Kennedy Assassination Timeline - Business Insider print Public Domain / wikimedia Friday, Nov. 22, 1963, 12:30 am: Lee Harvey Oswald and his wife Marina are not living together. While Oswald lives in a boarding house at 1026 N. Beckley Ave. in the Oak Cliff section of Dallas, Marina Oswald is living with Ruth Paine in Irving Texas. Unlike most weeks, Lee has showed up on Thursday evening instead of Friday evening. At 12:30am, Marina notices that Lee is still awake. 6:30am: Lee Harvey Oswald gets out of bed after a restless night and gets ready for work. Before he leaves the house, he takes off his wedding ring and leaves it in a cup on top of Marina’s dresser. He takes $170 out of his wallet and leaves it with his wedding ring. He gets a ride into work at the Texas School Book Depository with Buell Wesley Fraizer. He is carrying something long and tells Fraizer they’re curtain rods for his room in the boarding house. 7:00am: President John F. Kennedy is at the Hotel Texas getting ready for his day.

He will give a speech outside the hotel, give a speech to the Chamber of Commerce, and then leave Fort Worth for Dallas. After a motorcade through Dallas and a speech at the Trade Mart, the Kennedy’s will travel with the Johnson’s to Austin and then the Johnson Ranch for a weekend of rest. He has just picked up The Dallas Morning News. He sees the infamous “black border” ad which accuses Kennedy of treason. He also sees a prediction from Richard Nixon that Kennedy will be dropping Johnson from the ticket. 10:00am: As the weather starts clearing up, advance secret service agent Win Lawson has decided to take the bubbletop off the presidential limo. President Kennedy has made it clear that he wants to be accessible to the people. He wants to bubbletop off as much as possible and does not want secret service agents on the back on his limo. 10:30am: Kennedy returns to his suite in the Hotel Texas and prepares to leave for Dallas. He remarks to Jackie “you know, last night would have been a hell of a night to assassinate a president…” in reference to their late night motorcade through For Worth.

11:50am: Multiple co-workers see Oswald on the first floor of the book depository eating lunch. Simultaneously, the motorcade leaves Love Field to begin the motorcade through Dallas. 12:05pm: President Kennedy makes his first of many stops at groups of people waiting to meet him and shake his hand, delaying the motorcade by five minutes. 12:29pm: The presidents limo turns onto Elm St. The first shot is fired missing the president. A fragment from the bullet or debris from the street hit James Tauge who is watching the motorcade in Dealey Plaza. A man is standing near the Stemmons Freeway sign with an opened umbrella giving rise to the “umbrella man” conspiracy theory. 12:30pm: The second shot is fired, causing Kennedy to go into Thornburn’s position. This is a common neurological response to spinal damage. The third shot is fired, hitting the president on the back, right side of his head, causing a portion of his head behind his right ear to blow out. Right after the third shot is fired, Sheriff Bill Decker orders Dallas police officers to the railroad tracks behind the fence on the Grassy Knoll.

Oswald gets a Coke from the soda machine in the book depository and starts walking out of the buildings after being stopped briefly by Dallas police officer Marrion Baker. Oswald walks passed NBC’s Robert MacNeil who is looking for a phone to call in the shooting. 12:35pm: The presidential limo arrives at Parkland Memorial Hospital where “24740, white male” suffering from a gunshot wound is admitted and brought to trauma room 1. Secret service agent Roy Kellerman who is in charge in Dallas calls the head of secret service Jerry Behn to report that JFK has been hit. Dr. Charles Crenshaw enters and notes there is a large wound on the back of the president's head as well as a small hole in his throat. They use this hole to perform a tracheotomy. 12:45pm: Lee Harvey Oswald gets onto a bus 7 blocks away from the Texas School Book Depository. The bus isn’t moving much because of traffic in Dealey Plaza. Shortly after boarding, he gets off and gets into Whaley’s cab which he takes back to his boarding house where he changes and gets his pistol.

12:57pm: Father Hub er arrives at the hospital. Ken O’Donnell tells secret service agent Clint Hill to order a casket from somewhere near by. The president is already technically dead, but Jackie is worried about him receiving his last rites before he has died. Just after, Dr. Kemp Clark pronounces John F. Kennedy dead. Admiral Dr. George Burkley officially pronounces Kennedy dead. 1:15pm: After being told to patrol the Oak Cliff section of Dallas, Office J.D. Tippit speaks to someone who fits Oswald's description. Shortly after police hear a civilian on the police radio line saying, “It’s a police officer. Someone shot him.” 1:26pm: Lyndon B. Johnson leaves Parkland for Air Force One. As he and Mrs. Johnson are leaving, she sees the flags drop to half mast. Mac Kilduff confirms Kennedy’s death. 1:40pm: Oswald runs into a movie theater that is playing "War is Hell." He was seen sneaking in and police start to search the theater. The lights are raised and officer Nick McDonald spots Oswald in the seats.

