Sep 2

World War II Submarine Appendectomy

Thursday, September 2, 2010 12:01 AM

On 11 September 1942, Pharmacist’s Mate First Class (PhM1/c) Wheeler B. Lipes agonized over the most difficult decision of his life. He had just diagnosed his shipmate, Seaman First Class Darrel D. Rector, with acute appendicitis. With their submarine Seadragon (SS-194) cruising in enemy waters, there was no way to get Rector to port in time. World War II submarines always carried a well trained corpsman, but their small, 55-man complement did not rate a doctor. Lipes could attempt an appendectomy, but the operation might kill his shipmate.

After joining the Navy in 1936, Lipes had received his medical training in the Navy hospital course in San Diego and had served at the Naval Hospital in Philadelphia and at the Naval Hospital in Canacao near Manila before entering the submarine service in 1941. Classified as an electro cardiographer, he had assisted Navy doctors during many operations, including several appendectomies.

On 8 September 1942, the Seadragon was several days and thousands of miles out from Fremantle, Australia, on her fourth war patrol, cruising off the Indonesian coast, when Rector first came to Lipes complaining of nausea and abdominal pain. Lipes told him to get to his bunk and rest. At first the corpsman thought something might be wrong with Rector’s gall bladder, but Rector soon began to display the classic symptoms of appendicitis: fever, rigid abdominal muscles, abdominal tenderness, and acute, localized pain. Lipes kept Rector in his bunk, packed his abdomen with ice, and restricted him to a liquid diet.

Nevertheless, Rector’s condition worsened. On the morning of 11 September, Lipes reported the situation to the commanding officer, Lieutenant Commander William E. Ferrall. Lipes said that unless Rector received an emergency appendectomy almost immediately, the 19-year-old seaman would die. The skipper asked the pharmacist’s mate what he intended to do. “Nothing,” said Lipes. Ferrall lectured him that everyone had to do the best they could and asked the 23-year-old pharmacist’s mate whether he thought he could do the surgery. “Yes sir, I can do it,” said Lipes, but “everything is against us. Our chances are slim.” The skipper explained the situation to Rector. Would the seaman allow the pharmacist’s mate to operate? “Whatever the doc feels has to be done is okay with me,” said Rector. Ferrall ordered Lipes to perform the surgery.

The skipper took the boat into relatively safe water and submerged to 120 feet to provide a stable platform. Every member of the crew, from the box-plane man to the galley cook, participated in the operation. Lipes boned up on the appendix from a medical book. The ship’s medical kit provided a few basics, including sulfa tablets, twelve hemostats, a packet of scalpel blades, catgut for sutures, and a limited quantity of ether. The rest of the instruments had to be improvised. A hemostat became a scalpel handle. Five tablespoons with the handles bent back served as retractors. Commercially-sterilized “Handi-pads” substituted for gauze sponges. A tea strainer covered with gauze served as a mask for administering the ether. Boiling water and torpedo alcohol provided sterilization. The operation would be performed on the wardroom table, barely long enough for the patient to stretch out on without his head or feet hanging over.

Lipes didn’t know how long the operation would last and whether there was enough ether. He had no way to do a blood count or urinalysis or to monitor the patient’s blood pressure, nor was there any intravenous fluid.

Nevertheless, with everyone at his assigned station, the operation began. Lipes began administering the anesthesia at 1046. Thereafter Lieutenant Franz Hoskins, the Communications Officer, served as anesthetist. With the skipper making and recording detailed observations at four to seven minute intervals, Lipes made the incision at 1107. At first he had difficulty finding Rector’s appendix. But then he slipped his fingers down behind the caecum, and there it was. The distal tip was black and gangrenous.

Lipes detached the appendix, tied it off, removed it, and preserved it in a jar of torpedo alcohol. He cauterized the stump with carbolic acid. He took sulfa, ground from tablets into powder and baked in the ship’s oven to kill off spores, and sprinkled it into the peritoneal cavity. Lipes finished suturing at 1322. Rector regained consciousness less than half an hour later.

The seaman’s three-inch incision healed nicely and he was back on duty in a few days. The Seadragon returned to port six weeks after the operation. The medical officer of the submarine squadron pronounced Rector okay. After examining the appendix, the medical officer concluded that Lipes and his shipmates had indeed saved Rector’s life. When the story broke in the press, Lipes became a national hero.

At bottom, it was training and leadership that saved the seaman’s life. The training Lipes had received had given him the know-how and confidence to perform at a level well above the normal expectations of his rating. The skipper’s decision to order Lipes to perform the surgery reflected his own confidence in the pharmacist’s mate’s training. And it was Lieutenant Commander Ferrall’s leadership that inspired Lipes to go above and beyond the call of duty and enabled him to organize the crew for an operation totally outside the realm of their experience.

 
 
 
  • Robert

    I remember this incident being reenacted in the Cary Grant movie “Destination Tokyo”, but I had always been told it happened aboard the USS Silversides (the movie boat was called Copperfin).

    Great story.

