Destiny of the Republic - Candice Millard [109]
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 •
TERROR, HOPE, AND DESPAIR
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
In 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