Destiny of the Republic (29 page)

The president, however, was not getting better—a fact that his doctor, unable to change, was desperate to disguise. For nearly a month, Bliss had rarely left Garfield’s bedside, making every decision regarding his care, from what medicine he would receive, to what he could eat, to whom he could see. In a futile effort to have the decaying room “thoroughly aired and cleaned,” he insisted that all the carpets and upholstered furniture be removed, and he ordered the other doctors to take off their shoes so that the sound of their footsteps would not disturb the president’s rest.

As he grew increasingly nervous, Bliss no longer trusted even the doctors he had handpicked to help him. Soon after taking charge of the case, he had given Robert Reyburn, a professor of surgery at Howard University and a close friend of his, the task of taking the president’s temperature several times a day. So many times had Reyburn walked into Garfield’s room holding a thermometer that the president had begun referring to him as “Old Temperature.” Now, Bliss took over even that menial duty, personally taking the president’s vital signs and writing the results in his daily medical bulletins. The other doctors were expected to take Bliss’s word for it that the bulletins were accurate, and sign them without having examined the president themselves.

So tight was Bliss’s grip on the president’s case that it seemed as if he were fighting not for Garfield’s survival, but his own. In a confidential note to a friend, written on White House stationery, Bliss complained that he was “devoting all my professional skills—ability—time & thoughts to this case.” With little sleep and no relief from worry, his own health had begun to suffer, as had his medical practice, which he had completely neglected since the shooting. He had risked everything he had to treat the president, and, he wrote, underlining not just the sentence but each word with a heavy hand, “
I
can’t
afford
to
have
him
die
.”

What Bliss needed now, as he watched Garfield’s temperature rise and fall like a churning sea, was some good news. On July 30, after instructing Hamilton to insert a drainage tube “farther into the cavity of the [President’s] wound,” Bliss wrote once again to Bell, asking him to return to the White House for a second test of the induction balance on the president.

Bell was eager to try again, but he had not forgotten the humiliation of his first, failed test. “Courage,” Mabel had urged him as soon as she heard the news. “From failure comes success,” she wrote. “Be worthy of your patient.”

When Bliss’s letter arrived, Bell was literally knee-deep in his work. Piles of wire coils littered the laboratory, and battery cells, which consisted of electrodes resting in jars of noxious liquid, sloshed threateningly every time he bumped a table. He was running a new series of experiments, following less scientific theory than empirical method. What he had found was that, not only might it help to double his battery voltage—from four cells to eight—but, more important, he would be better off without the balancing coils. Without the extra coils, he could reduce the resistance, which significantly strengthened the current, and increased the hearing range.

The results, he wrote in his laboratory notebook, barely able to contain his excitement, were “Splendid!” In just four days, he had managed to extend the instrument’s range to more than five inches. The problem was that the only way to balance the induction with just two coils was to overlap them, and they were extraordinarily sensitive to the slightest movement in relation to one another.

By this point the last thing Bell was worried about was aesthetics, but the induction balance had to be portable. Using what he would later describe as “forced exertions,” he and Tainter managed to encase the coils in two rectangular wooden blocks, held together by four pins made of ebonite, a type of hard rubber. The wires now emerged from the sides of the blocks rather than through the top of the handle, but there was no time to make a new handle, so the original one, with an empty hole through the center, would have to do. “In its present form,” Bell admitted to Bliss, the instrument was a “very clumsy affair.”

On July 31, the day before he was scheduled to return to the White House, Bell tested his redesigned invention on a man who lived at the Soldiers’ Home, a veterans’ retirement compound that included the summer cottage where Lincoln had written the final draft of the Emancipation Proclamation. The test subject this time was Private John McGill, who, for nearly twenty years, had lived with a bullet from the Civil War battle of Gaines’ Mill. Bell had “no difficulty,” he wrote to Bliss that night, “in finding a sonorous spot in his back, where undoubtedly the bullet lies imbedded.” After the test Bell found that, in this case, he could actually confirm the results simply by pressing his fingers on the “sonorous spot,” and feeling the bullet beneath McGill’s skin.

