Destiny of the Republic: A Tale of Madness, Medicine and the Murder of a President, Page 2

  Next door to Machinery Hall, where Garfield spent his first day at the fair, was the Main Exhibition Building, a twenty-one-acre, glass-enclosed behemoth. Inside, at the far east end of the building, past row after row of dazzling exhibits from far-flung nations, was a small staircase that led upstairs to a quiet, easily overlooked gallery. In one corner of that gallery, bent over a rough, wooden table that held a collection of mysterious-looking brass-and-wood instruments, was a serious young Scotsman named Alexander Graham Bell.

  The invention Bell had brought with him from Boston was “a new apparatus operated by the human voice”—the telephone. He had won a patent for it just three months earlier, and he knew that the fair was his best opportunity to prove that it really worked. He had come to Philadelphia, however, with great reluctance, and with each passing day he had only grown more convinced that he should have stayed home.

  Bell’s principal work was not inventing, but teaching the deaf. He had inherited this work from his father, but he loved it with a passion that was all his own, and he was astonishingly good at it. Even the emperor of Brazil, on a recent break from the Centennial Exhibition, had visited Bell’s classroom in Boston. Bell’s school would administer its annual exams the next day. It was the most important day of the year for his students, and not being there to help them prepare made him miserable.

  From the moment Bell had stepped off the train, he had encountered one disaster after another. He suffered from debilitating headaches brought on by extreme heat, and Philadelphia was in the grip of a brutal heat wave. To his horror, when he examined his luggage, he discovered that some of his equipment had been lost in transit. Worse, what had arrived was damaged.

  When Bell had finally reached the fairgrounds and entered the Main Exhibition Building, he realized that not only was his telephone broken and incomplete, but his exhibit would be nearly impossible to find. Because of his reluctance to attend the fair, he had missed the official deadline for registering. His fiancée’s father, Gardiner Greene Hubbard, who was a member of the Massachusetts Centennial Committee and who had been urging Bell for months to enter his invention, had secured an exhibit space for him at the eleventh hour, but it was arguably the least desirable location in the entire hall. Instead of being taken to the electrical exhibits, Bell had been led upstairs to the Massachusetts educational section, his small table wedged between an exhibit of pipe organs and a collection of educational pamphlets. His invention would not even be listed in the fair’s program.

  Bell’s only hope lay in the cluster of exhausted, sweat-soaked judges that wearily made its way through the Main Exhibition Building one morning, examining a seemingly endless array of inventions. For days, Bell had worked feverishly on his equipment, desperately trying to repair the damage that had been done on the journey from Boston. There was little he could do, however, to make it seem exciting. In comparison to the colossal engines and locomotives in Machinery Hall and the rows of whirring contraptions in the electrical aisles, his small, battered machines seemed hopelessly unimpressive and inconsequential.

  Fearing that he would be forgotten altogether if he stayed upstairs, Bell made the long journey down to where the judges were gathered in the central hall. As the sun beat down mercilessly through the glass roof, the judges, sweltering in their stiff, formal suits, suddenly decided that they’d had enough. Unanimously, they agreed to end the day early. They would see only one more exhibit.

  Standing near enough to overhear their conversation, Bell realized that he had lost his only chance. All the time, expense, and effort he had poured into the fair, all the frustration and misery, were for nothing. Even if the judges returned the following day, they would never see his invention. By then, he would be back in Boston.

  As Bell stood in silence, watching the judges turn their backs to him and begin to walk away, he suddenly heard a familiar voice. “How do you do, Mr. Bell?” Surprised, he turned to find Emperor Dom Pedro II of Brazil, his full, white beard neatly trimmed, his deep-set eyes bright with curiosity, looking directly at him. A passionate promoter of the sciences, Dom Pedro had asked to accompany the judges on their rounds that morning, perfectly happy to be in the tropical-like heat that reminded him of home. When he saw Bell standing in the crowd of some fifty judges and a handful of hovering inventors, he immediately recognized him as the talented teacher of the deaf whom he had met in Boston.

