Preventive Medicine

Preventive Medicine

         Dr. Phillip Clark sat hunched at a round, rickety, wooden table sipping a tepid beer, oblivious to the raucous laughter and the irritating off-key tinkle of the piano only a few feet from him. More and more as he had aged, he turned in upon himself, reminiscing, remembering, reliving his younger days.

         He vaguely heard someone calling his name and, for an instant, thought the voice was a ghost from his past. Then the voice was accompanied by a slap on his back. "Doc? You wool-gathering again?"

         Doc Clark looked up into the squinty, faded green eyes of Perry O'Leary, owner and barkeep of the town's only saloon, aptly named, The Saloon. "Sorry, Perry. Yes, I'm afraid so, my friend -- enough wool to fill a boxcar."

         O'Leary wiped his hands on his once white, now gray, knee-length apron, and pulled up a chair. "Same thing, Doc . . . the war?"

         Taking a sip of beer, Doc Clark nodded almost imperceptibly.

         "Care to talk about it?" the Irishman asked. "I'm all ears."

         A long sigh escaped the doctor's lips. "Sure, Perry. Maybe it would help to get it out of me."

         Although O'Leary was listening to Doc Clark, his eyes kept darting back to the long bar, watching a spindly young man who wore his gun slung low on his hip. The man -- boy, actually, O'Leary realized, was half drunk and looking for trouble. Fortunately, Mesquite Grove was not an easy place to find trouble.

         Problem, Perry?" Doc Clark asked, following O'Leary's gaze.

         "Nah. Don't think so. Kid there has a loud mouth and a quick-draw holster, never a good combination, but nobody seems to be paying him much mind. Says his name is Cain. Any luck, he'll drink himself sick, and the worst that'll happen is I'll have a puddle of vomit to mop up. Go on, Doc, tell me about the war."

         The piano player was, blissfully, taking a break, and three townsmen sitting nearby overheard O'Leary's last remark. Over and done nearly fifteen years, The War Between the States was still a hot topic of conversation -- especially to those who were too young to serve. Entertainment in Mesquite Grove was scarce, so the opportunity to hear a good tale was always appreciated. The three men wandered over to Doc's table. "Mind if we listen in, Doc?" the taller of the men asked respectfully.

         "Don't mind at all, boys. Grab a chair," Doc Clark said, loosening the string tie around his neck and unbuttoning the top button of his shirt. "I was out of medical school six years when the war started and, full of Southern pride, I joined up as a field surgeon for the Confederacy. Saw the horrible wounds caused by shot and shell when our boys were brought to the rear for treatment and doctored them as best I could."

         Running his fingers through his wispy gray hair, the doctor continued: "I cut my teeth on smaller battles, perfecting my skills. When amputating an arm or leg, speed is of the essence. The limb must be removed and the stump sutured and bandaged quickly, or the patient will bleed to death. I can't describe to you the helplessness I felt when sawing through muscle and bone and, only half finished, watched the pallor of death creep into the young face of a soldier as his blood flowed out in a hot, red river."

         "Jeez, ya gonna cry about it, old man?" a voice rang out from behind O'Leary. The Irishman, his cheeks crimson enough to match his shock of unruly hair, turned in his chair to see the boy who had caused him concern earlier, Cain. The boy saw the anger in O'Leary's eyes and stepped back. His right hand slid to the handle of his Colt. "Come on, barkeep . . . get up and die."

         Doc Clark gripped O'Leary's strong forearm. "Don't do it, Perry. He's liquored up and itching to kill."

         Breathing heavily, O'Leary remained sitting. "I'm unarmed, son," he said to Cain. "But you put that gun down, and I'll whip some respect into your young hide." The boy only smirked.

         "It was boys no older than him I watched die, unable to help," Doc Clark said, shaking his head. "Mere children, dressed up like soldiers, armed like soldiers, but crying and screaming for their mothers when held down on my surgery table by four men, while I hacked and sawed, took their shattered, dangling limbs and tossed them aside like bones to a dog."

