Dr. Willard Bliss: A Man of His Time?

“If I can’t save him, no one can,” stated the overconfident Dr. Willard Bliss after the July 2, 1881 shooting of President James A. Garfield.  What drove Dr. Bliss to decide that he was the only one who could save the president?  What drives anyone to believe they stand above everyone else?  Why didn’t he consult with the leading surgeons of the time?  How did he manage to position himself above other doctors who had more knowledge and connections with the Garfield family? It is not my purpose to determine if Dr. Bliss was negligent in his service to President Garfield; history has already determined that.  He believed in his abilities above all else, and positioned himself within the situation to be in control.

d_w_bliss

Dr. D. Willard Bliss (U.S. National Library of Medicine).

Doctor (his actual first name!) Willard Bliss grew up not far from James Garfield , and the two appear to have known one another as youngsters.  Bliss graduated from the Cleveland Medical College in 1849 or 1850, then married and moved to the Grand Rapids, Michigan area where he joined the local medical community.

At the start of the Civil War in April 1861, Dr. Bliss offered his services to the Union cause.  He was assigned as regimental surgeon of the Third Michigan Volunteer Infantry. After the first battle of Bull Run (July 21, 1861), Bliss and his brother Dr. Z.E. Bliss received a letter of praise from the staff of the 3rd Michigan for their actions during the battle.  In May 1862, Willard Bliss was placed in charge of the Armory Square Hospital in Washington, D.C., a large facility with over 1,000 beds. Armory Square Hospital received some of the most severely injured soldiers from the many bloody battles in Virginia.  Bliss served the rest of the war in this position.

There is no clear record of Bliss having treated President Abraham Lincoln after he was shot by John Wilkes Booth on April 14, 1865. It appears that Bliss’s presence at the Petersen House (across the street from Ford’s Theater and where Lincoln was carried after he was shot) was requested by Dr. Charles Leale, one of the first doctors on the scene after the shooting.  In his post-assassination reports, Dr. Leale wrote that he “sent for the Surgeon General, J.K. Barnes, the family physician Robert K. Stone and the Commander of the Armory Square Hospital, D.W. Bliss.”  Robert Todd Lincoln, Abraham and Mary Lincoln’s eldest son, may have actually met Dr. Bliss at his father’s deathbed.

inside-armory-square-hospital

Patients in Ward K of the Armory Square Hospital in Washington, D.C. in 1865.  Dr. Willard Bliss was in charge of the Hospital for much of the Civil War.  (ghostsofdc.org)

How did Bliss position himself above everyone else after President Garfield’s shooting sixteen years later, in July 1881?  Dr. Smith Townsend was the first doctor to arrive on the scene after the shooting, followed by Dr. Charles Purvis.  While these doctors were treating the President, Secretary of War Robert Todd Lincoln, just forty or so feet away from Garfield when assassin Charles Guiteau attacked, called for Dr. Bliss.  Historical evidence suggests Robert Todd Lincoln also knew of the childhood connection between Garfield and Bliss.  Whether it was that connection or his service at the Armory and at Lincoln’s deathbed that led him to call for Bliss, Robert Lincoln’s decision would have lasting effects on history.

Was Bliss the best doctor for the job?  The end result suggests not, but judging the outcome based on twenty-first century medical standards is hardly fair.

As soon as Dr. Bliss arrived on the scene at the Baltimore & Potomac Railroad station just minutes after the shooting, he took charge-not a surprise based on his position and prior military experience.  He continued to insist on his own medical preeminence after the President was moved to the White House.

Garfield_assassination_engraving_cropped.jpg

Charles Guiteau shot President James A. Garfield on July 2, 1881.  The President endured extremely poor medical care–even by 1881 standards–at Dr. Bliss’s hands for the next 80 days.  (Wikipedia)

There were many factors involved in him becoming the President’s primary physician.  First, he was called to the scene by Lincoln.  Robert Todd Lincoln made this decision because he knew Dr. Bliss.  Once at the White House, Dr. Bliss refused to allow anyone to see the President without his approval–including the Garfield family physician.  He carefully chose with whom he would consult, mostly doctors who agreed with him about the case.  He “fired” all the other doctors who had been assisting, telling them that their services were no longer needed or relegating them to nursing duties.  He did this in the name of the President.  In fact,  neither James Garfield nor any member of his family ever requested that Bliss be the primary physician.

Dr. Bliss’s excising of the other physicians from the case carefully removed anyone questioning his authority.  Despite Bliss’s objection, First Lady Lucretia Garfield did manage to bring in two doctors she trusted to try to aid in the President’s care.  These were Dr. Susan Edson and Dr. Silas Boynton (the President’s own cousin), both of whom stayed at the President’s side even as Dr. Bliss ignored them and refused to listen to their medical opinions about President Garfield’s condition and care.

