Part I of this book by Candice Millard was about Garfield’s early life, his military service during the Civil War, entrance into politics, and his seemingly accidental connections to a madman named Charles Guiteau who shot him and the inventor, Alexander Graham Bell. This part will be about the medical treatment after Guiteau shot him, or more accurately the inept medical treatment of Garfield, the people who interacted with Garfield during his long decline to his end, and the remarkable transformation of Vice President Chester Arthur. Arthur was transformed from being a political hack to becoming an admirable American President.. He was influenced to become a decent President by the coaching from a previously unknown disabled woman and by his limited contact with the remarkable Garfield. I would be remiss if I did no encourage any student of history or anyone who enjoys a well written, interesting story to read this book. I give it a very high recommendation.
Alexander Graham Bell began working on an electrical induction device when he learned that President Garfield had been wounded by a gunshot from the insane Guitreau, and that there was doubt where the bullet had lodged. He hoped he could develop a metal detector that would assist in identifying the location of the lead slug embedded in Garfield. Bell would test his equipment with some success on a Civil War veteran who had carried a bullet in his body for many years. However, his equipment failed to find the bullet in Garfield in part because of an error in setting up the equipment, and in part because Bliss, the doctor in charge of Garfield’s treatment, gave him a completely incorrect assessment of the approximate location of the bullet. Bell continued to work on his equipment after failing to find the bullet in Garfield, and would eventually find the location of a slug in Private John McGill who had carried a bullet twenty years after being shot at the Battle of Gaines’ Mill. Bell made a return visit to Garfield’s bed and found a feeble signal in the general vicinity where Bliss believed the bullet to be lodged. Bell was unconvinced, but Bliss took it as proof of his ideas. Bell did not know the President was on a mattress with metal coils that probably gave the false signal that Bliss believed proved he was right.
During this time Bell’s wife Mabel gave birth to a premature son who died in three days, and Bell was wracked with guilt that he had been so preoccupied with developing the induction device that he had not given his wife the attention she needed.
Garfield continued to receive very poor medical care under the direction of Bliss. He was fed heavy foods such as bacon and pork chops, which caused him to be constantly nauseated and vomit. He was losing weight and strength. He was fed quinine in large doses to ward off malaria, but the quinine caused severe intestinal cramping. At least his care-givers devised an air conditioning system with fans and ice to combat the oppressive heat. Bliss continued to probe Garfield’s wound with unsterilized fingers, and of course did not know that an enormous cavity of pus had formed under Garfield’s liver.
The attempt on Garfield’s life and his struggles aroused patriotism in Americans. Blacks had been inspired by him from the first. He had told a gathering of black men just before he was elected, “Permit no man to praise you because you are black, nor wrong you because you are black.” Even Southerners were impressed with Garfield. Jefferson Davis, a man whom Garfield had voted to indict as a war criminal, admitted the Garfield assassination attempt had made “the whole Nation kin.” Charles Guiteau on the other hand was relishing his delusions. He said he had felt lighthearted and merry the moment he got into the cell. Reporters described his arrogance as nauseating. Guiteau announced his candidacy for president, “…a decision he believed the American people would not only welcome but actively encourage.”
Roscoe Conkling, a political power broker who attempted to gain political power through Chester Arthur, the man he had put into the position that resulted in Arthur’s Vice Presidency. Observers believed Conkling would succeed, because they had little respect for Arthur. However, something was happening to Arthur. First, he was devastated by the shooting of Garfield and openly mourned the plight of the president. In a remarkable turn of events Arthur began receiving and eagerly reading letters from Julia Sand, an unmarried invalid woman he had never met. He found her brutally honest assessments to match many of his own thoughts. She wrote that Americans had a complete lack of faith in Arthur, but assured him “Great emergencies awaken generous traits which have lain dormant half a life.” Arthur read and kept the letters. However, he continued to hope for Garfield’s recovery. Some officials considered whether Garfield’s disability required Arthur to be President. Neither the Constitution nor precedence gave an answer.
