The testimony of Dr. Robert Nelson McClelland was taken on March
21, 1964, at Parkland Memorial Hospital, Dallas, Tex., by Mr. Arlen
Specter, assistant counsel of the President's Commission.
Mr. SPECTER. Will you raise your right hand?
Dr. McCLELLAND. Yes.
Mr. SPECTER. Do you solemnly swear that the testimony you give in these
proceedings will be the truth, the whole truth, and nothing but the
truth, so help you God?
Dr. McCLELLAND. I do.
Mr. SPECTER. Dr. McClelland, the purpose of this proceeding is to
take your deposition in connection with an investigation which is
being conducted by the President's Commission on the Assassination
of President Kennedy, and the specific purpose of our requesting you
to answer questions relates to the topic of the medical care which
President Kennedy received at Parkland Memorial Hospital.
Dr. McClelland, will you tell us your full name for the record, please?
Dr. McCLELLAND. Robert Nelson McClelland.
Mr. SPECTER. Have you received a letter from the Commission which
enclosed a copy of the Executive order creating the Commission, and a
copy of the Congressional Resolution pertaining to the Commission, and
a copy of the procedures for taking testimony under the Commission?
Dr. McCLELLAND. Yes.
Mr. SPECTER. And is it satisfactory with you to answer these questions
for us today, even though you haven't had the 3 days between the time
of the receipt of the letter and today?
Dr. McCLELLAND. Yes.
Mr. SPECTER. What is your profession, Doctor?
Dr. McCLELLAND. I am a doctor of medicine.
Mr. SPECTER. Would you outline briefly your educational background,
starting with your graduation from college, please?
Dr. McCLELLAND. Since graduation from college I attended medical
school at the University of Texas, medical branch in Galveston, Tex.,
and received the M.D. degree from that school in 1954. I then went to
Kansas City, Kans., where I did a rotating internship at the University
of Kansas Medical Center from June 1954 to June 1955. Following that
period I was a general medical officer in the Air Force for 2 years
in Germany, and subsequent to my release from active duty, I became
a general surgery resident at Parkland Memorial Hospital in Dallas
in August of 1957. I remained at Parkland from that date to August
1959, at which time I entered private practice for ten months, and
then reentered my general surgery training program at Parkland in June
1960. I completed my 4 years of general surgical training in June 1962.
Following that time I became a full-time instructor of surgery on the
staff of the University of Texas, Southwestern Medical School, and I am
at the present time an associate professor of surgery at that school.
Mr. SPECTER. Dr. McClelland, in connection with your duties at Parkland
Hospital, or before, have you had any experience with gunshot wounds?
Dr. McCLELLAND. Yes.
Mr. SPECTER. Where in your background did you acquire that experience?
Dr. McCLELLAND. Largely during residency training and subsequent to
that in my capacity here on the staff.
Mr. SPECTER. And what has provided the opportunity for your experience
here at Parkland in residency training and on the staff with respect to
acquiring knowledge of gunshot wounds?
Dr. McCLELLAND. Largely this has been related to the type of hospital
which Parkland is; namely, City-County Hospital which receives all
of the indigent patients of this county, many of whom are involved
frequently in shooting altercations, so that we do see a large number
of that type patient almost daily.
Mr. SPECTER. Could you approximate for me the total number of gunshot
wounds which you have had an opportunity to observe?
Dr. McCLELLAND. I would estimate that it would be in excess of 200.
Mr. SPECTER. What was your duty assignment back on November 22, 1963?
Dr. McCLELLAND. At that time I was showing a film on surgical
techniques to a group of students and residents on the second floor of
Parkland Hospital in the surgical suite, where I was notified of the
fact that President Kennedy was being brought to the Parkland emergency
room after having been shot.
Mr. SPECTER. And what action, if any, did you take following that
notification?
Dr. McCLELLAND. Immediately upon hearing that, I accompanied the
Resident, Dr. Crenshaw, who brought this news to me, to the emergency
room, and down to the trauma room 1 where President Kennedy had been
taken immediately upon arrival.
Mr. SPECTER. And approximately what time did you arrive in Emergency
Room 1?
Dr. McCLELLAND. This is a mere approximation, but I would approximate
or estimate, rather, about 12:40.
Mr. SPECTER. And who was present, if anyone, at the time of your
arrival?
Dr. McCLELLAND. At the time I arrived, Dr. Perry--would you like the
full names of all these?
Mr. SPECTER. That would be fine, I would appreciate that.
Dr. McCLELLAND. Dr. Malcolm Perry, Dr. Charles Baxter, Dr. Charles
Crenshaw, Dr. James Carrico, Dr. Paul Peters.
Mr. SPECTER. Were they all present at the time you arrived?
Dr. McCLELLAND. They were not present when I arrived.
