Rawhide Down

by Del Quentin Wilber

  Joe Giordano and David Gens watched it with concern; perhaps the president had suffered a second injury. They rolled him over to inspect his body for more wounds, but found none. Gens “milked” the chest tube to get a sense of the blood’s temperature. The stream was warm, meaning that it came from deep inside the president’s body, another bad sign.

  Because the blood was flowing so fast, Giordano suspected that the bullet had ruptured an organ or an artery. Short of surgery, there was only one way to spot such damage. “We better get a chest X-ray,” Giordano said.

  A technician wheeled over an X-ray machine and positioned its camera above the president’s chest. The platoon of doctors and nurses around the gurney stepped back six feet as the technician pressed the trigger on a small cord. Then the technician collected the X-ray cartridge and rushed off to radiology.

  As the minutes ticked by, the president’s blood kept flowing. The Pleur-evac was now filled with over a liter of blood, more than 15 percent of Reagan’s total volume. Whatever the problem was, the chest tube wasn’t solving it. Giordano was running out of options—it was time to call a chest surgeon and get him to take a look.

  Speaking as much to himself as to the others in the trauma bay, Giordano said, “We need Ben Aaron.”

  * * *

  NOT WANTING TO stoke panic, Secretary of State Alexander Haig ordered his driver not to use his official car’s lights and sirens as they sped down Constitution Avenue toward the White House. The former general sat in the sedan’s backseat, his right leg crossed over his left, his right foot bouncing up and down, a sign that he was deep in thought. Sitting next to him was his executive assistant, Woody Goldberg. “We have to send a message to all of our posts about what is happening,” Haig told Goldberg. “We are not going to have another Kennedy situation. If there is a conspiracy, we have to let the American people know.”

  As a young military aide, Haig had helped plan Kennedy’s funeral, and he’d long suspected the Soviet Union or Cuba of playing a role in the killing. The former NATO commander also had firsthand experience with assassins: two years earlier, he had nearly been killed when terrorists bombed his motorcade in Brussels. Lately, such acts of political violence seemed to be happening with alarming frequency all over the world.

  Upon their arrival at the White House, Haig and Goldberg hurried to Jim Baker’s office. Baker—along with Ed Meese, Lyn Nofziger, and Larry Speakes—had already left for the hospital, but the office of the chief of staff was serving as an unofficial headquarters for various officials involved in the response to the assassination attempt. His square jaw clenched, the tail of his trench coat flapping, Haig entered Baker’s office, marched toward his desk, and gruffly asked to be connected to the vice president. Aides looked confused. “How do we do that?” one asked.

  When the White House switchboard eventually got Bush’s plane on the line, the connection was poor. Moreover, Air Force Two did not have scrambled voice communications; since anyone with a shortwave radio set could potentially listen to their conversation, Haig had to be vague when informing the vice president about the shooting.

  Standing at Baker’s desk, Haig held the phone tight to one ear and put his free hand over his other ear to block out the noise in the office. When Bush came on the line, the secretary of state spoke loudly: “Mr. Vice President, this is Secretary Haig. We had a serious incident and I’m sending you a message by secure line. I recommend you return to Washington as soon as possible.”

  Haig heard only static in reply.

  “Do you read me, over,” Haig said, his voice rising. “This is Al Haig, over.”

  Still there was no reply.

  “This is Secretary Haig, over!”

  Again Haig heard nothing but static.

  “George, this is Al,” Haig bellowed. “Turn around! Turn around!”

  Realizing that the bad connection made any communication with Bush impossible, Haig ended the call by saying, “I’ll have a message to you shortly.”

  * * *

  UNTIL NOW, THE vice president’s trip to Texas had been going exactly as planned. After his speech in Fort Worth, Bush returned to the airfield; at about 2:45, with Major Stetson Orchard at the controls, Air Force Two lifted off the runway.

  Minutes later, as the plane flew toward Austin, Orchard and his copilot received a radio call from an air traffic controller. “Are you continuing to Austin or diverting to Washington?” the controller asked.

  “We’re heading to Austin, as scheduled,” responded the copilot. He turned to Orchard with a raised eyebrow.

