Science Vs - How Bad Science Killed A President

Episode Date: June 6, 2019

When President Garfield was shot by an assassin in 1881, the best and brightest in medicine and science did everything they could to save him - and turned the President into a human guinea pig. But they missed something big, that could have saved him. To find out what it was, we spoke to surgeon and medical historian Dr Ira Rutkow, and Sara Murphy - collections manager at the National Museum of American History. To find out more about this story, read Dr Ira Rutkow’s book - James A. Garfield: The American Presidents Series. Check out the transcript, with all the citations here: http://bit.ly/33EMVl7 This episode was produced by Kaitlyn Sawrey with help from Wendy Zukerman, along with Meryl Horn, Rose Rimler and Michelle Dang. We’re edited by Blythe Terrell, extra editing help from Caitlin Kenny. Fact checking by Michelle Harris. Mix and sound design by Peter Leonard. Music written by Emma Munger, Peter Leonard, and Bobby Lord. Thanks to the National Museum of American History, Dr Howard Markel, Prof. Charles Rosenburg and Candice Millard.  Learn more about your ad choices. Visit podcastchoices.com/adchoices

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And this is... Quantum Magazine's podcast, The Joy of Why. New episodes drop every other Thursday, starting February 1st. Hi, I'm Wendy Zuckerman, and you're listening to Science Versus from Gimlet. On today's show, it's story time with Caitlin Zorri. Hello. Katie is the senior producer here at Science Versus and you've come to me with a story. I've come to you with a story. Ooh, a tale. A tale of science, madness and murder. Let's get into it. Okay, so I've got to take you back to 1881. The Civil War, still fresh.

The telephone has recently been invented. And this guy, James Garfield, has just been elected president. This is how I want to introduce it. That's my Washington, D.C. Wendy's famous mouth trumpet. Do we like this Garfield fella? What do you think of him? We do like him, actually.

Garfield was a general in the Union Army. He was very anti-slavery. And he was a thoughtful guy. He liked to read. And fun nerd fact, you're going to love this. He is the only president to have ever proved a math theorem. Well. Right?

Garfield seemed destined for greatness, but he didn't get a chance to be great because he was assassinated. Oh. So to get into this story, I've got to take you somewhere. I'm going to take you to the National Museum of American History in Washington, D.C. Oh, you have your own real music. I do.

Oh, you didn't need the mouth drop, but I understand. This is like a nerd's dream, getting to be in a museum before the pitfall turn up. Yes, we're going to go this way. And to help us tell this story is Sarah Murphy. I am a collections manager in the Division of Political and Military History. And I got talking to Sarah about the guy who shot President Garfield, and the assassin's name was Charles Gatteau. He was a little mentally unbalanced. He had delusions of grandeur.

So Gatteau tries to get a job with the government. They reject him for that job. And that tips him over the edge. And soon he thinks that God is talking to him and telling him that he's got to do something. And then he just got in his head that he was being told by God that he needed to remove Garfield. So Guiteau buys a gun and he starts following Garfield. And in 1881, the president doesn't have a security detail. So Garfield is a sitting duck. He was basically stalking the president and watching where he was going. How long for?

A couple of weeks. He's taking notes on everywhere he's going and basically figuring out when he's going to try and shoot him. And the president, of course, has no idea he's in danger. And on the morning of July 2nd, 1881, Garfield's going out of town. The president's going on summer vacation because it's the middle of summer holidays. And he heads to the train station to start his holiday. Like, they got out of their carriages and walked in and they had just gotten inside.

Like, they weren't, because Guiteau was waiting for them. He knew that they were going to the train station that day. So he was essentially laying in wait. He had just this look on his face of, like, calm and collected and raised his gun and... ..fired the first shot that grazed Garfield's arm. And that's when Garfield was like, oh, my God, what is this?

Guto shoots again. This one nails President Garfield in the back. The president falls to the ground and all hell breaks loose. But he doesn't die straight away. And in the fight to save him, the best and the brightest throw everything at him. They invent new technology and they basically treat the president like a human guinea pig.

Ooh, yeah, things get gross. But interestingly, the treatment of Garfield actually has a huge influence on American medicine. Oh. And that's the story I'm going to tell you after the break. Welcome back. So Caitlin Sorey, our senior producer, is here with me and she has just started telling us a story about a president, President Garfield, who's just been shot in a train station.

And apparently what's going to happen next is going to change the course of American medicine. Yeah, so people grab the assassin, Gatteau. They carry him off to prison. But meanwhile, President Garfield is alive. He's not looking good, though. He's vomiting, he's bleeding everywhere. A bunch of doctors are called.