  Eager as they were to leave, the judges could not go anywhere without Dom Pedro, who was not only the leader of a large country but, with his irrepressible energy and enthusiasm, had become the darling of the centennial fair. With the judges waiting anxiously nearby, the emperor struck up a leisurely conversation with the young teacher. When Bell told him that he had come to the fair hoping to show an invention, but would have to leave early in the morning, Dom Pedro reacted with characteristic vigor. “Ah!” he exclaimed. “Then we must have a look at it now.” Taking Bell’s arm in his own, he strode toward the stairs, a long line of judges shuffling resignedly behind.

  After the group had crossed the vast hall and climbed to the remote gallery, Bell led them to his table, around which he had optimistically arranged a few chairs. Among the various instruments assembled was something that Bell called an “iron box receiver,” a vertical metal cylinder that had a thin diaphragm in the center and had been secured to a square block of wood. Wires leading from the receiver had been strung along the gallery railing, disappearing into a small room about a hundred yards away. As the judges gathered around him, Bell explained his invention, the telephone. It was, he cautioned, but an “embryo of an idea.” However, with it, he had achieved something extraordinary—the electrical transmission of the human voice.

  With his audience’s full attention now, Bell crossed the gallery to the room where the wires led. Leaning into a transmitter he had set up earlier in the day, he slowly began to recite Hamlet’s famous soliloquy. For Bell, it was a natural choice. He had known the speech by heart since he was fourteen, when his grandfather had taught it to him in Scotland. As he spoke, Shakespeare’s words now traveled by wire, traversing the gallery to where the judges waited in suspense.

  Sitting at the table, with the iron box receiver pressed tightly to his ear, Dom Pedro heard an extraordinary sound—Bell’s voice, heart-wrenchingly clear. “To be, or not to be,” he said. Leaping from his chair, the emperor shouted, “I hear! I hear!” As the knot of judges watched in amazement, he turned toward the room at the far end of the gallery and raced off, “at a very un-emperor-like-gait.” Moments later, Bell, who was still reciting the soliloquy, with no understanding of the effect it had had, suddenly heard the unmistakable sound of pounding feet. Looking up, he saw the emperor of Brazil charging toward him, flush with excitement.

  In that moment, Bell’s life was transformed. To the rest of the world, he would no longer be a teacher, or even simply an inventor, but the creator of the telephone. Even as he watched the emperor’s eyes flash with joy and amazement, however, Bell knew that he would reach far beyond this one invention. His mind was too crowded, and his heart too hopeful, to stop here.

  While Bell’s technological innovation caught fire in an instant of understanding, on the same fairgrounds, in a building just yards away, Joseph Lister’s discovery, one of the most important advances in medical history, was lightly dismissed. Standing before a crowded hall at the centennial fair’s Medical Congress, the British surgeon struggled to convince his audience, a collection of the most experienced and admired physicians and surgeons in the United States, of the critical importance of antisepsis—preventing infection by destroying germs. Although the men listened politely, very few of them believed what Lister was telling them, and almost none of them seriously considered putting his theory into practice.

  At a time when many well-respected scientists still scoffed at the idea of germs, Lister’s time-consuming and complicated system for destroying them seemed ridiculous. Lister, however, knew that the difference between his method and the
old method was nothing less than the difference between life and death. He had developed antiseptic medicine eleven years earlier, after realizing that the same microorganisms that caused wine to ferment in Louis Pasteur’s experiments must also cause infection in wounds. Lister applied this theory to his own patients, creating an elaborate system of sterilization using carbolic acid, and transforming his surgical ward from the typical foul-smelling horror chamber that defined nineteenth-century hospitals to a place of daily miracles.

  Although the results were dramatic—the death rate among Lister’s surgical patients immediately plummeted—antisepsis had provoked reactions of deep skepticism, even fury. In England, Lister had been forced repeatedly to defend his theory against attacks from enraged doctors. “The whole theory of antisepsis is not only absurd,” one surgeon seethed, “it is a positive injury.” Another charged that Lister’s “methods would be a return to the darkest days of ancient surgery.”