He walks up to Oswald who says, “This is it!” and pulls a revolver. As they fight, officer McDonald gets his finger in front of the pistol's hammer so the gun will not fire. Oswald punches an officer in the face and the officer punches back giving Oswald a black eye. 2:00pm: Secret service agent Roy Kellerman gets into an argument with Dallas Country medical examiner Dr. Earl Rose. The Kennedy party wants his body put in a casket and want to leave the hospital. At this point, killing a president is not a federal offense. Because of this, the medical examiner argues that the autopsy has to be performed before the body is taken from Dallas. The new president orders the body to be released, but the ME refuses. Finally, he is overridden by Dallas district attorney Henry Wade, who only agrees to release the body if Admiral Dr. Burkley, Kennedy’s private physician, promises to stay with the body until it is put in the casket for the final time. Simultaneously, Lyndon Johnson phones grief stricken Robert Kennedy to find out what his legal options are about taking the oath of office. 2:07pm: Kennedy’s body leaves Parkland Hospital bound for Love Field.

After news of the assassination, the stock market has dipped 24 points. It now closes, not to reopen until Tuesday, Nov. 26. Oswald has arrived at the homicide and robbery office on the 3rd floor of city hall. When asked if he wants to hide his face from reports, he responds, “Why should I? I haven’t done anything to be ashamed of.” 2:38pm: The president's body has been loaded to Air Force One with much difficulty. The casket they got from the funeral home was too wide for the plane door and some of the handles had to be broken off. Despite what conspiracy theorist say, the damage to the casket was caused by the secret service, not the casket being opened and the body being altered. Nick Katzenbach, Deputy Attorney General has spoken to people in Washington to get the correct oath of office. Despite having trouble reading his writing, he dictates the oath of office and Lyndon Johnson becomes the 36th president of the United States. He is the first president to be sworn in by a woman, Judge Sarah T. Hughes. 3:00pm: Oswald’s first interrogation has started.

The police take paraffin tests of his hands and face. The test of the hands comes back positive. They have only charged him with the killing of Officer Tippit. He has not been charged with killing the president yet. 4:00pm: J. Edgar Hoover called RFK to tell him “we have the man.” Oswald waits for his first lineup with Helene Markham, the witness to Tippit’s murder. While waiting, Oswald is searched and five bullet cartridges are found in his pocket. Jack Ruby, who owns The Carousel Club, stops by the police station for the first time. Since many of the officers frequent the club, he is familiar with quite a few people and is able to walk around the police station freely. 4:30pm: Doctors from trauma room 1 fill out forms stating what they observed in the emergency room. The conflicting reports from the doctors leads to confusion and distrust. Dr. Marion Jenkins says there was a large hole on the right side of his head so large, the cerebellum had protruded from the wound. Dr.

James Carrico, the first doctor to enter the trauma room, noted a large wound located in the right occipito-parietal area and one small penetrating wound in the middle of the neck. Dr. Charles Baxter that the right temporal and occipital bones were missing and the brain was on the table. Dr. Kemp Clark, who pronounced Kennedy dead, noted two external wounds. Both the cerebral and cerebella tissue were extruding from the wound. Dr. McClelland stated that “the cause of death was due to a massive head and brain injury from a gunshot wound of the left temple.” Dr. Marion Jenkins later supported this statement. 6:00pm (est.): Air Force One arrives at Andrews Airforce Base. Among many others, waiting for the plane were Robert Kennedy, Robert McNamara, and General Maxwell Taylor. Jackie Kennedy has requested that the secret service agents that carried him onto the plane as well as “his friends” carry him off the plane. She has also requested that secret service agent and driver Bill Greer drive the ambulance with the coffin to Bethesda Naval Hospital. Robert Kennedy has rushed onto the plane to find Jackie. He puts his arm around her and quietly says “Hi, Jackie.

I’m here.” When they get into the ambulance with the casket Jackie recounts the motorcade, the shooting, and aftermath in detail to RFK. Lyndon Johnson makes his first statement on TV as president. 6:20pm (cst): Oswald’s second interrogation starts in Captain Fritz’s office. At this point, they are still only investigating and interrogating Oswald about the shooting death of Tippit. As he is taken out for his second lineup he yells to the press, “I didn’t shoot anyone!” He is identified by Cecil McWatters. McWatters says that Oswald was wearing a jacket, though the Warren Commission said he was not. Also, later when testifying to the Warren Commission, McWatters says he was wrong in selecting Oswald in the lineup. 7:00pm (est.): Jackie Kennedy and Robert Kennedy enter Bethesda Naval Hospital. RFK stops to sign the order for the autopsy of his brother. They are taken to a VIP suite on the 17 th floor of the hospital while the autopsy is performed. General Godfrey McHugh has stopped Admiral Calvin Galloway, who has assembled a team to perform the autopsy.

