Destiny of the Republic: A Tale of Madness, Medicine and the Murder of a President

by Candice Millard

The results of the autopsy would surprise no one more than Garfield’s own doctors. Soon after they had opened his abdomen, with a long, vertical incision and then another, transverse cut, they found the track of the bullet. “The missile,” they realized with sickening astonishment, “had gone to the left.” Following its destructive path—as it shattered the right eleventh and twelfth ribs, moved forward, down, and to the left, through the first lumbar vertebra, and into connective tissue—they finally found Guiteau’s lead bullet. It lay behind Garfield’s pancreas, safely encysted, on the opposite side of the body from where they had been searching. Running down the right side of Garfield’s body was a long channel, which Bliss and eleven other doctors had probed countless times, convinced that, at the end of it, lay the bullet. The autopsy report stated that, while “this long descending channel was supposed during life to have been the track of the bullet,” it was “now clearly seen to have been caused by the burrowing of pus from the wound.” Pus, however, does not burrow. It simply follows an open path, which, in this case, was made by the doctors’ own fingers and instruments. Alongside the channel lay Garfield’s liver, slightly enlarged but untouched. There was, the report noted, “no evidence that it had been penetrated by the bullet.”