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

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

Posted by Candice Millard

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Published: 2025-11-11 | Updated: 2025-11-11

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Book Details

James A. Garfield was one of the most extraordinary men ever elected president. Born into abject poverty, he rose to become a wunderkind scholar, a Civil War hero, and a renowned and admired reformist congressman. Nominated for president against his will, he engaged in a fierce battle with the corrupt political establishment. But four months after his inauguration, a deranged office seeker tracked Garfield down and shot him in the back.

But the shot didn’t kill Garfield. The drama of what hap­pened subsequently is a powerful story of a nation in tur­moil. The unhinged assassin’s half-delivered strike shattered the fragile national mood of a country so recently fractured by civil war, and left the wounded president as the object of a bitter behind-the-scenes struggle for power—over his administration, over the nation’s future, and, hauntingly, over his medical care. A team of physicians administered shockingly archaic treatments, to disastrous effect. As his con­dition worsened, Garfield received help: Alexander Graham Bell, the inventor of the telephone, worked around the clock to invent a new device capable of finding the bullet.

Meticulously researched, epic in scope, and pulsating with an intimate human focus and high-velocity narrative drive, The Destiny of the Republic will stand alongside The Devil in the White City and The Professor and the Madman as a classic of narrative history.

Book Takeaways

The cost of arrogance in science: The mistakes of physicians who resisted antisepsis (Lister methods) led to the debate about "doctors' fingers being more than the killer's bullet"; evidence-based medicine and sterilization are crucial.

Innovation alone is not enough: Bell's device failed because of bad assumptions and poor implementation; technology must be combined with sound methodology and an open mind.

Merit in public service: The assassination exposed the rottenness of the patronage system; the subsequent acceleration of civil service reform.

Institutional learning: Crises—in medicine and politics—can lead to the emergence of enduring standards (e.g., the widespread adoption of antisepsis and modern surgical practices).

Character and leadership: Garfield's integrity, intellectual curiosity, and inclusive vision exemplify leadership whose "tenure is short but impact is long."

Public awareness of mental health: Guiteau's instability reminds us of the importance of better understanding and processes regarding mental health for the justice system and society.

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