Throughout this period, the painful probing of Garfield’s wound with unwashed fingers and instruments continued, even as the President became noticeable weaker on many days.  Despite his patient’s failing health, Dr. Bliss’s arrogance continued to grow.  The procedures that Dr. Townsend—the first doctor on the scene–had used (unsterilized equipment and dirty hands) were common in the United States during this period.  Many American doctors of the day failed to believe in the unseen germs that Joseph Lister had proven were present.  The fact that “80% of operations (were) plagued by hospital gangrene and a nearly 50% mortality rate” had little effect on Bliss’s thinking or treatment.  Doctors continued to unnecessarily probe the wound until “his initial wound, a 3 inch deep harmless wound, was turned into a 20 inch long contaminated wound oozing more pus each day.”  It was infection introduced by Bliss and other doctors that killed the President on September 19, 1881, 80 days after the shooting.

garfield-death

Imagined view of President Garfield’s death on September 19, 1881.  This view shows him surrounded by his cabinet and his wife and daughter crying at his side.  Dr. Bliss is to the President’s right with his hand on Garfield.  Behind and to Bliss’s right is Dr. Susan Edson, whom Mrs. Garfield hoped could help Bliss save her husband’s life.  (Wikipedia)

Did other doctors think Bliss was the best surgeon for the job of treating President Garfield?  Certainly Edson and Boynton did not, and there were others that tried to speak up but to no avail.  What is clear is that Bliss’s arrogance played a significant role–and was perhaps the deciding factor– in the President’s demise.

Even Garfield’s autopsy was viewed by some as a cover up, with medical statements about his death that were not true. The original cause of death was listed as rupturing of a blood vessel injured by the gunshot.   In fact, his death was caused by a heart attack resulting from the infection introduced by his doctors. This autopsy should have been an independent investigation into the cause of death, but many of the doctors present had attended to the wounded president–including Bliss, which surely skewed the outcome.  This would hide the poor treatment Garfield received from his doctors.

Charles J. Guiteau

Charles Guiteau, the President’s assassin, argued that while he had shot Garfield, the doctors-not he-had killed the President.  (Wikipedia)

Charles Guiteau, the president’s mentally disturbed assassin, stated on the opening day of his murder trial “General Garfield died from malpractice, according to his own physician, he was not fatally shot.  The doctors who mistreated him ought to bear the odium of his death, and not his assailant.”  Though the jury didn’t buy it and eventually convicted Guiteau and sentenced him to death, his statement that “I did not kill the president; the doctors did that.  I merely shot at him,” was one of the few lucid things he said during his two-month trial.  Today, most historians and doctors agree with Guiteau’s assessment that botched medical treatment led by Dr. Willard Bliss killed President James A. Garfield.

 

-Mark A. Lombardi, Volunteer

 

The Tragedy…and Triumph of President James A. Garfield and Alexander Graham Bell

Scene at the Baltimore and Potomac Railroad Station after President Garfield was shot by Charles Guiteau. Printed in Frank Leslie’s Illustrated Newspaper, July 16, 1881. Library of Congress.

       “I am a dead man…” said President James A. Garfield as he lay in a pool of blood on the floor of the Baltimore and Potomac Railroad Station July 2, 1881. As onlookers stared in awe and wept, several men accompanying the President apprehended the shooter, Charles Guiteau, and the others quickly swept up the President and transported him to the White House.

       The question of the bullet was a curious one. Exploratory surgery was not done in the 19th century and X-rays were not yet invented, so the doctors attending James Garfield used the most primitive instruments – their fingers – to probe the entry wound in his back and try to manually locate the bullet. Bedridden, stoic, and even conversational, Garfield endured this crude method of examination for three weeks with no firm conclusion.   Then a glimmer of hope came from an unlikely source – the inventor of  the telephone, Alexander Graham Bell.

Alexander Graham Bell in 1876, photo courtesy of IEEE History Center.

By 1881, Mr. Bell was at the height of his career. The telephone, patented in 1876, earned the Bell Telephone Company its first million, the first corporation to achieve that benchmark inside of one year. Bell constantly invented and improved his creations, and a week after the shooting Bell felt he could help the President’s case by applying his telephone technology to a machine developed by Simon Newcomb, called the induction balance machine. The idea was that the machine could create an electric current and by passing coils over a mass, in this case a human body, any trace of metal would be detected and create a sound by interrupting the current. The amplification device which allowed telephone users to hear a voice from the other end of a phone line would be used to magnify the sound of the interruption on the induction balance machine, thus allowing Bell to pinpoint the location of the bullet.

