The Trach Incision -

[Tony Frank]

Much has been said of the large trach incision that appears in the autopsy photos. CTs often say it indicates body mutilation in an effort to remove a bullet. I personally believe the photos have been doctored to support the claim of shots from behind and the body looked the same at Parkland and Bethesda.

But about the seemingly large incision from the tracheotomy, I have something to suggest.

Perry thought the throat wound was an entrance wound and a bullet entered the President's chest. Could it be that without thinking he made the incision larger to get a better look at the damage from the bullet?

The tracheotomy had to be immediately performed, but Perry certainly knew that after dealing with the head wound, they would need to do something about the bullet that entered the President's throat. A small trach incision would not suffice in that regard.

[Pat Speer]

Much has been said of the large trach incision that appears in the autopsy photos. CTs often say it indicates body mutilation in an effort to remove a bullet. I personally believe the photos have been doctored to support the claim of shots from behind and the body looked the same at Parkland and Bethesda.

But about the seemingly large incision from the tracheotomy, I have something to suggest.

Perry thought the throat wound was an entrance wound and a bullet entered the President's chest. Could it be that without thinking he made the incision larger to get a better look at the damage from the bullet?

The tracheotomy had to be immediately performed, but Perry certainly knew that after dealing with the head wound, they would need to do something about the bullet that entered the President's throat. A small trach incision would not suffice in that regard.

I believe Dr. McClelland has claimed that the trach incision in the photos is consistent with what he saw at Parkland. So you could be on to something... For whatever reason, Perry made a large incision...

[Tony Frank]

Much has been said of the large trach incision that appears in the autopsy photos. CTs often say it indicates body mutilation in an effort to remove a bullet. I personally believe the photos have been doctored to support the claim of shots from behind and the body looked the same at Parkland and Bethesda.

But about the seemingly large incision from the tracheotomy, I have something to suggest.

Perry thought the throat wound was an entrance wound and a bullet entered the President's chest. Could it be that without thinking he made the incision larger to get a better look at the damage from the bullet?

The tracheotomy had to be immediately performed, but Perry certainly knew that after dealing with the head wound, they would need to do something about the bullet that entered the President's throat. A small trach incision would not suffice in that regard.

I believe Dr. McClelland has claimed that the trach incision in the photos is consistent with what he saw at Parkland. So you could be on to something... For whatever reason, Perry made a large incision...

Thanks, Pat.

[Daniel Gallup]

Much has been said of the large trach incision that appears in the autopsy photos. CTs often say it indicates body mutilation in an effort to remove a bullet. I personally believe the photos have been doctored to support the claim of shots from behind and the body looked the same at Parkland and Bethesda.

But about the seemingly large incision from the tracheotomy, I have something to suggest.

Perry thought the throat wound was an entrance wound and a bullet entered the President's chest. Could it be that without thinking he made the incision larger to get a better look at the damage from the bullet?

The tracheotomy had to be immediately performed, but Perry certainly knew that after dealing with the head wound, they would need to do something about the bullet that entered the President's throat. A small trach incision would not suffice in that regard.

I believe Dr. McClelland has claimed that the trach incision in the photos is consistent with what he saw at Parkland. So you could be on to something... For whatever reason, Perry made a large incision...

Thanks, Pat.

It is true that McClelland and a few others have claimed no inconsistency between the trach incision they remember and the autopsy photos. Then Tony, in your thinking there was no photographic tinkering with the trach wound as seen in the stare of death photo? I don't have my sources with me here at work, but how soon after Nov 22 did McClelland et al. confirm the size of the trach incision? Do early estimates of the size of the trach incision agree with later ones? If not, why not? Best, Daniel

[David Lifton]

I interviewed Doctor Perry in October, 1966--specifically about the size of the trach incision.

He said it was "2-3 cm."

I also spoke with Dr. Carrico within a day or so--and he said the same thing. Identical.

In fact, I interviewed all the Dallas doctors (that I could reach) on this very subject, and the results are laid out, in detail, in Chapter 11 of Best Evidence, devoted entirely to the throat wound ("Dallas vs Bethesda").

