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Three Patients at Parkland


Jack White
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Jack the second part on Connally I NEVER HAD it was not available some years back when i copied this from the web...i wish and if possbly someone does it certainly would be appreciated...thanks fwiw... b

START QUOTE

THREE PATIENTS at PARKLAND

This article is originally from the alts, found some years back, it was posted by Michael Parks...thanks...

........It came from "The Texas State Journal of Medicine", dated January, 1964. It was written in

late November/early December, 1963 before the 'OFFICIAL' story was set in stone.

I have been told, it is somewhat different, in content in some regards, than how it is found now on the web.?

..Though I have not checked...it is possible it could be....

Thanks....B

Michael Parks..

Part One.

THREE PATIENTS at PARKLAND

PARKLAND Memorial Hospital, Dallas, treats an average of 272 emergency cases a day. It is

adjacent to and is the major teaching hospital for the University of Texas Southwestern Medical

School. It is staffed by the faculty of the medical school and has 150 interns and residents in

all medical specialties. It is a modern hospital, well equipped, one of which any community

might be proud. Today and for none of these reasons-Parkland has a new reputation all over the

world, and historians are typing its name into manuscripts that will be textbooks for

generations to come. This has happened because three particular gunshot victims were carried

there out of the bright November sunlight, two to die and the third to leave by wheelchair

almost two weeks later, his arm in a sling.

Many Texas physicians have visited Parkland hospital; many have worked or trained there.

Members of the Parkland staff are their acquaintances and friends. Many Texas physicians know

personally the surviving gunshot victim, Gov. John Connally; some personally knew President John

F. Kennedy, who died in Trauma Room 1; perhaps a few even knew Lee Harvey Oswald, the man

charged by Dallas authorities with the assassination of the President and who was himself shot

two days later.

The assassination of President Kennedy, the wounding of Governor Connally, and the fatal

shooting of Oswald are events of profound import to people everywhere, but they have special,

personal meaning for Texans. So because a Texas hospital and Texas physicians figured

prominently in this tragedy, the Texas State Journal of Medicine records for its readers of the

medical profession a full account of treatment given a never-to-be-forgotten trio.

When President John F. Kennedy in a moribund condition entered Parkland on Nov. 22, there was

never opportunity for medical history taking. Such a history, had it been taken, would have

shown that the patient "had survived several illnesses, the danger of war, the rigor of exposure

in icy water, and . . . had waged grueling electoral campaigns in spite of a serious and painful

back injury."

Parkland records show that the President arrived at the emergency room sometime after 12:30

p.m. (There is conflict as to the exact moment.) At 1 p.m. Dr. William Kemp Clark, associate

professor and chairman of the Division of Neurosurgery of the University of Texas Southwestern

Medical School, declared him dead. During the interim of less than 30 minutes, continuous

resuscitative efforts were made.

Later that day, several attending physicians filed reports. The following identifies these

physicians and gives the gist of their reports:

Charles J Carrico - Dr. Carrico was the first physician to see the President. A 1961 graduate

of Southwestern Medical School, he is 28 and a resident in surgery at Parkland.

He reported that when the patient entered the emergency room on an ambulance carriage he had

slow agonal respiratory efforts and occasional cardiac beats detectable by auscultation. Two

external wounds were noted; one a small wound of the anterior neck in the lower one third. The

other wound had caused avulsion of the occipitoparietal calvarium and shredded brain tissue was

present with profuse oozing. No pulse or blood pressure were present. Pupils were bilaterally

dilated and fixed. A cuffed endotracheal tube was inserted through the laryngoscope. A ragged

wound of the trachea was seen immediately below the larynx. The tube was advanced past the

laceration and the cuff inflated. Respiration was instituted using a respirator assistor on

automatic cycling. Concurrently, an intravenous infusion of lactated Ringer's solution was

begun via catheter placed in the right leg. Blood was drawn for typing and crossmatching. Type

0 Rh negative blood was obtained immediately.

In view of the tracheal injury and diminished breath sounds in the right chest, tracheostomy

was performed by Dr. Malcolm 0. Perry and bilateral chest tubes inserted. A second intravenous

infusion was begun in the left arm. In addition, Dr. M. T. Jenkins began respiration with the

anesthesia machine, cardiac monitor and stimulator attached. Solu-Cortef (300 mg.) was given

intravenously. Despite those measures, blood pressure never returned. Only brief

electrocardiographic evidence of cardiac activity was obtained.