  By 1876, Lister’s steady and astonishing success had silenced nearly all of his detractors at home and in Europe. The United States, however, remained inexplicably resistant. Most American doctors simply shrugged off Lister’s findings, uninterested and unimpressed. Even Dr. Samuel Gross, the president of the Medical Congress and arguably the most famous surgeon in the country, regarded antisepsis as useless, even dangerous. “Little, if any faith, is placed by any enlightened or experienced surgeon on this side of the Atlantic in the so-called carbolic acid treatment of Professor Lister,” Gross wrote imperiously.

  The medical breakthroughs that won the attention and admiration of men like Gross were those they could readily understand. All around the Medical Congress, throughout the centennial fair, were examples of this type of practical progress. There was a much-admired exhibit of artificial limbs, “The Palmer Leg and Arm,” which were of particular interest in the wake of the Civil War. Dr. B. Frank Palmer himself wore an articulated leg of his own design, with impressive results. “We did not in the least suspect that he had himself been provided with one of his own artificial limbs,” marveled one of the judges. Down another aisle stood a pyramid of eight hundred ounces of pure morphine, and there were table after table of new and improved medical tools. Admiring a sturdy saw meant for amputations, one surgeon asked rhetorically, “Who has not experienced the annoyance, in the middle of an operation, of the saw breaking or becoming wedged in the bone so tightly as to be disengaged with difficulty?”

  The dangers Lister described were very different from, and far more lethal than, broken saws and inadequate prosthetics. They could not be seen by the naked eye, and many of the doctors in the audience still did not believe they existed. Despite the prevailing skepticism about his discovery, however, Lister refused to give up. If the scientific evidence he presented was not enough, he would appeal to something more powerful than logic: vanity. He would remind these doctors who they were, and what they, as a nation, had achieved. “American surgeons are renowned throughout the world for their inventive genius, and boldness and skill in execution,” he said. “It is to America that we owe anesthesia, the greatest boon ever conferred upon suffering humanity by human means.” After listing several other discoveries that were the result of American intelligence and industry, Lister beseeched his audience to cast aside their egos and listen to him. He was there, he said, in the hope that they would finally accept “the truth, the value, and the practical application of the principles of Antiseptic Surgery.”

  For three hours, Lister did all he could to persuade his audience. He explained his process, gave examples from his own surgical studies, and met each of the doctors’ criticisms, one by one. To the common complaint that antisepsis was “too much trouble,” he replied simply, “It is worth some trouble to be able to seal up an amputation, an exsection, or a large wound, with the absolute certainty that no evil effects will follow.”

  Seated in the audience, listening to Lister, was Dr. Frank Hamilton, a highly regarded surgeon from New York who would one day, quite literally, hold James Garfield’s fate in his hands. When given an opportunity to speak, Hamilton assured Lister that he would be “glad to have you convince us that your method is the best.” In his own practice, however, Hamilton preferred to use methods that were quite different from antisepsis. Among them was the “ ‘open-air treatment,’ in which no dressings whatever are employed, but the wound is left open to the air, the discharges being permitted to drop into proper receptacles, or to dry upon the surface.” Hamilton also highly recommended soaking dressings in warm water, and then applying them directly to open wounds.

  A few weeks after Lister tried in vain to persuade men like Hamilton that, without antisepsis, they risked the very real danger of killing their patients, James Garfield was descending, once again, into what he knew as the “darkness of death.” At his home in Washington, he watched helplessly as his youngest child, Neddie, a beautiful little boy who had contracted whooping cough soon after attending the centennial fair, died in his small bed.

  After he had lost Trot, so many years earlier, Garfield had thought he could never again feel such an all-consuming sorrow. He realized now how wrong he had been. “I am trying to see through it the deep meaning and lesson of this death,” he wrote. “God help me to use the heavy lesson for the good of those of us who remain.” Despite his belief in the goodness of God, however, Garfield knew that death was cruel, unpredictable, and, too often, unpreventable. Perhaps even harder to accept was that the science he so deeply admired, for all its awe-inspiring potential, seemed powerless in the face of it.

