Born into poverty in the woods of Ohio, James Garfield rose through the strata of American society on the strength of his intellect and strong work ethic. A civil war hero, he was elected the twentieth president of the United States in 1880. Just a few months later, a deranged office-seeker shot Garfield at a Washington train station. With the assassination of Abraham Lincoln still fresh in their minds, the American people once again watched helplessly as their president lay dying. The extraordinary life of James Garfield, the doctors who failed to save him from death, and how a senseless tragedy unified the country.


  • Candice Millard New York Times bestselling author of "The River of Doubt"; former editor and writer at National Geographic Magazine

Program Highlights

Four months after President James Garfield took office, an insane officer seeker named Charles Guiteau shot him twice with a pistol. A team of surgeons, and even Alexander Graham Bell, could not save him. Author Candice Millard tells a story of President Garfield’s inspiring life and tragic death – and why it was, in fact, a preventable infection and not an assassin’s bullet that actually killed him.

Garfield “Absolutely Extraordinary”

According to Millard, Garfield was a brilliant man who was born into extreme poverty and ended up putting himself through college. His first year at college, he was a carpenter and a janitor. By the second year, he was made a professor of literature and ancient languages. And by the time he was 26, he was the university President.

He Never Sought the Presidency

Millard: “Garfield never had what he called ‘Presidential fever.'” He traveled to the Republican convention in 1880 to give the nominating address for someone else. But his speech was so good that at one point during it, when he uttered “What do we want?” someone shouted, “Garfield!” and people started essentially writing him in to vote for him.

The Assassin’s Profile

Garfield’s assassin was a man named Charles Guiteau, who had tried many paths in life but failed at them all. Tragically, Guiteau was obviously mentally ill and delusional. He campaigned hard for Garfield and eventually came to believe that because of his work, Garfield would reward him with an ambassadorship or some appointment. Guiteau shot Garfield at point-blank range on July 2, 1881, at a railway station in downtown Washington D.C.

Lack of Medical Knowledge

Though Joseph Lister, a British surgeon, had already discovered antisepses, the medical community in the U.S. still did not really believe in germs, and Garfield’s doctors “…certainly weren’t going to go to all the trouble that antisepsis required.” They didn’t wash or change their surgical aprons, and sometimes if they driopped an instrument during surgery they would pick it up and keep using it. Some younger doctors in the states were more open to Lister’s ideas, but many of the older, well-respected, more established doctors were not.

Botched Care

After Garfield was shot, his doctors probed for the bullet that had lodged in his back, causing an infection to spread and fester. In a real sense, the care he received was more traumatic to his body than the shooting had been. “He suffered incredibly,” Millard said. “He would have been better off if they had just left him alone.”

Read the full transcript.

Read an Excerpt

Excerpted from Destiny of the Republic: A Tale of Madness, Medicine, and the Murder of a President by Candice Millard Copyright 2011 by Candice Millard. Excerpted by permission of Doubleday, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.


  • 12:06:55

    MS. DIANE REHMThanks for joining us, I'm Diane Rehm. Four months after President James Garfield took office, an insane officer seeker named Charles Guiteau shot him twice with a pistol. A team of surgeons and even Alexander Graham Bell, could not save him. Candice Millard tells a story of President Garfield's inspiring life and tragic death. And why it was, in fact, a preventable infection and not an assassin's bullet that actually killed him.

  • 12:07:39

    MS. DIANE REHMHer new book is titled "Destiny of the Republic." Candice Millard joins me in the studio. You are welcome to join us as well 800-433-8850. Send us your e-mail to, join us on Facebook or Twitter. Good morning to you, Candice.

  • 12:08:09

    MS. CANDICE MILLARDGood morning.

  • 12:08:11

    REHMJames Garfield is not very well known by anyone, perhaps in fact, because he spent so little time in office. Why did you select him?

  • 12:08:27

    MILLARDYou know, to be honest, I didn't know much about James Garfield either when I began researching this book, beyond the fact that he had been assassinated. And I wasn't necessarily interested in writing about another President. I'd written a book a few years earlier about Theodore Roosevelt. I was interested in writing about science.

  • 12:08:43

    MILLARDAnd I was doing some research on Alexander Graham Bell. And I stumbled upon this story of him trying to help find the bullet in Garfield's back after Garfield was shot by inventing something called an induction balance. And I was stunned. I had never heard this story before and I couldn't understand why Bell, who was at the height of his fame and his power. He had just invented the telephone five years earlier.

  • 12:09:12

    MILLARDHe was only 34 years old. Would drop everything he was doing, turn his life upside down to try to help Garfield. And I started doing research on Garfield and I realized that Garfield was absolutely extraordinary.

  • 12:09:28

    REHMExtraordinary in what way?

  • 12:09:31

    MILLARDWell, first of all, he was a brilliant man. He was born into incredible, extreme poverty, you know. He was literally in a log cabin with a dirt floor and oil paper windows. So to put himself through college, his first year, he was a janitor and carpenter. By his second year, he was made professor of literature and ancient languages.

  • 12:09:54

    MILLARDAnd by the time he was 26, he was the university President. He knew the entire (word?) by heart in Latin. And while he was in Congress, he wrote an original proof of the Pythagorean Theorem. He was just off the charts.

  • 12:10:09

    REHMTell us what life was like in America back then in 1876, after the Civil War.

