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Anarchy and the surgical care of President William McKinley

On September 6, 1901, a self-proclaimed anarchist, Leon Czolgosz, shot President William McKinley with a hand gun at point-blank range. One bullet ricocheted off a button on the President’s jacket and did not penetrate his skin. The second bullet entered the President’s abdomen before policemen could subdue the assailant. The events that followed, including the surgical care of the President, have been carefully scrutinized by historians and surgeons. Today, it is commonly assumed that the surgical care provided to the President of the United States in 1901 was not up to the standard of the day. In fact, it has been said that the President was brought to the wrong hospital, got the wrong operation, by the wrong surgeon with inadequate light, inadequate retraction, and inadequate instruments resulting in his death on the eighth postoperative day. In this article, we will attempt to analyze the surgical care of William McKinley relative to the standard of care in 1901, in an effort to determine whether the President’s injuries were survivable or if his fate was sealed by the injury itself and circumstances out of the control of the President’s physicians.