         With no warning, and as fast as lightning, Cain drew his Colt and slammed it against Doc Clark's left ear, staggering the doctor in his chair. "I ain't no child, you old goat. I'm seventeen years old and done already killed three men better'n the five'a you sittin' around this table tellin' fairy tales."

         None of the men were armed. Mesquite Grove wasn't the kind of town where wearing firearms was usually necessary. And the boy stood with his gun already drawn, waving it to emphasize his words.

         Doc Clark withdrew a wrinkled handkerchief from his vest pocket and first dabbed at the shallow gash running from his ear to his cheekbone, then wadded the linen into a ball and held it tightly against his skin to staunch the bleeding. "Fairy tales?" he growled, his eyes meeting the boy's. "No. Nightmares!

         "I was at Gettysburg where, in three days, we lost over twenty-eight thousand men killed or grievously wounded, and the Union lost nearly the same. I didn't sleep for days, nor did any of the other doctors. We couldn't. Not with those boys being carried and dragged to us, half dead, crazy with pain. Their blood saturated the ground where I worked; my surgical table dripped with it. Bits of flesh and lengths of intestine were strewn about, rotting and stinking in the July heat!"

         The wide-eyed, crazed look on Doc Clark's face faded. His voice, loud and wild only seconds before, drifted to a near whisper. "Like a hellish scene from Dante's Inferno, I created a veritable pyramid of amputated limbs. Boots and shoes, with feet still inside them, leaked more blood. The pyramid became two, then three, then . . ."

         The ghosts of the past were close. Closer than ever before. Paying no heed to the boy holding the gun, the doctor scooted his chair away from the table, stood, still holding the handkerchief to his head, and calmly walked away and through the batwing swinging doors of the saloon.

**********

         A short time later, Perry O'Leary tapped on the door to Doc Clark's combination office and home. Doc Clark opened the door and ushered the barkeep inside. A wide bandage covered the doctor's cheekbone. "You all right, Doc?"

         "Physically, yes. Just a minor cut. Mentally . . . I don't know. So many memories I'd rather forget. What happened to the boy?" Doc Clark asked.

         "He kept waving his gun around, getting louder and drunker. My piano player managed to slip up from behind and plant both barrels of a shotgun against the kid's spine. Straightened him right up, it did," O'Leary said with a smile. "He holstered his gun, tipped his hat and walked out of the saloon. He'll probably never see eighteen at the rate he's going."

         Then, for the first time, O'Leary noticed the open suitcase and trunk just inside the doctor's bedroom door. He nodded toward them. "Going somewhere, Doc?"

         Doc Clark was busy pouring two glasses half full of brandy. He turned and handed one to O'Leary -- sipped. "I'm going home, Perry. Back to Alabama where I was born. I've run all this way west to Nevada, trying to leave the ghosts of war behind -- to become just a small town doctor treating fractures, cuts, the occasional gunshot wound and delivering babies. I've gotten old and disillusioned with life, my friend. I still have a few living kin in Alabama and Arkansas, and it just feels like time to go home."

         O'Leary emptied his glass with one long swallow. "When you leaving, Doc?"

         Doc Clark took the empty glass from O'Leary and set it and his own on a low table. "First thing tomorrow. I checked the train schedule, and there's an eastbound coming through at six in the morning. I . . ."

         His words were cut off by the bark of gunshots, two or three, from nearby. He and O'Leary exchanged knowing looks. O'Leary said it first, "The kid."

         Before they could reach the door it flew open on its hinges. "Doc! Man's shot. They're bringin' him here," Cal Ferrell, owner of the livery stable announced. "He was lookin' fer a fight, and some cowboy obliged him."

