Part 8

Mr. SPECTER. Well, would the shock waves have any effect upon the size, and nature of the hole of exit?

Dr. BAXTER. No.

Mr. SPECTER. And if the bullet passed through the fascial plane without striking tissues of great density, would it have a tendency to tumble at all?

Dr. BAXTER. No, it would not.

Mr. SPECTER. What has your experience been, if any, Doctor, with gunshot wounds?

Dr. BAXTER. For the past 6 years--we admit and treat, I would estimate, around 500 gunshot wounds per year--thereabouts.

Mr. SPECTER. Have you ever had any formal training in gunshot wounds?

Dr. BAXTER. Only that I received in the Army, with demonstration of various velocities and that type missile wounds.

Mr. SPECTER. Where was President Kennedy lying when you first saw him, Dr. Baxter?

Dr. BAXTER. On the cart, on the emergency cart in trauma room 1.

Mr. SPECTER. Was he ever taken off of that cart from the time you first saw him until the time he was pronounced dead?

Dr. BAXTER. No.

Mr. SPECTER. Was he ever turned over?

Dr. BAXTER. No.

Mr. SPECTER. Would your examination have been conducted in any different way had this particular victim not been the President of the United States?

Dr. BAXTER. I think--yes--in that we would have, particularly, postmortem examined the body much more carefully than we did. We would certainly have undressed him completely and determined all of the direction of the wounds at the time. This did not seem feasible under the circumstances.

Mr. SPECTER. Why was it not feasible under the circumstances?

Dr. BAXTER. Mrs. Kennedy was in the room, there was a large number of people in the room by that time--Secret Service Agents, the priests and so on. As soon as the President was pronounced dead, the Secret Service more or less--well, requested that we clear the room and leave them with the President's body, which was done. Everything that the Secret Service wished was carried out.

Mr. SPECTER. What was that?

Dr. BAXTER. Everything that the Secret Service asked us to do, we did, as rapidly as possible and this was one of their requests.

In addition, I must say that the emotional condition of all of us at that time was such that probably we would not--we didn't feel that we should do any more, since we were certain that autopsy would take care of all that we were going to miss.

Mr. SPECTER. Did the emotional situation have any effect in your professional opinion on the quality of the medical care which was rendered to the President?

Dr. BAXTER. No; none at all. We, I think, everyone present in the room was certainly emotionally involved in the care of the President, but in no instance did I see less than the most meticulous and best judgment used in the care of the President.

Mr. SPECTER. And what, in your opinion, was the cause of death, Dr. Baxter?

Dr. BAXTER. Gunshot wound to the head.

Mr. SPECTER. Would you have an opinion as to whether or not President Kennedy would have survived the gunshot wound which you observed in the neck?

Dr. BAXTER. We saw no evidence that it had struck anything in the neck that would not be well taken care of by simply--by the tracheotomy and chest tubes.

Mr. SPECTER. Did you find any bullets in the President's body?

Dr. BAXTER. No, we did not.

Mr. SPECTER. Any fragments of bullets in the President's body?

Mr. BAXTER. No, sir.

Mr. SPECTER. Dr. Baxter, I now show you Commission Exhibit 392, which has been heretofore identified in Commission Proceedings as the report from Parkland Memorial Hospital, and I now call your attention to a page which purports to bear your signature, and a written report which you rendered under date of November 22, 1963. I ask you, first of all, if that is your signature?

Dr. BAXTER. Yes.

Mr. SPECTER. And, if this is the report which you submitted?

Dr. BAXTER. Yes.

Mr. SPECTER. Do you have any other writings or notes of any sort concerning your care of President Kennedy?

Dr. BAXTER. No.

Mr. SPECTER. Will you read into the record, Dr. Baxter, the contents of your report, because it is a little hard to read in spots?

Dr. BAXTER. "I was contacted at approximately 12:40 that the President was on the way to the Emergency Room, having been shot. On arrival there, I found an endotracheal tube in place with assisted respirations, a left chest tube being inserted, and cutdowns going in one leg and in the left arm.