McHugh tells Galloway that the autopsy and embalming should be done by his team and that “Mrs. Kennedy doesn’t want an undertaker.” Galloway responds, “We don’t have the facilities. I highly recommend a funeral parlor.” When he is asked if it’s possible he says, “It’s not impossible. It’s difficult though. And it might be unsatisfactory.” Sargent Shriver is preparing the White House to receive Kennedy’s body and for it to lay in repose. He has covered the White House in black bunting and, at the request of Jackie Kennedy, he has gotten books and documents so he can make the White House look like it did when Lincoln died and laid in repose in the White House. 7:10 (cst): Captain Fritz has questioned Marina Oswald, and Ruth and Michael Paine. He has also signed a complaint charging Oswald with the murder of Tippit. He is not formally arraigned for the murder of J.D. Tippit. FBI agents have been sitting in on the interrogations.

In regards to the president's assassination, Gordon Shanklin, agent in charge of the Dallas office tells Harry Maynor, New Orleans Bureau chief “Oswald was probably a good suspect but they have been unable to develop information connecting the rifle with Oswald.” 7:50 (cst): Oswald in interrogated for the third time. He is then taken for his third lineup where is he identified by J.D. Davies as the man people saw unloading a pistol as he came across their yard immediately following the Tippit shooting. Immediately following the lineup, Oswald’s finger and palm prints are taken on an inkless pad. 8:15pm (est.): Under the charge of Commander J.J. Humes the autopsy of John F. Kennedy begins. 9:00pm (cst): Buell Frazier has his sister have come to the homicide and robbery office. They both say they saw Oswald carrying a package with him to the Texas School Book Depository. He is later arrest and brought back in for questioning. 11:00pm (est.): President Kennedy’s autopsy is concluded. 11:26pm (cst): Captain Fritz signs the complaint charging Oswald with the murder of President Kennedy.

11:59pm (est.): Dr. Humes states that the autopsy results were that Kennedy was killed by two shots from the rear. Saturday, November 23rd, 1963, 1:30am (cst): Lee Harvey Oswald is charged by Judge David Johnson that he “voluntarily and with malice of forethought killed John F. Kennedy by shooting him with a gun.” 1:35am (cst): Oswald is officially told he has been charged with the murder of John F. Kennedy. 3:56am (est.): John F. Kennedy’s body is brought to the White House where he will lay in repose until Sunday. On Monday November 25 th , John Jr.’s 3 rd birthday, John Kennedy will be laid to rest at Arlington National Cemetery. This timeline comes from Business Insider's Beth Frutkin, who is researching and writing a book on Kennedy. See also her post on the significance of JFK's assassination . Three Patients at Parkland - JFK Assassination Debate - The Education Forum Three Patients at Parkland Somewhere online I have seen the State Journal of Medicine article THREE PATIENTS AT PARKLAND.

I have the magazine somewhere but cannot find it. I am trying to answer a researcher request. Does anybody know whether the article is online? Thanks. Somewhere online I have seen the State Journal of Medicine article THREE PATIENTS AT PARKLAND. I have the magazine somewhere but cannot find it. I am trying to answer a researcher request. Does anybody know whether the article is online? Thanks. Thanks, Michael...but I was looking for the article itself, which is quite long. Those include a review and an excerpt, but not the article. Jack This article should be on the Mary Ferrell website, but I could not find it there. I think my xerox copy I cannot find came from Mary. Jack January 6, 2010 (edited) Jack the second part on Connally I NEVER HAD it was not available some years back when i copied this from the web...i wish and if possbly someone does it certainly would be appreciated...thanks fwiw... b START QUOTE THREE PATIENTS at PARKLAND This article is originally from the alts, found some years back, it was posted by Michael Parks...thanks...

........It came from "The Texas State Journal of Medicine", dated January, 1964. It was written in late November/early December, 1963 before the 'OFFICIAL' story was set in stone. I have been told, it is somewhat different, in content in some regards, than how it is found now on the web.? ..Though I have not checked...it is possible it could be.... Thanks....B PARKLAND Memorial Hospital, Dallas, treats an average of 272 emergency cases a day. It is adjacent to and is the major teaching hospital for the University of Texas Southwestern Medical School. It is staffed by the faculty of the medical school and has 150 interns and residents in all medical specialties. It is a modern hospital, well equipped, one of which any community might be proud. Today and for none of these reasons-Parkland has a new reputation all over the world, and historians are typing its name into manuscripts that will be textbooks for generations to come. This has happened because three particular gunshot victims were carried there out of the bright November sunlight, two to die and the third to leave by wheelchair almost two weeks later, his arm in a sling.

