Thoughts on Dead Presidents

James A. Garfield was not assassinated.


He was shot by a madman, and killed by his doctors. In Destiny of the Republic, Candice Millard tells “a tale of madness, medicine, and the murder of a president,” contrasting how the vanity and personal ambition of his assassin was only second to the arrogance of the doctor who treated him.

Millard’s style is perfect to me. I’ve started loving nonfiction lately, my stipulation being that it needs a sciency or historical bent and a strong narrative arc. For this, Millard is perfect – her books read like fiction, but are painstakingly researched. Earlier this year, I read her previous book, The River of Doubt, about Teddy Roosevelt’s post-presidential journey to chart one of the most dangerous rivers in South America. She was a long time writer for National Geographic, so it doesn’t surprise me that her first book was a story about naturalists and exploration.

The River of Doubt was a story of honor, manhood, and adventure – a book that Roosevelt would have approved of. But where River of Doubt told the story of human triumph in the face of adversity, Destiny of the Republic delves into the dark parts of human nature.

Shot in a crowded train station just four months after his inauguration, Garfield was not fatally injured even by the standards of 19th century medicine. The bullet entered his back, clipped a vertebra, broke two ribs, and lodged itself under his pancreas. Had he been a soldier in the Civil War just a few decades earlier, he would have been bandaged and expected to recover, able to fight off the initial infection introduced by the wound due to his natural vitality. Had he access to modern medicine, Millard writes, he would have been out of the hospital and on his feet in a matter of weeks. (*Note: All this is according to Millard’s research – a Garfield biographer in the 70s claimed that while infection played a big part in Garfield’s death, the damage to his vertebrae would probably have killed him.)

It’s a testament to her storytelling skill how frustrated I was by the incompetence of his doctors. You know how sometimes you’re reading a story or watching a TV show and one of the characters is doing something painfully awkward or incompetent and you know it can only go badly so you want to turn off the TV or throw the book across the room but you’re just so frustrated because you know that it ultimately won’t change what’s about to happen? (*Another note: This is one of the reasons I stopped watching The Office.)

His attending doctor, Dr. Doctor Willard Bliss (yes, his first name was actually Doctor) immediately appointed himself Garfield’s chief surgeon, doctor, and physician, refusing to enlist the help of other medical experts because of his perceived superiority. Millard then paints a grotesque picture of 19th century medicine in America, including the American medical community’s derision towards Joseph Lister’s practice of antiseptic surgery, despite the success of antisepsis in Europe. Lister, Millard writes, had yet to lose a patient to gangrene or infection since practicing the lengthy process of antisepsis and sterilization in the operating room.

But in the United States, the most respected medical professionals raved about that good “ol’ surgical stink,” held scalpels in their teeth if their hands were busy, and never washed their scrubs; the more grime, pus, and blood you had on your uniform, it was believed, the more distinguished of a doctor you were.

After Garfield was shot in the train station, he was taken to a dirty room in a neighboring building, where Bliss and other doctors proceeded to poke unsterilized fingers and probes into his back, attempting to find the bullet.

Garfield’s wound actually prompted Alexander Graham Bell, whose invention of the telephone only a few years before had lifted him out of anonymity, to develop a metal detector for finding a bullet in a man’s back. He was one of the few outsiders Bliss allowed into the operating room, and even then, Bell was forbidden from using the detector on any area of Garfield’s back but where Bliss believed the bullet was. Though Bell’s device picked up something, he doubted he had actually found the bullet. He was right.

It was only after his autopsy that his doctors discovered the bullet was not in the right side of his back, but beneath his pancreas. Their poking and prodding had actually created a new pus-filled wound, which ultimately caused Garfield to suffer from an infection that literally rotted his body from the inside.

I’ll spare you the pus-talk, because like some of you, I’ve just eaten.

As Garfield worsened, Bliss became increasingly concerned for his own reputation, saying that he could not afford to have the President die under his care. He knew it would ruin him. Up until the very last day, as Garfield rapidly deteriorated, Bliss was telling reporters that his health had never been better – that he would be up and about in no time.

In spite of Bliss’s highest hopes, two months after being shot, Garfield finally died in his home in Ohio.

Millard’s narration is cleaner in this book than in The River of Doubt. She tells the story from three different perspectives: President Garfield and his doctors, Alexander Graham Bell, and the assassin Charles Guiteau. Guiteau is the “madness” in the book’s subtitle – a title I think he shares with Bliss. Millard flawlessly juxtaposes Bliss’s vanity with Guiteau’s own delusions of grandeur.

Prior to shooting the President, Guiteau had stalked members of the cabinet, claiming that he was responsible for getting Garfield elected. He had in fact given one partial speech in a near-empty New York bar, where he spoke for only a few minutes, and then complained of the heat. In numerous letters to Garfield and Secretary of State James Blaine, he believed this speech justified his appointment to United States consul in Paris “on the basis of first come first served.”

After being banned from the White House for his aggressive behavior, he stalked Garfield for weeks, carrying the gun he would eventually use to shoot him. He believed that when he finally removed Garfield (on orders from God, no less), he would be held aloft as a hero of the Stalwarts in the Republican Party, and would be adored by the nation. So deluded was he that he believed up until he was being walked to the gallows that he’d be acquitted of his crimes and would live a long life filled with speaking tours about his book The Truth, which was allegedly better than the Bible.

I thought for a long time about why this book left such an impression on me. I read a lot. Less than I did when I was a teenager, but probably more than my peers, and aside from reading, I consume a lot of culture. This whole blog was created on the idea that I like absorbing a lot of culture in a very short period of time. This book prompted so many Feelings. I was crushed when Garfield died – I genuinely wished it hadn’t happened.

In the epilogue, Millard writes about how Garfield’s death unified the post-reconstructionist nation.

“Americans understood that, as time passed, Garfield would begin to fade from memory . . . More painful even than the realization that his brief presidency would be forgotten was the thought that future generations would never know the man he had been.”

Millard went from writing a book about one of the most well-known presidents in history in River of Doubt to telling the story of a man who had not wanted the presidency in the first place, and died before he could do something truly amazing with it.


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