Reclaiming History

by Vincent Bugliosi

  The president’s throat wound has received an equal amount of attention from critics seeking to knock down the conclusion that the president was struck by a bullet fired from behind. And again, as in the case with the president’s head wound, conspiracy theorists have seized on the testimony of some of the Parkland doctors, as well as statements a few of them made to the press around the time of the president’s death, for the proposition that the wound to the president’s throat was an entrance wound rather than an exit wound, as the evidence clearly shows it was. “It is clear that the Parkland Hospital doctors [formed] an opinion of the anterior neck wound—they thought it was an entrance wound,” says Sylvia Meagher in her book Accessories after the Fact.183 “The [Parkland] doctors were unanimous [not true, as we shall see] about the nature of the throat wound: it was an entrance wound,” Mark Lane asserts in his book Rush to Judgment.184 Another conspiracy theorist, Harrison Edward Livingstone, writes that “all the doctors in Dallas” who saw the wound thought “it was a wound of entry.”185 The conspiracy theorists, convinced the shot came from the front, and citing the Warren Commission’s position that Oswald was to the president’s right rear in the Book Depository Building at the time of the shooting, conclude that Oswald could not have fired the bullet that caused the throat wound. And therefore, they argue, he is completely innocent, or at a minimum, there were two gunmen and hence a conspiracy.

  What has complicated the correct characterization of the wound and kept this from being a nonissue is the fact that as previously indicated, Dr. Malcolm Perry, a Parkland Hospital doctor, used the wound in the president’s throat as the point to make his tracheotomy incision (cutting into the president’s trachea, or windpipe, to enable the insertion of a tube to maintain breathing), and in the process enlarged the wound, destroying most of its original configuration.186 Indeed, when the Warren Commission asked Dr. Humes, “In spite of the incision made by the tracheotomy, was there any evidence left of the exit aperture?” he answered (erroneously), “Unfortunately not that we could ascertain, sir.”187 But although the tracheotomy had destroyed much of the exit wound’s original configuration, it had not completely obscured the wound. Looking at black-and-white photographs of the wound to the throat (which were sharper and clearer than similar color photographs), the nine-member panel of forensic pathologists for the HSCA noticed “a semicircular missile defect near the center of the lower margin of the tracheotomy incision.” The committee said it was an “exit defect.”188 Dr. Baden, who headed up the HSCA panel, said, “The semicircular defect was caused by the exiting bullet. I saw it right away in the photographs, even though they weren’t of the best quality.”189 The four-member 1968 Clark Panel of physicians and pathologists also saw a portion of the exit wound that was not obliterated by the tracheotomy.190

  Before we look at and evaluate the observations of the Parkland doctors, it should be noted that by their own admission, they did not even attempt to make a determination of whether the wound to the president’s throat was an entrance or exit wound. They were only trying to save his life.191 Among the later pathologists who did attempt to determine whether it was an entrance or exit wound, all fifteen of them not only concluded that it was an exit wound, but that it was the exit wound of the bullet that entered the president’s upper right back.* And as I pointed out in my cross-examination of Dr. Cyril Wecht at the docu-trial in London, even Wecht, a member of the nine-doctor HSCA panel and the leading medical voice for years for the conspiracy theorists, agreed in his testimony before the HSCA that the throat wound was a wound of exit when he conceded, by necessary implication, that no bullet that struck the president entered from the front. “The president was struck definitely twice,” Wecht said, “one bullet entering in the back, and one bullet entering in the back of [his] head.”192

  Dr. Perry testified before the Warren Commission that he did not know whether the throat wound was an entrance or exit wound.193 However, at a press conference at Parkland Hospital commencing at 3:16 p.m. on the day of the assassination, he told the assembled media that “the wound appeared to be an entrance wound in the front of the throat.”194 Confronted with this apparent contradiction when he was interviewed by the HSCA, he tried to explain his press conference remarks by saying that “I thought it looked like an entrance wound because it was small, but I didn’t look for any others, and so that was just a guess.”195† In a subsequent interview with author Gerald Posner on April 2, 1992, Dr. Perry said that the press “took my statement at the press conference out of context. I did say it looked like an entrance wound since it was small, but I qualified it by saying that I did not know where the bullets came from. I wish now that I had not speculated. Everyone ignored my qualification.”196

