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Battle to save president was futile, doctors knew

By
BRYCE MILLER, United Press International

One week ago the assassin's bullets struck President Kennedy.

It is now possible to reveal the step-by-step struggle of a team of 15 doctors to save his life though they knew from the start it was hopeless.

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The first call came to Parkland Hospital from the Dallas Police Department.

"The President has been shot. He is on the way to Parkland."

Surgical teams sprang into action.

Dr. Charles James Carrico, a resident in surgery, was in the emergency room when a Secret Serviceman burst through the swinging doors. A second one, with a submachine gun cradled in his arms, was right on his heels.

The first agent asked for two portable hospital carts (he called them "stretchers") one for Gov. John Connally, the other for the President.

In moments the portable carts were wheeled into Emergency Operating Room No. 1. Connally was first. Then the President, with Mrs. Jacqueline Kennedy walking beside the cart, holding his head, her pink suit bloody.

Connally was wheeled into Room No. 2, an identical 15-by 10-foot room directly across the hall.

Vice-President Lyndon Johnson walked in, hand on chest. Sen. Ralph Yarborough, who had been riding in the motorcade with him, was in tears.

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At first, some feared Johnson might have suffered a heart attack.

The operating table in Room No. 1 had been shoved out of the way. The doctors were moving so swiftly they did not want to take time to lift the President off the cart.

Dr. Carrico, the first man in the room, forced an endotracheal (breathing tube) down the President's windpipe as Dr. Malcolm Perry, an assistant professor of surgery, dashed in.

Perry decided further help in breathing was needed. The first bullet had opened the windpipe. Dr. Perry inserted a tube through the bullet hole.

Dr. Charles Baxter, assistant professor of surgery and director of student health science, arrived at this time, Mrs. Kennedy still was in the room. Baxter glanced at her and said, "I believe you had better step outside."

There were five staff members hovering around Kennedy at the time. Whenever one made an observation, the others immediately agreed.

Mrs. Kennedy turned to a White House aide in the corridor and said: "Call a priest."

The aide relayed the message to Steve Landregan, assistant to Hospital Administrator C.J. Price. Landregan immediately called the nearby Holy Trinity Catholic Church.

More doctors rushed to Kennedy's side. There were 15 in all. Besides Perry, Carrico and Baxter, there were Drs. William Kemp Clark, chairman of neurosurgery; Robert McClelland, assistant professor of surgery; M. T. Jenkins, chairman of anesthesiology; Fouad A. Bashour, associate professor of internal medicine; Adolph Giesecke, clinical associate in anesthesiology; Paul C. Peters, assistant professor urology; Dr. Ronald C. Jones, senior resident in surgery; Charles Crenshaw, surgery resident; Gene Akin, anesthesiology fellow; Don Curtis, oral surgery resident, and Kenneth Salyer, surgery resident.

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Carrico remembered reading that Kennedy suffered adrenal deficiency and immediately administered hydrocortisone.

Jones began a "cut-down" on Kennedy's left arm to insert a catheter - a device to force more blood into a vein and keep the passage open. Curtis completed the same procedure on the left leg.

Lactated Ringer's solution (a crystalloid solution sometimes called white blood and used until whole blood can be obtained) was pumped in. In seconds, a technician from the blood bank arrived with "O" negative blood (universal donor) and it was started.

To feed the blood faster, hand pumps were used.

By now, the cart had been elevated at the foot to help the blood get back to the heart.

Then one of the doctors noticed a frothing of the blood in the neck wound. "He's bubbling air," the doctor said. This means a hole in the lung.

Peters and Baxter immediately inserted a tube into the right upper part of the chest, just below the shoulder, to re-expand the lungs and keep them from collapsing. Perry and Jones at the same time inserted a similar tube on the left.

Doctors and nurses raced in and out. Each time the operating room door opened, Mrs. Kennedy tried to look in.

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"What is happening?" she would ask. "How is he?"

Clark, the neurosurgeon, had run all the way from the medical school. He was one of the last of the team to arrive. He raced through the emergency room door not more than five minutes after the President was brought in.

Clark looked down at the President. The eyes were open, staring back, sightless.

"His eyes are fixed and dilated," Clark said.

Any first-year medical student knows this means that there is no hope for the patient.

Clark had a "torpedo" hooked up immediately to Kennedy. This is a small machine with a scope that shows a heartbeat in waves as a little green light travels from one side to another. The green light moved straight across with a hopelessly steady line.

Clark looked up at Perry.

"It's too late, Mac," he said.

But Perry grabbed a stool, placed his knee on it to give him leverage and began giving Kennedy closed chest massage - using his fist in a rocking, pressing motion over the breastbone to provide, if possible, a 60-70 per minute beat. He and Clark took turns.

A more sensitive cardiotachyscope was brought in by Bashour. This was his machine. He specializes in cardiology. Before coming to the United States he was head of cardiology at Beirut, Lebanon.

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Electrodes from the machine were attached to Kennedy's left arm. But the green pinpoint of light on the scope did not waver the tiniest fraction of an inch.

An attendant was standing by with two rods that sometimes can shock a faltering heart into beating. He put them away. The President was dead. He had been dead for minutes, probably before he got to the hospital.

Jenkins, monitoring the oxygen equipment, turned the valves off. The President was dressed only in his trousers, shorts and brace for his ailing back.

Baxter got a fresh sheet. He and Jenkins tenderly pulled it across the body and up over the face. Kennedy's coat, shirt, undershirt and tie had been folded and put on one of the steel shelves lining the wall. The floor was littered with empty bottles, bloody bandages, boxes that had contained sterile dressings, bits of tubing. At the foot of the cart, among the litter, were the President's shoes. A doctor picked them up and placed them with his coat.

"The priest is outside," someone said.

There was nothing more the doctors could do.

They opened the emergency room door. The priest, The Very Rev. Oscar L. Huber, C. M., was waiting.

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Mrs. Kennedy stood up. Two White House aides stood on each side of her. She walked inside, toward the cart where her husband lay. The aides stayed outside.

At the foot of the cart, Mrs. Kennedy stopped. The President's feet were flush with the end of the cart, uncovered by the sheet which had been pulled over his face.

Mrs. Kennedy reached out, touched the right foot then bent down and kissed it. Then she walked along the cart and stood by the President's right shoulder.

Father Huber had walked in behind her. He did not notice her at first. He stopped beside her, glanced up, then stepped around her to the President's head.

The priest turned the sheet down.

Mrs. Kennedy bent over and kissed her husband's right cheek. Then she picked up his right hand, held it in both of hers, and pressed it on her left cheek, resting it on her husband's chest, her head on it, as the priest intoned, in Latin, the last rites.

"If you are living," the priest said, "I absolve you from your sins in the name of the Father, the Son, and of the Holy Ghost, Amen."

Father Huber then dipped his thumb in holy oil and traced the sign of the cross on the President's forehead.

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"Through this holy anointing may God forgive you whatever sins you have committed," the priest said.

Then the final blessing:

"By the faculty given to me by the Apostolic See, I grant to you a plenary indulgence and remission of all your sins and I bless you in the name of the Father, and of the Son and of the Holy Ghost, Amen."

As soon as the priest and his assistant left, the doctors walked from the operating room to the nurse's station in the ward. They gathered inside - Baxter, Clark, Perry and Jenkins.

It was nearly 1:10 p.m.

They had two things to decide quickly - what time the President died, and which should sign the death certificate.

Clark was chosen to sign the certificate because it was felt the President died of a neurological death.

They arbitrarily decided the time of death should be 1 p.m., immediately after the priest had finished the last rite.

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