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What if Abe Lincoln had survived?

Abraham Lincoln might have survived if today’s medical technology existed in 1865.  But, the question is whether Lincoln would have been able to return to office.
Abraham Lincoln is shown in this Nov. 8, 1863 file photo made available by the New York Public Library.
Abraham Lincoln is shown in this Nov. 8, 1863 file photo made available by the New York Public Library.Alexander Gardner / AP file
/ Source: The Associated Press

Abraham Lincoln might have survived being shot if today’s medical technology had existed in 1865.

Given that scenario, the question is whether Lincoln would have recovered well enough to return to office, a doctor and a historian said Friday at an annual University of Maryland School of Medicine conference on the deaths of historic figures.

While the conference has traditionally re-examined the deaths of historic figures to determine if the diagnosis of the time was correct, this year’s event asks if Lincoln could have been saved and what impact that would have had.

Dr. Thomas Scalea, the physician in chief at the University of Maryland’s Shock Trauma Center, said brain injuries are unpredictable but Lincoln would have stood a good chance of surviving.
“I don’t believe that the president had a uniformly fatal injury,” said Scalea, who explained how

Lincoln would have been treated at his center, the world’s first dedicated trauma center.
The trauma center can conduct CT scans, X-rays and a host of other tests within minutes of arrival. Physical therapy, nutrition and other rehabilitative treatment also can make for dramatic improvements, though recovery varies from patient to patient, Scalea said.

“He probably would have been left with substantial disability, but you never really know,” the surgeon told the conference.

Lincoln died within 10 hours of being shot in the head at Ford’s Theatre on April 14, 1865. If modern methods could have saved the 16th president, he may have also retained his cognitive abilities because the fatal shot did not damage the frontal lobes of Lincoln’s brain, which are responsible for language, emotion and problem solving, Scalea said.

However, Lincoln would have faced months of recovery before he could have returned to office, and whether he would have been able to communicate is unclear, the surgeon said.

U.S. presidential historian Steven Lee Carson said Lincoln’s secretary of war, Edwin Stanton, who made a number of important decisions the day after the assassination, would likely have played a greater role if Lincoln had survived.

Vice President Andrew Johnson would not automatically have taken charge had Lincoln lived because the 25th Amendment, which deals with the transfer of power when a president is incapacitated, was not in place until after the Kennedy assassination. The decision as to who took charge was handled on a case-by-case basis until then, Carson said.

For example, Woodrow Wilson’s wife essentially took over when her husband fell ill, Carson said.
Johnson, who took office after Lincoln’s death, was the only Southern senator not to leave office upon secession. Lincoln had put him on the presidential ticket as a symbol of unity, but Johnson was a southern Democrat who was not sympathetic to Lincoln’s Republican party or to helping the newly freed slaves, said Carson, who spoke at the conference Friday.

If Lincoln had survived and “could reason and somehow get his thoughts across, the United States certainly would have been a better and more just nation, especially on matters of race, and in a far quicker fashion,” Carson said.

Johnson eventually tried to replace Stanton, an abolitionist and a close friend of Lincoln, which led to the attempt by Republicans to remove Johnson from office by impeachment.

Previous conferences have examined the deaths of Alexander the Great, Mozart, Beethoven, Edgar Allan Poe and others. This year’s event is part of the School of Medicine’s bicentennial celebration and the annual reunion of its Medical Alumni Association.