Dr
Dr.
BAXTER/JENKINS
Volume VI
TESTIMONY
OF DR. CHARLES RUFUS BAXTER
The testimony of Dr. Charles Rufus Baxter was taken at 11:15 a.m., on
March 24, 1964, at
Mr. SPECTER. May the record show that Dr. Charles Baxter is present in
response to a letter requesting him to appear and give his deposition.
For the record I shall state that the President's Commission on the
Assassination of President Kennedy is investigating all facets of the shooting,
including the medical treatment performed on President Kennedy.
Dr. Baxter has been asked to give a deposition on his participation in
connection with the care and medical treatment of President Kennedy, and with
that statement of purpose, would you please stand up, Dr. Baxter, and raise your
right hand.
Do you solemnly swear the testimony you give before the President's
Commission in the course of this deposition proceeding will be the truth, the
whole truth and nothing but the truth, so help you God?
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Dr. BAXTER. I do.
Mr. SPECTER. Would you state your full name, please?
Dr. BAXTER. Charles Rufus Baxter.
Mr. SPECTER. What is your profession, sir?
Dr. BAXTER. I am a medical doctor of surgery, general surgeon.
Mr. SPECTER Will you outline briefly your educational background?
Dr. BAXTER. University of Texas--1948
through 1950, Southwestern Medical School, 1950 through 1954, 1955 straight
medicine internship, 1956 medicine residency--internal medicine residency, 1956
through 1958, surgical research at Brooke Army Medical Center, 1958 through
1964--surgical residency, and 1964
through
the present--this is 1964, I got out of the Army--in 1958, 1958 through
1962--surgery residency, and 1962 until now, assistant professor of surgery.
Mr. SPECTER. And are you board certified, Doctor?
Dr. BAXTER. Yes.
Mr. SPECTER. And what boards have you passed?
Dr. BAXTER. The American Board of Surgeons.
Mr. SPECTER. And what year were you so certified?
Dr. BAXTER. 1963.
Mr. SPECTER. And what is your specific title at the medical school?
Dr. BAXTER Assistant professor of surgery.
Mr. SPECTER. Did you have occasion to aid in the treatment of President
Kennedy at
Mr. BAXTER. Yes.
Mr. SPECTER. And will you outline briefly the circumstances surrounding
your being called to render such assistance?
Dr. BAXTER. I was conducting the student health service in the hours of
12 to 1 and was contacted there by the supervisor of the emergency room, who
told me that the President was on the way to the emergency room, having been
shot.
I
went on a dead run to the emergency room as fast as I could and it took me about
3 or 4 minutes to get there.
Mr. SPECTER. Approximately what time did you arrive at the emergency
room?
Dr. BAXTER. I think it was 12:40--thereabouts.
Mr. SPECTER. And who was present at that time?
Dr. BAXTER. Dr. Carrico and Dr. Jones and Dr. Jenkins--several nurses.
Mr. SPECTER. Can you identify the nurses?
Dr. BAXTER. Yes; Mrs. Nelson---and who else? There were two or three
others whose names--Miss Henchliffe was there.
Mr. SPECTER. Miss Bowron?
Dr. BAXTER. Who?
Mr. SPECTER. Was Miss Bowron there?
Dr. BAXTER. Yes; I believe so.
Mr. SPECTER. Were any other nurses there?
Dr. BAXTER. One or two more, but I'm not sure of their names.
Mr. SPECTER. Can you identify any other doctors who were there at that
time?
Dr. BAXTER. Oh, let's see---I'm not sure whether the others came before
or after I did. There was Crenshaw,
Peters, and Kemp Clark, Dr. Bashour finally came.
I believe Jackie Hunt--yes--she was, I believe she was the
anesthesiologist who came.
Mr. SPECTER. Was Dr. Don Curtis there?
Dr. BAXTER. I'm not sure---I just don't remember.
Mr. SPECTER. When you arrived, what did you observe as to the condition
of the President?
Dr. BAXTER. He was very obviously in extremis. There was a large gaping
wound in the skull which was covered at that time with blood, and its extent was
not immediately determined. His eyes
were bulging, the pupils were fixed and dilated and deviated outward, both
pupils were deviated laterally. At
that time his breathing was being assisted so that whether he was breathing on
his own or not, I couldn't determine.
Mr. SPECTER. In what way was his breathing being assisted?
Dr. BAXTER With an anesthesia machine.
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Mr. SPECTER. Would you continue to describe what you observed as to his
condition?
Dr. BAXTER. There were no pulses that I could feel present. The
anesthesiologist told me. that he did still have a heartbeat.
Mr. SPECTER. Who is that who said that to you?
Dr. BAXTER. Well, I believe this was Carrico who said that his heart was
still beating. There was present at
the time two intravenous catheters in place with fluids running.
We were informed at that time well,
having looked over the rest of the body, the only other wound was in his neck,
that we saw.
Dr. Carrico said that he had observed a tracheal laceration.
At that moment Dr. Jones, I believe, was placing in a left anterior chest
tube because of this information. We
proceeded at that time with a tracheotomy.
Mr. SPECTER. Who performed the 'tracheotomy?
Dr. BAXTER. Dr. Perry and myself, with the assistance of Dr. McClelland,
and I believe that's all--there may have been one more person that held the
retractor.
