Lincoln’s First Responder- Dr. Charles Augustus Leale

April 14, 1865, was a pleasant day in Washington, a welcome change from the rainy weather that had turned Washington’s streets into mud.  The dogwood trees were in full bloom, their pleasant scent wafted through the air. The sky was clear throughout most of the day, turning partly cloudy in the evening. By 8:30 p.m. when President Lincoln, his wife and their two guests, Major Henry Rathbone and his fiancee arrived at Ford’s Theatre on 10th Street, the temperature had dipped to a cool 54 degrees and a light fog had settled in.

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It was a slow night at the Armory Square General Hospital at the corner of 7th and Pennsylvania Avenue, where 23-year-old Dr. Charles Leale was Surgeon-in-Charge of the Wounded Commissioned Officers. Leale was anxious to get to his army quarters that night. He had read that President Lincoln would be at Ford’s that night, and he wanted to get to the theatre early enough so that he could get a good seat from which to see the President.

Just before leaving the hospital, Leale informed his Ward Master that he would be gone “for a short time,” made his way to his tent, and quickly changed out of his military uniform into his civilian wear. Leale did not have a pass from his superior to be out at night. Had he been in uniform, he might be stopped by military guards on the lookout for army personnel wandering about the city, instead of remaining at their assigned workplaces.

The Armory Square Hospital was about four blocks from Ford’s Theatre. Leale thought he would have enough time to buy a seat on the first floor Orchestra section from which he would have a good view of Lincoln in the Presidential box on the second floor Dress Circle, but  the streets were still muddy and it took longer than he anticipated trudging through the muck. By 8:15 p.m., when he finally arrived, all the seats in the Orchestra Section were taken. Leale grudgingly paid the 75¢ for a Dress Circle seat, climbed the red carpeted stairs to the second floor, and found his seat about 40 feet from the President’s box. About an hour later, Leale rose with the rest of the audience and cheered as Lincoln, his wife Mary, and their two guests, Major Henry Rathbone and his fiancée, Clara Harris, arrived and made their way along the back wall of the Dress Circle to the vestibule leading to the Presidential box.

Charles Augustus Leale was born on March 26, 1842, in New York City. His father, William Pickett Leale, had emigrated from England in 1836, when he was 16. William found work as a deck officer on board a merchant vessel. Four years later he married 17-year-old Anna Maria Burr, the daughter of a wealthy sea captain, William Burr.

The marriage was tragically cut short a year later when Leale’s father drowned at sea, leaving Anna to care for their one-year-old son. Anna did not remain a widow for long. In June 1844, she married Dr. George Humphries Wilson.

A year after their marriage, Wilson took a job as Superintendent of the United States Marine Hospital in Portland. Allowed to roam the wards with the attending surgeons, 14-year-old Charles watched physicians operate on patients and saw how they were bandaged, and medicines were compounded.

Wilson was pleased when his stepson told him he wanted to be a physician like himself. In 1860, Leale enrolled at a local medical school where he was taught how medicines were compounded, analyzed, and tested, and the antidotes for poison.

Although he graduated in 1863, Leale felt he had much more to learn. With his stepfather’s financial support, Leale enrolled at Bellevue Hospital Medical College and became the private pupil of Dr. Frank Hastings Hamilton, Sr. Leale’s timing was fortuitous. Hamilton had just returned from serving in military hospitals.

When he wasn’t attending lectures at Bellevue, Leale shadowed Hamilton as he made his rounds at the Blackwell Island Hospital, and learned military hygiene, how to dissect, amputate and ligate arteries, repair dislocations, and the treatment of gunshot wounds, by his mentor.

By February1864, Hamilton felt Leale was competent enough to recommend him for the Army’s Medical Cadet Program.  After passing his Army Medical Board exam, Leale was commissioned and posted to Camp Chemung, in Elmira, New York, as assistant to the Post Surgeon, and subsequently was appointed duty surgeon at the Barracks, attending Sick Call. In March 1865, Leale was awarded his M.D. degree, and subsequently sat for and passed his Army Medical Board exams. Commissioned as Assistant Surgeon of Volunteers, he was assigned to the Army Square General Hospital, as Surgeon-in-Charge of the Wounded Officer’s Ward.

Like hundreds of others, Leale trekked along Pennsylvania Avenue the evening of April 11, 1865, to hear Lincoln speak from the balcony of the White House about his plans for binding the nation’s wounds. Three days later he was at Ford’s Theatre, too late to buy a ticket in the Orchestra section where he would have been able to look up at Lincoln during the play and settled for a seat in the second floor Dress Circle.

