Incisions for Chest Tubes: The "Cut Downs" at Parkland

[Thomas H. Purvis]

Where do we find such men?

You're done on these pages, Purvis.

Go play with your plat maps, and leave honorable pursuits to honorable men and women.

Charles Drago

Were it that I were that ignorant of the medical facts of emphysema, and especially of the medical facts as relates to JFK's inturies and the treatment which is primarily responsible for this emphysema, then I too would run and hide as well Charles.

Certainly beats having to admit that one is completely lacking in research abililty and will thusly believe anything, as well as the fact that one displays those "sheeple" tendancies.

http://en.wikipedia.org/wiki/Sheeple

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Post #5

"Please document your "original work" that referenced Warren Commission and/or ARRB testimony in which "subcutaneous" appears in relation to the chest tubes, and where "emphysema" appears at all

Charles Drago

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[Robert Prudhomme]

I just read this entire thread for the first time, and I believe the main point of the whole chest tube drainage can be summed up in one question:

If subcutaneous emphysema is a non-life threatening condition, and is in fact more of an annoyance than anything else, why would Trauma Room One physicians, faced with a pulseless patient in agonal respirations, waste precious time attempting to relieve subcutaneous emphysema?

This would be on the same level as addressing an ingrown toenail prior to the commencement of CPR on a pulseless patient.

Edited June 4, 2014 by Robert Prudhomme

[Ray Mitcham]

Thanks for resurrecting the thread, Rob. I had never read that the doctors at Parkland and the autopsy doctors disagreed about the insertion of tubes into the chest of JFK. If, (and it seems to be a big "if") they were both right, then could there indeed be a case for body substitution?

1. The Parkland surgeons were right.

2. The Bethesda autopsy surgeonswas right.

3. Both sets of surgeons were right.

Which contention is correct?

[Robert Prudhomme]

The subject is far more complex than just the three questions you have posed, Ray. What is at stake here is the validity of the Single Bullet Theory itself. It is going to get very complicated but I intend to elaborate further on Mr. Drago's work and show what a farce the entire autopsy was, and how coercion and threats were able to change the testimony of the Parkland surgeons, and have good surgeons like Malcolm Perry making the most ridiculous of statements in their testimony to the WC.

Unfortunately, Tom Purvis has thrown so much misinformation into this discussion, it will take several posts just to debunk the nonsense he has so carefully woven.

Make no mistake! Charles Drago was absolutely correct about Tom Purvis. On this thread's subject, on the rifle and many other subjects, Mr. Purvis was feeding this forum totally bogus information. I appreciate that he claimed to be a CT but, I could never quite comprehend just which conspiracy theory he subscribed to, if, in fact, he did.

Edited June 4, 2014 by Robert Prudhomme

[Mark Knight]

re: Tom Purvis, he and I had several private but very spirited discussions on conspiracy. While he was at first an "LHO-did-it," three shots and three hits from the SE window of the 6th floor of the TSBD believer, I was able to get him to admit that NO ONE could convincingly place Oswald in THAT window, with THAT rifle, at the moment the assassination occurred. Purvis in turn convinced me that Oswald was CAPABLE of hitting objects with a rifle at 100 yards or less, which made the idea of him being "the" shooter somewhat possible, and therefore a patsy who "could have" done the deed...had he been in that window, etc.

Purvis' idea was that the cover-up was a conspiracy, and that there was a conspiracy which put Oswald in place at the TSBD [possibly military intelligence]. So there's where his "conspiracy theory" comes in...in case you didn't understand his position. I hope I'm stating it correctly.

And now, back to our regularly scheduled programming...

[Robert Prudhomme]

Before going further, I would like to state a number of conclusions I have drawn from the research I have done thus far. I will cite evidence and testimony to support each of these conclusions.

1. The back wound did far more damage to JFK than what has been reported to the public. If untreated, the back wound had the potential to be a fatal wound.

2. The back wound was lower than reported by the WC.

3. The bullet that penetrated JFK's back went deep enough to penetrate the right pleural cavity and likely did not exit the right pleural cavity. This would tend to rule out a round nosed FMJ Carcano bullet.

