Smith, Bennierita^{D} Acquaintance of Oswald Vol. VIII, p. 21.

at Beauregard Junior

High School in New

Orleans.

Smith, Edgar Leon, Member, Dallas Police Vol. VII, p. 565.

Jr.^{D} Department.

Smith, Glenn Emmett^{D} Service Station Vol. X, p. 399.

attendant in Dallas.

Smith, Hilda L.^{A} Employee, Louisiana Vol. XI, p. 474.

Department of Labor,

New Orleans.

Smith, Joe Marshall^{D} Member, Dallas Police Vol. VII, p. 531.

Department.

Smith, John Allison^{D} TV technician, Fort Vol. XIII, p. 277.

Worth.

Smith, William Witness in the vicinity Vol. VII, p. 82.

Arthur^{D} of the Tippit crime

scene.

Snyder, Richard Foreign Service Vol. V, p. 260.

Edward^{C} officer, stationed in

the Embassy in the

Soviet Union 1959-61.

Solomon, James Captain, Dallas Police Vol. XII, p. 87.

Maurice^{D} Department.

Sorrels, Forrest Agent, U.S. Secret Vol. VII, pp. 332,

V.^{DA} Service. 592.

Vol. XIII, p. 55.

Standifer, Roy E.^{D} Member, Dallas Police Vol. XV, p. 614.

Department.

Standridge, Ruth Head nurse of operating Vol. VI, p. 115.

Jeanette^{D} rooms, Parkland

Hospital.

Staples, Albert F.^{A} Dentist at Baylor Vol. XI, p. 210.

University

College of Dentistry.

Statman, Irving^{D} Assistant District Vol. X, p. 149.

Director of Dallas

District, Texas

Employment Commission.

Steele, Charles Hall, Resident of New Orleans Vol. X, p. 62.

Jr.^{D} who assisted Oswald

in distribution of

handbills.

Steele, Charles Hall, Father of Charles Hall Vol. X, p. 71.

Sr.^{D} Steele, Jr.

Steele, Don Francis^{D} Member, Dallas Police Vol. XII, p. 353.

Department.

Stevenson, M. W.^{D} Deputy Chief, Dallas Vol. XII, p. 91.

Police Department. Vol. XV, p. 133.

Stombaugh, Paul Hair and fiber expert, Vol. IV, p. 56.

Morgan^{CA} FBI. Vol. XV, p. 702.

Stovall, Richard S.^{D} Member, Dallas Police Vol. VII, p. 186.

Department.

Stovall, Robert L.^{D} President, Vol. X, p. 167.

Jaggars-Chiles-Stovall,

Dallas, Tex.

Strong, Jesse M.^{D} Employee, Western Union Vol. XIII, p. 284.

Telegraph Co.

Stuckey, William Radio program director, Vol. XI, p. 156.

Kirk^{D} New Orleans.

Studebaker, Robert Member, Dallas Police Vol. VII, p. 137.

Lee^{D} Department.

Surrey, Robert Alan^{C} Publisher of handbill Vol. V, p. 420.

attacking President

Kennedy.

Tague, James Thomas^{D} Witness at Vol. VII, p. 552.

assassination scene.

Talbert, Cecil E.^{D} Captain, Dallas Police Vol. XII, p. 108.

Department. Vol. XV, p. 182.

Tasker, Harry T.^{D} Taxicab driver in Vol. XV, p. 679.

Dallas.

Taylor, Gary E.^{DA} Acquaintance of the Vol. IX, p. 73.

Oswalds in Texas. Vol. XI, p. 470.

Thompson, Llewellyn Former U.S. Ambassador Vol. V, p. 567.

E.^{C} to Russia.

Thornley, Kerry Acquaintance of Oswald Vol. XI, p. 82.

Wendell^{D} in Marines.

Tice, Wilma May^{D} Resident of Dallas. Vol. XV, p. 388.

Tobias, Mahlon F., Manager of apartment Vol. X, p. 251.

Sr.^{D} house where the Oswalds

resided, Dallas.

Tobias, Mrs. Mahlon Wife of M. F. Tobias, Vol. X, p. 231.

F.^{D} Sr.

Tomlinson, Darrell Senior engineer, Vol. VI, p. 128.

C.^{D} Parkland Hospital.

Tormey, James J.^{D} Executive secretary, Vol. X, p. 107.

Hall-Davis Defense

Commission.

Truly, Roy Sansom^{ACD} Superintendent, TSBD. Vol. III, p. 212.

Vol. VII, pp. 380,

591.

Turner, F. M.^{D} Member, Dallas Police Vol. VII, p. 217.

Department.

Turner, Jimmy^{D} TV director, Fort Worth. Vol. XIII, p. 130.

Twiford, Horace Member, Socialist Labor Vol. XI, p. 179.

Elroy^{A} Party, Houston, Tex.

Twiford, Estelle^{A} Wife of Horace Elroy Vol. XI, p. 179.

Twiford.

Underwood, James R.^{D} Assistant news Vol. VI, p. 167.

director, TV and radio,

Dallas.

Vaughn, Roy Eugene^{D} Member, Dallas Police Vol. XII, p. 357.

Department.

Vinson, Philip Reporter, Fort Worth. Vol. VIII, p. 75.

Eugene^{D}

Voebel, Edward^{D} Acquaintance of Oswald Vol. VIII, p. 1.

in Beauregard Junior

High School, New

Orleans.

Voshinin, Igor Member of Vol. VIII, p. 448.

Vladimir^{D} Russian-speaking

community in Dallas.

Voshinin, Mrs. Igor Acquaintance of the Vol. VIII, p. 425.

Vladimir.^{D} Oswalds in Texas.

Wade, Henry^{C} District attorney, Vol. V, p. 213.

Dallas County.

Waldman, William J.^{D} Vice President, Klein’s Vol. VII, p. 360.

Sporting Sporting

Goods, Inc.

Waldo, Thayer^{D} Reporter, Forth Worth. Vol. XV, p. 585.

Walker, C. T.^{D} Member, Dallas Police Vol. VII, p. 34.

Department.

Walker, Maj. Gen. Resident of Dallas and Vol. XI, p. 404.

Edwin A.^{D} object of shooting in

April 1963.

Walker, Ira N., Jr.^{D} Broadcast technician, Vol. XIII, p. 289.

Fort Worth.

Wall, Breck (a.k.a. Acquaintance of Ruby. Vol. XIV, p. 599.

Billy Ray Wilson).^{D}

Walthers, Eddy Raymond Deputy sheriff, Dallas Vol. VII, p. 544.

^{D} County.

Warner, Roger C.^{A} Agent, U.S. Secret Vol. XV, p. 619.

Service.

Waterman, Bernice^{C} Adjudicator, Passport Vol. V, p. 346.

Office, Department of

State.

Watherwax, Arthur Printer, Dallas Vol. XV, p. 564.

William^{D} newspaper.

Watson, James C.^{D} Member, Dallas Police Vol. XII, p. 372.

Department.

Weinstock, Louis^{A} General manager, the Vol. XI, p. 207.

Worker.

Weissman, Bernard^{CD} Codraftsman and signer Vol. V, p. 487.

of November 22, 1963, Vol. XI, p. 428.

full page advertisement.

Weitzman, Seymour^{D} Deputy constable, Vol. VII, p. 105.

Dallas County.

West, Troy Eugene^{D} Employee, TSBD. Vol. VI, p. 356.

Westbrook, W. R.^{D} Captain, Dallas Police Vol. VII, p. 109.

Department.

Wester, Jane Nurse, Parkland Vol. VI, p. 120.

Carolyn^{D} Hospital.

Whaley, William Taxicab driver in Vol. II, pp. 253,

Wayne^{CD} Dallas. 292.

Vol. VI, p. 428.

White, J. C.^{D} Member, Dallas Police Vol. VI, p. 253.

Department.

White, Martin G.^{D} Doctor, Parkland Vol. VI, p. 82.

Hospital.

Whitworth, Edith^{D} Manager, used furniture Vol. XI, p. 262.

store, Irving, Tex.

Wiggins, Woodrow^{D} Lieutenant, Dallas Vol. XII, p. 388.

Police Department.

Wilcox, Laurance R.^{D} District manager, Vol. X, p. 414.

Western Union Telegraph

Co.

Williams, Bonnie Employee, TSBD. Vol. III, p. 161.

Ray^{C}

Willis, Linda Kay^{D} Daughter of Phillip L. Vol. VII, p. 498.

Willis.

Willis, Phillip L.^{D} Witness at Vol. VII, p. 492.

assassination scene.

Wilson, Billy Ray (see

Wall, Breck).

Wittmus, Ronald G.^{A} Fingerprint expert, FBI. Vol. VII, p. 590.

Wood, Homer^{D} Patron, Sports Drome Vol. X, p. 385.

Rifle Range.

Wood, Sterling Son of Dr. Homer Wood. Vol. X, p. 390.

Charles^{D}

Wood, Theresa^{D} Wife of Dr. Homer Wood. Vol. X, p. 398.

Worley, Gano E.^{D} Reserve Force, Dallas Vol. XII, p. 378.

Police Department.

Worrell, James Witness at Vol. II, p. 190.

Richard, Jr.^{C} assassination scene.

Wright, Norman Earl^{D} Acquaintance of Jack Vol. XV, p. 244.

Ruby.

Wulf, William E.^{D} Acquaintance of Oswald Vol. VIII, p. 15.

in his youth.

Yarborough, Ralph U.S. Senator from Texas. Vol. VII, p. 439.

W.^{A}

Yeargan, Albert C., Employee, H. C. Green, Vol. XI, p. 207.

Jr.^{A} Dallas.

Youngblood, Rufus Agent, U.S. Secret Vol. II, p. 144.

Wayne^{C} Service.

Zahm, James A.^{D} Marine Corps expert on Vol. XI, p. 306.

marksmanship.

Zapruder, Abraham^{D} Witness at Vol. VII, p. 569.

assassination scene.

APPENDIX VI

Commission Procedures for the Taking of Testimony

RESOLUTION GOVERNING QUESTIONING OF WITNESSES BY MEMBERS OF THE

COMMISSION STAFF

Pursuant to Executive Order No. 11130, November 29, 1963, which

authorizes this Commission “to prescribe its own procedures,” it is

therefore

_Resolved_, That the following are hereby adopted as the rules of

this Commission for the questioning of witnesses by members of the

Commission staff.

I. _Sworn Depositions_

A. Individual members of the staff are hereby authorized to

administer oaths and affirmations, examine witnesses, and

receive evidence in the form of sworn depositions on any matter

under investigation by the Commission.

B. Such sworn depositions may be taken only from witnesses

designated in writing for questioning in this manner by the

Commission, by a member of the Commission, or by the General

Counsel of the Commission.

C. A stenographic verbatim transcript shall be made of all

sworn depositions. Copies of the witness’ testimony shall be

available for inspection by the witness or his counsel. When

approved by the Commission, said copies may be purchased by the

witness or his counsel at regularly prescribed rates from the

official reporter.

