Friday, January 6, 2012

Destiny of the Republic

Regular readers of this blog know that I am in the habit of listening to audio books while I take my dog Suki on her daily walks. My tastes lean toward science, history, and biography, and I always keep a watch out for biological or medical physics in these books. Over the Christmas break, I listened to Destiny of the Republic: A Tale of Madness, Medicine and the Murder of a President, by Candice Millard, about the assassination of President James Garfield in 1881, shot by madman Charles Guiteau.

The book tells the fascinating story of Garfield’s nomination at the Republican National Convention in 1880, back in a time when conventions were less choreographed and predictable than they are today. Garfield nominated his fellow Ohioan John Sherman (General William Tecumseh Sherman’s brother), who was running against Senator James Blaine and former president Grant. After many ballots in which no nominee obtained a majority, the delegates turned to Garfield as their compromise choice. After being chosen the Republican nominee, he defeated Democrat and former Civil War general Winfield Scott Hancock in the general election.

A few months after being sworn in, Garfield was shot by Guiteau, who had applied for a job in the new administration but had been turned down. The bullet did not kill Garfield immediately, and he lingered on for weeks. At this point, medical physics enters the story through one of the book’s subplots about the career of Alexander Graham Bell, inventor of the telephone. Millard tells the tale of how Bell set up one of his early telephones for demonstration at the 1876 Centennial Exposition, but was ignored until a chance meeting with his acquaintance, Emperor Pedro II of Brazil, who drew attention to Bell’s display. Upon hearing that the President had been shot, Bell quickly invented a metal detector with the goal of locating the bullet still lodged in Garfield’s abdomen. The detector is based on the principle of electromagnetic induction, discussed in Section 8.6 of the 4th edition of Intermediate Physics for Medicine and Biology. A changing magnetic field induces eddy currents in a nearby conductor. These eddy currents produce their own magnetic field, which is then detected. Essentially, the device monitored changes in the inductance of the metal detector caused by the bullet. Such metal detectors are now common, particularly for nonmedical uses such as searching for metal objects buried shallowly in the ground. At the time, the device was rather novel. Michael Faraday (and, independently, Joseph Henry) had discovered electromagnetic induction in 1831, and Maxwell’s equations summarizing electromagnetic theory were formulated by James Maxwell in 1861, only twenty years before Garfield’s assassination. Being a champion of medical and biological physics, I wish I could say that Bell’s invention saved the president’s life, or at least had a positive effect during his treatment. Unfortunately, it did not, in part because of interference from metal springs in the mattress Garfield laid on, but mainly because the primary physician caring for Garfield, Dr. Willard Bliss, insisted that Bell only search the right side of the body where he believed the bullet was located, when in fact it was on the unexplored left side.

Another issue discussed in the book is the development of antiseptic methods in medicine, pioneered by Joseph Lister in the 1860s. Apparently the direct damage caused by the bullet was not life-threatening, and Millard suggests that if Garfield had received no treatment whatsoever for his wounds, he would have likely survived. Unfortunately, the doctors of that era, being skeptical or hostile to Lister’s new ideas, probed Garfield’s wound with various non-sterile instruments, including their fingers. Garfield died of an infection, possibly caused by these actions.

I enjoyed Millard’s book, and came away with a greater respect for President Garfield. Bell’s metal detector was used to locate bullets in injured soldiers throughout the rest of the 19th century, until X rays became the dominant method for finding foreign objects. It is an early example of the application of electricity and magnetism to medicine.

Click here to listen to Candice Millard speak about her book.

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