  At that moment, one of the plane’s radio operators burst into the cockpit. “We just got a high-priority message,” he said. “You may not want to land in Austin.” The operator scurried off to find someone on the vice president’s staff.

  Meanwhile, in an aft compartment of the plane, a Secret Service agent was getting a sketchy report about an assassination attempt over the radio headset plugged into his ear. He passed the information to the head of Bush’s detail, Agent Ed Pollard, who unclipped his seat belt and raced to Bush’s cabin. After knocking on the door, he entered and said, “Sir, we’ve just received word about a shooting in Washington. There is no indication that the president has been hit. Word is that two agents are down. That’s all we have right now. But I’m going to make some calls and see if I can get some more information.”

  “Oh, no,” said Bush, stunned. “Where did it happen?”

  “Outside the Washington Hilton.”

  A few minutes later, Bush got word that Haig was on the line, but after picking up the phone he had heard little but static. Soon Haig’s message emerged from Air Force Two’s secure teletype machine: “Mr. Vice President: In the incident you will have heard about by now, the president was struck in the back and is in serious condition. Medical authorities are deciding now whether or not to operate. Recommend you return to D.C. at the earliest possible moment.”

  Sitting in a high-backed chair in his small wood-paneled cabin, Bush began to sort through his thoughts about Haig’s message. His first concern, of course, was for the president’s health and safety; he also hoped that someone was comforting Nancy Reagan. As he tried to imagine how his responsibilities might change due to the crisis, the vice president remained calm. He felt prepared for this day. Yes, there was a brewing crisis in Poland, and yes, there were several other urgent items on the administration’s agenda. But the vice president had attended many of the president’s most important meetings, and he’d kept up with all the information in his briefing books. Bush felt confident that, if called upon, he could navigate the conflicting advice of aides and allies and make the necessary decisions.

  By now, others on Air Force Two, including members of the vice president’s staff and three congressmen, were learning about the assassination attempt from a television in the plane’s conference room. Sitting on a couch and crowded around the kidney-shaped desk installed by President Johnson, they watched news reports on a black-and-white set mounted on a bulkhead. Information was still incomplete and scattered; TV reception was poor anyway, and the screen filled with static whenever the pilots used their radios. But when Frank Reynolds, a respected anchor at ABC News, assured his viewers that Reagan had escaped injury, everyone in the small room felt great relief.

  “Mr. Reagan was not hit,” Reynolds reported. “He was bounced around as the Secret Service agents maneuvered or flung—I think is probably the right word—flung him into the car to get him out of there.” Sitting to Reynolds’s right was Sam Donaldson, who had come to the studio straight from the scene of the shooting.

  Reynolds was handed a note on a yellow piece of paper. “Here we have a report,” he said as the broadcast cut to a replay of the shooting. “The president was not wounded.” When the camera returned to Reynolds, Donaldson could be seen leaning toward the anchorman, studying the piece of paper. Then Donaldson pointed at a word and said quietly, “He was.”

  The anchor paused and looked at the
paper again. “He was wounded!” Reynolds said, slapping his right hand to his forehead. “My God. The president was hit?” The question was directed to a producer off camera. “He’s in stable condition. All of this information … The president was hit. He was hit in the left chest, according to this. But he is in stable condition.”

  After another pause, Reynolds continued. “The information we have been telling you is incorrect. We must redraw this entire tragedy in different terms. The president was hit today. He was hit in the left chest. But we are told he is all right. He is at George Washington University Hospital.”

  * * *

  ACROSS THE STREET from the hospital, Dr. Benjamin Aaron, head of GW’s cardiovascular and thoracic unit, was at his desk, filling out paperwork. His office, on the tenth floor of the building where the medical center’s physicians worked when not operating or on rounds, was entirely free of decoration. On the wall behind him, the shelves were filled with slide carousels and various medical books, including Grant’s Atlas of Anatomy, a classic text that he had picked up in a remainder pile back in medical school. The only personal touches, if they could be called that, were on the desk: a black coffee mug decorated with a bright red heart and a paperweight in the shape of a duck.

