PARKLAND MEMORIAL HOSPITAL
The Race to the Hospital
In the final instant of the assassination, the Presidential motorcade began a race to Parkland Memorial Hospital, approximately 4 miles from the Texas School Book Depository Building.[C2-177] On receipt of the radio message from Kellerman to the lead car that the President had been hit, Chief of Police Curry and police motorcyclists at the head of the motorcade led the way to the hospital.[C2-178] Meanwhile, Chief Curry ordered the police base station to notify Parkland Hospital that the wounded President was en route.[C2-179] The radio log of the Dallas Police Department shows that at 12:30 p.m. on November 22 Chief Curry radioed, “Go to the hospital—Parkland Hospital. Have them stand by.” A moment later Curry added, “Looks like the President has been hit. Have Parkland stand by.” The base station replied, “They have been notified.”[C2-180] Traveling at speeds estimated at times to be up to 70 or 80 miles per hour down the Stemmons Freeway and Harry Hines Boulevard, the Presidential limousine arrived at the emergency entrance of the Parkland Hospital at about 12:35 p.m.[C2-181] Arriving almost simultaneously were the President’s followup car, the Vice President’s automobile, and the Vice President’s followup car. Admiral Burkley, the President’s physician, arrived at the hospital “between 3 and 5 minutes following the arrival of the President,” since the riders in his car “were not exactly aware what had happened” and the car went on to the Trade Mart first.[C2-182]
When Parkland Hospital received the notification, the staff in the emergency area was alerted and trauma rooms 1 and 2 were prepared.[C2-183] These rooms were for the emergency treatment of acutely ill or injured patients.[C2-184] Although the first message mentioned an injury only to President Kennedy, two rooms were prepared.[C2-185] As the President’s limousine sped toward the hospital, 12 doctors rushed to the emergency area: surgeons, Drs. Malcolm O. Perry, Charles R. Baxter, Robert N. McClelland, Ronald C. Jones; the chief neurologist, Dr. William Kemp Clark; 4 anesthesiologists, Drs. Marion T. Jenkins, Adolph H. Giesecke, Jr., Jackie H. Hunt, Gene C. Akin; a urological surgeon, Dr Paul C. Peters; an oral surgeon, Dr. Don T. Curtis; and a heart specialist, Dr. Fouad A. Bashour.[C2-186]
Upon arriving at Parkland Hospital, Lawson jumped from the lead car and rushed into the emergency entrance, where he was met by hospital staff members wheeling stretchers out to the automobile.[C2-187] Special Agent Hill removed his suit jacket and covered the President’s head and upper chest to prevent the taking of photographs.[C2-188] Governor Connally, who had lost consciousness on the ride to the hospital, regained consciousness when the limousine stopped abruptly at the emergency entrance. Despite his serious wounds, Governor Connally tried to get out of the way so that medical help could reach the President. Although he was reclining in his wife’s arms, he lurched forward in an effort to stand upright and get out of the car, but he collapsed again. Then he experienced his first sensation of pain, which became excruciating.[C2-189] The Governor was lifted onto a stretcher and taken into trauma room 2.[C2-190] For a moment, Mrs. Kennedy refused to release the President, whom she held in her lap, but then Kellerman, Greer, and Lawson lifted the President onto a stretcher and pushed it into trauma room 1.[C2-191]
Treatment of President Kennedy
The first physician to see the President at Parkland Hospital was Dr. Charles J. Carrico, a resident in general surgery.[C2-192] Dr. Carrico was in the emergency area, examining another patient, when he was notified that President Kennedy was en route to the hospital.[C2-193] Approximately 2 minutes later, Dr. Carrico saw the President on his back, being wheeled into the emergency area.[C2-194] He noted that the President was blue-white or ashen in color; had slow, spasmodic, agonal respiration without any coordination; made no voluntary movements; had his eyes open with the pupils dilated without any reaction to light; evidenced no palpable pulse; and had a few chest sounds which were thought to be heart beats.[C2-195] On the basis of these findings, Dr. Carrico concluded that President Kennedy was still alive.[C2-196]