         Doc Clark tossed a clean sheet over the examination table and opened his black medical bag, performing a quick inventory. Seconds later Cain, cursing and struggling, was carried in by two men. The men plopped him none too gently onto the table and stood back, looking questioningly at Doc Clark. "You men can go," the doctor said. "O'Leary and I can handle him."

         The men left, along with Cal Ferrell, closing the door behind them.

         "Shut up and hold still," Doc Clark told the boy. "Let me see how badly you're hit."

         "He got off a luck shot. Soon's I get out'ta here, I'm gonna find him and finish this fight!" Cain said, his eyelids fluttering rapidly, and the color draining from his face.

         "It's his leg," Doc Clark said to O'Leary, spotting the spreading red stain on the boy's thigh. Cutting away Cain's trouser leg, Clark explored the wound with his slender, surgeon's fingers. "The way it's bleeding, it looks like an artery may have been nicked. But the bullet went clean through. I think I can fix it, but I have to work fast."

         The doctor tied a rawhide tourniquet around the boy's leg, above the wound, then reached into his bag and retrieved a small bottle. Tugging the cork from the mouth of the bottle, he tapped an unmeasured portion of the powder into a glass of water and stirred it with his finger. Then he slipped one hand beneath Cain's neck, lifting his head slightly, and held the glass to the boy's lips. "Drink it. Drink it all. Good. It's laudanum, to stop the pain while I operate."

         Cain, looking no more than twelve or thirteen lying there on the table, scared and shaking, reached out and clasped the doctor's wrist. "Operate? No! You ain't addin' my leg to them peery-mids you was talkin' about!"

         O'Leary held the boy's shoulders down until the opium worked its magic, and the boy lapsed into unconsciousness. "You aren't going to take the leg are you, Doc?" the Irishman asked with a tremor in his voice and a greenish pall replacing his usual ruddy complexion.

         "No. If I can find the nick and suture it up before he loses too much blood, he should be all right." Having said that, Doc Clark cleaned the area around the wound and made a deep cut with a razor-sharp scapel. Blood fountained up.

         "Uh, Doc . . ."

         The doctor, covered to his elbows in crimson, glanced up to see O'Leary swaying in place. "Go on, Perry, get out of here. You're not used to this. You'll end up on the floor in a minute if you stay. Nothing I can't handle alone. You can check back in the morning, and I'll tell you all about it."

         Nodding, O'Leary took a couple of unsteady steps toward the door, sucked in air, filling his lungs, then proceeded to the door and out.

         Doc Clark hummed as he worked.

**********

         Under a dark sky threatening rain, O'Leary made his way to the doctor's office the next morning. His knock was answered by a rotund woman with stout arms and a permanent stiff set to her thin lips. "Oh. Morning, Alice. Doc around?"

         Alice Hobson, Dr. Clark's occasional nurse, stood back and let O'Leary enter. "Nope," she answered. "Caught the train at first light. He asked me to take care of the kid he patched up for a few days, changing his bandages and whatnot. Paid me good for it, too. The boy's still sleeping. Doc filled him right to the brim with laudanum."

         O'Leary nodded. "Guess the boy's leg wasn't all that bad, then."

         "He'll recover. But he won't be gettin' in any more trouble. Doc saw to that," the woman remarked with a knowing snort. "He said to tell the boy he saved his life for now by fixing his leg, and saved his life for the future with the other."

         Confused, O'Leary said, "What do you mean, the other?"

         A high-pitched scream rang out from what had been Doc Clark's bedroom. Not a scream of pain, but more a scream of terrible disbelief.

         Alice Hobson turned toward the bedroom door. "I got to go take care of him now. He'll need some comforting."

         "Alice," O'Leary said, "what . . ."

         Walking away, she said tonelessly, "Doc amputated the boy's three middle fingers on his right hand. His gunfighting days are over and done. Doc said it wasn't the first time he'd had to cut something off for the good of the rest of the body."

         The woman disappeared into the bedroom as a cold shiver raced up O'Leary's spine.

The End

DM