At about nine o’clock that night, after sending Mabel a ringingly confident telegram, declaring that there was “no need of further secrecy,” Bell allowed a reporter from the
Boston Herald
to join him in his laboratory. Welcomed with a hail “Come up and see us” from Bell himself, the reporter made his way to the door of the brick building, which was nearly hidden behind overgrown trees and shrubs. After stopping for a moment to admire the light streaming from the windows, marveling that “every room was in use,” he was led into the laboratory, where Bell, his father, and Tainter stood, surrounded by the detritus of their work.

Every surface, from tables to chairs to cabinets, even the floor they stood on, was covered with “coils of wire, batteries, instruments and electrical apparatus of every sort,” the reporter marveled. “The light from the jets, burning brilliantly in the centre of the room, was reflected from a hundred metallic forms. It was reflected too from the smiling faces of the great electrician and his assistant, who saw success almost within their grasp.”

Bliss was waiting for Bell when he and Tainter arrived at the White House the next morning, carrying between them the induction balance, awkwardly shaped and roughly hewn but working perfectly, and with nearly twice the range it had had just four days earlier. For the first time since he had begun work on this invention, Bell felt calm and confident. “My new form of Induction Balance,” he had written to Bliss the day before, “gives brilliant promise of success.”

Bliss, however, had a very specific definition of success. He expected Bell not only to find the bullet, but to find it where Bliss believed it to be. He would not allow the inventor and his assistant to waste his time or the president’s energy on fruitless efforts. It was understood that they were to search the right side of Garfield’s body, and only the right. Bliss agreed to let Bell and Tainter conduct the test themselves this time, but he would be standing next to the president’s bed, closely watching the examination.

As Bell slowly ran the induction balance over what he referred to as the “suspected spot,” he suddenly heard a faint pulsating sound. He tried again several times over the same area, and each time got the same result. Tainter, “the only other person present whose ear had been sufficiently trained to be reliable in such an emergency,” repeated the test a number of times as well, assuring Bell that he heard the same sound. Still, Bell wanted another opinion. Finally, he asked the first lady to press her ear to the telephone receiver and tell him what she heard. Lucretia agreed that there seemed to be something there.

This spot, Bell knew, was exactly where Bliss wanted him to find the bullet. Despite that fact—or more likely because of it—he hesitated. There was, he would later write, “a general expectation that the bullet would be found in that part of the body.” His fear was that that expectation might lead him to “imagine a difference that did not exist.”

As far as Bliss was concerned, they had their answer. Like the rest of the city, he had certainly seen the
Washington Post
article that morning, announcing that, “if success crowns the effort, and the ball is where it is now very strongly suspected to be, the original diagnosis of the wound will be upheld.” It was no secret that that diagnosis had come from the president’s chief physician.

Without wasting any time, Bliss issued a bulletin to announce the successful test of Alexander Graham Bell’s invention. It was “now unanimously agreed,” he wrote, “that the location of the ball has been ascertained with reasonable certainty, and that it lies, as heretofore stated, in the front wall of the abdomen, immediately over the groin, about five inches below and to the right of the navel.”

As Bliss declared victory, Bell struggled with a nagging sense of unease. Whatever it was that he had heard as he tested the president, he had never heard it before. It certainly was not the faint but distinct buzzing sound that, after weeks of testing, he would have recognized immediately. Unfortunately, it had been clear to everyone in the room that Bell had heard something, and he had been unable to explain what else it could be. “In the absence of any other apparent cause for the phenomenon I was forced to agree in the conclusion that it was due to the presence of the bullet,” he would later write. “I was by no means satisfied, however, with the results.”

