Excerpts from The Letters Of Dr. Arthur Gordon Boggs
Transcribed, compiled and edited by Frances Tompkins
Dr. Arthur Boggs, Tim’s grandfather
Ongole, India, Oct. 13, 1946
Dear ones all,
I wonder whether our railway accident got into your papers. If so, I am sure you will understand why I didn’t start a letter last Sunday. We were very busy indeed, of course. Mr. Sitaramiah, the bus owner who has two wives, told us that the evening BBC broadcast on the 4th of October mentioned the accident at Ongole and said that the wounded were being cared for at the American Mission Hospital.
At about 2 A.M. on the 4th morning the Mail Train from Madras, while approaching the Ongole station (and therefore slowing down, fortunately) took the wrong turn at a switch and ploughed into a goods train which was taking water. I knew nothing about it until 4.20 A.M. when an Englishman who was a passenger on the train, and a Sub-Inspector of Police came here and called me. I went with them at once to the hospital where I told Esteramma, who is night supervisor this month, to get beds ready, and then we proceeded with a couple of stretchers and a couple of male nurses to the station. Of course very much relief work, and some of it highly commendable, had been done by the time we got there. There were some military doctors and some Red Cross nurses on the train and they had applied temporary splints and bandages to many patients, as well as extricating injured people from the wreckage. Herb Jackson was on the train and quite uninjured, the injuries being almost entirely confined to the first three carriages. Herb was carrying stretchers, transporting patients from the scene to the station.
By the time I reached the station the injured were being brought and laid on the floor; about half a dozen had been brought by the time I got there. I sent for some supplies and did what I could with the injured. Dr. Ramakrishna was with me part of the time. I suppose I was there about 3/4 of an hour. At Dr. Wood’s suggestion I wrote to the Sub-Collector asking for lorries to transport the injured to the hospitals in the town. They came fairly soon, and I left to get back to the hospital to be ready to deal with them on arrival. Sigrid meanwhile had come and seen and gone back to get things and staff ready. She was magnificent as always. By the time I left the station, there must have been about 25 patients lying all about on the cement floor and benches, and of the lot 3 died while I was there with them.
I returned to the hospital by way of the accident scene, which was only a couple of hundred yards from the station. As I went I overtook a woman who was sobbing. When I asked her why she was crying, she replied that she had lost 4 relatives. Both engines were badly smashed, and the two or three cars immediately behind the mail train engine were just a mass of kindling. Bodies and parts of bodies were strewn all about. A good many bodies of course had been laid out on the ground and covered with a sheet. The crowd, which was enormous, was kept back by the Police. The engine driver and fireman jumped but the driver failed to jump clear of the wreck and was pinned under it. He could not be extricated in time and died right there. The under guard was in the very next car, and he was pinned too, but extricated in time and proved to have only minor injuries. He was in our hospital for a few days. So we went back to the hospital and went to work. I spent almost the whole morning admitting the wounded by way of the X-ray room. I screened many of them and examined them at once and wrote orders. Almost all were given TAT and many received intravenous saline. One young man, with a crush injury of the leg and foot, was in extreme shock when we arrived and he died in an hour.
By the time we had surveyed the patients and got them classified and treated for shock, Dr. Wood and Sigrid went to work operating on them. Katamma and I also went to work operating shortly after noon, and both teams went on until we had done what we regarded as the most urgent. By 8.30 P.M. we had done 19 cases under chloroform. Some of them were fairly minor injuries, but almost all of them were multiple, and among the lot there were some very extensive and deep soft tissue injuries. One of those cases that fell into my hands had a large wound of the arm with much loss of skin and muscle, and his wound had been treated with a sulpha drug. Rather good, I thought, for first aid treatment at night. I mentioned it in my report so that the person who did it might get the credit. The next day we went on with the jobs that had seemed a little less urgent. I did a lot of X-ray work, and found many fractures. We applied a number of casts. For several days we were just about as busy as we could be, without time off except for meals and a bath, and we were dead tired at night.
On the first day we received 32 patients, and on the next two days 9 more by way of the Govt. Hospital. Of the 41, there have been 3 deaths, one from primary shock, one from rupture of lung, and one from skull fracture. We do not expect any of the rest to die. One of the men transferred from the other hospital had been sewed up, as he had a small wound of the ankle, besides a fracture of the femur. The wound did badly, and he developed gas gangrene and was extremely sick. We amputated above the knee and used lots of penicillin and sulphadiazine, and he is recovering. The wound, which had been sewed up over there, contained gross dirt which had not even been washed out. I have never been so impressed with the value of soap and water and surgical debridement before. Of the 19 cases which Dr. Wood and I did that first day, including perhaps 40 open wounds some of them very large and deep and ideal for gas and other infections, not one developed a serious infection of any kind. It would have warmed your heart to see Krupamma scrub up the dirty wounds; she really gave them the royal works. And how well it paid! It means that our people really do believe in surgical cleanliness, in fact as well as in theory. I was forced to do one other amputation, the forearm of a young boy. Those were the only two amputations done. There were thigh fractures, one hip dislocation, 3 fractured pelves (one very severe), 3 leg fractures, 2 upper arms, 1 clavicle, 1 skull, and ribs without number. There are 23 of these patients still in the hospital.
You can just imagine the officialdom that we had pouring in and out of the hospital day after day, and how our rules for visitors were shot to pieces. The big chief of the M. & S. Ry., a Mr. Maynard, came with a big retinue, including two other Englishmen as well as a lot of Indian officials. Then the Sub-Collector, then the District Collector, and then the Police of all grades, and railway officials in uncounted droves. And then the Govt. Inspector of Railways for all India, a Mr. Wardle, was in town for several days holding an inquiry. Dr. Wood and I were summoned, but they accepted a written report from me and we were not called. The officials were all very nice indeed, and many seemed grateful that there was a hospital close to the scene of the accident. Undoubtedly, if the accident had taken place at some stations along the line, the death rate would have been vastly greater. I believe the official figures are: 38 dead and 81 injured.
The accident patients have been fed by Ongole caterers under orders of the Sanitary Inspector. So we have not had that care. The railway officials did one very useful thing: they invited us to indent for all the penicillin and sulpha drugs that we required, and they supplied, from their stocks in Madras. So we have had plenty of penicillin without the trouble and expense of procuring it. We have charged no bills yet, but we fully expect the Railway to compensate us for the expenses incurred. At Miss Johnson’s request, the Red Cross supplied a lot of pillows and sheets. Citizens have made some generous gestures, such as a gift of Rs.50k from the church to enable the hospital to meet the extra expenses of this time. For several days I hardly went into any of the wards with the usual patients in them, with the result that my list of patients waiting for operations got unmanageably large again. During all the period, it was fine to have the other doctors to take care of all the regular patients.
I guess I have written enough on that subject, except to say that the accident seems to have been caused by the carelessness of a switchman. In other words, the operation of train signals and switches is not automatic and fool-proof. The lives of travelers are actually in the hands of employees, and often very low paid ones.