  The reason the press ignored Dr. Perry’s qualification is that he did not, in fact, make one. To the contrary, the transcript of the press conference, which Posner had and cites as a source, reflects just the opposite of what Perry told Posner and what Posner led his readers to believe. In response to the question “Which way was the bullet coming on the neck wound?” from a member of the press, Perry answered, “It appeared to be coming at him.” (In Dr. Perry’s mind, he may have felt unsure about what type of wound the wound to the throat was. His telling Dr. Robert McClelland, another attending physician, that the wound had “somewhat irregular margins,” which is indicative of an exit wound, supports this. But he never qualified at the press conference, at any point, his conclusion it was an entrance wound.)197‡

  Dr. Charles Carrico was the first Parkland doctor to see the president and to start the resuscitation effort. He testified before the Warren Commission that he made no determination whether the throat wound was an entrance or exit wound. “It could have been either,” he said.198 However, in his 4:20 p.m. Parkland Memorial Hospital “Admission Note” on November 22, 1963, he described the wound as a “penetrating” wound.199 Conspiracy theorists have alleged that by the word penetrating, Carrico meant an entrance wound (e.g., “Dr. Carrico…described the throat wound as one of entrance, using the phrase: [a] small penetrating wound”).200 When I asked Dr. Carrico what he meant by the word penetrating, he responded, “I was not using the word penetrating to be synonymous with entry, because I didn’t know at the time whether it was an entry or exit wound. Although Mr. Webster might not agree, we physicians differentiate the mechanism causing injury into two broad groups. One is blunt trauma, which is, for instance, broken bones from car wrecks, bruises and lacerations from aggravated assault, or other wounds caused by machine or blunt force or instrument. The other is penetrating trauma, which is a wound caused usually by a knife or gunshot, or by impalement from other sharp objects.”201 Although Carrico was unable to determine whether the throat wound was an entrance or exit wound, he did observe that the wound was “ragged,”202 virtually a sure sign of an exit wound as opposed to an entrance wound, which is usually round and devoid of ragged edges.

  Several points should be kept in mind about the observations of Drs. Perry and Carrico. Neither was a pathologist. In fact, of the many doctors in the resuscitation room at Parkland Hospital, none were pathologists,203 much less forensic pathologists, whose specialty is determining, for legal purposes, the cause of death and, among other things, the nature (e.g., entrance as opposed to exit) of wounds. To do this, forensic pathologists examine the track of the bullet through the victim’s body, examine the victim’s clothing, take measurements and photographs, and so on. The Parkland doctors did none of these things. In fact, as recently as 1992, all four of the principal doctors on the medical team that treated the president at Parkland (Drs. Marion “Pepper” Jenkins and Charles Baxter as well as Perry and Carrico) emphasized, in an interview with JAMA, that their experiences in the trauma room at Parkland Hospital did not qualify them to reach conclusions about the direction from which the fatal missiles were fired—that is, whether the wounds were entry or exit wounds.204 Indeed, Dr. Perry, thirty-four years old at the time, had just completed his residency the pre
vious year, and Dr. Carrico, only twenty-eight, was still a resident at Parkland, which means he hadn’t even yet completed all of his training to become certified in his specialty of surgery.205 Why, one may ask, were such young and relatively inexperienced doctors given the responsibility of saving the president’s life? (The conspiracy theorists have overlooked a natural argument for them: Parkland Hospital may have been in on the conspiracy to make sure the president died.) The reason is that nearly all the senior doctors at Parkland were attending a medical conference in Galveston, and only relatively junior doctors were available at Parkland to treat the president.206

