(Testimony of Dr. Robert Mcclelland Nelson)
Dr. Mcclelland.
cut, although somewhat irregular margins of less than a quarter inch in diameter, with minimal tissue damage surrounding it on the skin.
Mr. Specter.
Now, was there anything left for you to observe of that bullet wound, or had the incision obliterated it?
Dr. Mcclelland.
The incision had obliterated it, essentially, the skin portion, that is.
Mr. Specter.
Before proceeding to describe what you did in connection with the tracheostomy, will you more fully describe your observation with respect to the head wound?
Dr. Mcclelland.
As I took the position at the head of the table that I have already described, to help out with the tracheotomy, I was in such a position that I could very closely examine the head wound, and I noted that the right posterior portion of the skull had been extremely blasted. It had been shattered, apparently, by the force of the shot so that the parietal bone was protruded up through the scalp and seemed to be fractured almost along its right posterior half, as well as some of the occipital bone being fractured in its lateral haft, and this sprung open the bones that I mentioned in such a way that you could actually look down into the skull cavity itself and see that probably a third or so, at least, of the brain tissue, posterior cerebral tissue and some of the cerebellar tissue had been blasted out. There was a large amount of bleeding which was occurring mainly from the large venous channels in the skull which had been blasted open.
Mr. Specter.
Was he alive at the time you first saw him?
Dr. Mcclelland.
I really couldn't say, because as I mentioned in the hectic activity---I really couldn't say what his blood pressure was or what his pulse was or anything of that sort. The only thing I could say that would perhaps give evidence---this is not vital activity---at most, is that maybe he made one or two spontaneous respiratory movements but it would be difficult to say, since the machine was being used on him, whether these were true spontaneous respirations or not.
Mr. Specter.
Would you now describe the activity and part that you performed in the treatment which followed your arrival?
Dr. Mcclelland.
Yes; as I say, all I did was simply assist Dr. Perry and Dr. Baxter in doing the tracheotomy. All three of us worked together in making an incision in the neck, tracting the neck muscles out of the way, and making a small opening into the trachea near the spot where the trachea had already been blasted or torn open by the fragment of the bullet, and inserting a large metal tracheotomy tube into this hole, and after this the breathing apparatus was attached to this instead of the previous tube which had been placed here.
Mr. Specter.
In conducting that operation, did you observe any interior damage to the President?
Dr. Mcclelland.
Yes.
Mr. Specter.
Will you describe that for me, please?
Dr. Mcclelland.
That damage consisted mainly of a large amount of contusion and hematoma formation in the tissue lateral to the right side of the trachea and the swelling and bleeding around this site was to such extent that the trachea was somewhat deviated to the left side, not a great deal, but to a degree at least that it required partial cutting of some of the neck muscles in order to get good enough exposure to put in the tracheotomy tube, but there was a good deal of soft tissue damage anal damage to the trachea itself where apparently the missile had gone between the trachea on the right side and the strap muscles which were applied closely to it.
Mr. Specter.
What other treatment was given to President Kennedy at the time you were performing the procedures you have just described?
Dr. Mcclelland.
To the best of my knowledge, the other treatment had consisted of the placement of cutdown sites in his extremities, namely, the making of incisions over large veins in the arms and, I believe, in the leg; however, I'm not sure about that, since I was not paying too much attention to that part of the activity, and large plastic tubes were placed into these veins for the giving of blood and fluids, and as I recall, he received a certain amount of blood, but I don't know exactly how much, since I was not actually giving the blood.
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