  • 12:10:18

    MILLARDSo, obviously, the country is still deeply divided. And, you know, Lincoln's assassination only deepened that divide. It's a country full of promise and possibility but we weren't quite there yet. And there was incredible in-fighting within the political parties.

  • 12:10:42

    MILLARDAnd not just between the republicans and the democrats but within the republican party, there was a strong divide between these two warring factions, the very, very conservative -- believed strongly in patronage and the spoil system -- the stalwarts. And then what they were known as, the half breeds who are reformists. And Garfield belonged to that group.

  • 12:11:08

    REHMAnd how did he come to be President?

  • 12:11:12

    MILLARDWell, Garfield never wanted to be President. In fact, he never -- he said he never had what he called Presidential fever. When we went to the republican convention in 1880, he went there to give the nominating address for another man. But that speech, which is extemporaneous, was so powerful and so moving that, at one point, he's in this huge hall, 15,000 people, and he says and so gentlemen, I ask you, what do we want?

  • 12:11:41

    MILLARDAnd someone yells, we want Garfield. And the entire hall just went crazy and when the balloting began, people started voting for Garfield even though he wasn't even a candidate and didn't want to be one. And he tried to stop it. But what began as a trickle, became a river, became a torrent of ballots and suddenly he found himself, the republican nominee for President.

  • 12:12:03

    REHMWho else was running at the time?

  • 12:12:06

    MILLARDWell, it was John Sherman, he was the Secretary of Treasury and William Tecumseh Sherman's younger brother, was James Blaine who had been the speaker of the house and Ulysses S. Grant who was running for a third term. And all of those candidates were swept aside in favor of Garfield.

  • 12:12:21

    REHMAnd did they finally come together to support him?

  • 12:12:25

    MILLARDThey did not all. Garfield was not only thrust into the position of becoming President but he was also had his Vice President forced upon him. Chester Arthur belonged to the Stalwart, the other faction of the republican party. And he was the puppet and really the creation of a man named Roscoe Conkling who was a senior senator from New York. A vain, preening, incredibly powerful and ruthless man who saw, in Arthur, his chance to, sort of, rule the country and was infuriated when Garfield refused to follow what he asked.

  • 12:13:04

    REHMYou're such a young woman and to have become immersed in this kind of history. Why did you, to begin with, you've written now a book about Theodore Roosevelt, now a book about Garfield. What was behind that?

  • 12:13:26

    MILLARDWell, you know, what interests me about history are these personal stories. You know, I'm obviously interested in the events and the consequences but we have these great men. And I think what's interesting is to understand who they were as men, not just as politicians but really their character. And what I've found through years of research, is that you can see them most clearly in their moments of trial, of difficulty, of even desperation, more than in their large moments of public triumph.

  • 12:14:06

    MILLARDAnd so, that's why with Theodore Roosevelt, it was after his political career and it was on this very difficult, very dangerous expedition down an unmapped river, in the middle of the Amazon, a trip in which he nearly committed suicide and showed a kind of quiet courage that we're not used to. We're used to Roosevelt's swagger. And this is a completely different kind of courage.

  • 12:14:28

    MILLARDAnd this point, this is a man who, as you say, we've largely forgotten, but with such a brilliant man and had so much promise and was so kind and broad minded and I wanted to understand who he was and what his loss meant to the country.

  • 12:14:44

    REHMWhy did Teddy Roosevelt nearly commit suicide?

  • 12:14:50

    MILLARDWell, he had injured himself in the river. They were on this very, very remote river. No one knew what was happening to them. You know, they were hunted by indigenous tribesmen, they were starving, they were desperate and he became very, very ill. So ill that he could hardly sit up. And they came to a point where they didn't think they could continue on the river and they were going to have to strike out into the rain forest, every man for himself.

  • 12:15:15

    MILLARDAnd one of his sons was with him. And he believed that he was a danger to the -- and was to the rest of the men. He didn't want them to be a burden and then trying to get him out as well as themselves. And he had brought with him a lethal dose of morphine which he had carried on other expeditions, never wanting to be a burden or danger to the other men in the expedition. And he decided that it was time to take it.

  • 12:15:40


  • 12:15:40

    MILLARDBut he didn't. What he realized was, he had his son -Kermit with him. And Kermit was a very, sort of, introspective young man and was at his best when he had a mission, something to accomplish. And Roosevelt knew his son very well. And he realized that, the best way to save his son was to let his son save him. And he did. Kermit was really the hero of this expedition. He really saved all the men. He found a way to continue on the river, to get over these incredible rapids and he really -- he saved these men.

  • 12:16:11

    REHMYou, indeed, had a personal experience as you were working on that book.

  • 12:16:18

    MILLARDI did. While I was -- I was expecting my second child while I was working on the book. And it was actually when my final proofs were due. I had had a sonogram and I got a call one morning, out of the blue, from my OB/GYN and she said, you know, we saw the shadow of something on your last sonogram. You know, it's probably nothing, but I'd like for you to come in tomorrow morning to have a more detailed ultrasound to see if there's anything.

  • 12:16:46

    MILLARDAnd so my husband did -- husband and I did the next morning and we found that there was a large tumor. And very quickly realized -- and we had to have the baby that day. I had an hour to go home, pack a bag, get back to the hospital and have the baby.

  • 12:16:59

    REHMHow far along were you?

  • 12:17:00

    MILLARDI -- fortunately, I was 37 weeks. So she -- her lungs had developed, she was a good size. But we found out that she had neuroblastoma and -- stage four, and we were just thrust into this very extreme situation with, you know, no warning and that's really how life works so often. You know, you're going along and then you're blindsided.