Mr. SPECTER. What else, if anything, did you do for President Kennedy at
that
Dr. BAXTER. During the tracheotomy, I helped with the insertion of a
right anterior chest tube, and then helped Dr. Perry complete the tracheotomy.
At that point none of us could hear a heartbeat present.
Apparently this had ceased during the tracheotomy and the chest tube
placement.
We then gave him or Dr. Perry and Dr. Clark alternated giving him closed
chest cardiac massage only until we could get a cardioscope hooked up to tell us
if there were any detectible heartbeat electrically present, at least, and there
was none, and we discussed at that moment whether we should open the chest to
attempt to revive him, while the closed chest massage was going on, and we had
an opportunity to look at his head wound then and saw that the damage was beyond
hope, that is, in a word-- literally the right side of his head had been blown
off. With this and the observation
that the cerebellum was present--a large quantity of brain was present on the
cart, well--we felt that such an additional heroic attempt was not warranted,
and we did not pronounce him dead but ceased our efforts, and awaited the priest
and last rites before we pronounced him dead.
Mr. SPECTER. Did the priest then arrive to perform the last rites?
Dr. BAXTER. Yes.
Mr. SPECTER. At what time was he pronounced dead?
Dr. BAXTER. As I recall, it was 1:08, I'm not sure, it may have been that
that was Oswald.
Mr. SPECTER. But it was approximately 1 o'clock? Then, could the time of
death be fixed with any precision?
Dr. BAXTER. I don't think so--the time elapsing in all of this
resuscitation and the time the heart actually ceased, I don't think one could be
very sure of it. It was sometime between a quarter to 1 and 1 o'clock.
Mr. SPECTER. Have you now described all of the efforts which were made to
save the life of the President?
Dr. BAXTER. Only with the
exception, I think, of the fluids that were administered.
He was given hydrocortisone because of his previous medical condition. He
was given no negative blood because the blood loss was rather fierce and, I
believe that's all.
Mr. SPECTER. What other doctors arrived during the course of the
treatment, in addition to those whom you have already mentioned?
Dr. BAXTER. I don't recall--I know that there were more doctors present
in the room, but their names, I'm not sure of.
The reason I'm not sure is because we had some of the same crew and a
different crew on the Governor and on Oswald, and I'm afraid that I've gotten
them mixed up.
Mr. SPECTER. Now, will you describe in as much particularity as you can
the nature of the head wound
Dr. BAXTER. The only wound that I actually saw--Dr. Clark examined this
above the manubrium of the sternum, the sternal notch.
This wound was in temporal parietal plate of
bone laid outward to the side and there was a large area, oh, I would say
6 by 8 or 10 cm. of lacerated brain oozing from this wound,
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part
of which was on the table and made a rather massive blood. loss mixed with it
and around it.
Mr. SPECTER. Did you notice any bullet hole below that large opening at
the top of the head?
Dr. BAXTER. No; I personally did not.
Mr. SPECTER. Will you describe with as much particularity as you can the
wound which you noticed on the President's neck?
Dr. BAXTER. The wound on the neck was approximately an inch and a haft
above the manubrium of the sternum, the sternal notch.
This wound was in my estimation, 4 to 5 mm. in widest diameter and was a
spherical wound. The edges of
it--the size of the wound is measured by the hole plus the damaged skin around
the area, so that it was a very small wound.
And, it was directly in the midline.
Now, this wound was excised in the performance of the tracheotomy and on
the entery into the deeper tissues of the neck, there was considerable contusion
of the muscles of the anterior neck and a moderate amount of bleeding around the
trachea. The trachea was deviated slightly, I believe, to the left.
Our tracheotomy incision was made in the second tracheal ring which was
immediately above the area of damage where we thought the damaged area of the
trachea was, which we did not dissect out, but once the endotracheal tube was
placed, the tracheotomy tube was placed into the trachea, it was below this tear
in the trachea, and gave us good control or perfect control of respiration.
Mr. SPECTER. Were the characteristics of the wound on the neck sufficient
to enable you to form an opinion with reasonable medical certainty as to what
was the cause of the hole?
Dr. BAXTER. Well, the wound was, I think, compatible with a gunshot
wound. It did not appear to be a jagged wound such as one would expect with a
very high velocity rifle bullet. We
could not determine, or did not determine at that time whether this represented
an entry or an exit wound. Judging
from the caliber of the rifle that we later found or become acquainted with,
this would more resemble a wound of entry. However,
due to the density of the tissues of the neck and depending upon what a bullet
of such caliber would pass through, the tissues that it would pass through on
the way to the neck, I think that the wound could well represent either exit or
entry wound.
Mr. SPECTER. Assuming some
factors in addition to those which you personally observed, Dr. Baxter, what
would your opinion be if these additional facts were present: First, the
President had a bullet wound of entry on the right posterior thorax just above
the upper border of the Scapula with the wound measuring 7 by 4 mm. in oval
shape, being 14 cm. from the tip of the right acromion process and 14 cm. below
the tip of the right mastoid process--assume this is the set of facts, that the
wound Just described was caused by a 6.5 mm bullet shot from approximately 160
to 250 feet away from the President, from a weapon having a muzzle velocity of
approximately 2,000 feet per second, assuming as a third factor that the bullet
passed through the President's body, going in between the strap muscles of the
shoulder without violating the pleura space and exited at a point in the midline
of the neck, would the hole which you saw on the President's throat be
consistent with an exit point, assuming the factors which I have Just given to
you?