4. JFK had a condition known as a tension pneumothorax or "collapsed lung" on the right side of his chest as a direct result of the bullet that entered that lung. As stated in 1., this had the potential to be fatal.

5. Contrary to what was stated in the autopsy report, chest tubes were inserted in JFK's right pleural cavity by Parkland doctors to relieve the air pressure built up by the tension pneumothorax in JFK's right lung.

6. At no time was there a danger of the compromise in JFK's trachea leading to a tension pneumothorax once assisted ventilation was begun on JFK. This was even more so once the tracheotomy was performed on JFK. The tension pneumothorax was a result of a bullet wound in the back.

7. Subcutaneous emphysema apparent in JFK was never a concern to the Trauma Room One physicians and no attempt was made to deal with its condition, due to its non-threatening nature.

Edited June 5, 2014 by Robert Prudhomme

[James R Gordon]

Robert,

I have been very busy on another topic and have not been able to respond to this thread.

This thread is at the heart of the SBT. It is essential to the SBT that the Lung is established that it was never compromised. It is clear you intend to demonstrate that is not the case.

There was very clear evidence that the lung was compromised even though in his deposition H6: 10 and in his testimony H3: 370 Perry went on record to deny that it was damaged. However, it is interesting when he stated that the lung was not damaged it was not because he knew it was not damaged: he was simply reporting what he had read in the autopsy report. HSCA1 304

1. Even before Perry had entered Trauma room 1 Charles Carrico had already noted the trachea was deviated to the left. 1HSCA: 268

2. When Perry came to carry out the Tracheotomy he confirmed he also noted that that. H6: 10

3. After cutting the tracheotomy he noted blood in the right mediastinum. H6: 10

4. Doctors Baxter and McClelland concurred with the damage to the trachea and chest. CE 392

5. Perry noted that as well as the blood in the mediastinum, air was bubbling through it. HSCA 7: 303

6. Although not part of the Autopsy report itself, in the supplement report Humes observed that “Sections through the grossly described area of contusion in the right upper lobe exhibit disruption of alveolar walls and recent hemorrhage into alveoli.” CE 391: 2

So there was very sound reason for Perry to instruct that the chest tubes were attached. H6: 10

As you are aware Humes made two calls to Malcolm Perry. The first to establish what had occurred at Parkland. What is not clear is whether Perry informed him about the chest tubes then. The second call, however was why the Chest Tubes had been authorised. H6: 16 Most likely he reported back the reason noted above. However although Malcolm Perry informed Humes exactly why he instructed the chest tubes be attached, as you have pointed out that was not the reason Humes stated as the reason.

The only logical conclusion that can be reached for giving such a spurious reason for using the tubes demonstrates that Humes was aware that had he given the real reasons that would have made clear that the lung was indeed compromised. For political reason Humes decided to cover that up.

James.

[Robert Howard]

The following Warren Commission document mentions the insertion of a right chest tube at Parkland.

https://www.maryferrell.org/mffweb/archive/viewer/showDoc.do?mode=searchResult&absPageId=336574

[Ray Mitcham]

If the only tube inserted into JFK's chest was on his right side, what is this apparent slit on his left side?

In addition it says on the report above, that there was "obvious trachial and chest damage"

What chest damage?

Edited June 10, 2014 by Ray Mitcham

[Robert Prudhomme]

Hi Ray

Sorry for not responding sooner to you. I've been away for some time, and have not had Internet access.

This is indeed a puzzling photo, and for more reasons than you think. If you look closely at the relation of this slit to JFK's clavicle (collarbone), you'll see that it has been made at the "second intercostal space" or the gap between the second and third intercostal ribs. Also, the incision has been made about the midway point on the clavicle.

This incision can, by virtue of its location, be only one thing. It is an emergency attempt to decompress a tension pneumothorax, a condition noted by Dr. Jenkins and others. This is still, in 2014, the recommended site for insertion of a tube or needle to relieve built up air pressure in the right or left pleural cavity, and allow normal expansion of the unaffected lung.

