Destiny of the Republic: review

Since I had Candice Millard's Destiny of the Republic: A Tale of Madness, Medicine, and the Murder of a President on my phone's Kindle app, I finished reading it on the trip over to Daejeon right before I began my recent abortive walk. I've already reviewed the Netflix miniseries Death by Lightning, which is based on Millard's 2011 book, essentially a double-biography of the latter part of the intertwined lives of President James Garfield and his assassin, an insane man named Charles Guiteau. Like the miniseries, the book jumps back and forth between the lives of Guiteau and Garfield, showing with the benefit of hindsight how these men's lives are on a collision course from early on, what may be the true cause of Garfield's death, and what implications there are, after Garfield's assassination, for both presidential security and infection control in medicine.

We're given some of Garfield's background in terms of his earlier years, aptitude, education, thirst for knowledge, strong sense of family, and work ethic. Garfield becomes a professor of literature and ancient languages; later, he becomes the president of Western Reserve Eclectic Institute (Hiram College today). On top of that, Garfield serves as a general in the Civil War, then as a congressman for almost eighteen years. As the miniseries shows, he is indeed nominated for president at the 1880 Republican Convention in Chicago. After delivering an eloquent and captivating nomination speech on behalf of John Sherman, brother of General William Tecumseh Sherman (who had burned his way down to Atlanta in the Civil War), Garfield ends his address with the question, "What do we want?" to which a voice shouts, "We want Garfield!" And thus begins a process that culminates in Garfield's nomination and leads to his election as the United States' 20th president. Garfield is a good-hearted man with sharp people skills who always tends to build coalitions. His political enemies include corrupt, prideful, and stubborn New York Senator Roscoe Conkling and his henchman Chester A. Arthur. Arthur is chosen to be Garfield's running mate, and the two are often at loggerheads as Conkling tries to use Arthur as a way to influence presidential policy.

Charles Guiteau's story begins with the sinking of a ship he had been on: the Stonington, a steamship. Believing his survival to have been a miracle, Guiteau, already mentally unstable, begins to view his life as having some manner of sacred purpose or destiny. Talented in some ways but aimless, temperamental, and given to being a moocher, Guiteau spends time as part of a weirdly religious free-love commune before leaving and going back to doing various jobs. He is supported in part by his long-suffering sister Frances, but Guiteau's instability leads to his constantly getting into trouble. He often finds himself unable to pay the rent for whatever accommodation he's in, which means he quietly slips out and moves on to another unsuspecting landlord. Guiteau also borrows money from more parties than just his sister, but he rarely if ever pays anyone back. Initially coming to see his sacred destiny as somehow tied to that of James Garfield, Guiteau begins campaigning for Garfield during the election. He starts to see himself as instrumental in—even central to—Garfield's eventual electoral victory and thinks himself deserving of a high-level post, like ambassador to France. To this end, Guiteau often comes to the White House with a host of other petitioners in an attempt to see the president and present his request. In this effort, too, he fails, and his frustration mounts, which eventually leads to his purchase of a Webley British Bull Dog .442 pistol and his shooting of the president at a train station.

The miniseries covers Garfield's shooting in the fourth and final episode, but Millard's book covers Guiteau's shooting of Garfield at about the halfway point in her story. Much of the rest of the book is devoted to the horrible comedy of errors that ensues when Dr. D. Willard Bliss, recommended by Abraham Lincoln's son Robert Todd Lincoln, is requested to come and care for the wounded president, who is shot in July of 1881 and endures until September. At the time, European medicine is undergoing a revolution thanks to the work of Dr. Joseph Lister, a champion of antiseptics and infection control. Hand-washing, carbolic acid, and other procedures are found to radically reduce the rates of deadly in-hospital infections in Europe. But across the pond in America, venerable doctors are unconvinced that Lister's seemingly complicated procedures produce anything but delay and inefficiency. As a result, Dr. Bliss deals with the president in the manner of most of his American colleagues of the time: by probing the president's bullet wound with unwashed fingers and unsterile instruments. One embarrassing reality is that Bliss is unable to find Guiteau's bullet (Guiteau, meanwhile, is sitting in jail, with the American public loudly calling for his slow and agonizing death). The Scottish-born Canadian-American inventor Alexander Graham Bell does what he can to help by creating a device he calls an induction balance, which can essentially act as a noninvasive metal detector to find the embedded bullet. But Bliss is adamant that, as Bell goes through several iterations of this invention, Bell should probe only the side of the president's body where Bliss suspects the bullet to be.