  Aaron had returned to his office at about two p.m. Except for a short nap, this was his first moment of peace since early that morning. Just after midnight, he had received an urgent call at home and returned to the hospital for emergency surgery on a male patient who was bleeding badly two weeks after receiving a new heart valve. Aaron opened the man’s chest, drained the blood, and stopped the hemorrhaging; afterward, he caught some sleep on a hospital cot. Next he performed a five-hour coronary bypass operation, followed by two hours of rounds, during which he checked on his patients.

  Despite a grueling schedule of surgeries and clinical work, Aaron didn’t look or feel the worse for wear. While serving as a surgeon in the U.S. Navy for twenty-two years, he had become superbly disciplined. He had honed his body into the human equivalent of a surgical machine: he jogged at least four miles nearly every day and, by willing himself not to be tired, he could work for forty-eight straight hours without sleep. He had conquered hunger in much the same way. A few years earlier, Aaron had realized that although he was always famished at lunchtime, he never had time to eat. His solution was to simply force himself to forget about lunch, and he was never again hungry for a midday meal.

  Now, as Aaron worked on his reports, he turned on a small radio on his desk and heard an announcer say that there had been a shooting at the Washington Hilton involving the president, but that Reagan had not been hurt. Aaron wondered whether some of the victims might be coming his way; sure enough, he soon heard sirens and a few minutes after that his pager started beeping. When he called the operator, she told him he was needed immediately in the emergency room.

  Aaron threw on a lab coat, took the elevator to the ground floor, and strode across the street to the hospital. Entering the emergency room, he found pandemonium. Walking down a narrow hallway toward the trauma bay, he turned to his left and spotted a man being treated in Room 3. Even from a distance of ten feet, Aaron could see a neat bullet hole in the victim’s right chest. Ahead of him and to his right, in Trauma Bay 5B, he saw a second victim lying quietly on a gurney, his head wrapped in bandages. His years in the military had trained Aaron to quickly triage patients; he gave this one little chance of survival.

  A surgeon grabbed Aaron’s arm and steered him toward Bay 5A. Secret Service agents stepped aside as he slipped through the bay’s curtains. Glancing at this third victim, Aaron recognized him right away.

  Aaron could see that the president was in a good deal of pain. Joe Giordano told him that Reagan’s blood pressure was improving and that they had inserted a chest tube a few minutes ago.

  “He’s responding very nicely,” Giordano said—but, he pointed out, Reagan was still bleeding profusely. Checking the Pleur-evac, Aaron saw that it held 1.2 liters of blood.

  As Aaron surveyed the situation, he thought of the doctors who had treated President Kennedy in Dallas. He also thought about the physicians of the three earlier presidents who had been shot and who had died, either from a devastating wound or from appallingly poor care. A born-again Christian, Aaron believed that everything happened for a reason, and now, as he studied the president, he uttered a silent prayer. He didn’t ask for a miracle or ask God to spare Reagan. Instead, he simply asked for a chance to save the president’s life. God, he prayed, please don’t let the president be irretrievable.

  * * *

  AS THE TRAUMA bay buzzed around him, Aaron watched the blood pouring from Reagan’s chest. He touched the tube leading to the Pleur-evac; it was warm. He looked up and exchanged a knowing glance with David Gens: the blood was obviously coming from deep within Reagan’s chest. And the blood was not only warm but also dark. That meant it was probably streaming from a pulmonary artery. These arteries, which directly connect the heart with the lungs, are large and if breached tend to bleed until surgically repaired.

  Since the president was stable and responding well to fluids and transfusions, Aaron decided to allow a few more minutes to pass in the hope that the bleeding would stop on its own. He asked whether anyone had ordered an X-ray; Giordano said that one had already been taken and that it should be coming back from the radiology suite momentarily.

  Standing next to Aaron, Gens looked closely at Reagan’s lips through the clear oxygen mask and for the first time saw the blood on them. Gens also noticed spots of blood on his teeth. Leaning close to the president’s ear, Gens asked him what had happened.

