A sawbones is a slang term used to describe a physician, and more specifically a surgeon, especially one who would have served in battle. The term is often tied to the US Civil War, but in fact predates it. Author Charles Dickens used it to refer to a doctor in the 1837 novel Pickwick Papers, which suggests common use of the expression at least 20 years prior to the American Civil War.
The path from surgeon to sawbones is an easy one to follow. Before the advent of antibiotics, one of the principal means of treating infected wounds, large or small, was through amputation. The danger of gangrene developing from even the very slightest cuts often had surgeons cutting off extremities or limbs in order to avoid blood poisoning. Wounds were then often cauterized (burned) with heated pokers.
In order to cut through a limb or extremity, a doctor had to literally saw through the bones. This means that the nickname is really quite grisly when its origin is considered. Those who ascribe the term’s origin to the American Civil War are at least partially correct, since battlefield amputation was so common. There are descriptions of field hospitals with amputated limbs piled up that are enough to give a person with the strongest stomach nightmares.
Though the term is sometimes considered derogatory, this isn’t always the case, and doctors may call themselves by this name, particularly if they are surgeons. For instance, cardiac surgeons must use a sternal saw in a procedure called cracking the chest. They must literally saw through the sternum in order to get to the heart for open-heart repairs. Orthopedic surgeons, who specifically work with the skeletal system, may most refer to themselves as sawbones, though the term is certainly not used with the frequency that it once was.
While the term may not be used so much in present day, there’s an interesting, still fairly modern allusion to the term in the first Star Trek television series. Dr. Leonard McCoy is affectionately called “Bones” by Captain Kirk, which is an obvious reference to sawbones. It matters little that, in the Star Trek universe, cutting into people is generally considered a barbaric vestige of the past and relatively unnecessary.