The president’s only complaint was loneliness. Although Garfield appeared to have improved dramatically, Bliss continued to deny him any visitors. For a man who cherished his friends and delighted in long, rambling conversations, this isolation was more painful than anything else he had had to endure. His only link to the outside world was through the one window not obscured by the screens Bliss had placed around his bed. It was the same view he had had from his office—a stretch of trees on the White House grounds, the unfinished Washington Monument, and a silver thread of the Potomac. Now, however, as he lay on his back, unable to sit up, his bamboo bed frame lifting him just high enough to see out the window, the scene must have seemed lonely and remote, almost unfamiliar.
Turning to his friend Rockwell, Garfield asked for something with which to write. After handing him a clipboard and a pencil, Rockwell watched as the president wrote his name in a loose, drifting hand that was almost unrecognizable as his signature. Then, underneath his name, he scrawled the words “Strangulatus pro Republica”—Tortured for the Republic. “There was never a moment that the dear General was left alone,” Rockwell would later write, “and yet, when one thinks of the loneliness in which his great spirit lived, the heart is almost ready to break.”
Bliss permitted no one to see the president but the handful of friends and family members who had become his nurses. His children, whom he ached to see, were allowed only rare visits. Even Blaine had not seen Garfield since the day he had knelt over him in the train station. Finally, nearly a month after the shooting, Garfield insisted that he see his secretary of state. On a Friday morning in late July, Blaine was ushered into the president’s darkened sickroom. He was relieved to see that Garfield looked better than he had feared, but he had time to do little more than reassure himself that his friend was still alive. Just six minutes after Blaine had entered the room, Garfield’s doctors politely showed him back out.
In part, Bliss defended his decision to keep the president isolated by insisting that it was dangerous for Garfield to talk. By talking, he said, Garfield moved his diaphragm, which in turn moved the liver, the region where Bliss believed the bullet had lodged. “But I move the diaphragm every time I breathe,” Garfield had pointed out. Yes, he was told, but breathing was a gentle movement, while talking was violent.
Garfield did his best to follow his doctors’ instructions, but as his old friend Swaim sat by his bed one night, trying to conjure a small breeze with a fan, he could not resist talking to him. Terrified that Garfield would somehow further injure himself, Swaim asked him several times to stay silent. Finally, when the president tried to strike up yet another conversation, Swaim snapped at him, “I won’t talk to you and won’t listen to you.” Garfield laughed, laid his hand on his friend’s arm, and said, “I will make a treaty with you. If you keep my mouth filled with ice I will keep quiet.”
By late July, Garfield had seemed so strong and steady, so much like himself for so long, that it seemed impossible that he would not recover. Friends and family members in Ohio who had been packing their bags, expecting to go to Washington to be of support and help to Lucretia in her mourning, began canceling their travel plans. “Everywhere,” one reporter wrote, “hope and confidence have taken the place of alarm and doubt.” On July 21, Lucretia told Harriet Blaine that she considered her husband to be “out of danger.”
The very next day, in a descent that seemed as sudden and mysterious as it was terrifying, Garfield began to lose all the ground he had gained. When his wound was dressed that morning, a “large quantity” of pus escaped, carrying with it fragments of cloth that the bullet had dragged into his back and a piece of bone that was about an eighth of an inch long. By evening, he was uncharacteristically restless and so tired he did not even try to speak.
Bliss was not concerned about the pus. On the contrary, he considered it to be a good sign, as did many like-minded surgeons at that time. Just two years earlier, William Savory, a well-regarded British surgeon and prominent critic of Joseph Lister, had proclaimed in a speech to the British Medical Association that he was “neither ashamed nor afraid to see well formed pus.” A wound, he declared, was “satisfactory under a layer of laudable pus.” Bliss could not have agreed more heartily. Garfield’s wound, the medical bulletin announced that night, “was looking very well,” having “discharged several ounces of healthy pus.”
By the next morning, however, even Bliss’s confidence had begun to fade. At 7:00 a.m., the president’s temperature was 101 degrees. By 10:00 a.m., it had risen to 104. “He is feverish and quite restless,” one of Bliss’s attending physicians noted, “and has vomited three times this morning a fluid tinged with bile.”
Quietly, Bliss sent for his surgeons, David Hayes Agnew and Frank Hamilton, who arrived in Washington by a quarter past eight that evening. As Garfield lay in his bed, “drenched with a profuse perspiration,” the two surgeons examined his back and found a small pus sac about three inches below the wound. Using only a sulphuric ether, sprayed directly onto the site, to lessen the pain, Agnew made a deep incision into Garfield’s back and inserted a large drainage tube.
Bliss’s bulletin that day announced that “the President bore the operation well,” and was “much relieved.” Garfield’s condition, however, continued to deteriorate. He vomited repeatedly and was constantly bathed in sweat. Two days after the first surgery, Agnew again operated on the president, enlarging the opening he had earlier made over his rib and pulling out fragments of muscle, connective tissue, and bone, one piece of which was an inch long.