Malcolm 0. Perry - Dr. Perry is an assistant professor of surgery at Southwestern Medical

School from which he received his degree in 1955. He I9 34 years old and was certified by the

American Board of Surgery in 1963.

At the time of initial examination of the President, Dr. Perry has stated, the patient was

noted to be nonresponsive . His eyes were deviated and the pupils dilated. A considerable

quantity of blood was noted on the patient, the carriage, and the floor. A small wound was

noted in the midline of the neck in the lower third anteriorly. It was exuding blood slowly. A

large wound of the right posterior cranium was noted, exposing severely lacerated brain. Brain

tissue was noted in the blood at the head of the carriage.

Pulse or heart beat were not detectable but slow spasmodic respiration was noted. An

endotracheal tube was in place and respiration was being controlled. An intravenous infusion

was being placed in the leg. While additional venesections were done to administer fluids and

blood, a tracheostomy was effected. A right lateral injury to the trachea was noted. The

cuffed tracheostomy tube was put in place as the endotracheal tube was withdrawn and

respirations continued. Closed chest cardiac massage was instituted after placement of

sealed-drainage chest tubes, but without benefit. When electrocardiogram evaluation revealed

that no detectable electrical activity existed in the heart, resuscitative attempts were

abandoned. The team of physicians determined that the patient had expired.

Charles R. Baxter - Dr. Baxter is an assistant professor of surgery at Southwestern Medical

School where he first arrived as a medical student in 1950. Except for two years away in the

Army he has been at Southwestern and Parkland ever since, moving up from student to intern to

resident to faculty member. He is 34 and was certified by the American Board of Surgery in 1963.

Recalling his attendance to President Kennedy, he says he learned at approximately 12 :35

that the President was on the way to the emergency room and that he had been shot. When Dr.

Baxter arrived in the emergency room, he found an endotracheal tube in place and respirations

being assisted. A left chest tube was being inserted and cut-downs were functioning in one leg

and in the left arm. The President had a wound in the midline of the neck. On first

observation of the other wounds, portions of the right temporal and occipital bones were missing

and some of the brain was lying on the table. The rest of the brain was extensively macerated

and contused. The pupils were fixed and deviated laterally and were dilated. No pulse was

detectable and ineffectual respirations were being assisted. A tracheostomy was performed by

Dr. Perry and Dr. Baxter and a chest tube was inserted into the right chest (second interspace

anteriorly). Meanwhile one pint of O negative blood was administered without response. When

all of these measures were complete, no heart beat could be detected. Closed chest massage was

performed until a cardioscope could be attached. Brief cardiac activity was obtained followed

by no activity. Due to the extensive and irreparable brain damage which existed and since there

were no signs of life, no further attempts were made at resuscitation.

Robert N. McClelland - Dr. McClelland, 34, assistant professor of surgery at Southwestern

Medical School, is a graduate of the University of Texas Medical Branch in Galveston. He has

served with the Air Force in Germany and was certified by the American Board of Surgery in 1963.

Regarding the assassination of President Kennedy, Dr. McClelland says that at approximately

12:35 p.m. he was called from the second floor of the hospital to the emergency room. When he

arrived, President Kennedy was being attended by Drs. Perry, Baxter, Carrico, and Ronald Jones,

chief resident in surgery. The President was at that time comatose from a massive gunshot wound

of the head with a fragment wound of the trachea. An endotracheal tube had been placed and

assisted respiration started by Dr. Carrico who was on duty in the emergency room when the

President arrived. Drs. Perry, Baxter, and McClelland performed a tracheostomy for respiratory

distress and tracheal injury. Dr. Jones and Dr. Paul Peters, assistant professor of surgery, ;

inserted bilateral anterior chest tubes for pneumothoraces secondary to the tracheo-mediastinal

injury. Dr. Jones and assistants had started three cutdowns, giving blood and fluids

immediately. In spite of this, the President was pronounced dead at 1:00 p.m. by Dr. Clark, the

neurosurgeon, who arrived immediately after Dr. McClelland. The cause of death, according to

Dr. McClelland was the massive head and brain injury from a gunshot wound of the right side of

the head. The President was pronounced dead after external cardiac massage failed and

electrocardiographic activity was gone.

