Forward Surgery

HOURS OF WORK. It took some time before agreement was reached on this subject. Many surgeons consider sixteen hours operating, with eight hours sleep, gave the maximum output: others preferred twelve hours.work with twelve hours sleep. Finally, it was agreed that eight hours on and eight hours off, these times strictly adhered to, gave not only the maximum, but also the most efficient turnover, and this rate of work could be kept up indefinitely. At the end of sixteen hours continuous operating, the best work was not being done. Long sp'ells of twenty-four, fortyeight, or seventy-two hours, which can be done in isolated incidents, are not practical when casualties may come in for days and weeks on end. This is a great contrast to the home air-raids, where the volume of work for a period may be severe, but usually one can see a rest period somewhere ahead. Food, and particularly tea, must be in constant readiness. Tea seemed to be equally appreciated in the heat of the desert or in the snows of Italy. If the above held good for the surgeon, it applied even more so to the orderlies, who tire more quickly. The surgeon makes his own pace and is fully distracted by his work. The principle of having one orderly arriving early to get sterilizers, etc., working, and also naturally going off duty early, and another arriving late, but remaining afterwards to leave the place tidy, was found to be a great help. One felt that it was quite unfair to do a large surgical list, then walk off to rest, leaving the orderlies to get the place cleaned, and yet expect them to be on duty the next morning at the right time.