Dr. BAXTER. Although it would be unusual for a high velocity missile of
this type to cause a wound as you have described, the passage through tissue
planes of this density could have well resulted in the sequence which you
outline; namely, that the anterior wound does represent a wound of exit.
Mr. SPECTER. What would be the considerations which, in your mind, would
make it, as you characterized it, unlikely?
Dr. BAXTER. It would be unlikely because the damage that the bullet would
create would be---first its speed would create a shock wave which would damage a
larger number of tissues, as in its path, it would tend to strike, or usually
would strike, tissues of greater density than this particular missile did and
would then begin to tumble and would create larger jagged--the further it went,
the more jagged would be the damage that it created; so that ordinarily there
would have been a rather large wound of exit.
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Mr. SPECTER. But relating the situation as I hypothesized it for you?
Dr. BAXTER. Then it is perfectly understandable that this wound of exit
was not of any greater magnitude than it was.
Mr. SPECTER. Dr. Baxter, is there a channel through which the bullet
could have passed in the general direction which I have described to you where
there would be very few tissues and virtually no tissues of great density?
Dr. BAXTER. Yes; passing through the fascial plane which you have
described, it could well not have these things happen to it, so that it would
pass directly through--almost as if passing through a sheet of paper and the
wound of exit would be no larger than the wound we saw.
Mr. SPECTER. What would the situation there be as to the shock wave which
you have heretofore described?
Dr. BAXTER. There would be a large amount of tissue damage which is not
ordinarily seen immediately after a bullet has passed through. This is damage
that is recognized several days later.
Mr. SPECTER What causes the shock waves there, Doctor?
Dr. BAXTER. This is just the velocity imparting pressure to surrounding
tissues which damages them. It does
not show, however, in the early course after a missile has passed through.
Mr. SPECTER Well, would the shock waves have any effect upon the size,
and
nature
of the hole of exit?
Dr. BAXTER. No.
Mr. SPECTER. And if the bullet passed through the fascial plane without
striking tissues of great density, would it have a tendency to tumble at all?
Dr. BAXTER No, it would not.
Mr. SPECTER What has your experience been, if any, Doctor, with gunshot
wounds?
Dr. BAXTER For the past 6 years--we admit and treat, I would estimate,
around 500 gunshot wounds per year-- thereabouts.
Mr. SPECTER Have you ever had any formal training in gunshot wounds?
Dr. BAXTER Only that I received in the Army, with demonstration of
various velocities and that type missile wounds.
Mr. SPECTER. Where was President Kennedy lying when you first saw him,
Dr. Baxter?
Dr. BAXTER. On the cart, on the emergency cart in trauma room 1.
Mr. SPECTER Was he ever taken off of that cart from the time you first
saw him until the time he was pronounced dead?
Dr. BAXTER. No.
Mr. SPECTER. Was he ever turned over?
Dr. BAXTER. No.
Mr. SPECTER Would your examination have been conducted in any different
way had this particular victim not been the President of the
Dr. BAXTER. I think--yes--in that we would have, particularly, postmortem
examined the body much more carefully than we did.
We would certainly have undressed him completely and determined all of
the direction of the wounds
at
the time. This did not seem feasible
under the circumstances.
Mr. SPECTER. Why was it not feasible under the circumstances?
Dr. BAXTER Mrs. Kennedy was in the room, there was a large number of
people in the room by that time Secret
Service Agents, the priests and so on. As soon as the President was pronounced
dead, the Secret Service more or less--well, requested that we clear the room
and leave them with the President's body, which was done. Everything that the
Secret Service wished was carried out.
Mr. SPECTER. What was that?
Dr. BAXTER. Everything that the Secret Service asked us to do, we did, as
rapidly as possible and this was one of their requests.
In addition, I must say that the emotional condition of all of us at that
time was such that probably we would not--we didn't feel that we should do any
more, since we were certain that autopsy would take care of all that we were
going to miss.
Mr. SPECTER. Did the emotional situation have any effect in your
professional opinion on the quality of the medical care which was rendered to
the President?
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Dr. BAXTER. No; none at all. We, I think, everyone present in the room
was certainly emotionally involved in the care of the President, but in no
instance did I see less than the most meticulous and best judgment used in the
care of the President.
Mr. SPECTER, And what, in your opinion, was the cause of death, Dr.
Baxter?
Dr. BAXTER. Gunshot wound to the head.
Mr. SPECTER. Would you have an opinion as to whether or not President
Kennedy would have survived the gunshot wound which you observed in the neck?
Dr. BAXTER. We saw no evidence that it had struck anything in the neck
that
would
not be well taken care of by simply--by the tracheotomy and chest tubes.
Mr. SPECTER. Did you find any bullets in the President's body ?
Dr. BAXTER. No, we did not.
Mr. SPECTER, Any fragments of bullets in the President's body?
Mr. BAXTER. No, sir.
Mr. SPECTER, Dr. Baxter, I now show you Commission Exhibit 392, which has
been heretofore identified in Commission Proceedings as the report from Parkland
Memorial Hospital, and I now call your attention to a page which purports to
bear your signature, and a written report which you rendered under date of
November 22, 1963. I ask you, first of all, if that is your signature?