I can understand how you are confused by Dr. Jenkins' words, "obvious tracheal and chest damage". One must remember that Jenkins was a highly trained trauma physician, and had to make diagnoses based only on the quickest of observations. The tracheal damage would have been obvious, once Dr. Perry opened the bullet wound for the tracheostomy, but the chest damage required Jenkins to add up all of the clues. The most important clue observed was the noticeable deviation of the trachea to the left, indicative of one thing and one thing only. The only thing that will deviate or push the trachea to one side or the other is built up air pressure in the pleural cavity on the opposite side of the deviation, referred to medically as a "tension pneumothorax" or "collapsed lung". This could be the result of an expanding bullet entering the lung, and staying there. While the wound in his back could have made this an "open pneumothorax" or "sucking" chest wound, oftentimes these chest entry wounds will seal themselves, or, worse, act as a one way valve; allowing air to enter the pleural cavity on inspiration but sealing it in on expiration.

However, since all accounts from Trauma Room One place the deviated trachea on the left side of JFK's neck, JFK can only have had a tension pneumothorax in the right pleural cavity, and while blood and air present in the mediastinum could indicate bilateral chest tubes as a safeguard measure, I don't think there was any doubt in the minds of the Trauma Room One doctors as to which lung was actually damaged. Looking again at the autopsy photo, and comparing the location of the clavicles, it is entirely possible there is a matching incision on the right side, as well, that is just out of view of the camera. Another possibility is that, during the autopsy, a second incision was made on the left side, matching the one on the right, and drawing attention away from likely damage to the right lung. Still another possibility is that the autopsy photo has merely been reversed, placing the right handed incision on the left side.

[Robert Prudhomme]

BTW, just want to point out a small error made by Mr. Purvis.

He gives us a somewhat simplified explanation of "mediastinal emphysema", supplied by John McAdams, of course, and attempts to make us believe this build up of air in the right mediastinum was caused by the endotracheal tube being locked in place above the tracheal wound, and air from assisted ventilation being forced out of the tracheal wound, and into the mediastinum.

While air from a ruptured trachea or oesophagus has been known, on rare occasions, to induce this condition, it could not have happened in this instance. Air leaking from these sources must be contained to cause this condition, and JFK had a .25 inch hole in his throat. Any air escaping from the tracheal wound would have vented out from this hole to the atmosphere.

[Ray Mitcham]

Duncan, did you not read that Bob said he had been away for some time and had no internet access?

By the way "if that was his name" is hardly a "disgusting insulting post." IMO

Edited June 18, 2014 by Ray Mitcham

[Ray Mitcham]

Duncan, did you not read that Bob said he had been away for some time and had no internet access?

That's why the first sentence of my post is a question and not a statement.

No, Duncan, Your first sentence was a statement where you accused Bob of still being a " master of bad taste."

You appeared to answer your own question by then asking Bob to make a public apology, before you knew the answer.

[Robert Prudhomme]

I make no apologies for my comments. Trolls are trolls.

[Pat Speer]

Robert's insulting behavior towards a recently deceased member aside, this thread has renewed my interest in this aspect of the case.

The Parkland doctors believed that the bullet entering the throat had lodged in the lung. The damage to the lung was, one can only presume, consistent with that of a lung pierced by a bullet.

The Bethesda doctors, however, came to claim no bullet pierced the lung, and that the damage to the lung was consistent with a bullet's passing above the lung. Extensive reading on gunshot wounds to the lung, however, has convinced me that the bruise described would not be caused by the mere passage of a bullet, and could only have been caused by an impact on a bone overlying the lung. This destroys the single-bullet theory, of course.

But one needn't stop there. IF it can be shown that the surface bruise and/or small tracheal tear described at autopsy would not cause a pneumothorax, the possibility the lung was pierced needs to be re-examined.

Hmmm...

From wikipedia:

"Traumatic pneumothorax most commonly occurs when the chest wall is pierced, such as when a stab wound or gunshot wound allows air to enter the pleural space, or because some other mechanical injury to the lung compromises the integrity of the involved structures. Traumatic pneumothoraces have been found to occur in up to half of all cases of chest trauma, with only rib fractures being more common in this group."

So...would a bullet passing OVER the top of the lung "compromise the integrity" of the involved structures? It seems unlikely.

Edited June 18, 2014 by Pat Speer