At about 10:15 p.m., while watching the actors on stage from his seat, Leale, like most of the audience, was startled by a gunshot inside the theatre. Moments later, learning forward from his chair, he saw a man scrambling to his feet on stage, just below the Presidential box. The man then turned to the audience holding a knife in the air and shouted “sic semper tyrannis,” and then fled toward one of the passageways off stage.

Then from inside the Presidential box, Leale heard a woman screaming, “the President is shot!” Most of the audience panicked and rushed for the doors. Some rushed toward the vestibule entrance that led to the Presidential box. Although his arm was bleeding badly, Major Henry Rathbone, one of the other three people inside the Presidential box whom the assassin had wounded just after assassinating the President, managed to hold back the crowd and shouted for a surgeon.

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Leale forced his way through the swarming bodies trying to get in, identified himself, was allowed to enter, and rushed into the box. There were other doctors in the audience that night, but because his 75- cent ticket had put him closest to the vestibule, he was the first to reach Lincoln. By medical protocol, that made Lincoln his patient, until more senior physicians took over. Leale would later describe his experience that night in five separate accounts. Four of them were made within two years after the assassination. The last was written fifty years later and contains details not in the previous versions and omits some significant details that are in those earlier versions. Leale’s first account was written “a few hours after leaving [Lincoln’s] death bed. It remained lost for more than 100 years until discovered among Surgeon General Joseph K. Barnes’s papers at the National Archives in 2012.

When Leale entered the Presidential box, Lincoln was unconscious and slumped in his rocking chair. Mary and Clara Harris were on each side, trying to keep him from falling to the floor. Lincoln was still breathing, but his breathing was labored. Leale felt Lincoln’s wrist for any sign of a radial pulse but could not detect one. While he was feeling for a pulse, Dr. Albert King and William Kent, who had been sitting with him, entered the room. With their help Leale eased Lincoln’s body on to the floor to avoid syncope, a sudden loss of blood pressure that would cut off blood flow to his brain. Lying down, Lincoln’s heart would not have to pump as hard.

Leale still did not know where Lincoln was wounded. Seeing blood near Lincoln’s left shoulder, his first thought was that Lincoln had been stabbed. Finding no wound in Lincoln’s arm or shoulder, he felt for a wound on Lincoln’s back and then ran his hand up the back of Lincoln’s head where he found a firm blood clot on the left side of Lincoln’s head, behind his ear. Leale picked the scab away and using his little finger on his left hand as a probe, passed it into “the perfectly smooth opening made by the ball and found it had entered the encephalon.” More than a hundred years later a modern-day neurosurgeon would accuse Leale of killing Lincoln with that finger probe. But at the time physicians were unaware of germ theory and Leale should not be held responsible for what was not known at the time.

While Leale was examining Lincoln’s head wound, a third physician, Dr. Charles Sabin Taft, scrambled over the banister, having been hoisted up from the Orchestra seats by several men below. In the 1909 version of his account, the most accessible of his reports until the recently discovered report he wrote days after the assassination, Leale said that with the help of Drs. Taft and King, he kept Lincoln alive by performing chest compression, mouth-to-mouth resuscitation or heart massage. However, those procedures were not known in the United States until 1878 and are not mentioned in that much earlier report and were also not mentioned when Dr. Taft wrote his own account of Lincoln’s last hours, less than a week after the assassination.  Leale’s 1909 account of chest compression was likely the result of “false memory syndrome.”

When Lincoln’s condition stabilized, the three physicians discussed where to move him. An obvious place was the White House. But it was seven blocks away and the roads were deeply rutted, and the jolting might worsen his condition. Instead they decided to take him to one of the residences across the street. After no one answered at the first home they tried, they were able to bring the still unconscious Lincoln into the back bedroom at the William Petersen House a few doors away.

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The stretcher bearers lifted Lincoln onto the bed, but it was too short for his six-foot-four- inch body. Leale asked someone to pry the end board loose, but it was part of the bed’s structure and could not be removed. The only alternative was to position Lincoln’s body diagonally across the bed, with his feet, still wearing his boots, dangling over the side. A few minutes later, Mary, Major Rathbone and Clara Harris came into the Petersen House. Mary was immediately ushered into the bedroom, Rathbone and Clara Harris behind her. Seeing Lincoln sprawled across the bed, Mary sobbed for him to speak to her. By then, the room had become so suffocated by curious onlookers that Leale asked the ranking officer to clear everyone out except the medical men. Mary wanted to stay but agreed to leave when Leale told her to wait across the hall while the doctors removed Lincoln’s clothes so that they could conduct a thorough examination.