The President had a wound in the midline of the neck. On first observation of the remaining wounds, the temporal and parietal bones were missing and the brain was lying on the table with extensive lacerations and contusions. The pupils were fixed and deviated laterally and dilated. No pulse was detectable, respirations were (as noted) being supplemented. A tracheotomy was performed by Dr. Perry and I and a chest tube inserted into the right chest (second interspace anteriorly). Meanwhile, 2 pints of O negative blood was administered by pump without response. When all of these measures were complete, no heartbeat could be detected, closed chest massage was performed until a cardioscope could be attached, which revealed no cardiac activity was obtained.

Due to the extensive and irreparable brain damage which was detected, no further attempt to resuscitate the heart was made."

Mr. SPECTER. And that bears your signature?

Dr. BAXTER. Charles R. Baxter, M.D., assistant professor of surgery, Southwestern Medical School, University of Texas.

Mr. SPECTER. Dr. Baxter, has any representative of the Federal Government ever talked to you about this matter prior to today?

Dr. BAXTER. The only person was a Secret Service Agent about--approximately three weeks ago who asked me if I had any additional written comments anywhere or had made any writings on the medical treatment of the President, and the answer was "No."

Mr. SPECTER. Now, prior to the time that the court reporter started to transcribe my questions and your answers, did you and I briefly discuss this deposition proceeding, its purpose and the questions which I would ask you?

Dr. BAXTER. Yes.

Mr. SPECTER. And are the answers given on the record here the same as you gave me in our brief conversation before the transcription was started?

Dr. BAXTER. Yes.

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

Dr. BAXTER. No.

Mr. SPECTER. Thank you very much for coming, Dr. Baxter.

Dr. BAXTER. Thank you.

TESTIMONY OF DR. MARION THOMAS JENKINS

The testimony of Dr. Marion Thomas Jenkins was taken at 5:30 p.m., on March 25, 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. M. T. Jenkins has appeared in response to a letter request in connection with the inquiry of the President's Commission on the Assassination of President Kennedy, to testify concerning his observations and medical treatment performed by him on President Kennedy, and with this preliminary statement of purpose, would you stand up, please, Dr. Jenkins, and raise your right hand.

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

Dr. JENKINS. I do.

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

Dr. JENKINS. Marion Thomas Jenkins.

Mr. SPECTER. What is your profession, please?

Dr. JENKINS. I'm a physician.

Mr. SPECTER. Are you licensed by the State of Texas to practice medicine?

Dr. JENKINS. Yes.

Mr. SPECTER. And what is your specialty, Dr. Jenkins?

Dr. JENKINS. Anesthesiology.

Mr. SPECTER. Will you outline your educational background for me, please?

Dr. JENKINS. I am a graduate of the University of Texas in 1937. I have a B.A. degree and an M.D. degree from the University of Texas Medical Branch at Galveston in 1940, rotating internship at the University of Kansas Hospital, Kansas City, Kans., 1940-41; Assistant Residency in Internal Medicine, John Sealy Hospital in Galveston, Tex., 1941-42; active duty in the U.S. Navy as a Medical Officer, 1942 to 1946; Resident in Surgery--Parkland Hospital, Dallas, 1946-47; Resident in anesthesiology in the Massachusetts General Hospital, Boston, 1947-48; and Director of the Department of Anesthesiology, Parkland Hospital and Parkland Memorial Hospital, 1948 to the present; Professor and Chairman of the Department of Anesthesiology, University of Texas, Southwestern Medical School--since 1951. Diplomate--other certification, do you want this?

Mr. SPECTER. Yes, what Boards are you certified?

Dr. JENKINS. I am a Diplomate of the American Board of Anesthesiology and also fellow of the American College of Anesthesiologists.

Mr. SPECTER. And what year were you certified by the American Board?

Dr. JENKINS. 1952.

Mr. SPECTER. Did you have occasion to assist in the treatment of President Kennedy on November 22, 1963?

Dr. JENKINS. Yes.

Mr. SPECTER. And will you relate briefly the circumstances surrounding your being called into that case?