And this is actually the moment where our story really starts. They're doing whatever they could, which means they're giving him tonics to revitalize them. They're giving him shots of morphine, tons and tons of morphine. This is Dr. Ira Rutko. He's a surgeon and a medical historian. He wrote a book about President Garfield. And so the president's bleeding at the train station. And Ira says the people on the scene knew exactly who to get. Dr. Bliss. Bliss was one of the best known physicians in Washington, D.C. at the time. And so they wanted somebody with expertise. And it was Dr. Willard Bliss.

Willard was actually his middle name? What was his first name? Doctor was his actual first name. So if you were going to address him, you would have to have said Dr. Dr. Bliss. So Dr. Dr. Bliss. Yeah, Dr. Dr. Bliss turns up and he takes control because he's a military guy. He's got lots of experience and he's like, I'm the only one who knows how to fix this. Move aside. Bliss, who at that point was running the show, was a very dogmatic, autocratic

doctor slash surgeon. And he was not about to take any guff from anybody. He was the man in charge. So Dr. Dr. Bliss and co. take Garfield back to the White House and try to make him comfortable. And the president has a fever, so they're trying to do everything they can to cool him down. They actually call in naval engineers and try and construct one of the world's first air conditioning units. Oh, wow. Yeah. But it's a little bit more rustic than what you're imagining. Right. Basically, it was blocks of ice and they would run a fan and have cold air going into the room. Did it work? I mean, it cooled the room down, didn't stop the president's fever. But of course, like, that's not the only thing they're doing to

try and help the president. In fact, the doctors become fixated on removing the bullet from his body. The major thing that Dr. Bliss and all the doctors were worried about is where is the bullet? And why was it so important to find the bullet? Yeah. So reading reports at the time, doctors were worried that it may have hit an internal organ, like it might be messing with the liver or the intestines. And like this question just gets talked a lot about in the press. It's like, where is the bullet? And that question catches the eye of a brilliant inventor, a dashing young Alexander Graham Bell, the man behind the telephone. Well, yes, this is a cast of characters. It really is. And so for context, like Bell at this point, he's behind the telephone. Well. Yes. This is a cast of characters. It really is.

And so for context, like Bell at this point, he's invented the telephone. People know who he is. But all of these people are claiming that they also invented the telephone. So he's involved in all these lawsuits and he's just kind of getting dragged into it. And he's like, I just want to get back to inventing and tinkering around. And he gets in touch with Dr. Bliss to say, I can help save the president. I might have an invention. And it's basically one of the world's first metal detectors,

or what he calls an induction balance. Ooh, induction balance. That sounds very... More mouse trouble. I actually went to look at it because it's held at the museum where sarah works okay so the induction balance is a square wood block with a wooden handle it really looks like a ye olde contraption it does so it's like a wooden block with some cords hanging off it. And at one point it was connected to a phone receiver. And there would be an electric current that would run between two coils.

So when a bit of metal came close, you'd hear a sound because the metal was interrupting the electrical field. Oh, that's so clever. Yeah. He knew what all of the little hums and buzzes and clacks and creaks meant. So it's not like a modern metal detector. It's like, beep, beep, beep, beep. No, not at all.

Alexander Grainbell, he's a good scientist, so he runs a bunch of tests before he tries it out on the president. He finds some Civil War soldiers who've got some bullets stuck in them still and tries it on them. Amazing. He also heads down to the butcher. They also would get hunks of raw beef and hide bullets in there and test it. So he knew this would work. Oh my gosh, that's like the most horrifying game of like an Easter egg hunt. Hide the bullet in the meat. And find it.

Wow, but it worked. I mean, this is working. Yeah, totally. So like Alexander Graham Bell has done all these tests. He's feeling quietly confident. And by now it's been about a month since Garfield was shot. So Bell rocks up to the White House to hook up the induction balance to Garfield under the strict supervision of Dr. Dr. Bliss. They hear some sounds, some pops, some cracks, some hums that might be something,

but Graham Bell isn't really convinced. Huh. So what's going on? Yeah, it's kind of a letdown. The machine makes some noises, but it's not like super definitive that this is the bullet. But why did it work in the hunks of meat and not in the president, who is effectively a hunk of meat? Well, the president was lying on a new contraption that Alexander Bell hadn't thought about. Oh, it could have been some of the mattress, the wire spring mattress.

So that was also creating some interference. No. Yeah. The president was lying on one of the few metal spring mattresses in the country at the time. Yeah. So maybe the induction balance was actually picking up the metal in the springs rather than the actual bullet. And Bell wrote a paper later and he said this might have been one of the reasons why it didn't seem to work.

