Mr. SPECTER. Mrs. Nelson?
Dr. JONES. Nelson.
Mr. SPECTER. Was anyone else present then, other than those whom you
have already mentioned at the time you arrived?
Dr. JONES. There were three nurses there--Mrs. Nelson, Miss Henchliffe
and Miss Bowron.
Mr. SPECTER. And were any other doctors present when you arrived?
Dr. JONES. Dr. Carrico was the only doctor other than possibly Dr.
Dulany, and I do know Dr. Carrico was there when I arrived.
Mr. SPECTER. Was Dr. Don Curtis there when you arrived?
Dr. JONES. I didn't see him.
Mr. SPECTER. And who arrived with you, if you recall?
Dr. JONES. Dr. Perry.
Mr. SPECTER. And what did you observe the President's condition to be
upon your arrival?
Dr. JONES. He appeared to be terminal, if not already expired, and
Dr. Carrico said that he had seen some attempted respirations, agonal
respirations, and with that history, we went ahead with emergency
measures to try to restore the airway.
Mr. SPECTER. When you say "attempted agonal respiration," do you mean
an effort by the President?
Dr. JONES. Yes.
Mr. SPECTER. Or, an effort by someone else to induce respiration?
Dr. JONES. No, these apparently were as Dr. Carrico saw the President
was attempting to respire on his own, however, I did not personally see
this in the brief seconds that I stood there before I went ahead and
started work.
Mr. SPECTER. What is the lay definition for agonal respiration?
Dr. JONES. These are the respirations that are somewhat of a strain,
that is, seen in a patient who is expiring--just very short, irregular
type respirations.
Mr. SPECTER. Would you continue now to describe what you observed to be
the President's condition?
Dr. JONES. We felt that he was in extreme shock, merely by the fact
that there was no motion, that he was somewhat cyanotic, his eyes
were--appeared to be fixed; there was no evidence of motion of the
eyes; and we noticed that he did not have a satisfactory airway or
was not breathing on his own in a satisfactory way to sustain life so
that we felt that either an endotracheal tube had to be instituted
immediately, which was done by Dr. Carrico. We felt that this was not
adequate and since tracheotomy equipment was in the room, we felt that
he would profit more by tracheotomy and that we could be certain that
he was getting adequate oxygen.
Mr. SPECTER. What was done with respect to applying oxygen to the
President then?
Dr. JONES. Well, a tracheotomy was done, and then an adapter was fitted
to this tube, and we had an anesthesia machine there by this time with
Dr. Jenkins available so that he could give him straight oxygen from
the machine.
Mr. SPECTER. Did you observe anything else with respect to the
President's condition at that time?
Dr. JONES. You mean as far as wounds--that he had?
Mr. SPECTER. Did you observe any wounds?
Dr. JONES. As we saw him the first time, we noticed that he had a small
wound at the midline of the neck, just above the suprasternal notch,
and this was probably no greater than a quarter of an inch in greatest
diameter, and that he had a large wound in the right posterior side of
the head.
Mr. SPECTER. When you say "we noticed," whom do you mean by that?
Dr. JONES. Well, Dr. Perry and I were the two that were there at this
time observing.
Mr. SPECTER. Did Dr. Perry make any comment about the nature of the
wound at that time? Either wound?
Dr. JONES. Not that I recall.
Mr. SPECTER. Will you describe as precisely as you can the nature of
the head wound?
Dr. JONES. There was large defect in the back side of the head as the
President lay on the cart with what appeared to be some brain hanging
out of this wound with multiple pieces of skull noted next with the
brain and with a tremendous amount of clot and blood.
Mr. SPECTER. Will you describe as precisely as you can the wound that
you observed in the throat?
Dr. JONES. The wound in the throat was probably no larger than a
quarter of an inch in diameter. There appeared to be no powder burn
present, although this could have been masked by the amount of blood
that was on the head and neck, although there was no obvious amount
of powder present. There appeared to be a very minimal amount of
disruption of interruption of the surrounding skin. There appeared to
be relatively smooth edges around the wound, and if this occurred as a
result of a missile, you would have probably thought it was a missile
of very low velocity and probably could have been compatible with a
bone fragment of either--probably exiting from the neck, but it was a
very small, smooth wound.
Mr. SPECTER. Did you notice any lump in the throat area?
Dr. JONES. No; I didn't.
Mr. SPECTER. Was there any blood on the throat area in the vicinity of
the wound which you have described of the throat?
Dr. JONES. Not a great deal of blood, as if in relation to the amount
that was around the head--not too much.
Mr. SPECTER. What further action was taken by the medical team in
addition to that which you have described on the tracheotomy?
Dr. JONES. Well, as Dr. Perry started the tracheotomy, I started the
cut down in the left arm to insert a large polyethylene catheter, to
give an I.V. so that we could give I.V. solutions as well as blood,
and at the same time another doctor or two were doing some cutdowns
in the lower extremities around the ankle. We made the cutdown in
the left arm in the cephalic vein very rapidly and I.V. fluids were
started immediately and as I was doing this, Dr. Perry was performing
the tracheotomy, and it was about this time that Dr. Baxter came in
and went ahead to assist Dr. Perry with the tracheotomy, and as they
made a deeper incision in the neck to isolate the trachea, they thought
they saw some gush of air and the possibility of a pneumothorax on
one side or the other was entertained, and since I was to the left of
the President, I went ahead and put in the anterior chest tube in the
second intercostal space.