Dr. JENKINS. Well, I was in the dining room with other members of the hospital staff when we heard the Chief of Surgery, Dr. Tom Shires, being paged "Stat." This is a rather unusual call, for the Chief of any service to be called "Stat" as this is the emergency call.

Mr. SPECTER. What does that mean, "Stat"?

Dr. JENKINS. "Stat" means emergency, that's just a code word that has been used for years in medical terms. He was paged twice this way, and one of the surgical residents, Dr. Ronald Jones, answered the phone, thinking something bad must be up and that he would call the Chief of Surgery. I was sitting near the telephone and Dr. Jones immediately came back by with a very anguished look and the color was drained from his face--I'm sure I had that impression, and he said, "The President has been shot and is on his way to the hospital." At the same time we heard the sirens of the ambulance as they turned into the driveway from Harry Hines into the hospital drive, and it was obvious that this was the car coming in because the ambulance sirens usually stop in the street, but these came on clear to the building.

Mr. SPECTER. That's Harry Hines Boulevard right in front of the hospital?

Dr. JENKINS. Yes; I ran up the stairs to the Anesthesia Department, that's on the second floor--one floor above the dining room, where I was, and notified two members of the Department, the first two I saw, my Chief Associate, Dr. A. H. Giesecke, Jr., and Dr. Jackie Hunt, that the President had been shot and was being brought to the emergency room and for them to bring all the resuscitative equipment we have including an anesthesia machine. The emergency room is set up well, but we are used to working with our own equipment and I asked them to bring it down and I ran down the back stairs, two flights down, and I arrived in the emergency room just after or right behind him being wheeled in, I guess.

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

Dr. JENKINS. Oh, this was around 12:30-12:35 to 12:40. I shouldn't be indefinite about this--in our own specialty practice, we watch the clock closely, and there are many things we have to keep up with, but I didn't get that time exactly, I'll admit.

Mr. SPECTER. Who was present at the time of your arrival in the emergency room, if anyone?

Dr. JENKINS. The hallway was loaded with people.

Mr. SPECTER. What medical personnel were in attendance?

Dr. JENKINS. Including Mrs. Kennedy, I recognized, and Secret Service men, I didn't know whether to block the way or get out of it, as it turned out. Dr. James Carrico and Dr. Dulany--Dick Dulany, I guess you have his name, and several nurses were in the room.

Mr. SPECTER. Could you identify the nurses?

Dr. JENKINS. Well, not really. I could identify them only having later looked around and identified from my own record that I have, the names of all who were there later. Now, whether they are the same ones when I first went there, I don't know. I have all the names in my report, it seemed to me.

Mr. SPECTER. Could you now identify all of the nurses from your later observations of them?

Dr. JENKINS. Well, I can identify who was in there at the close of the procedure, that is, the doctors, as well as those who were helping.

Mr. SPECTER. Fine, would you do that for us, please?

Dr. JENKINS. These included a Mrs. or Miss Patricia Hutton and Miss Diana Bowron, B-o-w-r-o-n (spelling), and a Miss Henchliffe--I don't know her first name, but I do know it is Henchliffe.

Mr. SPECTER. Margaret?

Dr. JENKINS. Margaret--certainly. Those three--there were probably some student nurses too, whom I didn't recognize. Shall I continue?

Mr. SPECTER. Yes, please. Have you now covered all the people you recollect as being in the room?

Dr. JENKINS. Well, as I came into the room, I saw only the--actually--you know, in the haste of the coming of the President, two doctors whom I recognized, and there were other people and I have identified all I remember.

Mr. SPECTER. What did you observe as to the President's condition when you arrived in the emergency room?

Dr. JENKINS. Well, I was aware of what he was in an agonal state. This is not a too unfamiliar state that we see in the Service, as much trauma as we see, that is, he had the agonal respiratory gasp made up of jerking movements of the mylohyoid group of muscles. These are referred to sometimes as chin jerk, tracheal tug or agonal muscles of respiration. He had this characteristic of respiration. His eyes were opened and somewhat exophthalmic and color was greatly suffused, cyanotic--a purplish cyanosis.

