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Stacy Conradt
Stacy Conradt

Grave Sightings: James Garfield

Stacy Conradt
Stacy Conradt

Every time we so much as touch a toe out of state, I’ve put cemeteries on our travel itinerary. From garden-like expanses to overgrown boot hills, whether they’re the final resting places of the well-known but not that important or the important but not that well-known, I love them all. After realizing that there are a lot of taphophiles out there, I’m finally putting my archive of interesting tombstones to good use.

If you've ever taken one of those “Can you name all of the presidents?” quizzes, there’s a good chance you forgot about James Garfield. Though he spent nine terms in the House of Representatives, he was president for less than a year, shot by assassin Charles Guiteau just four months into office. He died 79 days later. Only one president spent less time in the role than Garfield—William Henry Harrison, who died just 32 days into office (but we'll save him for another "Grave Sightings").

Had Garfield been shot today, he would have likely survived his injuries. Guiteau fired at the president as he entered the Sixth Street train station in Washington, D.C., headed for a summer vacation. Two bullets struck the president: One in the arm and one in the back. No vital organs were hit, but the bullet in Garfield’s back remained lodged just behind his pancreas. If the bullet had been left alone, Garfield probably would have been just fine. Instead, 12 different doctors prodded at the open wounds—while Garfield was still sprawled on the dirty train station floorwith their ungloved fingers and unsterilized instruments.

Though no one thought he would survive the night, the president lingered all summer. His doctor continued to try to find the bullet, even enlisting Alexander Graham Bell and his new invention, the metal detector. Unfortunately, Bell had two major factors working against him. First of all, Garfield’s doctor insisted that the bullet was on the right side of the body. It wasn’t. Secondly, unbeknownst to Bell, the president was resting on a bed made of metal springs, which, you know, may have slightly affected the accuracy of the metal detector.

To make matters worse, Garfield's doctors starved him. Steak dinners were replaced with eggs, milk, whiskey, and opium. The president dropped 100 pounds in a matter of weeks, leaving him with just 130 pounds on his six-foot frame when he finally died on September 19, 1881. The death had nothing to do with the bullet in his body—it was blood poisoning and other complications from procedures that eventually did him in.

Even Guiteau knew how badly Garfield’s doctors had screwed up. “The doctors killed Garfield,” he later said in court. “I just shot him.”

Devastated by the loss of another president, Americans responded by erecting a 180-foot-tall memorial in Lake View Cemetery in Cleveland, Ohio. It remains one of the most elaborate presidential monuments to this day, with gold mosaics, stained glass windows, marble statues, and granite columns. So far, it’s the only memorial that puts a presidential casket, next to that of his wife, on full display. The ashes of the Garfields' daughter, Mollie, and her husband, Joseph Stanley Brown, are in the two urns in front of the caskets.

Peruse all the entries in our Grave Sightings series here.

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Essential Science
What Is Death?
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iStock

The only thing you can be certain about in life is death. Or is it? Merriam-Webster defines death as "a permanent cessation of all vital functions." The Oxford English dictionary refines that to "the permanent ending of vital processes in a cell or tissue." But determining when someone is dead is surprisingly complicated—the medical definition has changed over the centuries and, in many ways, is still evolving.

DEATH, DEFINED

For most of human history, doctors relied on basic observations to determine whether or not a person had died. (This may be why so many feared being buried alive and went to great lengths to ensure they wouldn't be.) According to Marion Leary, the director of innovation research for the Center for Resuscitation Science at the University of Pennsylvania, "If a person wasn't visibly breathing, if they were cold and bluish in color, for example, they would be considered dead."

As time went on, the markers for death changed. Before the mid-1700s, for example, people were declared dead when their hearts stopped beating—a conclusion drawn from watching traumatic deaths such as decapitations, where the heart seemed to be the last organ to give up. But as our understanding of the human body grew, other organs, like the lungs and brain, were considered metrics of life—or death.

Today, that remains true to some degree; you can still be declared dead when your heart and lungs cease activity. And yet you can also be declared dead if both organs are still working, but your brain is not.

In most countries, being brain dead—meaning the whole brain has stopped working and cannot return to functionality—is the standard for calling death, says neuroscientist James Bernat, of the Geisel School of Medicine at Dartmouth College in New Hampshire. "A doctor has to show that the loss of brain function is irreversible," he tells Mental Floss. In some cases, a person can appear to be brain dead if they have overdosed on certain drugs or have suffered from hypothermia, for example, but the lack of activity is only temporary—these people aren't truly brain dead.

In the U.S., all states follow some form of the Uniform Determination of Death Act, which in 1981 defined a dead person as "an individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem."

But that's not the end of the story. In two states, New York and New Jersey, families can reject the concept of brain death if it goes against their religious beliefs. This makes it possible for someone to be considered alive in some states and dead in others.

A BLURRED LINE

In the past, if one of a person's three vital systems—circulation, respiration, and brain function—failed, the rest would usually stop within minutes of each other, and there was no coming back from that. But today, thanks to technological advances and medical breakthroughs, that's no longer necessarily the case. CPR can be performed to restart a heartbeat; a person who has suffered cardiac arrest can often be resuscitated within a 20- to 30-minute window (in rare cases, people have been revived after several hours). And since the 1950s, machines have been used to take on the role of many of the body's vital functions. People who stop breathing naturally can be hooked up to ventilators to move air in and out of their lungs, for example.

