When James Garfield arrived at the suspenseful Republican convention of 1880 in Chicago, he was a U.S. senator. After 34 ballots, he departed as his party's surprise nominee for president.
"Imagine Newt Gingrich and all these guys going into the convention and not knowing what was going to happen. Every single delegate showed up for this convention, and it ended up going in a direction nobody could have guessed," said Candice Millard, author of "Destiny of the Republic: A Tale of Madness, Medicine and the Murder of a President."
Millard is a former editor and writer for National Geographic magazine. Her latest book provides an abject lesson in why doctors need to remain humble and open-minded.
"I didn't start out intending to write a book about Garfield," she said. "I didn't know anything about him beyond the fact that he had been assassinated. I didn't have much interest in writing about him. I wanted a story that had a lot of science in it."
That's why she initially focused on Alexander Graham Bell, who already had invented the telephone.
"(Bell) was 34. He could do anything. He had a little bit of money. He just turned his life upside down to try to help Garfield," Millard said. Bell invented a metal detector to remove two bullets from Garfield, who was shot in Washington on July 2, 1881, but doctors never allowed him to use it, and the president died in New Jersey more than two months later, on Sept. 19.
As Millard learned about Garfield's steady rise from crushing poverty and accomplishments, her interest was piqued.
"He was extraordinary. He was this huge hero in the Civil War," she said, adding that he was also a minister and an abolitionist.
Garfield was president for 200 days. So many people have forgotten about him. Mention "presidential assassinations" and many Americans think of John F. Kennedy, Abraham Lincoln or William McKinley, whose death ushered Theodore Roosevelt into office.
"This was a tremendous tragedy. The entire nation was transfixed by the shooting and by nearly three months of hope and prayer that he would survive," Millard said.
Most people do not know that Garfield was killed, "not by the bullet but by his own physicians," the author said.
Sixteen years earlier, renowned British surgeon Thomas Lister had discovered the value of disinfecting surgical instruments by spraying them with carbolic acid. Lister outlined his breakthrough at the Centennial Exposition of 1876 in Philadelphia. Some of the physicians who treated Garfield had even heard Lister speak.
But many American doctors "believed antisepsis was useless, dangerous. Some of them didn't believe in germs. It's sickening to read about these doctors probing, again and again, into Garfield's wound," Millard said. "He was on the floor of the train station. Can you imagine a more germ-infested environment?"
Garfield was shot twice, but neither bullet pierced his spinal cord or any vital organs.
"He didn't have to die," Millard said, adding that in the post-Civil War era, lots of military veterans had bullets in their bodies and did just fine.
After the media reported on Garfield's autopsy, his doctor, Willard Bliss, was immediately vilified, and antisepsis was adopted as standard practice.
"As soon as autopsy results were released, the American public understood that their president did not have to die," the author said.
Bliss "was publicly disgraced. He never regained his practice. He handed Congress an enormous bill. They paid a small fraction of it."