Mr. SPECTER. Will you start with the ones who were present?
Dr. McCLELLAND. Starting with the ones who were present, I'm sorry,
the ones who were present when I arrived were Drs. Carrico, Perry and
Baxter. The others I mentioned arrived subsequently or about the same
time that I did.
Mr. SPECTER. Then, what other doctors, if any, arrived after you did,
in addition to those whom you have already mentioned?
Dr. McCLELLAND. In addition, the ones that arrived afterwards, were Dr.
Kenneth Salyer.
Mr. SPECTER. S-a-l-y-e-r?
Dr. McCLELLAND. S-a-l-y-e-r, Dr. Fouad, F-o-u-a-d Bashour, Dr. Donald
Seldin----
Mr. SPECTER. S-e-l-d-i-n?
Dr. McCLELLAND. S-e-l-d-i-n--I believe that's all.
Mr. SPECTER. What did you observe as to President Kennedy's condition
at that time?
Dr. McCLELLAND. Well, on initially coming into the room and inspecting
him from a distance of only 2 or 3 feet as I put on a pair of surgical
gloves, it was obvious that he had sustained a probably mortal head
injury, and that his face was extremely swollen and suffused with blood
appeared cyanotic----
Mr. SPECTER. "Cyanotic"--may I interrupt--just what do you mean by that
in lay terms?
Dr. McCLELLAND. This mean bluish discoloration, bluish-black
discoloration of the tissue. The eyes were somewhat protuberant,
which is usually seen after massive head injuries denoting increased
intracranial pressure, and it seemed that he perhaps was not making, at
the time at least, spontaneous respiratory movements, but was receiving
artificial respiration from a machine, an anesthesia machine.
Mr. SPECTER. Who was operating that machine?
Dr. McCLELLAND. The machine--there was a changeover, just as I came
in, one of the doctors in the room, I don't recall which one, had been
operating what we call an intermittent positive pressure breathing
machine.
Mr. SPECTER. Had that machine been utilized prior to your arrival?
Dr. McCLELLAND. It was in use as I arrived, yes, and about the same
time I arrived--this would be one other doctor who came in the
room that I forgot about--Dr. Jenkins, M. T. Jenkins, professor of
anesthesiology, came into the room with a larger anesthesia machine,
which is a better type machine with which to maintain control of
respiration, and this was then attached to the tube in the President's
tracheotom; anyway, respiratory movements were being made for him with
these two machines, which were in the process of being changed when I
came in.
Then, as I took my post to help with the tracheotomy, I was standing at
the end of the stretcher on which the President was lying, immediately
at his head, for purposes of holding a tracheotom, or a retractory in
the neck line.
Mr. SPECTER. What did you observe, if anything, as to the status of the
neck wound when you first arrived?
Dr. McCLELLAND. The neck wound, when I first arrived, was at this time
converted into a tracheotomy incision. The skin incision had been made
by Dr. Perry, and he told me--although I did not see that--that he had
made the incision through a very small, perhaps less than one quarter
inch in diameter wound in the neck.
Mr. SPECTER. Do you recall whether he described it any more precisely
than that?
Dr. McCLELLAND. He did not at that time.
Mr. SPECTER. Has he ever described it any more precisely for you?
Dr. McCLELLAND. He has since that time.
Mr. SPECTER. And what description has he given of it since that time?
Dr. McCLELLAND. As well as I can recall, the description that he gave
was essentially as I have just described, that it was a very small
injury, with clear cut, although somewhat irregular margins of less
than a quarter inch in diameter, with minimal tissue damage surrounding
it on the skin.
Mr. SPECTER. Now, was there anything left for you to observe of that
bullet wound, or had the incision obliterated it?
Dr. McCLELLAND. The incision had obliterated it, essentially, the skin
portion, that is.
Mr. SPECTER. Before proceeding to describe what you did in connection
with the tracheostomy, will you more fully describe your observation
with respect to the head wound?
Dr. McCLELLAND. As I took the position at the head of the table that
I have already described, to help out with the tracheotomy, I was in
such a position that I could very closely examine the head wound, and I
noted that the right posterior portion of the skull had been extremely
blasted. It had been shattered, apparently, by the force of the shot so
that the parietal bone was protruded up through the scalp and seemed to
be fractured almost along its right posterior half, as well as some of
the occipital bone being fractured in its lateral half, and this sprung
open the bones that I mentioned in such a way that you could actually
look down into the skull cavity itself and see that probably a third or
so, at least, of the brain tissue, posterior cerebral tissue and some
of the cerebellar tissue had been blasted out. There was a large amount
of bleeding which was occurring mainly from the large venous channels
in the skull which had been blasted open.
Mr. SPECTER. Was he alive at the time you first saw him?