After returning to his laboratory, Bell felt none of the triumph he had felt the night before. As he turned the memory of the test over and over in his mind, trying to understand what had been different this time, he began to wonder if the problem had been some sort of outside interference. The next day, he returned to the White House and asked urgently to speak to Garfield’s surgeons. Were they “perfectly sure,” he asked, “that all metal had been removed from the neighborhood of the bed.” “It was then recollected,” Bell would later write, “that underneath the horse-hair mattress on which the President lay was another mattress composed of steel wires.”

The revelation stunned Bell, who had had no way to anticipate such an unusual and potentially disastrous factor in his work. Box springs would not become common in the United States for another twenty years. As Bell knew, however, it would be difficult to find a better way to interfere with an induction balance than a mattress made of metal. Still, Bell was not convinced that it was the entire source of the problem. It seemed to him that, since Garfield had been lying on the mattress, he would have heard the pulsating sound everywhere he tested, rather than in just a small area near the wound. He asked the White House to send him an exact duplicate of the president’s mattress for testing.

Acutely aware that time was running out, Bell returned to his lab and threw himself into meeting this new challenge. He had just begun, however, when he received an urgent message from Boston. Mabel, who was in the third trimester of her pregnancy, had fallen ill. She had been pleading with him to visit her and their children for more than a month. Now the situation had taken an ominous turn. Determined to find a way to keep working, Bell left Tainter with detailed instructions and then rushed aboard a train, already planning to ask Charles Williams for his old work space in the machine shop.

Waiting for Bell in Boston, however, was a tragedy that was far more personal than the one he was leaving behind, and which would leave him powerless to help Garfield, or indeed himself.

•
CHAPTER 20
•
T
ERROR
, H
OPE
,
AND
D
ESPAIR

I have sometimes thought that we cannot know any man thoroughly
well while he is in perfect health. As the ebb-tide discloses the real
lines of the shore and the bed of the sea, so feebleness, sickness, and pain
bring out the real character of a man.

JAMES A. GARFIELD

I
n his sickroom in the White House, Garfield was exhausted and weakened by the suffering he endured, but he was not surprised. He had been poor, and he had been a soldier, and like any man who had known want or war, he understood that the cruelest enemy was disease. “This fighting with disease,” he had written to Lucretia nearly ten years earlier, after watching twenty-two of his men die from typhoid fever during the Civil War, “is infinitely more horrible than battle.”

Now, his body, which had miraculously survived the initial trauma of the bullet wound, was so riddled with infection that he was literally rotting to death. Although Bliss closely tracked the spikes in the president’s temperature, the chills, restlessness, vomiting, pounding heart, and profuse sweating, he either did not know, or refused to acknowledge, that they were symptoms of severe septicemia. He also insisted that he was not worried about the small, pus-filled lumps that dotted Garfield’s back and arms. Known as “septic acne,” they were yet another indication of blood infection. When a reporter, who had seen them mentioned in the bulletins, asked Bliss about them, the doctor dismissed them as being fairly common. “They will not be allowed to get large,” he said, “but will be opened as they may form.”

On August 8, a few days after Bell left for Boston, Bliss directed Agnew to again operate on the president, to “facilitate the escape of pus.” When Bliss told Garfield that he would need to undergo another operation, Garfield, with “unfailing cheerfulness,” replied, “Very well; whatever you say is necessary must be done.” Using a long surgical knife with an ivory handle, Agnew made a deep incision down to and slightly past Garfield’s twelfth rib, following what he believed to be the track of the bullet, but which was, in fact, a long, vertical cavity that had been created by the doctors’ own fingers and instruments, and filled with infection. Before closing the incision, Agnew inserted two drainage tubes, which, Bliss noted with satisfaction, quickly issued “a profuse discharge of pus and bloody serum.” Garfield, Bliss recalled with astonishment, endured the procedure “without an anæsthetic, and without a murmur, or a muscular contraction.”