Fouad A, Bashour - Dr. Bashour received his medical education at the University of Beirut

School of Medicine in Lebanon. He is 39 and an associate professor of medicine in cardiology at

Southwestern Medical School.

At 12 :50 p.m. Dr. Bashour was called from the first floor of the hospital and told that

President Kennedy had been shot. He and Dr. Donald Seldin, professor and chairman of the

Department of Internal Medicine, went to the emergency room. Upon examination, they found that

the President had no pulsations, no heart beats, no blood pressure. The oscilloscope showed a

complete standstill. The President was declared dead at 1:00 p.m.

William Kemp Clark - Dr. Clark is associate professor and chairman of the Division of

Neurosurgery at Southwestern Medical School. The 38-year-old physician has done research on

head injuries and has been at Southwestern since 1956.

He reports this account of the President's treatment:

The President arrived at the emergency room entrance in the back seat of his limousine.

Governor Connally of Texas was also in this car. The first physician to see the President was

Dr. Carrico.

Dr. Carrico noted the President to have slow, agonal respiratory efforts. He could hear a

heart beat but found no pulse or blood pressure. Two external wounds, one in the lower third of

the anterior neck, the other in the occipital region of the skull, were noted. Through the head

wound, blood and brain were extruding. Dr. Carrico inserted a cuffed endotracheal tube and

while doing so, he noted a ragged wound of the trachea immediately below the larynx.

At this time, Drs. Perry, Baxter, and Jones arrived. Immediately thereafter, Dr. Jenkins and

Drs. A. H. Giesecke, Jr., and Jackie H. Hunt, two other staff anesthesiologists, arrived. The

endotracheal tube had been connected to a respirator to assist the President's breathing. An

anesthesia machine was substituted for this by Dr. Jenkins. Only 100 per cent oxygen was

administered.

A cutdown was performed in the right ankle, and a polyethylene catheter inserted in the vein.

An infusion of lactated Ringer's solution was begun. Blood was drawn for typing and

crossmatching, but unmatched type O Rh negative blood was immediately obtained and begun.

Hydrocortisone (300

mg.) was added to the intravenous fluids.

Dr. McClelland arrived to help in the President's care. Drs. Perry, Baxter, and McClelland

did a tracheostomy. Considerable quantities of blood were present in the President's oral

pharynx. At this time, Dr. Peters and Dr. Clark arrived.

Dr. Clark noted that the President had bled profusely from the back of the head. There was a

large (3 by 3 cm.) amount of cerebral tissue present on the cart. There was a smaller amount of

cerebellar tissue present also.

The tracheostomy was completed and the endotracheal tube was withdrawn. Suction was used to

remove blood in the oral pharynx. A nasogastric tube was passed into the stomach. Because of

the likelihood of mediastinal injury, anterior chest tubes were placed in both pleural spaces.

These were connected to sealed underwater drainage.

Neurological examination revealed the President's pupils to be widely dilated and fixed to

light. His eyes were divergent, being deviated outward; a skew deviation from the horizontal

was present. No deep tendon reflexes or spontaneous movements were found.

When Dr. Clark noted that there was no carotid pulse, he began closed chest massage. A pulse

was obtained at the carotid and femoral levels.

Dr. Perry then took over the cardiac massage so that Dr. Clark could evaluate the head wound.

There was a large wound beginning in the right occiput extending into the parietal region.

Much of the right posterior skull, at brief examination, appeared gone. The previously

described extruding brain was present. Profuse bleeding had occurred and 1500 cc. of blood was

estimated to be on the drapes and floor of the emergency operating room. Both cerebral and

cerebellar tissue were extruding from the wound.

By this time an electrocardiograph was hooked up. There was brief electrical activity of the

heart which soon stopped.

The President was pronounced dead at 1:00 p.m. by Dr. Clark.

