Doing What's Needed, When it's Needed,
Wheeler "Johnny" Lipes, had neither the formal training, the equipment, nor the urge to become a surgeon.
Because it's Needed.
But when one of his ship mates came down with acute appendicitis 120-feet below the South China Sea, with enemy warships circling above - he had no choice. He had to do what needed to be done or his shipmate would die.
It was the first major surgery ever preformed aboard a submarine. And it was performed by a man who stepped up to the job.
Four months after the successful surgery, Chicago Daily News reporter George Weller told the story. Below is his article, which won a Pulitzer Prize for distinguished reporting in 1942.
"Doc" Lipes Commandeers a
Submarine Officers' Wardroom
Somewhere in Australia -- "They are giving him ether now," was what they said back in the aft torpedo rooms.
Artist John Falter's rendition of the operation aboard USS Seadragon. Titled Submarine Appendectomy, it was originally published in Esquire magazine, July 1943. Nebraska State Historical Society
The story of Lipes' willingness to step-up was also made part of the submarine film "Destination Tokyo" starring Cary Grant.
"He's gone under, and they're ready to cut him open," the crew whispered, sitting on their pipe bunks cramped between torpedoes.
One man went forward and put his arm quietly around the shoulder of another man who was handling the bow diving planes.
"Keep her steady, Jake," he said. "They've just made the first cut. They're feeling around for it now."
"They" were a little group of anxious-faced men with their arms thrust into reversed white pajama coats. Gauze bandages hid all their expressions except the intensity in their eyes.
"It" was an acute appendix inside Dean Rector of Chautauqua, Kansas. The stabling pains had become unendurable the day before, which was Rector's first birthday at sea. He was nineteen years old.
The big depth gauge that looks like a factory clock and stands beside the "Christmas tree" of red and green gauges regulating the flooding chambers showed where they were. They were below the surface. And above them were enemy waters crossed and recrossed by whirring propellers of Japanese destroyers and transports.
The nearest naval surgeon competent to operate on the nineteen-year-old seaman was thousands of miles and many days away. There was just one way to prevent the appendix from bursting, and that was for the crew to operate upon their shipmate themselves.
And that's what they did; they operated upon him. It was probably one of the largest operations in number of participants that ever occurred.
"He says he's ready to take his chance," the gobs whispered from bulkhead to bulkhead.
"That guy's regular" – the word traveled from bow planes to propeller and back again.
They "kept her steady."
The chief surgeon was a twenty-three-year-old pharmacist's mate wearing a blue blouse with white-taped collar and squashy white duck cap. His name was Wheeler B. Lipes. He came from Newcastle near Roanoke, Virginia, and had taken the Navy hospital course in San Diego, thereafter serving three years in the naval hospital at Philadelphia, where his wife lives.
Lipes' specialty as laboratory technician was in operating a machine that registers heartbeats. He was classified as an electrocardiographer. But he had seen Navy doctors take out one or two appendixes and thought he could do it. Under the sea, he was given his first chance to operate.
There was difficulty about the ether. When below the surface the pressure inside a boat is above the atmospheric pressure. More ether is absorbed under pressure. The submariners did not know how long their operation would last.
They did not know how long it would take to find the appendix. They did not know whether there would be enough ether to keep the patient under throughout the operation.
They didn't want the patient waking up before they were finished.
They decided to operate on the table in the officers' wardroom. In the newest and roomiest American submarine the wardroom is approximately the size of a Pullman – car drawing room. It is flanked by bench seats attached to the wall, and a table occupies the whole room – you enter with knees already crooked to sit down. The only way anyone can be upright in the wardrooms is by kneeling.
The operating room was just long enough so that the patient's head and feet reached the two ends without hanging over.
First they got out a medical book and read up on the appendix, while Rector, his face pale with pain lay in the narrow bunk. It was probably the most democratic surgical operation ever performed.
Everybody from box plane man to the cook in the galley knew his role.
The cook provided the ether mask. It was an inverted tea strainer .They covered it with gauze.
The twenty-three-year-old "surgeon" had, as his staff of fellow "physicians," all men his senior in age and rank. His anesthetist was Communications Officer Lieutenant Franz Hoskins of Tacoma, Washington.
Before they carried Rector to the wardroom, the submarine Captain, Lieutenant Commander W.B. Ferrall of Pittsburgh, asked Lipes as the "surgeon" to have a talk with the patient.
"Look, Dean, I never did anything like this before," Lipes said. "Your don't have much chance to pull through, anyhow. What do you say?"
"I know just how it is, Doc."
"It was the first time in his life that anybody had called Lipes "Doc." But there was in him, added to the steadiness that goes with a submariner's profession, a new calmness.
The operating staff adjusted gauze masks while members of the engine room crew pulled tight their reversed pajama coats over their extended arms. The tools were laid out. They were far from perfect or complete for a major operation. The scalpel has no handle.
But submariners are used to "rigging" things. The medicine chest had plenty of hemostats, which are small pincers used for closing blood vessels. The machinist "rigged" a handle for the scalpel from a hemostat.
When you are going to have an operation, you must have some kind of antiseptic agent. Rummaging in the medicine chest, they found sulfanilamide tablets and ground them to powder.
One thing was lacking: there was no means of holding open the wound after the incision had been made. Surgical tools used to this are called "muscular retractors." What would they use for retractors? There was nothing in the medicine chest that gave the answer, so they went as usual to the cook's galley.
