We Were There

by Allen Childs

  Charles Baxter, MD

  (excerpted from his testimony at the Warren

  Commission Hearings)

  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. 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. Who is that who said that [the president still had a heartbeat] 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. What else, if anything, did you do for President Kennedy at that time?

  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. 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, two 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.

  Paul Peters, MD

  (excerpted from his testimony at the Warren

  Commission Hearings)

  Mr. SPECTER. Did you have occasion to render medical services to President John Kennedy on November 22, 1963?

  Dr. PETERS. Yes.

  Mr. SPECTER. And would you outline briefly the circumstances relating to your arriving on the scene where he was?

  Dr. PETERS. As I just gave you a while ago?

  Mr. SPECTER. Yes.

  Dr. PETERS. I was in the adjacent portion of the hospital preparing material for a lecture to the medical students and residents later in the day, when I heard over the radio that the president had been shot and there was a great deal of confusion at the time and the extent of his injuries was not immediately broadcast over the radio, and I thought, because of the description of the location of the tragedy he would probably be brought to Parkland for care, and so I went to the emergency room to see if I could render assistance.

  Mr. SPECTER. And at about what time did you arrive at the emergency room?

  Dr. PETERS. Well, could I ask a question or two?

  Mr. SPECTER. Sure.

  Dr. PETERS. As I recall, he was shot about 12:35 our time; is that correct?

  Mr. SPECTER. I believe that’s been fixed most precisely at 12:30, Dr. Peters.

  Dr. PETERS. So, I would estimate it was probably about 12:50 when I got there, I really don’t know for certain.

  Mr. SPECTER. Whom did you find present, if anyone, when you arrived?

  Dr. PETERS. When I arrived the following people I noted were present in the room: Drs. Perry, Baxter, Ron Jones, and McClelland. The first thing I noticed, of course, was that President Kennedy was on the stretcher and that his feet were slightly elevated. He appeared to be placed in a position in which we usually treat a patient who is in shock, and I noticed that Dr. Perry and Dr. Baxter were present and that they were working on his throat. I also noticed that Dr. Ron Jones was present in the room. I took off my coat and asked what I could do to help, and then saw it was President Kennedy. I really didn’t know it was President Kennedy until that time. Dr. Perry was there and he and Dr. Baxter were doing the tracheotomy and we asked for a set of tracheotomy tubes to try and get one of the appropriate size. I then helped Dr. Baxter assemble the tracheotomy tube which he inserted into the tracheotomy wound that he and Dr. Perry had created.

  Mr. SPECTER. Were there any others present at that time, before you go on as to what aid you rendered?

  Dr. PETERS. I believe Dr. Carrico—

  Mr. SPECTER. Any other doctors present?

  Dr. PETERS. And Dr. Jenkins was present.

  Mr. SPECTER. Have you now covered all of those who were present at that time?

  Dr. PETERS. And Dr. Shaw walked into the room and left—for a moment—but he didn’t stay. He just sort of glanced at the president and went across the hall. Mrs. Kennedy was in the corner with someone who identified himself as the personal physician of the president—I don’t remember his name.

  Mr. SPECTER. Dr. Burkley?

  Dr. PETERS. I don’t know his name. That’s just who he said he was, because he was asking that the president be given some steroids, which was done.

  Mr. SPECTER. He requested that.

  Dr. PETERS. That’s right, he said he should have some steroids because he was an Addisonian.

  Mr. SPECTER. What do you mean by that in lay language?

  Dr. PETERS. Well, Addison’s disease is a disease of the adrenal cortex which is characterized by a deficiency in the elaboration of certain hormones that allow an individual to respond to stress and these hormones are necessary for life, and if they cannot be replaced, the individual may succumb.

  Mr. SPECTER. And Dr. Burkley, or whoever was the president’s personal physician, made a request that you treat him as an Addisonian?

  Dr. PETERS. That’s right—he recommended that he be given steroids because h
e was an Addisonian—that’s what he said. . . .

  Mr. SPECTER. Now, tell us what aid was rendered to President Kennedy.

