manure to an open wound.
Even those doctors willing to try antisepsis rarely achieved better results than they had with traditional practices. Their failure, however, was hardly a mystery. Although they dipped their instruments in carbolic acid, they used wooden handles, which could not be sterilized, and they rested them on unsterilized towels. If the surgical knife they had carefully sterilized happened to fall on the floor during an operation, they would simply pick it up and continue to use it. If a procedure required both hands, they would hold the knife in their teeth until they needed it again.
In the midst of the arrogance, distrust, and misunderstanding that characterized the American medical establishment’s attitude toward Lister’s theories, there was a small but growing bastion of doctors who understood the importance of practicing antisepsis, not halfheartedly but precisely. A young surgeon in New York would later write that he and his colleagues had watched with helpless horror the progress of Garfield’s medical care. The president’s life might have been spared, he wrote with disgust, “had the physician in charge abstained from probing Garfield’s wound while he lay on a filthy mattress spread on the floor of a railroad station.”
Even as far west as Kansas, Lister’s followers sought to intervene on the president’s behalf. In a letter to Lucretia the day after the shooting, Dr. E. L. Patee, a highly respected surgeon from Manhattan, Kansas, warned her that she must shield her husband from potentially harmful medical care. “Do not allow probing of the wound,” he urged. “Probing generally does more harm than the ball.” Although he lived far from what was then considered the center of medical thought in the United States, Patee had read carefully Lister’s work and understood its importance. “Saturate everything with carbolic acid,” he begged the first lady. “Our whole state is in … great grief. God help you.”
Unfortunately, young, inexperienced surgeons and rural doctors had little hope of being heard. The morning after Patee wrote to Lucretia, two surgeons arrived at the White House, summoned there by Bliss. David Hayes Agnew, the chief of surgery at the University of Pennsylvania, and Frank Hamilton, a surgeon at the Bellevue Medical College in New York, were “old men,” an American doctor would write, “and not likely to be pioneers in a new field of surgery.” Both men had attended Lister’s talk at the Centennial Exhibition, and both had made it clear that they distrusted his ideas. So vigorously had Agnew and Lister disagreed that day that a journalist covering the conference had written that “these gentlemen used no buttons to their foils. Thrusts were given in earnest.” Hamilton had openly questioned the value of antisepsis, while extolling the virtues of his own practice of treating wounds with simple warm water, a common and germ-laden procedure that Lister had long warned “would in many cases sacrifice a limb or a life.”
In the five years since he had heard Lister speak, Hamilton’s opinions had not changed, and his arrogance, it seemed, had only grown. Soon after reaching the White House, he assured a reporter that the president’s care would “bear the severest scrutiny of the experts,” and that there was little danger of him dying. “The symptoms are so encouraging,” Hamilton said, “that it seems to me the President now has pretty clear sailing. He is fairly in deep water, with no threatening rocks and little danger of running aground.”
In his confidence, Hamilton was exceeded only by Bliss, who was impatient to present himself to the American people as the calm, competent leader of the president’s medical team. Just a few days after the shooting, he settled into Joseph Stanley Brown’s office with a journalist from the New York Times. Languidly lighting a cigar, he told the reporter, “I think that we have very little to fear.” As a crowd began to gather around him, anxious for news of the president, Bliss warmed to his subject. “President Garfield has made a remarkable journey through this case, and it was a happy wound after all,” he assured his audience. “I think it almost certain that we shall pull him through.”
As Bliss spoke, smoke from his cigar rising in thick curls and filling the room with a heavy, pungent smell, the bright sky outside Brown’s window darkened. Without warning, an afternoon thunderstorm swept through the city. Rain fell in torrents, distorting the trees and river beyond, and lightning illuminated the grounds in short, sharp flashes.
The president, Bliss said, was “the most admirable