Part 7

Mr. SPECTER. Now, you have just characterized it in that last answer as an entrance wound.

Dr. McCLELLAND. Well, perhaps I shouldn't say the wound anyway, not the entrance wound--that might be a slip of the tongue.

Mr. SPECTER. Do you have a firm opinion at this time as to whether it is an entrance wound or exit wound or whatever?

Dr. McCLELLAND. Of course, my opinion now would be colored by everything that I've heard about it and seen since, but I'll say this, if I were simply looking at the wound again and had seen the wound in its unchanged state, and which I did not, and, of course, as I say, it had already been opened up by the tracheotomy incision when I saw the wound--but if I saw the wound in its state in which Dr. Perry described it to me, I would probably initially think this were an entrance wound, knowing nothing about the circumstances as I did at the time, but I really couldn't say--that's the whole point. This would merely be a calculated guess, and that's all, not knowing anything more than just seeing the wound itself.

Mr. SPECTER. But did you, in fact, see the wound prior to the time the incision was made?

Dr. McCLELLAND. No.

Mr. SPECTER. So that any preliminary thought you had even, would be based upon what you had been told by Dr. Perry?

Dr. McCLELLAND. That's right.

Mr. SPECTER. Now, did you tell Mr. Dudman of the St. Louis Post Dispatch that you did not in fact see the wound in the neck, but your only information of it came from what Dr. Perry had told you?

Dr. McCLELLAND. I don't recall whether I told him that or not. I really don't remember whether I said I had seen the wound myself or whether I was merely referring to our sort of collective opinion of it, or whether I told him I had not seen the wound and was merely going by Dr. Perry's report of it to me. I don't recall now, this far away in time exactly what I said to him.

Mr. SPECTER. Dr. McClelland, I want to ask you a few additional questions, and some of these questions may duplicate questions which I asked you last Saturday, and the reason for that is, we have not yet had a chance to transcribe the deposition of last Saturday, so I do not have before me the questions I asked you at that time and the answers you gave, and since last Saturday I have taken the depositions of many, many doctors on the same topics, so it is not possible for me to be absolutely certain of the specific questions which I asked you at that time, but permit me to ask you one or several more questions on the subject.

First, how many bullets do you think were involved in inflicting the wounds on President Kennedy which you observed?

Dr. McCLELLAND. At the present time, you mean, or at the immediate moment?

Mr. SPECTER. Well, take the immediate moment and then the present time.

Dr. McCLELLAND. At the moment, of course, it was our impression before we had any other information from any other source at all, when we were just confronted with the acute emergency, the brief thoughts that ran through our minds were that this was one bullet, that perhaps entered through the front of the neck and then in some peculiar fashion which we really had, as I mentioned the other day, to strain to explain to ourselves, had coursed up the front of the vertebra and into the base of the skull and out the rear of the skull.

This would have been a very circuitous route for the bullet to have made, so that when we did find later on what the circumstances were surrounding the assassination, this was much more readily explainable to ourselves that the two wounds were made by two separate bullets.

Mr. SPECTER. And what is your view or opinion today as to how many bullets inflicted the injuries of President Kennedy?

Dr. McCLELLAND. Two.

Mr. SPECTER. Now, what would be the reason for your changing your opinion in that respect?

Dr. McCLELLAND. Oh, just simply the later reports that we heard from all sources, of all the circumstances surrounding the assassination. Certainly no further first-hand information came to me and made me change my mind in that regard.

Mr. SPECTER. Dr. McClelland, let me ask you to assume a few additional facts, and based on a hypothetical situation which I will put to you and I'll ask you for an opinion.

Assume, if you will, that President Kennedy was shot on the upper right posterior thorax just above the upper border of the scapula at a point 14 cm. from the tip of the right acromion process and 14 cm. below a tip of the right mastoid process, assume further that that wound of entry was caused by a 6.5-mm. missile shot out of a rifle having a muzzle velocity of approximately 2,000 feet per second, being located 160 to 250 feet away from President Kennedy, that the bullet entered on the point that I described on the President's back, passed between two strap muscles on the posterior aspect of the President's body and moved through the fascial channel without violating the pleura cavity, and exited in the midline lower third anterior portion of the President's neck, would the hole which Dr. Perry described to you on the front side of the President's neck be consistent with the hole which such a bullet might make in such a trajectory through the President's body?

Dr. McCLELLAND. Yes; I think so.

Mr. SPECTER. And what would your reasoning be for thinking that that would be a possible hole of exit on those factors as I have outlined them to you?