Dr. McCLELLAND. I really couldn't say, because as I mentioned in the
hectic activity--I really couldn't say what his blood pressure was or
what his pulse was or anything of that sort. The only thing I could say
that would perhaps give evidence--this is not vital activity--at most,
is that maybe he made one or two spontaneous respiratory movements but
it would be difficult to say, since the machine was being used on him,
whether these were true spontaneous respirations or not.
Mr. SPECTER. Would you now describe the activity and part that you
performed in the treatment which followed your arrival?
Dr. McCLELLAND. Yes; as I say, all I did was simply assist Dr. Perry
and Dr. Baxter in doing the tracheotomy. All three of us worked
together in making an incision in the neck, tracting the neck muscles
out of the way, and making a small opening into the trachea near the
spot where the trachea had already been blasted or torn open by the
fragment of the bullet, and inserting a large metal tracheotomy tube
into this hole, and after this the breathing apparatus was attached to
this instead of the previous tube which had been placed here.
Mr. SPECTER. In conducting that operation, did you observe any interior
damage to the President?
Dr. McCLELLAND. Yes.
Mr. SPECTER. Will you describe that for me, please?
Dr. McCLELLAND. That damage consisted mainly of a large amount of
contusion and hematoma formation in the tissue lateral to the right
side of the trachea and the swelling and bleeding around this site
was to such extent that the trachea was somewhat deviated to the left
side, not a great deal, but to a degree at least that it required
partial cutting of some of the neck muscles in order to get good enough
exposure to put in the tracheotomy tube, but there was a good deal of
soft tissue damage and damage to the trachea itself where apparently
the missile had gone between the trachea on the right side and the
strap muscles which were applied closely to it.
Mr. SPECTER. What other treatment was given to President Kennedy at the
time you were performing the procedures you have just described?
Dr. McCLELLAND. To the best of my knowledge, the other treatment had
consisted of the placement of cutdown sites in his extremities, namely,
the making of incisions over large veins in the arms and, I believe, in
the leg; however, I'm not sure about that, since I was not paying too
much attention to that part of the activity, and large plastic tubes
were placed into these veins for the giving of blood and fluids, and
as I recall, he received a certain amount of blood, but I don't know
exactly how much, since I was not actually giving the blood.
In addition to that, of course, while we were working on the
tracheotomy incision, the other physicians that I have mentioned were
attaching the President rapidly to a cardiac monitor, that is to say,
an electrocardiogram, for checking the presence of cardiac activity,
and in addition, chest tubes were being placed in the right and left
chest--both, as I recall.
Mr. SPECTER. Do you recall who was placing those tubes?
Dr. McCLELLAND. One of the tubes, I believe, was placed by Dr. Peters.
The other one, I'm not right certain, I don't really recall--I perhaps
better not say.
Mr. SPECTER. Do you know about how long that took in placing those
chest tubes?
Dr. McCLELLAND. As well as I am aware, the tubes were both placed in.
What this involves is simply putting a trocar, a large hollow tube, and
that is put into the small incision, into the anterior chest wall and
slipping the tube into the chest between a group of ribs for purposes
of relieving any collection of air or fluid which is present in the
lungs. The reason this was done was because it was felt that there was
probably quite possibly a mediastinal injury with perhaps suffusion of
blood and air into one or both pleural cavities.
Mr. SPECTER. What effect did this medical treatment have on President
Kennedy?
Dr. McCLELLAND. As near as we could tell, unfortunately, none. We felt
that from the time we saw him, most of us agreed, all of us agreed
rather, that this was a mortal wound, but that in spite of this feeling
that all attempts possible should be made to revive him, as far as
establishing the airway breathing for him, and replacing blood and what
not, but unfortunately the loss of blood and the loss of cerebral and
cerebellar tissues were so great that the efforts were of no avail.
Mr. SPECTER. Was he conscious at that time that you saw him?
Dr. McCLELLAND. No.
Mr. SPECTER. And, at what time did he expire?
Dr. McCLELLAND. He was pronounced dead at 1 p.m. on November 22.
Mr. SPECTER. What was the cause of death in your opinion?
Dr. McCLELLAND. The cause of death, I would say, would be massive head
injuries with loss of large amounts of cerebral and cerebellar tissues
and massive blood loss.
Mr. SPECTER. Did you observe anything in the nature of a wound on his
body other than that which you have already described for me?
Dr. McCLELLAND. No.
Mr. SPECTER. In what position was President Kennedy maintained from the
time you saw him until the pronouncement of death?
Dr. McCLELLAND. On his back on the cart.
Mr. SPECTER. On his what?
Dr. McCLELLAND. On his back on the stretcher.
Mr. SPECTER. Was he on the stretcher at all times?
Dr. McCLELLAND. Yes.
Mr. SPECTER. In the trauma room No. 1 you described, is there any table
onto which he could be placed from the stretcher?