While remarkable, this life-extending technology has blurred the line between life and death. "A person can now have certain characteristics of being alive and others of being dead," Bernat says.

People with severe, irreversible brain damage fall into this mixed category. Many lie in intensive care units where ventilators breathe for them, but because they have minimal reflexes or movements, they're considered alive, especially by their families. Medical professionals, however, may disagree, leading to painful and complex debates about whether someone is alive.

Take the case of Jahi McMath, whose tonsil surgery in 2013, at age 13, went terribly wrong, leaving her brain dead—or so doctors thought. Her family refused to believe she was dead and moved her from Oakland, California, to New Jersey, where she was provided with feeding tubes in addition to her ventilator. After several months, her mother began recording videos that she said were proof that Jahi could move different parts of her body when asked to. Additional brain scans revealed that although some parts of her brain, like her brain stem, were largely destroyed, the structure of large parts of her cerebrum, which is responsible for consciousness, language, and voluntary movements, was intact. Her heart rate also changed when her mother spoke, leading a neurologist to declare last year, after viewing many of her mother's videos, that she is technically alive—nearly four years after she was pronounced brain dead. By her mother's reckoning, Jahi turned 17 on October 24, 2017.

Organ donation adds another layer of complications. Since an organ needs to be transplanted as quickly as possible to avoid damage, doctors want to declare death as soon as they can after a person has been disconnected from a machine. The protocol is usually to wait for five minutes after a donor's heart and breathing have stopped. However, some believe that's not long enough, since the person could still be resuscitated at that point.

Bernat—whose research interests include brain death and the definition of death, consciousness disorders including coma and vegetative states, and ethical and philosophical issues in neurology—disagrees. "I would argue that breathing and circulation has permanently ceased even if it hasn't irreversibly ceased," he says. "It won't restart by itself."

THE FUTURE OF BRINGING PEOPLE BACK TO LIFE

As resuscitation technology improves, scientists may find new ways to reverse death. One promising approach is therapeutic hypothermia. Sometimes used on heart attack patients who have been revived, the therapy uses cooling devices to lower body temperature, usually for about 24 hours. "It improves a patient's chance of recovering from cardiac arrest and the brain injury [from a lack of oxygen] that can result from it," says Leary, who specializes in research and education relating to cardiac arrest, CPR quality, and therapeutic hypothermia.

One more out-there possibility—which had its heyday in the early 2000s but still has its proponents today—is cryonic freezing, in which dead bodies (and in some cases, just people's heads) are preserved in the hope that they can be brought back once technology advances. Just minutes after death, a cryonaut's body is chilled; a chest compression device called a thumper keeps blood flowing through the body, which is then shot up with anticoagulants to prevent blood clots from forming; and finally, the blood is flushed out and replaced with a kind of antifreeze to halt the cell damage that usually occurs from freezing.

The idea is highly controversial. "It makes a good story for a movie, but it seems crazy to me," Bernat says. "I don't think it's the answer." But even if cryogenics is out, Bernat does believe that certain types of brain damage now thought to be permanent could one day be subject to medical intervention. "There is currently a huge effort in many medical centers to study brain resuscitation," he says.

Genetics provides another potential frontier. Scientists recently found that some genes in mice and fish live on after they die. And even more surprisingly, other genes regulating embryonic development, which switch off when an animal is born, turn on again after death. We don't yet know if the same thing happens in humans.

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History
Doctor Weighs In on What May Have Killed Saladin, the 12th-Century Muslim Military Leader
Hulton Archive, Getty Images
Hulton Archive, Getty Images

Saladin, the 12th-century sultan of Egypt and Syria, was one fearless ruler. After unifying much of the Muslim world, he took on the Christian Franks at the Battle of Hattin and won, bringing Jerusalem back under Islamic rule and setting off the Third Crusade.

It wasn’t battle that did him in, though. Dr. Stephen Gluckman, a professor of medicine at the University of Pennsylvania, believes the cause of Saladin's death in 1193 was most likely typhoid, LiveScience reports.

Up until now, the circumstances of Saladin’s passing have largely remained a mystery, as is often the case with people who lived long before modern diagnostic tools were invented. Gluckman was able to reach a diagnosis by analyzing Saladin’s symptoms as they were recorded more than 800 years ago, and shared his medical opinion at this year’s Historical Clinicopathological Conference at the University of Maryland, which taps experts to diagnose a different deceased historical figure each year. In past years, some theorized that Charles Darwin’s cause of death was cyclic vomiting syndrome, and Edgar Allan Poe’s demise was attributed to either rabies or delirium tremens—“a severe form of alcohol withdrawal.”

As for Saladin, he suffered a “mysterious fever and two-week illness,” according to LiveScience. He died at age 55 or 56, despite efforts to revive him with bloodletting techniques and enemas.

Gluckman was able to rule out plague and smallpox because they tend to kill quickly, and tuberculosis and malaria didn’t fit the bill, either. Typhoid, however, was common at that time, and Saladin's symptoms seemed consistent with other cases. Caused by the bacteria Salmonella typhi, typhoid is spread through contaminated water or food. High fever is the main symptom, but weakness and loss of appetite are also typically observed.

Saladin was buried next to the sword he had carried during the Holy War, but otherwise, his burial rites were “as simple as a pauper’s funeral,” according to author Stanley Lane-Poole in Saladin and the Fall of the Kingdom of Jerusalem. The money for his funeral had to be borrowed because he had given away all his riches.

[h/t LiveScience]

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