Dr. McCLELLAND. Well, I think my reasoning would be basically that the missile was traveling mainly through soft tissue, rather than exploding from a bony chamber and that by the time it reached the neck that it had already lost, because of the distance from which it was fired, even though the muzzle velocity was as you stated--would have already lost a good deal of its initial velocity and kinetic strength and therefore would have perhaps made, particularly, if it were a fragment of the bullet as bullets do sometimes fragment, could have made a small hole like this in exiting. It certainly could have done that.

Mr. SPECTER. What would have happened then to the other portion of the bullet if it had fragmented?

Dr. McCLELLAND. It might have been left along, or portions of it along the missile track--sometimes will be left scattered up and down this. Other fragments will maybe scatter in the wound and sometimes there will be multiple fragments and sometimes maybe only a small fragment out of the main bullet, sometimes a bullet will split in half--this is extremely difficult for me to say just what would happen in a case like that.

Mr. SPECTER. Well, assuming this situation--that the bullet did not fragment, because the autopsy report shows no fragmentation, that is, it cannot show the absence of fragmentation, but we do know that there were no bullets left in the body at any point, so that no fragment is left in.

Dr. McCLELLAND. I think even then you could make the statement that this wound could have resulted from this type bullet fired through this particular mass of soft tissue, losing that much velocity before it exited from the body. Where you would expect to see this really great hole that is left behind would be, for instance, from a very high velocity missile fired at close range with a heavy caliber bullet, such as a .45 pistol fired at close range, which would make a small entrance hole, relatively, and particularly if it entered some portion of the anatomy such as the head, where there was a sudden change in density from the brain to the skull cavity, as it entered. As it left the body, it would still have a great deal of force behind it and would blow up a large segment of tissue as it exited. But I don't think the bullet of this nature fired from that distance and going through this large area of homogenous soft tissue would necessarily make the usual kind of exit wound like I just described, with a close range high velocity heavy caliber bullet.

This is why it would be difficult to say with certainty as has been implied in some newspaper articles that quoted me, that you could tell for sure that this was an entrance or an exit wound. I think this was blown up a good deal.

Mr. SPECTER. Dr. McClelland, why wasn't the President's body turned over?

Dr. McCLELLAND. The President's body was not turned over because the initial things that were done as in all such cases of extreme emergency are to first establish an airway and second, to stop hemorrhage and replace blood, so that these were the initial things that were carried out immediately without taking time to do a very thorough physical examination, which of course would have required that these other emergency measures not be done immediately.

Mr. SPECTER. Did you make any examination of the President's back at all?

Dr. McCLELLAND. No.

Mr. SPECTER. Was any examination of the President's back made to your knowledge?

Dr. McCLELLAND. Not here--no.

Mr. SPECTER. Do you have anything to add which you think might be helpful in any way to the Commission?

Dr. McCLELLAND. No; I think not except again to emphasize perhaps that some of our statements to the press about the nature of the wound may have been misleading, possibly--probably because of our fault in telling it in such a way that they misinterpreted our certainty of being able to tell entrance from exit wounds, which as we say, we generally can make an educated guess about these things but cannot be certain about them. I think they attributed too much certainty to us about that.

Mr. SPECTER. Now, have you talked to anyone from the Federal Government about this matter since I took your deposition last Saturday?

Dr. McCLELLAND. No.

Mr. SPECTER. And did you and I chat for a moment or two with my showing you this translation of "L' Express" prior to the time we went on the record here?

Dr. McCLELLAND. Yes.

Mr. SPECTER. And is the information which you gave to me in response to my questions the same that we put on the record here?

Dr. McCLELLAND. To the best of my knowledge--yes.

Mr. SPECTER. Thank you very much, Dr. McClelland.

Dr. McCLELLAND. All right. Thank you.

TESTIMONY OF DR. CHARLES RUFUS BAXTER

The testimony of Dr. Charles Rufus Baxter was taken at 11:15 a.m., on March 24, 1964, at Parkland Memorial Hospital, Dallas, Tex., by Mr. Arlen Specter, assistant counsel of the President's Commission.

Mr. SPECTER. May the record show that Dr. Charles Baxter is present in response to a letter requesting him to appear and give his deposition. For the record I shall state that the President's Commission on the Assassination of President Kennedy is investigating all facets of the shooting, including the medical treatment performed on President Kennedy.

Dr. Baxter has been asked to give a deposition on his participation in connection with the care and medical treatment of President Kennedy, and with that statement of purpose, would you please stand up, Dr. Baxter, and raise your right hand.