  Most importantly by far, the Parkland doctors, as previously alluded to, weren’t there to determine the nature of the president’s wounds. Dr. Perry said that whether the wounds were entrance or exit wounds “really made very little difference [to us]. Some things must take precedence and priority, and in this instance the airway and the bleeding [had to] be controlled.”207 “We were trying to save a life, not worrying about entry and exit wounds,” Dr. Carrico told JAMA in the 1992 interview, echoing his 1964 testimony before the Warren Commission that “this was an acutely ill patient and all we had time to do was to determine what things were life-threatening right then and attempt to resuscitate him…after which a more complete examination would be carried out [by others].”208

  Question by Warren Commission counsel: “Why did you not make an effort to determine the track of the bullets?”

  Carrico: “The time to do this was not available. The examination conducted was to try to establish what life-threatening situations were present and to correct these.”209New York Times White House correspondent Tom Wicker, who was at the press conference at Parkland when the media was informed of Kennedy’s death, wrote that the doctors “gave us copious details, particularly as to the efforts they had made to resuscitate the president. They were less explicit about the wounds, explaining that the body had been in their hands only a short time and they had little time to examine [them] closely.”210

  Illustrating the rushed circumstances, Dr. Perry told JAMA in the 1992 interview, “Jim [Carrico] was having trouble inserting the endotracheal tube because of the wound to the trachea and I didn’t even wipe off the blood before doing a ‘trach.’ I grabbed a knife and made a quick and large incision.”211

  Briefly, the following Parkland doctors, in addition to Perry and Carrico, gave an opinion on the nature of the president’s throat wound, or passed on hearsay information about the wound:

  Dr. Charles Baxter: “We…did not determine at that time whether this represented an entry or an exit wound. Judging from the caliber of the rifle that [was] later found…this would more resemble a wound of entry. However…depending upon what a bullet of such caliber would pass through, the tissues it would pass through on the way to the [throat], I think that the wound could well represent either an exit or entry wound.”212

  Dr. Marion Jenkins: “I thought this was a wound of exit because it was not a clean wound, and by ‘clean,’ [I mean] clearly demarcated, round.”213

  Dr. Robert McClelland: “The neck wound, when I first arrived, was [already] converted into a tracheotomy incision…The description that [Dr. Perry] gave me was…a very small injury, with clear-cut, although somewhat irregular margins.”214

  Dr. Ronald Jones: “[The] small hole in anterior midline of neck [was] thought to be a bullet entrance wound.”215

  Dr. Gene Akin: “[The wound] was slightly ragged around the edges…The thought flashed through my mind that this might have been an entrance wound. I immediately thought it could also have been an exit wound.”216

  Undoubtedly, one of the main reasons, if not the main reason, why the Parkland doctors were clearly confused as to whether the throat wound was a wound of entry or exit, with several actually believing it was an entry wound, is the simple fact that none of them were aware at the time of the corresponding wound (the real entrance wound) in the president’s back. “We were not aware,” Dr. Carrico testified before the Warren Commission, “of the missile wound to the back…We knew of no other entrance wound.”217 Common sense tells us that seeing only the wound to the front of the president’s neck, the Parkland doctors would instinctively have been more inclined to think of it as an entrance wound. Almost anyone would be so predisposed. But if the Parkland doctors had been aware of the corresponding wound to the president’s back, and particularly that it was small and oval with clean and not ragged edges,218 the very strong likelihood is that they all would have concluded that the throat wound was the exit wound every pathologist later found it to be.

  Why weren’t the Parkland doctors aware of the wound to the president’s back? Because they did not turn the president’s body over. Why didn’t they? Again, they weren’t there to examine bullet wounds and their trajectory, but were engaged in a frantic effort to save the president’s life. And turning the president’s body over to examine his back for bullet wounds when you’re right in the middle of an attempt to save his life would be clearly counterproductive. As Dr. Perry testified when asked by Commission counsel Arlen Specter why he didn’t turn the president’s body over, “At that point it was necessary to attend to the emergent procedure, and a satisfactory effective airway is uppermost in such a condition.”