  • 12:17:25

    MILLARDAnd I certainly saw that again and again in Roosevelt's life and how he approached loss and hardship and certainly witnessed that with Garfield and his family as well. So it's interesting, all these emotions, they're very familiar to me and inspirational.

  • 12:17:46

    REHMHow is your daughter now?

  • 12:17:48

    MILLARDShe's doing very well, thank you for asking. She just started first grade a few weeks ago and she's still tested, of course, every year. But we have every reason to believe that she's going to be just fine.

  • 12:17:59

    REHMI'm so glad.

  • 12:18:00

    MILLARDThank you very much.

  • 12:18:01

    REHMWhat an extraordinary time for you, trying to finish up this book and then you have the baby. Was the book delayed because you had your baby?

  • 12:18:13

    MILLARDIt was, you know, it was interesting because my editor didn't even know I was pregnant because I thought "Well, you know, I'll turn in the manuscript, I'll have a few weeks, I'll have the baby, he doesn't need to know, he's in New York, I'm in Kansas City." But -- so, you know, as I'm driving home to pack my bag, I had to call him and say "You know, I'm having a baby today."

  • 12:18:36

    REHMCandice Millard, her new book is titled "Destiny of the Republic." When we come back, we'll talk about that title.

  • 12:20:03

    REHMAnd welcome back. Candice Millard is with me. She's New York Times bestselling author of "The River of Doubt" and former editor and writer at National Geographic Magazine. Her new book is all about James Garfield, the president who after four months in office was shot by a distraught and disappointed office-holder. The book is titled "Destiny of the Republic: A Tale of Madness, Medicine and Murder of a President."

  • 12:20:47

    REHMCandice, the book begins with an account of a shipwreck on the night of June 11, 1880. Tell us about Charles Guiteau and why he was on the Stonington.

  • 12:21:03

    MILLARDCharles Guiteau was a deeply delusional and deranged young man. And he had tried everything in his life and he had failed at everything. He was a failed lawyer, a failed evangelist. He had even been in a free-love commune and had failed there too. The women in the free-love commune nicknamed him Charles Get-out.

  • 12:21:23

    MILLARDAnd he was also, though, at the same time, highly intelligent, very articulate and he read the newspapers obsessively. And so when Garfield won the nomination in this stunning turn of events, he became obsessed with Garfield. And he decided that he would singlehandedly make Garfield president. And out of gratitude, Garfield would make him Ambassador to France. You know, this is the height of the spoil system. And so he believed that all he had to do was maybe give a speech and be the first in line with his request and he would get the appointment he wished for.

  • 12:22:00

    MILLARDAnd so he -- so after the nomination, he gets on this ship to go to New York to campaign for Garfield. And while he's on this ship it's night, he's standing on the deck. And all of a sudden the ship collides with its sister ship in the middle of the water. And it's this horrible, horrible tragedy that the ship explodes in flames and goes down. And many people die. More than 30 people die on this ship. And Guiteau survives and he believes that this is a sign from God that he has been chosen for some unique mission.

  • 12:22:38

    REHMSo how does he continue his effort to meet Garfield to campaign for him? He goes on.

  • 12:22:48

    MILLARDHe does. He goes -- so he's in New York and he goes to the campaign offices every day, every day. He even goes to Chester Arthur's home. He has written this speech and he wants to give it. And finally, they say, okay, you can give it at this one little gathering. He gives it for about five minutes, runs off the stage when he thinks, okay, you know, I've done my duty. When Garfield's elected, it's because of me. He then moves to Washington...

  • 12:23:10

    REHMHe believes that.

  • 12:23:11

    MILLARDHe honestly believes that.

  • 12:23:11


  • 12:23:12

    MILLARDAnd he -- you know, he's mentally ill. And he moves to Washington and he goes to the White House and the State Department every single day asking for an appointment. I mean, they know him and he just becomes more and more obsessed and more delusional. And it just spirals out of control.

  • 12:23:31

    REHMDoes he, before the assassination, actually meet Garfield?

  • 12:23:38

    MILLARDHe does. He, at one point, actually walks into the president's office while the president is there in the office. You know, this is an incredible time. You know, this is 16 years after Abraham Lincoln's assassination. There's still no secret service protection for the president. And he has a 24-year-old private secretary and an aging policeman and that is it. And he is forced to meet with the public every day for hours of his day.

  • 12:24:04

    REHMThey just walk in.

  • 12:24:06

    MILLARDAnybody can come up the street. He would meet with 100 office seekers every day and Garfield is desperate. You know, he wants time to work and think. He can do great things for this country if he would just be given the time. But it's just extreme and Guiteau takes advantage of that.

  • 12:24:26

    REHMTell me about your sources and what you used to create this?

  • 12:24:32

    MILLARDWell, that was -- this is one of the reasons I wanted to tell the story is because there are so many primary sources, as you can imagine, with the assassination of a president, you know, newspaper articles after newspaper articles. But Guiteau in particular -- and I think this is very rare for a presidential assassin -- I was in his mind. I knew not just his childhood, not just his actions, but his thoughts. Because of his unique illness, because he was delusional, he loved this attention.