After the president's death from severe sepsis, the autopsy reveals the bullet to be, frustratingly, on the opposite side of the body from where Bliss had thought it was. Not only that, but the bullet had nestled close to certain vital organs and become encysted by new tissue: the bullet, left alone, would have done the president no harm. Even though Guiteau's bullet instigates this horrible chain of events, Dr. D. Willard Bliss is arguably more directly responsible for James Garfield's death thanks to a combination of pride, stupidity, incompetence, and stubbornness about the need for antisepsis. In the wake of Garfield's death, changes are made to American medical procedures to reflect Lister's discoveries and imperatives. Changes are eventually also made to presidential protection (the Secret Service, already in existence in Garfield's time, becomes a full-time security detail only later, in 1902, after the assassination of President William McKinley in 1901) despite a general public feeling that America is not a monarchy, and that the US president should be more readily available to the people than any king. But with Abraham Lincoln's assassination in 1865, then Garfield's in 1881, those close to the president realize they have no choice but to bow to certain realities. Charles Guiteau, meanwhile, is hanged in front of witnesses in 1882, almost a year after shooting Garfield. After Garfield's death, Chester Arthur is elevated to the presidency, and he is a changed man, dissociating himself from his former master Roscoe Conklin and enthusiastically adopting most if not all of Garfield's policies and priorities. It's an extreme metanoia, and Arthur is inspired by one correspondent in particular—Julia Sand, a bedridden woman who constantly writes him, urging him to change his ways, to find his better self, and to lead a grieving nation with strength and wisdom. Sand is never mentioned in the Netflix miniseries, but according to Millard, she is a quietly enormous influence on the life, reformation, and spiritual redemption of Chester A. Arthur.

Overall, I found Candice Millard's retelling of events to be a compelling, lively, and detailed read. I did often wonder, though, how she was able to insert certain bits of fine-grained detail into her narrative. I realize that she worked extensively with voluminous amounts of correspondence, so she was doubtless able to plausibly deduce and re-create events and dialogue based on the letters she read. Millard succeeds in giving us a sad tale of wasted potential: Garfield was a fiercely intelligent and amazingly noble man, the likes of whom would not survive in today's dirty, truth-twisting political reality. For his life to be cut short was painful not only for his immediate family but also for the nation. Millard's narrative is also sophisticated enough to allow the reader to speculate as to who and what really caused James Garfield's death. Was it Charles Guiteau, who fired a bullet that would have done no harm had the bullet wound been left alone? Was it Robert Todd Lincoln's fateful recommendation of Dr. Bliss, the doctor who had been there when his father Abraham Lincoln had been shot? Was it the willfully incompetent Dr. Bliss himself—a man who, until his death, never backed down from his obviously errant conclusions and convictions?

On a personal level, the hubristic figure of Dr. Bliss reminds me strongly of certain types of Korean incompetence in important fields ranging from health care to aviation. Bliss enjoyed the same sort of benefits deriving from social hierarchy that older Koreans in prominent positions enjoy. With underlings unable to question decisions, with new inventions and techniques not being permitted to be used to their full potential (Alexander Graham Bell could have saved the president had he been permitted to conduct his exploration of the president's body on his own terms), with one's own pride, status, and ego being more important than truth and reality... Dr. Bliss's situation felt rather Korean to me. I'm not saying Koreans are generally incompetent (quite the opposite!), but in cases where tragedies or scandals occur (e.g., Asiana 214 in 2013, or Dr. Hwang Woo-seok's 2006 bioethics fraud, or any number of preventable disasters), they're often the result of the abovementioned social factors, and this was apparently also true of 1880s-era America (and, for all I know, still true in America today, though probably to a lesser degree than in Korea).

My buddy Mike had recommended that I read Millard's book, and I'm very glad I did. It's a worthwhile read—a compassionate, dynamic, well-written narrative, and I look forward to reading more of Millard's work.