  Dr. PETERS. Dr. Perry and Dr. Baxter were doing the tracheotomy and a set of tracheotomy tubes was obtained and the appropriate size was determined and I gave it to Baxter, who helped Perry put it into the wound, and Perry noted also that there appeared to be a bubbling sensation in the chest and recommended that chest tubes be put in. Dr. Ron Jones put a chest tube in on the left side and Dr. Baxter and I put it in on the right side—I made the incision in the president’s chest, and I noted that there was no bleeding from the wound.

  Mr. SPECTER. Did you put that chest tube all the way in on the right side?

  Dr. PETERS. That’s our presumption—yes.

  Mr. SPECTER. And what else was done for the president?

  Dr. PETERS. About the same time—there was a question of whether he really had an adequate pulse, and so Dr. Ronald Jones and I pulled his pants down and noticed that he was wearing his brace which had received a lot of publicity in the lay press, and also that he had an elastic bandage wrapped around his pelvis at—in a sort of a figure eight fashion, so as to encompass both thighs and the lower trunk.

  Mr. SPECTER. What was the purpose of that bandage?

  Dr. PETERS. I presume that it was—my thoughts at the time were that he probably had been having pelvic pain and had put this on as an additional support to stabilize his lower pelvis. It seemed quite interesting to me that the president of the United States had on an ordinary $3 Ace bandage probably in an effort to stabilize his pelvis. I suppose he had been having some back pain and that was my thought at the time, but we removed this bandage in an effort to feel a femoral pulse. We were never certain that we got a good pulse. . . .

  Mr. SPECTER. [The brace was running] in his waist area at the top of his hips up to the lower part of his chest?

  Dr. PETERS. I would estimate that it went from the lower part of his chest to the pelvic girdle. About this time it was noted also that he had no effective heart action, and Dr. Perry asked whether he should open the chest and massage the heart. In the meantime, of course, the tracheotomy had been done and completed and had been hooked on to apparatus for assisting his respiration.

  Mr. SPECTER. And what action, if any, was taken on the open-heart massage?

  Dr. PETERS. It was pointed out that an examination of the brain had been done. Dr. Jenkins had observed the brain and Dr. Clark had observed the brain and it was pointed out to Dr. Perry that it appeared to be a mortal wound, and involving the brain, and that open-heart massage would probably not add anything to what had already been done, and that external cardiac massage is known to be as efficient as direct massage of the heart itself.

  Mr. SPECTER. Was there any further treatment rendered to the president?

  Dr. PETERS. Yes, Dr. Perry began immediate external compression of the chest in an effort to massage the heart, even before he asked the question as to whether the thoracotomy should be done. As soon as there was a question as to whether there was a pulse or not, he immediately began external chest compression.

  Mr. SPECTER. What other action was taken to aid the president, if any?

  Dr. PETERS. Well, cutdowns were done on the extremities, and tubes were inserted in the veins, and I know on the right ankle anteriorly, and I believe in the left arm and also in the left leg, in order to administer fluid and blood which he did receive.

  Mr. SPECTER. Have you now described all of the medical attention given the president?

  Dr. PETERS. Well, I believe I have.

  Mr. SPECTER. And was the president subsequently pronounced dead?

  Dr. PETERS. That’s correct.

  Mr. SPECTER. And about what time was that pronouncement made?

  Dr. PETERS. I could not give you the time within five or ten minutes— I can tell you this much, though, I know what actually did happen.

  Mr. SPECTER. Tell me that.

  Dr. PETERS. I was—we pronounced him dead and I was in the room, present while the priest gave him the last rites, during which time there was Dr. Jenkins and Dr. Baxter and Dr. McClelland, Mrs. Kennedy, the priest, and myself. Dr. Perry had left, as had most of the others by that time.

  Ron Jones, MD

  (from Baylor Reflections, November 22, 1998)

  I called the operator asking why so many stat pages for department chairmen and she said, “The president has been shot and they’re bringing him to the emergency room and need physicians.”

  Dr. Malcolm Perry and I, along with Red Duke, one of the junior residents, took the back steps down one flight to the emergency room. Dr. Perry and I went to Trauma Room 1 and Dr. Duke to Trauma Room 2.

  As we entered the room, the president was already on a cart, motionless, his eyes open with a stare. Mrs. Kennedy was standing in the corner near the doorway. Dr. Jim Carrico, a second year resident was attempting to intubate the president and two junior residents were attempting to start an intravenous line. It was obvious the president was not breathing although Dr. Carrico thought he had seen agonal respirations. There was a small wound in the midline of the lower neck, less than 1 cm. and a posterior head injury on the right.