Professor A. Graham Bell’s induction balance for ascertaining the location of a bullet in a human body, Frank Leslie’s Illustrated Newspaper, August 20, 1881. Library of Congress.

        From the time he arrived in Washington on July 26, 1881 Bell worked tirelessly with his assistant, William Taintor. The pair scrounged for parts to connect the amplifier to Newcomb’s apparatus, and experimented with lengths and locations of the coils which would be used to scan the President’s body.  When the machine was in working order, they conducted several trial runs to test the ability of the coils to pick up the presence of lead. Both men hid bullets in their cheeks, in sacks of cotton, in corpses the approximate size of the President, and finally inside of raw beef. Met with success every time, the professors brought the contraption to the Army War Hospital and used it on Civil War veterans with spent bullets in their bodies. All trials were successful, and with some minor tweaking an anxious Bell was ready to try it on his most famous patient: the President of the United States.

       A confident Bell and Taintor arrived at the White House with high hopes the morning of July 26. Those hopes were replaced by shock as Bell caught his first glimpse of the sleeping President.  “His face is very pale – or rather it is of an ashen grey colour which makes one feel for a moment that you are not looking upon a living man,” Bell observed. Feeling the sense of urgency, the anxious orchestrator immediately began setting up the equipment.

       When Garfield awoke, his attending physicians prepared him for the experiment. His dressing gown was pulled to one side, and with support from an attendant, Garfield slowly rotated his body to expose the wound and surrounding areas.  “A calm peaceful expression” came across Garfield’s face, and he closed his eyes as the testing began. Dr. Willard Bliss, the doctor in charge of Garfield’s case, took the coils from the induction balance machine and scanned the President’s body near the bullet hole in his back. This puzzled Bell, since Bliss predicted the bullet was near Garfield’s abdomen in the front of his body. Nonetheless, Bell took his place behind the President, listening in anticipation of that magic sound coming through the telephone earpiece. 

Two scenes of Bell’s attempt at using his induction balance to determine where the bullet was lodged. Left: “The Wounded President: Ascertaining the location of the bullet.” Harper’s Weekly, August 13, 1881. Right: “The attempted assassination of the President – The Discovery of the Location of the Bullet by Means of Professor Bell’s Induction Balance.” Frank Leslie’s Illustrated Newspaper, August 20, 1881. Library of Congress.

        “THE PATIENT STILL MAKING GOOD PROGRESS – SUCCESSFUL EXPERIMENTS WITH THE INDUCTION BALANCE—THE BULLET IN THE PLACE FIRST DECIDED UPON BY THE SURGEONS” was the morning headline on August 1, 1881. The New York Times printed a report given by Alexander Graham Bell on his attempt to locate the bullet: “…on July 26, a feeble tone was perceived…but too feeble to be entirely satisfactory.” Based on Bell’s earlier attempts at concealing bullets in meat, corpses, etc, he expected a louder sound when the coils were placed near the bullet in Garfield’s body. Bell took the machine back to his lab, made some further modifications, conducted some more bullet-in-flesh experiments, and returned confidently to the White House on August 1 for a second try.   The Times reported after this attempt that “it is now unanimously agreed that the location of the ball has been ascertained with reasonable certainty…” in Garfield’s abdominal wall toward the front of his body below and to the right of his belly button. 

       Bell was guardedly pleased at the positive response from the doctors, although he himself knew the truth. The induction balance machine did not record a significant difference in sound when waved over different parts of Garfield’s body on August 1. Bell was not satisfied, but the medical professionals had closure and the matter was laid to rest. 

Headline from The Chicago Daily Tribune, September 20, 1881

       On the morning of September 20, 1881 the newspapers, which for 80 days had religiously detailed the President’s medical condition, had a new headline: “He is Dead.”  Upon autopsy of the President’s  body, the bullet was found to the right of Garfield’s spinal cord, rendered harmless by a layer of scar tissue that formed around it. Bell was understandably upset by these results, which showed the bullet was nowhere near where the doctors thought it was. Had he been permitted to scan Garfield’s body thoroughly during his examination, Bell quite possibly could have located the bullet. Despite the successes of his earlier experiments, Bell returned home a defeated man, fearing his reputation was soiled and the lifesaving potential of his machine’s lost on this bad news.

       After mentally healing from the death of President Garfield, Alexander Graham Bell rose above tragedy to triumph.  He mended whatever reputation he believed damaged from his failure to save the President and went on to perfect the induction balance machine, known today simply as a metal detector. These machines are commonly available and affordable. People use them as a form of recreation to find coins, old nails, and perhaps treasure, but very few hobbyists realize the contraption they are holding was first conceived to save a wounded and dying President.

-Allison Powell, Park Ranger