Still, we have patients in the state, as far as cyanosis and agonal type respiration, who are resuscitatable. Of course, you don't stop at this time and think, "Well, this is a hopeless circumstance,"--because one in this state can often be resusciated--this represents the activities prior to one's demise sometimes, and if it can be stopped, such as the patient is oxygenated again and circulation reinstituted, he can be saved.

Dr. Carrico had just introduced an endotracheal tube, I'm very proud of him for this because it's not as easy as it sounds. At times and under the circumstances--it was harder--he had just completed a 3-month rotation on the anesthesiology service, and I thought this represented good background training for a smart individual, and he told me he had a cuff on the endotracheal tube and he introduced it below the wound.

The reason I said this, of course, this is a reflex--there is a tube, the endotracheal tube, if it is pushed down a little too far it can go into the right main stem of the bronchus impairing respiration from both lungs, or both chests.

There was in the room an intermittent positive pressure breathing apparatus, which can be used to respire for a patient. As I connected this up, however, Dr. Carrico and I connected it up to give oxygen by artificial respiration, Dr. Giesecke and Dr. Hunt arrived on the scene with the anesthesia machine and I connected it up instead with something I am more familiar with--not for anesthesia, I must insist on that--it was for the oxygenation, the ability to control ventilation with 100 percent oxygen.

As I came in there, other people came in also. This is my recollection. Now, by this time I was in familiar surroundings, despite the anguish of the circumstance.

Despite the unusual circumstance, in terms of the distinguished personage who was the patient, I think the people who had gathered or who had congregated were so accustomed to doing resuscitative procedures of this nature that they knew where to fit into the resuscitation team without having a preconceived or predirected plan, because, as obviously--some people were doing things not necessarily in their specialty, but there was the opening and there was the necessity for this being done.

There were three others who came in as I did who recognized at once the neck wound, in fact, where the wound was, would indicate that we would have serious pulmonary problems unless a tracheotomy tube was put in. This is one way of avoiding pushing air out through a fractured trachea and down into each chest cavity, which would cause a pneumothorax or a collapse of the lungs. These were doctors Malcolm Perry, Charley Baxter, and Robert McClelland, who with Dr. Carrico's help, I believe, started the tracheotomy.

About this time Drs. Kemp Clark and Paul Peters came in, and Dr. Peters because of the appearance of the right chest, the obvious physical characteristics of a pneumothorax, put in a closed chest drainage--chest tube. Because I felt no peripheral pulse and was not aware of any pulse, I reported this to Dr. Clark and he started closed chest cardiac massage.

There were other people--one which started an I.V. in a cutdown in the right leg and one a cutdown in the left arm. Two of my department connected up the cardioscope, in which we had electrical silence on the cardioscope as Dr. Clark started closed chest massage. That's the sequence of events as I reconstructed them that day and dictated them on my report, which you have here, I think.

Mr. SPECTER. Speaking of your report, Dr. Jenkins, permit me to show you a group of papers heretofore identified as Commission Exhibit No. 392 which has also been identified by Mr. Price, the hospital Administrator, as being photostatic copies of original reports in his possession and controlled as Custodian of Records, and I show you what purports to be a report from you to Mr. Price, dated November 22, 1963, and ask you if in fact this 2-page report was submitted by you to Mr. Price?

Dr. JENKINS. Yes; it was.

Mr. SPECTER. Now, going back to the wound which you observed in the neck, did you see that wound before the tracheotomy was performed?

Dr. JENKINS. Yes; I did, because I was just connecting up the endotracheal tube to the machine at the time and that's when Dr. Carrico said there was a wound in the neck and I looked at it.

Mr. SPECTER. Would you describe that wound as specifically as you can?

Dr. JENKINS. Well, I'm afraid my description of it would not be as accurate, of course, as that of the surgeons who were doing the tracheotomy, because my look was a quick look before connecting up the endotracheal tube to the apparatus to help in ventilation and respiration for the patient, and I was aware later in the day, as I should have put it in the report, that I thought this was a wound of exit because it was not a clean wound, and by "clean" clearly demarcated, round, punctate wound which is the usual wound of an entrance wound, made by a missile and at some speed. Of course, entrance wounds with a lobbing type missile, can make a jagged wound also, but I was of the impression and I recognized I had the impression it was an exit wound. However, my mental appreciation for a wound--for the wound in the neck, I believe, was sort of--was overshadowed by recognition of the wound in the scalp and skull plate.