  Searching for a way to teach his children this hard truth, to prepare them for what inevitably lay ahead, Garfield had often turned to what he knew best—books. After dinner one evening, he pulled a copy of Shakespeare’s Othello off the shelf and began to read the tragedy aloud. “The children were not pleased with the way the story came out,” he admitted in his diary, but he hoped that they would come to “appreciate stories that [do not] come out well, for they are very much like a good deal of life.”

  • CHAPTER 2 •

  PROVIDENCE

  I never meet a ragged boy in the street without feeling that I may owe him a salute, for I know not what possibilities may be buttoned up under his coat.

  JAMES A. GARFIELD

  James Garfield’s father, Abram, had died on a spring day in 1833, just a few months after his thirty-third birthday. As he had peered out a window that day, surveying the farmland he had just saved from a raging wildfire, he had known that he would not survive the “violent cold” that had so suddenly seized him. The house he would die in was a log cabin he had built four years earlier. It consisted of one room, three small windows, and a rough, wooden plank floor. The windowpanes were made of oiled paper, and the gaps between the logs were filled with clay in a futile attempt to shut out the brutal Ohio winters. The house and the land were all his family had, and he had done everything he could to protect them from the fire.

  Like his ancestors, who had sailed from Chester, England, to Massachusetts in 1630, just ten years after the Mayflower, Abram had left all he knew in search of a better life. His father had stayed in the East, on a small farm in New York, but as a very young man Abram had set his sights on the West. In 1819, he and his half brother Amos packed their bags and moved to Ohio. After several years of struggling to make a living, Abram took a job helping to build the Ohio and Erie Canal, as he had helped to build the Erie Canal when he was a teenager.

  In the early 1800s, Ohio was the American frontier. Wild and largely unmapped, it had not joined the Union until 1803, becoming the country’s seventeenth state. Ohio was the first state to be created out of the Northwest Territory. Iroquois and Shawnee tribes were still scattered throughout the Ohio Valley, fiercely fighting for the little land they had left, but time was running out. They had lost their British allies after the War of 1812, and Andrew Jackson would pass the Indian Removal Act less than twenty years later, forcing them all onto reservations.

  Althou
gh land was available for two dollars an acre, ten years would pass before Abram and Amos had saved enough money for a farm. Soon after their arrival, they met and married a pair of sisters from New Hampshire named Eliza and Alpha Ballou. In 1829 the two couples, now with children of their own, bought a hundred acres of heavily wooded land in Cuyahoga County. They were just sixteen miles from Cleveland but two miles from the nearest road, surrounded by a vast, thick forest. It was the life they had hoped for, but it was far from easy.

  When Abram had seen the wildfire racing toward his cabin, he had met it with equal ferocity. He worked all day, digging ditches, hacking away brush, and fighting back the roaring, choking flames. Somehow, miraculously, he had saved his farm, but his victory came at a high cost. Although he was young and strong, he was also poor and isolated. With no medical care beyond an unlicensed, itinerate doctor, he quickly succumbed to exhaustion and fever. Within days, he would die, keenly aware that he was leaving Eliza with four children to feed. Their youngest, James, not yet two years old.

  There would come a time when the story of James Garfield’s early life would be widely admired. Throughout the nation and around the world, his extraordinary rise from fatherlessness and abject poverty would make him the embodiment of the American dream. Garfield himself, however, refused ever to romanticize his childhood. “Let us never praise poverty,” he would write to a friend, “for a child at least.”

  Even by the standards of the hardscrabble rural region in which he lived, Garfield was raised in desperate circumstances. His mother, left with debts she could not hope to pay after her husband’s death, was forced to sell much of their land. What was left, she farmed herself with the help of her oldest son, James’s eleven-year-old brother, Thomas. Between them, working as hard as they could, they managed to avoid giving the younger children to more prosperous families to raise, as their relatives had advised them to do. So little did they have to spare, however, that James did not have a pair of shoes until he was four years old.