FYI: Dr. McClelland came into the room AFTER the trach tube was in place, and so the flange covered the incision.

There's little question in my mind, based on these interviews, and other data, that the throat wound was enlarged by the time the body reached Bethesda.

In the "other data" department:

Remember what Dr. Finck testified to in New Orleans: that he could not find any trace of the original bullet wound on the edges of the so-called trach incision: "I do not know why it is not there," he said. (And doctor Humes answered a similar question--before the WC--the same way).

All of this is laid out crystal clear in Chapter 11 of Best Evidence.

But, I must say, one of my favorite quotes, indicating body alteration, comes from Paul O'Connor in our on-camera interview, circa 1989 (although this may be in our original 1980 filmed interiew--I'm just not sure):

QUOTE: You wouldn't do a tracheotomy on a man without a brain. UNQUOTE

DSL

[Tony Frank]

I interviewed Doctor Perry in October, 1966--specifically about the size of the trach incision.

He said it was "2-3 cm."

I also spoke with Dr. Carrico within a day or so--and he said the same thing. Identical.

In fact, I interviewed all the Dallas doctors (that I could reach) on this very subject, and the results are laid out, in detail, in Chapter 11 of Best Evidence, devoted entirely to the throat wound ("Dallas vs Bethesda").

FYI: Dr. McClelland came into the room AFTER the trach tube was in place, and so the flange covered the incision.

There's little question in my mind, based on these interviews, and other data, that the throat wound was enlarged by the time the body reached Bethesda.

In the "other data" department:

Remember what Dr. Finck testified to in New Orleans: that he could not find any trace of the original bullet wound on the edges of the so-called trach incision: "I do not know why it is not there," he said. (And doctor Humes answered a similar question--before the WC--the same way).

All of this is laid out crystal clear in Chapter 11 of Best Evidence.

But, I must say, one of my favorite quotes, indicating body alteration, comes from Paul O'Connor in our on-camera interview, circa 1989 (although this may be in our original 1980 filmed interiew--I'm just not sure):

QUOTE: You wouldn't do a tracheotomy on a man without a brain. UNQUOTE

DSL

If the trach incision was 2-3 cm. in length, then how could they ascertain the damage caused by the bullet?

Dr. Carrico told the House Select Committee on Assassinations, There was some injury to the trachea behind it, and the bullet must have been going front to back.

Dr. Marion Jenkins wrote up a report at 4:30 p.m. on November 22 stating Doctors Baxter, Perry, and McClelland began a tracheotomy and started the insertion of a right chest tube because President Kennedy had sustained obvious tracheal and chest damage.

Dr. Clark testified to the Warren Commission that when Dr. Perry made the incision for a tracheotomy, He discovered that the trachea was deviated so he felt that the missile had entered the Presidents chest.

Edited January 7, 2011 by Tony Frank

[David Josephs]

Hey David... a quick thanks for your fantastic book. Enjoyed and continue to enjoy your work

A thought dawned on me after your post...

Were was Perry trained that would have him do a horizontal incision versus a vertical one?

This article suggests that VERTICAL incisions were the order of the day for years and years....

yet I am having a tough time finding what would have been the suggested method in 1963 ER settings

just a thought.

DJ

Tracheostomy—The horizontal tracheal incision

I. Katoa1 c1, K. Uesugia1, M. Kikuchiharaa1, H. Iwasawaa1, J. Iidaa1, K. Tsutsumia1, H. Iwatakea1 and I. Takeyamaa1

a1 (Kawasaki, Japan)

Abstract

The complication rate after emergency tracheostomy is two to five times greater than after elective procedures. One of the main causes of the high risk of complications in emergency tracheostomy appears to be the amount of time required to open the trachea. Therefore, simple and fast procedures are mandatory. We have developed a new procedure as follows: A horizontal skin incision is performed. Strap muscles are dissected and retracted laterally. A transverse cut between tracheal rings below the thyroid isthmus is performed up to membranous portion of the trachea. The cut ends of the trachea remain open naturally because of the elasticity of the trachea. Skin and tracheal cut-ends are then joined by interrupted sutures.