Mr. SPECTER. Was that tube fully inserted, Doctor?
Dr. JONES. I felt that the tube was fully inserted, and this was
immediately connected to underwater drainage.
Mr. SPECTER. What do you mean by "connected to underwater drainage",
Dr. Jones?
Dr. JONES. The tube is connected to a bottle whereby it aerates in
the chest from a pneumothorax and as the patient breathes, the air is
forced out under the water and produces somewhat of a suction so that
the lung will reexpand and will not stay collapsed and this will give
adequate aeration to the body, and we decided to go ahead and put in a
chest tube on the opposite side; since I could not reach the opposite
side due to the number of people that were working on the President.
Dr. Baxter was over there helping Dr. Perry on that side, as well as
Dr. Paul Peters, the assistant head of urology here, and the three of
us then inserted the chest tube on the right side, primarily done by
Dr. Baxter and Dr. Peters on the right side.
Mr. SPECTER. Then what other treatment, if any, was afforded President
Kennedy?
Dr. JONES. After the tracheotomy was done, the intravenous fluid, blood
was started--I believe that the President was also administered some
hydrocortisone because of his history of adrenal insufficiency, and
at this time an electrocardiogram had been connected and it showed no
evidence of a heartbeat. Closed cardiac massage was then first begun by
Dr. Perry and then I believe that after about 5 minutes no significant
or no myocardial activity was present and he was pronounced dead.
Mr. SPECTER. What history did you refer to of President Kennedy's
adrenal insufficiency?
Dr. JONES. As I recall, there had been in news that the President
had several years ago been on some type of steroid therapy and that
he possibly had Addison's disease. We had no documented evidence
that he did or did not, but caution was taken nonetheless in case his
insufficiency was of severe enough nature, because at the time of
severe trauma a patient with adrenal insufficiency often goes into
a rapid degree of adrenal insufficiency and can expire from lack of
steroids being produced from the adrenal gland in such a stressed
situation.
Mr. SPECTER. Did you obtain that history from Mrs. Kennedy, or any
other person on the scene?
Dr. JONES. No.
Mr. SPECTER. You just relied upon what had been occurring in the news?
Dr. JONES. Yes.
Mr. SPECTER. What would that reaction cause, if anything, if the
President had no adrenal insufficiency?
Dr. JONES. This would not cause severe effects on any organ at all if
the adrenal gland were producing enough steroids.
Mr. SPECTER. Did any other doctors arrive during the time this
treatment was going on, other than those whom you have already
mentioned?
Dr. JONES. Several doctors did subsequently appear in the room--Dr.
McClelland appeared shortly after Dr. Baxter, within a matter of
just a very few minutes, as well as Dr. Kemp Clark, who is head of
neurosurgery here.
Mr. SPECTER. Any other doctors?
Dr. JONES. Dr. Jenkins was there and I think these are primarily
the ones that actually had any part, as far as taking care of the
President, although there were some other doctors in the room.
Mr. SPECTER. Dr. Jones, I now hand you a report which purports to bear
your signature, labeled "Summary of treatment of the President," dated
November 23, 1963, which I shall now ask the Court Reporter to mark as
Dr. Jones' Exhibit No. 1.
(Instrument mentioned marked by the Reporter as Dr. Jones' Exhibit No.
1, for identification.)
Mr. SPECTER. I ask you if this in fact is your signature?
Dr. JONES. Yes.
Mr. SPECTER. And I ask you if this was the report which you submitted
concerning your participation of the treatment of President Kennedy?
Dr. JONES. Yes; it was.
Mr. SPECTER. In this report, Dr. Jones, you state the following,
"Previously described severe skull and brain injury was noted as well
as a small hole in anterior midline of the neck thought to be a bullet
entrance wound." What led you to the thought that it was a bullet
entrance wound, sir?
Dr. JONES. The hole was very small and relatively clean cut, as you
would see in a bullet that is entering rather than exiting from a
patient. If this were an exit wound, you would think that it exited at
a very low velocity to produce no more damage than this had done, and
if this were a missile of high velocity, you would expect more of an
explosive type of exit wound, with more tissue destruction than this
appeared to have on superficial examination.
Mr. SPECTER. Would it be consistent, then, with an exit wound, but of
low velocity, as you put it?
Dr. JONES. Yes; of very low velocity to the point that you might think
that this bullet barely made it through the soft tissues and just
enough to drop out of the skin on the opposite side.
Mr. SPECTER. What is your experience, Doctor, if any, in the treatment
of bullet wounds?
Dr. JONES. During our residency here we have approximately 1 complete
year out of the 4 years on the trauma service here, and this is in
addition to the 2 months that we spend every other day and every
other night in the emergency room during our first year, so that we
see a tremendous number of bullet wounds here in that length of time,
sometimes as many as four and five a night.