  “I coughed up blood in the car ride over,” Reagan said through his mask. “I am still having trouble breathing, but it is better since you inserted the tube.”

  “You are going to be all right, Mr. President,” Gens said.

  As a precaution in case Reagan’s condition began deteriorating rapidly, the trauma team attempted to insert a large-bore IV line into his right jugular vein. This would allow them to quickly pump more fluids into the president.

  Again Gens leaned close to Reagan and spoke to him. “We’re going to put a line into your jugular vein in the neck, and in order to do that, I’m going to lay you flat.”

  Earlier, the president’s gurney had been elevated to a 45-degree angle, which alleviated some of the pressure in his chest. The plan to lower the bed again seemed to make Reagan anxious. “But I’m short of breath,” he said. “If I’m lying down, it’ll be more difficult to breathe.”

  “It’s only for two minutes at the most,” Gens said.

  Once the gurney had been lowered and the president was horizontal, a surgeon tried to slip a needle into the neck vein. When he couldn’t find the vein on the first attempt, he tried a second time and failed again. Reagan began complaining of increasing chest pain. After two minutes, the surgeon abandoned the attempt, and nurses returned the president to the 45-degree position.

  By now, the X-ray image of Reagan’s chest had been developed and brought to the trauma bay. Back in the radiology suite, Dr. David Rockoff had closely studied the film. The left lung seemed to have re-expanded, which was good news. But when Rockoff examined the image of a bean-shaped piece of metal that was presumably the bullet, he couldn’t determine its precise location. The bullet might be lodged in the lung, near the heart, or even in the heart itself. There was also the terrifying possibility that the bullet had nicked and weakened the aorta. If that had happened, the artery could rupture at any moment.

  Now, holding the image aloft for Aaron in the trauma bay, Rockoff commented that the chest tube was in a good position. But the metal fragment seemed small and deformed, which suggested that the bullet might have fragmented either before entering the president or upon impact. If it had somehow broken apart inside the president, there could be other pieces of shrapnel somewhere in his body.

  Rockoff also told Aaron that he didn’t know the caliber of the round. Turning to a Sec
ret Service agent, Rockoff asked: “What caliber bullet was it?”

  The agent, who hadn’t heard any specifics about the weapon or the bullet, asked another agent to find out. Using a phone near the trauma bay, that agent called the FBI, which had confiscated Hinckley’s gun.

  After the agent hung up a few moments later, he reported—erroneously—that it was a .38-caliber bullet. Rockoff was shocked: a .38 is a sizable shell, and the object on the X-ray was too small to be a .38. This suggested that it was indeed just a fragment. Rockoff and Aaron believed that if there was more shrapnel inside the president, it was most likely in his abdomen, where any number of organs and blood vessels could be hemorrhaging. Concerned, the trauma team ordered another X-ray, this one of the president’s belly.

  * * *

  EVER SINCE ARRIVING at the hospital, Nancy Reagan had been politely pestering doctors and nurses about when she would be permitted to see her husband. The hospital’s acting chief of surgery, Dr. Neofytos Tsangaris, was deputized to act as the liaison between the first lady and the trauma team; when Tsangaris asked whether Mrs. Reagan could come to the trauma bay, he was told that the president’s doctors needed more time. For one thing, they hadn’t completed their evaluation of their patient. But they also wanted to clean up some of the blood and fluids on the floor and cart away some of the cut-up clothes. They didn’t want the messy and chaotic scene to upset the first lady.

  Once the doctors decided to allow Mrs. Reagan to see her husband, Tsangaris retrieved the first lady and led her to the far corner of the ER and the trauma bay. Accompanying her were Paul Laxalt and George Opfer.

  When Mrs. Reagan entered the bay through its parted curtains, she was badly shaken by the sight of her wounded husband lying on the gurney. IV lines stretched from his arms and a clear oxygen mask covered his face. His skin was shockingly pale, and the first lady immediately spotted the caked blood on his lips. She also noticed that his new blue suit—the one she had had made for him—was a shredded mess, crumpled in the corner of the bay. Laxalt, beside her, saw a frightened look in Reagan’s eyes; Opfer thought the president looked terribly gray.