Do you solemnly swear the testimony you give before the President's Commission in the course of this deposition proceeding will be the truth, the whole truth and nothing but the truth, so help you God?

Dr. BAXTER. I do.

Mr. SPECTER. Would you state your full name, please?

Dr. BAXTER. Charles Rufus Baxter.

Mr. SPECTER. What is your profession, sir?

Dr. BAXTER. I am a medical doctor of surgery, general surgeon.

Mr. SPECTER. Will you outline briefly your educational background?

Dr. BAXTER. University of Texas--1948 through 1950. Southwestern Medical School, 1950 through 1954, 1955 straight medicine internship, 1956 medicine residency--internal medicine residency. 1956 through 1958, surgical research at Brooke Army Medical Center, 1958 through 1964--surgical residency, and 1964 through the present--this is 1964, I got out of the Army--in 1958, 1958 through 1962--surgery residency, and 1962 until now, assistant professor of surgery.

Mr. SPECTER. And are you board certified, Doctor?

Dr. BAXTER. Yes.

Mr. SPECTER. And what boards have you passed?

Dr. BAXTER. The American Board of Surgeons.

Mr. SPECTER. And what year were you so certified?

Dr. BAXTER. 1963.

Mr. SPECTER. And what is your specific title at the medical school?

Dr. BAXTER. Assistant professor of surgery.

Mr. SPECTER. Did you have occasion to aid in the treatment of President Kennedy at Parkland Hospital?

Dr. BAXTER. Yes.

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. Approximately what time did you arrive at the emergency room?

Dr. BAXTER. I think it was 12:40--thereabouts.

Mr. SPECTER. And who was present at that time?

Dr. BAXTER. Dr. Carrico and Dr. Jones and Dr. Jenkins--several nurses.

Mr. SPECTER. Can you identify the nurses?

Dr. BAXTER. Yes; Mrs. Nelson--and who else? There were two or three others whose names--Miss Henchliffe was there.

Mr. SPECTER. Miss Bowron?

Dr. BAXTER. Who?

Mr. SPECTER. Was Miss Bowron there?

Dr. BAXTER. Yes; I believe so.

Mr. SPECTER. Were any other nurses there?

Dr. BAXTER. One or two more, but I'm not sure of their names.

Mr. SPECTER. Can you identify any other doctors who were there at that time?

Dr. BAXTER. Oh, let's see--I'm not sure whether the others came before or after I did. There was Crenshaw, Peters, and Kemp Clark, Dr. Bashour finally came. I believe Jackie Hunt--yes--she was, I believe she was the anesthesiologist who came.

Mr. SPECTER. Was Dr. Don Curtis there?

Dr. BAXTER. I'm not sure--I just don't remember.

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. In what way was his breathing being assisted?

Dr. BAXTER. With an anesthesia machine.

Mr. SPECTER. Would you continue to describe what you observed as to his condition?

Dr. BAXTER. There were no pulses that I could feel present. The anesthesiologist told me that he did still have a heartbeat.

Mr. SPECTER. Who is that who said that 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. Who performed the tracheotomy?

Dr. BAXTER. Dr. Perry and myself, with the assistance of Dr. McClelland, and I believe that's all--there may have been one more person that held the retractor.

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. Did the priest then arrive to perform the last rites?

Dr. BAXTER. Yes.

Mr. SPECTER. At what time was he pronounced dead?

Dr. BAXTER. As I recall, it was 1:08, I'm not sure, it may have been that that was Oswald.

Mr. SPECTER. But it was approximately 1 o'clock? Then, could the time of death be fixed with any precision?

Dr. BAXTER. I don't think so--the time elapsing in all of this resuscitation and the time the heart actually ceased, I don't think one could be very sure of it. It was sometime between a quarter to 1 and 1 o'clock.

Mr. SPECTER. Have you now described all of the efforts which were made to save the life of the President?

Dr. BAXTER. Only with the exception, I think, of the fluids that were administered. He was given hydrocortisone because of his previous medical condition. He was given no negative blood because the blood loss was rather fierce and, I believe that's all.

Mr. SPECTER. What other doctors arrived during the course of the treatment, in addition to those whom you have already mentioned?

Dr. BAXTER. I don't recall--I know that there were more doctors present in the room, but their names, I'm not sure of. The reason I'm not sure is because we had some of the same crew and a different crew on the Governor and on Oswald, and I'm afraid that I've gotten them mixed up.

Mr. SPECTER. Now, will you describe in as much particularity as you can the nature of the head wound?

