Destiny of the Republic - Candice Millard [110]
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