was that kind of man.”
Conkling survived that night, even returned to work, but on April 4 he fell ill again. For nearly two weeks, he fought to gain the upper hand, falling in and out of a feverish delirium. Twelve years earlier, while suffering from a severe case of malaria, Conkling had told a friend through clenched teeth, “I am not going to die.” Now, he paced the floor of his room, fighting off those who tried to help him as his temperature soared. The battle lasted until two o’clock on the morning of April 17, when, more than a month after he had walked through one of the deadliest snowstorms in New York history, Conkling died from pulmonary edema.
Although there were many deaths in the late nineteenth century that even the most skilled physicians had no ability to prevent, Garfield’s was not one of them. In fact, following his autopsy, it became immediately and painfully apparent that, far from preventing or even delaying the president’s death, his doctors very likely caused it.
Bliss had a few loyal defenders, but as a whole, the international medical community forcefully condemned the decisions he had made and the actions he had taken, particularly the repeated, unsterilized probing of the president’s wound. Just six months after Garfield’s death, The Boston Medical and Surgical Journal printed a lecture by the renowned German surgeon Friedrich Esmarch. “It seems that the attending physicians were under the pressure of the public opinion that they were doing far too little,” Esmarch had said. “But according to my opinion they have not done too little but too much.”
American physicians were less gentle in their assessment. Bliss had done “more to cast distrust upon American surgery than any time heretofore known to our medical history,” one doctor wrote. Young surgeons, especially, were scornfully critical of Bliss’s care. “None of the injuries inflicted by the assassin’s bullet were necessarily fatal,” wrote Arpad Gerster, a thirty-three-year-old New York surgeon who had recently been in Europe, studying the “Listerian method of wound treatment,” and would write the first American surgical textbook based on that method. To the physicians of his generation, Gerster continued, Garfield’s death proved with certainty that, as the poet Thomas Gray had written more than a century earlier, “ignorance is Bliss.”
Bliss, however, refused to be cowed. Garfield, he said, had died not from a massive blood infection, but as the result of a broken backbone. He insisted, moreover, that the care he had given the president had been not only adequate, but exemplary. In a document titled “Statement of the Services Rendered,” Bliss and the few surgeons he had allowed to work with him argued that “he should receive, as he merits, the sympathy and goodwill (as well as the lasting confidence) of every patriotic citizen for the great skill, unequalled devotion and labor performed in this notable case, which … secured to the distinguished patient the perfection of surgical management.”
To the astonishment of the members of Congress, Bliss confidently presented them with a bill for $25,000—more than half a million dollars in today’s currency. While caring for the president, Bliss said, he had lost twenty-three pounds, and his health was “so greatly impaired as to render him entirely unable to recover or attend to his professional duties.” Congress agreed to pay Bliss $6,500, and not a penny more. Bliss, outraged, refused to accept it, bitterly complaining that it was “notoriously inadequate as a just compensation.” Seven years later, Bliss would die quietly at his home following a stroke, having never recovered his health, his practice, or his reputation.
The day after her husband’s funeral, Lucretia Garfield returned home to Mentor. At first, even surrounded by family and friends—her children, her mother-in-law, Rockwell and his family, and Swaim and his wife had all gone with her—the house felt achingly empty. “Now that Papa has gone,” James, her second son, wrote that night, “our home will be desolate.” For Lucretia, the farmhouse had always been filled with her husband’s great, booming laughter, or with the happy anticipation of his return. “Had it not been that her children needed her more than at any time in their lives,” Mollie would write of her mother years later, “life would have meant very little to her.”
Lucretia, however, would not surrender to grief. One of the few outward concessions she would make to a life of mourning was her stationery, which, from the day of James’s death until her own, would be trimmed in black. The letters