I have done it--only partially successful.
Last night, in accordance with my decision, I operated on Wiener. Voigtman assisted me. It was a terrible business, but I think it desirable to record the details whilst they are fresh in my memory, as a Court of Inquiry may be held later on. Voigtman and I spent the whole afternoon in the study of such meagre details on the subject as are available in the "Medical Handbook." We selected our knives and a saw and sterilized them; we also disinfected our hands.
At 7.45 I dived the boat to sixty metres, at which depth the boat was steady. We had done our best with the wardroom-table, and upon this the patient was placed. I decided to amputate about four inches above the knee, where the flesh still seemed sound. I considered it impracticable to administer an anaesthetic, owing to my absolute inexperience in this matter.
Three men held the patient down, as with a firm incision I began the work. The sawing through the bone was an agonizing procedure, and I needed all my resolution to complete the task. Up to this stage all had gone as well as could be expected, when I suddenly went through the last piece of bone and cut deep into the flesh on the other side. An instantaneous gush of blood took place, and I realized that I had unexpectedly severed the popliteal artery, before Voigtman, who was tying the veins, was ready to deal with it.
I endeavoured to staunch the deadly flow by nipping the vein between my thumb and forefinger, whilst Voigtman hastily tried to tie it. Thinking it was tied, I released it, and alas! the flow at once started again; once more I seized the vein, and once again Voigtman tried to tie it. Useless--we could not stop the blood. He would undoubtedly have bled to death before our eyes, had not Voigtman cauterized the place with an electric soldering-iron which was handy.
Much shaken, I completed the amputation, and we dressed the stump as well as we could.
At the moment of writing he is still alive, but as white as snow; he must have lost litres of blood through that artery.
9 p.m.
Wiener died two hours ago. I should say the immediate cause of death was shock and loss of blood. I did my best.