  • 12:25:01

    MILLARDHe loved every -- he was happier when he was in prison than any other time in his life because he had reporters coming to him to interview him. He wrote an autobiography that was published in the New York Herald. The trial itself, you know, they went through, because it was an insanity defense, every aspect of his childhood. It's nearly 3,000 pages long, the trial transcript. So -- and his -- he had a wife for a little while and they talked to her, his brothers and sisters. And he loved, loved, loved to talk. And so I know everything about him.

  • 12:25:34

    REHMThere is another character who is central to this book even beyond Alexander Graham Bell, and that's Dr. Joseph Lister.

  • 12:25:45


  • 12:25:45

    REHMTell us about him.

  • 12:25:47

    MILLARDSo 16 years earlier, Joseph Lister had discovered antisepses. And he was a British surgeon and he had seen dramatic and immediate results in his own surgical ward, many fewer deaths. And so he had gone throughout Europe and it had been widely accepted in Europe and he had come to the United States begging American doctors to sterilize their instruments and their fingers. And they really had dismissed him. You know, they didn't really believe in germs. They laughingly called them invisible germs.

  • 12:26:21

    MILLARDAnd they certainly weren't going to go to all the trouble that antisepses required. In fact, they called their good old surgical stink. You know, they wouldn't change or wash their surgical aprons. They thought the more blood and puss incrusted, the more experience it showed. And even those who did some antisepses, they didn't go all the way. For instance, they would sterilize their surgical knives. But if they dropped them during surgery, they would just pick them up and keep using them. Or if they needed both hands, they would hold the knife in their teeth and then continue to use it.

  • 12:26:51

    REHMAnd there, I gather, was not much thought to hand washing.

  • 12:26:56

    MILLARDNo. But even more than that obviously you need to really sterilize. Joseph Lister used carbolic acid at that time to really kill the...

  • 12:27:05

    REHMBut why was there, do you believe, such resistance to Lister? Was it more than simply this is the way we do things? We're not paying attention to you.

  • 12:27:20

    MILLARDWell, you know, I think it just shows the dangers of arrogance. You know, they had their ways. And interestingly, it wasn't all the doctors. It was really the more experienced, the better respected doctors. They were young doctors who had been studying in Europe and learning about Lister, And who saw what was happening with the president and didn't feel that they -- it was their place to speak up against these more experienced -- there was a doctor in Kansas who wrote to the First Lady after Garfield was shot and said, don't let them probe the wound. Sterilize everything. But no one was listening to them.

  • 12:27:53

    MILLARDAnd it's, I think, really a case of willful ignorance and arrogance.

  • 12:27:58

    REHMYou talked about Garfield's early life of poverty. What about Guiteau's life?

  • 12:28:06

    MILLARDHe had a difficult childhood. His mother died when he was very young. He had an older sister who really tried to fill that role for him, and really throughout his life tried to take care of him. You know, he lived a very peripatetic life moving from city to city, boarding house to boarding house.

  • 12:28:21

    REHMWas he educated at all?

  • 12:28:24

    MILLARDHe did. He started -- he went to school -- went to college for a while in Michigan. But his father was a very obsessive sort of fanatical Christian with this one particular sect, and had raised Guiteau to believe that too. And that's when he ended up leaving school and joining this free-love commune.

  • 12:28:46

    REHMAnd the free-love commune as supposed to, what, empower him to become an even better person?

  • 12:28:58

    MILLARDThey believed that they could perfect themselves to a point at which they literally would not die. And so they would have these meetings and they would sit down and they would talk about one person's imperfections and -- which was incredibly difficult for Guiteau who had all these delusions of grandeur.

  • 12:29:19

    REHMAnd, of course, once Garfield got to the White House, he had to take his wife, his children. But there were already tragedies brewing there.

  • 12:29:33

    MILLARDHe had lost two children before. His youngest daughter and his -- I'm sorry, his oldest daughter and his youngest son had died. And so, yes, he knew a lot of pain and loss. In fact, his own father had died before he was two years old. And Garfield had this sense that he would die a young -- as a young man and he would die an early death. And it was out of character for him because he was a very optimistic, very cheerful young man. And his friends never understood it. But he-- and he didn't either really, but he just couldn't shake the sense.

  • 12:30:10

    REHMSo Guiteau finally decides why that he's going to kill President Garfield?

  • 12:30:18

    MILLARDSo he becomes more and more delusional, more obsessed. And finally has an encounter with the Secretary of State who tells him, listen, this is not going to happen. We're not going to -- you're not qualified. We're not going to give you this position. And he's angry and hurt and he goes home and he has what he believes is a divine inspiration, a message from God that actually Chester Arthur should be president and that he needs to kill the president.

  • 12:30:44

    REHMSo how does he go about planning...

  • 12:30:47

    MILLARDSo he becomes...

  • 12:30:47

    REHM...what he's going to do?

  • 12:30:49 he has no money and he borrows some money and he buys a gun. He's never shot a gun before. And he goes down to the Potomac and practices a little and he begins to stalk the president. He sits outside of the White House on a park bench watching every day for Garfield to emerge. He goes to his church -- to Garfield's church. Thinks he might shoot him in his church. He follows him to a train station.

  • 12:31:14

    MILLARDOne night he even watches as Garfield leaves the White House, walks down the street to his Secretary of State's house. They walk around the city. Guiteau follows them the whole way, holding a loaded gun. And it's after that night that he decides, the next opportunity I have, I will shoot the president.

  • 12:31:33

    REHMHere is an e-mail from Frank who says, "My mother always said that my great, great grandmother was with Garfield when he was shot. Her husband was the Postmaster General. As the family told it, she nursed Garfield at the White House until Garfield's wife returned. I assume," he says, "that these family stories are true."

