characteristic of respiration. His eyes were opened and somewhat exophthalmic and color was greatly suffused, cyanotic---a purplish cyanosis.
Still, we have patients in the state, as far as cyanosis and agonal type respiration, who are resuscitatable. Of course, you don't step at this time and think, "Well, this is a hopeless circumstance,"--because one in this state can often be resusciated--this represents the activities prior to one's demise sometimes, and if it can be stepped, such as the patient is oxygenated again and circulation reinstituted, he can be saved.
Dr. Carrico had just introduced an endotracheal tube, I'm very proud of him for this because it's not as easy as it sounds. At times and under the circumstances--it was harder--he had. just completed a 3-month rotation on the anesthesiology service, and I thought this represented good background training for a smart individual, and he told me he had a cuff on the endotracheal tube and he introduced it below the wound.
The reason I said this, of course, this is a reflex--there is a tube, the endotracheal tube, if it is pushed down a little too far it can go into the right main stem of the bronchus impairing respiration from both lungs, or both chest.
There was in the room an intermittent positive pressure breathing apparatus, which can be used to respire for a patient. As I connected this up, however, Dr. Carrico and I connected it up to give oxygen by artificial respiration, Dr. Giesecke and Dr. Hunt arrived on the scene with the anesthesia machine and I connected it up instead with something I am more familiar with--not for anesthesia, I must insist on that--it was for the oxygenation, the ability to control ventilation with 100 percent oxygen.
As I came in there, other people came in also. This is my recollection. Now, by this time I was in familiar surroundings, despite the anguish of the circumstance.
Despite the unusual circumstance, in terms of the distinguished personage who was the patient, I think the people who had gathered or who had congregated were so accustomed to doing resuscitative procedures of this nature that they knew where to fit into the resuscitation team without having a preconceived or predirected plan, because, as obviously--some people were doing things not necessarily in their specialty, but there was the opening and there was the necessity for this being done.
There were three others who came in as I did who recognized at once the neck wound, in fact, where the wound was, would indicate that we would have serious pulmonary problems unless a tracheotomy tube was put in. This is one way of avoiding pushing air out through a fractured trachea and down into each chest cavity, which would cause a pneumothorax or a collapse of the lungs. These were doctors Malcolm Perry, Charley Baxter, and Robert McClelland, who with Dr. Carrico's help, I believe, started the tracheotomy.
About this time Drs. Kemp Clark and Paul Peters came in, and Dr. Peters because of the appearance of the right chest, the obvious physical characteristics of a pneumothorax, put in a closed chest drainage chest tube. Because I felt no peripheral pulse and was not aware of any pulse, I reported this to Dr. Clark and he started closed chest cardiac massage.
There were other people--one which started an I.V. in a cutdown in the right leg and one a cutdown in the left arm. Two of my department connected up the cardioscope, in which we had electrical silence on the cardioscope as Dr. Clark started closed chest massage. That's the sequence of events as I reconstructed them that day and dictated them on my report, which you have here, I think.
Mr. SPECTER Speaking of your report, Dr. Jenkins, permit me to show you a group of papers heretofore identified as Commission Exhibit No. 392 which has also been identified by Mr. Price, the hospital Administrator, as being photostatic copies of original reports in his possession and controlled as Custodian of Records, and I show you what purports to be a report from you to Mr. Price, dated November 22, 1963, and ask you if in fact this 2-page report was submitted by you to Mr. Price?
Dr. JENKINS. Yes; it was.
Mr. SPECTER. Now, going back to the wound which you observed in the neck, did you see that wound before the tracheotomy was performed?

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