This is non-fiction history at its best. Candice Millard has a remarkable ability to selectively pick out interrelated story lines from an abundance of historical records and arrange them in a narrative to create a compelling read. This book focuses on the 1881 assassination of the James Garfield, the 20th President of the United States, and in the process of telling the story also describes the lives of various other individuals who were a part of that time in history.
This story takes place during one of those "no-war" interludes of American history which tends to be overlooked or forgotten by most Americans. This book brings to life in an interesting manner a period of history that many of us don't know much about, the second half of the 19th century.
The subtitle, "A Tale of Madness, Medicine and the Murder of a President," may sound a bit sensational, but the author successfully makes the case for it.
"Madness" refers to the assassin and in this case there was an especially kooky individual involved. Even though many assassinations had been occurring during this time in Europe, no body guard protection was provided for the President. Such protection was apparently considered not needed in a democracy. So accomplishing the act of assassination was remarkably easy to perform.
"Medicine" refers to the bungled efforts of the medical profession to administer to the President's injuries. Based upon what we know now about antisepsis, hydration and nutrition, almost everything wrong that could have been done in the medical treatment of Garfield after he was shot was done. It is generally agreed by impartial observers that if Garfield's wounds had simply been cleaned and covered and left alone, he would have survived.
"Murder" refers to the possibility that the doctors may have been as responsible for Garfield's death as the assassin. The irony is that the practice of providing antiseptic conditions by surgeons was widely practiced in Europe at the time. But for some reason many American surgeons were reluctant to adopt such "new fangled" concepts of concern for "unseen" bacteria.
Public criticism over the medical treatment of Garfield after his death probably contributed to speeding up the adoption of antisepsis techniques in the United States. Also, the fact that the assassin had been seeking a political appointment contributed to the adoption of civil service reform after Garfield's death.
However, for some reason no improvements were made to measures to protect the President from assassins. Secret service protection for the President didn't begin until after the assassination of President McKinley some 20 years later.