Many Texas physicians have visited Parkland hospital; many have worked or trained there. Members of the Parkland staff are their acquaintances and friends. Many Texas physicians know personally the surviving gunshot victim, Gov. John Connally; some personally knew President John F. Kennedy, who died in Trauma Room 1; perhaps a few even knew Lee Harvey Oswald, the man charged by Dallas authorities with the assassination of the President and who was himself shot two days later. The assassination of President Kennedy, the wounding of Governor Connally, and the fatal shooting of Oswald are events of profound import to people everywhere, but they have special, personal meaning for Texans. So because a Texas hospital and Texas physicians figured prominently in this tragedy, the Texas State Journal of Medicine records for its readers of the medical profession a full account of treatment given a never-to-be-forgotten trio. When President John F. Kennedy in a moribund condition entered Parkland on Nov. 22, there was never opportunity for medical history taking. Such a history, had it been taken, would have shown that the patient "had survived several illnesses, the danger of war, the rigor of exposure in icy water, and . . .

had waged grueling electoral campaigns in spite of a serious and painful back injury." Parkland records show that the President arrived at the emergency room sometime after 12:30 p.m. (There is conflict as to the exact moment.) At 1 p.m. Dr. William Kemp Clark, associate professor and chairman of the Division of Neurosurgery of the University of Texas Southwestern Medical School, declared him dead. During the interim of less than 30 minutes, continuous resuscitative efforts were made. Later that day, several attending physicians filed reports. The following identifies these physicians and gives the gist of their reports: Charles J Carrico - Dr. Carrico was the first physician to see the President. A 1961 graduate of Southwestern Medical School, he is 28 and a resident in surgery at Parkland. He reported that when the patient entered the emergency room on an ambulance carriage he had slow agonal respiratory efforts and occasional cardiac beats detectable by auscultation. Two external wounds were noted; one a small wound of the anterior neck in the lower one third.

The other wound had caused avulsion of the occipitoparietal calvarium and shredded brain tissue was present with profuse oozing. No pulse or blood pressure were present. Pupils were bilaterally dilated and fixed. A cuffed endotracheal tube was inserted through the laryngoscope. A ragged wound of the trachea was seen immediately below the larynx. The tube was advanced past the laceration and the cuff inflated. Respiration was instituted using a respirator assistor on automatic cycling. Concurrently, an intravenous infusion of lactated Ringer's solution was begun via catheter placed in the right leg. Blood was drawn for typing and crossmatching. Type 0 Rh negative blood was obtained immediately. In view of the tracheal injury and diminished breath sounds in the right chest, tracheostomy was performed by Dr. Malcolm 0. Perry and bilateral chest tubes inserted. A second intravenous infusion was begun in the left arm. In addition, Dr. M. T. Jenkins began respiration with the anesthesia machine, cardiac monitor and stimulator attached. Solu-Cortef (300 mg.) was given intravenously.

Despite those measures, blood pressure never returned. Only brief electrocardiographic evidence of cardiac activity was obtained. Malcolm 0. Perry - Dr. Perry is an assistant professor of surgery at Southwestern Medical School from which he received his degree in 1955. He I9 34 years old and was certified by the American Board of Surgery in 1963. At the time of initial examination of the President, Dr. Perry has stated, the patient was noted to be nonresponsive . His eyes were deviated and the pupils dilated. A considerable quantity of blood was noted on the patient, the carriage, and the floor. A small wound was noted in the midline of the neck in the lower third anteriorly. It was exuding blood slowly. A large wound of the right posterior cranium was noted, exposing severely lacerated brain. Brain tissue was noted in the blood at the head of the carriage. Pulse or heart beat were not detectable but slow spasmodic respiration was noted. An endotracheal tube was in place and respiration was being controlled. An intravenous infusion was being placed in the leg.

While additional venesections were done to administer fluids and blood, a tracheostomy was effected. A right lateral injury to the trachea was noted. The cuffed tracheostomy tube was put in place as the endotracheal tube was withdrawn and respirations continued. Closed chest cardiac massage was instituted after placement of sealed-drainage chest tubes, but without benefit. When electrocardiogram evaluation revealed that no detectable electrical activity existed in the heart, resuscitative attempts were abandoned. The team of physicians determined that the patient had expired. Charles R. Baxter - Dr. Baxter is an assistant professor of surgery at Southwestern Medical School where he first arrived as a medical student in 1950. Except for two years away in the Army he has been at Southwestern and Parkland ever since, moving up from student to intern to resident to faculty member. He is 34 and was certified by the American Board of Surgery in 1963. Recalling his attendance to President Kennedy, he says he learned at approximately 12 :35 that the President was on the way to the emergency room and that he had been shot. When Dr.

