Destiny of the Republic: A Tale of Madness, Medicine and the Murder of a President

Candice Millard’s account of President James Garfield’s assassination brings back to roaring life a tragic but irresistible historical period.

First, the killer walks away from a deadly steamship accident on Long Island Sound.

Then, in a flashback from four years earlier, the other major protagonists, from the soon-to-be 20th president to men who revolutionized medicine and communications, share the stage at the nation’s Centennial Exhibition in Philadelphia in 1876. The backdrop: portions of the yet-to-be-assembled Statue of Liberty on display for thousands of curious onlookers.

So begins Destiny of the Republic: A Tale of Madness, Medicine and the Murder of a President, Candice Millard’s account of President James Garfield’s assassination and the medical bungling that led to his death at the age of 49. It is a fascinating look into a period of neglected American history.

Garfield served less than a year as commander in chief and is remembered as a footnote president, if at all. In that regard, it seems a safe bet the background of his months-long death spiral after the shooting is even more obscure.

But, as Millard makes clear, the fate of Garfield and the suffering of his wife and children wracked the country throughout the summer of 1881.

As an Ohio Congressman, Garfield was a respected, learned man with a propensity for loquaciousness. When he first appears in Millard’s account, Garfield is with his wife and six children, strolling through the exhibition in anticipation of exploring the scientific marvels on display.

Said scientific wonders included the unsung work of a Scotsman named Alexander Graham Bell, who – thanks to an improbable encounter with the emperor of Brazil – becomes an overnight wunderkind for his invention of the telephone.

Nearby, British surgeon Joseph Lister stands before America’s elite doctors and surgeons lecturing on antisepsis, his groundbreaking theory of killing germs to prevent post-operative infection and death in patients. Though Lister’s methods had already dramatically reduced death rates in operating rooms across Europe, in the United States he faced a skeptical audience wary of sterilizing instruments or even washing lab coats before surgery.

With this foundation in place, Millard builds a popular history that is both substantive and satisfying. Filled with memorable characters, hairpin twists of fate and consequences that bring a young nation to the breaking point, “Destiny of the Republic” brings back to roaring life a tragic but irresistible historical period.

This is Millard’s second book, following “The River of Doubt,” her account of Theodore Roosevelt’s near-death experience on the Amazon River. That book proved popular with readers and critics alike, and “Destiny of the Republic” shows no signs of a sophomore jinx.

Garfield may not rival Roosevelt’s larger-than-life character, but, as Millard’s meticulous research and anecdotes reveal, he was an admirable figure. For a country still beset by post-Reconstruction disunion, Garfield’s integrity and fairness helped to foster a more truly united United States.

Garfield grew up dirt-poor in rural Ohio, lost his father before he had reached the age of two, and didn’t have a pair of shoes until he was four.

Education provided escape from his hardscrabble existence. Garfield worked as a janitor to pay for his classes at a preparatory school and eventually made his way to Williams College in Massachusetts, where he graduated with honors.

Even with such an industrious nature, Garfield hardly seemed destined for the White House. He detoured from an academic career into the Civil War, routing a decorated military opponent in a key battle in Kentucky.

Circumstance, as much as anything, led him to Congress in 1862. And, 18 years later, he was shocked as anyone when delegates made him the Republican presidential nominee despite his impassioned protests against such a notion.

Humility was more than a pretense with Garfield, who once said, “I so much despise a man who blows his own horn, that I go to the other extreme.”

As Millard writes of Garfield’s unlikely ascent, “Having never agreed to become even a candidate – on the contrary, having vigorously resisted it – he was suddenly the nominee.”

The Republican incumbent, Rutherford B. Hayes, frustrated by the spoils system of blatant pay-to-play patronage, opted against seeking the nomination, but party powerbrokers such as US Senator Roscoe Conkling of New York favored former two-term president Ulysses S. Grant to lead the ticket.

At the 1880 convention in Chicago, Garfield delivered a stirring nomination speech on behalf of John Sherman, a Hayes cabinet member longing to be president. Instead of catapulting Sherman to the head of the GOP ticket, the speech inspired a successful push to make Garfield the party standard-bearer.

Despite his resistance to the idea (“My name must not be used,” he said), Garfield eventually capitulated and went on to defeat Winfield Scott Hancock in the general election.

“This honor comes to me unsought,” Garfield said upon becoming president. “I have never had the Presidential fever; not even for a day.”

He quickly became a beloved figure. Blacks embraced him for taking strong stands on racial equality, while Northerners and Southerners alike appreciated his pragmatic approach and rags-to-riches rise.

But it was the new president’s refusal to honor the spoils system of patronage that led an itinerant, deluded man named Charles Guiteau to assassinate him.