Dr. BAXTER. Yes.
Mr. SPECTER. And, if this is the report which you submitted?
Dr. BAXTER. Yes.
Mr. SPECTER. Do you have any other writings or notes of any sort
concerning
your
care of President Kennedy?
Dr. BAXTER. No.
Mr. SPECTER. Will you read into the record, Dr. Baxter, the contents of
your report, because it is a little hard to read in spots ?
Dr. BAXTER. "I was contacted at approximately 12:40 that the
President was on the way to the Emergency Room, having been shot.
On arrival there, I found an endotracheal tube in place with assisted
respirations, a left chest tube being inserted, and cutdowns going in one leg
and in the left arm.
The. President had a wound in the midline of the neck.. On first
observation of the remaining wounds, the temporal and parietal bones were
missing and the brain was lying on the table with extensive lacerations and
contusions. The pupils were fixed
and deviated laterally and dilated. No pulse was detectable, respirations were
(as noted) being supplemented. A tracheotomy was performed by Dr. Perry and I
and a chest tube inserted into the right chest (second interspace anteriorly).
Meanwhile, 2 pints of O negative blood was administered by pump without
response. When all of these measures
were complete, no heartbeat could be detected, closed chest massage was
performed until a cardioscope could be attached, which revealed no cardiac
activity was obtained.
Due to the extensive and irreparable brain damage which was detected, no
further attempt to resuscitate the heart was made."
Mr. SPECTER. And that bears your signature?
Dr. BAXTER. Charles R. Baxter, M.D., assistant professor of surgery,
Southwestern Medical School,
Mr. SPECTER. Dr Baxter, has any representative of the Federal Government
ever talked to you about this matter prior to today?
Dr. BAXTER. The only person was a Secret Service Agent
about--approximately three weeks ago who asked me if I had any additional
written comments anywhere or had made any writings on the medical treatment of
the President, and the answer was "No."
Mr. SPECTER, Now, prior to the time that the court reporter started to
transcribe my questions and your answers, did you and I briefly discuss this
deposition proceeding, its purpose and the questions which I would ask you ?
Dr. BAXTER. Yes.
Mr. SPECTER. And are the answers given on the record here the same as you
gave me in our brief conversation before the transcription was started?
Dr. BAXTER. Yes.
Mr. SPECTER. Do you have anything to add which you think might be helpful
in any way to the work of the Commission?
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Dr. BAXTER. No.
Mr. SPECTER. Thank you very much for coming, Dr. Baxter.
Dr. BAXTER. Thank you.
Dr.
Marion Thomas Jenkins
Page 45
TESTIMONY
OF DR. MARION THOMAS JENKINS
The testimony of Dr. Marion Thomas Jenkins was taken at 5:30 p.m., on
March 25, 1964, at
Mr. SPECTER. May the record show that Dr. M. T. Jenkins has appeared in
response to a letter request in connection with the inquiry of the President's
Commission on the Assassination of President Kennedy, to testify concerning his
observations and medical treatment performed by him on President Kennedy, and
with this preliminary statement of purpose, would you stand up, please, Dr.
Jenkins, and raise your right hand.
Do you solemnly swear the testimony you give before the President's
Commission in this deposition proceeding, will be the truth, the whole truth,
and nothing but the truth, so help you God?
Dr. JENKINS. I do.
Mr. SPECTER. Would you state your full name for the record, please?
Dr. JENKINS. Marion Thomas Jenkins.
Mr. SPECTER. What is your profession, please?
Dr. JENKINS. I'm a physician.
Mr. SPECTER. Are you licensed by the State of Texas to practice medicine?
Dr. JENKINS. Yes.
Mr. SPECTER. And what is your specialty, Dr. Jenkins?
Dr. JENKINS. Anesthesiology.
Mr. SPECTER. Will you outline your educational background for me, please?
Dr. JENKINS. I am a graduate of the University of Texas in 1937.
I have a B.A. degree and an M.D. degree from the University of Texas
Medical Branch at Galveston in 1940, rotating internship at the University of
Kansas Hospital, Kansas City, Kans., 1940-41; Assistant Residency in Internal
Medicine, John Sealy Hospital in Galveston, Tex., 1941-42; active duty in the
U.S. Navy as a Medical Officer, 1942 to 1946; Resident in Surgery--Parkland
Hospital, Dallas, 1946-47; Resident in anesthesiology in the Massachusetts
General Hospital, Boston, 1947-48; and Director of the Department of
Anesthesiology, Parkland Hospital and Parkland Memorial Hospital, 1948 to the
present; Professor and Chairman of the Department of Anesthesiology, University
of Texas, Southwestern Medical School--since 1951. Diplomate--other
certification, do you want this?
Mr. SPECTER. Yes, what Boards are you certified?
Dr. JENKINS. I am a Diplomate of the American Board of Anesthesiology and
also fellow of the American College of Anesthesiologists.
Mr. SPECTER. And what year were you certified by the American Board?
Dr. JENKINS. 1952.
Mr. SPECTER. Did you have occasion to assist in the treatment of
President Kennedy on November 22, 1963?
Dr. JENKINS. Yes.