The truth was that Garfield had been exposed to so much contamination that his body would have no chance to recover. The author’s assessment was difficult to read. “Now, his body, which had miraculously survived the initial trauma of the bullet wound, was so riddled with infection he was literally rotting to death.” His body was so toxic that he was a danger to others. Bliss cut his finger and some pus from the President gave him a severe infection of his hand. Bliss was concerned that Garfield would starve. His weight had gone from 210 to 130. Bliss prescribed “enemata,” or rectal feeding. Dehydration was also a risk. Garfield’s demeanor while he was suffering the agony of dying from the inside out perhaps gives the best insight into what a magnificent man he was. “Even as he lay dying, Garfield was kind, patient, cheerful, and deeply grateful.” He died in great pain. The autopsy revealed the magnitude of infection and the location of the “safely encrusted” bullet behind the pancreas on the opposite side of where Bliss had persisted in probing. The cause of death was profound septic poisoning.
Chester Arthur was sworn in as President at 2:15 A.M September 20th. Julia Sand wrote to him advising “…not action, but compassion.”
The nation’s attention turned to Guiteau after Garfield’s death, and there were many advocating that he be immediately lynched or tortured to death. General Sherman spoke out advocating “…the sacred promises of the law.” Guiteau pled, “Insanity, in what was God’s act and not mine.” He also presented a defense that undoubtedly had merit. He said that, “General Garfield died from malpractice.” He would later say, “I deny the killing if your honor please. We admit the shooting.” The jury was not moved by either defense, and declared him guilty. Guiteau believed he would be set free even with the verdict, but his appeals, including to Arthur, were denied. He may have been insane, but he maintained his presence of mind even on the way to the gallows. He tripped on the first step. He turned to the minister who had been comforting him, Reverend Hicks, smiled, and said, “I stubbed my toe going to the gallows.” He asked that he be allowed to signal the execution by dropping the paper containing the prayer he had composed. He read the poem, Reverend Hicks said a few words, and Guiteau called out “Glory, glory, glory.” He opened his hand, the prayer paper fell, and he was hanged.
The hanging was greeted by a triumphant shout from the large crowd. However, the author observes it “…accomplished nothing. It did not prevent future assassinations, brought no solace to a heartbroken nation, no comfort to Lucretia, Garfield’s wife, or her children, or even lasting satisfaction to those who had screamed for vengeance.”
On the subject of future assassinations, the Secret Service would not begin protecting the President until after William McKinley was shot in 1901. Robert Todd Lincoln “…was once again standing with the president, thus earning the dubious distinction of being the only man to be present at three of our nation’s four presidential assassinations.”
There were several positive outcomes from the sad death of Garfield. The nation was helped in the healing from the Civil War by a common grief. Chester Arthur, following the advice of Julia Sand, was converted into an admirable President. He shocked Roscoe Conkling by not only refusing to appoint Conkling his Secretary of State; he also advocated reforms that would end the spoils system. Conkling died of pneumonia after he insisted on walking several miles in a blizzard that killed several New Yorkers. Arthur not only extricated himself from Conkling’s control, he also signed the Pendleton Civil Service Act that was to transform the awarding of positions as gifts from powerful officials to a merit-based system.
Chester Arthur would meet Sand for the first time in August 1882. He was widely respected, but did not run for a second term. He died two years later from Bright’s disease, an excruciatingly painful kidney disease.
Bliss demanded $25,000 (equivalent to half a million in current value) for his treatment of Garfield, and was given a check for $6500, which he refused. He died of a stroke seven years later after never recovering his health, practice, or reputation.
Lucretia Garfield busied herself organizing a library of her husband’s papers. Daughter Mollie fell in love with and married Garfield’s secretary Joseph Stanley Brown. Son Harry became a professor at Princeton. James became Secretary of Interior for Theodore Roosevelt. Bell’s Induction Balance would be used to treat wounded soldiers in the Sino-Japanese War and Boer War before perfection of the X-ray. He also developed the iron lung, which would have helped to save life of his baby son. Helen Keller would say of her meeting with Bell “…as the door through which I should pass from darkness into light.” Joseph Lister, the doctor who advocated infection control that would have helped save Garfield, lived long enough “…to see his ideas not only vindicated, but venerated.” He would be called “…conqueror of disease.”