Once the room was cleared, Dr. Taft stuck his finger into the wound in Lincoln’s head to see if he could feel the bullet. It was the second time a foreign object was inserted into Lincoln’s brain, enlarging the wound, and essentially dooming him from infection. Before he died, another finger and three metal probes would be inserted into that wound.

Once Lincoln’s clothes were removed, Leale noticed his body had begun to cool, and asked someone to fetch hot-water bottles, warm blankets, and ingredients to make a ”sinapsism,” a mustard-based paste that generated heat when placed on the skin. Around 11:00 p.m., Dr. Stone, the Lincoln’s family physician, came into the room. Leale introduced himself as the physician who had been in charge since the shooting. Leale informed Stone of  the nature of Lincoln’s wound and what he had done, and asked if Stone wished to take over, which he did. A few minutes later, Surgeon General Joseph K. Barnes, Assistant Surgeon General Charles Henry Crane, Dr. Willard Bliss, Leale’s superior at the Armory Square Hospital, other doctors, and all of Lincoln’s cabinet members entered the room at one time or another.

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Lincoln held onto life for nine hours after being shot. His final breath came at 7:22 a.m.   Surgeon General Barnes announced his passing, A stillness hung over the room until Secretary Stanton broke the silence with his now memorable eulogy, “He belongs to the ages now.”

Years later, Leale recalled his last efforts on behalf of the slain President: “I gently smoothed the President’s contracted facial muscles, took two coins from my pocket, placed them over his eyelids, and drew a white sheet over the martyr’s face.”  He then made his way through the crowd outside back to his office. As he walked hunched over to keep a chilly rain from falling down his neck, he remembered he had left his hat back at the theatre and looked down at his once freshly starched cuffs, now embedded with “the martyr’s blood,” vowing to keep them forever. (The blood- stained cuffs later came into possession of his daughter, Helen Leale Harper who later donated them, along with the sword he held while serving as Lincoln’s Honor Guard, to the National Museum of American History.)

The next day while he was attending patients, a nurse informed him that a messenger had called on him inviting him to attend Lincoln’s autopsy at the White House later that day at noon, and later another doctor (Leale did not identify) also invited him. Leale declined, saying he “did not dare to leave the large number of severely wounded men expecting my usual personal care. I was fearful that the shock of hearing of the sudden death of the President might cause trouble in their depressed painful conditions.”

Leale did agree, however, to be one of the Honor Guards in the East Room of the White House.  Wearing his uniform and sword, its handle covered in black mourning crepe, Leale stood solemnly at the head of Lincoln’s coffin, beneath the black-draped catafalque, during the viewing and obsequies on Wednesday, April 19.  As the long line of escorts formed to accompany Lincoln’s casket along Pennsylvania Avenue to the Capitol to lay in state, Leale and the other physicians during Lincoln’s last hours, rode in a carriage in the place of honor in front of the funeral car. At some point in the procession,  “an officer of high rank” leaned into Leale’s carriage and told him “Dr. Leale, I would rather have done what you did to prolong the life of the President than to have accomplished my duties during the entire war.” Once Lincoln’s casket was laid inside the Capitol rotunda, Leale once again stood at the head of his casket as one of the Honor Guards. Several days later, Leale put on the uniform and his sword, with the mourning crepe, and had his photograph taken by Mathew Brady.

Emotionally drained by the last few days and the lengthy funeral services, Leale returned to his office at the hospital. Unable to stop thinking about it, he asked Surgeon-General Barnes what he advised to give him some respite. Barnes told him “Cast it from your memory.”

A grateful public, however, insisted on honoring his efforts. On May 24, when more than 70,000 Union veterans marched down Pennsylvania Avenue in review, Leale was invited to be in the reviewing stand in front of the White House, along with President Johnson, his Cabinet, and several Foreign Ministers. Leale particularly remembered seeing General Sherman riding by on a horse garlanded by roses.  Despite Barnes’s advice to try to forget what he had been through, Leale could not refrain from sitting in at one of the sessions of the conspirator’s trial. “Dr. Mudd is the only one that has any intellectual expression,” Leale told his friend and colleague, Dr. Dwight Dudley. Leale commented that the conspirators were “all very pale except the Dr.”

