As a result of long days and nights of working on countless mutilated bodies under insufferable conditions, the surgeon has become callous to both the humanity and pain of the wounded soldiers that come his way. Because it is a known fact "that the surgeons in the dressing stations amputate on the slightest provocation...(it) is much simpler than complicated patching", Paul's greatest fear is that he might lose his leg. So that he can prevent this from happening, Paul refuses to go under anesthesia, preferring to bear the terrible pain of treatment rather than to go through life as a cripple. The surgeon, annoyed at Paul's obstinancy, roughly "pokes around in the wound", then gruffly reprimands Paul for "carrying on" when "a blackness comes before (his) eyes" because of the pain. When Paul, in excruciating suffering, breaks loose from the orderlies holding him down, the surgeon "roars madly...'Chloroform the scoundrel!'" Paul gains control of himself, and humbly apologizing, promises to keep still under his own volition, at which point the surgeon begins "to (torment him)...raking about in the wound and look(ing) up surreptitiously at (him) over his glasses" to gauge his reaction. The surgeon, impressed by Paul's "self-control", finally extracts a piece of shell, sets his leg carefully, and tells him, "To-morrow you'll be off home" (Chapter 10).