Baxter arrived in the emergency room, he found an endotracheal tube in place and respirations being assisted. A left chest tube was being inserted and cut-downs were functioning in one leg and in the left arm. The President had a wound in the midline of the neck. On first observation of the other wounds, portions of the right temporal and occipital bones were missing and some of the brain was lying on the table. The rest of the brain was extensively macerated and contused. The pupils were fixed and deviated laterally and were dilated. No pulse was detectable and ineffectual respirations were being assisted. A tracheostomy was performed by Dr. Perry and Dr. Baxter and a chest tube was inserted into the right chest (second interspace anteriorly). Meanwhile one pint of O negative blood was administered without response. When all of these measures were complete, no heart beat could be detected. Closed chest massage was performed until a cardioscope could be attached. Brief cardiac activity was obtained followed by no activity. Due to the extensive and irreparable brain damage which existed and since there were no signs of life, no further attempts were made at resuscitation. Robert N.

McClelland - Dr. McClelland, 34, assistant professor of surgery at Southwestern Medical School, is a graduate of the University of Texas Medical Branch in Galveston. He has served with the Air Force in Germany and was certified by the American Board of Surgery in 1963. Regarding the assassination of President Kennedy, Dr. McClelland says that at approximately 12:35 p.m. he was called from the second floor of the hospital to the emergency room. When he arrived, President Kennedy was being attended by Drs. Perry, Baxter, Carrico, and Ronald Jones, chief resident in surgery. The President was at that time comatose from a massive gunshot wound of the head with a fragment wound of the trachea. An endotracheal tube had been placed and assisted respiration started by Dr. Carrico who was on duty in the emergency room when the President arrived. Drs. Perry, Baxter, and McClelland performed a tracheostomy for respiratory distress and tracheal injury. Dr. Jones and Dr.

Paul Peters, assistant professor of surgery, ; inserted bilateral anterior chest tubes for pneumothoraces secondary to the tracheo-mediastinal injury. Dr. Jones and assistants had started three cutdowns, giving blood and fluids immediately. In spite of this, the President was pronounced dead at 1:00 p.m. by Dr. Clark, the neurosurgeon, who arrived immediately after Dr. McClelland. The cause of death, according to Dr. McClelland was the massive head and brain injury from a gunshot wound of the right side of the head. The President was pronounced dead after external cardiac massage failed and electrocardiographic activity was gone. Fouad A, Bashour - Dr. Bashour received his medical education at the University of Beirut School of Medicine in Lebanon. He is 39 and an associate professor of medicine in cardiology at Southwestern Medical School. At 12 :50 p.m. Dr. Bashour was called from the first floor of the hospital and told that President Kennedy had been shot. He and Dr. Donald Seldin, professor and chairman of the Department of Internal Medicine, went to the emergency room.

Upon examination, they found that the President had no pulsations, no heart beats, no blood pressure. The oscilloscope showed a complete standstill. The President was declared dead at 1:00 p.m. William Kemp Clark - Dr. Clark is associate professor and chairman of the Division of Neurosurgery at Southwestern Medical School. The 38-year-old physician has done research on head injuries and has been at Southwestern since 1956. He reports this account of the President's treatment: The President arrived at the emergency room entrance 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. Carrico. Dr. Carrico noted the President to have slow, agonal respiratory efforts. He could hear a heart beat but found no pulse or blood pressure. 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 and while doing so, he noted a ragged wound of the trachea immediately below the larynx. At this time, Drs. Perry, Baxter, and Jones arrived. Immediately thereafter, Dr. Jenkins and Drs. A. H. Giesecke, Jr., and Jackie H. Hunt, two other staff anesthesiologists, arrived. The endotracheal tube had been connected to a respirator to assist the President's breathing. An anesthesia machine was substituted for this by Dr. Jenkins. Only 100 per cent 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 typing and crossmatching, but unmatched type O Rh negative blood was immediately obtained and begun. Hydrocortisone (300 mg.) was added to the intravenous fluids. Dr. McClelland arrived to help in the President's care. Drs. Perry, Baxter, and McClelland did a tracheostomy.

Considerable quantities of blood were present in the President's oral pharynx. At this time, Dr. Peters and Dr. Clark arrived. Dr. Clark noted that the President had bled profusely from the back of the head. There was a large (3 by 3 cm.) amount of cerebral tissue present on the cart. There was a smaller amount of cerebellar tissue present also. The tracheostomy was completed and the endotracheal tube was withdrawn. Suction was used to remove blood in the oral pharynx. A nasogastric tube was passed into the stomach. Because of the likelihood of mediastinal injury, 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. When Dr. Clark noted that there was no carotid pulse, he began closed chest massage. A pulse was obtained at the carotid and femoral levels. Dr. Perry then took over the cardiac massage so that Dr.