M. T. Jenkins - Dr. Jenkins is professor and chairman of the Department of Anesthesiology at

Southwestern Medical School. He is 46, a graduate of the University of Texas Medical Branch in

Galveston, and was certified by the American Board of Anesthesiology in 1952. During World War

II he served in the Navy as a lieutenant commander.

When Dr. Jenkins was notified that the President was being brought to the emergency room at

Parkland, he dispatched Drs. Giesecke and Hunt with an anesthesia machine and resuscitative

equipment to the major surgical emergency room area. He ran downstairs to find upon his arrival

in the emergency operating room that Dr. Carrico had begun resuscitative efforts by introducing

an orotracheal tube, connecting it for controlled ventilation to a Bennett intermittent positive

pressure breathing apparatus. Drs. Baxter, Perry, and McClelland arrived at the same time and

began a tracheostomy and started the insertion of a right chest tube, since there was also

obvious tracheal and chest damage. Drs. Peters and Clark arrived simultaneously and immediately

thereafter assisted respectively with the insertion of the right chest tube and with manual

closed chest cardiac compression to assure circulation. Dr. Jenkins believes it evidence of the

clear thinking of the resuscitative team that the patient received 300 mg. hydrocortisone

intravenously in the first few minutes.

For better control of artificial ventilation, Dr. Jenkins exchanged the intermittent positive

pressure breathing apparatus for an anesthesia machine and continued artificial ventilation.

Dr. Gene Akin, a resident in anesthesiology, and Dr. Giesecke connected a cardioscope to

determine cardiac activity.

During the progress of these activities, the emergency room cart was elevated at the feet in

order to provide a Trendelenburg position, a venous cutdown was performed on the right saphenous

vein and additional fluids were begun in a vein in the left forearm while blood was ordered from

the blood bank. All of these activities were completed by approximately 12:50 at which time

external cardiac massage was still being carried out effectively by Dr. Clark as judged by a

palpable peripheral pulse. Despite these measures there was only brief electrocardiographic

evidence of cardiac activity.

These described resuscitative activities were indicated as of first importance, and after

they were carried out, attention was turned to other evidences of injury. There was a great

laceration on the right side of the head (temporal and occipital), causing a great defect in the

skull plate so that there was herniation and laceration of great areas of the brain, even to the

extent that part of the right cerebellum had protruded from the wound. There were also

fragmented sections of brain on the drapes of the emergency room cart. With the institution of

adequate cardiac compression, there was a great flow of blood from the cranial cavity,

indicating that there was much vascular damage as well as brain tissue damage. President

Kennedy was pronounced dead at 1 p.m.

It is Dr. Jenkins' personal feeling that all methods of resuscitation were instituted

expeditiously and efficiently. However, he says, the cranial and intracranial damage was of

such magnitude as to cause irreversible damage.

end part one....

B......

Part III

Lee Harvey Oswald

On Nov. 24, two days after the shooting of President Kennedy and Governor Connally, an ironic

event brought to Parkland the man whom Dallas police had charged with the murder of the

President. Lee Harvey Oswald, 24, had been shot.

Initial care and surgery were handled by Parkland physicians, including some of those who had

cared for the President and the Governor. Oswald was brought into the emergency room at 11:32

a.m., to the operating room at 11:42 a.m. and at 1:07 p.m. he was pronounced dead in spite of

all efforts.

Dr. Shires.--The surgery performed on Oswald, who had been shot in the upper abdomen and

chest, was done by Drs. Shires, Perry, McClelland, and Jones, and included an exploratory

laparotomy, thoracotomy, and efforts to repair the aortu, vena cava, and multiple organ

injuries. Dr. Shires has said that on previous inspection an entrance wound over the left lower

lateral chest edge was revealed and an exit was identified by subcutaneous palpation of the

bullet over the right lower lateral chest cage. At the time he wag geen preoperatively, Oswald

was without perceptible blood pressure, his heart beat wag heard intermittently at 130 beats per

minute, he had an endotracheal tube in place and was receiving only oxygen by ane8the8ia at the

time he wag moved to the operating room.

