Broken Fibula - Again!

[Houmes]

(08-10-2012 09:43 AM)Gene C Wrote:  Is that type of break similiar to a stress fracture? I got a stress fracture in my foot when backpacking (those days are over). I was able to continue hiking, but after about two hours I couldn't.

I'm not convinced when hearing comparisons that a stress fracture is similar to a true long bone fracture, which I consider to be like comparing a paper cut to an amputation. True stress fractures are a mere crack in the bone, and do not cross completely through the bone. They're frequently not seen on a plain xray, and require a CT, MRI, or nuclear scan for diagnosis. In children, with more flexible bones, it's called a Greenstick fracture. Dr. Mudd described Booth's fracture as a straight fracture across the fibula. There are discrepancies in Dr. Mudd's accounts, and he did admit to a limited exam, as Booth was in pain and much of the doctor's time was spent finding material for a splint and then applying it. And different people do react differently to pain, due to being stoic, under stress, shock, or being distracted--Frank Shorter ran with a stress fracture in his foot and won a Silver medal at the 1976 Montreal Olympics--but the majority of victims of a fractured fibula I've seen still walking on it the next day were drunk the night before. What's really interesting and needs to be explained is why Booth had severe back pain in addition to the ankle pain. A seasoned, athletic actor and horseman like Booth wouldn't be expected to have pain from the ride to Dr. Mudd's house. And falling from the President's box would not have explained it; you need axial loading for a compression fracture of a vertebra in the back, and you need to land on your bottom to achieve it, and I've never read an account from any witness at Ford's that mentioned Booth landing that way--they all mention him in a crouch, or on one knee, or falling almost to one side while in a near stooped position. A serious muscle spasm from a fall is possible, but it would be quite odd unless the person had a significant back injury history....or had a horse fell on him.

[Laurie Verge]

Blaine,

Do you remember any other reference to Booth complaining about his back any place but Mudd's?

[jonathan]

Here's something else that I've wondered about. Was it common for a horse to trip and "fall" on someone? I know absolutely nothing about this, but it just seems to me that if a horse and rider were going along at a brisk pace, which I assume was the case with Booth, and the horse tripped, the horse would fall more suddenly, while the rider would be pitched forward a little bit. It just seems that the rider's momentum would carry him far enough in front of the horse that it would be very difficult for the horse to "fall" on him. But if this is not the case, and the rider fell suddenly along with the horse, isn't it reasonable to expect an injury far worse than a broken fibula?? I would think that much more serious injuries would be not only possible, but likely. In either case, as I said in a previous post, I would expect all of the rider to be muddy, rather than just his legs.

As far as Booth's back hurting, I guess if I've read that, then I'd forgotten it. But there are any number of explanations for a sore back. Over the years, I've rarely had problems with my back, but when I do it has been a from a variety of different reasons. Playing sports and being active, as Booth was active, all kinds of things can lead to a day or two of back pain. Of course that didn't happen to me as much when I was Booth's age, but I can remember the occasional back problem even in high school. Then there are people who just develop chronic back pain, even at a relatively young age. I have a cousin with that problem. She's in her late 30's now, but has had back problems for years and years. It's certainly possible that Booth was developing back problems and it became aggravated while he was making his escape, whether it be from a jump to the stage or a fall from the horse.

[L Verge]

I believe that Mr. Kauffman has stated that some horsemen's association told him that the type of injury that Booth incurred was very common with a horse falling on its rider. I always thought, like you, that the rider would pitch over the horse's neck - but I haven't been on a horse in fifty years...

I have also heard discussions on Booth getting his left foot in the stirrup at Ford's and the horse frisking away from him before he could fully mount. He had to get her under control. Might that account for him twisting his back? Frankly, just being on a galloping nag for nigh on to six hours would make my back hurt!

Betty O is our equestrian here. Let's ask for her opinion.

As I stated before, I suspect that historians will always be divided on the issue of where Booth's leg was broken.