Bliss, Agnew, and Hamilton would later insist that, as they examined and operated on the president, they used an adequate degree of antisepsis. Occasionally, they sprayed Garfield’s back with carbolic acid or rinsed the wound with a “weak solution of car bolic [sic] acid (one-fourth of 1 per cent).” Like the surgeons who sterilized their knives and then held them in their teeth, however, the doctors’ efforts did little more than give the appearance of antisepsis. Each time they inserted an unsterilized finger or instrument into Garfield’s back, something that happened several times every day, they introduced bacteria, which not only caused infection at the site of the wound, but entered Garfield’s bloodstream.
Unbeknownst to his doctors, cavities of pus had begun to ravage the president’s body. One cavity in particular, which began at the site of the wound, would eventually burrow a tunnel that stretched past Garfield’s right kidney, along the outer lining of his stomach, and down nearly to his groin. An enormous cavity, six inches by four inches, would form under his liver, filling with a greenish-yellow mixture of pus and bile.
Nearly a month had passed since the shooting, but Bliss and his team of doctors were still probing Garfield’s wound in the hope of answering one question: Where was the bullet? Eager to help solve the mystery, Americans flooded the White House with letters not just of concern and sympathy but medical advice. “We received every morning literally bushels of letters,” one doctor in the White House would later recall. “Every crank … in the country seemed to think himself called upon to offer to cure the president.” One man sent the doctors plans for a suction device that he assured them would suck the bullet right out of Garfield. Another suggested that they simply hang the president upside down until the bullet fell out. A man in Maryland wrote to Bliss saying that there was no reason for concern. The bullet was not in Garfield at all, but with him in Annapolis.
Although Bliss admitted that he could not be certain where the bullet lay, he had made it clear from the moment he took charge of the case that he believed it was in or near Garfield’s liver. In this belief, he was joined by nearly every other doctor who had examined the president. While Garfield was still at the train station, one doctor had claimed that he could feel his liver as he probed the wound with his little finger. Hamilton had told a reporter that he “had a suspicion, founded upon a good deal of evidence, that the ball was in the right iliac region, not far above the right groin.” So convincing w
ere the doctors that, soon after the shooting, the New York Times had announced that the “bullet has pierced the liver, and it is a fatal wound.”
At least one doctor in Washington, however, believed strongly that the bullet wasn’t anywhere near the president’s liver—that it was, in fact, on the opposite side of his body. Frank Baker, a young man who had recently completed his medical degree and taken a position as an “assistant demonstrator of anatomy” at Columbian University (now George Washington University), had been carefully following Garfield’s case since the day of the shooting. After considering the president’s symptoms and applying some of the basic theories he had learned in medical school, he concluded that, although the bullet had entered Garfield’s back on the right, it had come to rest on the left.
Baker even drew up a diagram, which traced with remarkable accuracy the course of the bullet. On July 7, just five days after the assassination attempt, he showed it to three doctors, one of whom was Smith Townsend, who had been the first doctor to examine Garfield at the train station. Although he had little doubt that he was right, Baker never shared his theory with Bliss, or with any of the doctors caring for the president at the White House. Acutely aware of his own modest position, he worried that it would be disrespectful to question men of their stature. “I felt,” he would later explain, “that it was improper to urge views which were diametrically opposed to those of gentlemen of acknowledged skill and experience.”
As Baker had guessed, Bliss would not have welcomed his help. Even the physicians Bliss had personally invited to advise him on Garfield’s care were strongly discouraged from disagreeing with him. Bliss’s medical bulletins, which were uniformly optimistic, even when there was clear cause for concern, were a central point of contention. “These bulletins were often the subject of animated and sometimes heated discussion between Dr. Bliss and the other attending surgeons,” one of the doctors would later admit. “The surgeons usually taking one side of the question and Dr. Bliss the other.”
Bliss argued that he was only protecting the president, who had the newspapers read to him every morning. “If the slightest unfavorable symptom was mentioned in one of the bulletins,” one of Garfield’s surgeons recalled Bliss saying, “it was instantly telegraphed all over the country, and appeared in every newspaper the next morning.”
Bliss expected the greatest possible discretion from everyone involved in the president’s care, even Alexander Graham Bell. In Bell’s case, however, he need not have worried. The inventor was well aware that his reputation too was at risk. In that respect, in fact, he had more to lose than Bliss, as he was by far the more famous man. By trying a new and largely untested invention on a dangerously wounded president, Bell was jeopardizing the respect and admiration he had so recently won. If the induction balance did not work, it would be his failure alone.
Reporters had been following Bell closely since the day he had arrived in Washington. “Your arrival and ‘Professor’ Tainter’s was in the papers yesterday,” Mabel had warned him on July 16. “Also a full account of what was said to be the instrument you would use.” The day before, the Washington Post had printed a brief description of the induction balance and promised that “the experiment will be watched with great interest.”
In an attempt to retain some privacy, Bell had avoided sending telegrams. “Ordinary telegrams I presume are private enough,” he explained to Mabel in a long-awaited letter, “but in the case of my telegrams to you concerning the experiments to locate the bullet in the body of the President—I have no doubt they are all discussed by the employees of the Telegraph Company—and thus run a great chance of leaking out to the public Press.”