  • 12:32:04

    MILLARDWell, there were several people who were there. It's certainly possible. You know, one of the interesting things is there were so many people, it was -- he went to the -- it was in the Baltimore Potomac train station where he was shot, which was where the National Gallery of Art is today. And there -- he had some of his members of his cabinet with him. He had his two oldest sons with him. And obviously, it was horrific, you know.

  • 12:32:27

    MILLARDAnd there was screaming and crying and there were several people trying to help him. Ten different doctors came to the station. Many people accompanied him back to the White House. And -- but this one doctor in particular, Dr. Doctor Willard Bliss -- his first name was Doctor...

  • 12:32:46

    REHM...was Doctor.

  • 12:32:47

    MILLARD...his parents had named him Doctor -- took over. He just assumed control in the middle of this chaos. And Garfield had never asked him to -- Lucretia, Garfield's wife, had never asked him to, but he ends up dismissing all the other doctors, even Garfield's own physician, personal physician who had been his doctor for years, and just takes control. And completely isolates the president inside the White House literally putting a screen around his bed, letting him have very few visitors. Not even the Secretary of State could see him for days, and just assumes control of his medical care.

  • 12:33:20

    REHMAnd you're listening to "The Diane Rehm Show." Take us back a bit. Did Guiteau simply walk up to him and shoot?

  • 12:33:30

    MILLARDHe did. Garfield walked into the train station. Again, there's no protection for him.

  • 12:33:34

    REHMNo protection.

  • 12:33:35

    MILLARDHe just walks in and his Secretary of State is with him just because he thinks it's unseemly for the president to enter the train station by himself.

  • 12:33:41

    REHMWhere was he headed?

  • 12:33:43

    MILLARDHe was going on a trip, his -- sort of a family vacation. He was going to go to Williams College where his sons -- he had attended. And he was going to meet his wife and so it's a several multifaceted trip. And Guiteau just steps out of the shadows and shoots him twice, once in the arm and once in the back. But the bullet that hits him in the back, it doesn't hit his spinal cord, it doesn't hit any vital organs. It goes behind his pancreas and then sits there.

  • 12:34:11

    REHMSo they take him back to the White House. I mean, what you talk about here is more horrendous than the actual shooting itself. What happens?

  • 12:34:26

    MILLARDAbsolutely. He suffered incredibly. It's just astonishing. This Dr. Bliss and a very small group of surgeons he had with him repeatedly inserted unsterilized fingers and instruments in Garfield's back probing for this bullet. And he -- an infection grows and grows and grows. By the end he is just riddled with infection. You know, he has pneumonia -- infection-induced pneumonia in both of his lungs. He has an abscess that's half a foot in diameter near his liver.

  • 12:34:59

    MILLARDHe had -- at one point, he had an abscess in his face that paralyzed part of his face and ruptured. And he nearly drowned there was so much puss. And his doctors are calling this healthy puss and a good sign and telling the public -- they're giving, you know, reports saying he's doing well.

  • 12:35:20

    REHMHow does Alexander Graham Bell get involved?

  • 12:35:24

    MILLARDSo Bell had a small laboratory here in D.C. and he learns of the shooting. And he remembers that he had this induction balance, something he had invented a few years earlier to basically get rid of static in the telephone line. And he remembered there was also a metal detector. And he gets a hold of the White House and he says, I can help. And Bliss is desperate by this point, knows that things are not going well. And he lets Bell help.

  • 12:35:50

    REHMAnd how?

  • 12:35:52

    MILLARDSo Bell continues to work on this invention and work on it and increase the range. And he comes into the White House and he uses it on the president. Unfortunately two things happen. One, they don't tell him that the president is on a very new kind of bed at that time that actually had metal coils in it, which would obviously affect a metal detector. And they don't tell him that. Two, and worse than that, Bliss believed and had publicly stated that the bullet was on the president's right side and would only let Bliss (sic) examine and use his induction balance on the right side of the president's body.

  • 12:36:31

    REHMSo Bliss would only let Bell...

  • 12:36:34

    MILLARDDid I say -- yes...

  • 12:36:35

    REHMYou -- yeah.

  • 12:36:35

    MILLARD...Bliss would only let Bell examine the right side of the president's body. The bullet was on the left.

  • 12:36:40

    REHMSo nobody found the bullet.

  • 12:36:45

    MILLARDUntil the autopsy.

  • 12:36:47

    REHMAnd by this time President Garfield is riddled with infection.

  • 12:36:53

    MILLARDAnd starving to death. You know, this is a very handsome, 6' tall, 210-pound man who was reduced to 130 pounds by the time -- he couldn't keep any food down. And as well as this infection, they're also -- I mean, this is a gunshot victim. They're giving him rich foods to eat. They're giving him alcohol, morphine and he's just vomiting. He didn't keep anything down and they're desperately trying to find ways to feed him.

  • 12:37:20

    REHMPoor Lucretia.

  • 12:37:22

    MILLARDIt was so sad. That's one of the saddest parts of the story because they had such a close relationship. You know, they had very difficult early years in their marriage but very much in love by the end.

  • 12:37:32

    REHMCandice Millard. She has written a new book about the life and death of President James Garfield. It's titled "Destiny of the Republic."