D. Process and papers of the Commission issued under Paragraph

(d) of Joint Resolution S.J. 137, 88th Congress, 1st session,

shall be returnable no less than three days from the date on

which such process or papers are issued, and shall state the

time, place, and general subject matter of the deposition. In

lieu of such process and papers, the Commission may request

the presence of witnesses and production of evidence for the

purpose of sworn depositions by written notice mailed no less

than three days from the date of the deposition.

E. The period of notice specified in Paragraph D may be waived

by a witness.

F. A witness at a sworn deposition shall have the right to be

accompanied by counsel of his own choosing, who shall have

the right to advise the witness of his rights under the laws

and Constitution of the United States, and the state wherein

the deposition shall occur, and to make brief objections to

questions. At the conclusion of the witness’ testimony, counsel

shall have the right to clarify the testimony of the witness by

questioning the witness.

G. At the opening of any deposition a member of the

Commission’s staff shall read into the record a statement

setting forth the nature of the Commission’s inquiry and the

purpose for which the witness has been asked to testify or

produce evidence.

H. Any witness who refuses to answer a question shall state the

grounds for so doing. At the conclusion of any deposition in

which the witness refuses to answer a question the transcript

shall be submitted to the General Counsel for review and

consideration whether the witness should be called to testify

before the Commission.

II. _Sworn Affidavits_

A. Members of the Commission staff are hereby authorized

to obtain sworn affidavits from those witnesses who have

been designated in writing by the Commission, a member of

the Commission, or the general counsel of the Commission as

witnesses whose testimony will be obtained in this manner.

B. A copy of the affidavit shall be provided the affiant or his

counsel.

_RESOLUTION_

Pursuant to Executive Order No. 11130, November 29, 1963, which

authorizes this Commission “to prescribe its own procedures,” it is

therefore

_Resolved_, That the following are hereby adopted as the rules of this

Commission in connection with hearings conducted for the purpose of the

taking of testimony or the production of evidence.

1. One or more members of the Commission shall be present at all

hearings. If more than one Commissioner is present, the Chairman of the

Commission shall designate the order in which the Commissioners shall

preside.

2. Any member of the Commission or any agent or agency designated by

the Commission for such purpose, may administer oaths and affirmations,

examine witnesses, and receive evidence.

3. Process and papers of the Commission issued under Paragraph (d)

of Joint Resolution S.J. 137, 88th Congress, 1st session, shall be

returnable no less than three days from the date on which such process

or papers are issued, and shall state the time, place, and general

subject matter of the hearing. In lieu of such process and papers, the

Commission may request the presence of witnesses and the production of

evidence by written notice mailed no less than 3 days from the date of

the hearing.

4. The period of notice specified in paragraph three (3) may be waived

by a witness.

5. At the opening of any hearing at which testimony is to be received a

member of the Commission shall read into the record a statement setting

forth the nature of the Commission’s inquiry and the purpose for which

the witness has been asked to testify or produce evidence. A copy of

this statement shall be given to each witness prior to his testifying.

6. A witness shall have the right to be accompanied by counsel, of his

own choosing, who shall have the right to advise the witness of his

rights under the laws and Constitution of the United States and to

make brief objections to questions. At the conclusion of the witness’

testimony, counsel shall have the right to clarify the testimony of the

witness by questioning the witness.

7. Every witness who testifies at a hearing shall have the right to

make an oral statement and to file a sworn statement which shall be

made part of the transcript of such hearing, but such oral or written

statement shall be relevant to the subject of the hearing.

8. Rulings on objections or other procedural questions shall be made by

the presiding member of the Commission.

9. A stenographic verbatim transcript shall be made of all testimony

received by the Commission. Copies of such transcript shall be

available for inspection or purchase by the witness or his counsel at

regularly prescribed rates from the official reporter. A witness or his

counsel shall be permitted to purchase or inspect only the transcript

of his testimony before the Commission.

APPENDIX VII

A Brief History of Presidential Protection

In the course of the history of the United States four Presidents have

been assassinated, within less than 100 years, beginning with Abraham

Lincoln in 1865. Attempts were also made on the lives of two other

Presidents, one President-elect, and one ex-President. Still other

Presidents were the objects of plots that were never carried out. The

actual attempts occurred as follows:

Andrew Jackson Jan. 30, 1835.

Abraham Lincoln Apr. 14, 1865. Died Apr. 15, 1865.

James A. Garfield July 2, 1881. Died Sept. 19, 1881.

William McKinley Sept. 6, 1901. Died Sept. 14, 1901.

Theodore Roosevelt Oct. 14, 1912. Wounded; recovered.

Franklin D. Roosevelt Feb. 15, 1933.

Harry S. Truman Nov. 1, 1950.

John F. Kennedy Nov. 22, 1963. Died that day.

Attempts have thus been made on the lives of one of every five American

Presidents. One of every nine Presidents has been killed. Since 1865,

there have been attempts on the lives of one of every four Presidents

and the successful assassination of one of every five. During the last

three decades, three attacks were made.

It was only after William McKinley was shot that systematic and

continuous protection of the President was instituted. Protection

before McKinley was intermittent and spasmodic. The problem had existed

from the days of the early Presidents, but no action was taken until

three tragic events had occurred. In considering the effectiveness of

present day protection arrangements, it is worthwhile to examine the

development of Presidential protection over the years, to understand

both the high degree of continuing danger and the anomalous reluctance

to take the necessary precautions.

BEFORE THE CIVIL WAR

In the early days of the Republic, there was remarkably little concern

about the safety of Presidents and few measures were taken to protect

them. They were at times the objects of abuse and the recipients of

threatening letters as more recent Presidents have been, but they

did not take the threats seriously and moved about freely without

protective escorts. On his inauguration day, Thomas Jefferson walked

from his boarding house to the Capitol, unaccompanied by any guard, to

take the oath of office. There was no police authority in Washington

itself until 1805 when the mayor appointed a high constable and 40

deputy constables.[A7-1]

John Quincy Adams received many threatening letters and on one occasion

was threatened in person in the White House by a court-martialed

Army sergeant. In spite of this incident, the President asked for no

protection and continued to indulge his fondness for solitary walks and

early morning swims in the Potomac.[A7-2]

Among pre-Civil War Presidents, Andrew Jackson aroused particularly

strong feelings. He received many threatening letters which, with a

fine contempt, he would endorse and send to the Washington Globe for

publication. On one occasion in May 1833, Jackson was assaulted by a

former Navy lieutenant, Robert B. Randolph, but refused to prosecute

him. This is not regarded as an attempt at assassination, since

Randolph apparently did not intend serious injury.[A7-3]

Less than 2 years later, on the morning of January 10, 1835, as Jackson

emerged from the east portico of the Capitol, he was accosted by a

would-be assassin, Richard Lawrence, an English-born house painter.

Lawrence fired his two pistols at the President, but they both

misfired. Lawrence was quickly overpowered and held for trial. A jury

found him not guilty by reason of insanity. He was confined in jails

and mental hospitals for the rest of his life.[A7-4]

The attack on Jackson did not inspire any action to provide protection

for the Chief Executive. Jackson’s immediate successor, Martin Van

Buren, often walked to church alone and rode horseback alone in

the woods not far from the White House. In August 1842, after an

intoxicated painter had thrown rocks at President John Tyler, who was

walking on the grounds to the south of the White House, Congress passed

an act to establish an auxiliary watch for the protection of public and

private property in Washington. The force was to consist of a captain

and 15 men. This act was apparently aimed more at the protection of

the White House, which had been defaced on occasion, than of the

President.[A7-5]

LINCOLN

Even before he took the oath of office, Abraham Lincoln was thought

to be the object of plots and conspiracies to kidnap or kill him.

Extremist opponents apparently contemplated desperate measures to

prevent his inauguration, and there is some evidence that they plotted

to attack him while he was passing through Baltimore on his way to

Washington.[A7-6]

For the inauguration, the Army took precautions unprecedented up to

that time and perhaps more elaborate than any precautions taken since.

Soldiers occupied strategic points throughout the city, along the

procession route, and at the Capitol, while armed men in plain clothes

mingled with the crowds. Lincoln himself, in a carriage with President

Buchanan, was surrounded on all sides by such dense masses of soldiers

that he was almost completely hidden from the view of the crowds. The

precautions at the Capitol during the ceremony were almost as thorough

and equally successful.[A7-7]

Lincoln lived in peril during all his years in office. The volume

of threatening letters remained high throughout the war, but little

attention was paid to them. The few letters that were investigated

yielded no results.[A7-8] He was reluctant to surround himself with

guards and often rejected protection or sought to slip away from it.

This has been characteristic of almost all American Presidents. They

have regarded protection as a necessary affliction at best and contrary

to their normal instincts for either personal privacy or freedom to

meet the people. In Lincoln these instincts were especially strong, and

he suffered with impatience the efforts of his friends, the police, and

the military to safeguard him.[A7-9]

The protection of the President during the war varied greatly,

depending on Lincoln’s susceptibility to warnings. Frequently, military

units were assigned to guard the White House and to accompany the

President on his travels. Lincoln’s friend, Ward H. Lamon, on becoming

marshal of the District of Columbia in 1861, took personal charge of

protecting the President and provided guards for the purpose, but he

became so exasperated at the President’s lack of cooperation that he

tendered his resignation. Lincoln did not accept it. Finally, late in

the war, in November 1864, four Washington policemen were detailed to

the White House to act as personal bodyguards to the President. Lincoln

tolerated them reluctantly and insisted they remain as inconspicuous as

possible.[A7-10]

In the closing days of the war, rumors of attempts on Lincoln’s life

persisted. The well-known actor, John Wilkes Booth, a fanatical

Confederate sympathizer, plotted with others for months to kidnap

the President. The fall of the Confederacy apparently hardened his

determination to kill Lincoln.[A7-11] Booth’s opportunity came on

Good Friday, April 14, 1865, when he learned that the President would

be attending a play at Ford’s Theater that night. The President’s

bodyguard for the evening was Patrolman John F. Parker of the

Washington Police, a man who proved himself unfit for protective duty.