Mr. SPECTER. And will you relate briefly the circumstances surrounding
your being called into that case?
Dr. JENKINS. Well, I was in the dining room with other members of the
hospital staff when we heard the Chief of Surgery, Dr. Tom Shires, being paged
"Stat." This is a rather
unusual call, for the Chief of any service to be called "Stat" as this
is the emergency call.
Mr. SPECTER. What does that mean, "Stat"?
Dr. JENKINS. "Stat" means emergency, that's just a code word
that has been used for years in medical terms.
He was paged twice this way, and one of the
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surgical
residents, Dr. Ronald Jones, answered the phone, thinking some thing bad must be
up and that he would call the Chief of Surgery.
I was sitting near the telephone and Dr. Jones immediately came back by
with very anguished look and the color was drained from his face-- I'm sure I
had that impression, and he said, "The President has been shot and is on
his way to the hospital." At the same time we heard the sirens of the
ambulance as they turned into the driveway from Harry Hines into the hospital
drive, and it was obvious that this was the car coming in because the ambulance
sirens usually stop in the street, but these came on clear to the building.
Mr. SPECTER. That's Harry Hines Boulevard right in front of the hospital
Dr. JENKINS. Yes; I ran up the stairs to the Anesthesia Department,
that's on the second floor-one floor above the dining room, where I was, and
notified two members of the Department, the first two I saw, my Chief Associate,
Dr. A. H. Giesecke, Jr., and Dr. Jackie Hunt, that the President had been shot
and was being brought to the emergency room and for them to bring all the
resuscitative equipment we have including an anesthesia machine.
The emergency room is set up well, but we are used to working with our
own equipment and I asked them to bring it down and I ran down the back stairs,
two flights down, and I arrived in the emergency room just after or right behind
him, being wheeled in, I guess.
Mr. SPECTER At about what time did you arrive at the emergency room
Dr. JENKINS. Oh, this was around 12:30-12:35 to 12:40.
I shouldn't be indefinite about this--in our own specialty practice, we
watch the clock closely and there are many things we have to keep up with, but I
didn't get that time exactly, I'll admit.
Mr. SPECTER Who was present at the time of your arrival in the emergency
room, if anyone?
Dr. JENKINS. The hallway was loaded with people.
Mr. SPECTER. What medical personnel were in attendance?
Dr. JENKINS. Including Mrs. Kennedy, I recognized, and Secret Service
men, I didn't know whether to block
the way or get out of it, as it turned out. Dr. James Carrico and Dr. Dulany-Dick
Dulany, I guess you have his name, and several nurses were in the room.
Mr. SPECTER. Could you identify the nurses?
Dr. JENKINS. Well, not really. I
could identify them only having later looked around and identified from my own
record that I have, the names of all who were there later.
Now, whether they are the same ones when I first went there, I don't
know. I have all the names in my
report, it seemed to me
Mr. SPECTER. Could you now identify all of the nurses from your later
observations of them?
Dr. JENKINS. Well, I can identify who was in there at the close of the
procedure, that is, the doctors, as well as those who were helping.
Mr. SPECTER. Fine, would you do that for us, please?
Dr. JENKINS. These included a Mrs. or Miss Patricia Hutton and Miss Diana
Bowron, B-o-w-r-o-n (spelling), and a Miss Henchliffe--I don't know her first
name, but I do know it is Henchliffe.
Mr. SPECTER Margaret?
Dr. JENKINS. Margaret---certainly. Those
three--there were probably some student nurses too, whom I didn't recognize.
Shall I continue?
Mr. SPECTER. Yes, please. Have you now covered all the people you
recollect as being in the room?
Dr. JENKINS. Well, as I came into the room, I saw only the, actually--you
know, in the haste of the coming of the President, two doctors whom I
recognized, and there were other people and I have identified all I remember
Mr. SPECTER What did you observe as to the President's condition when you
arrived in the emergency room?
Dr. JENKINS. Well, I was aware of what he was in an agonal state.
This is not a too unfamiliar state that we see in the Service, as much
trauma as we see, that is, he had the agonal respiratory gasp made up of jerking
movements of the mylohyoid group of muscles.
These are referred to sometimes as chin jerk, tracheal tug or agonal
muscles of respiration. He had this
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characteristic
of respiration. His eyes were opened
and somewhat exophthalmic and color was greatly suffused, cyanotic---a purplish
cyanosis.
Still, we have patients in
the state, as far as cyanosis and agonal type respiration, who are
resuscitatable. Of course, you don't
step at this time and think, "Well, this is a hopeless
circumstance,"--because one in this state can often be resusciated--this
represents the activities prior to one's demise sometimes, and if it can be
stepped, such as the patient is oxygenated again and circulation reinstituted,
he can be saved.
Dr. Carrico had just introduced an endotracheal tube, I'm very proud of
him for this because it's not as easy as it sounds. At times and under the
circumstances--it was harder--he had. just completed a 3-month rotation on the
anesthesiology service, and I thought this represented good background training
for a smart individual, and he told me he had a cuff on the endotracheal tube
and he introduced it below the wound.
The reason I said this, of course, this is a reflex--there is a tube, the
endotracheal tube, if it is pushed down a little too far it can go into the
right main stem of the bronchus impairing respiration from both lungs, or both
chest.
