The New York Times https://www.nytimes.com/1964/09/28/archives/autopsy-showed-2-bullet-wounds-shot-through-brain-fatal-medical.html
Sept. 28, 1964
AUTOPSY SHOWED 2 BULLET WOUNDS; Shot Through Brain Fatal, Medical Report Says
There was no chance of saving President Kennedy's life after the assassin's bullet passed from the back of his head through the right side of the brain, according to the Warren Commission report.
This point, confirming what had been widely believed, was a major conclusion of the three doctors who performed an autopsy on the President six hours after his death.
The autopsy report appears to have ended any confusion about the number of bullet wounds the President suffered. There appeared to have been two bullets, each of which caused an entrance and an exit wound. The medical and physical evidence gave no way of proving which struck first, the doctors said.
The bullet that hit the back of the President's head seemed to have caused a small entrance wound (one‐fourth of an inch by five‐eights of an inch) and the other massive wound that gravely damaged the right side of the President's brain. The other bullet made a small hole at the base of the back of the neck, which was not found until autopsy, and an exit wound in the front of the neck.
Findings of the autopsy were made public for the first time as an appendix to the Warren Commission report. The examination was performed at the Naval Medical School, Bethesda, Md.
“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 report said.
Eyewitness accounts of the assassination have indicated that President Kennedy was struck first in the upper back and that the second shot tore his head.
The autopsy desscribed the bullet entering the skull as “the fatal missile.”
As a concluding statement the doctors said: “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.” The autopsy report was signed by J. J. Humes, Commander, Medical Corps, U.S.N.; Hhornton Boswell, Commander, Medical Corps, U.S.N., and Pierre A. Finck, Lieut. Col., Medical Corps, U.S. Army.
Other testimony before the commission confirmed that the President's head wound was fatal and that there was vanishingly small likelihood that he ever regained consciousness after that bullet struck.
The bullet hit the upper right portion of the back of the President's skull, ripped through the brain leaving traces of metal in its path. Part of it emerged further to the front, carrying with it pieces of brain tissue, scalp and skull.
Most of the pieces of bone were recovered later in a search of Elm Street and the President's car. The wound lacerated much of the right side of Mr. Kennedy's brain and caused many criss‐cross skull fractures. A sizabze metal fragment was found just above the President's right eye.
The second primary wound was at the base of the back of the neck to the right of the spine, according to the autopsy report. This was presumably the point of entry of the other bullet, the report said.
The presumed exit wound from this bullet was a small wound in the lower neck in front, which involved damage to the trachea or windpipe. This wound's original dimensions were distorted by surgeons efforts to restore an air passage to the President's lungs.
The President had arrived at the emergency room of Parkland Memorial Hospital at 12:43 P.M., C.S.T., according to documents in the commission's report. He was first seen by Dr. Charles J. Carrico, a resident in general surgery.
Dr. Carrico described the President as “blue‐white or ashen in color.” His breathing was slow, spasmodic and without any coordination. His eyes were open; the pupils were dilated and did not react to light. He had no pulse. A few chest sounds, thought to be heart beats, could be heard.
On these observations Dr. Carrico decided the President was alive, if only barely so. Two wounds could be seen; a small one in the front lower neck and a large one in the head where a sizable portion of the skull was missing (measurement later showed this wound measured more than five inches in its largest dimension).
The first examination took only a few moments. Dr. Carrico felt the President's back, determined there was no wound there large enough to be an immediate threat to life, and immediately started working to improve flow of air to the lungs by the use of a tube to the windpipe at the site of the front neck wound.
At that point, Dr. Malcolm O. Perry, assistant professor of surgery, reached the emergency room and took over the direction of the fight to save the President's life.
Altogether 12 doctors had rushed to the emergency area as soon as the message was passed that the President had been wounded and was on his way.
The rapidly assembling team tried all the measures that might conceivably have saved the President's life.
These included a tube into the trachea to assist breathing; intravenous injections of fluids and blood, direct heart massage to maintain circulation; even injection of hdrocortisons because of the President's known deficiency in adrenal gland function.
None of these measures was of any avail. Finally, since there were no nervous, muscular or heart responses, the doctors conconcluded the efforts were hopeless.
Dr. William Kemp Clark officially declared the President dead at 1 P.M.
Dr. Clark was chosen to do so because brain damage was considered the ultimate cause of death and this put the matter within his field of specialization as director of neuroolgical surgery.
The Warren Commission report noted that, since the doctors had directed all their efforts to controlling the massive bleeding caused by the head wound, to reconstructing an airway to the lungs to heart stimulation, the President remained on his back throughout the ordeal.
Not much attention was paid to the other wound except for the damaged trachea where, evidently, part of the bullet must have emerged in front.
The Commission later asked Dr. Carrico if he had looked at the President's back.
The answer was that there had been no time during the first examination because the President's needs were so obvious and pressing. Later while the President was being given closed chest heart massage, such examination was not possible.
The Commission report then gives this sequence in the testimony:
Q. Was any effort made to inspect the President's back after he had expired?
A. No, sir.
Q. And why was no effort made at that time to inspect his back?
A. I suppose nobody really had the heart to do it.