He was supposed to remain on guard in the corridor outside of the

Presidential box during the entire performance of the play, but he soon

wandered off to watch the play and then even went outside the theater

to have a drink at a nearby saloon. Parker’s dereliction of duty left

the President totally unprotected.[A7-12] Shortly after 10 o’clock on

that evening, Booth found his way up to the Presidential box and shot

the President in the head. The President’s wound was a mortal one; he

died the next morning, April 15.[A7-13]

A detachment of troops captured Booth on April 26 at a farm near

Bowling Green, Va.; he received a bullet wound and died a few

hours later. At a trial in June, a military tribunal sentenced

four of Booth’s associates to death and four others to terms of

imprisonment.[A7-14]

Lincoln’s assassination revealed the total inadequacy of Presidential

protection. A congressional committee conducted an extensive

investigation of the assassination, but with traditional reluctance,

called for no action to provide better protection for the President

in the future. Nor did requests for protective measures come from the

President or from Government departments. This lack of concern for the

protection of the President may have derived also from the tendency of

the time to regard Lincoln’s assassination as part of a unique crisis

that was not likely to happen to a future Chief Executive.[A7-15]

THE NEED FOR PROTECTION FURTHER DEMONSTRATED

For a short time after the war, soldiers assigned by the War Department

continued to protect the White House and its grounds. Metropolitan

Washington policemen assisted on special occasions to maintain order

and prevent the congregation of crowds. The permanent Metropolitan

Police guard was reduced to three and assigned entirely to protection

at the White House. There was no special group of trained officers to

protect the person of the President. Presidents after Lincoln continued

to move about in Washington virtually unattended, as their predecessors

had done before the Civil War, and, as before, such protection as they

got at the White House came from the doormen, who were not especially

trained for guard duty.[A7-16]

This lack of personal protection for the President came again

tragically to the attention of the country with the shooting of

President James A. Garfield in 1881. The President’s assassin, Charles

J. Guiteau, was a self-styled “lawyer, theologian, and politician”

who had convinced himself that his unsolicited efforts to help elect

Garfield in 1880 entitled him to appointment as a consul in Europe.

Bitterly disappointed that the President ignored his repeated written

requests for appointment to office and obsessed with a kind of

megalomania, he resolved to kill Garfield.

At that time Guiteau was 38 years old and had an unusually checkered

career behind him. He had been an itinerant and generally unsuccessful

lecturer and evangelist, a lawyer, and a would-be politician. While

it is true he resented Garfield’s failure to appoint him consul in

Paris as a reward for his wholly illusory contribution to the Garfield

campaign, and he verbally attacked Garfield for his lack of support

for the so-called Stalwart wing of the Republican Party, these may not

have supplied the total motivation for his crime. At his trial he

testified that the “Deity” had commanded him to remove the President.

There is no evidence that he confided his assassination plans to anyone

or that he had any close friends or confidants. He made his attack on

the President under circumstances where escape after the shooting was

inconceivable. There were some hereditary mental problems in his family

and Guiteau apparently believed in divine inspiration.[A7-17]

Guiteau later testified that he had had three opportunities to attack

the President prior to the actual shooting. On all of these occasions,

within a brief period of 3 weeks, the President was unguarded. Guiteau

finally realized his intent on the morning of July 2, 1881. As Garfield

was walking to a train in the Baltimore and Potomac Railroad Station

in Washington, Guiteau stepped up and shot him in the back. Garfield

did not die from the effects of the wound until September 19, 1881.

Although there was evidence of serious abnormality in Guiteau, he was

found guilty of murder and sentenced to be hanged. The execution took

place on June 30, 1882.[A7-18]

At least one newspaper, the New York Tribune, predicted that the

assault on Garfield would lead to the President becoming “the slave

of his office, the prisoner of forms and restrictions,” in sharp and

unwelcome contrast to the splendidly simple life he had been able to

live before.

The bullet of the assassin who lurked in the Washington railway

station to take the life of President Garfield shattered the

simple Republican manner of life which the custom of nearly

a century has prescribed for the Chief Magistrate of the

United States. Our Presidents have been the first citizens of

the Republic--nothing more. With a measure of power in their

hands far greater than is wielded by the ruler of any limited

monarchy in Europe, they have never surrounded themselves with

the forms and safeguards of courts. The White House has been a

business office to everybody. Its occupant has always been more

accessible than the heads of great commercial establishments.

When the passions of the war were at fever heat, Mr. Lincoln

used to have a small guard of cavalry when he rode out to his

summer residence at the Soldier’s Home; but at no other time in

our history has it been thought needful for a President to have

any special protection against violence when inside or outside

the White House. Presidents have driven about Washington like

other people and travelled over the country as unguarded and

unconstrained as any private citizen.[A7-19]

The prediction of the Tribune did not come to pass. Although the

Nation was shocked by this deed, its representatives took no steps to

provide the President with personal protection. The President continued

to move about Washington, sometimes completely alone, and to travel

without special protection. There is a story that President Chester A.

Arthur, Garfield’s successor, once went to a ceremony at the Washington

Navy Yard on a public conveyance that he hailed in front of the White

House.[A7-20]

During Grover Cleveland’s second administration (1893-97) the number of

threatening letters addressed to the President increased markedly, and

Mrs. Cleveland persuaded the President to increase the number of White

House policemen to 27 from the 3 who had constituted the force since

the Civil War. In 1894, the Secret Service began to provide protection,

on an informal basis.[A7-21]

The Secret Service was organized as a division of the Department of the

Treasury in 1865, to deal with counterfeiting.[A7-22] Its jurisdiction

was extended to other fiscal crimes against the United States in

later appropriations acts,[A7-23] but its early work in assisting in

protecting the President was an unofficial, stopgap response to a

need for a trained organization, with investigative capabilities, to

perform this task. In 1894, while investigating a plot by a group of

gamblers in Colorado to assassinate President Cleveland, the Secret

Service assigned a small detail of operatives to the White House to

help protect him. Secret Service men accompanied the President and

his family to their vacation home in Massachusetts; special details

protected the President in Washington, on trips, and at special

functions.[A7-24] For a time, two agents rode in a buggy behind

President Cleveland’s carriage, but this practice attracted so much

attention in the opposition newspapers that it was soon discontinued

at the President’s insistence.[A7-25] These initially informal and

part-time arrangements eventually led to the organization of permanent

systematic protection for the President and his family.

During the Spanish-American War the Secret Service stationed a detail

at the White House to provide continuous protection for President

McKinley. The special wartime protective measures were relaxed after

the war, but Secret Service guards remained on duty at the White House

at least part of the time.[A7-26]

Between 1894 and 1900, anarchists murdered the President of France,

the Premier of Spain, the Empress of Austria, and the King of Italy.

At the turn of the century the Secret Service thought that the strong

police action taken against the anarchists in Europe was compelling

them to flee and that many were coming to the United States. Concerned

about the protection of the President, the Secret Service increased the

number of guards and directed that a guard accompany him on all of his

trips.[A7-27]

Unlike Lincoln and Garfield, President McKinley was being guarded when

he was shot by Leon F. Czolgosz, an American-born 28-year-old factory

worker and farmhand. On September 6, 1901, the President was holding

a brief reception for the public in the Temple of Music at the Pan

American Exposition in Buffalo. Long lines of people passed between

two rows of policemen and soldiers to reach the President and shake

his hand. In the immediate vicinity of the President were four Buffalo

detectives, four soldiers, and three Secret Service agents. Two of

the Secret Service men were facing the President at a distance of 3

feet. One of them stated later that it was normally his custom to

stand at the side of the President on such occasions, but that he had

been requested not to do so at this time in order to permit McKinley’s

secretary and the president of the exposition to stand on either side

of McKinley. Czolgosz joined the line, concealed a pistol under a

handkerchief, and when he stood in front of the President shot twice

through the handkerchief. McKinley fell critically wounded.[A7-28]

Czolgosz, a self-styled anarchist, did not believe in rulers of any

kind. There is evidence that the organized anarchists in the U.S.A. did

not accept or trust him. He was not admitted as a member to any of the

secret anarchist societies. No co-plotters were ever discovered, and

there is no evidence that he had confided in anyone. A calm inquiry

made by two eminent alienists about a year after Czolgosz was executed

found that Czolgosz had for some time been suffering from delusions.

One was that he was an anarchist; another was that it was his duty to

assassinate the President.[A7-29]

The assassin said he had no grudge against the President personally but

did not believe in the republican form of government or in rulers of

any kind. In his written confession he included the words, “‘I don’t

believe one man should have so much service and another man should

have none.’” As he was strapped to the chair to be electrocuted, he

said: “‘I killed the President because he was the enemy of the good

people--the good working people. I am not sorry for my crime.’”[A7-30]

McKinley lingered on for 8 days before he died of blood poisoning

early on the morning of September 14. Czolgosz, who had been

captured immediately, was swiftly tried, convicted, and condemned to

death. Although it seemed to some contemporaries that Czolgosz was

incompetent, the defense made no effort to plead insanity. Czolgosz was

executed 45 days after the President’s death. Investigations by the

Buffalo police and the Secret Service revealed no accomplices and no

plot of any kind.[A7-31]

DEVELOPMENT OF PRESIDENTIAL PROTECTION

This third assassination of a President in a little more than a

generation--it was only 36 years since Lincoln had been killed--shook

the nation and aroused it to a greater awareness of the uniqueness of

the Presidency and the grim hazards that surrounded an incumbent of

that Office. The first congressional session after the assassination of

McKinley gave more attention to legislation concerning attacks on the

President than had any previous Congress but did not pass any measures

for the protection of the President.[A7-32] Nevertheless, in 1902 the

Secret Service, which was then the only Federal general investigative

agency of any consequence, assumed full-time responsibility for the

safety of the President. Protection of the President now became one of

its major permanent functions, and it assigned two men to its original

full-time White House detail. Additional agents were provided when the

President traveled or went on vacation.[A7-33]

Theodore Roosevelt, who was the first President to experience the

extensive system of protection that has surrounded the President ever

since, voiced an opinion of Presidential protection that was probably

shared in part by most of his successors. In a letter to Senator Henry

Cabot Lodge in 1906, from his summer home, he wrote:

The Secret Service men are a very small but very necessary

thorn in the flesh. Of course, they would not be the least

use in preventing any assault upon my life. I do not believe

there is any danger of such an assault, and if there were, as

Lincoln said, “though it would be safer for a President to live

in a cage, it would interfere with his business.” But it is

only the Secret Service men who render life endurable, as you

would realize if you saw the procession of carriages that pass

through the place, the procession of people on foot who try to

get into the place, not to speak of the multitude of cranks and

others who are stopped in the village.[A7-34]

Roosevelt, who had succeeded to the Presidency because of an assassin’s

bullet, himself became the object of an assassination attempt a few

years after he left office and when he was no longer under Secret

Service protection. During the Presidential campaign of 1912, just as

he was about to make a political speech in Milwaukee on October 14, he

was shot and wounded in the breast by John N. Schrank, a 36-year-old

German-born ex-tavern keeper. A folded manuscript of his long speech

and the metal case for his eyeglasses in the breast pocket of

Roosevelt’s coat were all that prevented the assassination.[A7-35]

Schrank had had a vision in 1901, induced possibly by McKinley’s

assassination, which took on meaning for him after Roosevelt, 11 years

later, started to campaign for the Presidency. In this vision the ghost

of McKinley appeared to him and told him not to let a murderer (i.e.,

Roosevelt, who according to the vision had murdered McKinley) become

President. It was then that he determined upon the assassination. At

the bidding of McKinley’s ghost, he felt he had no choice but to kill

Theodore Roosevelt. After his attempt on Roosevelt, Schrank was found

to be insane and was committed to mental hospitals in Wisconsin for the

rest of his life.[A7-36]

The establishment and extension of the Secret Service authority for

protection was a prolonged process. Although the Secret Service

undertook to provide full-time protection for the President beginning

in 1902, it received neither funds for the purpose nor sanction

from the Congress until 1906 when the Sundry Civil Expenses Act for

1907 included funds for protection of the President by the Secret

Service.[A7-37] Following the election of William Howard Taft in 1908,

the Secret Service began providing protection for the President-elect.

