This story was read by the late Jere Lawrence Crook, A.M. M.D., F.A.C.S, Jackson, Tenn., at a medical meeting in Corinth, Miss. This was in 1941 and the events described had taken place in 1902.
The story later appeared in The Mississippi Doctor, the professional Mississippi Physicians. The title of Dr. Crooks original story was, A Reminiscense of Forty Years Ago."
In the autumn of 1901 the writer attended the Tri-State Medical Association, comprised of doctors from Mississippi, Arkansas and Tennessee, and discussed the subject of appendicitis which had been presented by one of the essayists on the program. Dr. W.B. Keaton, of Scotts Hill, Tennessee, was in the audience and heard both the paper and the discussion.
In February, 1902, following that meeting one cold, snowy night I had a long distance call from Doctor Keaton from Scotts Hill in which he stated he had a patient suffering with appendicitis who had been ill nearly a week. He believed the appendix was ruptured. The patient was in a critical condition from peritonitis. He requested that I come out the next morning to Lexington and drive over to Saltillo and operate on the patient. I asked if it would be possible to bring the patient to Jackson but he said it would be absolutely impossible to move him without killing him.
He then directed me to take the early N.C. & St. L. train from Jackson due in Lexington at eight oclock and there he suggested that I secure a double team and drive through to a point near Saltillo within three miles of the Tennessee River. He said I could get full directions from the livery stable owner in Lexington.
I accepted the call and went down to the Rochelle-Warford Sanatorium, where I did my surgical work, and borrowed the head nurse, a Miss Bernard who agreed to go with me. She and I spent quite a while in assembling instruments, sheets, towels, et cetera, that would be required.
Early the next morning I had my horse and buggy at the door and drove to the Sanatorium and picked up Miss Bernard and two suitcases filled with sheets, towels and dressings and all the instruments which I thought would be needed and which had been carefully sterilized the night before. We left Jackson at seven oclock and reached Lexington one hour later. I immediately went to the livery stable and engaged a single buggy with two horses. The livery stable proprietor drew a little map on my prescription pad showing the route I should take to reach the patients home near Saltillo.
The snow was on the ground and was beginning to thaw so that the roads were almost impassable. The buggy would mire up almost to the hubs and it was with great difficulty that we were able to get up the first hill leaving Lexington. In some way I misinterpreted the map and drove ten miles up the road via Scotts Hill. There I was set right and directed to take the road to Reagan and from that point I would be directed for the rest of the journey. It was ten miles from Scotts Hill to Reagan. Halfway between these two points the singletree on the buggy broke in two due to the heavy strain on it from pulling through the mud. It was necessary for me to unhitch one of the horses and leave the nurse wrapped in the lap robe sitting in the buggy while I rode bareback five miles to Scotts Hill where I secured a new singletree. I brought it back and attached it to the buggy and we continued our journey to Reagan.
When we arrived there it was almost dark and my nurse was almost frozen. I took her into a nice home opposite the one store in Reagan and the lady of the house had the nurse to go to bed, wrapped her up in blankets, gave her a stimulant, and I allowed her to rest for an hour.
I went across the road to the store, a long frame building of one story with a porch in front and steps leading down to the road. In the store I found a red-hot stove and four or five men sitting around it. I introduced myself and stated that I was on my way to Saltillo to operate on Mr. Montgomery and would like to get further directions from them as I had lost my way and had gone by Scotts Hill by mistake. I said, "I encountered some awful roads and had great difficulty in getting through at all." One of the men sitting around the stove, chewing tobacco vigorously, sized me up and emitted a generous mouthful of tobacco juice which struck the stove at a tangent. While the juice was still sizzling, he said, "Young fellow, you aint seen no roads yit," and I found out later that he was more than right.
Five miles beyond Reagan my weary horses refused to budge any farther, as the buggy was mired up to the hubs in thick, sticky mud. We could not do anything but sit there and hope for someone to come along. We were about two hundred yards from a farmhouse from which light was shining from the windows. In a little while the farmer who lived there came by on horseback. Seeing my plight and learning my mission, he said, "I think I can get you out. I will go back to the house and have a negro come out and unhitch your weary beasts, and I will lend you a fresh team to carry you the rest of your journey." He certainly was a good Samaritan to me, to the nurse, and to the team and to the patient. I do not know his name and I have always wished that I had secured it.
With the fresh team we drove the remaining distance of about six miles and reached the patients home at eight oclock, just twelve hours from the time we left Lexington. The snow had begun again en route and it was snowing when we arrived. The patients home was a two-room log house with a lean-to for the kitchen. The room in which he lay had only one window which fortunately opened toward the east. I soon learned that the patient had been sick eight days. I found on examination that he apparently had a localized abscess; otherwise he would have been dead. There was great tenderness over the abdomen but the patients general condition was fairly good. We, therefore, decided to wait for daylight to do the operation as the house was only supplied with coal oil lamps.
I was assigned to sleep in a nearby house about one-fourth of a mile away through the woods. I awoke at daylight the next morning and went out on the stoop and washed my face in a tin pan with water dipped from the bucket on which there was a comparatively thick layer of ice. When I reached the patients home after breakfast I found about fifty of his neighbors and friends assembled.
