Who Really Killed a President: The Case of James Garfield
THURSDAY, JUNE 27, 2019 -- I was greatly impressed by the writing of Candice Millard when I read her wondrous The River of Doubt: Theodore Roosevelt's Darkest Journey. Her almost poetic recounting of TR's dangerous, desperate and health-destroying Amazon journey was an unusually satisfying read.

More than a decade later, I find myself addicted to Millard's Destiny of the Republic: A Tale of Madness, Medicine and the Murder of a President, another New York Times bestseller. In this historical biography from 2011, Millard explores a chilling, eerie and largely forgotten page in the American saga.

History tell us that a man named Charles Guiteau shot President John Garfield on July 2, 1881, as he embarked on a family vacation mere months after he took the oath of office on March 4th. History also tells us that Garfield did not die on the dirty floor of the Baltimore and Potomac Railroad Station in Washington. He lingered 79 days, dying on September 19, 1881.

Guiteau was eventually hung for shooting Garfield. But was he the only one who should have been held accountable? Thanks to Millard's thorough research and medical sleuthing, we learn who was responsible for Garfield's tortured last days and the events that directly contributed to his demise.

Destiny of the Republic reveals how a healthy, 49-year-old man, who could have survived his wounds, was robbed of his life in what may have been the most egregious case of malpractice ever perpetrated. As the title suggests, this medical madness is what leads some observers to say that Garfield was murdered by doctors, not just Guiteau. Millard contends that it wasn't the bullet, but medical mistreatment, that ended Garfield's life. My take? Garfield's self-appointed physician--who performed an exam so invasive and unhygienic that another doctor implored him to stop--should have faced criminal charges.

But Destiny isn't solely focused on the assassination attempt--which occurs almost halfway through the book--and Garfield's precarious health in the aftermath. To provide context for the multiple factors and forces surrounding the assassination attempt, and to better understand Garfield's fate, Millard weaves together a number of back stories:

      Garfield's truly American success story. He rose from poverty to become the principal (at 26) of the school that his family saved to get him admitted. He labored almost two decades in the House of Representatives with stints as the Chair of three major committees.

      The obsessions and delusions that afflicted the unstable and increasingly frustrated Guiteau, a liar and cheat who stalked Garfield in search of a government job he felt he deserved.

      The terrible misjudgment made by two doctors first on the scene at the railway station to seek the assistance of a physician that Garfield knew. That decision allowed Doctor Willard Bliss, an egotist with a questionable history--bribes, specious cancer cures and more saw him kicked out of Washington's medical society--to exert "immediate and complete" control over Garfield's care. His maniacal and grave miscalculations doomed Garfield.

      Joseph Lister's landmark work on preventing infection and the practice of medicine in the late 19th century. Lister's approach was controversial in the United States and rejected by many in the medical community, including Bliss.

      The story of how the friendship and expertise of a famous inventor could not help save Garfield. To locate the bullet inside Garfield, Alexander Graham Bell twice used a modified version of an earlier invention dubbed an "induction balance." It acted as a crude metal detector. Bliss thwarted Bell's efforts by allowing him access to only one side of Garfield's body. It was the not the side where the bullet was lodged. Bliss wasn't only a fool, but also woefully misnamed. His family gave him the first names Doctor and Willard, meaning he was officially known as Dr. Doctor Bliss.

Along the way, much to my delight, Millard delves into the chaos of the contentious 1880 Republican convention in Chicago. Garfield never sought nor desired the nomination. At the start of the seven-day marathon, Garfield received one vote on the first ballot. On the 36th, and final, ballot, Garfield received 399 votes. That bested Ulysses S. Grant's 306 votes and angered Grant's back room champion, New York Senator Roscoe Conkling, then considered the most powerful and corrupt politician in the nation.

Millard also focuses on political patronage--the "spoils system"--and its role in fueling Guiteau's sense of entitlement. Back then, government jobseekers were allowed to physically lobby a president, a practice that allowed Guiteau to easily get close to Garfield and fire off multiple shots. The spoils system only ended in 1883 when Chester Arthur, who became president on Garfield's death, signed the Pendleton Civil Service Reform Act. The Pendleton Act mandated that government employment be based on merit, not patronage.

Destiny also is a sad and heartbreaking story of personal stoicism in the face of horrific circumstances. Garfield was in constant pain, literally rotting to death from infection and being starved. But he did not complain. Meanwhile, the incompetent Bliss tried to bill Congress $25,000 for his work, the equivalent of about $650,000 in 2019. He was offered $6,500, but rejected it.

Candice Millard captures the drama of a moment in American history that has not gotten as much attention as it deserves. Her book is a compelling, well-written narrative and makes an excellent summer read.

Destiny of the Republic: A Tale of Madness, Medicine and the Murder of a President in available in a variety of print, audio and digital formats from Amazon.com.