In truth, reporters had little idea what Bell was up to, as he spent every day holed up in his laboratory, desperately trying to perfect his invention so that it would be ready when Bliss was. Since he had agreed to a brief interview with a few reporters nearly a week earlier, the only people Bell had allowed in the lab besides his assistants were fellow scientists and envoys from the White House. That would change on July 22, when he welcomed his first live test subject.
That day, a veteran of the Civil War named Lieutenant Simpson knocked on the door of the Volta Laboratory. Bliss had recommended Simpson to Bell because he had “carried a bullet in his body for many years.” Bell found a “sonorous spot” on the lieutenant’s back, but he worried that it was too faint to be trusted. He ran the test several times, asking Tainter, his father, and even Simpson himself to try to replicate the results. He also attempted a blindfold test, in which Tainter “closed his eyes and turned away.” Tainter thought that he heard something in the same area Bell had noted, but Bell was skeptical. “I find that very feeble sounds like that heard are easily conjured up by imagination and expectancy,” he wrote to Bliss the following day.
Bell needed more time, but as Garfield’s condition continued to worsen, Bliss began to panic. Finally, at noon on July 26, he sat down and wrote a letter to the inventor, avoiding, as had Bell, the telegraph station. “Will you do us the favor to call at the Executive Mansion at about 5 p.m. today and work the experiment with the Induction Balance on the person of the President?” he wrote in an elegant, slanting hand on White House stationery. “We would be glad to have the experiment tried at the time of the dressing changing, about six p.m.”
That morning, Bell had slept until eleven. He felt “tired, ill, dispirited and headachy,” and had crawled into bed the night before “thoroughly exhausted from several days of hard labour.” He was still hunched over his breakfast when Tainter arrived, carrying Bliss’s letter, which had been sent to the laboratory by White House courier. As he held the letter in his hands, Bell regarded it with a mingled sense of excitement and fear. “Our last opportunity for improving the apparatus had come!” he would write Mabel later that night. Throwing on some clothes, he rushed to the laboratory with Tainter at his side and immediately set to work. He had one objective in mind: improving the induction balance’s hearing range, so that it could detect an even deeper-seated bullet.
The day before, Professor Henry Rowland, who occupied the chair of physics at Johns Hopkins University in Baltimore, had visited Bell to make a suggestion. If Bell added a condenser, which can store and quickly release an electric charge, to the induction balance’s primary circuit, he could increase the current’s rate of change, and probably obtain a clearer sound. Bell didn’t have a condenser and didn’t have time to find one. That morning, however, in a moment of inspiration, he suddenly remembered that, when returning from his last trip to England, he had brought with him a large induction coil. Inside the coil was a condenser.
Breaking open the instrument, Bell removed the condenser, attached it to his invention, and was thrilled with what he found. Not only did it improve the sound, it increased the induction balance’s range. Bell could now detect a bullet nearly three inches deep in the president’s back. That, he hoped, would be enough.
As he left the laboratory, Bell made a rare stop at the telegraph station. Deciding to try his hand at subterfuge, he wrote to Mabel that the “trial of the apparatus on [the] President” would not take place for several days. The telegram, he later told her, was “intended not for you at all—but for the employees of the Telegraph Company.”
A few hours later, Bell and Tainter arrived at the White House. Between them, they carried the newly improved induction balance, with all of its many parts and a tangle of wires. Approaching the house, they headed not for the front door, where they would risk being seen by the crowds of people still camped out in the park across the street, but to a private entrance in the back.
Bell was uncomfortably aware that the president had expressed reservations about this test. “Mr. Garfield himself is reported to have said that he was much obliged, but did not care to offer himself to be experimented on,” Mabel had written to her mother a week earlier. “Of course not, but Alec isn’t going to experiment upon him.” The test, however, was an experiment. Bell’s inventi
on was less than a month old and had undergone significant changes only that afternoon. He had tested it, moreover, on only one other person, a man who had been perfectly well for many years.
After being quickly ushered inside, Bell and Tainter were shown up the narrow servants’ staircase to the president’s room. When Bell walked in the door, he was astonished by what he saw. The president lay sleeping, a peaceful expression on his face. He looked “so calm and grand,” Bell later wrote Mabel, “he reminded me of a Greek hero chiselled in marble.” Garfield, however, bore little resemblance to the man Bell had seen so many times before in pictures and paintings, always with the appearance of vibrant health—“the look of a man who was accustomed to work in the open air.” The man before him now was an “ashen gray colour,” Bell wrote, “which makes one feel for a moment that you are not looking upon a living man. It made my heart bleed to look at him and think of all he must have suffered to bring him to this.”
While the president slept, Bell worked quickly in an adjoining room to set up the induction balance. Having sent Tainter to the basement with the interrupter, which was too loud to have nearby as they performed the test, he now arranged the battery, condenser, and balancing coils on a simple wooden table. After everything had been connected, Bell lifted the telephone receiver to his ear. To his horror, what he heard was not the cool silence of a balanced induction, but a strange sputtering sound he had never heard before.
Destiny of the Republic: A Tale of Madness, Medicine and the Murder of a President Page 22