No arrangements had been made for an operating table or any other equipment for the operation. Doctor Keaton had been with the patient all day and remained during the night before the operation to help me the next morning. I took several of the friends of the patient out to the barnyard and we found some planks under the corn crib covered with snow, dust and dirt. I asked the gentleman to select three planks to make a barn door. I asked some of them to do this work and other friends to scald and wash off the door after it was completed. It was simply three planks nailed together with three cross pieces, sawed off for a six-foot length. Doctor Keaton and I then got the meal barrel and the kitchen table and we placed the newly-made barn door on these supports. The patients wife furnished me several quilts for padding on which I placed the red oilcloth that I had taken from the kitchen table. This, of course, could not be sterilized but was thoroughly cleansed with hot water and soap. On this improvised table my nurse placed the sterilized sheets which we had brought with us and she very efficiently prepared the room as well as she could for the operation.
Doctor Keaton had never assisted in an operation, but said he would watch the patients condition while the nurse and I did the operation. A young man who had taken one year of a medical course was present and consented to give the anesthetic which was ether. Due perhaps to inexperience he gave a little too much of the anesthetic and the patient ceased breathing. His condition became so alarming that I was forced to remove my sterile gloves and use artificial respiration and make every effort possible to keep the patient from dying on the table. After his breathing. became normal I then put on my gloves again to start the operation. The same thing occurred a second time while I was in the midst of the operation and the same measures were repeated to prevent the patients death. After the second episode I was able to continue my operation and removed a sloughing, partially gangrenous appendix which was lying in a pool of pus found in a localized abscessed area which I was careful not to break down. The operation was completed, a large drainage tubes inserted and the patient was turned over to the nurse for further treatment, She had meanwhile consented to remain with the patient until his condition was safe for her to leave.
When I emerged from the room with the appendix grasped by hemostatic forceps in my hand I found the adjoining room crowded with the patients friends who had overflowed out into the yard. It was a sense of great satisfaction to me to be able to show the foul, sloughing appendix as a trophy of the operation so that in the eves of the patients death no one could question the necessity for the operation.
Doctor Keaton and I then retired to the kitchen for a conference as to the fee He said the patient and his two brothers owned their own store and a fine farm and were able to pay a fair fee. I asked him if $250 for the operation and my detentions from home would be exorbitant, and he said it would be reasonable. I then added $5 for the hire of the team and we called in the two brothers of the patient for a conference. They said they did not have any money available at the time to pay for the operation. I then said, "Will you sign a note or due bill until you can arrange to get the money?" They agreed to do this and I took out one of my prescription blanks and wrote out the following due bill: "Ten days after date we promise to pay to the order of Dr. Jere L. Crook the sum of $255 for surgical operation and expenses for our brother." I presented this and one of the men signed it "Montgomery Brothers" which, of course, made all of them responsible for it.
There was a primitive stagecoach which made a trip daily from Saltillo to Lexington that passed by the front of the patients home. Doctor Keaton had arranged for me to take passage in this rig for my return trip. I was the only occupant at first and I sat by the driver, a big, husky, outdoor man. As we started off from the house he asked me about the condition of the patient and I told him it was satisfactory and it looked like he had a good chance to get well. Then looking me straight in the face he said: "It is a powerful good thing he is going to get well." I replied: "Yes, I agree with you." He said, "You dont ketch my pint. He is one of the best citizens we got in this part of the country and I mean its a powerful good thing for you that you did not kill him on the operating table." To this I made no reply but thanked my lucky stars that the chances of survival for the patient were fairly good, at least until I could get out of the country.
The third day after this eventful trip a long distance call came in from Saltillo. At that time there was only an iron or steel wire for the long distance connection and the voice coming over this wire was very difficult to distinguish or to understand; however I was able to hear the voice at the other end of the line say, "Is that you, Doctor Crook?" I said, "Yes." He replied, "Well, Doctor Crook, you will have to come back here and do your job over again on my brother. His bowels are busted open and coming through his belly. You will have to come out here and sew him up." I assured him that the condition was no more than I had expected due to the delay in operating on the patient; that the bowel near the appendix had become soft and also had sloughed, and I believed if he would keep the nurse and have the patient cared for by her every day the patient would get well and the hole in the bowel would heal up without further surgery. After I had told him this he said, "Well, you charged too much for that job. We think $150 is a plenty to pay you." To this statement I reacted somewhat differently and in place of assuming an apologetic note I said to him, "You are too late in your demand. I have already deposited your due bill in the First National Bank and have already collected the $255. I also learned from the bank at Jackson that Montgomery Brothers credit is good for $5000 or more at the bank in Lexington. I do not think you can get out of paying your note to your own bank."
This settled him and I heard no more from the patient until the nurse returned at the end of ten days, and she had a great many experiences to relate regarding her stay in the backwoods. She left the patient convalescent with the fecal fistula closed and no further trouble marring his convalescence.
Thirty-five years later I met Mr. Montgomery on the street in Jackson as we were waiting for a street-car. I simply asked his name and when he said "Montgomery" I asked him if he ever knew Mr. Montgomery who lived near Saltillo and told him my name. He said, "Doctor Crook, I am the Montgomery you operated on thirty-five years ago and I have been in perfect health ever since." Needless to say this was one of the most gratifying experiences I have ever had in my professional life.
- The History of Scotts Hill, Tennessee by Gordon H. Turner, Jr., (Carter Printing Company, Southhaven, Mississippi, 1977)