Dr. Shaw. No.
Mr. Specter. Is there anything else on diagram 4 which would be helpful by way of elaborating that which appeared on diagram 2?
Dr. Shaw. No.
Mr. Specter. Now as to the treatment or operative procedure which you performed on Governor Connally, would you now describe what you did for him?
Dr. Shaw. As soon as anesthesia had been established and an endotracheal tube was in place so that respiration could be controlled with positive pressure, the large occlusive dressing which had been applied in the emergency room was removed. This permitted better inspection of the wound of exit, air passed to and fro through the damaged chest wall, there was obvious softening of the bony framework of the chest wall as evidenced by exaggerated motion underneath the skin along the line of the trajectory of the missile.
The skin of the chest wall axilla and back were thoroughly cleaned and aseptic solution was applied for further cleaning of the skin, the whole area was draped so as to permit access to both the wound of exit and the entrance wound. Temporarily, the wound of entrance was covered with a sterile towel.
First an elliptical incision was made to remove the ragged edges of the wound of exit. This incision was then extended laterally and upward in a curved direction so as to not have the incision through the skin and subcutaneous tissue directly over the line of the trajectory of the bullet where the chest had been softened.
It was found that approximately 10 cm. of the fifth rib had been shattered and the rib fragments acting as secondary missiles had been the major contributing factor to the damage to the anterior chest wall and to the underlying lung.
Mr. Specter. What do you mean, Doctor, by the words "fragments acting as secondary missiles"?
Dr. Shaw. When bone is struck by a high velocity missile it fragments and acts much like bowling pins when they are struck by a bowling ball—they fly in all directions.