This practice received statutory authorization in 1913, and in

the same year, Congress authorized permanent protection of the

President.[A7-38] It remained necessary to renew the authority annually

in the Appropriations Acts until 1951.

As in the Civil and Spanish-American Wars, the coming of war in 1917

caused increased concern for the safety of the President. Congress

enacted a law, since referred to as the threat statute, making it a

crime to threaten the President by mail or in any other manner.[A7-39]

In 1917 Congress also authorized protection for the President’s

immediate family by the Secret Service.[A7-40]

As the scope of the Presidency expanded during the 20th century,

the Secret Service found the problems of protection becoming more

numerous. In 1906, for the first time in history, a President traveled

outside the United States while in office. When Theodore Roosevelt

visited Panama in that year, he was accompanied and protected by

Secret Service men.[A7-41] In 1918-19 Woodrow Wilson broadened the

precedent of Presidential foreign travel when he traveled to Europe

with a Secret Service escort of 10 men to attend the Versailles Peace

Conference.[A7-42]

The attempt on the life of President-elect Franklin D. Roosevelt

in 1933 further demonstrated the broad scope and complexity of the

protection problems facing the Secret Service. Giuseppe Zangara was

a bricklayer and stonemason with a professed hatred of capitalists

and Presidents. He seemed to be obsessed with the desire to kill a

President. After his arrest he confessed that he had first planned to

go to Washington to kill President Herbert Hoover, but as the cold

climate of the North was bad for his stomach trouble, he was loath

to leave Miami, where he was staying. When he read in the paper that

President-elect Roosevelt would be in Miami, he resolved to kill

him.[A7-43]

On the night of February 15, 1933, at a political rally in Miami’s

Bayfront Park, the President-elect sat on the top of the rear seat of

his automobile with a small microphone in his hand as he made a short

informal talk. Fortunately for him, however, he slid down into the seat

just before Zangara could get near enough to take aim. The assassin’s

arm may have been jogged just as he shot; the five rounds he directed

at Roosevelt went awry. However, he mortally wounded Mayor Anton

Cermak, of Chicago, and hit four other persons; the President-elect,

by a miracle, escaped. Zangara, of course, never had any chance of

escaping.[A7-44]

Zangara was electrocuted on March 20, 1933, only 33 days after his

attempt on Roosevelt. No evidence of accomplices or conspiracy came to

light, but there was some sensational newspaper speculation, wholly

undocumented, that Zangara may have been hired by Chicago gangsters to

kill Cermak.[A7-45]

The force provided since the Civil War by the Washington Metropolitan

Police for the protection of the White House had grown to 54 men by

1922.[A7-46] In that year Congress enacted legislation creating the

White House Police Force as a separate organization under the direct

control of the President.[A7-47] This force was actually supervised

by the President’s military aide until 1930, when Congress placed

supervision under the Chief of the Secret Service.[A7-48] Although

Congress transferred control and supervision of the force to the

Secretary of the Treasury in 1962,[A7-49] the Secretary delegated

supervision to the Chief of the Secret Service.[A7-50]

The White House detail of the Secret Service grew in size slowly from

the original 2 men assigned in 1902. In 1914 it still numbered only 5,

but during World War I it was increased to 10 men. Additional men were

added when the President traveled. After the war the size of the detail

grew until it reached 16 agents and 2 supervisors by 1939. World War II

created new and greater protection problems, especially those arising

from the President’s trips abroad to the Grand Strategy Conferences in

such places as Casablanca, Quebec, Tehran, Cairo, and Yalta. To meet

the increased demands, the White House detail was increased to 37 men

early in the war.[A7-51]

The volume of mail received by the White House had always been large,

but it reached huge proportions under Franklin D. Roosevelt. Presidents

had always received threatening letters but never in such quantities.

To deal with this growing problem, the Secret Service established in

1940 the Protective Research Section to analyze and make available to

those charged with protecting the President, information from White

House mail and other sources concerning people potentially capable of

violence to the President. The Protective Research Section undoubtedly

permitted the Secret Service to anticipate and forestall many incidents

that might have been embarrassing or harmful to the President.[A7-52]

Although there was no advance warning of the attempt on Harry S.

Truman’s life on November 1, 1950, the protective measures taken by the

Secret Service availed, and the assassins never succeeded in firing

directly at the President. The assassins--Oscar Collazo and Griselio

Torresola, Puerto Rican Nationalists living in New York--tried to force

their way into Blair House, at the time the President’s residence while

the White House was being repaired. Blair House was guarded by White

House policemen and Secret Service agents. In the ensuing gun battle,

Torresola and one White House policeman were killed, and Collazo and

two White House policemen were wounded. Had the assassins succeeded in

entering the front door of Blair House, they would probably have been

cut down immediately by another Secret Service agent inside who kept

the doorway covered with a submachine gun from his vantage point at the

foot of the main stairs. In all, some 27 shots were fired in less than

3 minutes.[A7-53]

Collazo was brought to trial in 1951 and sentenced to death, but

President Truman commuted the sentence to life imprisonment on July 24,

1952. Although there was a great deal of evidence linking Collazo and

Torresola to the Nationalist Party of Puerto Rico and its leader, Pedro

Albizu Campos, the Government could not establish that the attack on

the President was part of a larger Nationalist conspiracy.[A7-54]

The attack on President Truman led to the enactment in 1951 of

legislation that permanently authorized the Secret Service to protect

the President, his immediate family, the President-elect, and the Vice

President, the last upon his request. Protection of the Vice President

by the Secret Service had begun in January 1945 when Harry S. Truman

occupied the office.[A7-55]

In 1962 Congress further enlarged the list of Government officers

to be safeguarded, authorizing protection of the Vice President (or

the officer next in order of succession to the Presidency) without

requiring his request therefor; of the Vice President-elect; and of a

former President, at his request, for a reasonable period after his

departure from office. The Secret Service considered this “reasonable

period” to be 6 months.[A7-56]

Amendments to the threat statute of 1917, passed in 1955 and 1962, made

it a crime to threaten to harm the President-elect, the Vice President,

or other officers next in succession to either office. The President’s

immediate family was not included in the threat statute.[A7-57]

Congressional concern regarding the uses to which the President might

put the Secret Service--first under Theodore Roosevelt and subsequently

under Woodrow Wilson--caused Congress to place tight restrictions on

the functions of the Service and the uses of its funds.[A7-58] The

restrictions probably prevented the Secret Service from developing into

a general investigative agency, leaving the field open for some other

agency when the need arose. The other agency proved to be the Federal

Bureau of Investigation (FBI), established within the Department of

Justice in 1908.[A7-59]

The FBI grew rapidly in the 1920’s, and especially in the 1930’s

and after, establishing itself as the largest, best equipped, and

best known of all U.S. Government investigative agencies. In the

appropriations of the FBI there recurred annually an item for the

“protection of the person of the President of the United States,” that

had first appeared in the appropriation of the Department of Justice

in 1910 under the heading “Miscellaneous Objects.”[A7-60] But there

is no evidence that the Justice Department ever exercised any direct

responsibility for the protection of the President. Although it had no

prescribed protection functions, according to its Director, J. Edgar

Hoover, the FBI did provide protection to Vice President Charles Curtis

at his request, when he was serving under Herbert Hoover from 1929 to

1933. Over the years the FBI contribution to Presidential protection

was confined chiefly to the referral to the Secret Service of the names

of people who might be potentially dangerous to the President.[A7-61]

In recent years the Secret Service has remained a small and specialized

bureau, restricted to very limited functions prescribed by Congress.

In 1949, a task force of the Commission on Organization of the

Executive Branch of the Government (Hoover Commission), recommended

nonfiscal functions be removed from the Treasury Department.[A7-62] The

recommendation called for transfer of the White House detail, White

House Police Force, and Treasury Guard Force from the Secret Service

to the Department of Justice. The final report of the Commission

on the Treasury Department omitted this recommendation, leaving the

protective function with the Secret Service.[A7-63] At a meeting of

the Commission, ex-President Hoover, in a reference to the proposed

transfer, expressed the opinion that “the President will object to

having a ‘private eye’ looking after these fellows and would rather

continue with the service.”[A7-64]

In 1963 the Secret Service was one of several investigative agencies

in the Treasury Department. Its major functions were to combat

counterfeiting and to protect the President, his family, and other

designated persons.[A7-65] The Chief of the Secret Service administered

its activities through four divisions: Investigation, Inspection,

Administrative, and Security, and 65 field offices throughout the

country, each under a special agent in charge who reported directly

to Washington. The Security Division supervised the White House

detail, the White House Police, and the Treasury Guard Force. During

fiscal year 1963 (July 1, 1962-June 30, 1963) the Secret Service had

an average strength of 513, of whom 351 were special agents. Average

strength of the White House Police during the year was 179.[A7-66]

APPENDIX VIII

Medical Reports From Doctors at Parkland Memorial Hospital, Dallas, Tex.

The president arrived in the Emergency Room at exactly 12:43 p.m. in

his limousine. He was in the back seat, Gov. Conally was in the front

seat of the same car, Gov. Connally was brought out first and was

put in room two. President was brought out next and put in room one.

Dr. Clark pronounced the President dead at 1 p.m. exactly. All of

the President’s belongings except his watch were given to the Secret

Service. His watch was given to Mr. C. P. Wright. He left the Emergency

Room, the President, at about 2 p.m. in an O’Neal ambulance. He was put

in a bronze colored plastic casket after being wrapped in a blanket

and was taken out of the hospital. He was removed from the hospital.

The Gov. was taken from the Emergency room to the Operating Room.

The President’s wife refused to take off her bloody gloves, clothes.

She did take a towel and wipe her face. She took her wedding ring off

and placed it on one of the President’s fingers.

[Illustration: COMMISSION EXHIBIT NO. 392]

SUMMARY

The President arrived at the Emergency Room at 12:43 P.M., the 22nd

of November, 1963. He was in the back seat of his limousine. Governor

Connally of Texas was also in this car. The first physician to see the

President was Dr. James Carrico, a Resident in General Surgery.

Dr. Carrico noted the President to have slow, agonal respiratory

efforts. He could hear a heartbeat but found no pulse or blood pressure

to be present. Two external wounds, one in the lower third of the

anterior neck, the other in the occipital region of the skull, were

noted. Through the head wound, blood and brain were extruding. Dr.

Carrico inserted a cuffed endotracheal tube. While doing so, he noted a

ragged wound of the trachea immediately below the larynx.

At this time, Dr. Malcolm Perry, Attending Surgeon, Dr. Charles Baxter,

Attending Surgeon, and Dr. Ronald Jones, another Resident in General

Surgery, arrived. Immediately thereafter, Dr. M. T. Jenkins, Director

of the Department of Anesthesia, and Doctors Giesecke and Bunt, two

other Staff Anesthesiologists, arrived. The endotracheal tube had been

connected to a Bennett respirator to assist the President’s breathing.

