My friend Joe Waeckerle was the first physician on the scene at the Hyatt Regency disaster and directed the triage. A man’s leg was trapped under an I-beam and had to be amputated on the scene. The article in the Kansas City Star said “…the amputation, completed with a chain saw, took about 20 minutes.”
So…heavens forbid I ever need this information…let’s say you have to perform some sort of amputation on yourself with tools unsuited to such a job. Do you amputate through a joint if you don’t have anything to cut the bone?
And since I read that proper amputations go through the bone, if you survive will the doctors at that point cut through the bone to clean up the rookie work you performed on yourself.
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The human body has a remarkable ability to block pain, when it wants to. If a limb is so traumatized as to need amputation, the patient (victim?) might already be in shock. Not the best time to operate but that patient might not even feel the operation.
I’m not sure if living joints are any easier to cut through than bones, really. Tendons and ligaments are really tough. But I think the real answer is, do what you gotta do, and if you survive, they will knock you out to clean up your work.
Yep. They call that a “revision”. The idea is to give you a stump of a size and shape that makes fitting/using a prosthetic easier.
Incidentally, has anyone here ever seen the film “None But The Brave”, starring Frank Sinatra as an army surgeon in WW2?
There is a scene where a Japanese soldier has been diagnosed as having a gangrenous leg. The soldier himself is willing to lose the leg rather than lose his leg, but Sinatra doesn’t feel he has the necessary equipment to perform the operation.
In the end he goes and does the deed with whatever instruments he has available. No anaesthetic is used, however, and the soldier let’s out the most blood curdling agonised scream, possibly in the history of cinema. The scene cuts almost immediately as showing too much of the amputation would have no doubt resulted in censorship difficulties at the time of the film’s release. I’m not an expert on the history of WW2 and so don’t know if anaesthetic less surgery was a common practice during wartime.
I have actually read an article in some magazine somewhere all about a woman in an iron lung, which was written by one of her attendants. It was stated that she actually had her appendix taken out without anaesthesia in the fifties because at that time they did not know how to administer general anaesthesia to an iron lung patient. It wouldn’t exactly surprise me if this was the plain truth as appendectomies were being carried out before anaesthesia was invented.
I don’t actually think it was the pain that was lethal (though it made the experience horrific needless to say). The blood loss and the post-operative infection is what accounted for the mortality rate in per-anesthesia (and antiseptic/antibiotic) amputations.
I think the reticence of people to undergo the surgery (even though not doing so would almost certain be lethal) was the fact you had to undergo that horrific experience and still only had a slim chance of survival.
Yes, this is a zombie thread, but worth mentioning the recent discovery of a surgical foot amputation performed some 31,000 years ago on a human in Southeast Asia, with enough subsequent bone growth to confirm they survived it.
The implication is there was sufficient competence and care demonstrated to indicate that this was not a bold one-off experiment, but something that had been practiced before. If these peoples’ pharmacopeia were as well established as those of modern Southeast Asians they may have identified natural painkillers or other drugs that may have taken the edge off the patient’s pain, but even so…
Which raises the question. What is the difference in time and pain going through bone rather than a joint? Would he have been better off if they took his leg off at the knee, at least in terms of getting through the procedure?
Fun Fact: The painter of Robert Liston’s portrait displayed on the Wikipedia page was named Samuel Stump.
I’m wondering if she had the procedure under local (probably spinal) anesthesia.
Can’t remember which movie specifically, maybe Master and Commander, maybe one of the Captains Courageous, but there was a scene where the ships surgeon amputates an arm after using a specialized tourniquet to cut off circulation and feeling to the limb. Not sure how accurate that is.
I have Season Six of House M.D. on DVD. I don’t know if anyone has seen the last episode of it, called “Help Me”, but it’s a little bit scary to say the very least.