[RJNorton]

This is a real stretch, but it came to mind after I read Jonathan's post. Did Booth have a back problem at an early age? Well, he was shot, apparently accidentally, by Matthew Canning in his hotel room in 1860. The exact location of the wound seems somewhat unclear, but it apparently was in the thigh or buttock region. I immediately thought of the sciatic nerve. Personally I have leg pain due to a back problem (sciatica). Maybe Dr. Houmes will read this and comment; I am asking if an injury to or near the sciatic nerve could cause chronic referred pain upwards into the lower back.

In all honesty, just the thought of jumping 11 or 12 feet increases my back pain, let alone actually doing it.

[jonathan]

It just occured to me also (and I'm sure it's been suggested over the years), that surely it's possible that the jump from the box caused some sort of stress fracture, which was then aggravated by the horse falling on him/throwing him. That would make everybody right.

[L Verge]

My staff member at the museum, Joan Chaconas, made that observation years ago when Mr. Kauffman first brought up his theory. She asked if the fibula could have been cracked in the jump at the theater and then aggravated by either the ride or the possible fall. If I remember correctly, she was basically ignored. All things are certainly possible.

[BettyO]

(08-13-2012 06:25 PM)L Verge Wrote:  I believe that Mr. Kauffman has stated that some horsemen's association told him that the type of injury that Booth incurred was very common with a horse falling on its rider. I always thought, like you, that the rider would pitch over the horse's neck - but I haven't been on a horse in fifty years...

I have also heard discussions on Booth getting his left foot in the stirrup at Ford's and the horse frisking away from him before he could fully mount. He had to get her under control. Might that account for him twisting his back? Frankly, just being on a galloping nag for nigh on to six hours would make my back hurt!

Betty O is our equestrian here. Let's ask for her opinion.

As I stated before, I suspect that historians will always be divided on the issue of where Booth's leg was broken.

Hey, Laurie!

Yes, as Mr. Booth's mare was quite skittish and with one foot in the stirrup, he could very well have wrenched his back or pulled a muscle attempting to control her as he swung his body around to mount. Quite possible, although it's more or likely improbable in my mind. I've never heard of anyone wrenching their back while mounting, but it could be possible, I guess; especially if the mare is side stepping and swinging away as he attempted to mount.

I had a mare like that years ago. She had been trained as a barrel racer and I was attempting to make a jumper out of her. As soon as she felt the weight of your foot in the stirrup, she would take off! A hard to break habit and a dangerous one, too.

[Houmes]

(08-13-2012 06:33 PM)RJNorton Wrote:  This is a real stretch, but it came to mind after I read Jonathan's post. Did Booth have a back problem at an early age? Well, he was shot, apparently accidentally, by Matthew Canning in his hotel room in 1860. The exact location of the wound seems somewhat unclear, but it apparently was in the thigh or buttock region. I immediately thought of the sciatic nerve. Personally I have leg pain due to a back problem (sciatica). Maybe Dr. Houmes will read this and comment; I am asking if an injury to or near the sciatic nerve could cause chronic referred pain upwards into the lower back.

In all honesty, just the thought of jumping 11 or 12 feet increases my back pain, let alone actually doing it.

The sciatic nerve runs deep in the posterior buttock, and any lesion of note (like a gunshot wound to the rear) would be expected to cause permanent paralysis below the knee or loss of sensation on the outside of the leg and both sides of the feet. The sciaic nerve can be contused, meaning compressed or bruised, which can cause temporary problems--like hitting your funny bone, or in over the road truck drivers and long distance male sales personnel, where they have similar discomfort from a fat wallet in the back pocket on the affected side, pressing on the muscles and nerves for hours. Most true sciatica results from wear and tear on the disks of the back or from arthritis of the spine, closing the foramina passage of the nerve from the spinal cord to the leg, compressing the nerve over time without relief.

I appreciate the experiences listed above about personal back injuries, but my concern was comparing a stress fracture to a true, debilitating long bone fracture. I have never heard of Booth having other back problems, and apparently neither had Art Loux in his excellent article "The Accident-Prone Johne Wilkes Booth," Lincoln Herald, 1983:85(4). Dr. Mudd's mention of the back pain was interesting, but like many of his other statements either inadvertently misstating the truth (he called the fibula a tibia), misleading, or deliberate prevarication.