Dr. Carrico noted two wounds: a small bullet wound in the front lower neck, and an extensive wound in the President’s head where a sizable portion of the skull was missing.[C2-197] He observed shredded brain tissue and “considerable slow oozing” from the latter wound, followed by “more profuse bleeding” after some circulation was established.[C2-198] Dr. Carrico felt the President’s back and determined that there was no large wound there which would be an immediate threat to life.[C2-199] Observing the serious problems presented by the head wound and inadequate respiration, Dr. Carrico directed his attention to improving the President’s breathing.[C2-200] He noted contusions, hematoma to the right of the larynx, which was deviated slightly to the left, and also ragged tissue which indicated a tracheal injury.[C2-201] Dr. Carrico inserted a cuffed endotracheal tube past the injury, inflated the cuff, and connected it to a Bennett machine to assist in respiration.[C2-202]
At that point, direction of the President’s treatment was undertaken by Dr. Malcolm O. Perry, who arrived at trauma room 1 a few moments after the President.[C2-203] Dr. Perry noted the President’s back brace as he felt for a femoral pulse, which he did not find.[C2-204] Observing that an effective airway had to be established if treatment was to be effective, Dr. Perry performed a tracheotomy, which required 3 to 5 minutes.[C2-205] While Dr. Perry was performing the tracheotomy, Drs. Carrico and Ronald Jones made cutdowns on the President’s right leg and left arm, respectively, to infuse blood and fluids into the circulatory system.[C2-206] Dr. Carrico treated the President’s known adrenal insufficiency by administering hydrocortisone.[C2-207] Dr. Robert N. McClelland entered at that point and assisted Dr. Perry with the tracheotomy.[C2-208]
Dr. Fouad Bashour, chief of cardiology, Dr. M. T. Jenkins, chief of anesthesiology, and Dr. A. H. Giesecke, Jr., then joined in the effort to revive the President.[C2-209] When Dr. Perry noted free air and blood in the President’s chest cavity, he asked that chest tubes be inserted to allow for drainage of blood and air. Drs. Paul C. Peters and Charles R. Baxter initiated these procedures.[C2-210] As a result of the infusion of liquids through the cutdowns, the cardiac massage, and the airway, the doctors were able to maintain peripheral circulation as monitored at the neck (carotid) artery and at the wrist (radial) pulse. A femoral pulse was also detected in the President’s leg.[C2-211] While these medical efforts were in progress, Dr. Clark noted some electrical activity on the cardiotachyscope attached to monitor the President’s heart responses.[C2-212] Dr. Clark, who most closely observed the head wound, described a large, gaping wound in the right rear part of the head, with substantial damage and exposure of brain tissue, and a considerable loss of blood.[C2-213] Dr. Clark did not see any other hole or wound on the President’s head. According to Dr. Clark, the small bullet hole on the right rear of the President’s head discovered during the subsequent autopsy “could have easily been hidden in the blood and hair.”[C2-214]
In the absence of any neurological, muscular, or heart response, the doctors concluded that efforts to revive the President were hopeless.[C2-215] This was verified by Admiral Burkley, the President’s physician, who arrived at the hospital after emergency treatment was underway and concluded that “my direct services to him at that moment would have interfered with the action of the team which was in progress.”[C2-216] At approximately 1 p.m., after last rites were administered to the President by Father Oscar L. Huber, Dr. Clark pronounced the President dead. He made the official determination because the ultimate cause of death, the severe head injury, was within his sphere of specialization.[C2-217] The time was fixed at 1 p.m., as an approximation, since it was impossible to determine the precise moment when life left the President.[C2-218] President Kennedy could have survived the neck injury, but the head wound was fatal.[C2-219] From a medical viewpoint, President Kennedy was alive when he arrived at Parkland Hospital; the doctors observed that he had a heart beat and was making some respiratory efforts.[C2-220] But his condition was hopeless, and the extraordinary efforts of the doctors to save him could not help but to have been unavailing.
Since the Dallas doctors directed all their efforts to controlling the massive bleeding caused by the head wound, and to reconstructing an airway to his lungs, the President remained on his back throughout his medical treatment at Parkland.[C2-221] When asked why he did not turn the President over, Dr. Carrico testified as follows:
A. This man was in obvious extreme distress and any more thorough inspection would have involved several minutes—well, several—considerable time which at this juncture was not available. A thorough inspection would have involved washing and cleansing the back, and this is not practical in treating an acutely injured patient. You have to determine which things, which are immediately life threatening and cope with them, before attempting to evaluate the full extent of the injuries.
