"Doctor, the wound is still oozing. You have to do something," was the gentle reminder from the Papua New Guinean nurse in charge of the surgical ward at Sopas Adventist Hospital. "The crossmatching of the donated blood is complete."

The young woman lay on the hospital bed. Hours earlier, her husband--angry at her chattering--clipped her over the back of the head with the blunt end of an axe, and when that failed to quiet her, chopped through her knee with the sharpened edge.

Realising his mistake, he tied his shirt as a tourniquet to stem the awful flow. Being the only doctor at the 100-bed hospital, and just arriving to relieve for a few days after the regular doctor had not arrived back from vacation, I was trying to avoid the inevitable decision.

It was just before midnight. The other young woman referred from a smaller hospital was bleeding internally from a ruptured ectopic pregnancy.

The overwhelming responsibility had fallen on this doctor who usually sat behind a desk 3000 kilometres away in Sydney. A decade since last putting scalpel to skin, I was struggling. I had put both these patients in the hands of God, but He needed mine tonight.

A search of the operating suite changing room uncovered the remote surgeon's friend, A Guide to Surgical Technique for Small Hospitals. The phone was down. I needed both an orthopaedic surgeon and a gynaecologist--right now! The surgeon's friend was the best I had.

Leafing through the pages, I came across the section on catastrophic leg injury. It stated that if the lower leg was hanging by only a tread of tissue "you must amputate." The next page led stepby-step through the procedure for an above-knee amputation.

I don't know how many times I reread those pages. The full team assembled in the operating room, including Paul, the final-year medical student doing his six-week overseas elective at this mission hospital.

At Sopas, prayer preceded every operation. Tonight saw the nonsurgeon attempting his first amputation at two o'clock on a Sunday morning, with a medical student as an assistant. Prayer was entirely appropriate.

The next hour-and-a-half is now a blur. The limb was prepared with skin disinfectant, draped expertly by the operating room staff that had been through this procedure too many times to fail me now. Mark the lines on the skin, follow every step memorised from the book, before closing with the flaps to meet behind the thigh so the patient could eventually use a prosthetic lower limb.

The relief that followed was tempered by the need to go through the second life-saving operation half an hour later. Once again the book was my guide. And then back to bed just before sunrise. Sleep came easily. I had done all I could. I had experienced God in the room that morning. God was there working through the skilled and patient staff. They could see my deficiencies as a surgeon. They knew I was terrified the wrong decisions could be made. They gave me strength. God worked through them and through me that night.

After just three hours sleep, I woke with the urge to go to the surgical ward and check on the survival or otherwise of my two patients. Sitting up in bed, with her mother behind her for support, was my now one-legged patient with the heavily bandaged stump pointing toward me. The bandage was dry. The patient was smiling.

"Thank you, Doctor," she said in perfect English. I knew God was there.

The other patient acknowledged my presence. The only sensation bettering this was that of the relief at the successful arrival of each of the 500 babies I have delivered in three different countries. But this time it was a different relief. Without God being there, these women would have left their husbands widowers.

The husband was coerced by his in-laws to now do all the chores his wife would normally see as hers: dig the garden, cook the food, wash the clothes, sweep the hut, jump at her every request. I felt sorry for him. Months later another visitor to Sopas saw her in her village walking on crutches. I was pleased. A year later I heard she and her husband had a beautiful baby daughter. I was pleased once again, and I am sure God was too. When I pray, you answer me; you encourage me by giving me the strength I need. Psalm 138:3. Percy Harrold is a family doctor and health educator who has worked as associate director of Adventist Health Ministries for the South Pacific Division.