Dr. BAXTER. The only wound that I actually saw--Dr. Clark examined this above the manubrium of the sternum, the sternal notch. This wound was in temporal parietal plate of bone laid outward to the side and there was a large area, oh, I would say 6 by 8 or 10 cm. of lacerated brain oozing from this wound, part of which was on the table and made a rather massive blood loss mixed with it and around it.

Mr. SPECTER. Did you notice any bullet hole below that large opening at the top of the head?

Dr. BAXTER. No; I personally did not.

Mr. SPECTER. Will you describe with as much particularity as you can the wound which you noticed on the President's neck?

Dr. BAXTER. The wound on the neck was approximately an inch and a half above the manubrium of the sternum, the sternal notch. This wound was in my estimation, 4 to 5 mm. in widest diameter and was a spherical wound. The edges of it--the size of the wound is measured by the hole plus the damaged skin around the area, so that it was a very small wound. And, it was directly in the midline. Now, this wound was excised in the performance of the tracheotomy and on the entry into the deeper tissues of the neck, there was considerable contusion of the muscles of the anterior neck and a moderate amount of bleeding around the trachea. The trachea was deviated slightly, I believe, to the left.

Our tracheotomy incision was made in the second tracheal ring which was immediately above the area of damage--where we thought the damaged area of the trachea was, which we did not dissect out, but once the endrotracheal tube was placed, the tracheotomy tube was placed into the trachea, it was below this tear in the trachea, and gave us good control or perfect control of respiration.

Mr. SPECTER. Were the characteristics of the wound on the neck sufficient to enable you to form an opinion with reasonable medical certainty as to what was the cause of the hole?

Dr. BAXTER. Well, the wound was, I think, compatible with a gunshot wound. It did not appear to be a jagged wound such as one would expect with a very high velocity rifle bullet. We could not determine, or did not determine at that time whether this represented an entry or an exit wound. Judging from the caliber of the rifle that we later found or become acquainted with, this would more resemble a wound of entry. However, due to the density of the tissues of the neck and depending upon what a bullet of such caliber would pass through, the tissues that it would pass through on the way to the neck, I think that the wound could well represent either exit or entry wound.

Mr. SPECTER. Assuming some factors in addition to those which you personally observed, Dr. Baxter, what would your opinion be if these additional facts were present: First, the President had a bullet wound of entry on the right posterior thorax just above the upper border of the scapula with the wound measuring 7 by 4 mm. in oval shape, being 14 cm. from the tip of the right acromion process and 14 cm. below the tip of the right mastoid process--assume this is the set of facts, that the wound just described was caused by a 6.5 mm. bullet shot from approximately 160 to 250 feet away from the President, from a weapon having a muzzle velocity of approximately 2,000 feet per second, assuming as a third factor that the bullet passed through the President's body, going in between the strap muscles of the shoulder without violating the pleura space and exited at a point in the midline of the neck, would the hole which you saw on the President's throat be consistent with an exit point, assuming the factors which I have just given to you?

Dr. BAXTER. Although it would be unusual for a high velocity missile of this type to cause a wound as you have described, the passage through tissue planes of this density could have well resulted in the sequence which you outline; namely, that the anterior wound does represent a wound of exit.

Mr. SPECTER. What would be the considerations which, in your mind, would make it, as you characterized it, unlikely?

Dr. BAXTER. It would be unlikely because the damage that the bullet would create would be--first its speed would create a shock wave which would damage a larger number of tissues, as in its path, it would tend to strike, or usually would strike, tissues of greater density than this particular missile did and would then begin to tumble and would create larger jagged--the further it went, the more jagged would be the damage that it created; so that ordinarily there would have been a rather large wound of exit.

Mr. SPECTER. But relating the situation as I hypothesized it for you?

Dr. BAXTER. Then it is perfectly understandable that this wound of exit was not of any greater magnitude than it was.

Mr. SPECTER. Dr. Baxter, is there a channel through which the bullet could have passed in the general direction which I have described to you where there would be very few tissues and virtually no tissues of great density?

Dr. BAXTER. Yes; passing through the fascial plane which you have described, it could well not have these things happen to it, so that it would pass directly through--almost as if passing through a sheet of paper and the wound of exit would be no larger than the wound we saw.

Mr. SPECTER. What would the situation there be as to the shock wave which you have heretofore described?

Dr. BAXTER. There would be a large amount of tissue damage which is not ordinarily seen immediately after a bullet has passed through. This is damage that is recognized several days later.

Mr. SPECTER. What causes the shock waves there, Doctor?

Dr. BAXTER. This is just the velocity imparting pressure to surrounding tissues which damages them. It does not show, however, in the early course after a missile has passed through.