There was in the room an intermittent positive pressure breathing
apparatus, which can be used to respire for a patient. As I connected this up,
however, Dr. Carrico and I connected it up to give oxygen by artificial
respiration, Dr. Giesecke and Dr. Hunt arrived on the scene with the anesthesia
machine and I connected it up instead with something I am more familiar
with--not for anesthesia, I must insist on that--it was for the oxygenation, the
ability to control ventilation with 100 percent oxygen.
As I came in there, other people came in also. This is my recollection.
Now, by this time I was in familiar surroundings, despite the anguish of the
circumstance.
Despite the unusual circumstance, in terms of the distinguished personage
who was the patient, I think the people who had gathered or who had congregated
were so accustomed to doing resuscitative procedures of this nature that they
knew where to fit into the resuscitation team without having a preconceived or
predirected plan, because, as obviously--some people were doing things not
necessarily in their specialty, but there was the opening and there was the
necessity for this being done.
There were three others who came in as I did who recognized at once the
neck wound, in fact, where the wound was, would indicate that we would have
serious pulmonary problems unless a tracheotomy tube was put in.
This is one way of avoiding pushing air out through a fractured trachea
and down into each chest cavity, which would cause a pneumothorax or a collapse
of the lungs. These were doctors
Malcolm Perry, Charley Baxter, and Robert McClelland, who with Dr. Carrico's
help, I believe, started the tracheotomy.
About this time Drs. Kemp Clark and Paul Peters came in, and Dr. Peters
because of the appearance of the right chest, the obvious physical
characteristics of a pneumothorax, put in a closed chest drainage
chest tube. Because I felt no
peripheral pulse and was not aware of any pulse, I reported this to Dr. Clark
and he started closed chest cardiac massage.
There were other people--one which started an I.V. in a cutdown in the
right leg and one a cutdown in the left arm.
Two of my department connected up the cardioscope, in which we had
electrical silence on the cardioscope as Dr. Clark started closed chest massage.
That's the sequence of events as I reconstructed them that day and
dictated them on my report, which you have here, I think.
Mr. SPECTER Speaking of your report, Dr. Jenkins, permit me to show you a
group of papers heretofore identified as Commission Exhibit No. 392 which has
also been identified by Mr. Price, the hospital Administrator, as being
photostatic copies of original reports in his possession and controlled as
Custodian of Records, and I show you what purports to be a report from you to
Mr. Price, dated November 22, 1963, and ask you if in fact this 2-page report
was submitted by you to Mr. Price?
Dr. JENKINS. Yes; it was.
Mr. SPECTER. Now, going back to the wound which you observed in the neck,
did you see that wound before the tracheotomy was performed?
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Dr. JENKINS. Yes; I did, because I was just connecting up the
endotracheal tube to the machine at the time and that's when Dr. Carrico said
there was a wound in the neck and I looked at it.
Mr. SPECTER Would you describe that wound as specifically as you can?
Dr. JENKINS. Well, I'm afraid my description of it would not be as
accurate, of course, as that of the surgeons who were doing the tracheotomy,
because my look was a quick look before connecting up the endotracheal tube to
the apparatus to help in ventilation and respiration for the patient, and I was
aware later in the day, as I should have put it in the report, that I thought
this was a wound of exit because it was not a clean wound, and by
"clean" clearly demarcated, round, punctate wound which is the usual
wound of an entrance wound, made by a missile and at some speed. Of course,
entrance wounds with a lobbing type missile, can make a jagged wound also, but I
was of the impression and I recognized I had the impression it was an exit
wound. However, my mental appreciation for a wound--for the wound in the neck, I
believe, was sort of--was overshadowed by recognition of the wound in the scalp
and skull plate.
Mr. SPECTER. Have you now described the wound in the neck as specifically
as you can at this moment?
Dr. JENKINS. I believe so.
Mr. SPECTER. Now, will you now describe the wound which you observed in
the head?
Dr. JENKINS. Almost by the time I was--had the time to pay more attention
to the wound in the head, all of these other activities were under way.
I was busy connecting up an apparatus to respire for the patient,
exerting manual pressure on the breathing bag or anesthesia apparatus, trying to
feel for a pulse in the neck, and then reaching up and feeling for one in the
temporal area, seeing about connecting the cardioscope or directing its being
connected, and then turned attention to the wound in the head.
Now, Dr. Clark had begun closed chest cardiac massage at this time and I
was aware of the magnitude of the wound, because with each compression of the
chest, there was a great rush of blood from the skull wound.
Part of the brain was herniated; I really think part of the cerebellum,
as I recognized it, was herniated from the wound; there was part of the brain
tissue, broken fragments of the brain tissue on the drapes of the cart on which
the President lay.
Mr. SPECTER. Did you observe any wounds immediately below the massive
loss of skull which you have described?
Dr. JENKINS. On the right side?
Mr. SPECTER. Yes, sir.
Dr. JENKINS. No---I don't know whether this is right or not, but I
thought there was a wound on the left temporal area, right in the hairline and
right above the zygomatic process.
Mr. SPECTER. The autopsy report discloses no such development, Dr.
Jenkins.
Dr. JENKINS. Well, I was feeling for---I was palpating here for a pulse
to see whether the closed chest cardiac massage was effective or not and this
probably was some blood that had come from the other point and so I thought
there was a wound there also.