Clark could evaluate the head wound. There was a large wound beginning in the right occiput extending into the parietal region. Much of the right posterior skull, at brief examination, appeared gone. The previously described extruding brain was present. Profuse bleeding had occurred and 1500 cc. of blood was estimated to be on the drapes and floor of the emergency operating room. Both cerebral and cerebellar tissue were extruding from the wound. By this time an electrocardiograph was hooked up. There was brief electrical activity of the heart which soon stopped. The President was pronounced dead at 1:00 p.m. by Dr. Clark. M. T. Jenkins - Dr. Jenkins is professor and chairman of the Department of Anesthesiology at Southwestern Medical School. He is 46, a graduate of the University of Texas Medical Branch in Galveston, and was certified by the American Board of Anesthesiology in 1952. During World War II he served in the Navy as a lieutenant commander. When Dr. Jenkins was notified that the President was being brought to the emergency room at Parkland, he dispatched Drs.

Giesecke and Hunt with an anesthesia machine and resuscitative equipment to the major surgical emergency room area. He ran downstairs to find upon his arrival in the emergency operating room that Dr. Carrico had begun resuscitative efforts by introducing an orotracheal tube, connecting it for controlled ventilation to a Bennett intermittent positive pressure breathing apparatus. Drs. Baxter, Perry, and 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. Drs. Peters and 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. Dr. Jenkins believes it evidence of the clear thinking of the resuscitative team that the patient received 300 mg. hydrocortisone intravenously in the first few minutes. For better control of artificial ventilation, Dr. Jenkins exchanged the intermittent positive pressure breathing apparatus for an anesthesia machine and continued artificial ventilation. Dr. Gene Akin, a resident in anesthesiology, and Dr. 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 12:50 at which time external cardiac massage was still being carried out effectively by Dr. Clark as judged by a palpable peripheral pulse. Despite these measures there was only brief 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 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 part of the right 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. President Kennedy was pronounced dead at 1 p.m. It is Dr. Jenkins' personal feeling that all methods of resuscitation were instituted expeditiously and efficiently. However, he says, the cranial and intracranial damage was of such magnitude as to cause irreversible damage. end part one.... Part III Lee Harvey Oswald On Nov. 24, two days after the shooting of President Kennedy and Governor Connally, an ironic event brought to Parkland the man whom Dallas police had charged with the murder of the President. Lee Harvey Oswald, 24, had been shot. Initial care and surgery were handled by Parkland physicians, including some of those who had cared for the President and the Governor. Oswald was brought into the emergency room at 11:32 a.m., to the operating room at 11:42 a.m. and at 1:07 p.m. he was pronounced dead in spite of all efforts. Dr.

Shires.--The surgery performed on Oswald, who had been shot in the upper abdomen and chest, was done by Drs. Shires, Perry, McClelland, and Jones, and included an exploratory laparotomy, thoracotomy, and efforts to repair the aortu, vena cava, and multiple organ injuries. Dr. Shires has said that on previous inspection an entrance wound over the left lower lateral chest edge was revealed and an exit was identified by subcutaneous palpation of the bullet over the right lower lateral chest cage. At the time he wag geen preoperatively, Oswald was without perceptible blood pressure, his heart beat wag heard intermittently at 130 beats per minute, he had an endotracheal tube in place and was receiving only oxygen by ane8the8ia at the time he wag moved to the operating room. Under enaotracheal oxygen anesthesia, a long midline abdominal incision was made. Bleeders were not apparent and none were clamped or tied. Upon opening the peritoneal cavity, approximately 2 to S liters of blood, both liquid and in clots, was encountered. This was 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 medially, 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 re-vealed a huge hematoma in the midline. The stomach had been penetrated by the bullet. The spleen was then mobilized, as was the left colon, and the retroperitoneal approach was made to the midline structures.

The pancreas appeared to be shattered in its midportion; bleeding was seen to be coming from the aorta. This was dissected free. Bleeding was controlled with finger pressure by Dr. Perry. Upon identification of this injury, it was seen that the superior mesenteric artery had been sheared off of the aorta; there was some back bleeding from the 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 by Dr. Perry through an intercostal incision in approximately the fourth intercostal space. A Finochietto re-tractor was inserted, and 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 suction chest tube had been introduced while the patient was in the emergency room prior to surgery, so that there was no significant pneumothorax on the leM side. The pericardium was opened, cardiac massage was started, and a pulse was obhinable with massage. The heart was flabby, consequently calcium chloride followed by 1 mg. epinephrine hydrochloride and 90 mg. Xylocaine Hydrochloride were injected into the left ventricle. The standstill converted to fibrillation. Following this defibrillation was done, using 240, 860, 500, and 750 volts, and finally successful defibrillation was accomplished after a second attempt with the defibrillator. However, no effective heart beat could be instituted. A pacemaker was 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 heart beat. At this time Dr.

