On Tuesday, February 2, PBS’s American Experience will air “Murder of a President,” a two-hour documentary about the 1881 assassination of President James A. Garfield. The film is based on author Candice Millard’s 2011 bestseller Destiny of the Republic: A Tale of Madness, Medicine and the Murder of a President. The book and film both demonstrate that while Garfield’s wounds were certainly serious, it was nineteenth century American medical hubris and ignorance that killed him. As horrific as Charles Guiteau’s attack was, the tragedy of the President’s death is compounded by the knowledge—known to many even then—that he did not have to die.
The first four months of James A. Garfield’s term as twentieth President of the United States were a nightmare. He battled members of his own party over patronage appointments and had a very public squabble with New York Senator Roscoe Conkling, one of the nation’s most powerful Republicans and a man who had already told the new president that “your administration will only be as successful as I wish it to be.” Garfield’s own vice president, Chester A. Arthur, worked against Garfield by supporting Conkling. More concerning than any of this, however, was the health of First Lady Lucretia Garfield, who was near death with malaria for several weeks in the spring of 1881.
By July 2, though, Garfield was ebullient. Conkling was defeated and out of the Senate, his wife’s health was restored, and he was going on vacation. He left the White House and made his way to Washington, D.C.’s Baltimore and Potomac train station, where he was due to travel to meet the First Lady, who had been recovering at the New Jersey seashore. They would then head to New England, where the President would speak at his alma mater, Williams College, and the Garfields would vacation at the Maine home of Secretary of State James G. Blaine. They would then travel back to their Ohio farm before finally returning to Washington.
Secretary Blaine rode to the train station with Garfield that morning, and the two were walking through the lobby when Charles Guiteau approached from behind and, from a distance of about four or five feet, fired two .44 bullets at the President. Struck in the arm and back, Garfield crumpled to the floor muttering, “My God! What is this?” Guiteau made little attempt to escape, and when grabbed by a Washington police officer calmly stated, “I did it and will go to jail for it. I am a Stalwart, and Arthur will be president.”
The President of the United States lay on the filthy floor of the train station bleeding and vomiting. Secretary of War Robert Todd Lincoln, just fifty feet away and approaching Garfield when the assassin struck, sent for his friend Dr. Willard Bliss to quickly come to the train station to aid the wounded president. Garfield was moved to a waiting room, and when Bliss arrived he immediately probed the President’s back wound with his unwashed fingers. The long, slow, and torturous death of President James A. Garfield began at this moment. At one point, Bliss assured Garfield that he would recover. The president responded, “Thank you, doctor, but I am a dead man.” Garfield would be proven right, though it would take another eighty days. Just an hour or two after the shooting, Bliss approved moving Garfield back to the White House, which would be Garfield’s home and prison until early September. The First Lady was told of the shooting and immediately left New Jersey to return to the White House.
Once Garfield was back in the Executive Mansion, Dr. Bliss asserted himself as the physician fully in charge of the President’s treatment and care. He insisted that finding and removing the bullet lodged in Garfield’s back was paramount and conducted numerous probes of the wound that left Garfield nearly delirious with pain. Bliss demoted to nursing duty several other doctors that questioned his course of treatment and suggested that probing the wound was doing more harm than good. Those demoted for questioning Bliss included Dr. Susan Edson, one of the nation’s first female physicians and a friend of the First Lady; and Dr. Silas Boynton, the President’s own cousin. Bliss, a former Civil War surgeon, should have known that it was not necessarily imperative to remove the bullet and that thousands of veterans still carried bullets and shrapnel in their bodies. Like many American doctors of the era, Bliss also rejected the idea that microscopic germs caused infection and that sterilization of hands and instruments was necessary. Listerian theories about germs and antisepsis, by then widely accepted in Europe, would not be taken to heart by most American physicians for several more years. Had Garfield been shot even a decade later, he may very well have survived.
Bliss and his assistants poked, prodded, and probed the President of the United States for the next two months. They fed him rich foods and alcohol that caused Garfield to vomit regularly. Bliss eventually ordered the patient to be fed rectally with enemas of beef bouillon. Garfield, normally a burly 210-pounder, lost an alarming amount of weight. Bliss, however, maintained his original course of treatment and continued to insist that he knew where the bullet was and that it had to come out. He invited inventor Alexander Graham Bell into the White House to examine Garfield with a rudimentary metal detector Bell called an “induction balance,” but Bliss only permitted Bell to examine the right side of Garfield’s body where Bliss insisted the bullet was lodged near the liver. Bell’s machine found nothing, and the inventor worried that his reputation would suffer from his inability to help President Garfield.
In an effort to keep the public informed of the President’s condition, Bliss issued regular press bulletins that appeared in newspapers across the country. The bulletins shared Garfield’s temperature, respiration, and sometimes explicit details about how often he vomited or the appearance of the pus leaking from his wound. The most important impact of these bulletins, though, was to make the American public interested and emotionally invested in how their president was faring. Most of Bliss’s public reports indicated that Garfield was improving, which gave false hope that all would eventually be well. It was apparent to many in the White House, however, that Garfield was dying.
By early September, Garfield wanted out of the White House and insisted on traveling to the seashore. The President was moved to Elberon, New Jersey, very near the spot his wife had recovered from her bout with malaria and which she was preparing to leave on July 2 when informed of the assassination attempt. “I have always felt the ocean was my friend,” the President had written earlier that summer, “and the site of it brings rest and peace.” Now James A. Garfield had come to the sea to die. Against Bliss’s wishes, Garfield was taken to the shore on September 6, and he died there on September 19, exactly two months shy of his fiftieth birthday and having lost seventy-five pounds since being shot. The autopsy revealed that the bullet was on the opposite side of where Dr. Bliss had insisted it was since the day of the shooting. The bullet was lodged near the President’s pancreas and was already partially encased in scar tissue. A surgeon writing a few years after Garfield’s death noted, “Nature did all she could to restore him to health. She caused a capsule of thick, strong, fibrous tissue to be formed around the bullet, completely walling it off from the rest of the body, and rendering it entirely harmless.” The cause of Garfield’s death was infection introduced into his body by Bliss and his associates, not damage from bullet wounds. Garfield could have lived a relatively normal life for many more years with the bullet in his body.
Unbelievably, Bliss submitted to Congress a bill for $25,000 for his services in treating Garfield. Outcry from the medical community and the public about Bliss’s substandard treatment had already begun, and Congress agreed to pay the doctor only $6,500. Bliss, outraged, refused to accept it, calling it “notoriously inadequate as a just compensation.” He died seven years later with his reputation still in tatters over his care of Garfield.
Garfield’s body lay in state in the U.S. Capitol building before being taken to Cleveland, Ohio for a state funeral that rivaled that of Abraham Lincoln sixteen years earlier. As the nation recovered from the shock of its second presidential assassination, attention turned to the mentally unstable assassin, Charles Guiteau, who was set to go on trial for murder in November 1881. What had led this drifter and self-proclaimed “Stalwart” to shoot President James A. Garfield?