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As they arrived in Milwaukee for this week's Republican National Convention, reporters a historical plaque on a hotel wall memorializing an assassination attempt on an ex-president who was campaigning to return to the White House after bitter years in exile.

Theodore Roosevelt, just like former President Donald Trump this past weekend, survived a gunshot wound that came close to killing him. The story of Roosevelt's medical care in 1912 is a not-entirely-unfamiliar tale of a stubborn patient who refused to follow instructions, a star surgeon with a healthy ego, and uncertainty about the best treatment strategy.

An Ex-President Who Understood Chest Wounds

John Schrank, an unemployed saloonkeeper from Germany, had spent weeks stalking Roosevelt across the country during his long-shot, third-party campaign. Just after 8 p.m. on October 14, 1912, as Roosevelt ducked out of his hotel to take a car ride to a speaking engagement at the Milwaukee Auditorium, Schrank pulled out a .38-caliber revolver and fired a single shot from 6 feet away.

As the bullet entered his right chest, Roosevelt "" but kept his balance. "He pinked me," Roosevelt reportedly told an aide. In the car, he felt under his heavy overcoat and pulled out fingers red with blood. "It looks," he said, "as if I had been hit."

Roosevelt coughed but no blood came up. He knew this was good news, at least for the moment, a sign that the bullet had missed his lungs.

"He had been in the service and had seen people shot in the chest. It was an incredibly crude measure, but he was looking for blood," Duke University surgeon and presidential medical historian Theodore N. Pappas, MD, told 番茄社区app. Pappas and a colleague wrote about the Roosevelt assassination attempt in .

In the auditorium dressing room, it became clear that Roosevelt was bleeding from a wound , causing a stain around the size of a man's hand on his shirt. His metal eyeglasses case and a 50-page copy of his speech had weakened the bullet's force.

Roosevelt refused again to seek medical care and put a handkerchief over the wound before beginning his speech. He announced he'd been shot and revealed his bloody shirt to the audience. "Fake, fake!" shouted one man, while the crowd gasped. "It takes more than one bullet to kill a 'Bull Moose,'" Roosevelt declared, referring to the name of the third party he formed to run for president.

Enter Star Surgeon With a Reputation to Uphold

Later, Roosevelt appeared to swoon from blood loss, but he again told his worried physician that he wouldn't stop to get help. Finally, a woozy Roosevelt ended his speech, reportedly after 90 minutes. "Now," he told his doctor, "I am ready to go with you and do what you want."

An ambulance sped him to a Milwaukee emergency hospital where x-rays showed the bullet had stopped before reaching his lungs. Then, Roosevelt chose to take his private train car to Chicago for better care, reportedly because he feared the fate of former President James Garfield, whose agonizing death from a bullet wound is blamed on an incompetent medical team.

In Chicago, prominent surgeon John Murphy, MD, waited at the train station for his patient in order to examine him right away. Murphy was one of the most prominent and influential surgeons of this time, and his last name lives on in medical terminology through (abdominal tenderness linked to gallbladder inflammation) and (used for rectal feeding).

"There's detail about him wanting to beat everybody to the punch by getting on the train early," Pappas said. "This is typical Murphy, who had an outlandish personality. He was not going to have anybody upstage the management of a former president."

Perennial Question: Leave the Bullet In or Take It Out?

At the Chicago train station, portable x-rays "demonstrated that the bullet injured the fourth rib and had lodged just outside the pleural cavity between the fourth and fifth ribs anteriorly," Pappas and his colleague wrote in the 2022 report.

Doctors chose to leave the bullet where it was, and Roosevelt went to a hospital – "Shot again!" he joked to photographers as their bulbs flashed – and stayed under observation for 7 days. The treatment course made sense at the time, Pappas said, "since there was no guarantee something was wrong."

The media with detailed descriptions of his temperature, his pulse, and even the anti-tetanus serum he got to prevent lockjaw.

Today, a patient with a similar injury would get a CT scan, Pappas said, although clinicians would still have to choose to remove the bullet or let it stay. "There are people all over this planet running around with bullets [in their bodies] that don't cause any trouble."

Indeed, Roosevelt, who went on to lose the presidential election to Woodrow Wilson, never had the bullet removed. He surprised the world by dying suddenly in 1919 at the age of 60, apparently of an embolism, although there's a that a tropical parasite killed him.

The assassin, who had delusions and wanted to stop Roosevelt from reaching a third term, was declared insane. He lived until 1943, when he died at an asylum at the age of 67.

Pappas noted that both Roosevelt and Trump -- a pair of ex-presidents who survived assassination attempts while trying to regain the power they lost – are united by "their narcissism, outspokenness, and boldness." He mentioned a quote sometimes attributed to Mark Twain: "History may not repeat itself. But it often rhymes."

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