An Anesthesia machine was substituted for this by Dr. Jenkins. Only

100% oxygen was administered.

A cutdown was performed in the right ankle, and a polyethylene catheter

inserted in the vein. An infusion of lactated Ringer’s solution was

begun. Blood was drawn for type and crossmatch, but unmatched type “O”

RH negative blood was immediately obtained and begun. Hydrocortisone

300 mgms was added to the intravenous fluids.

Dr. Robert McClelland, Attending Surgeon, arrived to help in the

President’s care. Doctors Perry, Baxter, and McClelland began a

tracheostomy, as considerable quantities of blood were present from

the President’s oral pharynx. At this time, Dr. Paul Peters, Attending

Urological Surgeon, and Dr. Kemp Clark, Director of Neurological

Surgery, arrived. Because of the lacerated trachea, anterior chest

tubes were placed in both pleural spaces. These were connected to

sealed underwater drainage.

Neurological examination revealed the President’s pupils to be widely

dilated and fixed to light. His eyes were divergent, being deviated

outward; a skew deviation from the horizontal was present. No deep

tendon reflexes or spontaneous movements were found.

There was a large wound in the right occipito-parietal region, from

which profuse bleeding was occurring. 1500 cc. of blood were estimated

on the drapes and floors of the Emergency Operating Room. There

was considerable loss of scalp and bone tissue. Both cerebral and

cerabellar tissue were extruding from the wound.

Further examination was not possible as cardiac arrest occurred at this

point. Closed chest cardiac massage was begun by Dr. Clark. A pulse

palpable in both the carotid and femoral arteries was obtained. Dr.

Perry relieved on the cardiac massage while a cardiotachioscope was

connected. Dr. Fouad Bashour, Attending Physician, arrived as this was

being connected. There was electrical silence of the President’s heart.

President Kennedy was pronounced dead at 1300 hours by Dr. Clark.

Kemp Clark, M.D,

Director

Service of Neurological Surgery

KC:ca

cc to Dean’s Office, Southwestern Medical School

cc to Medical Records, Parkland Memorial Hospital

[Illustration: COMMISSION EXHIBIT NO. 392--Continued]

[Illustration: COMMISSION EXHIBIT NO. 392--Continued]

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[Illustration: COMMISSION EXHIBIT NO. 392--Continued]

[Illustration: COMMISSION EXHIBIT NO. 392--Continued]

[Illustration: COMMISSION EXHIBIT NO. 392--Continued]

[Illustration: COMMISSION EXHIBIT NO. 392--Continued]

[Illustration: COMMISSION EXHIBIT NO. 392--Continued]

THE UNIVERSITY OF TEXAS

SOUTHWESTERN MEDICAL SCHOOL

DALLAS

M. T. JENKINS. M. D.

PROFESSOR AND CHAIRMAN

Department of Anesthesiology

Clinical Departments of Anesthesia

PARKLAND MEMORIAL HOSPITAL

CHILDREN’S MEDICAL CENTER

November 22, 1963

1630

To: Mr. C. J. Price, Administrator

Parkland Memorial Hospital

From: M. T. Jenkins, M.D., Professor and Chairman

Department of Anesthesiology

Subject: Statement concerning resuscitative efforts for

President John F. Kennedy

Upon receiving a stat alarm that this distinguished patient was

being brought to the emergency room at Parkland Memorial Hospital, I

dispatched Doctors A. H. Giesecke and Jackie H. Hunt with an anesthesia

machine and resuscitative equipment to the major surgical emergency

room area, and I ran down the stairs. On my arrival in the emergency

operating room at approximately 1230 I found that Doctors Carrico

and/or Delaney had begun resuscitative efforts by introducing an

orotracheal tube, connecting it for controlled ventilation to a Bennett

intermittent positive pressure breathing apparatus. Doctors Charles

Baxter, Malcolm Perry, and Robert McClelland arrived at the same time

and began a tracheostomy and started the insertion of a right chest

tube, since there was also obvious tracheal and chest damage. Doctors

Paul Peters and Kemp Clark arrived simultaneously and immediately

thereafter assisted respectively with the insertion of the right

chest tube and with manual closed chest cardiac compression to assure

circulation.

For better control of artificial ventilation, I exchanged the

intermittent positive pressure breathing apparatus for an anesthesia

machine and continued artificial ventilation. Doctors Gene Akin and

A. H. Giesecke assisted with the respiratory problems incident to

changing from the orotracheal tube to a tracheostomy tube, and Doctors

Hunt and Giesecke connected a cardioscope to determine cardiac activity.

During the progress of these activities, the emergency room cart was

elevated at the feet in order to provide a Trendelenburg position,

a venous cutdown was performed on the right saphenous vein, and

additional fluids were begun in a vein in the left forearm while

blood was ordered from the blood bank. All of these activities were

completed by approximately 1245, at which time external cardiac massage

was still being carried out effectively by Doctor Clark as judged

by a palpable peripheral pulse. Despite these measures there was no

electrocardiographic evidence of cardiac activity.

These described resuscitative activities were indicated as of first

importance, and after they were carried out attention was turned to

all other evidences of injury. There was a great laceration on the

right side of the head (temporal and occipital), causing a great

defect in the skull plate so that there was herniation and laceration

of great areas of the brain, even to the extent that the cerebellum

had protruded from the wound. There were also fragmented sections of

brain on the drapes of the emergency room cart. With the institution of

adequate cardiac compression, there was a great flow of blood from the

cranial cavity, indicating that there was much vascular damage as well

as brain tissue damage.

It is my personal feeling that all methods of resuscitation were

instituted expeditiously and efficiently. However, this cranial and

intracranial damage was of such magnitude as to cause the irreversible

damage. President Kennedy was pronounced dead at 1300.

Sincerely,

M. T. Jenkins, M.D.

[Illustration: COMMISSION EXHIBIT No. 392--Continued]

[Illustration: COMMISSION EXHIBIT NO. 392--Continued]

PARKLAND MEMORIAL HOSPITAL

OPERATIVE RECORD

DATE: 11-22-63 Thoracic Surg

ROOM: 220

STATUS: Pvt

NAME: John Connally

Unit # 26 36 99

AGE:

RACE: W/M

PRE-OPERATIVE DIAGNOSIS: Gunshot wound of the chest with comminuted

fracture of the 5th rib

POST-OPERATIVE DIAGNOSIS: Same with laceration right middle lobe,

hematoma lower lobe of lung

OPERATION: Thoractomy, removal rib fragment, debridement of wound

BEGAN: 1335

ENDED: 1520

ANESTHETIC: General

BEGAN: 1300

ANESTHESIOLOGIST: Giesecke

SURGEON: Robert Shaw. M.D

ASSISTANTS: Drs. Boland and Duke

SCRUB NURSE: King/Burkett

CIRC. NURSE: Johnson

SPONGE COUNTS: 1ST Correct

2ND Correct

DRUGS

I.V. FLUIDS AND BLOOD

111-500 cc whole blood

11-1000cc D-5-RL

COMPLICATIONS: None

CONDITION OF PATIENT: Satisfactory

CLINICAL EVALUATION: The patient was brought to the OR from the EOR.

In the EOR a sucking wound of the right chest was partially controlled

by an occlusive dressing supported by manual pressure. A tube had

been placed through the second interspace in the mid-clavicular line

connected to a waterseal bottle to evacuate the right pneumothorax and

hemathorax. An IV infusion of RL solution had already been started.

As soon as the patient was positioned on the OR table the anesthesia

was Induced by Dr. Giesecke and an endotracheal tube was in place. As

soon as it was possible to control respiration with positive pressure

the occlusive dressing was taken from the right chest and the extent

of the wound more carefully determined. It was found that the wound of

entrance was just lateral to the right scapula close the the axilla yet

had passed through the latysmus dorsi muscle shattered approximately

ten cm of the lateral and anterior portion of the right fifth rib and

emerged below the right nipple. The wound of entrance was approximately

three cm in its longest diameter and the wound of exit was a ragged

wound approximately five cm in its greatest diameter. The skin and

subcutaneous tissue over the path of the missile moved in a paradoxical

manner with respiration indicating softening of the chest. The skin

of the whole area was carefully cleansed with Phisohex and Iodine.

The entire area including the wound of entrance and wound of exit was

draped partially excluding the wound of entrance for the first part

of the operation. An elliptical incision was made around the wound of

exit removing the torn edges of the skin and the damaged subcutaneous

tissue. The incision was then carried in a downward curve up toward the

right axilla so as to not have the skin incision over the actual path

of the missile ban through the chest wall. This incision was carried

down through the subcutaneous tissue to expose the Serratus anterior

muscle and the anterior border of the latissimus dorsi muscle. The

fragmented and damaged portions of the Serratus anterior muscle were

excised. Small rib fragments that were adhering to periosteal tags were

carefully removed preserving as much periosteum as possible. The fourth

intercostal muscle bundle and fifth intercostal muscle bundle were not

appreciably damaged.

The ragged ends of the damaged fifth rib were cleaned out with the

rongeur. The plura had been torn open by the secondary missiles

created by the fragmented fifth rib. The wound was open widely and

exposure was obtained with a self retaining retractor. The right

plural cavity was then carefully inspected. Approximately 200 cc of

clot and liquid blood was removed from the pleural cavity. The middle

lobe had a linear rent starting at its peripheral edge going down

towards itshilum separating the lobe into two segments. There was an

open bronchus in the depth of this wound. Since the vascularlty and

the bronchial connections to the lobe were intact it was decided to

repair the lobe rather then to remove it. The repair was accomplished

with a running suture of #000 chromic gut on atraumatic needle closing

both plural surfaces as well as two runnin sutures approximating the

tissue of the central portion of the lobe. This almost completely

sealed off the air leaks which were evident in the torn portion of the

lobe. The lower lobe was next examined and found to be engorged with

blood and at one point a laceration of allowed the oozing of blood.