Lipes used bent spoons as retractors
In the galley they found tablespoons made of Monel metal. They bent these at right angles and had their retractors.
Sterilizers? They went to one of the greasy copper-colored torpedoes waiting beside the tubes. They milked alcohol from the torpedo mechanism and used it as well as boiling water.
The light in the wardroom seemed insufficient; operating rooms always have big lamps. So they brought one of the big floods used for night loadings and rigged it inside the wardroom's sloping ceiling.
The moment for the operation had come. Rector, very pale and stripped, stretched himself out on the wardroom table under the glare of the lamps.
Rubber gloves dipped in torpedo alcohol were drawn upon the youthful "Doc's" hands. The fingers were too long. The rubber ends dribbled limply over.
"You look like Mickey Mouse, Doc," said one onlooker.
Lipes grinned behind the gauze.
Rector on the wardroom table wet his lips, glancing a side look at the tea-strainer ether mask.
With his superior officers as his subordinates, Lipes looked into their eyes, nodded and Hoskins put the tea mask down over Rector's face. No words were spoken; Hoskins already knew form the look that he should watch Rector's eye pupils dilate.
The twenty-three-year-old surgeon following the ancient hand rule, put his little finger on Rector's subsiding umbilicus, his thumb on the point of the hipbone, and, by dropping his index finger straight down, found the point where he intended to cut. At his side stood Lieutenant Norvell Ward of Indian Head, Maryland, who was his assistant surgeon.
"I chose him for his coolness and dependability," said the Doc afterward of his superior officer. "He acted as my third and fourth hands."
Lieutenant ward's job was to place tablespoons in Rector's side as Lipes cut through successive layers of muscles.
Engineering Officer Lieutenant S. Manning of Cheraw, South Carolina, took the job which in a normal operating room is known as "circulating nurse." His job was to see that packets of sterile dressings kept coming and that the torpedo alcohol and boiling water arrived regularly from the galley.
They had what is called an "instrument passer" in chief Yeoman H.F. Wieg of Sheldon, North Dakota, whose job was to keep the tablespoons coming and coming clean.
Submarine Skipper Ferrall too had his part. They made him "recorder." It was his job to keep count of the sponges that went into Rector. A double count of the tablespoons used as retractors was kept: one by the Skipper and one by the cook, who was himself passing them out from the galley.
It took Lipes in his flap-finger rubber globes nearly twenty minutes to find the appendix.
"I have tried one side of the caecum," he whispered after the first minutes. "Now, I'm trying the other."
Whispered bulletins seeped back into the engine room and the crews' quarters.
"The Doc has tried one side of something and now is trying the other side."
After more search, Lipes finally whispered, "I think I've got it. It's curled way into the blind gut."
Lipes was using the classical McBurney's incision. Now was the time when his shipmate's life was completely in his hands.
"Two more spoons." They passed the word to Lieutenant Ward.
"Two spoons at 14.45 hours [2:45 p.m.]," wrote Skipper Ferrall on his note pad.
"More flashlights. And another battle lantern," demanded Lipes.
The patent's face, lathered with white petrolatum, began to grimace.
"Give him more ether," ordered the Doc.
Hoskins looked doubtfully at the original five pounds of ether now shrunk to hardly three quarters of one can, but once again the tea strainer was soaked in ether. The fumes mounted up, thickening the wardroom air and making the operating staff giddy.
"Want those blowers speeded up?" the Captain asked the Doc.
The blowers began to whir louder.
Suddenly came the moment when the Doc reached out his hand, pointing toward the needle threaded with twenty-day chromic catgut.
One by one the sponges came out. One by one the tablespoons bent into right angles were withdrawn and returned to the galley. At the end it was the skipper who nudged Lipes and pointed to the tally of bent tablespoons. One was missing. Lipes reaches into the incision for the last time and withdrew the wishboned spoon and closed the incision.
They even had the tool ready to cut off the thread. It was a pair of fingernail scissors, well scalded in water and torpedo juice.
At that moment the last can of ether went dry. They lifted up Rector and carried him into the bunk of Lieutenant Charles K. Miller of Williamsport, Pennsylvania. Lieutenant Miller alone had had control of the ship as diving officer during the operation.
It was half an hour after the last tablespoon had been withdrawn that Rector opened his eyes. His first words were, "I'm still in there pitching."
By that time the sweat-drenched officers were hanging up their pajamas to dry. It had taken the amateurs about two and a half hours for an operation ordinarily requiring forty-five minutes.
"It wasn't one of those 'snappy valve' appendixes," murmured Lipes apologetically as he felt the first handclasps upon his shoulders.
Within a few hours, the bow and stern planesmen, who, under Lieutenant Miller's direction, had kept the submarine from varying more than half a degree vertically in 150 minutes below the stormy sea, came around to receive Rector's winks of thanks.
Rector's only remark was, "Gee, I wish Earl was here to see this job." His brother Earl, a seaman on the Navy submarine tender Pigeon, is among the list of missing at Corregidor, probably captured.
When the submarine surfaced that night, the ether-drunk submarine crewmen found themselves grabbing the sides of the conning tower and swaying unsteadily on their feet.
Thirteen days later Rector, fully recovered, was at his battle station, manning the phones.
In a bottle vibrating on the submarine's shelves was the prize exhibit of surgeon Lipes – the first appendix ever known to have been removed below enemy waters.
Reprinted from the Chicago Daily News, Dec. 14, 1942