Hmmm... this one didn't do much for me. I mean, being in that situation would suck, I have no doubts about that. I think that anxiety might end up driving me to an early grave if I were in the doc's shoes. But I also had no doubt that it was the only correct choice to make. Amputation is the kind of thing that learning about it in theory is far from performing it in practice. Doc gets that, the patients get that. And if a wound has taken an infection and you don't have medication to fight the infection, then that infection WILL kill you if you don't take drastic measures like amputation. The patient knows he's going to die, and die painfully, whether or not he allows the surgery. The patient knows that if he does allow the surgery, he'll probably still die painfully, and will die sooner, BUT by choosing to die in a way that gives Doc more surgical experience, he might be helping to save someone else's life down the road. Maybe Doc's first dozen patients will die in surgery, maybe his 13th will survive. If we're talking about certainly-fatal conditions like gangrenous limbs anyway, those first 12 patients were going to die either way, but that 13th might survive and that 13th would've survived because of the choice the other 12 made. Once Doc figures out some procedures to limit fatalities, Doc can start training apprentices with those improved procedures so that there's not a single failure point to their entire medical system.
This is a sucky situation, a gory anxiety-driven situation. But I guess it didn't inspire much horror in me simply because Doc seemed to be making the best possible choice in a crap situation and improving the world in whatever way possible as a result.
I found the notes after the story, and how the story related to the author's transgender narrative, to be much more compelling, and cast the story in a new light.