Mr. SPECTER. Have you now described the wound in the neck as specifically as you can at this moment?

Dr. JENKINS. I believe so.

Mr. SPECTER. Now, will you now describe the wound which you observed in the head?

Dr. JENKINS. Almost by the time I was--had the time to pay more attention to the wound in the head, all of these other activities were under way. I was busy connecting up an apparatus to respire for the patient, exerting manual pressure on the breathing bag or anesthesia apparatus, trying to feel for a pulse in the neck, and then reaching up and feeling for one in the temporal area, seeing about connecting the cardioscope or directing its being connected, and then turned attention to the wound in the head.

Now, Dr. Clark had begun closed chest cardiac massage at this time and I was aware of the magnitude of the wound, because with each compression of the chest, there was a great rush of blood from the skull wound. Part of the brain was herniated; I really think part of the cerebellum, as I recognized it, was herniated from the wound; there was part of the brain tissue, broken fragments of the brain tissue on the drapes of the cart on which the President lay.

Mr. SPECTER. Did you observe any wounds immediately below the massive loss of skull which you have described?

Dr. JENKINS. On the right side?

Mr. SPECTER. Yes, sir.

Dr. JENKINS. No--I don't know whether this is right or not, but I thought there was a wound on the left temporal area, right in the hairline and right above the zygomatic process.

Mr. SPECTER. The autopsy report discloses no such development, Dr. Jenkins.

Dr. JENKINS. Well, I was feeling for--I was palpating here for a pulse to see whether the closed chest cardiac massage was effective or not and this probably was some blood that had come from the other point and so I thought there was a wound there also.

Mr. SPECTER. At approximately what time was President Kennedy pronounced dead?

Dr. JENKINS. Well, this was pronounced, we know the exact time as 1300, according to my watch, at least, at the time.

Mr. SPECTER. And what, in your opinion, was the cause of death?

Dr. JENKINS. Cerebral injury--brain injury.

Mr. SPECTER. Was President Kennedy ever turned over during the course of this treatment at Parkland?

Dr. JENKINS. No.

Mr. SPECTER. Why was he not turned over, Dr. Jenkins?

Dr. JENKINS. Oh, I think this was beyond our prerogative completely. I think as we pronounced the President dead, those in attendance who were there just sort of melted away, well, I guess "melted" is the wrong word, but we felt like we were intruders and left. I'm sure that this was considerably beyond our prerogative, and the facts were we knew he had a fatal wound, and I think my own personal feeling was that this was--would have been meddlesome on anybody's part after death to have done any further search.

Mr. SPECTER. Was any examination of his back made before death, to your knowledge?

Dr. JENKINS. No, no; I'm sure there wasn't.

Mr. SPECTER. Did he remain on the stretcher cart at all times while he was being cared for?

Dr. JENKINS. Yes, sir.

Can I say something that isn't in the report here, or not?

Mr. SPECTER. Yes; let's go off the record a minute.

(Discussion off the record between Counsel Specter and the witness, Dr. Jenkins.)

Mr. SPECTER. May the record show that we are back on the record and Dr. Jenkins has made an interesting observation about the time of the declaration of death, and I will ask you, Dr. Jenkins, for you to repeat for the record what you have just said off the record.

Dr. JENKINS. As the resuscitative maneuvers were begun, such as "chest cardiac massage," there was with each compression of the sternum, a gush of blood from the skull wound, which indicated there was massive vascular damage in the skull and the brain, as well as brain tissue damage, and we recognized by this time that the patient was beyond the point of resuscitation, that he was in fact dead, and this was substantiated by getting a silent electrical pattern on the electrocardiogram, the cardioscope that was connected up.

However, for a period of minutes, but I can't now define exactly, since I didn't put this in a report, after we knew he was dead, we continued attempted resuscitative maneuvers.