Hundreds of British forces were killed or injured in the opening days,
and those clinging to life were ferried to the Betty, where the sailors and
soldiers who had suffered bullet and shrapnel wounds were tended to by
Hunter and his fellow surgeons. “While the storm tossed and dispersed the
wooden ships, Hunter battled to save the wounded, bleeding, and dying
men in his primitive surgery.”^29 An age-old question has always been, why
does the meaning of “casualty” include both those killed in battle and
those who are injured? The answer is that prior to World War II, most
seriously injured combatants were likely to die in a rather short period of
time, so a “casualty of war” was essentially done for. “With no anesthetics
to numb the pain, many patients died of shock as the amputation knife cut
through their flesh, or bled to death while the surgeons probed around in
their wounds to extract debris. Their bodies were given hurried burials at
sea. Others would join them days later as sepsis took hold in their wounds
while they lay in the hammocks of the foul-smelling sick bay.”^30
After a second assault on the island two weeks later, the British were
successful in establishing a hospital of sorts among its cottages. Here,
John Hunter began a program of investigation on the proper treatment of
war wounds. Whereas most of the other surgeons adhered to the ancient
practice of exploring traumatic war wounds, Hunter began to realize that
less was more. His fellow surgeons were actually inflicting greater pain
and hastening death by inserting grimy fingers and filthy tools into
wounds. Exercising great restraint, particularly when considering his years
of dissection and his renowned dexterity, Hunter opted not to probe and
enlarge bullet wounds, instead “being very quiet” in the treatment of
wounds.
A chance development occurred in the first week on the island that
cemented Hunter’s belief that conservative care was better and the
humbling realization that surgeons were violating the central tenet of
Hippocratic care, primum non nocere, “above all else, do no harm.” In the
midst of battle, five French soldiers had been shot during an exchange of
fire, but had avoided capture. Although some of their injuries were serious
(including chest- and thigh-penetrating bullet wounds), the men ensconced
themselves in a barn and evaded capture until being discovered four days
later. Hunter tended to the men, realizing that the French troops who had
received no care at all were faring better than the British forces who were
unlucky enough to have been “treated.” In the end, in what amounts to a