How Did Lincoln Die?

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Everyone knows that the ball John Wilkes Booth fired into Abraham Lincoln’s brain inflicted a terrible, mortal wound. But when a prominent neurosurgeon began to investigate the assassination, he discovered persuasive evidence that Lincoln’s doctors must share the blame with Booth’s derringer. Without their treatment the President might very well have lived.

Threat of assassination may seem the greatest risk a President of the United States must take upon entering office, but history suggests that until recently a Chief Executive’s life was threatened more by his post-assault medical treatment than by his assassin’s bullet. There have been at least eleven attempts on the lives of American Presidents, four of them successful. John F. Kennedy was shot with a high-velocity bullet that destroyed his brainstem, an instantly fatal injury that rendered any medical treatment useless. The three other victims did not immediately suffer fatal wounds.

Both James Garfield and William McKinley received substandard medical care after being shot, which probably contributed more to their deaths than the wounds themselves. Garfield, who was shot in 1881, died of sepsis, an infection that may result from any wound but in his case most likely resulted from a series of unsterile wound probes by his doctors. It is curious that while Garfield’s doctors took every other antiseptic measure throughout the case, they explored the wound with naked fingers fourteen times , repeatedly engaging in a practice thoroughly condemned by medical texts of the day.

McKinley’s death twenty years later also appears to have been the result of his doctors’ poor judgment. The surgeon who attended him, Dr. Mathew Mann, was an obstetrician-gynecologist who had never operated on a gunshot victim and should have declared himself unqualified. Dr. Herman Mynter, the first surgeon on the scene, was responsible for the hasty appointment of Dr. Mann. Mynter decided that the surgery must be performed as soon as possible, and Mann lived nearby. However, the time it took actually to begin operating would have been sufficient to bring the wounded President to one of the most advanced medical facilities in the country, the Buffalo General Hospital, which owned one of the first X-ray machines and employed doctors well qualified to perform the procedure. Instead McKinley was taken to an ill-equipped, unlit room in the Exposition Hospital and, like Garfield, died of sepsis.

Booth stood four feet behind the President and pulled the trigger; Lincoln’s head drop to his chest.

After having discovered the quality of medical care given to these two American Presidents, I thought it reasonable to investigate the care of their predecessor, Abraham Lincoln. Many details of the event that took place on the night he was shot are obscured by misleading and contradictory accounts, but a consensus of various sources maintains certain facts.

On the evening of April 14, 1865, five days after General Lee surrendered his exhausted army, President Abraham Lincoln attended a performance of Our American Cousin at Ford’s Theater in Washington. He arrived late, at approximately 8:15 P.M. , and the play was briefly halted to welcome his entrance. Lincoln was accompanied to the President’s box with his wife and his guests, Miss Clara Harris and her fiancé, Maj. Henry R. Rathbone. At around ten o’clock John Wilkes Booth, who frequently performed at Ford’s Theatre and had a close rapport with most of the staff, walked into the theater’s main entrance and approached the ticket taker, Joseph ("Buck") Buckingham, whom he knew very well. Jokingly Booth asked him, “You’ll not want a ticket from me?” Buck laughed and told his friend, “Courtesy of the house.” Booth headed up the stairs to the dress circle.

Sometime between ten-fifteen and ten-thirty, he entered the President’s box. Lincoln, his attention temporarily diverted from the stage, was sitting with his head tilted forward and to the left, probably watching a musician in the orchestra. Standing about four feet behind the President, Booth pulled the trigger of his derringer and Lincoln’s head dropped to his chest.

The first doctor to reach the wounded President was Charles A. Leale. He was the assistant surgeon of United States Volunteers and only twentythree years old. The remainder of this account of Lincoln’s death is taken mostly from a report Leale rewrote from notes he made the day Lincoln died and submitted to the Congressional Assassination Committee in 1867. Directly after Leale saw Booth leap onto the stage, wave a dagger, and hurry toward the exit, the doctor heard shouts for a surgeon. Leale made his way to the President’s box. “While approaching the President—I was told that—he had been murdered, and I sent for some brandy and water.” He arrived at the box and saw Major Rathbone standing at the door. Lincoln was sitting on a high-backed armchair with his head leaning toward his right side, supported by Mrs. Lincoln. Miss Harris was at the left and behind the President.