It was with this supreme, yet unwarranted, confidence that Guiteau shuffled about the station’s waiting room for a few minutes until President Garfield arrived in his State Department carriage. The President was excited to be leaving the stifling, swampy heat of a particularly grueling Washington summer for his 25th reunion at Williams College in Massachusetts, where he was to provide the keynote address and perhaps impress upon his two teenage sons the importance of a college education—especially one garnered from his alma mater. Despite the assassination of President Lincoln 16 years earlier, Garfield arrived at the station with no security of any sort. At the time, it was thought that accompanying a President with personal guards would look too ostentatious and, while the Secret Service did exist, they wouldn’t be formally charged with looking after the President’s safety until after Mckinley’s assassination in 1901. Garfield would have walked to the platform all by his lonesome had not the man who was riding with, his Secretary of State James Blaine, insisted that he accompany him there, thinking it improper for the President of the United States be alone in public. Ironically, considering the events that were about transpire, the man waiting to greet the President at the station platform was Robert Todd Lincoln, the eldest son of America’s 16th Commander in Chief and Garfield’s Secretary of War.

But Garfield would never make it to the platform. Almost immediately after he stepped into the station’s waiting room, Charles Guiteau came up from behind the President and fired off two shots with a .44 caliber British Bulldog revolver. The first shot missed its mark, merely clipping the President’s right arm, but the second was right on target, plunging into Garfield’s back just above his waistline and 4 inches to the right of his spinal column. Unbeknownst to the doctors who would treat him at scene, as well as Dr. D. Willard Bliss, the man who would take control of the President’s medical care at The White House, the initial bullet wound was likely not fatal on its own. After entering the body, the bullet tore through two of the President’s ribs along with the body and connective tissue of his first lumbar vertebra, before finally coming to rest behind his pancreas.

Had his doctors simply left the bullet well enough alone and properly tended to and cleaned the President’s wound, there is little doubt that he would have survived. Hundreds of veterans of The Civil War were still alive and walking around at the time with chunks of Union or Confederate lead in them, while Andrew Jackson had already set a rather impressive presidential precedent by living the last 39 years of his life with a bullet in his chest. And, while we will never know whether or not Garfield would have recovered from his injuries had they been given time to heal, we do know that the actions of his physicians, and not the bullet itself, were the primary cause of the President’s death.

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President Garfield on his deathbed

Despite the advances of men like Louis Pasteur and Joseph Lister, who was the first to promote antiseptic medical treatment and the sterilization of surgical implements in recent years, most of the American medical community had yet to buy into germ theory. In 1881, many surgeons still refused to clean off the smears of dried blood on their aprons, which they considered to be badges of honor, and would rarely wash their hands before operating on someone. On July 2nd —and for the 80 days after that—doctor after doctor after doctor poked, probed and prodded at President Garfield’s wound, leading to a series of infections and eventually causing sepsis. In just the 24 hours following the assassination attempt, 15 different pairs of unsterilized hands fumbled about in the President’s open wound in a well-meaning, but ultimately destructive hunt for the bullet.

When Garfield finally died that September and was autopsied, the physicians were shocked to find the area surrounding the bullet on the left side of his body to be infection free, with the hunk of lead firmly encased in fibrous tissue. However, on the right side of the President’s body lay a deep channel that ran 12 inches from the entry point of the bullet wound down into his pelvic tract. For nearly 3 months, the President’s doctors had been operating under the assumption that the bullet would be found in or around this corridor of infected flesh, but they were mistaken. In reality all they had been doing was digging a footlong tunnel in the President’s insides with their own fingers and probes that would swell with pus and lead to catastrophic septic poisoning.

As it turns out, Guiteau spoke the truth during his trial. “The doctors killed Garfield,” he told the court shortly after the President’s death. “I just shot him.”