Vital Times 2021 - 92

1822
placed on her arms, shoulders, and thighs to
restrain her.
It is 1822. The patient is brought to the surgeon's
home, which also serves as his " office. " She is fully
awake and very anxious. Like most patients of that
time, she has never had a surgical procedure. Her
husband and children are with her and are told to
wait in the surgeon's parlor. Her pastor arrives and
prays with the family for a favorable outcome.
The patient is brought to the kitchen, which also
serves as the operating room. To calm her, she is
given a large amount of alcohol to drink.
The surgical team, consisting of the surgeon and
several young men, arrive. All are wearing aprons
and rubber boots. The surgeon carries his box of
instruments, wiped with a cloth since their previous
use. One of the attendants also carries a bucket
filled with straw. He places the straw on the floor
around the kitchen table to absorb any blood shed
during the operation.
After an informal introduction, the patient is
told to lie down on soft, warm blankets on the
kitchen table. Her body is then covered with a
white sheet, and a damp, cold towel is placed on
her forehead. One of the assistants places a firm
opaque cloth over her eyes and holds it in place. A
knotted handkerchief is placed in her mouth, and
she is given instructions to bite on it during the
procedure. Cloth straps are then placed over her
thighs and waist and secured to the table. She is
fully awake and frightened. Several minutes pass.
She can hear the steel instruments being placed on
the table. Without warning, firm hands are abruptly
There is no intravenous line for fluids or
medications, no monitoring of vital signs,
no supplemental oxygen to breathe... and no
anesthetic! The surgical site is not cleaned or
prepped. The surgeon doesn't wash his hands or
wear a mask or gloves.
The surgeon takes a scalpel and makes a
wide incision over the patient's breast. Blood
immediately fills the surgical field. The patient
stiffens, but the handkerchief in her mouth mutes
her screams. The assistants hold her firmly on the
kitchen table as she pleads for help. The cries and
screams finally subside when the patient faints
from intolerable pain.
Surgery progresses with blood flowing onto the
blankets and then onto the straw on the floor. After
several episodes of fainting, crying, screaming,
pleading for help, and asking for the procedure to
end, the patient survives. After 30 excruciating
minutes, dressings are applied to the patient, who
is alive but emotionally exhausted. She is carefully
lifted from the kitchen table and placed onto a bed.
Her family is then allowed to visit. Opium is given
by mouth, but extreme pain is still present.
Over the following two days, the patient is
febrile and in severe pain. The opium has made
her sedated and nauseated. On the second
postoperative day, she develops shortness of
breath and delirium. Attempts to feed her are
92 | CSA Vital Times

Vital Times 2021

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