Mr. SPECTER. Have you ever had any formal training in bullet wounds?
Dr. JONES. No.
Mr. SPECTER. Have you ever had occasion to observe a bullet wound which
was inflicted by a missile at approximate size of a 6.5 mm. bullet
which passed through the body of a person and exited from a neck
without striking anything but soft tissue from the back through the
neck, where the missile came from a weapon of the muzzle velocity of
2,000 feet per second, and the victim was in the vicinity of 160 to 250
feet from the weapon?
Dr. JONES. No; I have not seen a missile of this velocity exit in the
anterior portion of the neck. I have seen it in other places of the
body, but not in the neck.
Mr. SPECTER. What other places in the body have you seen it, Dr. Jones?
Dr. JONES. I have seen it in the extremity and here it produces a
massive amount of soft tissue destruction.
Mr. SPECTER. Is that in the situation of struck bone or not struck bone
or what?
Dr. JONES. Probably where it has struck bone.
Mr. SPECTER. In a situation where it strikes bone, however, the bone
becomes so to speak a secondary missile, does it not, in accentuating
the soft tissue damage?
Dr. JONES. Yes.
Mr. SPECTER. Dr. Jones, did you have any speculative thought as to
accounting for the point of wounds which you observed on the President,
as you thought about it when you were treating the President that day,
or shortly thereafter?
Dr. JONES. With no history as to the number of times that the President
had been shot or knowing the direction from which he had been shot, and
seeing the wound in the midline of the neck, and what appeared to be an
exit wound in the posterior portion of the skull, the only speculation
that I could have as far as to how this could occur with a single wound
would be that it would enter the anterior neck and possibly strike a
vertebral body and then change its course and exit in the region of the
posterior portion of the head. However, this was--there was some doubt
that a missile that appeared to be of this high velocity would suddenly
change its course by striking, but at the present--at that time, if I
accounted for it on the basis of one shot, that would have been the way
I accounted for it.
Mr. SPECTER. And would that account take into consideration the
extensive damage done to the top of the President's head?
Dr. JONES. If this were the course of the missile, it
probably--possibly could have accounted for it, although I would
possibly expect it to do a tremendous amount of damage to the vertebral
column that it hit and if this were a high velocity missile would also
think that the entrance wound would probably be larger than the one
that was present at the time we saw it.
Mr. SPECTER. Did you observe whether or not there was any damage to the
vertebral column?
Dr. JONES. No, we could not see this.
Mr. SPECTER. Did you discuss this theory with any other doctor or
doctors?
Dr. JONES. Yes; this was discussed after the assassination.
Mr. SPECTER. With whom?
Dr. JONES. With Dr. Perry--is the only one that I recall specifically,
and that was merely as to how many times the President was shot,
because even immediately after death, within a matter of 30 minutes,
the possibility of a second gunshot wound was entertained and that
possibly he had been shot more than once.
Mr. SPECTER. Did you observe any wound on the President's back?
Dr. JONES. No.
Mr. SPECTER. Was the President ever turned over?
Dr. JONES. Not while I was in the room.
Mr. SPECTER. What was he on when you first saw him?
Dr. JONES. He was on an emergency room cart, which is on wheels and
can be changed to varying heights and also varying positions, as far
as elevating the head or elevating the feet, lowering the head and so
forth.
Mr. SPECTER. Was he ever taken off that cart from the time he was
brought into the emergency room to the time he was pronounced to be
dead?
Dr. JONES. No.
Mr. SPECTER. Doctor, are you working toward board certification at this
time?
Dr. JONES. Yes.
Mr. SPECTER. And what is your status on your progress with that,
generally?
Dr. JONES. I will finish my formal training in surgery in July of this
year, which will complete 5 years of general surgery residency.
Mr. SPECTER. How old are you at the present time, Dr. Jones?
Dr. JONES. Thirty-one.
Mr. SPECTER. Have you discussed this matter with any representatives of
the Federal Government prior to today?
Dr. JONES. Yes, I believe the Secret Service has been here on at least
two occasions.
Mr. SPECTER. And what did they ask you on those occasions?
Dr. JONES. I think, primarily, to verify that what I had written was
true and that I had been one of the first doctors to be in the room
with the President.
Mr. SPECTER. Did they ask you anything else other than that?
Dr. JONES. On one occasion they asked if there were any other pieces
of paper that had been written on as to the care that had been
administered to the President that I had not turned in, and I told them
"No."
Mr. SPECTER. And did you and I sit down and talk for a few minutes
before we went on the record in this deposition, with me indicating to
you the general purpose and the line of questioning, and you setting
forth the same information which we have put on the record here today?
Dr. JONES. Yes, sir.
Mr. SPECTER. Do you have anything to add which you think might be
helpful to the Commission in any way?
Dr. JONES. No, sir.
Mr. SPECTER. That concludes the deposition. Thank you very much, Dr.
Jones.
Dr. JONES. All right.