Mr. SPECTER. At approximately what time was President Kennedy pronounced
dead?
Dr. JENKINS. Well, this was pronounced, we know the exact time as 1300,
according to my watch, at least, at the time.
Mr. SPECTER. And what, in your opinion, was the cause of death?
Dr. JENKINS. Cerebral injury--brain injury.
Mr. SPECTER. Was President Kennedy ever turned over during the course of
this treatment at Parkland?
Dr. JENKINS. No.
Mr. SPECTER Why was he not turned over, Dr. Jenkins?
Dr. JENKINS. Oh, I think this was beyond our prerogative completely.
I think as we pronounced the President dead, those in attendance who were
there just sort of melted away, well, I guess "melted" is the wrong
word, but we felt like we were intruders and left.
I'm sure that this was considerably beyond our prerogative, and the facts
were we knew he had a fatal wound, and I think my
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own
personal feeling was that this was--would have been meddlesome on anybody's part
after death to have done any further search.
Mr. SPECTER. Was any examination of his back made before death, to your
knowledge?
Dr. JENKINS. No, no; I'm sure there wasn't.
Mr. SPECTER. Did he remain on the stretcher cart at all times while he
was being cared for?
Dr. JENKINS. Yes, sir. Can I say something that isn't in the report here,
or not?
Mr. SPECTER. Yes; let's go
off the record a minute.
(Discussion off the record between Counsel Specter and the witness, Dr.
Jenkins.)
Mr. SPECTER. May the record show that we are back on the record and Dr.
Jenkins has made an interesting observation about the time of the declaration of
death, and I will ask you, Dr. Jenkins, for you to repeat for the record what
you have just said off the record.
Dr. JENKINS. As the resuscitative maneuvers were begun, such as
"chest cardiac massage," there was with each compression of the
sternum, a gush of blood from the skull wound, which indicated there was massive
vascular damage in the skull and the brain, as well as brain tissue damage, and
we recognized by this time that the patient was beyond the point of
resuscitation, that he was in fact dead, and this was substantiated by getting a
silent electrical pattern on the electrocardiogram, the cardioscope that was
connected up.
However, for a period of minutes, but I can't now define exactly, since I
didn't put this in a report, after we knew he was dead, we continued attempted
resuscitative maneuvers.
When we saw the two priests who arrived in the corridor outside the
emergency room where this was taking place, I went to the door and asked one of
those after turning over my ventilation, my respiration job to another one of my
department-and asked him what is the proper time to declare one dead.
That is, I am not a Catholic and I was not sure of the time for the last
rites. As I remember now, he said,
"The time that the soul leaves the body--is not at exactly the time that
medical testimony might say that death was declared." There would be a
period of time and so if we wished to declare him dead at that time they would
still have the final rites.
Mr. SPECTER Did they then have the final rites after the time he was
declared dead medically?
Dr. JENKINS. Well, just a minute now--I suspect that was hazy to me that
day--I'm not sure, it's still hazy. This
was a very personal---on the part of the very anguished occasion, and Mrs.
Kennedy had come back into the room and most of the people were beginning to
leave because they felt like this was such a grief stricken and private affair
that they should not be there. It
was real intrusion even after they put forth such efforts at resuscitation and
I'm not sure now whether the priests came in while I was still doing the
resuscitative procedure, respiration at least, and while Dr. Clark was still
doing the other. My memory is that
we had stopped. I was still present,
however, and that's the reason I'm not clear, because I hadn't left the room and
I was still there as the rites were performed and a prayer was said.
Mr. SPECTER. Dr. Jenkins, would your observation of the wound and your
characterization of it as an exit hole be consistent with a set of facts which I
will ask you to assume for purposes of giving me your view or opinion.
Assume, first of all, if you will, that President Kennedy had a wound on
the upper right posterior thorax just above the upper border of the scapula,
measuring 14 cm. from the tip of the right acromion process and 14 cm. below the
tip of the right mastoid process, and that the missile was a 6.5 mm. jacketed
bullet fired from a weapon having a muzzle velocity of approximately 2,000 feet
per second and approximately 160 to 250 feet from the President, and that after
entering the President's body at the point indicated, the missile traveled
between two strap muscles and through a fascia plane without violating the
pleura cavity, and then struck the right side of the trachea and exited through
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the
throat, would the throat wound which you observed be consistent with such a
wound inflicted in the manner I have just described?
Dr. JENKINS. As far as I know, it wouldn't be inconsistent with it, Mr.
Specter.
Mr. SPECTER What has your experience been with gunshot wounds, that is,
to what extent have you had experience with such wounds?
Dr. JENKINS. Well, having been Chief of the Anesthesia Service here for
this 16 years, we have a rather large trauma emergency service, and so I see
gunshot wounds many times a week. I'm
afraid I couldn't hazard a guess at the moment as to how many we see a year, and
I'm afraid probably if I knew, I would not like to admit to this number, but I
do go further in saying that my main interest is not in the tracks of the
wounds. My main interest is what
physiological changes that they have caused to the patient that I am to
anesthetize or a member of the department is to anesthetize, what has happened
to the cardiovascular system, respiratory, and neurological, and so I am aware
of the wounds of entrance and exit only by a peripheral part of my knowledge and
activities during the time.