This laceration had undoubtedly been caused by a rib fragment. This

laceration was closed with a single suture of #3-O chromic gut on

atraumatic needle. The right pleural cavity was now carefully examined

and small ribs fragments were removed, the diaphram was found to be

uninjured. There was no evidence of injury of the mediastinum and its

contents. Hemostasis had been accomplished within the plural cavity

with the repair of the middle lobe and the suturing of the laceration

in the lower lobe. The upper lobe was found to be uninjured. The

drains which had previously been placed in the second interspace

in the midclavicular line was found to be longer than necessary so

approximately ten cm of it was cut away and the remaining portion was

demonstrated with two additional openings. An additional drain was

placed through a stab wound in the eighth interspace in the posterior

axillary line. Both these drains were then connected to a waterseal

bottle. The fourth and fifth intercostal muscles were then approximated

with interrupted sutures of #O chromic gut. The remaining portion

of the Serratus anterior muscle was then approximated across the

closure of the intercostal muscle. The laceration of the latissimus

dorsi muscle on its intermost surface was then closed with several

interrupted sutures of #O chromic gut. ~The subcutaneous tissue was th~

Before closing the subcutaneous tissue one million units of Penicillin

and one gram of Streptomycin in 100 cc normal saline was instilled

into the wound. The stab wound was then made in the most dependent

portion of the wound coming out near the angle of the scapula. A large

Penrose drain was drawn out through this stab wound to allow drainage

of the wound of the chest wall. The subcutaneous tissue was then closed

with interrupted #O chromic gut inverting the knots. Skin closed with

interrupted vertical mattress sutures of black silk. Attention was next

turned to the wound of entrance. It was excised with an elliptical

incision. It was found that the latissimus dorsi muscle although

lacerated was not badly damaged so that the opening was closed with

sutures of #O chromic gut in the fascia of the muscle. Before closing

this incision ~the~ palpation with the index finger the Penrose drain

could be felt immediately below in the space beneath the latissimus

dorsi muscle. The skin closed with interrupted vertical mattress

sutures of black silk. Drainage tubes were secured with safety pens and

adhesive tape and dressings applied. As soon as the operation on the

chest had been concluded Dr. Gregory and Dr. Shires started the surgery

that was necessary for the wounds of the right wrist and left thigh.

Dr. Robert Shaw

RS:bl

* There was also a comminuted fracture of the right radius secondary to

the same missile and in addition a small flesh wound of the left thigh.

The operative notes concerning the management of the right arm and left

thigh will be dictated by Dr. Charles Gregory and Dr. Tom Shires.

[Illustration: COMMISSION EXHIBIT No. 392--Continued]

[Illustration: COMMISSION EXHIBIT No. 392--Continued]

PARKLAND MEMORIAL HOSPITAL

OPERATIVE RECORD

DATE: 11-22-63 Ortho

ROOM: 220

STATUS: Pvt.

NAME: Governor John Connally

UNIT: 26 36 99

AGE: W/M

RACE:

PRE-OPERATIVE DIAGNOSIS: Comminuted fracture of the right distal

radius, open secondary to gunshot wound

POST-OPERATIVE DIAGNOSIS: Same

OPERATION: Debridement of gunshot wound of right wrist, reduction of

fracture of the radius

BEGAN: 1600

ENDED: 1650

ANESTHETIC: General

BEGAN: 1300

ANESTHESIOLOGIST: Giesecke

SURGEON: Dr. Charles Gregory

ASSISTANTS: Drs. Osborne and Parker

SCRUB NURSE: Rutherford

CIRC. NURSE: Schroeder

COMPLICATIONS: None

CONDITION OF PATIENT: Fair

(handwritten: also a partial transection of the superficial radial

nerve or Ext. Pol Brevis)

CLINICAL EVALUATION: While still under general anesthesia and following

a thoracotomy and repair of the chest injury by Dr. Robert Shaw, the

right upper extremity was thoroughly prepped in the routine fashion

after shaving. he was draped in the routine fashion using stockinette,

the only addition was the use of a debridement pan. The wound of entry

on the dorsal aspect of the right wrist over the junction of the distal

fourth of the radius and shaft was approximately two cm in length and

rather oblique with the loss of tissue with some considerable contusion

at the margins of it. There was a wound of exit along the volar surface

of the wrist about two cm above the flexion crease of the wrist and in

the midline. The wound of entrance was carefully excised and developed

through the muscles and tendons from the radial side of the bone to

the bone itself where the fracture was encountered. It was noted that

the tendon of the abductor palmaris longus was transected, only two

small fragments of bone ~was~ were removed, one approximately one cm

in length and consisted of lateral cortex which lay free in the wound

and had no soft tissue connections, another much smaller fragment

perhaps 3 mm in length was subsequently removed. Small bits of metal

were encountered at various levels throughout the wound and these were

wherever they were identified and could be picked up were picked up and

have been submitted to the Pathology department for identification and

examination. Throughout the wound ~it was not~ and especially in the

superficial layers and to some extent in the tendon and tendon sheaths

on the radial side of the arm small fine bits of cloth consistent with

fine bits of Mohair. It is our understanding that the patient was

wearing a Mohair suit at the time of the injury and this accounts for

the deposition of such organic material within the wound. After as

careful and complete a debridement as could be carried out and with

an apparent integrity of the flexor tendons and the median nerve in

the volar side, and after thorough irrigation the wound of exit on

the volar surface of the wrist was closed primarily with wire sutures

while the wound of entrance on the radial side of the forearm was only

partially closed being left open for the purpose of drainage should any

make spontaneous appearance.

This is because of the presence of Mohair and organic material deep

into the wound which is prone to produce tissue reactions and to

encourage infection and this precaution of not closing the wound was

taken in correspondence with our experience in that regard.

In view of the urgency of the Governor’s original chest injury it was

impossible to definitely ascertain the status of the circulation and

the nerve supply to the hand and wrist on the right side. Accordingly,

it was determined as best we could at the time of operation and the

radial artery was found to be intact and pulsating normally. The

integrity of the median nerve and the ulnar nerve is not clearly

established but it is presumed to be present. Following closure of

the volar wound and partial closure of the radial wound, dry sterile

dressings were applied and a long arm cast was then applied with skin

tape traction, rubber band variety, attached to the thumb and index

finger of the right hand. ~The-righ~ An attitude of flexon was created

at the right elbow, and post operatively the limbus suspended from

an overhead frame using tape traction. The post operative diagnosis

for the right forearm remains the same and again I suggest that you

incorporate this particular dictation together with other dictations

which will be given to you by the surgeons concerned with this patient.

Charles Gregory, M.D.

CG:bl

[Illustration: COMMISSION EXHIBIT NO. 392--Continued]

[Illustration: COMMISSION EXHIBIT NO. 392--Continued]

PARKLAND MEMORIAL HOSPITAL

OPERATIVE RECORD

DATE: NOV. 22, 1963

ROOM: 220

STATUS: Pvt.

NAME: Connally, John

UNIT #: 263699

A #24842

RACE: W/M

PRE-OPERATIVE DIAGNOSIS: Gunshot Wound, Right Chest, Right Wrist, Left

Thigh

POST-OPERATIVE DIAGNOSIS: Same

OPERATION: Exploration and Debridement of Gunshot Wound of Left Thigh

(*See below)

BEGAN: 16:00

ENDED: 16:20

ANESTHETIC: General

BEGAN: 13:00

ANESTHESIOLOGIST: Geisecke

SURGEON: Dr. Shires

ASSISTANTS: Drs. McClelland, Baxter and Patman

SCRUB NURSE: Oliver

CIRC. NURSE: Deming and Schroder

SPONGE COUNTS: 1ST Correct PS

COMPLICATIONS: *This portion of the operation is involved only with the

operation on the left thigh. The chest injury has been dictated by Dr.

Shaw, the orthopedic injury to the arm by Dr. Gregory.

CONDITION OF PATIENT:

CLINICAL EVALUATION: There was a 1 cm. punctate missile wound over the

juncture of the middle and lower third, medial aspect, of the left

thigh. X-rays of the thigh and leg revealed a bullet fragment which

was imbedded in the body of the femur in the distal third. The leg

was prepared with Phisohex and I.O. Prep and was draped in the usual

fashion.

Following this the missile wound was excised and the bullet tract was

explored. The missile wound was seen to course through the subcutaneous

fat and into the vastus medialis. The necrotic fat and muscle were

debrided down to the region of the femur. The direction of the missile

wound was judged not to be in the course of the femoral vessel,

since the wound was distal and anterior to Hunter’s canal. Following

complete debridement of the wound and irrigation with saline, the

wound was felt to be adequately debrided enough so that three simple

through-and-through, stainless steel Aloe #28 wire sutures were used

encompassing skin, subcutaneous tissue, and muscle fascia on both

sides. Following this a sterile dressing was applied. The dorsalis

pedis and posterior tibial pulses in both lags were quite good. The

thoracic procedure had been completed at this time, the debridement of

the compound fracture in the arm was still in progress at the time this

soft tissue injury repair was completed.

Tom Shires, M.D.

fa

[Illustration: COMMISSION EXHIBIT NO. 392--Continued]

PARKLAND MEMORIAL HOSPITAL

OPERATIVE RECORD

DATE: 11/24/63 Surg.

ROOM:

STATUS: S NAME: Oswald, Lee Harvey

EOR UNIT # 25260

AGE: 24 Yr.

RACE: W/M

PRE-OPERATIVE DIAGNOSIS: GSW of upper abdomen and chest with massive

bleeding

POST-OPERATIVE DIAGNOSIS: Major vascular injury in abdomen and chest

OPERATION: Exploratory laparotomy, thoracotomy, efforts to repair aorta

1’15”

BEGAN: 1142

ENDED: 1307

ANESTHETIC: General

BEGAN: 1142

ANESTHESIOLOGIST:

Dr. M.T. Jenkins

Dr. Gene Akin

Dr. Curtis Spier

SURGEON: Dr. Tom Shires

ASSISTANTS: Dr. Perry, Dr. McClelland, Dr. Ron Jones

SCRUB NURSE: Schrader-Lunsford

CIRC. NURSE: Schrader-Bell-Burkett-Simpson

2 counted sponges missing when body closed. Square pack count correct.

DRUGS

Ca chloride--3 vials

Cedilanid--12

One molar lactate--6

Isuprel--24

Adrenalin 1:1000--3

I.V. FLUIDS AND BLOOD

3-1000 cc. lactated Ringer’s solution

16--500cc. whole blood

6--1000cc. 5% dextrose in lactated Ringer’s solution

CONDITION OF PATIENT: Expired at 1307

Measured blood loss--8,376 cc.

CLINICAL EVALUATION: Previous inspection had revealed an entrance wound

over the left lower lateral chest cage, and an exit was identified

by subcutaneous palpation of the bullet over the right lower lateral

chest cage. At the time he was seen preoperatively he was without blood

pressure, heart beat was heard infrequently at 130 beats per minute,

And preoperatively had endotracheal tube placed and was receiving

oxygen by anesthesia at the time he was moved to the operating room.

DESCRIPTION OF OPERATION: Under endotracheal oxygen anesthesia,

a long mid-line abdominal incision was made. Bleeders were not

apparent and none were clamped or tied. Upon opening the peritoneal

cavity, approximately 2 to 3 liters of blood, both liquid and in

clots, were encountered. These were removed. The bullet pathway was

then identified as having shattered the upper medial surface of the

spleen, then entered the retroperitoneal area where there was a large

retroperitoneal hematoma in the area of the pancreas. Following this,

bleeding was seen to be coming from the right side, and upon inspection

there was seen to be an exit to the right through the inferior vena

cava, thence through the superior pole of the right kidney, the lower

portion of the right lobe of the liver, and into the right lateral

body wall. First the right kidney, which was bleeding, was identified,

dissected free, retracted immediately, and the inferior vena cava

hole was clamped with a partial occlusion clamp of the Satinsky type.

