Task in Hand

AS THE DUST SETTLED, the crowd’s tension rose around the victim. The startling interruption of a gun shot still hung in the air as a madman ranted and a president lay dying. Snubbed ambassadorial candidate Charles Guiteau shot President James Garfield twice with a Bulldog .44 on the morning of July 2, 1881. Both bullets found their target. One grazed Garfield’s arm, the other lodged deep behind his left lung near his spine. As the would-be assassin was being muscled to the ground just a few feet away, the victim faded in and out of consciousness lying in the lap of the man who would ultimately kill him – his doctor.

Condemning Dr. Doctor (his parents ambitiously named him Doctor) Willard Bliss for the death of the 20th US President may be unfair. After all, he didn’t fire the bullets. Nevertheless, placing part of the blame for the patient’s death in the doctor’s (and his team’s) hands is accurate. Most historians and medical experts now believe that Garfield probably would have survived his wounds had Bliss and his team been more hygienic – or at least, less contaminated. Several inserted their un-sterilized fingers (trace amounts of horse manure were found along the bullet’s tunnel) and instruments into the wound to probe for the bullet. President Garfield died 80 days later of a massive heart attack, following blood poisoning caused by Streptococcus bacteria introduced into his body by his physician – a scenario that could have been avoided if the doctors had only washed their hands. Because of the high ranking status of the victim, a poor hand-washing regimen was responsible for dramatically changing the world.

Hand washing as a part of medical practice was not new at the time of Garfield’s death. As early as 1843, renowned physician and author Oliver Wendell Holmes, Sr. argued for the benefits of hand washing in the prevention of Peurperal (or “childbed”) Fever. In 1847, Ignaz Semmelweiss in Austria began using chlorine compounds for hand-washing after noticing a much lower mortality rate at a midwive’s delivery clinic that incorporated the chemicals. In 1867, after seeing the benefits of carbolic acid (also known as Phenol –an ingredient in aspirin, but also used as a lethal injection into prisoners at Auschwitz during WWII) as a sewage deodorizer, Britain’s Dr. Joseph Lister successfully demonstrated the use of carbolic acid as an antiseptic, finally getting the attention of medical practitioners world-wide. (Dr. Lister’s notoriety also grew eventually lending his namesake to Listerine mouthwash.) Dr. Lister’s application utilized a spray pump that rendered the caustic acid airborne for all in the operating theater to breathe. Unfortunately for President Garfield, much of the American medical community was not yet convinced of these methods and was unwilling to allow ‘foreign’ practice into a community with no shortage of hubris. (After an autopsy on Garfield’s remains revealed the extent of the infection and physical damage caused by the team’s treatment, the doctors still submitted a bill of $18,500 to the Office of the President.)