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Could Modern Medicine Have Saved Abraham Lincoln?

View profile for Malcolm Underhill
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Abraham Lincoln was the first US President to be assassinated, drawing his last breath at 7.20 am, on 15th April 1865.  He died from a traumatic brain injury caused by a bullet, shot from almost point blank range as he watched a performance of Our American Cousin at Ford’s Theatre in Washington DC.

America in 1865 had torn itself apart, enduring four years of a bloody civil war which was mercifully drawing to a close. In fact, President Lincoln was fearful of assassination, he predicted that he would die in such as way; after his death, an envelope with eighty letters warning him that he would be killed was found among his personal effects.  But on the night he was shot, he told his bodyguard that he did not need him to accompany him to the theatre. 

Thus, he was left completely unguarded.

Would Abraham Lincoln have survived if he had been shot today?  Could modern medicine have rehabilitated him, giving him the chance of having a normal life?  Or were his wounds too grave for even today's finest surgeons to heal?

“Oh physician, is he dead? Can he recover.”

These were the words of Mr Lincoln’s wife after John Wilkes Booth fired a .44 calibre bullet into the back of the President’s skull.  The bullet entered to the left of the midline and severed the lateral sinus, a large channel that drains blood from the left side of the brain.  It fractured both orbital plates of the frontal skull, pushing bits of bone into the brain.

Mrs Lincoln cried out her anguished words to a surgeon who arrived within minutes of the shooting.  The President was not dead, but in just under nine hours he would be.

The young doctor who was first on the scene declared that the wound suffered by the President was mortal and he was right.  In 1865, nothing could be done for someone who had suffered such a catastrophic brain injury.

However, in 2007, Dr Thomas M. Scalea at the University of Maryland School of Medicine told an audience at the school’s bicentennial celebration that today, not only could Mr Lincoln have been saved, modern medicine could have restored much of his neurological function.

Probing the wound

One of the first things doctors did back in 1865 with a shooting victim was to probe the wound to try and locate the bullet.  Today bullets are often left in place because removal can cause more damage.   According to reports, the two doctors who were first on the scene following the shooting of President Lincoln, Dr Charles Leale and Dr Charles Taft, both young and recent graduates, probed the wound.  No antiseptic would have been used, or hygiene practices followed – the understanding of infection was many years away.

The repeated probing would have allowed blood to escape from Mr Lincoln’s skull and relieved pressure on the brain, but it would have led to substantial blood loss.  The likely cause of the President’s death was cerebral herniation and massive haemorrhaging.

Treatment in 2017

If Mr Lincoln had been shot today, drugs and surgery would have been used to relieve the pressure on his brain.  Antibiotics would have been administered to prevent infection, and CT scans would have been performed to establish the damage done to the brain.

He may have been saved.

President Lincoln’s future

Although aggressive rehabilitation may have helped the President to some extent, given the extent of his injuries, he would likely have been left with permanent neurological damage.  In an article by Philip Mackowiak in the Atlantic magazine, it states that patient suffering this type of traumatic brain injury tend to have low impulse control, difficulty controlling their emotions, decreased problem-solving abilities and impaired movement.  It is also likely Mr Lincoln would have suffered a speech impediment, dyslexia and been paralysed on his right side.  However, his cognitive functions would likely have remained intact.

Final words

When President Lincoln told his bodyguard to stay at home that fateful night of 14th April 1865, he did not say goodnight.  Instead, he said goodbye.

Did he have a premonition that his time on earth had come to an end?  We will never know.  And we will also never know whether he would have lived, had he been shot today and had he survived, whether he could have led a normal life. Because, despite modern medicine, recovery from traumatic brain injuries is unpredictable, varying from person to person.

Had Abraham Lincoln lived, America would have been left in further chaos because, in 1865, no provision existed for anyone to take over from an incapacitated President.

History may well have turned out very differently.

We shall never know.

Claiming compensation if you have been injured

If you have received a traumatic brain injury, you may be able to make a claim for compensation if you can prove that an organisation or individual was negligent and this resulted in you suffering damage. 

Compensation can assist with rehabilitation costs and cover living experiences whilst you take the time needed to rebuild your life.

At IBB, our personal injury team, led by Malcolm Underhill, has the expertise and knowledge to advise and represent those who have suffered a traumatic brain injury and wish to claim compensation for negligence. To talk about how we might be able to help, please phone us on 0333 123 9099, email us at  or fill in our contact form.  Any discussions you have with us will be in the strictest of confidence.

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