Sumner performed an emergency surgery for a missionary

Patrick Sumner’s emergency operation on the priest is a desperate act of surgery performed with sparse supplies, far from any hospital and without practical experience of the procedure. It brings Sumner’s medical knowledge into direct contact with its limits: he can diagnose and intervene, but neither his improvisation nor the initial result can guarantee that the priest will live.

Illness and Diagnosis

The crisis develops after the priest’s condition appears to improve. He has been able to sit up for breakfast and return to his scholarly work, but after lunch he vomits what he has eaten. His lower abdominal pain becomes more severe, and he can barely urinate. Sumner examines him, checking his pulse and tongue and pressing on his abdomen. The priest’s reaction to pressure above the ilium points to a serious internal problem, even though Sumner finds no hernia.

The illness worsens through the afternoon and night. The priest’s pain grows, and he repeatedly wakes in distress; Sumner gives him brandy and tries to ease the symptoms with a warm poultice and the medicines available in the cabin. By the following morning, Anna asks Sumner whether the priest is going to die. Sumner explains that an abscess has formed inside him and that a rupture is filling his abdomen with poison. When Anna insists that Sumner will save him, he answers that he can do nothing and that the situation is impossible. Her appeal to his claimed status as an Angakoq meets his practical account of the crisis: they are a thousand miles or more from a hospital, and he has almost no medicines.

After further deterioration, the priest develops violent shivering, becomes cold and clammy, and has a faint, irregular pulse. He can no longer keep brandy down. Sumner steps outside, away from the sounds and smell of the illness, and looks over the sea ice beneath a sky where the stars remain visible at noon. The stillness and apparent absence of life sharpen the isolation of the decision awaiting him. He turns back to the cabin and acts rather than prolonging the examination of what cannot be changed by the medicines at hand.

Decision and Preparation

Sumner prepares to open and drain the abscess. He removes ether, lint, and a lancet from the medicine chest, sharpens the blade with a whetstone, clears the books from the table, and wipes it clean. His proposed treatment is an incision to let the diseased matter escape. He explains that the affected part may be an abscessed or ulcerated cecum, and that the distinction does not alter what he believes must be done. He would use opium to help if any were available, but the cabin has none.

The decision is not grounded in prior surgical practice. Asked whether he has done the operation before, Sumner admits that he has neither performed it nor seen it performed. His knowledge comes from reading an account of a procedure by a surgeon named Hancock at Charing Cross hospital in London; the patient in that case survived. Sumner recognizes the distance between that precedent and their circumstances, warning that they will need considerable luck. The priest accepts the risk and places what remains beyond Sumner’s control in the hands of the Lord. Sumner’s own explanation of his authority is spare: he is a surgeon. The moment tests that identity against the absence of experience, equipment, and medical support.

The Operation

Sumner asks Anna to bring her brother in from the igloo. He wets lint with ether and places it over the priest’s nose and mouth, then has the unconscious man moved from the cot onto the table. An extra candle on the windowsill gives Sumner light. Anna begins to pray and cross herself, but Sumner redirects her attention to the work: she must watch for signs that the priest is reviving and apply more ether when needed. He assigns her brother the bucket and a towel and tells him to remain alert beside him.

Before cutting, Sumner examines the abdomen again. He briefly considers whether he may have mistaken a hernia or tumor for an abscess, then recalls why he believes those alternatives do not fit. He tests the lancet and makes an incision into the abdomen. The procedure takes several attempts as he passes through the layers of tissue. When he reaches the cavity, a large quantity of infected fluid drains through the opening. The unexpected volume and the conditions make the operation difficult, but Sumner continues, directing the others to help manage the drainage and clean the table. They turn the priest onto his side to assist the flow, while Anna maintains the ether and her brother wipes away the discharge. Sumner presses around the wound to release what remains, and the flow eventually slows and stops.

Aftermath and Significance

The group carries the priest back to bed. Sumner dresses the wound, washes his hands, opens the window, and gathers the few medicines that might reduce or moderate the pain. He gives Anna instructions about how and when to use them. The operation has addressed the immediate abscess, but it has not removed the underlying danger. Sumner doubts the priest will live more than a day; he fears that the severity of the abscess has also caused a perforation in the gut, which could prove fatal. His estimate makes clear that performing the operation and securing recovery are different things.

The next morning, the priest is still breathing and appears no worse than before. Sumner removes and examines the dressing, cleans around the incision, and replaces it. This survival is a limited reprieve, not a confirmed recovery: the evidence does not establish that the priest is out of danger. When the priest asks what Sumner found inside him, Sumner gives no reassuring account, answering only that it was nothing good.

The operation therefore turns on a narrow distinction between action and certainty. Sumner has enough knowledge to recognize a condition he believes requires intervention and enough resolve to attempt it, but his own admission that he has never witnessed the procedure keeps the scene from becoming a simple triumph of medical authority. Anna’s faith in the Angakoq and the priest’s faith in divine care frame the act differently from Sumner’s clinical judgment. In the isolated cabin, neither belief nor technical skill can promise an outcome; the operation opens a chance of survival while leaving its consequences unresolved.