  Specter: “Did you ever turn him over?”

  Dr. Perry: “I did not.”219

  When Specter asked Dr. Carrico, “Why did you not take the time to turn him over?” Carrico replied, “[A] thorough inspection would have involved…considerable time which at this juncture was not available. [It] would have involved washing and cleaning the back, and this is not practical in treating an acutely injured patient. You have to determine which things…are immediately life-threatening and cope with them.”

  Specter: “Was any effort made to inspect the president’s back after he had expired?”

  Carrico: “No, sir.”

  Specter: “And why was no effort made at that time to inspect his back?”

  Carrico: “I suppose nobody really had the heart to do it.”220

  Carrico told me, “Once the president died, we discontinued all examination of the president’s body. That was for the medical examiner. It would have been needless meddling on our part.”221 Dr. Jenkins spoke similarly. Explaining why the president’s body was never turned over, he said, “I think as we pronounced the president dead, those…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 [would have been] beyond our prerogative and…[it] would have been meddlesome on anybody’s part after death to have done any further search.”222

  The very nature of an emergency trauma room at a hospital is such that forensically precise and accurate descriptions of the character of a gunshot wound cannot be expected. In fact, a 1993 article in JAMA reported that “the odds that a trauma specialist will correctly interpret certain fatal gunshot wounds are no better than the flip of a coin.” A study conducted by investigators at Bowman Gray School of Medicine at Wake Forest University in Winston-Salem, North Carolina, from 1987 to 1992, compared the post-mortem findings of a board-certified forensic pathologist with the medical records of emergency medicine physicians, trauma surgeons, and neurosurgeons. It was discovered that out of forty-six cases, trauma specialists made errors in 52 percent, either in differentiating the exit and entrance wound or in determining the number of bullets. In 15 percent of the cases, the trauma specialist made both types of error. As expected, multiple gunshot wounds (the situation with the president) were more often misinterpreted, accounting for 74 percent of the errors. Even single gunshot wounds were misclassified in 37 percent of the cases.223

  Even under the most optimum of circumstances, people’s perceptions of what they think they saw are more often than not seriously conflicting. For instance, there’s the famous law school experiment where the professor has someone run into the classroom and do several things (such as speak some words, p
ick up a book, turn over a small trash can, etc.), then immediately run out. The students, sitting calmly in their seats with nothing to do except observe what is taking place in front of them, give wildly divergent descriptions of the person, his clothing, and his conduct. Yet here we have the Parkland doctors, in the middle of their desperate attempt to save the life of the most powerful man on earth, and with absolutely no need or desire on their part to determine the correct physical characteristics of his wounds, and the conspiracy theorists expect them, in the chaotic frenzy of the moment, to make observations that should be treated like immutable mosaic truths, trumping photographs and X-rays and subsequent contrary conclusions by the autopsy surgeons and all other pathologists who have studied and examined the available evidence.

  Though conspiracy theorists are almost unanimous in believing that the president was shot from the front and his throat wound was an entrance wound, they are strangely silent as to what happened to this bullet after it entered the president’s throat. Unlike the fatal head wound, which most conspiracists also say came from a shot from the front and exited to the rear of the president’s head, they don’t say what happened to the bullet that entered the president’s throat from the front. Since no bullet was found inside the president’s body at the time of the autopsy, by definition, it would have had to exit the president’s body. But where? Virtually the only argument the conspiracists have ever made about this bullet is the contention, by some of them, that it was the “missile” given to the FBI agents by Dr. Humes at the time of the autopsy. But they don’t even contend this anymore since the agents said it was not a bullet, only two fragments, and the naval corpsman who typed up the word missile has conceded that it was not a missile, only fragments, and he had made a mistake.224 Moreover, it would be virtually impossible for a bullet entering the soft tissue of the neck at a speed of two thousand feet per second to stop inside the neck and not exit the body.