E. Lawrence Abel sets out to investigate whether Lincoln’s
doctors could have saved his life. I’ll warn the reader that he doesn’t find
any concrete guilt or innocence, and even if he did, I wouldn’t be able to blame
it on the doctors. With all the great advances in medicine today, it’s still
unlikely that anyone could survive a gunshot to the head at close range. What
the author does provide, however, is a book on the quality of physicians in
Abraham Lincoln’s time. I found it all quite surprising.
In chapter 8, the author describes how surviving a headshot
depends on where the bullet strikes the head. If it hits the front, it will
destroy speech, but if it hits the back, it will cause blindness or death. In a
later chapter, Abel discusses the way Lincoln’s physicians handled the physical
care; they stuck their fingers in the bullet hole! If you’re wondering what
these qualified men were thinking, the author shows that they weren’t qualified
at all. He quotes President Grant’s physician, Dr. John Binton, on how bad the
army’s medical professionals were during the war. Keep in mind that Dr. Binton
graduated from the best medical school in the nation at the time, but as Binton
recounts, most of them had never been to medical school at all. One of the
surgeons had never performed an amputation, and upon doing so, now had a
reputation as a great surgeon.
Medical professionals didn’t have to be licensed in 1865,
and most of them never went to school to learn the craft. The best you could
hope for was that your physician had done an apprenticeship somewhere, so in
reality they weren’t much different from the barber surgeons of old. Medical
associations had published standards, but only the best-educated doctors
followed them, and those doctors only served the officers and the wealthy. The
rest of the army doctors could only do crude stitching and amputate limbs. Medicines
were little more than 150 proof alcohol laced with opium and cocaine, and there
was no such thing as antiseptics. As for anesthetics, those too would come
later.
The question arises as to whether Lincoln could be saved if
he were shot today, and the modern physicians quotes in this book say yes. It
would’ve required a brain scan, intravenous salinity to shrink the brain
slightly, draining away blood in the brain, and other than that, Lincoln would’ve
been permanently disabled. As for the physicians who attended Lincoln, they
took notes and did tests, including how he responded to light, in which one
pupil was unresponsive. That would tell a modern health professional that one
side of the brain was intact. But when the doctors stuck their fingers into the
bullet hole, did that introduce an infection that killed the President?
It didn’t take this book to surprise me at all. I’d heard
the story of how President Garfield’s doctors stuck all kinds of probes and
unwashed fingers down the bullet hole, when they could’ve just left the bullet
in there and sewn him up. President Roosevelt had a bullet in his shoulder (assassination
attempt) as did President Jackson (battle of New Orleans) and both had those
bullets in there for the rest of their lives. Both survived for years
afterward. Jackson may have gotten lead poisoning from the bullet, but that’s
another story. The use of morphine in the Civil War meant that the questionable
doctors of the time could operate longer, and take bullets out rather than
amputate the limbs. Ironically, these soldiers now had “veterans disease” which
today we call “drug addiction.”
This book serves as a history of medicine in the USA. It
shows what happens when doctors are not regulated by standards.
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