Dr. McCLELLAND. No; generally we do not move patients from the
stretcher until they are ready to go into the operating room and then
they are moved onto the operating table.
Mr. SPECTER. Well, in fact, was he left on the stretcher all during the
course of these procedures until he was pronounced dead?
Dr. McCLELLAND. That's right.
Mr. SPECTER. Then, at any time was he positioned in a way where you
could have seen the back of his body?
Dr. McCLELLAND. No.
Mr. SPECTER. Did you observe any gunshot wound on his back?
Dr. McCLELLAND. No.
Mr. SPECTER. Have you had discussions with the other doctors who
attended President Kennedy as to the possible nature of the wound which
was inflicted on him?
Dr. McCLELLAND. Yes.
Mr. SPECTER. And what facts did you have available either to you or to
the other doctors whom you talked this over with, with respect to the
nature of the wound, source of the wounds, and that sort of thing?
Dr. McCLELLAND. Immediately we had essentially no facts. We knew
nothing of the number of bullets that had supposedly been fired.
We knew nothing of the site from which the bullet had been fired,
essentially none of the circumstances in the first few minutes, say, 20
or 30 minutes after the President was brought in, so that our initial
impressions were based upon extremely incomplete information.
Mr. SPECTER. What were your initial impressions?
Dr. McCLELLAND. The initial impression that we had was that perhaps the
wound in the neck, the anterior part of the neck, was an entrance wound
and that it had perhaps taken a trajectory off the anterior vertebral
body and again into the skull itself, exiting out the back, to produce
the massive injury in the head. However, this required some straining
of the imagination to imagine that this would happen, and it was much
easier to explain the apparent trajectory by means of two bullets,
which we later found out apparently had been fired, than by just one
then, on which basis we were originally taking to explain it.
Mr. SPECTER. Through the use of the pronoun "we" in your last answer,
to whom do you mean by "we"?
Dr. McCLELLAND. Essentially all of the doctors that have previously
been mentioned here.
Mr. SPECTER. Did you observe the condition of the back of the
President's head?
Dr. McCLELLAND. Well, partially; not, of course, as I say, we did not
lift his head up since it was so greatly damaged. We attempted to avoid
moving him any more than it was absolutely necessary, but I could see,
of course, all the extent of the wound.
Mr. SPECTER. You saw a large opening which you have already described?
Dr. McCLELLAND. I saw the large opening which I have described.
Mr. SPECTER. Did you observe any other wound on the back of the head?
Dr. McCLELLAND. No.
Mr. SPECTER. Did you observe a small gunshot wound below the large
opening on the back of the head?
Dr. McCLELLAND. No.
Mr. SPECTER. Based on the experience that you have described for us
with gunshot wounds and your general medical experience, would you
characterize the description of the wound that Dr. Perry gave you as
being a wound of entrance or a wound of exit, or was the description
which you got from Dr. Perry and Dr. Baxter and Dr. Carrico who were
there before, equally consistent with whether or not it was a wound of
entrance or a wound of exit, or how would you characterize it in your
words?
Dr. McCLELLAND. I would say it would be equally consistent with either
type wound, either an entrance or an exit type wound. It would be quite
difficult to say--impossible.
Mr. SPECTER. Dr. McClelland, I show you now a statement or a report
which has been furnished to the Commission by Parkland Hospital and
has been identified in a previous Commission hearing as Commission
Exhibit No. 392, and I direct your attention specifically to a page,
"Third Report", which was made by you, and I would ask you first of all
if this is your signature which appears at the bottom of Page 2, and
next, whether in fact you did make this report and submit it to the
authorities at Parkland Hospital?
Dr. McCLELLAND. Yes.
Mr. SPECTER. And are all the facts set forth true and correct to the
best of your knowledge, information and belief?
Dr. McCLELLAND. To the best of my knowledge, yes.
Mr. SPECTER. Dr. McClelland, did you and I sit down together for just a
few minutes before I started to take your deposition today?
Dr. McCLELLAND. Yes, sir.
Mr. SPECTER. And I discussed this matter with you?
Dr. McCLELLAND. Yes.
Mr. SPECTER. And, during the course of our conversations at that time,
did we cover the same material in question form here and to which you
have responded in answer form with the court reporter here today?
Dr. McCLELLAND. Yes.
Mr. SPECTER. And has the information which you have given me on the
record been the same as that which you gave me off of the record in
advance?
Dr. McCLELLAND. Yes.
Mr. SPECTER. Do you have any interest, Dr. McClelland in reading your
testimony over or signing it at the end, or would you be willing to
waive any such signature of the testimony?
Dr. McCLELLAND. I would be willing to waive my signature.
Mr. SPECTER. Thank you so much for coming and giving us your deposition
today.
Dr. McCLELLAND. All right, thank you.