This is an unmistakable conclusion from the story Millard tells. A main focus of the book is that Garfield need not have died from the wounds inflicted by Guiteau’s bullet, if only modern medical treatments had been followed. Dr. Bliss, the doctor in charge of the president’s care, clearly represents the old guard of the medical establishment, rejecting Joseph Lister’s ideas about antiseptic methods. Lister and Alexander Graham Bell represent the newer generation, each of whom presented evidence of something that could have saved Garfield’s life. Lister was rejected outright while Bell was limited in scope of service.

The result of President Garfield’s murder was in fact a change in something that had contributed to it: the spoils system. In his mind, Charles Guiteau thought he deserved a job in Garfield’s administration based on what he saw as his great contribution to the success of Garfield’s campaign. (Actually, he had done next to nothing.) This was common at the time under the spoils system, though not without its detractors. Garfield had been part of the faction of the Republican Party that had sought to change this system. Before he died, he had bucked the system by appointing his own head of the New York Customs House without consulting Senator