Oh, wow. Yeah. But anyway, this doesn't help the president. It's just another dead end. Meanwhile, it's been a month since he's been shot and Garfield is going downhill. Alexander Bell, when he saw him, wrote a letter about it at the time describing the president. He said, quote,

His face is very pale, or rather it is of an ashen grey colour which makes one feel for a moment you are not looking upon a living man. End quote. Here's Dr Ira Rotko again. He was just fading away. Other people coming in, they were shocked by his appearance because he didn't look like anything that was human anymore. So President Garfield is not looking good

and letters come in from across the country with suggestions on how to save him. And a lot of these are nonsense. But there was one message that might have saved his life, but do his doctors take it seriously? Do they? That's coming up after the break. Welcome back. We've just been hearing the story of President Garfield, who was shot in the late 1800s.

The best scientists of the day are trying to save him, and Caitlin Sori, our senior producer, is telling us this story. Katie. Hello. What happens next? Well, there's all these letters from the public. Everyone's got an idea on how to save the president. Someone wrote in suggesting a suction machine that could suck out a bullet.

Oh, like a vacuum cleaner. Something like that. Someone else wrote in to suggest hanging the president upside down and just shaking the bullet out of him. I forget we're in the 1800s, but that sounds about right for medicine of the time. Yeah, totally. But amongst all of these unhelpful letters, there was actually some gold in there. This doctor from Kansas got in touch and he was like, maybe you should not worry about getting it out.

Maybe we should just like leave the bullet in there. Why would he say that? Because Garfield's doctors were looking for the bullet by using their grubby fingers in the wound. Here's Ira. So these men had bad germs all over their hands, be it horse manure or other things. So they were all sticking their fingers into this hole. And then they proceeded to stick probes, metal probes into the hole. And these instruments were not washed. So the instrument that they used on you, they would use on me. Oh, so they don't know about bacteria? Well, it's complicated because it's all pretty new. And to really understand what's going on, I want to tell you about the guy who worked out that bacteria was important here.

And he figured this out more than a decade before Garfield was shot. Oh. Yeah. So his name was Joseph Lister and he was a surgeon in Scotland. And he was seeing all sorts of really horrible things in the hospital there. He would see people coming in with, like, say, a really badly broken arm and their wound would get all weird and then their body would just start producing all of this pus.

Ew. Yeah. The surgeons would literally have buckets of pus that they would collect from patients who would just ooze just tons of pus out of their incisions or out of their wounds. So many people were dying from stuff like gangrene and sepsis, and no one really knew why it was happening. And then Lister starts reading these papers that described little bacteria

that were causing stuff to ferment and go rotten, like stuff like beer and wine and milk. Lister picked up the idea of germs and bacteria and said, hmm, I wonder if that's connected. I wonder if bacteria is connected to what I'm seeing in the hospital. Maybe. There are these little things that you and I can't see called bacteria cause big problems,

especially in the world of medicine and surgery. So he thinks bacteria are the problem here, but now he has to figure out how to kill them. So he starts experimenting with different chemicals to see what will kill infections in wounds or stop them from starting. And he has to try a few different things before he hits upon a chemical that will work, carbolic acid. And he showed that it actually killed bacteria. And once he finds this, he just goes mad for it. He starts covering everything in carbolic acid. He'd wash his hands in it, his tools, the bandages. He starts spraying the air with carbolic acid with like this little foot pedal. And when he starts doing this, he has amazing results.

Like before he started using a septic, about half his patients were dying from infection after surgery. Once he starts using carbolic acid, it drops to 15%. So it went from around 50% to 15%. Yeah, it had this huge effect. And when these experiments were published in 1867, people got really excited, particularly in Europe. So by the mid-1870s, doctors in Germany were following his methods to a T and they saw great results, like they were saving lives. Wait, so then why weren't Garfield's doctors following this?

Like, did they know about this in America? So Lister toured America about five years before Garfield was shot and he gave lectures, he did a surgery in front of medical students and he was really trying to get his ideas about infection and antiseptics to catch on. And people had shouted at him that he had no idea what he was talking about. A very famous American doctor said he has no idea what he was talking about. A very famous American doctor said he has a grasshopper in his head, meaning that he was crazy. He's got

a grasshopper in his head. And there are some people who got it in America, but they tended to be the younger doctors. But the big problem is that because these older doctors don't believe in it and they are the ones who are treating Garfields. This is a classic example of generational divide. They didn't believe in it. This is so frustrating though. Like why didn't they listen? I mean, from their perspective, there's a lot of kooks in medicine at this time. They also had to get their head around this idea of bacteria,

like tiny little microscopic creatures covering everything. That's a wild idea. It would be like if I told you today that there's another dimension out there, and that dimension is occupied by aliens, and we can't see them, and they can barely see us, but they're around all the time looking at us when we're in our bedrooms, when we're doing whatever. They are there, okay? If I said that to you today, you would look at me and what would you say? That sounds crazy.

