Could Modern Medicine Save Abe?
On the night of April 14, 1865, just as a would-be assassin barged into the home of Secretary of State William Seward and slashed the secretary and four others in the house with a Bowie knife, John Wilkes Booth—actor and Confederate spy—slipped into the presidential box at Ford's Theater and blasted a bullet from his .44-caliber single-shot Derringer pistol into Abraham Lincoln's head. The low-velocity bullet entered the left side of Lincoln's skull above the brainstem, sliced through areas responsible for speech, and lodged in white matter near the center of his skull. Charles A. Leale, a 23-year-old Army surgeon who happened to be nearby, was the first physician to reach Lincoln. He found the president sprawled against his wife—bloodied and breathing laboriously with closed eyes and a faint pulse. "His wound is mortal," Leale concluded. He was right, of course. By 7:22 a.m. the next day, Lincoln was dead, despite getting the best care doctors of the era had to offer.
But consider if he had been shot in 2007, as participants at a recent conference sponsored by the University of Maryland School of Medicine and the Veterans Affairs Maryland Health Care System did. "I think he probably would have lived," says Thomas Scalea, the physician in chief at R Adams Cowley Shock Trauma Center, an emergency care facility in Baltimore. "He may well have ended up disabled, but he clearly had treatable injuries," says Scalea, who notes that Lincoln's sense of reason probably would have been preserved while he could have lost his ability to communicate.
Everything from quick transport to the hospital, ct scans, better hygiene during surgery, and better icu care would have improved Lincoln's chances for survival, says Scalea. All bets are off, however, had Lincoln been shot with modern, high-caliber weaponry. "This would be a whole different discussion if he'd been shot with an Uzi," says Scalea.
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