History of Medicine

   THE GUNFIGHTER’S SURGEON:

  GEORGE E. GOODFELLOW

 

“On the night of January 14, 1889, I was called to see Mr. R. A. Clark of… who had been shot in a fight a few minutes before. I reached him about half an hour after the reception of the injury and found him with a gunshot wound of the abdomen, evidently bleeding to death…

It was midnight in a little mountain mining town. I was alone entirely, having no skilled assistance of any sort, therefore was compelled to depend for aid upon the willing friends who were present — these consisting mostly of hard-handed miners just from their work on account of the fight.

Without delay he was put upon a table in the large dining room of a restaurant; the anaesthetic administered by a barber; lamps held, hot water brought, and other assistance rendered by others. There being no time to lose, the abdomen was opened in the mesial line, from the sternum to the umbilicus, by a single sweeping cut. An immense quantity of blood poured out through the incision.”

So begins a report in the Southern California Practitioner by Dr. George E. Goodfellow, a surgeon in Tombstone, Arizona. The report includes five cases of gunshot wounds to the abdomen, four of whom survived, a remarkable record at the time.

George Goodfellow (Wikipedia)

Goodfellow was one of several doctors providing medical service to a gun-toting population in the silver-mining town of Tombstone. 

Goodfellow, son of a mining engineer, was born in Downieville, California, in 1855. After a year at the University of California he enrolled at the U.S. Naval Academy but was expelled after a hazing incident. He read medicine briefly with a Pennsylvania doctor and received a medical diploma from the University of Wooster in Cleveland (now Wooster College) in 1877. After a brief stint practicing in Oakland, CA, and Prescott, Arizona, and possibly seeking more “action,” he moved to Tombstone, where he opened an office above the Crystal Palace Saloon in 1880. 

A silver strike three years earlier in vacant land had created a stampede for silver and by the time Goodfellow arrived about 2,000 people, primarily miners, supplemented by twelve “doctors” (only four had diplomas), populated the newly created town of Tombstone. Sharing space with the multiple saloons were three theaters, five churches, and a local scientific society. 

Tombstone in 1882 (Arizona Historical Society)

Men in Tombstone carried weapons, outlaws drifted in, and gunfights were especially frequent during 1881-3, a period Goodfellow called “our reign of terror.” Gunmen intending to kill generally aimed for the abdomen, where surgeons seldom dared to operate. Guns in the west were usually 44 to 45 caliber, larger than most guns in the east and more deadly. Goodfellow’s skills and reputation grew both from operating on multiple cases and from his own innovations. 

For abdominal wounds, Goodfellow sewed up tears in the intestinal wall, irrigated the abdomen generously with sterilized water, and followed the new “Lister method” of surgery, using sterilized instruments and carbolic acid spray in the operating area, a method to prevent infection that many surgeons resisted. Indeed, President Garfield, shot in 1881 while Goodfellow was in Tombstone, eventually died of infection after several “prominent” surgeons probed his wound with unwashed hands after dismounting from their horse. Goodfellow strongly advocated operating for abdominal gunshot wounds, advising that death was certain without surgery but might be avoided with it. He could not repair torn blood vessels and availability of transfusions and intravenous fluids was still in the future.

Goodfellow made another important observation. During a quarrel between two men, one shot the other in the chest with a 45 caliber Colt revolver at close range. The victim died quickly of a pierced heart and Goodfellow, who was also the town coroner, performed an autopsy. He wrote that from the wound “a silk handkerchief protruded, which I presumed had been stuffed in by some of his friends to prevent bleeding. I withdrew it and with it came the bullet. It was then seen that it had been carried in by the ball.” The bullet, he found, at six feet would pierce a four-inch plank of pine. He reported two further cases in which silk had not been pierced by a bullet. His discovery eventually led to the creation of bulletproof vests made from silk, worn by gangsters of the early 20^th century. Kevlar later replaced silk as a stronger material.

Reenactment of shootout at OK Corral (author's photograph)

Dr. Goodfellow had many adventures. As coroner, he autopsied the victims of the shoutout at the OK Corral, treated Wyatt Earp’s brother Virgil for multiple wounds and was present at the fatal shooting of Wyatt’s other brother, Morgan. He participated in the chase of Geronimo after his escape from a reservation and aided earthquake victims in nearby Mexico. Eventually, for a quieter life he moved to Tucson in 1891 as surgeon to a railroad.

Goodfellow performed a wide range of surgeries but perhaps most surprising is his interest in prostatic surgery. He was one of the first to develop a perineal approach to prostatectomy. He published on several cases and demonstrated his technique to Dr. Hugh Young at Johns Hopkins, one of the creators of the specialty of urology, who acknowledged its success.

During the Spanish-American War, Col. William Shafter brought him to Cuba as an aide, partly for his knowledge of Spanish. After the war he practiced in Los Angeles, then in San Francisco, and finally accepted a job as surgeon to the Southern Pacific Railroad in Mexico, where he died in 1910 of a progressive neuropathy.

         Donald Trunkey, a San Francisco trauma surgeon, has praised Dr. Goodfellow as the first civilian trauma surgeon. And urologists recognize him for popularizing a perineal approach to prostatectomy, though seldom practiced today.

 

 

SOURCES:

 

Goodfellow, G E, “Cases of Gunshot Wound of the Abdomen Treated by Operation” Southern Calif Practitioner 1889; 4 (5): 209-17.

 

Goodfellow, G E, “Note on the Impenetrability of Silk to Bullets” Southern Calif Practitioner 1887; 2: 95-8.

 

Goodfellow, G E “Perineal Prostatectomy” Occident Med Times 1901; 15 (11): 385-9.

 

Nation, E F, “George E. Goodfellow, M.D. (1855-1910): Gunfighter’s Surgeon and Urologist” Urology 1973; 11 (1): 85-92.

 

Trunkey, D D, “Doctor George Goodfellow, the First Civilian Trauma Surgeon” Surg Gyn Obst 1975; 141 (1): 97-104.

 

Quebbeman, F E, Medicine in Territorial Arizona. Thesis submitted 1966, Univ of Arizona.

 

Wesson, M B, “George E. Goodfellow, Frontier Surgeon and Soldier (1855-1910)” Ann Med Hist1933; 5(3): 236-245.

 

A full index of past essays is available at: 

https://museumofmedicalhistory.org/j-gordon-frierson%2C-md