  • 12:40:03

    REHMAnd it's time to open the phones now for Candice Millard. Her fascinating of the life and death of President James Garfield, just four months after he took office, remembering at the time, no secret service, no police protection. People simply walking into his office. When he was out in public, no protection.

  • 12:40:34

    REHMHe was assassinated -- well, we shouldn't say that, he was shot, by Charles Guiteau, but he did not die of those shots. He died of massive infection because of the carelessness with which doctors, at the time and in the mode of that current practice of medicine, treated him. Isn't that fair to say?

  • 12:41:09

    MILLARDThat is fair to say. Unfortunately, they should've known better, you know. Joseph Lister -- this was not a new fangled theory. And they chose not to, they chose to rely on old methods. And, I think, one of the problems, really, I think, it was worse for Garfield because he was President. You know, at this time, there are many, many Civil War veterans walking around with bullets inside of them who had survived. And -- but the fact that he was President meant that he got, really, too much medical care. He would've been better off if they had just left him alone.

  • 12:41:44

    REHMAll right. We're going to open the phones now. First to Juan in Raleigh, N.C. Good morning, you're on the air.

  • 12:41:53

    JUANYes, good morning. It's a real honor to speak to the author because, I think, "River of Doubt" is just one of the greatest books I've ever read.

  • 12:42:00

    MILLARDThank you, very much.

  • 12:42:00

    JUANIt talks about Theodore Roosevelt. It was refreshing to have an episode where Theodore Roosevelt's heroism wasn't tainted by his usual jingoism which sometimes, you know, kind of marred things a little bit. And my question is, are there any plans to make "River of Doubt" into a movie? It just seems like it would be, just, made for cinema.

  • 12:42:19

    JUANAnd my second question is about President Garfield. Do you think that Guiteau should've been executed? It seems like, on a good day, he was half psychotic and I don't see how they can, you know, argue that the man wasn't just a lunatic. And finally, I also read that Garfield could write in -- with one hand in Greek while writing with the other in Latin. I don't know if that's neurologically possible but I read that somewhere and I thought that was kind of interesting. I'll get off the phone to hear your...

  • 12:42:50

    REHMAll right, sir. Thanks for calling.

  • 12:42:51

    MILLARDHey, thank you very much. "The River of Doubt" has been optioned. It was actually optioned a few years ago by John Turtletaub. And -- so we'll see. There's a script, you know, who knows if it'll ever be made into a movie. But the script is actually quite good. So we'll see.

  • 12:43:07

    REHMDid you do the script?

  • 12:43:09

    MILLARDNo, I didn't.

  • 12:43:09


  • 12:43:10

    MILLARDI -- no, I did not write the script. I wouldn't know the first thing about screen writing. But it, you know, it takes some liberties but that's to be expected, I guess. And as far Guiteau, you know, he was insane. He was clearly insane and I think that, really, that's one of the tragedies of this story. If anyone should've been found not guilty by reason of insanity, it was Charles Guiteau. You know, his family knew that he was insane and actually had tried, several times, to have him institutionalized but he kept, sort of, disappearing.

  • 12:43:45

    MILLARDAnd if he had been institutionalized, then you know, Garfield never would've been shot. And so I think it's just one of the tragedies. But the country was so grief stricken and so enraged that they were going to see him hanged. And he did hang, unfortunately.

  • 12:44:03

    REHMAnd then the third question about left hand, right hand.

  • 12:44:05

    MILLARDThe third question, yes, that's an old story. You know, I think, it's actually probably apocryphal. I mean, he certainly did know both languages, ancient Greece -- Greek and Latin and could write in both. Whether he could do that at the same time, you know, has not been proven but it's a good story.

  • 12:44:23

    REHMHow quickly did the public learn that the President had died of massive infection, rather than the bullet wounds themselves?

  • 12:44:33

    MILLARDRight away. So there was an autopsy right away and his doctors were there and they were as surprised as anyone. You know, they -- first of all, they find that the bullet's on the left side. They find that what they had assumed was a track of the bullet was actually -- they had made by their probing and it had filled with pus and they see all of this massive infection. And so the autopsy results are released and the country knows right away that their President didn't have to die and they know why he did.

  • 12:45:03

    REHMNow, what positive effects came out of that?

  • 12:45:07

    MILLARDSo Dr. Bliss was immediately vilified and, you know, and newspapers and medical journals, everyone openly says it's because antisepsis wasn't followed. And we have lost this promising President because of that. And it changes immediately. And it saves countless lives because of that. The medical practice throughout the United States changes immediately and antisepsis is adopted.

  • 12:45:34

    REHMJames writes, "I'd like to ask Ms. Millard if she has any information about the final resting place of Guiteau's remains. I live in Bethlehem, Conn. The local rumor is he was buried in an unmarked grave in the North cemetery. But there's never been any real historic confirmation."

  • 12:46:04

    MILLARDWell, after his hanging, he was first buried, actually, in the prison and then -- but the next day his remains were exhumed for study. And they're actually at the National Museum of Health and Medicine, here in Washington, D.C.

  • 12:46:17


  • 12:46:17

    MILLARDAnd I saw them. Yeah, it's really moving. They have a section of Garfield's spine that shows where the bullet entered. It was used during the trial. And in another drawer, they have the remains of John Wilkes Booth and Charles Guiteau. And they have a, it's grim, but they have a jar filled with chunks of Guiteau's brain. His brain was divided up and sent to experts around the country to study it, to see if they could see physical signs of insanity.

  • 12:46:48

    REHMWhat happened to his wife, Lucretia?