Neither the incisions the surgeons made, however, nor even the drainage tubes they inserted could keep up with the copious amounts of pus Garfield’s body was producing. Just two weeks after the surgery, another abscess formed, this one on Garfield’s right parotid gland, the largest salivary gland, which lies between the mouth and ear. Within days, the abscess had become so filled with pus that it caused his eye and cheek to swell and paralyzed his face. Finally, it ruptured, flooding Garfield’s ear canal and mouth with so much pus, mixed with thick, ropy saliva, that it nearly drowned him.

So toxic was the infection in Garfield’s body that it was a danger even to those who were treating him. One morning, while dressing the president’s wound, Bliss reached for a knife that was partially hidden under some sheets. Unable to see the blade, he accidentally sliced open the middle finger of his right hand. “It is thought that some pus from the President’s wound penetrated the cut,” the
New York Times
reported the next day, “and produced what is known as pus fever.” The resulting infection caused Bliss’s hand to become so painfully swollen that he had to carry it in a sling.

Before his hand had even had a chance to fully heal, Bliss gave an interview in which he proclaimed that there was no evidence of blood infection in the president. “Not the minutest symptom of pyæmia has appeared thus far in the President’s case,” he told a reporter. “The wound,” he said, “is healthier and healing rapidly.… In a word, the wound is in a state that causes us no apprehension whatever.”

What did cause Bliss apprehension was the very real possibility that the president might die—not from infection, but starvation. In less than two months, Garfield had lost more than a third of his body weight, plunging from 210 pounds to 130. The barrel-chested, broad-shouldered former soldier who had taken office just five months earlier, radiating health and vitality, was now a near skeleton, so weak he could hardly hold a pen. The president, one of his doctors privately told a reporter, had reached “the limit of what a man can lose and yet live.”

Not only did Garfield continue to suffer from violent bouts of vomiting, but he had long since lost any interest in eating. Edson, Lucretia’s doctor who had agreed to serve as a nurse so that she could watch over the president, had told the
New York Herald
earlier in the month that, “at the best meal he has had lately, after the couple of mouthfuls he would ask to have it removed.” Most days, Garfield was able to keep down a little bit of oatmeal. Unfortunately, that happened to be the one food he despised.

Although Garfield found it difficult to eat anything, for a while at least he seemed to relish drinking a glass of milk. He dutifully swallowed the koumiss, a drink made from fermented horse milk, that Bliss gave him nearly every day, but he strongly preferred cow’s milk. Eager to help in any way, Americans latched onto this small piece of information. So that the president might have the freshest possible milk, a company in Baltimore sent him an Alderney cow, which could be seen tied up on the White House lawn. The White House cook, who was the only Catholic among the staff, poured a large glass of milk for Garfield every day. Just before she carried his tray up the winding servant stairs to his sickroom, she quietly sprinkled holy water into his glass.

Realizing that he urgently needed to find a way to feed the president, Bliss came up with an alternative to food: “enemata,” or rectal feeding. He mixed together beef bouillon—predigested with hydrochloric acid—warmed milk, egg yolk, and a little bit of opium, to help with retention. The solution, which, if absorbed, would provide protein, fatty acids, and saline, was injected into the president rectally every four hours, night and day. For a stretch of eight days, Garfield had nothing but enemata.

Then Bliss began altering the mixture. On one day he added 5 drams, or roughly 1.25 tablespoons, of whiskey. On another, he removed the egg yolk, which had been causing the president gastric pain, and replaced it with a small amount of charcoal. The danger was that, if the solution was too thick, this type of feeding could actually contribute to malnutrition rather than combat it. At first, Garfield seemed to rally, but as the days passed, he continued to lose weight at an alarming rate.

As well as being malnourished, Garfield was almost certainly suffering from profound dehydration. He had lost a dangerous amount of fluid through profuse bleeding on the day he was shot, and had continued to lose water every day, through vomiting, fever, drenching sweats, frequent enemas, and nearly constant drainage of his wound. Bliss had also been giving him almost daily doses of alcohol, from brandy to claret to whiskey, all of which are dehydrating. Not only was Garfield losing large quantities of fluid, he was not ingesting nearly enough. In a modern hospital, a sweating, feverish patient would be given at least two quarts of intravenous fluid every day. Garfield’s daily fluids never amounted to more than a single quart.