  • CaptT J McEnaney Jr USN (RET)

    Small boys are always short of MED resources. In command of a 185′ spit kit, converted AM hull, I leaped from my bridge chair when
    our HM1 told me he would have to perform a tracheomotoy, if the
    OPS Officer’s breathing didn’t improve. Didn’t happen, we found
    a safer solution. In the same 2 year tour, an appendix was loaded with penicillin after our HM2 had a med Consult with a sub’s HMC over gertrude while we steamed for Charleston harbor–got a speeding ticket from SOPA, ADM Daspie(SP),for trashing the speed
    limit in the Cooper River. Sucessful surgery and a call to his
    Mom in Philly, netted a query,” I thought he was going to P Rico”

  • Douglas E. Nunnery

    I served on USS Requin SSR-481, a W.W. II vintage submarine from Jan 56 thru Dec 58. I can only imagine the pressure on Lipes, the Captain and the entire crew. I spent many hours as the stern planesman so I can also feel the pressure of the two guys on the planes, to keep the boat level to give Lipes a sturdy operating table. God bless the whole crew. I think they all should receive a “well done”

    Doug

  • Capt. Jerome Imburg, MC, USN,(Ret.)

    I performed an appendectomy at sea abord the USNS Thomas,formerly an APH. Fortunately we had all of the equipment required. However one of my colleagues from another ship in the Military Sea Transport Service told me previously that he had done an appendectomy using drop ether and while this is probably the safest anaesthetic, everybody in the operating room got a little drunk from the fumes, including the surgeon. Not good, to have a drunk surgeon, but I guess that would not be the first time.
    So I tried a spinal. But that did not work. So we used intravenous Pentothal. Foutunately we had another Medica Officer who acted as anaesthesiologist. The patient developed a spasm of his larynx, but that was overcome with a little more Pentothal. After the inflammed appendix was removed and the stump cauterized, the usual practice is to invert the stump using a purse string suture around the stump. In this instance the purse string broke and ahd to be replaced. But, all’s well that ended well.

  • Paul Berman

    Anyone know of British submarine appendectomies during World WarII or a sheet with anatomical markings to tell coxswain where to cut?

  • Mike Malone

    I rode USS Salmon (SS-573) from 1959-62, and my Chief Was ENC George Platter. While on a WESTPAC I read a book that said he went through the same experience as the patient. Maybe it happened more than once.

  • Chuck Fleming HMC(SS), Retired

    Fascinating historical narrative. As a independent duty Hospital Corpsman serving aboard diesel boats I often wondered what I would do in a similar situation. I did not know (and it is not common knowledge) the skipper ordered him to do the surgery. In reality, I expect if a HM was to do such a thing and his patient survived, he would be highly praised. On the other hand, if the patient dies, it would be a career ending decision. I have to give this guy credit for his anatomical knowledge, skills, improvision, and daring. Those days are likely gone forever.

  • Kenny B

    Mike M.- Your Motor Mac Chief was right; it did happen a few times on war patrols during WWII. In fact, Admiral Jimmy Fife while ComSubSWPac wanted to have all submariners appendixes removed prior to patrols as preventive maintenance.

  • James Graham

    Being a corpman in the navy i can understand his feelings about operating on a shipmate. The training and equipment we get today is superior. i also noticed the article about Tony Curtis. one of his old movies was “The Great Impersonator” where he was on a ship and did surgery at sea from a book.

  • Tom Fiorillo

    I heard about this on an old radio program dramatization late last night. Truely the greatest generation!

  • Woody Sanford

    I was a submarine medical officer during the decade of the 1960s when the Polaris Boats carried doctors- I made 3 patrols with the Blue Crew of USS James Madison, SSBN-627. In Sub Med school at Groton, the Instructors advised us not to attempt appendectomy at sea. If redesvous and transfer was impossible, one should place the patient at complete rest,administer IV antibiotics and analgesics and put ice packs on the abdomen. The patient should recover, but on return from patrol he would be evaluated for an “interval” appendectomy. I don’t know how often this protocol was followed. I was never faced with that.

    My most frequent patient those 3 patrols was the XO, who required Fiorinal for his Co2 headaches. I also drained a large peri-rectal abscess and re-attached a severed finger tip.(mess cook using the meat slicer) Not a whole lot of real medicine, but satisfying. I also qualified on the dive and stood regular watches for 2 patrols. On Sea Trials, I stood-by Topside for helicopter medevac exercises and for the ship’s lead diver to go over the side to open and close a valve for pumping reactor waste overboard.

    By far the worst thing that happened–In May/June 1968 on my last patrol, The USS Scorpion went down almost right underneath us. Just about everybody on the Madison knew somebody on that submarine. Five years after the Thresher was lost, a disaster had happened again. H. W. Sanford, MD, Capt,MC,USNR(ret.)

  • Magali Gongora

    I had the pleasure and privledge of working for Wheeler B. Lipes most affectionally known as “Johnnie”. Mr. Lipes worked at Memorial Medical Center in Corpus Christi, Texas and was one of the best administrators we ever had. He had tremendous knowledge of medicine, medical equipment and procedures. He ran the hosptial like a fine watch. He became our mentor and a friend to many of the medical staff and employees in that hospital. He told us the story of this procedure and gave us copies of article and showed us a mural of the procedure that sits in a museum. There will never be another Johnnie Lipes and it was and extreme pleasure and great opportunity to have shared so much information and knowledge with one of the great genius’ of that time. He recognized potential in me and gave me the opportunity to be more than I thought I could be and because of his support and faith I became a better person. May you rest in peace.

  • Diana Wright

    I bet that radio program was produced by Bill Robson, for whom I used to work.

  • John J. Chapman

    I remember this being reenacted in the 1950′s television show, “The Silent Service.” I believe that the late character actor Richard Deacon portrayed Doc Lipes. Sadly, Gunner Mate 3/c Darrel Dean Rector was lost when the USS Tang SS-306 was lost on October 24, 1944 on her fifth war patrol. She was sunk by her own torpedo on circular run.