  • 12:46:52

    MILLARDSo Lucretia went on to live many years. You know, was devastated and her daughter said if it hadn't been for her children, she would've had a hard time finding a reason to live. But she was a very strong woman, you know, had to endure the deaths of two of her children.

  • 12:47:09

    MILLARDAnd -- so she went back to their farmhouse that they had in Ohio and a fund was raised for him but -- for their family because they did not have much money and she used that to build a wing onto the house and established the first Presidential library. She kept all of their letters. They're at the Library of Congress, today, but that library still exists.

  • 12:47:29

    REHMYou said you had a hard time writing about her death.

  • 12:47:35

    MILLARDAbout Garfield's death.

  • 12:47:36


  • 12:47:36

    MILLARDAbout President Garfield's death.

  • 12:47:37

    REHMHer death.

  • 12:47:38

    MILLARDOh, I had a hard time...

  • 12:47:39

    REHMLucretia's death.

  • 12:47:40

    MILLARDIt was actually…

  • 12:47:42

    REHMI thought you said, you had...

  • 12:47:44

    MILLARDOh, I'm sorry.

  • 12:47:44

    REHM...but perhaps it was Garfield's death.

  • 12:47:46

    MILLARDIt was President Garfield's death. Yeah, I had come to care about him, really...

  • 12:47:50

    REHMI understand.

  • 12:47:50

    MILLARD...over these years of studying him. And had real affection for him and when I needed to write his death scene, it was -- yeah, it was difficult for me.

  • 12:47:58

    REHMAll right. To Inverness, Fla. Good morning, Pete.

  • 12:48:03

    PETEThank you, it's really a pleasure. Garfield was a man of destiny. And I'd like to briefly mention his actions at the Battle of Chickamauga, during the Civil War. He was the chief of staff to the Army commander. And one wing of the Army was defeated. And the decision was made, one of the men had to go back to the base and one of the men had to ride to the other wing of the Army.

  • 12:48:25

    PETEAnd the Army commander decided to go back to the base and he was eventually disgraced and Garfield rode to join the other wing of the Army and became a great hero. And if the roles had been reversed, Garfield would never have made it to be President.

  • 12:48:41

    MILLARDHe did become a hero during the Civil War, absolutely. In that instance, also, the Battle of Middle Creek in which he was up against a much, much larger confederate force and he divided his, much smaller, union Army -- union regiment into three divisions and attacked, first on one side, then on another and then on a third side and completely confused and frightened the much larger confederate force. And really was instrumental in saving Kentucky for the union. And it did, it made him -- they promoted him to Brigadier General and made him a national hero.

  • 12:49:19

    REHMAnd to Todd in Concord, Mich. Good morning.

  • 12:49:24

    TODDGood morning, Diane. Another great show.

  • 12:49:26

    REHMOh, thanks.

  • 12:49:28

    TODDI just had a quick question. My great grandmother, who came from Sweden, loved James A. Garfield. She came in the 1890s, she played the guitar. And a song was passed down and my grandmother used to sing it when I was a child. And I'll just sing a couple bars in what, "My name is Charles Guiteau, a name I'll never deny. I'll be taken to the sky for tomorrow, for to die. Little did I think, that in my youthful bloom, I'd be taken to the sky, for to meet my fatal doom."

  • 12:50:00

    TODDAnd the song goes on and it had several versus. I'm just curious to know if that's something that she had made up or if there was everything -- anything ever published or printed.

  • 12:50:09

    MILLARDWell, you know, there's that song. I don't -- I haven't seen it printed but there's also a wonderful song that Johnny Cash sang about "Charles Guiteau, shot a good man down." And it's a wonderful song. You can -- there's actually a YouTube video of him singing it.

  • 12:50:25


  • 12:50:25

    MILLARDIt's fantastic. Yeah, it was -- you know, this was a huge loss, devastating to the country, at the time. And so a lot of things, obviously, came out of it. That was a wonderful song, thank you for singing it.

  • 12:50:36

    REHMDo you recognize the song Todd sang?

  • 12:50:41

    MILLARDI have heard it before.

  • 12:50:42


  • 12:50:42

    MILLARDI have, yes.

  • 12:50:43

    REHMTodd, you have a great voice.

  • 12:50:45

    MILLARDYou do.

  • 12:50:46

    TODDWell, thank you, Diane. And like I say, a great show.

  • 12:50:49


  • 12:50:49

    TODDThank you very much for your...

  • 12:50:50

    REHMThanks for calling.

  • 12:50:51

    TODDYou too.

  • 12:50:51

    REHMAnd let's go to Don in Ft. Worth, Texas. Good morning, you're on the air.

  • 12:51:00

    DONGood morning, thank you for taking my call.

  • 12:51:01


  • 12:51:02

    DONI was curious about the criminal charges against the doctors. If a doctor, did today, what they did then, well, there'd be lawsuits and there would be criminal -- I just -- I'm curious about criminal charges against the doctors, the dirty instruments and filthy hands and...

  • 12:51:21

    MILLARDYou know, that's a great question. It was a very different time. And, no, there were no criminal charges. But Dr. Bliss, you know, he lost his medical practice. He really -- you know, the last thing Bliss wanted was for Garfield to die.

  • 12:51:34

    REHMOf course.