Under enaotracheal oxygen anesthesia, a long midline abdominal incision was made. Bleeders

were not apparent and none were clamped or tied. Upon opening the peritoneal cavity,

approximately 2 to S liters of blood, both liquid and in clots, was encountered. This was

removed. The bullet pathway was then identified as having shattered the upper medial surface of

the spleen, then entered the retroperitoneal area where there was a large retroperitoneal

hematoma in the area of the pancreas. Following this, bleeding was seen to be coming from the

right side, and upon inspection, there was seen to be an exit to the right through the inferior

vena cava, thence through the superior pole of the right kidney, the lower portion of the right

lobe of the liver, and into the right lateral body wall.

First the right kidney, which was bleeding, was identified, dissected free, retracted

medially, and the inferior vena cava hole was clamped with a partial occlusion clamp of the

Satinsky type. Following this immobilization, packing controlled the bleeding from the right

kidney.

Attention was then turned to the left, as bleeding was massive from the left side. The

inspection of the retroperitoneal area re-vealed a huge hematoma in the midline. The stomach had

been penetrated by the bullet. The spleen was then mobilized, as was the left colon, and the

retroperitoneal approach was made to the midline structures. The pancreas appeared to be

shattered in its midportion; bleeding was seen to be coming from the aorta. This was dissected

free. Bleeding was controlled with finger pressure by Dr. Perry. Upon identification of this

injury, it was seen that the superior mesenteric artery had been sheared off of the aorta; there

was some back bleeding from the artery. This was cross-clamped with a small, curved DeBakey

clamp. The aorta was then occluded with a straight DeBakey clamp above and a Potts clamp below:

At this point all major bleeding was controlled, blood pressure was reported to be in the

neighborhood of 100 systolic. Shortly thereafter, however, the pulse rate, which had been in the

80 to 90 range, was found to be 40, and a few seconds later found to be zero. No pulse was felt

in the aorta at this time.

Consequently, the left chest was opened by Dr. Perry through an

intercostal incision in approximately the fourth intercostal space. A Finochietto re-tractor was

inserted, and the heart was seen to be flabby and not beating at all. There was no

hemopericardium. There was a hole in the diaphragm but no hemothorax. A left closed suction

chest tube had been introduced while the patient was in the emergency room prior to surgery, so

that there was no significant pneumothorax on the leM side. The pericardium was opened, cardiac

massage was started, and a pulse was obhinable with massage. The heart was flabby, consequently

calcium chloride followed by 1 mg. epinephrine hydrochloride and 90 mg. Xylocaine Hydrochloride

were injected into the left ventricle. The standstill converted to fibrillation. Following this

defibrillation was done, using 240, 860, 500, and 750 volts, and finally successful

defibrillation was accomplished after a second attempt with the defibrillator. However, no

effective heart beat could be instituted.

A pacemaker was inserted into the wall of the right

ventricle and grounded on skin, and pacemaking was started. A very feeble, small, localized,

muscular response was obtained with the pacemaker, but still no effective heart beat. At this

time Dr. Shires was informed by Dr. Jenkins that there were no signs of life in that the pupils

were fixed and dilated, there was no retmal blood flow, no respiratory effort, and no effective

pulse could be maintained even with cardiac massage. The patient was pronounced dead at 1:07

p.m.

Anesthesia consisted entirely of oxygen. The patient was never conscious from the time of his

arrival in the emergency room until his death at 1:07 p.m. The subcutaneous bullet was extracted

from the side during the attempts at defibrillation which were' rotated among the surgeons. The

cardiac massage and defibrillation attempts were carried out by Drs. McClelland, Perry, and

Jones. Assistance was obtained from the cardiologist, Dr. Bashour.

Dr. Jenkins.--In a statement concerning resuscitative efforts for Oswald, Dr. Jenkins

reported that Dr. Jones, after being notified through the office of the administrator of the

hospital, informed a surgical and anesthesiology team that Lee Harvey Oswald had sustained a

gunshot wound and was being -brought to the emergency operating room for emergency and

definitive treatment. By the time that the patient, Oswald, was registered into the emergency

operating room, there was assembled a resuscitative team in the emergency operating room

surgical room.