Following this immobilization, packing controlled the bleeding from

the right kidney. Attention was then turned to the left, as bleeding

was massive from the left side. The inspection of the retroperitoneal

area revealed a huge hematoma in the mid-line. The spleen was then

mobilized, as was the left colon, and the retroperitoneal approach was

made to the mid-line structures. The pancreas was seen to be shattered

in its mid portion, bleeding was seen to be coming from the aorta. This

was dissected free. Bleeding was controlled with finger pressure by

Dr. Malcolm O. Perry. Upon identification of this injury, the superior

mesenteric artery had been sheared off of the aorta, there was back

bleeding from the superior mesenteric artery. This was cross-clamped

with a small, curved DeBakey clamp. The aorta was then occluded with

a straight DeBakey clamp above and a Potts clamp below. At this point

all major bleeding was controlled, blood pressure was reported to be

in the neighborhood of 100 systolic. Shortly thereafter, however, the

pulse rate, which had been in the 80 to 90 range, was found to be 40

and a few seconds later found to be zero. No pulse was felt in the

aorta at this time. Consequently the left chest was opened through an

intercostal incision in approximately the fourth intercostal space. A

Finochietto retractor was inserted, the heart was seen to be flabby

and not beating at all. There was no hemopericardium. There was a

hole in the diaphragm but no hemothorax. A left closed chest tube had

been introduced in the Emergency Room prior to surgery, so that there

was no significant pneumothorax on the left side. The pericardium was

opened, cardiac massage was started, and a pulse was obtainable with

massage. The heart was flabby, consequently calcium chloride followed

by epinephrine-Xylocaine® were injected into the left ventricle without

success. However, the standstill was converted to fibrillation.

Following this, defibrillation was done, using 240, 360, 500, and 750

volts and finally successful defibrillation was accomplished. However,

no effective heart beat could be instituted. A pacemaker was then

inserted into the wall of the right ventricle and grounded on skin,

and pacemaking was started. A very feeble, small, localized muscular

response was obtained with the pacemaker but still no effective beat.

At this time we were informed by Dr. Jenkins that there were no signs

of life in that the pupils were fixed and dilated, there was no retinal

blood flow, no respiratory effort, and no effective pulse could be

maintained even with cardiac massage. The patient was pronounced dead

at 1:07 P.M. Anesthesia consisted entirely of oxygen. No anesthetic

agents as such were administered. The patient was never conscious from

the time of his arrival in the Emergency Room until his death at 1:07

P.M. The subcutaneous bullet was extracted from the right side during

the attempts at defibrillation, which were rotated among the surgeons.

The cardiac massage and defibrillation attempts were carried out by

Dr. Robert N. McClelland, Dr. Malcolm O. Perry, Dr. Ronald Jones.

Assistance was obtained from the cardiologist, Dr. Fouad Bashour.

Tom Shires, M.D.

[Illustration: COMMISSION EXHIBIT NO. 392--Continued]

[Illustration: COMMISSION EXHIBIT NO. 392--Continued]

APPENDIX IX

Autopsy Report and Supplemental Report

CLINICAL RECORD AUTOPSY PROTOCOL A63-272 (JJH:ec)

DATE AND HOUR DIED 22 November 1963 1300 (CST)

DATE AND HOUR AUTOPSY PERFORMED 22 November 1963 2000 (EST)

FULL AUTOPSY X

PROSECTOR (497831) CDR J.J. HUMES, MC., USN

ASSISTANT (439878) CDR “J” THORNTON BOSWELL, MC, USN

LCOL PIERRE A. FINCK, MC, USA (04 043 322)

Ht.--72½ inches

Wt.--170 pounds

Eyes--Blue

Hair--Reddish brown

PATHOLOGICAL DIAGNOSES

CAUSE OF DEATH: Gunshot wound, head.

APPROVED-SIGNATURE J.J. HUMES, CDR, MC, USN

MILITARY ORGANIZATION (When required) PRESIDENT, UNITED STATES

AGE 46

SEX M

RACE Cauc.

AUTOPSY NO. A63-272

PATIENT’S IDENTIFICATION

KENNEDY, JOHN F.

NAVAL MEDICAL SCHOOL

CLINICAL SUMMARY: According to available information the deceased,

President John F. Kennedy, was riding in an open car in a motorcade

during an official visit to Dallas, Texas on 22 November 1963. The

President was sitting in the right rear seat with Mrs. Kennedy seated

on the same seat to his left. Sitting directly in front of the

President was Governor John B. Connolly of Texas and directly in front

of Mrs. Kennedy sat Mrs. Connolly. The vehicle was moving at a slow

rate of speed down an incline into an underpass that leads to a freeway

route to the Dallas Trade Mart where the President was to deliver an

address.

Three shots were heard and the President fell forward bleeding from the

head. (Governor Connolly was seriously wounded by the same gunfire.)

According to newspaper reports (“Washington Post” November 23, 1963)

Bob Jackson, a Dallas “Times Herald” Photographer, said he looked

around as he heard the shots and saw a rifle barrel disappearing into

a window on an upper floor of the nearby Texas School Book Depository

Building.

Shortly following the wounding of the two men the car was driven to

Parkland Hospital in Dallas. In the emergency room of that hospital the

President was attended by Dr. Malcolm Perry. Telephone communication

with Dr. Perry on November 23, 1963 develops the following information

relative to the observations made by Dr. Perry and procedures performed

there prior to death.

Dr. Perry noted the massive wound of the head and a second much

smaller wound of the low anterior neck in approximately the midline. A

tracheostomy was performed by extending the latter wound. At this point

bloody air was noted bubbling from the wound and an injury to the right

lateral wall of the trachea was observed. Incisions were made in the

upper anterior chest wall bilaterally to combat possible subcutaneous

emphysema. Intravenous infusions of blood and saline were begun and

oxygen was administered. Despite these measures cardiac arrest occurred

and closed chest cardiac massage failed to re-establish cardiac action.

The President was pronounced dead approximately thirty to forty minutes

after receiving his wounds.

The remains were transported via the Presidential plane to Washington,

D.C. and subsequently to the Naval Medical School, National Naval

Medical Center, Bethesda, Maryland for postmortem examination.

GENERAL DESCRIPTION OF BODY: The body is that of a muscular,

well-developed and well nourished adult Caucasian male measuring 72½

inches and weighing approximately 170 pounds. There is beginning rigor

mortis, minimal dependent livor mortis of the dorsum, and early algor

mortis. The hair is reddish brown and abundant, the eyes are blue, the

right pupil measuring 8 mm. in diameter, the left 4 mm. There is edema

and ecchymosis of the inner canthus region of the left eyelid measuring

approximately 1.5 cm. in greatest diameter. There is edema and

ecchymosis diffusely over the right supra-orbital ridge with abnormal

mobility of the underlying bone. (The remainder of the scalp will be

described with the skull.)

There is clotted blood on the external ears but otherwise the ears,

nares, and mouth are essentially unremarkable. The teeth are in

excellent repair and there is some pallor of the oral mucous membrane.

Situated on the upper right posterior thorax just above the upper

border of the scapula there is a 7 x 4 millimeter oval wound. This

wound is measured to be 14 cm. from the tip of the right acromion

process and 14 cm. below the tip of the right mastoid process.

Situated in the low anterior neck at approximately the level of the

third and fourth tracheal rings is a 6.5 cm. long transverse wound with

widely gaping irregular edges. (The depth and character of these wounds

will be further described below.)

Situated on the anterior chest wall in the nipple line are bilateral

2 cm. long recent transverse surgical incisions into the subcutaneous

tissue. The one on the left is situated 11 cm. cephalad to the nipple

and the one on the right 8 cm. cephalad to the nipple. There is no

hemorrhage or ecchymosis associated with these wounds. A similar clean

wound measuring 2 cm. in length is situated on the antero-lateral

aspect of the left mid arm. Situated on the antero-lateral aspect of

each ankle is a recent 2 cm. transverse incision into the subcutaneous

tissue.

There is an old well healed 8 cm. McBurney abdominal incision. Over

the lumbar spine in the midline is an old, well healed 15 cm. scar.

Situated on the upper antero-lateral aspect of the right thigh is an

old, well healed 8 cm. scar.

MISSILE WOUNDS: 1. There is a large irregular defect of the scalp and

skull on the right involving chiefly the parietal bone but extending

somewhat into the temporal and occipital regions. In this region

there is an actual absence of scalp and bone producing a defect which

measures approximately 13 cm. in greatest diameter.

From the irregular margins of the above scalp defect tears extend in

stellate fashion into the more or less intact scalp as follows:

a. From the right inferior temporo-parietal margin anterior to the

right ear to a point slightly above the tragus.

b. From the anterior parietal margin anteriorly on the forehead to

approximately 4 cm. above the right orbital ridge.

c. From the left margin of the main defect across the midline

antero-laterally for a distance of approximately 8 cm.

d. From the same starting point as c. 10 cm. postero-laterally.

Situated in the posterior scalp approximately 2.5 cm. laterally to

the right and slightly above the external occipital protuberance is

a lacerated wound measuring 15 x 6 mm. In the underlying bone is a

corresponding wound through the skull which exhibits beveling of the

margins of the bone when viewed from the inner aspect of the skull.

Clearly visible in the above described large skull defect and exuding

from it is lacerated brain tissue which on close inspection proves to

represent the major portion of the right cerebral hemisphere. At this

point it is noted that the falx cerebri is extensively lacerated with

disruption of the superior saggital sinus.

Upon reflecting the scalp multiple complete fracture lines are seen

to radiate from both the large defect at the vertex and the smaller

wound at the occiput. These vary greatly in length and direction, the

longest measuring approximately 19 cm. These result in the production

of numerous fragments which vary in size from a few millimeters to 10

cm. in greatest diameter.

The complexity of these fractures and the fragments thus produced

tax satisfactory verbal description and are better appreciated in

photographs and roentgenograms which are prepared.

The brain is removed and preserved for further study following formalin

fixation.

Received as separate specimens from Dallas, Texas are three fragments

of skull bone which in aggregate roughly approximate the dimensions

of the large defect described above. At one angle of the largest of

these fragments is a portion of the perimeter of a roughly circular

wound presumably of exit which exhibits beveling of the outer aspect of

the bone and is estimated to measure approximately 2.5 to 3.0 cm. in

diameter. Roentgenograms of this fragment reveal minute particles of

metal in the bone at this margin. Roentgenograms of the skull reveal

multiple minute metallic fragments along a line corresponding with a

line joining the above described small occipital wound and the right

supra-orbital ridge. From the surface of the disrupted right cerebral

cortex two small irregularly shaped fragments of metal are recovered.

These measure 7 x 2 mm. and 3 x 1 mm. These are placed in the custody

of Agents Francis X. O’Neill, Jr. and James W. Sibert, of the Federal

Bureau of Investigation, who executed a receipt therefor (attached).