We have used this procedure during the past three years and have not experienced any major complications. This demonstrates the clear advantage and the more physiological nature of the procedure over various other incisions of the tracheal wall.

(Accepted January 09 1990)

Correspondence:

c1 Dr. I. Kato, Department of Otolaryngology, St. Marianna University School of Medicine, Miyamae, Sugao 2-16-1, 213 Kawasaki, Kanagawa, Japan

Footnotes

Paper presented by Dr. K. Uesugi at the 6th World Congress of Bronchoesophagology in Tokyo 15-18 October 1989.

[David Josephs]

I interviewed Doctor Perry in October, 1966--specifically about the size of the trach incision.

He said it was "2-3 cm."

I also spoke with Dr. Carrico within a day or so--and he said the same thing. Identical.

In fact, I interviewed all the Dallas doctors (that I could reach) on this very subject, and the results are laid out, in detail, in Chapter 11 of Best Evidence, devoted entirely to the throat wound ("Dallas vs Bethesda").

FYI: Dr. McClelland came into the room AFTER the trach tube was in place, and so the flange covered the incision.

There's little question in my mind, based on these interviews, and other data, that the throat wound was enlarged by the time the body reached Bethesda.

In the "other data" department:

Remember what Dr. Finck testified to in New Orleans: that he could not find any trace of the original bullet wound on the edges of the so-called trach incision: "I do not know why it is not there," he said. (And doctor Humes answered a similar question--before the WC--the same way).

All of this is laid out crystal clear in Chapter 11 of Best Evidence.

But, I must say, one of my favorite quotes, indicating body alteration, comes from Paul O'Connor in our on-camera interview, circa 1989 (although this may be in our original 1980 filmed interiew--I'm just not sure):

QUOTE: You wouldn't do a tracheotomy on a man without a brain. UNQUOTE

DSL

If the trach incision was 2-3 cm. in length, then how could they ascertain the damage caused by the bullet?

Dr. Carrico told the House Select Committee on Assassinations, “There was some injury to the trachea behind it,” and the bullet “must have been going front to back.”

Dr. Marion Jenkins wrote up a report at 4:30 p.m. on November 22 stating Doctors Baxter, Perry, and McClelland “began a tracheotomy and started the insertion of a right chest tube” because President Kennedy had sustained “obvious tracheal and chest damage.”

Dr. Clark testified to the Warren Commission that when Dr. Perry made the incision for a tracheotomy, “He discovered that the trachea was deviated so he felt that the missile had entered the President’s chest.”

http://www.history-matters.com/archive/jfk/hsca/reportvols/vol7/html/HSCA_Vol7_0139b.htm

Tony,

Dr. C says here "I successfully passed an oral, endotrachael tube by mouth"

Seems to me he was in a perfect position to see what was happening down there... no need to see thru the 3mm hole or the 2-3cm slit.

They saw the damage from the inside.

He continued, "I noticed at that time some deviation of the trachea to the left.....

Edited January 7, 2011 by David Josephs

[David Josephs]

This ices it Tony.... Dr. C did not make his comments from viewing the OUTSIDE of the throat or trach but the inside.

I believe DL's theory still stands... that throat wound was definitely enlarged along the way...

DJ

[David Josephs]

Milicent Cranor wrote an interesting article about thi sissue once.

Fastidious researcher that she is, she even found an article by Perry in which he described tracheotomies as wide.

So did Griffith

PRESIDENT KENNEDY'S THROAT WOUND

Michael T. Griffith

1996

@All Rights Reserved

In light of Dr. David Mantik's determination, based on his

study of the original autopsy x-rays and photos at the National

Archives, that no bullet could have gone from President Kennedy's

back wound to the wound in the front of his throat without

smashing straight through the spine (Livingstone, KILLING

KENNEDY, 93-94), we can now be highly confident that the throat

wound was an entrance wound, just as the doctors and nurses at

Parkland Hospital in Dallas originally said it was. This wound

was situated in the middle (or midline) of the neck and was

slightly below the Adam's apple.