Millard’s account shows how vulnerable presidents were in the 19th Century. Despite Lincoln’s assassination less than two decades earlier, Garfield had no bodyguards or security detail of significance. Like his predecessors, Garfield was expected to — and did — meet with importunate citizens in the White House on a regular basis. On average, 100 callers per day sought presidential favors.

It was in this spirit that Guiteau arrived in Washington, where he wandered through hotels and inns, promising payments for his stays before being chased away. At the White House, he sought a consulship in Paris and other sinecures.

Finally, Garfield’s secretary of state rebuked Guiteau. A testy, humiliating exchange, combined with Garfield’s refusal to placate Conkling, the New York patronage king, led Guiteau to convince himself the president had to be killed. Long considered mentally ill by family members and others, Guiteau believed God wanted him to end the president’s life and, in turn, rescue the Republican Party by reviving Conkling’s diminished faction.

Before he went ahead with his plot to assassinate Garfield, Guiteau made a final entreaty in a letter to the president, beseeching him to meet at the White House.

It was, quite literally, an impossible request, as Garfield’s staff had already banned Guiteau from seeing the president, who never even saw the letter. Guiteau followed the president to church and elsewhere in Washington. On these occasions, he could have easily shot Garfield but didn’t.

Finally, on July 2, 1881, as the president walked through the Baltimore and Potomac Railroad Station in Washington, Guiteau shot Garfield twice. The first bullet went through the president’s right arm, while the second missed his spinal cord by four inches and lodged near Garfield’s pancreas.

The wound wasn’t fatal, but the medical care was, starting with Dr. Smith Townshend, the district health officer who first treated Garfield. Townshend left Garfield lying on the germ-plagued depot floor and inserted his bare, unwashed finger into the wound. That decision was almost certainly more damaging than the bullet itself.

Millard, citing subsequent research and analysis, makes a convincing case that had the president not been treated at all for the gunshot wounds, he would have survived the shooting.

In one of many intriguing subplots, Robert Todd Lincoln was with Garfield during the attack. Lincoln, a member of the president’s cabinet, was 16 years removed from watching his father die from an assassin’s attack. Seeking to prevent another deathbed vigil, Lincoln summoned Dr. D. Williard Bliss, a surgeon who had tried to revive Abraham Lincoln after the shooting at Ford’s Theatre.

It proved to be a fatal mistake. Bliss was headstrong, dismissive of Lister’s antisepsis and, above all, unwilling to listen to divergent medical opinions. For Bliss, Garfield offered a chance at not just glory, but redemption. In that spirit, he refused to cede authority to anyone, including Garfield’s wife and his personal physician.

Bliss embodied the ethos of American medicine at the time. As Millard writes, “Not only did American doctors not believe in germs, they took pride in the particular brand of filth that defined their profession.”

As Garfield lingered for months amid torpid temperatures in the White House, Bliss and the rest of the medical team put the president through agonizing treatment, including frequent, painful probes in search of the bullet. Here, too, Bliss and his team misdiagnosed by a wide margin.

The ongoing search for the bullet intrigued the tireless curiosity of Graham Bell, who drove himself to the brink of a nervous breakdown trying to create an accurate detector to locate the bullet inside Garfield’s body. Bliss allowed Graham Bell two separate attempts to locate the bullet, but inconclusive results and Bliss’ strong-arming left Garfield languishing as before.

Guiteau narrowly avoided lynching in the wake of the shooting, but his delusions were hard to dispel. He believed the vice president, Chester Arthur, as well as William Sherman, the famed Civil War general, would free him and offer their thanks.

Bliss embodied his name by embracing ignorance and arrogance alike. As Garfield vomited and suffered from fever while infection and pus ravaged his body, the president’s de facto chief physician told a reporter, “I think that we have very little to fear.”

Isolated in the White House and with any hope of recovery fading, Garfield demanded to be taken to New Jersey to see the ocean one last time before his death. He died there on Sept. 19.

Bliss billed Congress $25,000 for his services – the equivalent of $500,000 today – and was instead offered $6,500. He declined, calling it an insult, and died seven years later, his reputation in tatters. Guiteau was hanged in 1882.

Even after Garfield’s assassination, presidents lacked for security. It wasn’t until 1901, after William McKinley was assassinated, that the Secret Service in its modern guise began to take shape. McKinley died eight days after being shot.

Among those with McKinley when the killer’s bullet was fired: Robert Todd Lincoln, whose presence gave him the tragic distinction of being the only man to witness three of the four American presidential assassinations.

Erik Spanberg regularly reviews books for the Monitor.

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