Reminiscences of McKinley Week

     When the directors of the Pan-American Exposition made me its medical director, I began my work with the conviction that it was quite necessary to have upon the grounds a sufficiently equipped hospital, in which care could be given to any emergency cases that might occur within the Exposition limits, for I could not forget that in all previous large affairs of the kind serious as well as minor accidents and illnesses had happened which called for immediate attention. The fire which occurred in Chicago during the World’s Fair, and various happenings in St. Louis and elsewhere, had profoundly impressed me with this need. I had difficulty at first in impressing this conviction upon the officials, but succeeded in equipping first a temporary assignment of a few rooms in the main office building, and as the need became more apparent, in obtaining an appropriation for the erection of a small but convenient structure near the Elmwood Avenue entrance. The lower floor of this building was given up to the usual hospital purposes, while the upper floor contained rooms for the superintendent (Miss Walters) and for half a dozen nurses. The latter were changed every month, affording during the six months of the Fair an opportunity for at least thirty trained nurses from various parts of the country, thus given an opportunity to act in their professional capacity as well as to see the Exposition. These assignments to a month’s tour of duty were eagerly sought, and many more applications were received than could be granted. Thus is happened that both during the construction period, as well as during the progress of the Fair, first aid was offered to a large number of individuals.
     The the erection and the conduct of the Pan-American Exposition Hospital was amply justified was proven not only by the principal tragic event, which for the time being made Buffalo the center of the world’s interest, but by the fact that at the close of the Exposition some 5,400 individuals received aid or comfort of some character as recorded by our books. A complete duplicate card system was put into effect, the cards giving a brief history of each case, while all accident cases were carefully observed and recorded, in order that should controversy arise and suits be instituted we should have a first hand [sic] account for our own protection. One set of cards was kept in the hospital, while the duplicates were transmitted daily to the legal bureau for reference there, should occasion require. During the construction period minor accidents were frequent, [374][375] and one or two fatalities occurred. During the progress of the Exposition one of the Government officials suffered very serious injury by a fall from the cupola of the Government Building onto the roof beneath. One or two apoplectic strokes also occurred during the Fair, while faintings, convulsions or epileptic seizures and cases of heart failure were not infrequent.
     It was the rule of the hospital that no patient should be kept there over night; this rule was practically observed in all but one or two cases which were too serious to be moved, or in a few instances of illness occurring among the concessionary inhabitants on the grounds; thus, late one night I had to operate upon a case of appendicitis on one of the latter who, being a foreigner and not speaking English, was allowed to remain throughout his convalescence where his people could have easy access to him so that his wants could be made known.
     It was a curious feature that the eskimos wore their furs even during our hot weather, while during the spring they seemed to suffer from the cold more than did our own people during the previous winter. They were unexpectedly susceptible; at one time it was necessary to quarantine their village because of measles, two or three cases being sent to the General Hospital, while one young woman developed a rapid tubercular condition of which she subsequently died. In fact among the various villages there was considerable sickness, and a notable carelessness obtained regarding all sanitary precautions. Dr. Wilson, who acted as sanitary inspector during the Fair, had much trouble, especially in the “Streets of Cairo,” in forcing ordinary and necessary precautions, and more than once it became necessary for us to call in the highest official aid in compelling these people to observe our simple rules.
     Dr. Kenerson was the deputy medical director, while three recent University of Buffalo graduates constituted a house staff, of whom two usually, and always one, were constantly on duty. At first I had great trouble with the reporters and newspaper men who sought details regarding our patients, thus endeavoring to give publicity to their private affairs which savored too much of yellow journalism. From the outset it was made a positive rule that patients who sought relief should be afforded the same privacy that their own homes would furnish, and absolutely nothing was given out from the hospital regarding any individual or case.