Other than the fact that Dr. Mantik's discovery very

probably proves the throat wound was an entrance wound, what is

some of the other evidence that this wound was an entry point?

Here is a brief summary:

* The wound was very small, no more than 5 mm in diameter,

and possibly only 2-3 mm in diameter. In a taped 1979 interview,

Dr. Charles Baxter said the wound "was no more than a pinpoint."

He added that it was "made by a small caliber weapon. And it was

an entry wound" (Groden and Livingstone 45). Interviewed again

in 1992, Dr. Baxter said,

Looking at that hole, one would have to [think]--and my

immediate thought was that this was an entry wound because

it was so small. The hole was only the size of a pencil

eraser, about 2 or 2.5 mm across. . . . (Livingstone,

KILLING THE TRUTH, 718)

Dr. Pierre Finck, one of the autopsists, wrote that the

throat wound was approximately 5 mm in diameter (Livingstone,

KILLING KENNEDY, 217). When Dr. James Humes, the chief

pathologist at the autopsy, spoke with Dr. Malcolm Perry, the

surgeon who performed the tracheostomy on the President, the

throat wound, according to the notes of that phone conversation,

was described as "only a few mm in size, 3-5 mm" (Lifton 275).

The caliber of the ammunition that was supposedly used by

the alleged lone-gunman was 6.5 mm. A missile of this caliber

would have made a much larger wound if it had exited the throat.

* The wound was not jagged or punched out like a normal

exit wound, but rather was round and relatively clean-cut.

Dr. Robert McClelland reported that the throat wound "had

the appearance of the usual entrance wound of a bullet"

(Livingstone, KILLING THE TRUTH, 717). Dr. Malcolm Perry

repeatedly described the wound as an entrance wound on the day of

the assassination, on national television. Dr. Charles Carrico

described the wound as a "small PENETRATING wound" in his

11/22/63 report (WCR 519; CE 392; Livingstone, KILLING THE TRUTH,

717).

The problem posed by the throat wound's neat appearance was

highlighted to the Warren Commission by Dr. Ronald Jones of

Parkland Hospital. Dr. Jones noted that a bullet traveling at

the required speed would have had a shock wave, and might very

well have begun to wobble while passing through the neck, thereby

leaving a larger wound of exit than the pencil-sized hole in

Kennedy's throat that he and the other Dallas doctors had

observed. (The shock wave alone almost certainly would have

caused the resulting exit wound to be punched out and larger than

the caliber of the bullet. See below on the Warren Commission's

own wound ballistics tests involving simulated human necks.) Dr.

Jones went on to explained that one could not have both a tiny,

neat exit wound and a bullet traveling as fast as the magic

bullet would have been moving when it allegedly exited the throat

(Lifton 68). Surprisingly, WC counsel Arlen Specter then

elicited from Dr. Jones the fact that in order for the small,

neat throat wound to have been an exit wound the bullet must have

been traveling at a very low velocity:

Specter: Would it [the Parkland throat wound] be

consistent, then, with an exit wound but of low

velocity, as you put it?

Jones: Yes, of very low velocity to the point that

you might think that this bullet barely made it

through the soft tissues and [had] just enough

[velocity] to drop out of the skin on the opposite

side. (Lifton 68)

Such a missile, of course, would have posed no threat to

Governor John Connally, who was supposedly struck by the bullet

that allegedly exited the President's throat. Dr. Jones'

testimony was not discussed in the WC's report.

* Dr. Carrico told the HSCA that the damage he saw beneath

the small hole in the throat indicated that the bullet must have

been traveling from front to back (7 HSCA 270). Similarly, Dr.

Nathan Jacobs observed that the Parkland doctors described a

laceration of the pharynx and trachea that was LARGER than the

small throat wound, "indicating that the bullet had traveled from

the front of the neck to the back" (Meagher 158 n 39).