A woman has been trapped at the scene of a disaster in which a crane driver has fallen asleep at the wheel, resulting in a collapsed building. Despite firefighters saying they need to amputate her leg to get her free, she is adamant she wishes to hold on 'til the bitter end to all four of her limbs.
Dr. House promises her they will do anything in their power to get her free without cutting off any of her limbs. However, it eventually gets to the point where he can no longer keep taking sides with his stubborn patient. He explains to her that he himself regrets not going through with an amputation, and so persuades her to finally make the decision to go through with hers.
He explains that he cannot put her out because, as he puts it, “depressive respiration’s just too much”. He does give her some form of pain relief prior to doing the deed but, as he cuts her leg open with a scalpel and then proceeds to cut through the bone with an electric saw, she still cries out very loudly. When they have got her free and got her on the stretcher, she is obviously not too much in shock to speak to her husband despite the ordeal she has just gone through.
At least two YouTube users have posted the scene and some of those who have commented on it are saying that not everything portrayed in movies and TV is exactly true to life. In this case, they are saying a limb could be removed quite painlessly in this day and age, whatever the circumstances.
I can actually tell you the first film I saw on TV when I was a kid that showed someone undergoing a limb amputation without anaesthetic (as far as I can remember).
It was “Frankenstein - The True Story”. I think the idea of it was that really the surgeon who performed the operation could have saved the arm in question if he’d so wished but chose to craftily hack it off while the patient was in shock following some sort of an industrial accident or something. He was eager to obtain body parts by hook or by crook to help him with his experimentation, which was keeping stuff alive after death. It was revealed shortly afterwards that he’d managed to keep the arm alive by some means after it had been dismembered.
There are some “shock” sites on the Internet where it is possible to see videos of drug cartels and the like exacting terrible revenge on people who have slighted them. I have seen examples of people having limbs cut off at joints in only a few seconds, so clearly amputations don’t necessarily have to take minutes or longer. In the middle east they do hand amputations in mere moments too, obviously industrial accidents and the like can remove limbs in fractions of a second. Clearly patient care and aftercare are secondary to the procedures in these cases, but I thought it worth mentioning that people can survive such things and you don’t have to wait around for minutes while they happen.
I suppose during the pre-anaesthetic era many parents would have had to deal with a child who was forced to go through with some surgical procedure which they were terrified of. I suppose they would have had to have just reassured the child by telling that sometimes we just have to be brave in the face of pain.
Having some knowledge of the way the adolescent mind works, I would say that more than a few teenagers would have considered what was about to be done to them as torture, and would no doubt have committed suicide rather than be subjected to it.
I’m guessing that children generally did not undergo surgery until they were basically in extremis, and too sick to put up a fight.
Plus, the soldier had just been hit by a 3/4 inch musket ball, a cannonball, or a big shell fragment. I sort of doubt that a surgeon removing the rest of the limb is going to somehow be more painful.
There were also post-surgery advantages- if you waited, that was just more time for a bacterial infection to get a foothold in the patient.
This thread is just nightmare fuel. I can’t imagine any kind of surgery before modern anaesthetic, let alone battlefield lop-it-off limb removal. I’m reacting the way I did when I saw the torture exhibits at the Tower of London…seeing sketches of folks being sawed in half from the crotch, I could only imagine they’d go utterly insane right away (or even before, seeing what was coming for them).
A friend of mine from high school had to have both of his legs amputated below the knees. It was a complete shock when he posted pics on Facebook out of the blue one day (“So, here’s something new…”). He was always a pretty heavy guy, so I think the popular guess was that it was diabetes-related, as he didn’t give details. He passed away a few years later, and the story finally came out. He had gone in for some other surgery, and he had a one-in-a-million negative reaction to the anaesthetic, which caused some sort of necrosis in those limbs. He kept a cheery whaddyagonnado? attitude about it, which was amazing to me.
I’m saying, yes, based on a real life event from 15 years ago.
It’s Been 15 Years Since Aron Ralston Amputated His Arm In Blue John Canyon