Opinion

By Dr Lesley Russell

Of 43 American presidents, only eight have died in office, and four of those deaths were at the hands of assassins.  However in two of those cases, arguments can now be made that perhaps the doctors involved also played a role in the final adverse outcomes.  And ironically both Presidents might have been saved by new technologies which were either not used or malfunctioned.

On 2 July 1881, President James Garfield was struck by two bullets from a pistol fired by Charles Guiteau, a mentally disturbed, unsuccessful office seeker.  One bullet grazed the President's right arm. The second bullet entered the right side of Garfield's back, breaking a rib, piercing the spine (but not the spinal cord), and lodging near the backbone, below the pancreas. 

The wounded Garfield was moved to the White House, where he was placed under the care of a team of prominent physicians.  The doctors inspected the wound with their unsterilised fingers and a long silver probe, but they could not locate the bullet.

Although it was thought he would not survive the night, the President remained conscious and alert. The next morning his vital signs were good and there was hope for recovery.  But the doctors continued to probe his wound with their fingers and one punctured Garfield's liver.  Alexander Graham Bell devised a metal specifically for the purpose of finding the bullet, but the metal bed frame made the instrument malfunction.  The President lingered for 80 days before dying of the consequences of blood poisoning.

The assassination of President William McKinley occurred on 6 September, 1901 while he was visiting the Pan-American Exposition in Buffalo, New York.  He was shot twice by anarchist Leon Czolgosz. One bullet left only a superficial wound, but the second bullet hit McKinley in the abdomen and lodged somewhere in the muscles of his back.

Once more the doctors were unable to find the bullet. An experimental X-ray machine, which might have helped, was on hand at the exhibition, but for unknown reasons, it was not used. In the following days Thomas Edison arranged for an X-ray machine to be delivered to the hospital from his shop in New Jersey, but it was never used either.  Doctors sewed up McKinley’s wound but did not drain it.

For a few days McKinley seemed to be recovering.  But eventually he succumbed to infection and gangrene, and died on 14 September, 1901.

Dr Lesley Russell works in health policy in Washington DC.  She is a Research Associate at both the Menzies Centre for Health Policy and the US Studies Centre at The University of Sydney.