2. The second wound presumably of entry is that described above in the

upper right posterior thorax. Beneath the skin there is ecchymosis

of subcutaneous tissue and musculature. The missile path through the

fascia and musculature cannot be easily probed. The wound presumably

of exit was that described by Dr. Malcolm Perry of Dallas in the

low anterior cervical region. When observed by Dr. Perry the wound

measured “a few millimeters in diameter”, however it was extended

as a tracheostomy incision and thus its character is distorted at

the time of autopsy. However, there is considerable ecchymosis of

the strap muscles of the right side of the neck and of the fascia

about the trachea adjacent to the line of the tracheostomy wound. The

third point of reference in connecting these two wounds is in the

apex (supra-clavicular portion) of the right pleural cavity. In this

region there is contusion of the parietal pleura and of the extreme

apical portion of the right upper lobe of the lung. In both instances

the diameter of contusion and ecchymosis at the point of maximal

involvement measures 5 cm. Both the visceral and parietal pleura are

intact overlying these areas of trauma.

INCISIONS: The scalp wounds are extended in the coronal plane to

examine the cranial content and the customary (Y) shaped incision is

used to examine the body cavities.

THORACIC CAVITY: The bony cage is unremarkable. The thoracic organs are

in their normal positions and relationships and there is no increase in

free pleural fluid. The above described area of contusion in the apical

portion of the right pleural cavity is noted.

LUNGS: The lungs are of essentially similar appearance the right

weighing 320 Gm., the left 290 Gm. The lungs are well aerated with

smooth glistening pleural surfaces and gray-pink color. A 5 cm.

diameter area of purplish red discoloration and increased firmness

to palpation is situated in the apical portion of the right upper

lobe. This corresponds to the similar area described in the overlying

parietal pleura. Incision in this region reveals recent hemorrhage into

pulmonary parenchyma.

HEART: The pericardial cavity is smooth walled and contains

approximately 10 cc. of straw-colored fluid. The heart is of

essentially normal external contour and weighs 350 Gm. The pulmonary

artery is opened in situ and no abnormalities are noted. The cardiac

chambers contain moderate amounts of postmortem clotted blood. There

are no gross abnormalities of the leaflets of any of the cardiac

valves. The following are the circumferences of the cardiac valves:

aortic 7.5 cm., pulmonic 7 cm., tricuspid 12 cm., mitral 11 cm. The

myocardium is firm and reddish brown. The left ventricular myocardium

averages 1.2 cm. in thickness, the right ventricular myocardium 0.4 cm.

The coronary arteries are dissected and are of normal distribution and

smooth walled and elastic throughout.

ABDOMINAL CAVITY: The abdominal organs are in their normal positions

and relationships and there is no increase in free peritoneal fluid.

The vermiform appendix is surgically absent and there are a few

adhesions joining the region of the cecum to the ventral abdominal

wall at the above described old abdominal incisional scar.

SKELETAL SYSTEM: Aside from the above described skull wounds there are

no significant gross skeletal abnormalities.

PHOTOGRAPHY: Black and white and color photographs depicting

significant findings are exposed but not developed. These photographs

were placed in the custody of Agent Roy H. Kellerman of the U. S.

Secret Service, who executed a receipt therefore (attached).

ROENTGENOGRAMS: Roentgenograms are made of the entire body and of the

separately submitted three fragments of skull bone. These are developed

and were placed in the custody of Agent Roy H. Kellerman of the U. S.

Secret Service, who executed a receipt therefor (attached).

SUMMARY: Based on the above observations it is our opinion that the

deceased died as a result of two perforating gunshot wounds inflicted

by high velocity projectiles fired by a person or persons unknown. The

projectiles were fired from a point behind and somewhat above the level

of the deceased. The observations and available information do not

permit a satisfactory estimate as to the sequence of the two wounds.

The fatal missile entered the skull above and to the right of the

external occipital protuberance. A portion of the projectile traversed

the cranial cavity in a posterior-anterior direction (see lateral skull

roentgenograms) depositing minute particles along its path. A portion

of the projectile made its exit through the parietal bone on the right

carrying with it portions of cerebrum, skull and scalp. The two wounds

of the skull combined with the force of the missile produced extensive

fragmentation of the skull, laceration of the superior saggital sinus,

and of the right cerebral hemisphere.

The other missile entered the right superior posterior thorax above

the scapula and traversed the soft tissues of the supra-scapular and

the supra-clavicular portions of the base of the right side of the

neck. This missile produced contusions of the right apical parietal

pleura and of the apical portion of the right upper lobe of the lung.

The missile contused the strap muscles of the right side of the neck,

damaged the trachea and made its exit through the anterior surface of

the neck. As far as can be ascertained this missile struck no bony

structures in its path through the body.

In addition, it is our opinion that the wound of the skull produced

such extensive damage to the brain as to preclude the possibility of

the deceased surviving this injury.

A supplementary report will be submitted following more detailed

examination of the brain and of microscopic sections. However, it is

not anticipated that these examinations will materially alter the

findings.

J. J. HUMES CDR, MC, USN (497831)

“J” THORNTON BOSWELL CDR, MC, USN (489878)

PIERRE A. FINCK LT COL, MC, USA (04-043-322)

[Illustration: COMMISSION EXHIBIT NO. 387]

[Illustration: COMMISSION EXHIBIT NO. 387]

[Illustration: COMMISSION EXHIBIT NO. 387]

[Illustration: COMMISSION EXHIBIT NO. 387]

[Illustration: COMMISSION EXHIBIT NO. 387]

[Illustration: COMMISSION EXHIBIT NO. 387]

SUPPLEMENTARY REPORT OF AUTOPSY NUMBER A63-272 PRESIDENT JOHN F. KENNEDY

PATHOLOGICAL EXAMINATION REPORT No. A63-272

GROSS DESCRIPTION OF BRAIN: Following formalin fixation the brain

weighs 1500 gms. The right cerebral hemisphere is found to be markedly

disrupted. There is a longitudinal laceration of the right hemisphere

which is para-sagittal in position approximately 2.5 cm. to the right

of the of the midline which extends from the tip of the occipital lobe

posteriorly to the tip of the frontal lobe anteriorly. The base of the

laceration is situated approximately 4.5 cm. below the vertex in the

white matter. There is considerable loss of cortical substance above

the base of the laceration, particularly in the parietal lobe. The

margins of this laceration are at all points jagged and irregular, with

additional lacerations extending in varying directions and for varying

distances from the main laceration. In addition, there is a laceration

of the corpus callosum extending from the genu to the tail. Exposed in

this latter laceration are the interiors of the right lateral and third

ventricles.

When viewed from the vertex the left cerebral hemisphere is intact.

There is marked engorgement of meningeal blood vessels of the left

temporal and frontal regions with considerable associated sub-arachnoid

hemorrhage. The gyri and sulci over the left hemisphere are of

essentially normal size and distribution. Those on the right are too

fragmented and distorted for satisfactory description.

When viewed from the basilar aspect the disruption of the right cortex

is again obvious. There is a longitudinal laceration of the mid-brain

through the floor of the third ventricle just behind the optic chiasm

and the mammillary bodies. This laceration partially communicates with

an oblique 1.5 cm. tear through the left cerebral peduncle. There are

irregular superficial lacerations over the basilar aspects of the left

temporal and frontal lobes.

In the interest of preserving the specimen coronal sections are not

made. The following sections are taken for microscopic examination:

a. From the margin of the laceration in the right parietal lobe.

b. From the margin of the laceration in the corpus callosum.

c. From the anterior portion of the laceration in the right

frontal lobe.

d. From the contused left fronto-parietal cortex.

e. From the line of transection of the spinal cord.

f. From the right cerebellar cortex.

g. From the superficial laceration of the basilar aspect of the

left temporal lobe.

During the course of this examination seven (7) black and white and

six (6) color 4x5 inch negatives are exposed but not developed (the

cassettes containing these negatives have been delivered by hand to

Rear Admiral George W. Burkley, MC, USN, White House Physician).

MICROSCOPIC EXAMINATION:

BRAIN: Multiple sections from representative areas as noted above are

examined. All sections are essentially similar and show extensive

disruption of brain tissue with associated hemorrhage. In none of the

sections examined are there significant abnormalities other than those

directly related to the recent trauma.

HEART: Sections show a moderate amount of sub-epicardial fat. The

coronary arteries, myocardial fibers, and endocardium are unremarkable.

LUNGS: Sections through the grossly described area of contusion

in the right upper lobe exhibit disruption of alveolar walls and

recent hemorrhage into alveoli. Sections are otherwise essentially

unremarkable.

LIVER: Sections show the normal hepatic architecture to be well

preserved. The parenchymal cells exhibit markedly granular cytoplasm

indicating high glycogen content which is characteristic of the “liver

biopsy pattern” of sudden death.

SPLEEN: Sections show no significant abnormalities.

KIDNEYS: Sections show no significant abnormalities aside from

dilatation and engorgement of blood vessels of all calibers.

SKIN WOUNDS: Sections through the wounds in the occipital and upper

right posterior thoracic regions are essentially similar. In each there

is loss of continuity of the epidermis with coagulation necrosis of the

tissues at the wound margins. The scalp wound exhibits several small

fragments of bone at its margins in the subcutaneous tissue.

FINAL SUMMARY: This supplementary report covers in more detail the

extensive degree of cerebral trauma in this case. However neither this

portion of the examination nor the microscopic examinations alter the

previously submitted report or add significant details to the cause of

death.

J. J. HUMES CDR, MC, USN, 497831

[Illustration: COMMISSION EXHIBIT NO. 391]

[Illustration: COMMISSION EXHIBIT NO. 391]

6 December 1963

From: Commanding Officer, U. S. Naval Medical School

To: The White House Physician

Via: Commanding Officer, National Naval Medical Center

Subj: Supplementary report of Naval Medical School autopsy No. A63-272,

John F, Kennedy; forwarding of

1. All copies of the above subject final supplementary report are

forwarded herewith.

J. H. STOVER, JR.

- - - - - - - - - -

6 December 1963

FIRST ENDORSEMENT

From: Commanding Officer, National Naval Medical Center To: The White

House Physician

1. Forwarded.

C. B. GALLOWAY

[Illustration: COMMISSION EXHIBIT NO. 391]

APPENDIX X

Expert Testimony

FIREARMS AND FIREARMS IDENTIFICATION

Three experts gave testimony concerning firearms and firearms

identification: Robert A. Frazier and Cortlandt Cunningham of the

FBI, and Joseph D. Nicol, superintendent of the Bureau of Criminal

Identification and Investigation of the State of Illinois. Frazier has

been in the field of firearms identification for 23 years, following a

1-year course of specialized training in the FBI Laboratory. Cunningham

has been in the field for 5 years, having also completed the FBI

course. Nicol has been in the firearms identification field since 1941,

having begun his training in the Chicago police crime laboratory. Each

has made many thousands of firearms identification examinations.[A10-1]

Frazier testified on the rifle, the rifle cartridge cases, and the

rifle bullets; Cunningham on the revolver, the revolver cartridge

cases, the revolver bullets, and the paraffin test; and Nicol on all

the bullets and cartridge cases and the paraffin test.[A10-2] Nicol’s

conclusions were identical to those of Frazier and Cunningham, except

as noted.

General Principles