Q. Did you ever have occasion to look at the President’s back?
A. No, sir. Before—well, in trying to treat an acutely injured patient, you have to establish an airway, adequate ventilation and you have to establish adequate circulation. Before this was accomplished the President’s cardiac activity had ceased and closed cardiac massage was instituted, which made it impossible to inspect his back.
Q. Was any effort made to inspect the President’s back after he had expired?
A. No, sir.
Q. And why was no effort made at that time to inspect his back?
A. I suppose nobody really had the heart to do it.[C2-222]
Moreover, the Parkland doctors took no further action after the President had expired because they concluded that it was beyond the scope of their permissible duties.[C2-223]
Treatment of Governor Connally
While one medical team tried to revive President Kennedy, a second performed a series of operations on the bullet wounds sustained by Governor Connally.[C2-224] Governor Connally was originally seen by Dr. Carrico and Dr. Richard Dulany.[C2-225] While Dr. Carrico went on to attend the President, Dr. Dulany stayed with the Governor and was soon joined by several other doctors.[C2-226] At approximately 12:45 p.m., Dr. Robert Shaw, chief of thoracic surgery, arrived at trauma room 2, to take charge of the care of Governor Connally, whose major wound fell within Dr. Shaw’s area of specialization.[C2-227]
Governor Connally had a large sucking wound in the front of the right chest which caused extreme pain and difficulty in breathing. Rubber tubes were inserted between the second and third ribs to reexpand the right lung, which had collapsed because of the opening in the chest wall.[C2-228] At 1:35 p.m., after Governor Connally had been moved to the operating room, Dr. Shaw started the first operation by cutting away the edges of the wound on the front of the Governor’s chest and suturing the damaged lung and lacerated muscles.[C2-229] The elliptical wound in the Governor’s back, located slightly to the left of the Governor’s right armpit approximately five-eighths inch (a centimeter and a half) in its greatest diameter, was treated by cutting away the damaged skin and suturing the back muscle and skin.[C2-230] This operation was concluded at 3:20 p.m.[C2-231]
Two additional operations were performed on Governor Connally for wounds which he had not realized he had sustained until he regained consciousness the following day.[C2-232] From approximately 4 p.m. to 4:50 p.m. on November 22, Dr. Charles F. Gregory, chief of orthopedic surgery, operated on the wounds of Governor Connally’s right wrist, assisted by Drs. William Osborne and John Parker.[C2-233] The wound on the back of the wrist was left partially open for draining, and the wound on the palm side was enlarged, cleansed, and closed. The fracture was set, and a cast was applied with some traction utilized.[C2-234] While the second operation was in progress, Dr. George T. Shires, assisted by Drs. Robert McClelland, Charles Baxter, and Ralph Don Patman, treated the gunshot wound in the left thigh.[C2-235] This punctuate missile wound, about two-fifths inch in diameter (1 centimeter) and located approximately 5 inches above the left knee, was cleansed and closed with sutures; but a small metallic fragment remained in the Governor’s leg.[C2-236]
Vice President Johnson at Parkland
As President Kennedy and Governor Connally were being removed from the limousine onto stretchers, a protective circle of Secret Service agents surrounded Vice President and Mrs. Johnson and escorted them into Parkland Hospital through the emergency entrance.[C2-237] The agents moved a nurse and patient out of a nearby room, lowered the shades, and took emergency security measures to protect the Vice President.[C2-238] Two men from the President’s followup car were detailed to help protect the Vice President. An agent was stationed at the entrance to stop anyone who was not a member of the Presidential party. U.S. Representatives Henry B. Gonzalez, Jack Brooks, Homer Thornberry, and Albert Thomas joined Clifton C. Carter and the group of special agents protecting the Vice President.[C2-239] On one occasion Mrs. Johnson, accompanied by two Secret Service agents, left the room to see Mrs. Kennedy and Mrs. Connally.[C2-240]
Concern that the Vice President might also be a target for assassination prompted the Secret Service agents to urge him to leave the hospital and return to Washington immediately.[C2-241] The Vice President decided to wait until he received definitive word of the President’s condition.[C2-242] At approximately 1:20 p.m., Vice President Johnson was notified by O’Donnell that President Kennedy was dead.[C2-243] Special Agent Youngblood learned from Mrs. Johnson the location of her two daughters and made arrangements through Secret Service headquarters in Washington to provide them with protection immediately.[C2-244]