     But the event which surpassed all others in interest and importance was the murderous attempt upon the life of President McKinley, which occurred September 6th, 1901. The principal features of [375][376] this tragedy are still fresh in the minds of the people, and have become matters of common history. It is regarding my own personal experiences and observations during the trying week which followed the assault in the Temple of Music that I wish to recall in these notes. The President spent the forenoon and noontide of that eventful day in Niagara Falls, reaching Buffalo in the afternoon in time to make his promised appearance and address in the Temple of Music. Early that afternoon I had myself gone to Niagara Falls in order to operate upon a Mr. Ransom, of Ransomville, at the Memorial Hospital in that city. His was a case of malignant lymphoma of the neck, requiring careful dissection, and constituting a difficult and serious operation. Drs. Campbell and Chapin were assisting me. Just as I had completed the most serious part of the operation someone entered the operating room bearing a special message to me that the President had been shot, and that I was wanted upon the Pan-American grounds at once. As soon as I had recovered my equanimity I turned to Dr. Campbell, who knew all the railroad people at the station, and asked him to go at once and make the necessary arrangements for a special engine or train, saying that Dr. Chapin and I would finish the operation and be at the station by the time things could be ready. Leaving the dressings to Dr. Chapin, I hurried to the railway station, reaching there shortly after Dr. Campbell’s arrival. There I found everything in confusion, everybody upset by the sad news, and the station master, not only confused, but waiting for orders from Buffalo. It has always seemed to me that an engine might have been speedily detached or furnished for the emergency, but I was told that a Michigan Central through train would be along shortly, and that I should be sent up on that, while a special engine would be waiting at the Black Rock junction to take me round on the Belt Line and down upon the special tracks which had been laid into the Exposition grounds. Dr. Campbell requested that he might accompany me. We had to wait fifteen or twenty minutes for this train, but upon its arrival Dr. Campbell and I jumped upon the engine, and the train was hurried toward Buffalo. At the junction we alighted and then mounted the special engine which was awaiting me, and lost no time in reaching the grounds. I had the engine stop at the Elmwood Avenue crossing, not far from the hospital, and we entered the grounds through the Elmwood Avenue entrance, scarcely a stone’s throw from the hospital. A large crowd surrounded the hospital, but were kept at a reasonable distance by the city and the Exposition police. Passing the lines I hurried into the little building, [376][377] where I found Mr. Milburn, Mr. Buchanan, Mr. Charles Goodyear and others, with Mr. Cortelyou, to whom I was at once introduced.
     A very few moments [sic] observation in the operating room and a little reflection convinced me that everybody’s attention and interest were centered upon the event of the moment and that no thought nor care had been given by anyone present as to what was to be done after the operation was concluded, and that I could be of the greatest service by attending to the immediate future of the case. Accordingly I joined the group of gentlemen above mentioned and at once raised the question, which I had already practically decided, that our little hospital was not place for the President to remain in after leaving the operating table. Mr. Milburn, however, settled the matter by saying that he had promised the President that he should be removed to the Milburn house as soon as possible, to which Mr. Cortelyou added his assertion that this removal was to be effected in the speediest and best possible manner. At once I turned to Miss Walters and directed her to detail the two nurses of the six then on duty who seemed best fitted for the purpose, and have them prepare to go at once to Mr. Milburn’s house and have everything ready. I also directed her to select a surgical bed, with ample supply of bedding, and also everything that could be required, utensils, etc., in the care of such a case. These were all quickly put in readiness, and were sent down with the nurses in a police patrol wagon, in which they reached Mr. Milburn’s home and so efficiently made everything ready in the room selected—a large, rear one, connecting with an equally large front room—that when we reached the house with the ambulance conveying the President everything was ready down to the smallest detail for his reception. To illustrate the rapidity and the perfection of the arrangements, Mr. Huntley of the General Electric Company had run a special wire, and installed electric fans, with possibilities for anything else needed in this direction, and the fans were actually in operation by the time we reached the house.
     Immediately after the conclusion of the operation I hastily gathered the men principally interested in my little office, and closing the door spoke to the following effect: That through Mr. Cortelyou’s direction we were practically under a sort of military discipline, if not martial law, and that first of all we were to follow directions laid down by him, first of which was absolute reticence so far as giving out any definite information was concerned; that whatever bulletins or information were given out were to be transmitted through him, and that the President was to be promptly [377][378] removed to Mr. Milburn’s house. To this I added that everything was ready for this transference, both at the house and at the hospital, where the ambulance was in waiting. I furthermore added an injunction to the effect that we must by all means preserve a united appearance, and that we must avoid all the discussions and differences of opinion which had so conspicuously marked the conduct of President Garfield’s case, and other cases which they might easily recall to mind. I then called for definite action as to who should be in charge of the case, and suggested that inasmuch as Dr. Rixey was there in his official capacity, and as the President’s own medical advisor he should be allowed to select those whom he wished to serve with him.
     Dr. Rixey spoke to the effect that he did not know any of the men present and that it would be well for us to make our own selections, which all resulted in the selection of Dr. Mann, Dr. Mynter, Dr. Wasdin and myself, it being thought that too many would constitute an unwieldy and unnecessarily large number. It was understood furthermore that the others would cheerfully join at any desired moment, and in this way Dr. Stockton was subsequently added to the staff and, at the last, Dr. Cary as well. Dr. Wasdin was added in his official capacity, and Captain (now Major) Kendall of the Army would have been invited to join had we known him, but at that time he had only just arrived at Fort Porter and was not known to any of us. Others present at this conference were Drs. Van Peyma, Nelson Wilson, John Parmenter and a Dr. Lee of St. Louis. The conference in my office was brief, and at its conclusion those who had been doing the operating retired to dress themselves, while Dr. Wasdin and myself entered the ambulance in which the President had been already placed and we took up our leisurely passage toward the Milburn home. We were surrounded by military escort and city police, while just behind the ambulance rode two of the Government Secret Service officials on bicycles. The little procession passed no faster than men could easily walk, this partly because many of the escort were on foot, and because, although the streets were smooth, we did not want to jostle the patient any more than was necessary. The passage of that small procession through the crowd and down Delaware Avenue was one of the most dramatic incidents I have ever witnessed. The Fair grounds were crowded that day, and it seemed as though the entire crowd had gathered to witness this event. Every man’s hat was in his hands, and there were handkerchiefs at many eyes. I never saw a large crowd so quiet; not even the President’s funeral was marked by [378][379] so much evidence of profound sympathy. On arriving at the house the transfer of the patient from the ambulance to the bed was effected in the easiest possible manner, and before his recovery from the anæsthetic. Everything had been placed in the most complete readiness by the nurses detailed from the Pan-American Hospital and within five minutes after the patient’s arrival the room presented only the ordinary appearance of a sick room.