Dr. Jenkins recalls that the following physicians were members of the resuscitation team:

Drs. Jenkins and Akin, with an anesthesia machine and full resuscitative equipment for the

maintenance of ventilation; Drs. Gerry Gustafson, Dale Coln, and Charles Crenshaw, all residents

in surgery, who were prepared to introduce cannulae in-to the veins via cutdowns or percutaneous

puncture; Dr. Jones with chest drainage equipment; Dr. William R. Osborne, resident in

orthopedics, for necessary orthopedic services; and Dr. William Risk, resident in urology, for

evaluation of possible urological damage. Dr. Perry was present to direct the surgical approach.

There were many other medical personnel present in addition to these, but the physicians named

figured importantly in the initial resuscitative experience, Dr. Jenkins said.

As the patient, Oswald, was brought into the operating room, Dr. Akin introduced a #36 cuffed

endotracheal tube and connected it to an anesthesia machine for assisted ventilation or

controlled respiration with oxygen. It was obvious that the patient was in extremis as judged by

his general pallor, the cold extremities, the dusky or ashen gray color of his nail beds, his

gasping respiration, and his dilated pupils and dry conjunctiva. There was a small, oval,

traumatized area in approximately his left anterior axillary line at approximately the sixth

intercostal space, and a foreign object, thought to be a bullet, could be palpated in his right

posterior axillary line at about thoracic dermatome ten.

No time was expended in making these observations and evaluation of the patient's status, for

at the time the endotracheal tube was being inserted, three members of the staff were performing

venous cutdowns, one in each lower extremity and one in the left forearm, These were performed

by Drs. Coln, Crenshaw, and Gustafson. Because of the obvious chest wound and appearance of

pneumothorax on the left, Dr. Jones inserted a chest tube and connected it to a closed waterseal

drainage bottle. The head of the emergency room cart was lowered into a Trendelenburg position.

There was no perceptible peripheral arterial pulsation. How-ever, the cardioscope tracing showed

electrical cardiac activity with a heart rate of approximately 130 per minute. Blood was sent to

the blood bank for immediate typing and crossmatching, and two units of uncross-matched type 0,

Rh negative blood was started by pressure infusion from plastic blood containers.

It was obvious that this patient had sustained such an injury that he was continuing to lose

blood internally very rapidly. Drs. Shires, McClelland, and Perry collaborated in the decision

to move the patient immediately to the main operating suite for emergency laparotomy, since the

suspected path of the bullet would seem to traverse the left leaf of the diaphragm, the aorta

and inferior vena cava, and perhaps the right kidney and part of the liver. (Dr. Risk had

inserted a Foley catheter into the urinary bladder, obtaining only a scant quantity of urine

which was not blood tinged.

With the anesthesia machine still connected to the patient, he was transported to the

elevator and into the operating room which had already been prepared for emergency surgery. The

abdominal incision was made at 11:44 a.m., 12 minutes from the time the patient was first

admitted to the emergency operating room.

The operating team consisted of Drs. Shires, McClelland, Perry, and Jones. The anesthesia

team consisted of Drs. Akin, Jenkins, and Dr. Harlan Pollock, resident on anesthesiology.

In describing the patient's condition and the parasurgical considerations, Dr. Jenkins says

that by the time of the beginning of surgery, type-correct blood (A-1, Rh negative) was

available and was administered under pressure through the three venous cutdowns. Dr. Curtis

Spier, fellow in anesthesiology, cannulated a vein in the right forearm to aid in fluid

replacement.

Under the influence of blood administration and pulmonary ventilation with 100 per cent

oxygen, the patient's pulse rate slowed from 130-160 to 80 per minute, and by 12 o'clock he had

a discernible peripheral blood pressure, recorded at about 60 systolic, and by 12 :10 p.m. his

blood pressure was 90/60 and his pulse rate remained regular at 80 per minute.

By 12:16 p.m. he had received 3000 ml. of blood and 800 ml. of 6 per cent dextrose in

lactated Ringer's solution. Estimated and measured blood loss at this time was 4000 ml.

By 12 :30 p.m. he had received 6000 ml. of blood and 1 gm. of calcium gluconate

intravenously. His measured blood loss at this time was 6000 ml., and it was also obvious that

an additional quantity was sequestered in his bowel lumen and bowel wall.