* In the WC's own wound ballistics tests, the SMALLEST wound

of exit that was created in the simulated human necks was 10

MM IN DIAMETER. WC supporters attempt to explain these tests,

and the throat wound's size and neat appearance, by speculating

that the collar band of Kennedy's shirt restrained the skin of

the neck and prevented it from stretching too far, thereby

enabling the bullet to cause the resulting wound to be small and

neat. This theory is invalid, however, because WC supporters

also claim that the bullet made the slits in the front of the

President's shirt as it allegedly exited his neck, and those

slits were undeniably BELOW the collar band (see, for example,

Weisberg 245).

* Nurse Margaret Henchliffe, an experienced emergency room

nurse at Parkland Hospital who saw the throat wound, insisted

the wound was an entrance wound. When a WC attorney asked

her to describe what the wound appeared to be, she replied,

"an entrance bullet hole" (Groden and Livingstone 68-69). The

attorney then asked her, "Could it have been an exit bullet

hole?" She answered, "I have never seen an exit bullet hole

. . . that looked like that" (Groden and Livingstone 69).

* On the day of the assassination, several Parkland doctors

concluded that the bullet which entered the throat had ranged

downward into the chest. Dr. Kemp Clark told newsmen soon after

the shooting that the bullet entered the throat and then "ranged

downward in his chest and did not exit" (Lifton 280). The

accounts of the Dallas doctors contain evidence that a bullet did

in fact enter the chest (Lifton 279-280). Dr. Perry, for

example, found that the President's trachea was torn and

deviated, that respiration was especially inadequate on the right

side, and that there was free blood and air in the chest cavity.

Dr. Roy Jones recalled that as Dr. Perry performed the

tracheostomy, there was a "gush of air" (Lifton 279). Dr. Paul

Peters described a "bubbling" sensation in Kennedy's chest. Dr.

Clark told the WC that "Dr. Perry assumed that the findings in

the neck were due to penetration of the missile into the chest.

For this reason, he requested chest tubes to be placed" (Lifton

280 n).

* Dr. Perry was so certain the throat wound was an entrance

wound that when asked to comment on the report that the alleged

lone assassin fired from the Texas School Book Depository

Building (TSBD), which was to the right rear of the limousine

when the shooting occurred, he suggested that the President must

have been turned toward the building when he was wounded in the

throat (Lifton 58; cf. Lifton 65). It appears that initially

there was some thought given to claiming that Kennedy had turned

toward the TSBD when the throat bullet struck. The NEW YORK

TIMES reported that on December 5, 1963, the FBI conducted a

reconstruction in Dallas based on the assumption that the throat

wound was an entrance wound. The TIMES reported that a

"competent source" had explained that "the President had turned

to his right to wave, and was struck at that moment" (Lifton 65).

--------------------------------------------------------------

About the Author: Michael T. Griffith is a two-time graduate of

the Defense Language Institute in Monterey, California, and is

the author of four books on Mormonism and ancient texts. His

articles on the assassination have appeared in THE ASSASSINATION

CHRONICLES, in the JFK-DEEP POLITICS QUARTERLY, in DALLAS '63,

and in DATELINE: DALLAS. He is also the author of the book

COMPELLING EVIDENCE: A NEW LOOK AT THE ASSASSINATION OF PRESIDENT

KENNEDY (Grand Prarie, TX: JFK-Lancer Productions and

Publications, 1996).

Bibliography

------------

Groden, Robert and Harrison Edward Livingstone, HIGH

TREASON: THE ASSASSINATION OF PRESIDENT KENNEDY AND THE NEW

EVIDENCE OF CONSPIRACY, Berkley Edition, New York: Berkley

Books, 1990.

Lifton, David, BEST EVIDENCE, New York: Carroll & Graf, 1988

Livingstone, Harrison Edward, KILLING KENNEDY AND THE HOAX

OF THE CENTURY, New York: Carroll & Graf Publishers, 1995.