  • 12:51:34

    MILLARDBut he was desperate but he -- and he worked and worked and worked, night and day, with Garfield. And so he, sort of, lost his health. But he insisted to the end that he had given Garfield, you know, extraordinary surgical care. And, in fact, he presented Congress with a very large bill and was offended when Congress refused to pay it.

  • 12:52:00


  • 12:52:00

    MILLARDI know. It's just extreme, yeah. He just refused...

  • 12:52:05

    REHMI mean, talk about...

  • 12:52:05 admit that he had done any...

  • 12:52:06

    REHM...chutzpah. Really.

  • 12:52:09

    MILLARDHe never admitted he had done anything wrong, on the contrary.

  • 12:52:12

    REHMHere is an e-mail from Mary in North Carolina who says, she read, "Somewhere a long time ago that when Garfield was shot, he was near, what I believe, was the World's Fair, where there was a tent showcasing a new invention, the x-ray. It was said, if he only knew about this helpful invention, they would've found the bullet sooner."

  • 12:52:40

    MILLARDThat may have been McKinley. The x-ray wasn't -- medical x-ray wasn't invented for another 14 years. And McKinley was shot, 20 years later.

  • 12:52:48

    REHMAnd you're listening to the Diane Rehm show. And until after McKinley was assassinated…

  • 12:52:56

    MILLARDThen we had secret service.

  • 12:52:56

    REHM...we didn't have secret service.

  • 12:52:58

    MILLARDIt's incredible, isn't it?

  • 12:52:59


  • 12:52:59

    MILLARDI know, I know. Three Presidential assassinations. Well, you know, they didn't think that Lincoln's assassination was -- they thought it was due to war. You know, it was just a result of war. And even -- and then they thought Garfield's because he was a frustrated office seeker and so they had civil service reform. And then with McKinley, the finally got it.

  • 12:53:19


  • 12:53:19

    MILLARDYou have to protect our President's.

  • 12:53:19

    REHM...and e-mail from Joanne in Florida who says "Amazingly enough, there is still much of the same willful arrogance as there was in Garfield's day, when it comes to the washing of one's hands. MRSA, the infection, would not be as rampant if physicians, as well as other, hospital staff would simply wash their hands between each patient.

  • 12:53:50

    MILLARDWell, you know, I think, then as now, it largely depends on the doctor you get. You know, you -- again, you have to battle arrogance and knowledge. You know, everything Garfield stood for, scientific progress, broad mindedness, education, would have saved his life and would save lives today. And, you know, again, as a mother of a child who was born of cancer, I can see the great promise and the incredible ability of the doctors we have.

  • 12:54:20

    MILLARDAnd I -- there's no person more grateful to doctors then I am. And we have extraordinary doctors. But they have to be open minded and they have to set their own ego aside.

  • 12:54:30

    REHMHow do you think the U.S. did change after Garfield's assassination?

  • 12:54:37

    MILLARDWell, we had, almost immediate, civil service reform. You know, Chester Arthur, signed the Pendleton Act which brought about civil service reform. But more than that, it really brought the country together, for the first time, since the civil war. Lincoln's death had only deepened that divide. But Garfield was respected and trusted by freed slaves, by Southerner's, by immigrants, by pioneers, really the whole country came together and mourned his loss, as one.

  • 12:55:08

    REHMAnd, now, how do you see his legacy?

  • 12:55:11

    MILLARDYou know, he was a brilliant man and so much promise. And so, I think, in the end, what the story teaches us, is the dangers of arrogance and the importance of, again, everything that Garfield stood for, of progress in science, especially, of open mindedness, of tolerance, of education. You know, he was -- he established the first department of education. You know, all of these things that he couldn't do through his life, maybe we can see and achieve because of what we know about his death.

  • 12:55:52

    REHMHave you, by chance, distributed this book to the members of Congress?

  • 12:56:02

    MILLARDI have sent a copy -- I sent a copy to Senator Durbin because he had written to me -- he read "The River of Doubt" and liked it. And I met Senator McConnell when I was on my book tour for "The River of Doubt" and I sent him a copy as well. So we'll...

  • 12:56:17


  • 12:56:18

    MILLARD...see if they read it.

  • 12:56:19

    REHMThat's terrific. I want to congratulate you, Candice. It's really an extraordinary book.

  • 12:56:27

    MILLARDThank you so much. I really appreciate that.

  • 12:56:29

    REHMI hope it does very, very well.

  • 12:56:32

    MILLARDThank you.

  • 12:56:32

    REHMCandice Millard, she's a New York Times bestselling author of "The River of Doubt" about Theodore Roosevelt and now her newest book about James Garfield who was assassinated four months after being elected President, it's titled, "Destiny of the Republic." Thanks for listening all, I'm Diane Rehm.

  • 12:57:01

    ANNOUNCER"The Diane Rehm Show" is produced by Sandra Pinkard, Nancy Robertson, Susan Nabors, Denise Couture, Monique Nazareth, Sarah Ashworth, Lisa Dunn and Nikki Jecks. The engineer is Tobey Schreiner, A.C. Valdez answers the phones. Visit for audio archives, transcripts, podcasts and CD sales. Call 202-885-1200 for more information. Our e-mail address is And we're on Facebook and Twitter. This program comes to you from American University in Washington. This is NPR.

Related Links

Topics + Tags

Most Recent Shows

A Push To Improve America’s Nursing Homes

Thursday, Sep 28 2023The Biden administration has released a proposal  to raise standards in nursing homes. Why one expert calls it the most significant development for the industry in decades -- and why it might still not be enough.