At this time the surgical and anesthesia teams consulted about the patient's fluid status and

decided that he needed a quantity of balanced salt solution; therefore, in two of the cutdown

veins, 6 per cent dextrose in lactated Ringer's solution was begun. (Despite this rapid blood

and fluid replacement, the patient's pulmonary status seemed satisfactory in that there was no

perceptible change in compliance, as judged by the resistance to ventilation by compressing the

reservoir breathing bag.

At 12 :37, Dr. Akin, who was monitoring the heart sounds with a chest stethoscope, reported

that the cardiac tones were becoming weaker and the pulse rate was slowing from the previous

rate of 80, to 60, to 40, to 30, and then became imperceptible. (These changes in rate were

verified by a change in electrical activity as shown on the cardioscope.) Palpation of the heart

through the diaphragm from the abdominal operating site was performed by Dr. Shires, who

reported that he could not feel cardiac activity and he noted that the aorta had now ceased to

pulsate. Dr. Perry opened the left chest with an incision at approximately the fourth

interco8tal space, extending from the sternum laterally to the left anterior axillary line.

Under direct vision it was verified that rhythmic cardiac activity had ceased, the heart was

dilated. Ten milliliters of 10 per cent calcium chloride were injected into the chamber of the

left ventricle.

The heart, which had been flaccid prior to this injection, showed an increase in

muscular tone and was not dilated. One mg. of epinephrine hydrochloride in 90 mg of 1 per cent

lidocaine was injected into the left ventricular chamber, reducing the heart in overall size.

Ventricular fibrillation ensued. Manual cardiac systole (cardiac massage) was begun by Dr.

Perry while the internal defibrillation apparatus was readied. Four attempts at ventricular

defibrillation were made, with Dr. McClelland applying the defibrillation paddles to the heart,

utilizing successively voltages of 240, 360, 600, and 760 without successfully effecting

defibrillation. Between the applications of the defibrillation paddles, manual cardiac systole

was continued alternately by Drs. Perry and McClelland.

At 12 :55 p.m., the internal pacemaker, provided by Dr. Bashour, was attached to the heart,

but the electrical stimulus provided by this pacemaker was not effective in producing visible

cardiac systole. Two other attempts at internal defibrillation were made. The second

defibrillating current produced asystole, but the internal pacemaker still did not stimulate

effective cardiac activity.

Manual cardiac systole was re-started, causing palpable carotid pulse, but the patient's

obvious external appearance was that circulation was ineffective as judged by the development of

an ashen gray cyanosis. With an ophthalmoscope, Dr. Jenkins had periodically checked the retina

for circulation during the resuscitative processes, and the retina could be visualized until

1:06 p.m., when it was apparent that the lens had become opaque, and retinal circulation was not

observed.

The patient was pronounced dead at 1:07 p.m. The bullet which was palpable in the

right posterior axillary line was removed and sent out by the operating room supervisor, Miss

Audrey Bell, to be turned over to the legal authorities.

As a summary of fluid replacement, this patient received 16 and 1/2 units of blood and 4200

ml. of 6 per cent dextrose in lactated Ringer's solution.

It is Dr. Jenkins personal feeling that all methods of resuscitation were instituted

expeditiously and efficiently. Having observed this patient from the time he was wheeled into

the emergency operating room, Dr. Jenkins felt that Oswald sustained a period of cerebral

hypoxia or anoxia for the period of time lapsing between the gunshot wound which he received and

the time that effective ventilation with oxygen was started in the emergency operating room.

Considering the cerebral changes which would begin at the time of initial anoxia, notably

cerebral edema, Dr. Jenkins felt that many vital centers, including the cardiovascular center,

were irreparably damaged, despite all resuscitative measures, introducing the final cardiac

asystole. The trauma which patient Oswald had sustained was too great for resuscitation.

END QUOTE

The information on the third patient Gov. John Connally, is not available, so far....

Thanks for your time.....

Edited by Bernice Moore
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Thanks, Bernice!

Jack

Jack & Bernice,

You were correct, Jack. The article, including the part about Connally is online at the Mary Ferrell Foundation website. The first two pages are blank. The actual article begins on page 3.

http://www.maryferrell.org/mffweb/archive/...amp;relPageId=1

Regards,

Mike

Edited by Michael Griffin
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Thanks, Bernice!