Exactly, and that's exactly what people said. So you can kind of understand why some doctors would be skeptical of this idea, but what it means is that Garfield is getting worse and worse. Infections are running rampant throughout his body. And six weeks after getting shot, it's getting really serious. Like there's these pockets of pus that are coming to the surface that his doctors have to keep lancing to let the pus out. He was getting so sick that an abscess developed in his jaw and then exploded in his mouth. Yeah, it was grotty.

So the pus is coming out and you're swallowing the pus and you can theoretically drown because it's so much pus. By the middle of August, he can no longer eat. And Dr. Bliss is desperate to keep him alive. So he's like, how am I going to feed this guy if he can't eat? And he decides to try up the butt. So Dr. Bliss starts giving President Garfield nutritional enemas, and they've got things like beef bouillon and eggs in them. And then up the butt.

Up the butt, right. So it's just like the eggs really make the whole situation gross. It caused him severe flatulence. His gas became horrendous. People couldn't stay in the room because of the smell of the gas. Amongst all this farting and wild medical ideas, the president is dying. He drops a ton of weight. He goes from being about 210 pounds, so a pretty big guy, to 130 pounds. And then on

September 19, 1881, two and a half months after being shot, Garfield finally dies. The American flag in the window of his room is covered in black and bells across the US start ringing to announce his death. The next day, the doctors open him up to see what was happening inside his body. Bliss is there for the autopsy. And weirdly, even though these doctors don't clearly believe in bacteria, they look at him and say he died with a really bad blood infection or septicemia in his system. But they don't point the finger at their grubby fingers. They blame the infection on a broken back. A broken back? Yeah. They say the bullet hit his spine and fractured it and that's where the infection came from. What? Yeah. And when they released the autopsy to the public,

it triggers a debate in the science world. Well, I would hope so. There were older people, older physicians who said, listen, you guys were perfect. You did everything that you could do as doctors. Just it's too bad he died. You know, but he died. Yeah.

So on the other side of like these young guns who believe in germ theory, who are like, what are you talking about? This broken back thing doesn't make any sense. And there's this scathing speech that was translated from a German doctor who just like totally went for Garfield's doctors. Trust the Germans to like germ theory. Right. It was published in the Boston Medical and Surgical Journal, So it got a lot of eyes on it in America. And this German doctor says, look, Garfield's guys messed this up royally. If they hadn't dug around for the bullet,

the president would be alive. Wow. Yeah. And Ira agrees with that, actually. When we asked him, what do you think killed Garfield, this is what he had to say. I think the state of the art of medicine is what killed Garfield. They didn't understand antisepsis. They didn't understand hand washing. They didn't understand washing instruments. I mean, we can't know for sure if Garfield would have survived.

We don't have a time machine. But we do know that doctors were introducing germs into his body and that he had massive infections. Right. So, I mean, obviously the bullet was a big problem here, but it is really looking like the grubby fingers played a big part in his death. I think that's fair. But what's interesting here is that this very public test case of germ theory

and all the debate that happened around it started to move the needle towards the younger generation of doctors who did believe in germ theory. I firmly believe that the assassination and death of Garfield absolutely pushed the country, the doctors and the public for that matter, into greater acceptance of antisepsis. And that was fundamental, a fundamental change. So by the end of the decade, just nine years after Garfield died, you start to see some real changes in American medicine. Doctors believe in germs more

often than not. They're using antiseptic. They're sterilizing their instruments. They're wearing clean gowns. And deaths from infection started rapidly dropping. So it's not just Garfield's death that pushed them in the right direction, but the president's death was important. What are we to make of this story? Like, you know, on the one hand, I think that Dr. Dr. Bliss and co. are so frustrating. But then on the other hand, like, I get that bacteria would have been this weird concept before the 21st century. Yeah, we're kind of playing Monday morning quarterback, but 140 years later.

Right. I mean, Dr Bliss, he was just a man of his time. He was a product of his generation. It really does make you wonder, like, what are the old-timey establishment doctors of today saying that 140 years in the future we will be laughing at and being horrified by? Yeah. It's not so simple when you're there, in the moment.

That's science versus. That's science versus. If you want to know more about this story, you can check out our show notes. That's science versus. the season and we're taking on sharks. Should you be afraid of the big bad waiting in the water this summer? I knew that it was bad because I saw its entire mouth clamped down on my arm. Oh my God. It was a f***ing shark. Run and call a f***ing ambulance. This episode was produced by Caitlin Sori, with help from me, Wendy Zuckerman, along with Meryl Horne, Rose Rimler and Michelle Dang.

We're edited by Blythe Terrell. Extra editing help from Caitlin Kenny. Fact-checking by Michelle Harris. Mix and sound design by Peter Leonard. Music written by Emma Munger, Peter Leonard and Bobby Lord. Thanks to the National Museum of American History, Dr Howard Markle, Charles Rosenberg and Candice Millett. I'm Wendy Zuckerman.

Back to you next time.