Mr. SPECTER. Have you ever had any formal training in ballistics or in
exit wounds or entrance wounds--bullet wounds?
Dr. JENKINS. No, I have not.
Mr. SPECTER. Have you talked to any representative of the Federal
Government at any time prior to today?
Mr. JENKINS. Oh, there was a man whose name I don't remember now, who
showed what looked like the proper credentials from the FBI, who came to ask
only whether the report I had submitted to Mr. Price for the hospital record or
for Mr. Price's record constituted all the reports I had. That's the only time
and that was the extent of our conversation, I think.
Mr. SPECTER. And is that the only written record you have of your
participation in the treatment of the President?
Dr. JENKINS. Oh, I submitted one to the Dean of the Medical School,
essentially the same, and a very little more. I don't think you have that. I
don't know whether you want it or not.
Mr. SPECTER. Yes, I would like to see it.
Dr. JENKINS. It is
essentially the same report--however---can I ask you something off of the record
here?
Mr. SPECTER. Sure.
(Discussion between Counsel Specter and the witness, Dr. Jenkins, off the
record.)
Mr. SPECTER. The record will show that we have been off the record on a
couple of matters which I am going to now put on the record, but I will ask the
court reporter to identify this as Dr. Jenkins' Exhibit No. 36.
(Instrument referred to marked by the Reporter as Dr. Jenkins' Exhibit
No. 36, for identification.)
Mr. SPECTER. I will ask you, Dr. Jenkins, for the record to identify this
as a report which you submitted to Dean Gill.
Dr. JENKINS. Yes, it is.
Mr. SPECTER. And is this in conjunction with the report you submitted to
Mr. Price--do these reports constitute all the writings you have on your
participation in the treatment of President Kennedy?
Dr. JENKINS. Yes; that's right.
Mr. SPECTER. One of the comments we were just discussing off the
record---I would like to put on the record, Dr. Jenkins, is the question as to
whether or not the wound in the neck would have been fatal in your opinion,
absent the head wound. What would
your view of that be?
Mr. JENKINS. Well, from my knowledge of the wound in the neck, this would
not have been fatal, except for one thing, and that is--you have not told me
whether the wound with its point of entrance and point of exit had contacted the
vertebral column in its course?
Mr. SPECTER. It did not.
Dr. JENKINS. In that case I would not expect this wound to have been
fatal.
Mr. SPECTER. What is your view, Dr. Jenkins, as to whether the wounds
which you observed were caused by one or two bullets?
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Dr. JENKINS. I felt quite sure at the time that there must have been two
bullets--two missiles.
Mr. SPECTER. And, Dr. Jenkins, what was your reason for that?
Dr. JENKINS. Because the wound with the exploded area of the scalp, as I
interpreted it being exploded, I would interpret it being a wound of exit, and
the appearance of the wound in the neck, and I also thought it was a wound of
exit.
Mr. SPECTER. Have you ever changed any of your original opinions in
connection with the wounds received by President Kennedy ?
Dr. JENKINS. I guess so. The
first day I had thought because of his pneumothorax, that his wound must have
gone--that the one bullet must have traversed his pleura, must have gotten into
his lung cavity, his chest cavity, I mean, and from what you say now, I know it
did not go that way. I thought it
did.
Mr. SPECTER. Aside from that opinion, now, have any of your other
opinions about the nature of his wounds or the sources of the wounds been
changed in any way ?
Dr. JENKINS. No; one other. I
asked you a little bit ago if there was a wound in the left temporal area, right
above the zygomatic bone in the hairline because there was blood there and I
thought there might have been a wound there (indicating).
Mr. SPECTER. Indicating the left temporal area?
Dr. JENKINS. Yes; the left temporal, which could have been a point of
entrance and exit here (indicating), but you have answered that for me. This was
my only other question about it.
Mr. SPECTER. So, that those two points are the only ones on which your
opinions have been changed since the views you originally formulated?
Dr. JENKINS. Yes, I think so.
Mr. SPECTER. On the President's injuries?
Dr. JENKINS. Yes, I think so.
Mr. SPECTER. Is the conversation you had with that Secret Service Agent
the only time you were interviewed by anyone from the Federal Government prior
to today about this subject?
Dr. JENKINS. As far as I remember--I don't believe so.
Mr. SPECTER. Now, you say that was the only time you were interviewed?
Dr. JENKINS. Yes, as far as I remember--I have had no formal interviews.
I have been asked--there have been some people calling on the phone.
As you know, there were many calls from various sources all over the
country after that, wanting to know whether we had done this method of treatment
or some other method and what principles we followed.
Mr. SPECTER. But the only one you can identify as being from the Federal
Government is the one you have already related from the Secret Service?
Dr. JENKINS. Yes.
Mr. SPECTER. And did you and I have a very brief conversation before the
deposition started today, when you gave me some of your views which you
expounded and expanded upon during the course of the deposition on the record?
Dr. JENKINS. Yes.
Mr. SPECTER. And is there anything which you think of to add that you
believe would be of some assistance or any assistance to the President's
Commission in its inquiry?
Dr. JENKINS. I believe not, Mr. Specter.
Mr. SPECTER. Well, thank you very much, Dr. Jenkins.
Dr. JENKINS. All right.
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