What do Michael Jackson, King of Pop and James A. Garfield, 20th president of the United States, have in common? For one, both were charismatic and immensely popular. Both careers ended in premature death -- Jackson at age 50, Garfield two months shy of 50. And most significantly, both involved highly questionable medical care that resulted in their deaths. In Jackson's case, Dr. Conrad Murray administered a fatal dose of a major anesthetic and is found guilty of involuntary manslaughter. The jury is still out as to who is legally accountable for the tragedy.
With Garfield, responsibility is unambiguous and quite devastating. It's the doctors who killed him, not an assassin's bullet.
A little back story here: Garfield, a major-general in the civil war, then a congressman, beat out Ulysses Grant to be the Republican presidential nominee and victor in 1881. To this date, he's the only sitting representative to ever be elected president. In Candice Millard's absorbing audio and print book, Destiny of the Republic: a Tale of Madness, Medicine and the Murder of a President, Garfield is seen as a big-hearted and warm man with an expansive laugh who prefers a bear hug over a hand shake.
He's in office only four months when a rejected and delusional office seeker shoots him in the back at a train station. You'd think a hospital is the appropriate venue for the wounded president. Apparently not. The medical establishment believes hospitals only serve the poor and are not appropriate for a president. Instead Garfield is taken to the White House, which is next to a swamp with disease-carrying mosquitoes -- not considered harmful at this time.
The physician-in-charge is a Dr. Doctor Bliss - yes, his first name is 'Doctor,' which should be a clue. Dr. Doctor believes that bad air called 'miasma' is responsible for all infections. Dr. Doctor does NOT believe in Joseph Lister's contemporary and ground-breaking bacterial theory of disease that says GERMS are the cause of infection. Lister is a British surgeon and pioneer of antiseptic surgery and the reason your mouthwash is called Listerine. Garfield's Doctor Bliss says Lister's theory is experimental medicine and outside the mainstream of medical thought.
Bliss and his team cannot imagine how a germ -- something they cannot see -- could possibly be harmful. Result: sterilization is not on their minds or their hands, which is why the doctor repeatedly sticks his unwashed finger into the president's three inch bullet wound. Bliss is more concerned with his role as the alpha-doc. To fend off anyone trying to challenge his position with his famous patient, Bliss sends out a turf warning letter saying, "At the request of the president I write to advise you that his symptoms are at present so favorable as to render unnecessary any further consultations." In other words: BUTT OUT, DOC!
Bliss' first task is to find and extract the bullet lodged in the president's back. Fortunately it hasn't hit a vital organ, which significantly helps the president's chances for recovery. A Scottish scientist called Alec Bell is brought in to help locate the bullet. He's got a metal detecting machine called an induction device. We know this man as telephone inventor Alexander Graham Bell. But neither Bliss nor Bell can find the bullet -- because the doctor is looking on the WRONG SIDE of the president's back.
On the 75th day of outrageously inept medical care, President James A. Garfield dies -- not from the bullet but from rampant infection due to septic poisoning. Following an autopsy the international medical community condemns Bliss' team saying that instead of preventing the president's death, his doctors very likely caused it. Bliss comes across as a wholly owned subsidiary of arrogance. It isn't that he can't see a solution; he can't see the problem. But he does have chutzpah. Following the president's avoidable death, Bliss presents his bill to congress for $25,000 -- equal to a half million dollars today. They pay, but well less than half of that amount.
Aside from the history-altering events that follow Garfield's death and a Chester Arthur presidency, a new phrase enters our vocabulary in 1881 that is still with us today: 'IGNORANCE IS BLISS.'
The audiobook of Millard's Destiny of the Republic is the preferred format over print because of Paul Michael's compelling narration. Instead of doing a Brick and over-playing the drama of this story, he wisely lets the events speak for themselves. Smart voice-casting on the part of Random House Audio.