  Dr. Perry immediately started performing a tracheotomy and I performed a cutdown on the cephalic vein of the left arm. . . . I inserted a left anterior chest tube in the second interspace in the mid-clavicular line. Dr. Paul Peters, Dr. Charles Baxter, who had been helping Dr. Perry with the tracheotomy—with some assistance from me—inserted a right chest tube. A portable EKG machine was moved into the room and a tracing obtained on the president revealed a straight line.

  I left the room and was quickly greeted by a Secret Service agent and asked, “What is the condition of the president? I need to phone Joseph Kennedy and tell him the condition of his son.” Within a few steps, I was also greeted by someone from the Federal Bureau of Investigation who asked the same question and stated, “I have to call J. Edgar Hoover and inform him of the condition of the president.”

  At that moment, no announcement of the president’s condition had been made. The agents were unable to get an outside telephone line since all phones were blocked by incoming calls, which would soon be coming from all over the world. I took them to the telephone switchboard operator in an attempt for her to obtain an outside line.

  We went down the back steps and went into Trauma Room 1, which was just across the hall from Trauma Room 2 where Governor Connally had been taken. The president was already in the room and apparently had just arrived perhaps seconds or a minute before we arrived in the trauma room. And very quickly—and I mean, within a minute or so—that room literally filled with physicians, both residents and attending staff. As you entered the trauma room, the emergency room supervisor, Doris Nelson, was on one side of the door, and there was a policeman on the opposite side. And they were trying to determine who needed to come into that room, but that was very difficult without knowing what the injuries were because many of these physicians represented different specialties.

  Ideally, you would not have that room so crowded, but they did not know who to keep out and who to let in. And as a result, many, many people came into that room to the point that you literally could not move around the room to get to . . . directly to supplies. It was a relatively small room. It had a stretcher in the middle of it, and there was probably five feet, six feet on each side of that stretcher. And the same distance at the head and maybe a little more at the foot. And as we entered the room, Mrs. Kennedy was standing in the corner of the room to my left as I entered the room.

  Dr. Malcom Perry was a young staff man at that time. I was chief resident under him, and when we went into that room together, he was the senior person in that room. And so he took charge of the president’s room. Dr. Duke apparently went into Governor Connally’s room as a resident, and I think from there, Dr. Robert Shaw was contacted, who was a well-known thoracic surgeon. And Dr. Shaw seemed to take charge then of Governor Connally. That
probably took a few minutes to establish that relationship. As other people came in the room, some of them were residents and some were young attending staff at that time. But I think that Dr. Perry seemed to be the one in charge of the president’s room. Dr. Jenkins came down just a short time later. Dr. James Carrico was already in the room when we entered to look at the president.

  I didn’t pay any attention to the police at that time other than to know that they were there. They did not have any obstacles as far as the treatment. And I really didn’t appreciate the presence of the FBI and the Secret Service until I walked out of the room. At that point, we were so focused on what we were doing that we, I think . . . at least I didn’t pay much attention to who was around me other than I just knew a lot of people were in the room. And sort of felt the awesome responsibility that these people had.

  I think very quickly we determined who was going to do what. As I looked at the president, I didn’t see him move at all. I personally did not see any respiration activity or attempt at respiration. The eyes, as I recall, were open but staring straight ahead without any motion. I did not [shaking head] take the blood pressure, nor did I listen to a heartbeat. I think what triggered the resuscitative effort was that Dr. Carrico had thought that he had seen some agonal respiration at the time the president arrived.

  I knew that he was not breathing. And I talked to Dr. Perry very quickly, and I said, “We probably need to do a trach and get a cutdown or access to a vein to get an IV started.” [nodding] And one of us—or both of us simultaneously—said that doctor . . . that Malcolm would do the tracheotomy, and I would do the cutdown in the left arm, which is just making an incision in the skin, isolating or finding a vein and getting a catheter into the vein. So, he started on the tracheotomy, and I started on the cutdown. Dr. Carrico was at the head of the table, I recall, and he was attempting to place a tube into the throat or into the trachea and in the tracheal tube to establish an airway.