Extreme Medicine by M.D. Kevin Fong

supplied by the vessels running through its attached edge, but left it fixed in position. McIndoe would then fold the sheet of skin into a tube, stitching its long edges to each other to protect its raw undersurface from infection.
    To move this tube of skin, he would make an incision in the patient’s arm and form a pocket into which its free edge could be tucked. He would then stitch the flap into place, fastening arm to thigh in the process, and wait for it to heal into position. This healing could take weeks, during which the patient was handicapped by the strange new anatomical arrangement.
    Once the flap had established itself in the pocket, its link with the thigh could be severed. This arduous process left a flap of skin, previously from the thigh, now drawing its blood supply from the patient’s arm and free to be moved to any location which the arm could reach. This process of walking a tube of skin end over end from one part of the body to another was known as waltzing. Gillies had invented the technique, but McIndoe brought it to maturity, waltzing flaps from larger areas than ever before. It provided the plasticity in McIndoe’s reconstructive technique, allowing him to address larger areas of burn injury by walking skin up from distant uninjured sites.
    But aesthetic considerations were at the heart of McIndoe’s work. It was not enough simply to provide protective coverage; cosmesis was essential. Skin is indeed one of the principal organs through which we are able to experience the world. But McIndoe understood that it is also the means through which the world experiences us. When the war started and the toll of burned airmen began to become apparent, it was thought that the best thing you could do with the victims was to institutionalize them away from society with the intention of protecting one from the other. But McIndoe was unwilling to accept this fate for his patients, and his efforts in reconstructing the injured went far beyond surgical innovation. McIndoe would give them new faces, but they in turn would be expected to face the world again.
    Ward 3 became famous for its feats of plastic reconstruction and notorious for the antics of its resident airmen. McIndoe resisted the militarization of the ward. The Queen Victoria Hospital was his—quite literally. The Air Ministry had seen that control of the facility was signed over to McIndoe, and it was run by his rules. Military discipline was relaxed, and rank ceased to have significance among the men in the beds—except, of course, when it came to McIndoe, whom they referred to as the Maestro, the Boss, or simply Sir. Beer kegs stood freely accessible on the ward, and at times it came to resemble something like a workingmen’s club.
    All of this did something to distract from the grimness of the pilots’ reality. Not only were they assaulted by disturbing odors of char and infection, but they were also exposed to a series of strange new procedures that left them with arms stitched temporarily to thighs, abdomens, and faces, initially leaving them looking more bizarre than even their injuries had.
    Confronted with long drawn-out weeks of suffering, with free beer as their only real comfort, the patients of Ward 3 set up a drinking club. At first they stumbled with the name, coming up with the Maxillonians, in reference to their ongoing maxillofacial surgeries. But they quickly realized that this was unwieldy and didn’t quite capture the spirit of their circumstances. They were a new breed of casualty patient under the care of a pioneer surgeon armed with groundbreaking techniques. They knew at heart that they were the subjects of experimentation—however well intentioned. And so the drinking party reformed under a new name: the Guinea Pig Club, with Tom Gleave the first and only chief guinea pig.
    The club’s activities moved rapidly beyond drinking and singing around pianos to rehabilitation and support.