-----, KILLING THE TRUTH: DECEIT AND DECEPTION IN THE JFK

CASE, New York: Carroll & Graf Publishers, 1993.

Meagher, Sylvia, ACCESSORIES AFTER THE FACT, New York:

Vintage Books edition, 1992.

Weisberg, Harold, NEVER AGAIN: THE GOVERNMENT CONSPIRACY IN

THE JFK ASSASSINATION, New York: Carroll & Graf

Publishers/Richard Gallen, 1995.

[Tony Frank]

This ices it Tony.... Dr. C did not make his comments from viewing the OUTSIDE of the throat or trach but the inside.

It is true that Carrico told the HSCA that he used a laryngoscope to observe a wound in the trachea, and he told Perry about it.

But Perry made it clear to the HSCA that he, Perry, observed the damage when looking directly at the wound while performing the tracheotomy. I have attached Perry's HSCA testimony and it is obvious that he cut into the bullet wound and observed damage by doing so.

And let us not forget that Perry knew he would have to do something about the damage if they could take care of the head wound. And he would have to retrieve the bullet that he assumed entered JFK's chest. A small trach incision would not suffice.

Edited January 8, 2011 by Tony Frank

[Tony Frank]

Does anyone agree that Perry's HSCA testimony in my previous post shows that he saw the damage when he made the trach incision?

[Thomas H. Purvis]

Much has been said of the large trach incision that appears in the autopsy photos. CTs often say it indicates body mutilation in an effort to remove a bullet. I personally believe the photos have been doctored to support the claim of shots from behind and the body looked the same at Parkland and Bethesda.

But about the seemingly large incision from the tracheotomy, I have something to suggest.

Perry thought the throat wound was an entrance wound and a bullet entered the President's chest. Could it be that without thinking he made the incision larger to get a better look at the damage from the bullet?

The tracheotomy had to be immediately performed, but Perry certainly knew that after dealing with the head wound, they would need to do something about the bullet that entered the President's throat. A small trach incision would not suffice in that regard.

I believe Dr. McClelland has claimed that the trach incision in the photos is consistent with what he saw at Parkland. So you could be on to something... For whatever reason, Perry made a large incision...

"For whatever reason, Perry made a large incision"

And, as with most other aspects of the assassination (& medical evidence), the answer is not only simple, but is also fully within the public domain as well.

Perhaps Mark Knight; Gary Mack; or John McAdams would care to explain it.

Actually, about 5,000 subscribers to the George County Times newspaper could explain it to you and not even truly know what they were talking about.

[David Josephs]

Does anyone agree that Perry's HSCA testimony in my previous post shows that he saw the damage when he made the trach incision?

As I continued to search around for somehting that would show what a "normal" tracheotomy would look like I find in EVERY CASE a much larger opening than the 2-3cms that Perry claims... They couldn't do what they were doing with only a 2-3cm opening or see what he saw.

This diagram is the best I've found to illustrate the point. It's not just "cut it open and stick a tube in"

Seems to me from all I've researched about this, the incision we see in F1 may have opened a little but based on this diagram it even looks as if the opening is much larger than the tube which should allow for Perry to see inside rather easily.

Tony, since you have Perry's HCSA testimony handy, is there a more full explanation of what he did to prepare the throat for the trachestomy?

thanks

DJ

[David Josephs]

Does anyone agree that Perry's HSCA testimony in my previous post shows that he saw the damage when he made the trach incision?

As I continued to search around for somehting that would show what a "normal" tracheotomy would look like I find in EVERY CASE a much larger opening than the 2-3cms that Perry claims... They couldn't do what they were doing with only a 2-3cm opening or see what he saw.

This diagram is the best I've found to illustrate the point. It's not just "cut it open and stick a tube in"

Seems to me from all I've researched about this, the incision we see in F1 may have opened a little but based on this diagram it even looks as if the opening is much larger than the tube which should allow for Perry to see inside rather easily.

Tony, since you have Perry's HCSA testimony handy, is there a more full explanation of what he did to prepare the throat for the trachestomy?

thanks

DJ