While newspapers continued to print Bliss’s assurances that the only danger to the president now was exhaustion, it was painfully apparent to anyone who saw Garfield that he could not live long. “This dreadful sickness will soon be over,” Harriet Blaine wrote to her son in late August. “Every night when I go to bed I try to brace for that telephone which I am sure before morning will send its shrill summons through our room. The morning is a little reassuring, for light itself gives courage.”

Each time she stepped into the White House, however, Harriet felt even that small source of strength slip away. It seemed that everyone she encountered, from the cook to cabinet members, had already succumbed to despair. Dr. Edson, who had spent many long nights by Garfield’s side, admitted to Harriet in a private conversation that she no longer held out hope. Robert Todd Lincoln’s “darkness,” she told her family, “is unillumined by one ray of courage.” Even Almon Rockwell, who, since the day of the shooting, had reacted with anger and indignation at the slightest suggestion that Garfield might not survive, looked as though he had already lost his old friend. His “feathers,” Harriet wrote sadly, “I imagined drooped.”

So desperate had the situation become that her husband felt that, as secretary of state, he was obliged to ask Chester Arthur to take over the president’s responsibilities, at least temporarily. “Your father [is] much exercised on the question of disability,” Harriet wrote to her daughter. “Should Arthur be brought to the front, and how?”

The Constitution was of no help. Nothing in it offered any guidance on how to determine when a president was no longer able to perform his duties. Nor was there any precedent. Only three other presidents had died while in office. Lincoln had lived only a few hours after he was shot; Zachary Taylor had succumbed to cholera in just a few days; and William Henry Harrison had survived only one month after contracting pneumonia while giving the longest inaugural address in history on a cold, rainy day. Garfield—much younger, stronger, and with a family to care for—had already lived twice as long as Harrison.

Finally, Blaine sent a cabinet member to New York to discuss the transition with the vice president. Arthur, however, made it clear that he would not even consider taking over the presidency while Garfield still lived. He refused even to return to Washington, concerned that it would appear as if he were preparing for his own inauguration. “Disappoint our fears,” his young invalid friend, Julia Sand, had urged him. “Force the nation to have faith in you. Show from the first that you have none but the purest of aims.”

In the White House, Blaine found it impossibly painful to talk to the president about any of this. Garfield, however, had no illusions about his chances of survival. When asked if he knew that he might not live, he had replied simply, “Oh, yes, I have always been conscious of that.” What worried him now was not his own death, but the suffering it would bring to those he loved most. The last letter he would write was to his mother, in the hope that he could bolster her spirits, if only for a short time. Taking a pen, he began writing in a thin, shaky script that slipped down the page.

Dear Mother,

Don’t be disturbed by conflicting reports about my condition. It is true I am still weak, but I am gaining every day, and need only time and patience to bring me through.

Give my love to all the relatives & friends, & especially to sisters Hetty and Mary.

Your loving son,

James A Garfield

Only to his wife did Garfield admit his weariness. “I wonder,” he told her one night, “if all this fight against death is worth the little pinch of life I will get anyway.” Lucretia knew that what her husband wanted more than anything now was to escape, not just from this dreary, lonely room, but from Washington altogether. He dreamed of returning to his farm in Ohio, seeing his old friends, sitting in the shade of his neighbor’s maple trees, maybe even having a slice of his aunt’s homemade bread.

If he could not go home, he hoped to go to the sea. He had never lost his childhood love of the ocean, which had seemed almost mythical to a boy from Ohio, and he wanted to see it one last time. “I have always felt that the ocean was my friend,” he had written in his diary just a few weeks before the assassination attempt. “The sight of it brings rest and peace.”