown, the man was naked. His skin was as pale as paper. On Carslow’s instructions, a strap was secured around each of the patient’s ankles. On a further nod from the surgeon, the patient’s knees were drawn up and back towards his chest, and his legs were pulled apart until his genitalia and buttocks were fully exposed.

Carslow again addressed the onlookers. “The patient must be restrained and kept absolutely still. The slightest deviation, a slip of the blade for example, could mean inadvertent damage to the patient’s leg or rectum, or even the surgeon’s finger, and we would not want that, now, would we?”

A polite ripple of laughter ran around the room. The look of alarm on the patient’s face made it clear that at least one man present did not share the surgeon’s sense of humour. His body was visibly quaking.

Carslow moved towards the foot of the operating table. His hands hovered over the row of instruments.

“Mr Liston and Mr Oliver, a wrist each, if you please. Mr Allerdyce and Mr Flynn, if I may direct you to take the patient’s ankles and knees. A firm hold is required, gentlemen. Are you ready, Mr Ashby?”

It was the first time the patient’s name had been used. But from the stricken expression on his face, Hawkwood suspected that the poor man had probably forgotten what his own name was. There wasn’t even so much as a weak nod.

Carslow cocked an enquiring eye at the dressers, the two students and his colleague, Gibson. All five helpers nodded back imperceptibly. Hawkwood saw the muscles along their forearms stiffen as they took up the strain.

The surgeon’s hand dropped to the table. It rose into view holding a straw’s-breadth metal rod, curved at one end like a large un-barbed fishhook. The implement was held up for the audience to see. “The bladder sound. Note the groove in the outer curve of the staff.”

Holding the rod in his right hand, Carslow leaned forward, took hold of the patient’s flaccid manhood with his left hand, held it upright and, without pausing, placed the hooked end of the rod into the tip of the penis and pushed it down inside the shaft.

Christ Jesus! Hawkwood clenched his fists at the unexpectedness of it.

A bellow of pain erupted from the patient’s mouth and his body arched. The table became a melee of thrashing arms and legs.

“Hold him still, gentlemen! Hold him! Calm, Mr Ashby! Calm!”

It was clear from the speed with which the two dressers hauled down on the straps that they were accustomed to grappling with patients. The two students, however, despite their hold, had plainly been taken by surprise at the ferocity of the resistance. It was only with the help of the surgeon’s chief assistant, Gibson, who laid himself across the patient’s chest, that they were finally able to renew their grip.

It took several seconds before the man on the table was held fast. Through it all his head continued to whip from side to side like a newly landed fish.

Hawkwood found that his palms were slick with sweat. It had been an extraordinarily unnerving scene. There couldn’t have been a man watching who hadn’t imagined himself in the patient’s position as the probe went in.