The Slow Death of President Garfield: How 19th-Century Medicine Failed a Nation
When President James A. Garfield was shot on July 2, 1881, the country held its breath, but few realized that it wasn’t the assassin’s bullet that would kill him. It was the hands that tried to save him. What followed over the next 79 days was a slow, excruciating decline fueled by outdated medical practices, arrogance, and a refusal to accept modern science. Garfield’s death became one of the most tragic and preventable medical failures in American history.
The Moment of the Shooting
That summer morning, President Garfield walked into the Baltimore and Potomac Railroad Station in Washington, D.C., preparing to board a train for Massachusetts. He was accompanied by his friend and Secretary of State, James G. Blaine, and was in good spirits about his young presidency.
Out of the crowd emerged Charles J. Guiteau, a delusional office seeker who believed he deserved a government position. When his repeated requests for a diplomatic appointment were ignored, Guiteau convinced himself that Garfield’s death would be an act of divine will and fired two shots at the President from behind.
One bullet grazed Garfield’s arm. The other entered his lower back, lodging somewhere near his pancreas. It missed every major organ and artery. In a modern hospital, that kind of wound might have been survivable. But in 1881, American medicine was still trapped between old traditions and emerging science. The Medical Chaos Begins
Garfield collapsed to the floor of the train station but remained conscious. “My God, what is this?” he reportedly cried. Within moments, doctors and bystanders surrounded him, but instead of stabilizing the wound, they began to probe it with their bare fingers and unsterilized instruments.
At the time, British surgeon Joseph Lister’s antiseptic methods, which used carbolic acid and sterile instruments to prevent infection, had already gained acceptance in Europe. However, many American physicians viewed these techniques as unnecessary or even insulting. One prominent American surgeon called antiseptic practice “a fad.”
Leading the president’s care was Dr. D. Willard Bliss, a man with as much ego as medical training. His very name, ironically, stood for “Doctor Doctor Bliss.” Bliss took control of the case and dismissed any physician who questioned his methods. He insisted the bullet had lodged on the right side of Garfield’s body and focused his treatment there, despite evidence suggesting it was on the left.
For days, Bliss and his team repeatedly inserted unwashed fingers, metal probes, and rubber tubes into the wound, trying to locate the bullet. Each touch introduced new bacteria. Each day, Garfield’s fever climbed higher. Infection Takes Hold
Within a week, Garfield’s body began to betray him. Pockets of pus formed along his back and groin. His temperature spiked to dangerous levels. His appetite vanished. He vomited often and lost pounds by the day.
Still, Bliss insisted he was improving. Newspapers carried daily updates on the president’s “progress,” even as he visibly withered. The infection, what doctors at the time called “blood poisoning,” spread through his body, but without understanding germ theory, they had no concept of what they were doing wrong.
Garfield’s wound became a national obsession. The public followed every bulletin as though the country’s soul depended on it. What they didn’t know was that the bullet was not the problem. The problem was the treatment. The Bell That Couldn’t Save Him
By late July, Garfield’s condition was dire. Desperate for answers, Bliss sought help from a famous inventor, Alexander Graham Bell. Bell had been experimenting with an early metal detector, hoping to locate the bullet without further surgery.
Bell’s invention worked, but only under ideal conditions. When he brought it to the White House, Bliss interfered again, insisting Bell scan only the right side of Garfield’s body. Bell’s device found nothing. What neither man realized was that the metal coils in the bed’s mattress disrupted the machine’s signal, rendering it useless.
Tragically, when Garfield’s body was later examined, the bullet was found lodged safely on the left side, surrounded by scar tissue. It had never threatened a vital organ. A Move to the Sea
By September, Garfield was barely alive. His doctors, believing fresh air would help him heal, arranged to move him to the seaside town of Elberon, New Jersey. Engineers built a special railroad spur straight to the house where he would stay so the president could be transported without being jostled.
Crowds lined the tracks as his train passed, thousands of citizens silently watching, many with tears in their eyes. For a moment, the country seemed united in its grief and helplessness.
At the shore, Garfield’s condition briefly seemed to stabilize. He could smell the ocean from his bed, and his spirits lifted. But the infection had already spread too far. He was severely emaciated, weighing only about 130 pounds, down from more than 200. His body was riddled with abscesses, and his bloodstream was full of bacteria. The Final Hours
On the evening of September 19, 1881, Garfield suddenly clutched his chest and gasped, “Oh, Swaim, can’t you stop this pain?” Moments later, his heart gave out.
An autopsy revealed the truth that Bliss refused to see: the bullet had lodged harmlessly in soft tissue, far from any organ that could have killed him. The fatal injury came not from the shot itself but from months of infection caused by the very doctors who had sworn to save him. His death certificate might as well have listed the cause as medical ignorance. National Mourning and Hard Lessons
When word of his death reached Washington, the country plunged into mourning. Flags flew at half-staff. Crowds gathered outside the White House and the Capitol, many openly weeping. Garfield had lingered for so long that the nation had lived through every twist of his suffering as if it were a shared ordeal.
His funeral train traveled from New Jersey to Cleveland, where he was laid to rest. Along the route, tens of thousands stood silently beside the tracks to pay their respects.
The tragedy left a deep mark on American medicine and politics. Garfield’s death spurred interest in antiseptic techniques and forced many American physicians to reconsider their skepticism toward germ theory. While change came slowly, it set the stage for a new era of medical science in the United States.
Politically, the assassination and its aftermath also led to the Pendleton Civil Service Reform Act of 1883, which began dismantling the corrupt patronage system that had inspired Guiteau’s delusions in the first place. The Legacy of a Preventable Death
President Garfield’s 79-day ordeal remains a haunting reminder of how science and pride can collide. His death was not an assassination in the usual sense; it was a medical tragedy magnified by arrogance. Had his doctors washed their hands, sterilized their instruments, or listened to one another, Garfield likely would have survived.
In the years after his death, as antiseptic surgery became standard practice, American medicine finally caught up to the rest of the developed world. But that progress came at a steep price: the life of a president who might have led the nation into a new age of unity and reform.
Garfield’s story is not just about one man’s suffering. It is about the turning point where ignorance met innovation and the cost of refusing to listen to science. The bullet did not kill him. Medicine did.
ChristopherBlackwell
Such a shame. I can't imagine living back when medical knowledge was so
On a personal note, my maternal grandmother died from spinal meningitis in 1946 simply because penicillin wasn't widely available. She lingered in a hospital for 3 days before dying, leaving 8 children motherless.
If she'd gotten antibiotics, she would have easily survived. At the time, only the military had any so civilians were sh!t out of luck.
Nowhere near the national significance of a POTUS dying needlessly, but simply one story of millions that happened because of a lack of medical knowledge a/o medicines widely available today.
on February 16, 2026, 6:30 pm