Shires was informed by Dr. Jenkins that there were no signs of life in that the pupils were fixed and dilated, there was no retmal 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. 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 side during the attempts at defibrillation which were' rotated among the surgeons. The cardiac massage and defibrillation attempts were carried out by Drs. McClelland, Perry, and Jones. Assistance was obtained from the cardiologist, Dr. Bashour. Dr. Jenkins.--In a statement concerning resuscitative efforts for Oswald, Dr. Jenkins reported that Dr. Jones, after being notified through the office of the administrator of the hospital, informed a surgical and anesthesiology team that Lee Harvey Oswald had sustained a gunshot wound and was being -brought to the emergency operating room for emergency and definitive treatment.

By the time that the patient, Oswald, was registered into the emergency operating room, there was assembled a resuscitative team in the emergency operating room surgical room. Dr. Jenkins recalls that the following physicians were members of the resuscitation team: Drs. Jenkins and Akin, with an anesthesia machine and full resuscitative equipment for the maintenance of ventilation; Drs. Gerry Gustafson, Dale Coln, and Charles Crenshaw, all residents in surgery, who were prepared to introduce cannulae in-to the veins via cutdowns or percutaneous puncture; Dr. Jones with chest drainage equipment; Dr. William R. Osborne, resident in orthopedics, for necessary orthopedic services; and Dr. William Risk, resident in urology, for evaluation of possible urological damage. Dr. Perry was present to direct the surgical approach. There were many other medical personnel present in addition to these, but the physicians named figured importantly in the initial resuscitative experience, Dr. Jenkins said. As the patient, Oswald, was brought into the operating room, Dr.

Akin introduced a #36 cuffed endotracheal tube and connected it to an anesthesia machine for assisted ventilation or controlled respiration with oxygen. It was obvious that the patient was in extremis as judged by his general pallor, the cold extremities, the dusky or ashen gray color of his nail beds, his gasping respiration, and his dilated pupils and dry conjunctiva. There was a small, oval, traumatized area in approximately his left anterior axillary line at approximately the sixth intercostal space, and a foreign object, thought to be a bullet, could be palpated in his right posterior axillary line at about thoracic dermatome ten. No time was expended in making these observations and evaluation of the patient's status, for at the time the endotracheal tube was being inserted, three members of the staff were performing venous cutdowns, one in each lower extremity and one in the left forearm, These were performed by Drs. Coln, Crenshaw, and Gustafson. Because of the obvious chest wound and appearance of pneumothorax on the left, Dr. Jones inserted a chest tube and connected it to a closed waterseal drainage bottle.

The head of the emergency room cart was lowered into a Trendelenburg position. There was no perceptible peripheral arterial pulsation. How-ever, the cardioscope tracing showed electrical cardiac activity with a heart rate of approximately 130 per minute. Blood was sent to the blood bank for immediate typing and crossmatching, and two units of uncross-matched type 0, Rh negative blood was started by pressure infusion from plastic blood containers. It was obvious that this patient had sustained such an injury that he was continuing to lose blood internally very rapidly. Drs. Shires, McClelland, and Perry collaborated in the decision to move the patient immediately to the main operating suite for emergency laparotomy, since the suspected path of the bullet would seem to traverse the left leaf of the diaphragm, the aorta and inferior vena cava, and perhaps the right kidney and part of the liver. (Dr. Risk had inserted a Foley catheter into the urinary bladder, obtaining only a scant quantity of urine which was not blood tinged. With the anesthesia machine still connected to the patient, he was transported to the elevator and into the operating room which had already been prepared for emergency surgery.