Incidentally, I plead nolo contendere for the grammar error in my first response, ending "...or had a horse fell on him." I should have used the past participle rather than the simple past form. My apologies to the teachers in the forum.

[LincolnMan]

Dr. Houmes: welcome to the Forum. You sent me a personal letter years ago answering a question. So with everything you've said-do you believe that Booth's jump does not account for his physical complaints? Do you personally think that how fell with his horse?

[jonathan]

I apologize if these questions have been asked in the past and discussed to death, but here's something else that just nags at me a little bit regarding the view that Booth's horse fell on him. If we look at what Booth wrote in his diary, he basically sticks to the truth, though he exaggerates most things. Specifically, if we look at his description of the physical acts regarding the assassination and escape, we find this…

1. "I struck boldly, and not as the papers say." - This can be seen as a matter of opinion, but I believe that it's true. He didn't strike honorably, but certainly boldly.

2. "I walked with a firm step through a thousand of his friends, was stopped, but pushed on." - True, but exaggerated

3. "A colonel was at his side" - Wrong rank, but otherwise true

4. "I shouted Sic simper before I fired." - True that he shouted it, but the before or after is unclear.

5. "In jumping broke my leg." - ?

6. "I passed all his pickets, rode sixty miles that night with the bone of my leg tearing the flesh at every jump." - True, with multiple exaggerations.

7. "After being hunted like a dog through swamps, woods, and last night being chased by gunboats till I was forced to return wet, cold, and starving, with every man's hand against me, I am here in despair." - True, with exaggerations

8. "Tonight I will once more try the river with the intent to cross." - True

9. "Tonight I try to escape these bloodhounds once more." - True, some exaggeration

So, looking at what Booth wrote in his diary regarding the act of assassination and the act of trying to escape, we see that he basically stuck pretty close to the truth on each point. There are exaggerations to make himself look better, but as far as we know, it's fairly accurate. Why then, would he deviate so far from the truth on the one point of breaking his leg? Concerning the horse fall vs. the balcony jump, one is not an exaggeration of the other. They are completely different. Why would he dance right around the truth on every other point, while running away from it on the one point of when the leg was broken? It's just something that nags at me a little bit.

[LincolnMan]

Jonathon...really nice job laying it out like that! It's also interesting that he noted that a "colonel" at there (referring to Rathbone, of course). Did Booth know that because Rathbone was in uniform-or did he read that Rathbone was in the military-from the papers afterward. In other words, was Rathbone in uniform?

[RJNorton]

I would like to second Bill and say kudos, Jonathan. Also, another "truism" is the part where he says, "The little, the very little, I left behind to clear my name, the Government will not allow to be printed." This probably is a reference to the letter he gave to John Mathews, but he didn't know Mathews had burned the letter rather than deliver it to the editor of the National Intelligencer.

Mathews' memory of the letter "enlarged" as the years passed.

[Gene C]

I guess how Booth broke his leg, depends on who he wants to be at the moment.
Lincoln's assassin who has a broken leg while doing the patriotic deed and needs help to get away from the Union or...
just some poor traveler who had a road accident and broke his leg. Is he among people who he thinks will help him because he killed Lincoln the enemy, or people who will help him because he's an innocent wounded traveler.

[Laurie Verge]

Just had a very nice lunch with Dr. Terry Alford, whose book, Fortune's Fool (a Booth biography), should go to publication in the spring next year. I asked his opinion on the broken leg, and he gave an answer very similar to Jonathan's and also said that he feels the horse story may be just another aspect of Dr. Mudd distorting history to save his own hide - which is certainly understandable considering what Mudd knew he was facing.

Terry teased me with some more things that his research has turned up. He is a very thorough researcher and well-respected in the field. I'm betting that Fortune's Fool is going to set the Booth field on its ear with some new information. I told him that I was giving him one more year to get that book finished and expected him to be a speaker at the Surratt conference in 2014 -- or I will slap him silly. I made the same threat to Sidney Blumenthal several months ago. His reply was that, if his book wasn't ready by 2014, he would slap himself silly!