How much did I know about James Garfield before reading Candice Millard's most recent book, Destiny of the Republic ? Almost nothing. He was just a trivia answer to me, one of our four assassinated presidents. But here's the thing: Garfield didn't die from the assassin's bullet. He died from massive infection eighty days after the shooting, almost certainly caused by his doctors.
Luckily for Garfield, the wound caused by his shooter was not mortal, though that would have been merciful. Unfortunately, the U.S. medical profession, for the most part, did not believe that there were such things as microorganisms. In 1881 doctors in America believed in the "old stink" of surgery, and were proud of it.
The infection that raged through Garfield's body was introduced within moments of the shooting by the unwashed hands and instruments of the doctors who battled to attend to him, determined that they would be the one to find the bullet. Their poking and prodding would continue daily, and it makes for cringe-worthy reading. Garfield lingered for months, getting weaker, always in excruciating pain, suffering in the heat of a humid D.C. summer, in a White House in disrepair where rats were a constant problem. When he finally succumbed and the autopsy was done, the doctors knew immediately what the cause of death was. The bullet was not where they had insisted it had to be, but on the other side of the body, "safely encysted." However, infection was everywhere. The doctor's words were "Gentlemen...we made a mistake." Profound septic poisoning was the cause of death.
The story of Garfield's life and death by Candice Millard is a stunning read, and gets an "un-put-downable" rating from me. Two remarkable ironies: had Garfield been an average Joe in America in 1881, he would've likely survived the shooting without a doctor's care, and simply walked around with a bullet in his body, like tens of thousands of his fellow Civil War veterans. Second, had the shooting happened just a few years later, it would have been easily survivable, even with a doctor's care.
[Destiny of the Republic: A Tale of Medicine, Madness and the Murder of a President by Candice Millard won the Edgar Award for Best Fact Crime, and was also a New York Times Notable Book of the Year, 2011]