When consulted by the Vice President, O’Donnell advised him to go to the airfield immediately and return to Washington.[C2-245] It was decided that the Vice President should return on the Presidential plane rather than on the Vice-Presidential plane because it had better communication equipment.[C2-246] The Vice President conferred with White House Assistant Press Secretary Malcolm Kilduff and decided that there would be no release of the news of the President’s death until the Vice President had left the hospital.[C2-247] When told that Mrs. Kennedy refused to leave without the President’s body, the Vice President said that he would not leave Dallas without her.[C2-248] On the recommendation of the Secret Service agents, Vice President Johnson decided to board the Presidential airplane, Air Force One, and wait for Mrs. Kennedy and the President’s body.[C2-249]
Secret Service Emergency Security Arrangements
Immediately after President Kennedy’s stretcher was wheeled into trauma room 1, Secret Service agents took positions at the door of the small emergency room. A nurse was asked to identify hospital personnel and to tell everyone, except necessary medical staff members, to leave the emergency room. Other Secret Service agents posted themselves in the corridors and other areas near the emergency room. Special Agent Lawson made certain that the Dallas police kept the public and press away from the immediate area of the hospital.[C2-250] Agents Kellerman and Hill telephoned the head of the White House detail, Gerald A. Behn, to advise him of the assassination. The telephone line to Washington was kept open throughout the remainder of the stay at the hospital.[C2-251]
Secret Service agents stationed at later stops on the President’s itinerary of November 22 were redeployed. Men at the Trade Mart were driven to Parkland Hospital in Dallas police cars.[C2-252] The Secret Service group awaiting the President in Austin were instructed to return to Washington.[C2-253] Meanwhile, the Secret Service agents in charge of security at Love Field started to make arrangements for departure. As soon as one of the agents learned of the shooting, he asked the officer in charge of the police detail at the airport to institute strict security measures for the Presidential aircraft, the airport terminal, and the surrounding area. The police were cautioned to prevent picture taking. Secret Service agents working with police cleared the areas adjacent to the aircraft, including warehouses, other terminal buildings and the neighboring parking lots, of all people.[C2-254] The agents decided not to shift the Presidential aircraft to the far side of the airport because the original landing area was secure and a move would require new measures.[C2-255]
When security arrangements at the airport were complete, the Secret Service made the necessary arrangements for the Vice President to leave the hospital. Unmarked police cars took the Vice President and Mrs. Johnson from Parkland Hospital to Love Field. Chief Curry drove one automobile occupied by Vice President Johnson, U.S. Representatives Thomas and Thornberry, and Special Agent Youngblood. In another car Mrs. Johnson was driven to the airport accompanied by Secret Service agents and Representative Brooks. Motorcycle policemen who escorted the automobiles were requested by the Vice President and Agent Youngblood not to use sirens. During the drive Vice President Johnson, at Youngblood’s instruction, kept below window level.[C2-256]
Removal of the President’s Body
While the team of doctors at Parkland Hospital tried desperately to save the life of President Kennedy, Mrs. Kennedy alternated between watching them and waiting outside.[C2-257] After the President was pronounced dead, O’Donnell tried to persuade Mrs. Kennedy to leave the area, but she refused. She said that she intended to stay with her husband.[C2-258] A casket was obtained and the President’s body was prepared for removal.[C2-259] Before the body could be taken from the hospital, two Dallas officials informed members of the President’s staff that the body could not be removed from the city until an autopsy was performed. Despite the protests of these officials, the casket was wheeled out of the hospital, placed in an ambulance, and transported to the airport shortly after 2 p.m.[C2-260] At approximately 2:15 p.m. the casket was loaded, with some difficulty because of the narrow airplane door, onto the rear of the Presidential plane where seats had been removed to make room.[C2-261] Concerned that the local officials might try to prevent the plane’s departure, O’Donnell asked that the pilot take off immediately. He was informed that takeoff would be delayed until Vice President Johnson was sworn in.[C2-262]