Jack

Jack & Bernice,

You were correct, Jack. The article, including the part about Connally is online at the Mary Ferrell Foundation website. The first two pages are blank. The actual article begins on page 3.

http://www.maryferrell.org/mffweb/archive/...amp;relPageId=1

Regards,

Mike

hi mike hope you and all are well and a happy new year been some time since i saw you around..thank you very much..appreciated now i shall have the rest of the story...take care...best b..

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  • 1 month later...

Interesting article on Dr. Robert McClelland, whom the author describes as perhaps "the most credible conspiracy theorist alive."

http://www.dmagazine.com/Home/2008/10/24/T...nnedy_Died.aspx

(I was not aware that Geraldo Rivera was on the

Johnny Carson show. I think the author is most likely

mistaken about that. Of course the Zapruder film was

initially shown on Rivera's Good Night America program.)

Edited by Michael Hogan
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I find it very curious that no accounting of J.D. Tippet after he was shot appears in this report, and don't remember ever reading anything about what happened to Tippet's body after he was shot.

Why doesn't Tippet figure?

Tippet as a casualty is as significant in this as the other three celebrities.

Edited by Jerry Ellis
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  • 2 months later...

Has anyone listened to these Sixth Floor Oral History Project tapes or read the transcripts?

Thanks, BK

PARKLAND

Pat Holloway A Dallas attorney, Holloway attended a political luncheon at the Adolphus Hotel on November 22, 1963. Shortly after the assassination, his senior law partner received an unusual, business-related call from Lyndon Johnson at Parkland Memorial Hospital. Holloway later became an oil and gas operator, founding the Humble Exploration Company. Recorded January 11, 2010.

Marvin Burlison An installation supervisor with Southwestern Bell Telephone in 1963, Burlison managed the special telephone service at the Trade Mart in preparation for the presidential visit. Immediately after the assassination, Burlison supervised the installation of new direct dialing service at Parkland Memorial Hospital. Recorded March 25, 2005.

Sharon Calloway An X-Ray Technology School intern at Parkland Memorial Hospital in 1963, Calloway saw the back of President Kennedy's head before he was moved into Trauma Room One. She later worked closely with the Dallas County medical examiner, Dr. Earl F. Rose, and recalled his feelings about the handling of the president's remains. Recorded January 27, 2002.

Dr. Robert G. Grossman A neurosurgeon at Parkland Memorial Hospital in 1963, Grossman was in Trauma Room One during the treatment of President Kennedy and claims to have examined the president's head wound; however, he was not called to testify before the Warren Commission. Recorded October 4, 2003.

Dr. James Carrico A resident in general surgery at Parkland Memorial Hospital in 1963, Carrico was the first physician to see President Kennedy upon his arrival at the hospital. Recorded August 2, 1997.

Dr. Ronald C. Jones Jones was the chief surgery resident in Parkland Memorial Hospital's emergency room on November 22, 1963. He was among the team of doctors that worked on the resuscitation of President Kennedy in Trauma Room One. Less than 48 hours later, he was part of the surgical team that treated Lee Harvey Oswald. Recorded October 31, 1997, and November 21, 2005.

Dr. Robert V. Walker A medical researcher and doctor of oral surgery at Parkland Memorial Hospital in 1963, Walker was briefly inside Trauma Room One as an observer during the treatment of President Kennedy. Recorded March 18 and July 29, 2009.

Dr. Robert N. McClelland McClelland was an instructor in surgery at Parkland Memorial Hospital in 1963 and was among the team of doctors in Trauma Room One who worked on President Kennedy. Less than two days later, he also assisted in the treatment of Lee Harvey Oswald. Recorded July 16, 2001.

Edited by William Kelly
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I find it very curious that no accounting of J.D. Tippet after he was shot appears in this report, and don't remember ever reading anything about what happened to Tippet's body after he was shot.

Why doesn't Tippet figure?

Tippet as a casualty is as significant in this as the other three celebrities.

This article only deals with the three patients who were taken to/treated at Parkland Hospital. Some of the doctors

had a hand in the treatment of at east 2 of the 3 that weekend.

Tippit was taken to Methodist Hospital.

Bests,

Barb :-)

Edited by Barb Junkkarinen
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