Destiny of the Republic: A Tale of Madness, Medicine and the Murder of a President by Candice Millard
My rating: 4 of 5 stars
This nineteenth-century, post-Civil-War story, like almost all stories, intertwines the lives of several people. Key characters include U.S. President James Garfield, Alexander Graham Bell, Garfield’s assassin, Garfield’s chief doctor/surgeon, Bell’s wife and son, Garfield’s wife, and Vice President Chester Arthur.
An assassin – clearly mentally ill, probably with bipolar disorder – shoots Garfield, but not fatally. His American doctors continually probe the wound with their unclean hands. They did so after Lister made and publicized his finding of the value of antisepsis, but before his reforms were widely adopted in America. The physicians were unable to find the bullet as they assumed it lay on the right side of Garfield’s body, where the skin wound lay.
Bell invented a primitive metal detector to search for the bullet. He was unable to succeed, however, in Garfield’s case because Garfield’s doctors forbade him from searching on the left side of his body. Nonetheless, Bell’s device was used to find bullets well into the twentieth century (when X-Rays became the gold standard).
The assassin, delusional that the country wanted Garfield dead, ended up trying the insanity defense and failing. He was eventually hung.
Garfield’s autopsy showed the true location of the bullet and the real cause of death – bacterial infection (sepsis) of the blood. His body contained pus vacuoles all over, and pustules covered his skin.
Nonetheless, this magnanimous event united the Republic as both North and South expressed deep concern about the president’s medical course and mourned the president’s death. The newly christened President Arthur becomes the most dynamic character in this story. Previously held in suspicion as being cowardly and deferential towards the political machine, he resolves to lead the country as Garfield would. He reasoned that the people of the United States elected Garfield, not him, and they deserved that their will be borne out. Arthur became an effective one-term President who led meaningful (but not ambitious) reforms of the corrupt “Spoils” system that previously buoyed his career.