Mr. SPECTER. It is fine.
Dr. PERRY. It is based on rank and experience, essentially. For
example, Dr. Carrico being the senior surgical resident in the area,
at the time President Kennedy was brought in to the emergency suite,
would have done what we felt was necessary and would have assumed
control of the situation being as there were interns and probably
medical students around the area, but being senior would take it. This,
of course, catapulted me into this because I was the senior attending
staff man when I arrived and at that time Dr. Carrico has noted I took
over direction of the care since I was senior of all the people there
and being as we are surgeons, the department of surgery operates that
portion of the emergency room and directs the care of the patients.
Mr. DULLES. Did you try to clear the room of unnecessary people?
Dr. PERRY. This was done, not by me, but by the nurse supervisor,
I assume, but several of the people were asked to leave the room.
Generally, this is not necessary. In an instance such as this, it is a
little more difficult, as you can understand.
Mr. DULLES. Yes.
Dr. PERRY. But this care of an acutely injured and acutely injured
patients goes on quite rapidly. Over 90,000 a year go through that
emergency room, and, as a result, people are well trained in the
performance of their duties. There is generally no problem in asking
anyone to leave the room because everyone is quite busy and they know
what they have to do and are proceeding to do it.
Mr. DULLES. Thank you very much.
Mr. SPECTER. Upon your arrival in the room, where President Kennedy was
situated, what did you observe as to his condition?
Dr. PERRY. At the time I entered the door, Dr. Carrico was attending
him. He was attaching the Bennett apparatus to an endotracheal tube in
place to assist his respiration.
The President was lying supine on the carriage, underneath the
overhead lamp. His shirt, coat, had been removed. There was a sheet
over his lower extremities and the lower portion of his trunk. He was
unresponsive. There was no evidence of voluntary motion. His eyes were
open, deviated up and outward, and the pupils were dilated and fixed.
I did not detect a heart beat and was told there was no blood pressure
obtainable.
He was, however, having ineffective spasmodic respiratory efforts.
There was blood on the carriage.
Mr. DULLES. What does that mean to the amateur, to the unprofessional?
Dr. PERRY. Short, rather jerky contractions of his chest and diaphragm,
pulling for air.
Mr. DULLES. I see.
Mr. SPECTER. Were those respiratory efforts on his part alone or was he
being aided in his breathing at that time?
Dr. PERRY. He had just attached the machine and at this point it was
not turned on. He was attempting to breathe.
Mr. SPECTER. So that those efforts were being made at that juncture at
least without mechanical aid?
Dr. PERRY. Those were spontaneous efforts on the part of the President.
Mr. SPECTER. Will you continue, then, Dr. Perry, as to what you
observed of his condition?
Dr. PERRY. Yes, there was blood noted on the carriage and a large
avulsive wound on the right posterior cranium.
I cannot state the size, I did not examine it at all. I just noted the
presence of lacerated brain tissue. In the lower part of the neck below
the Adams apple was a small, roughly circular wound of perhaps 5 mm. in
diameter from which blood was exuding slowly.