MAES 24: A Heavy Responsibility
AN: I researched the Hippocratic Oath for this fic, because Stephen mentions it in the book. There have been several versions, and I chose the wording from the oldest version of them all, the original literally translated into English, because it is the one most commonly referenced today, and Stephen would certainly be familiar with the original.
“Shall we save it, do you suppose?” asked Evans as they returned to the open air.
“I doubt it,” said Stephen, “and sometimes I am much tempted to cut…
-The Fortune of War, pg. 147, Norton Press paperback
A Heavy Responsibility
He was indeed much tempted to cut, Stephen thought some time later, as the Constitution was preparing to enter Boston harbor. If it had been another man under his care with the same wounds - any other man - he would have cut long before this. But Jack was a special case.
Stephen knew there had long been a contradiction in how he treated Jack compared to how he treated his other patients. He often wondered if he was denying a part of his oath:
I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.
The words of the ancient Hippocratic Oath resounded in his head constantly. The good of his patient, in this case, was to take no risks with his life; to take the surest course of preserving Jack, and for a long while now, that course had been to amputate.
Yet the situation was changed. Jack had been made so weak by pneumonia that it was unlikely his body could withstand such an operation. Still, even before now when Jack had been stronger in body, apart from his arm, Stephen had still not cut, because Jack was a special case, reason how Stephen might, and he cared not who condemned him for this judgment.
Although the state of Jack’s shattered arm was indeed bad, it was not, perhaps, irredeemable. If there had been no doubt that the arm could not be saved, Stephen would not have hesitated for a moment. Yet there was still a slight chance, in spite of its poor state, that the arm might be preserved. Stephen knew that if he cut now, before there was absolutely no hope, he would always wonder if he might have saved the limb, if he had only waited a little longer; tried a little harder.
And then there was Jack himself: he might idolize Nelson, yet Stephen had no doubt that Jack would just as soon keep all his limbs than follow the Admiral’s example in that respect. Jack had once joked that it was a pity the surgeon who had tended to Nelson had not been as skilled as Stephen, for then he might never have had to learn to write left-handed.
Jack’s trust in him as a physician was a heavy responsibility. Jack knew as well as Stephen did the unlikelihood of being able to keep his arm, yet the word ‘amputation’ had never been heard in conversation between them. Jack’s only reference to the possibility was when Killick and a Marine brought him to Stephen during the battle, the wound minutes old, and he had said “Quick, just bind it up, splint it up. You shall have it off afterwards if you wish. I must go on deck.”
Have it off afterwards he might have done, if Jack had been anyone else. Stephen knew well the close relationship between the state of Jack’s body and the state of his mind. He had seen him brought low by wounds whose effects, though occasionally long-lasting, were not permanent. He did not like to think what the complete loss of a limb might do to his friend’s psyche.
In anyone else I would cut. But if I cut him now, not only will I always wonder it the step was indeed necessary to his survival, I believe it may soon prove the kinder thing to have let him die, than so cripple him. I am not sure if he would rather die than live with a limb lost, but I hope to avoid learning the answer to that question altogether.