Leale remained at the Armory Square Hospital until it was deactivated in September 1865, after which he was appointed Surgeon-in-Charge of Post Hospitals taking care of soldiers stationed along Washington’s Northern Defenses. The area was a breeding ground for malaria, typhoid, and dysentery.  After succumbing to “typho-malarial fever” himself, Leale was honorably mustered out of service in January 1866. Seven months later, in recognition of his efforts to save Lincoln, he was brevetted to Captain of U. S. Volunteers.

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After his discharge, Leale became aware that Asiatic cholera had become rampant in northern Europe and might soon threaten the United States. Still recuperating from his own illness, he left for Europe to study the disease at clinics in England and France. Returning to London, he learned the disease had become an epidemic in Liverpool, one of the main ports for emigrants leaving for the United States. Leale applied for and was granted legal status to treat patients in England as a physician and went to Liverpool where he examined over a thousand emigrants, quarantining those with cholera symptoms. On May 2, 1866, he sailed from Liverpool with 1,003 immigrants on the Harvest Queen as its ship’s doctor.

Despite his efforts to prevent the spread of cholera to the United States, the disease had already taken hold in much of the country, including New York City where people were dying every day from the disease. Until his retirement in 1928, Leale was actively involved in philanthropic, medical and scientific societies. While establishing his own practice in the city, Leale worked tirelessly as a volunteer among the poor stricken with the disease in his neighborhood, saving many lives.

Children had a special place in his heart. From 1866 to 1871, he served gratuitously as physician in charge of the Children’s ward at the Northwestern Dispensary, taking care of over five thousand sick and needy children, and served as Chairman of the “Floating Hospital,” which took distressed mothers and their children on boat trips on the Atlantic. He helped to reorganize the hospital nursery on Staten Island; was one of the founders and consulting surgeons at the Children’s Free Hospital; provided medical aid for the New York Society for the Relief of Widows and Orphans of Medical Men; and was a trustee of the New York Instruction of the Deaf and Dumb. As President of the St. John’s Guild, a charity that annually took care of more than forty thousand poor mothers and their sick children in their homes and helped convert its nursery into one of the largest seaside hospitals for children in the world.  While other physicians left the steaming city for cooler summer vacation retreats, Leale stayed in the city providing medical care to children in the city’s slums.

If Leale thought he could “cast” the memory of Lincoln’s assassination out of his mind, he was mistaken. In July 1867, Leale received a request from Major General Benjamin F. Butler, Chairman of the Assassination Committee. Butler’s committee was gathering information to investigate President Andrew Johnson’s possible role in the assassination prior to his impeachment hearings and asked him to relate “what he saw and heard” the night of the assassination. Leale duly sent Butler a summary of the notes he had made after the assassination, but the Committee did not find anything incriminating and it was not made public.

In July1881, after President Garfield was shot, Leale, as “a well-known expert in cases of gunshot wounds, and who was the first surgeon who attended Abraham Lincoln the night he was assassinated,” was asked for his opinion about Garfield’s prognosis. Leale’s lengthy response was quoted in several newspapers. At the same time, many newspapers also carried stories of Leale’s efforts on Lincoln’s behalf at the time of his assassination.

Somehow, he found time to meet and marry Rebecca Medwin Copcutt, the daughter of New York industrialist, John Copcutt. The couple were married on September 3, 1867, at the Copcutt Mansion in nearby Yonkers and would eventually have six children.

In addition to the many positions he held at local hospitals, he was also a member of many of the country’s medical societies and was elected to several of their executive committees including President of the Northwest Medical and Surgical Society and the New York County Medical Association. In 1881 he was a delegate at the International Medical Congress in London and their meeting six years later in Philadelphia. Leale’s proudest association was with the New York Commandery of the Military Order of the Loyal Legion of the United States (MOLLUS), a patriotic society whose membership was restricted to Civil War Union officers.

Leale died at age 90 on June 13,1932 at his home on Madison Avenue in New York City. He was buried in Oakland Cemetery in nearby Yonkers, where his wife (died in 1923) was also interred. Leale was the first doctor to treat Lincoln after he was shot, and the last surviving doctor among those who attended him at his death bed.

Lawrence Abel is a Professor at Wayne State University and author of A Finger in Lincoln’s Brain.