On July 2, 1881, President James Garfield, age 49, was shot by an assassin in a Washington, DC, train station.  He was taken to the White House where care would be better than in a crowded hospital. That day, several doctors used their unwashed fingers and unsterilized instruments to probe for the bullet, hoping they could extract it. But it was in too deep. In the days before X-rays, cutting into his body to search for the missing bullet was out of the question.

Although few people expected Garfield to survive the first night, he rallied. During the two weeks after the shooting, his doctors reported that he made steady, slow improvement. His temperature was slightly elevated, but they weren’t worried.  The bullet wound discharged “healthy pus” through a drainage tube, which his doctors interpreted as a sign of healing. Everyone was optimistic. Recuperation might take time, but Garfield was a strong and energetic man.

Today, a physician would recognize that fever and a pus-producing wound pointed to a serious infection.

On July 22, everything suddenly changed. Garfield was sweating and having intense chills. He ran a high fever. His heart raced. A sac full of pus had formed near the bullet hole. Despite surgery to relieve the pus, Garfield relapsed. The pus built up faster than the doctors could drain it. 

Six weeks after the shooting, Garfield was failing rapidly. He couldn’t keep food down, and his weight had plummeted by 80 pounds. A river of pus oozed from his drainage tubes. He developed abscesses in his armpits and on his chest and back. Fluid started to accumulate in his lungs.

Even though the lead physician, D. W.  Bliss, continued to talk as if recovery was likely, Garfield understood the gravity of his condition. Weary and weak, he begged to leave the White House sickroom. He ached to be outside to see the sky and gaze at the sea.

Arrangements were made to transport him by train to Elberon, New Jersey, a seaside town where Garfield had enjoyed vacations. On September 6, a specially outfitted train took him north to a large cottage next to the ocean. Close friends and family held out hope that the sea air and change of scenery would help him recover.

Garfield savored the sounds of the ocean and sight of people swimming. He said he felt as if “he was himself again.”

But the pus kept draining from the president’s gunshot wound.  His lung infection worsened, and he coughed up pus and mucous. He had periods of chills followed by sweating. At times, he hallucinated.

On Monday evening, September 19, Garfield called to his friend who was on duty in the president’s candlelit room. “What a pain I have right here.” He placed his hand over his heart.

With that, James Garfield fell unconscious.  Less than a half hour later, he took his last breath. It was 10:35 p.m. James Garfield was dead, eighty days after the bullet had pierced his back. 

An autopsy was performed, but controversy went on. What actually killed the president? The bullet or medical malpractice? Could his life have been saved?

Long after President Garfield’s death on September 19, 1881, his assassination affected politics, government, and medicine.  I tell the entire tragic story in AMBUSHED!: The Assassination Plot Against President Garfield.