     The operation concerned was a difficult one because there was a layer of at least two inches of fat between the skin and the abdominal muscles; the abdomen was large and protuberant, and the deeper portion of the bullet track would not have been easy to expose under the very best of auspices, and while the operating room was practically sufficient for all ordinary purposes in must be acknowledged that both light and equipment were not all that could have been desired. Only six or seven weeks later I had a case, at the General Hospital, of a similar kind, in every respect as nearly as could be made out, of a woman who attempted suicide by firing a bullet into the upper abdomen. I found perforation of the stomach, and injury to the pancreas; at all events I closed the stomach perforation and made posterior as well as anterior drainage; this case recovered without an untoward symptom.
     But to return to the events of that day and period. The first question was of nursing. While the two nurses detailed from the hospital were to remain during the night, they were not there in any permanent capacity and were to be relieved the following morning. After conference with Dr. Mann I secured the services of Miss Mohan and Miss Connolly, who both reached the house the following morning at eight o’clock, thus relieving the Misses Shannon and Dorchester. I also felt that we ought to have male nurses and for obvious reasons, and for this purpose and in order to secure efficient men I appealed, through Mr. Cortelyou, for the assignment to duty of men from the hospital corps which was connected with the Government exhibit, where a detachment of hospital corps men formed a part. If I remember correctly, two men were promptly sent from this corps and one from the hospital at Fort Porter; at all events by midnight we had three efficient male nurses and had established for each of them a tour of duty of eight hours out of the twenty-four. A tent was put up for these men on a vacant lot across the street, where were also encamped a detail of soldiers from Fort Porter, who maintained around the house a strict military guard, no one being allowed to pass the lines except those whose duty required their presence within. The most efficient arrangements [379][380] were everywhere made, and by nine o’clock that same evening the northwest corner of Delaware Avenue and Ferry Street was essentially a military post under martial law. The city police drew their lines a block distant in each direction, and all traffic and passage of vehicles was arrested, thus preventing any possible noise from such a source. Our own teams and those carrying various officials were alone permitted to drive up to the adjoining corner. The vacant lot at the northeast corner of Delaware Avenue and Ferry Street presented the appearance of a small camp, where were encamped not only soldiers comprising the guard, but the press representatives, who had a large tent to themselves. Into this were run special wires, while into the Milburn house passed another set of wires connecting directly both by telephone and telegraph with the White House, and a telegraph operator was on constant duty from early the first morning.
     Government officials quickly gathered from various directions. The Cabinet officials who were not guests of private citizens (as Mr. Root, for instance, who was the guest of Mr. Sprague) were given rooms at the Buffalo Club, and here special Cabinet meetings were held; thus, for the time being, the Milburn house became the White House of the country, and this home, with the Buffalo Club, was for a week the capitol of the United States.
     Arrangements were made with marvelous rapidity; by the following morning a corps of servants, including the chef, had been transferred from the private car in which the President was traveling, bringing with them White House service for both dining room and kitchen. These were later augmented by more help, and more service from the White House, as well as by other help secured from the city. In this way a complete corps of servants were ready to serve meals or refreshments at any hour of the day or night, and I remember that one day some one hundred and forty dinners were served. I remember also that at no time during the day or night did I fail to secure anything desired, solid or fluid.
     To return to the patient. He bore his illness and such pain as he suffered with beautiful, unflinching and Christian fortitude, and no more tractable or agreeable patient was ever in charge of his physicians. No harsh word of complaint against his assassin was ever heard to pass his lips. As the days went by, the peculiarity of his Christian character became ever more apparent, and was particularly noticeable at the last, up to the very moment of his lapsing into unconsciousness. Up to this time I had hardly ever believed that a man could be a good Christian and a good politician. [380][381] His many public acts showed him to be the latter, while the evidences of his real Christian spirit were most impressive during his last days. His treatment of Mrs. McKinley during the many trying experiences which he had with her fortified a gentleness in his manly character, while the few remarks or expressions which escaped from him during his last hours stamped him as essentially a Christian in the highest and most lovable degree.