The abdominal incision was made at 11:44 a.m., 12 minutes from the time the patient was first admitted to the emergency operating room. The operating team consisted of Drs. Shires, McClelland, Perry, and Jones. The anesthesia team consisted of Drs. Akin, Jenkins, and Dr. Harlan Pollock, resident on anesthesiology. In describing the patient's condition and the parasurgical considerations, Dr. Jenkins says that by the time of the beginning of surgery, type-correct blood (A-1, Rh negative) was available and was administered under pressure through the three venous cutdowns. Dr. Curtis Spier, fellow in anesthesiology, cannulated a vein in the right forearm to aid in fluid replacement. Under the influence of blood administration and pulmonary ventilation with 100 per cent oxygen, the patient's pulse rate slowed from 130-160 to 80 per minute, and by 12 o'clock he had a discernible peripheral blood pressure, recorded at about 60 systolic, and by 12 :10 p.m.

his blood pressure was 90/60 and his pulse rate remained regular at 80 per minute. By 12:16 p.m. he had received 3000 ml. of blood and 800 ml. of 6 per cent dextrose in lactated Ringer's solution. Estimated and measured blood loss at this time was 4000 ml. By 12 :30 p.m. he had received 6000 ml. of blood and 1 gm. of calcium gluconate intravenously. His measured blood loss at this time was 6000 ml., and it was also obvious that an additional quantity was sequestered in his bowel lumen and bowel wall. At this time the surgical and anesthesia teams consulted about the patient's fluid status and decided that he needed a quantity of balanced salt solution; therefore, in two of the cutdown veins, 6 per cent dextrose in lactated Ringer's solution was begun. (Despite this rapid blood and fluid replacement, the patient's pulmonary status seemed satisfactory in that there was no perceptible change in compliance, as judged by the resistance to ventilation by compressing the reservoir breathing bag.

At 12 :37, Dr. Akin, who was monitoring the heart sounds with a chest stethoscope, reported that the cardiac tones were becoming weaker and the pulse rate was slowing from the previous rate of 80, to 60, to 40, to 30, and then became imperceptible. (These changes in rate were verified by a change in electrical activity as shown on the cardioscope.) Palpation of the heart through the diaphragm from the abdominal operating site was performed by Dr. Shires, who reported that he could not feel cardiac activity and he noted that the aorta had now ceased to pulsate. Dr. Perry opened the left chest with an incision at approximately the fourth interco8tal space, extending from the sternum laterally to the left anterior axillary line. Under direct vision it was verified that rhythmic cardiac activity had ceased, the heart was dilated. Ten milliliters of 10 per cent calcium chloride were injected into the chamber of the left ventricle. The heart, which had been flaccid prior to this injection, showed an increase in muscular tone and was not dilated. One mg.

of epinephrine hydrochloride in 90 mg of 1 per cent lidocaine was injected into the left ventricular chamber, reducing the heart in overall size. Ventricular fibrillation ensued. Manual cardiac systole (cardiac massage) was begun by Dr. Perry while the internal defibrillation apparatus was readied. Four attempts at ventricular defibrillation were made, with Dr. McClelland applying the defibrillation paddles to the heart, utilizing successively voltages of 240, 360, 600, and 760 without successfully effecting defibrillation. Between the applications of the defibrillation paddles, manual cardiac systole was continued alternately by Drs. Perry and McClelland. At 12 :55 p.m., the internal pacemaker, provided by Dr. Bashour, was attached to the heart, but the electrical stimulus provided by this pacemaker was not effective in producing visible cardiac systole. Two other attempts at internal defibrillation were made. The second defibrillating current produced asystole, but the internal pacemaker still did not stimulate effective cardiac activity.

Manual cardiac systole was re-started, causing palpable carotid pulse, but the patient's obvious external appearance was that circulation was ineffective as judged by the development of an ashen gray cyanosis. With an ophthalmoscope, Dr. Jenkins had periodically checked the retina for circulation during the resuscitative processes, and the retina could be visualized until 1:06 p.m., when it was apparent that the lens had become opaque, and retinal circulation was not observed. The patient was pronounced dead at 1:07 p.m. The bullet which was palpable in the right posterior axillary line was removed and sent out by the operating room supervisor, Miss Audrey Bell, to be turned over to the legal authorities. As a summary of fluid replacement, this patient received 16 and 1/2 units of blood and 4200 ml. of 6 per cent dextrose in lactated Ringer's solution. It is Dr. Jenkins personal feeling that all methods of resuscitation were instituted expeditiously and efficiently. Having observed this patient from the time he was wheeled into the emergency operating room, Dr.

Jenkins felt that Oswald sustained a period of cerebral hypoxia or anoxia for the period of time lapsing between the gunshot wound which he received and the time that effective ventilation with oxygen was started in the emergency operating room. Considering the cerebral changes which would begin at the time of initial anoxia, notably cerebral edema, Dr. Jenkins felt that many vital centers, including the cardiovascular center, were irreparably damaged, despite all resuscitative measures, introducing the final cardiac asystole. The trauma which patient Oswald had sustained was too great for resuscitation. END QUOTE The information on the third patient Gov. John Connally, is not available, so far.... Thanks for your time.....

Question: Who was admitted to Parkland Memorial Hospital, Dallas, as ‘Patient 24740, white male’?
Answer: JOHN F. KENNEDY