The death of President James A. Garfield from an assassin’s bullet, if not so tragic, could be construed as almost comical with the level of care he received from his incompetent doctors. They were as much to blame for the man’s death as the bullet lodged in his back. From sticking their dirty fingers into his wound to Alexander Graham Bell trying to locate the bullet with his “metal detector”, the whole process became a sad chapter in our national, as well as our medical, history.
James Garfield was elected president in 1880 and took office in March of 1881. A brilliant man who could simultaneously write Greek with one hand and Latin with the other, he supported civil service reform and the lenient treatment of the South after the Civil War. As he was walking through the Sixth Street Station of the Baltimore and Potomac Railroad on July 2nd, 1881, he was shot in the back by a mentally ill Charles Guiteau. The bullet lodged in Garfield’s back as Guiteau was arrested and led away. Doctors were immediately summoned to aid the wounded president.
First at the scene was the renowned Washington D.C. physician D.W. Bliss. He began his treatment by giving Garfield hot water bottles for his feet and a shot of morphine. Garfield promptly threw up. Nine hours after he was shot, Bliss gave Garfield a glass of champagne as they removed his bloody suit. Vomiting every half hour now, Garfield was visited by Navy Surgeon General Wales. This doctor stuck his finger in the wound and concluded that Garfield’s liver had been hit. More doctors were called in; a total of fifteen. They all stuck their fingers in the president’s wound. None even thought to make sure their hands were clean. Indeed, many doctors of this period didn’t bother to clean the blood off their the clothes they operated in.
The theory of germs and antiseptic methods were not at all accepted at this time. In fact, Joseph Lister, who was a proponent of sterile conditions to prevent germs, was widely ridiculed. Most physicians actually thought that the appearance of pus was vital to the healing process, not a sign of infection as we know it today. There were two prevailing types of thinking among most doctors of this period. One group was prone to invasive, drastic infection causing surgeries; the other would try various herbs and poisons diluted in water to cure a patient. These factions now fought over how to treat Garfield. The president’s personal physician, a Dr. Baxter, actually got into a fistfight with Dr. Bliss over how to administer to Garfield. Bliss won and Baxter left, never seeing the president again. The entire time he was being treated, Garfield remained president, not giving up his executive powers until his death.
Unable to find the bullet with their fingers, the doctors turned to technology. Alexander Graham Bell was called in with an electrical device that could best be described as the first metal detector, two electromagnets between a telephone receiver. However, the bed Garfield was on had metal bedsprings causing false readings and the device failed to find the bullet. Even had Bell been successful, it is doubtful that the projectile could have been removed.
The hot summer weather did not help Garfield’s condition any. All sorts of ideas were tried in an attempt to keep him cool. Nothing worked. Losing eighty pounds in the six weeks since he had been shot, Garfield, who was on a diet of steak, eggs and brandy, was now subjected to a nutritional enema consisting of egg, bouillon, milk, whiskey and opium. Needless to say this had no effect, and the team of doctors decided to operate to remove the bullet. Unable to find it, they inserted tubes to remove the awful amounts of pus from the president’s body. In late August, Garfield’s right eye was swollen shut from infection and incisions were made in his face to help the draining. He lingered on in this state, fully aware of his surroundings, until he ordered that he be moved to New Jersey to escape the sweltering summer. There was little relief from the heat there, and James A. Garfield finally succumbed on September 19th, 1881, in Elberon, New Jersey. He had contracted blood poisoning and pneumonia, and likely died of an aneurysm or massive heart failure, eighty days after he had been shot.
Historians generally agree that had Garfield received better care he likely would have survived. The infection was probably the result of unsterile fingers poking and prodding his wound; one doctor actually had punctured his liver. His doctors still demanded their fees, with Congress picking up the bill. Charles Guiteau, who today would be diagnosed as a schizophrenic, argued that the poor handling at the hands of his physicians had killed Garfield. Although he was right, he was convicted of murder and hung on June 30th, 1882 in Washington.