The assassination took place as the presidential party drove from the airport into the city of Dallas. One witness said the shots were fired from the window of a building. People flung themselves to the ground as armed policemen and Secret Service agents rushed into the building. A rifle with telescopic sights was found there.

The President was wounded in the head and collapsed into the arms of his wife: She was heard to cry, "Oh, no", as she cradled his head in her lap and the car, spattered with blood, speeded to Parkland Hospital.

The President was still alive when he reached the hospital. He was taken into an emergency room where facilities were said to be adequate. Two Roman Catholic priests were called and the last rites were administered. Mr. Kennedy died at 2 p.m. Eastern Standard Time (7 p.m. G.M.T.), about 35 minutes after the shots were fired.

Vice-President Lyndon Johnson escaped because his car, following the presidential vehicle, was delayed by the large crowds.

Mrs. Connally said afterwards that she thought that President Kennedy was shot first. She said that the President was in the right rear seat of the open car and Mrs. Kennedy was at his left. Mr. Connally faced the President on a jump seat. She herself faced Mrs. Kennedy.

"They had just gone through the town. They were pleased at the reception they had received. They got ready to go through the underpass when a shot was heard. When the first shot was fired Governor Connally turned in his seat and almost instantly was hit."

An assistant to the Governor said: "She does not know about the third shot, but it may have been the one that hit the Governor's wrist. Jackie grabbed the President, and Mrs. Connally grabbed Connally, and they both ducked down in the car."

Two Secret Service men were in the front of the car and one of them instantly telephoned to a control centre and said, "Let's go straight to the nearest hospital."

President Kennedy was shot through the throat and head, possibly by the same bullet, according to Dr. Malcolm Perry, the surgeon who attended him. Dr. Perry said that a tracheotomy was performed to relieve the President's breathing and blood and fluid were administered intravenously. Chest tubes were inserted, and Dr. Perry tried chest cardiac massage, but to no avail....

Dr. Perry said later that Mr. Kennedy suffered a neck wound - a bullet hole in the lower part of the neck. There was a second wound in the President's head, but Dr. Perry was not certain whether it was inflicted by the same bullet.

He said the President lost consciousness as soon as he was hit and never recovered consciousness. "We never had any hope of saving his life," Dr. Perry said, though eight or 10 doctors attended him.

Dr. Perry said that soon after he reached the hospital, Mr. Kennedy's heart action failed and "there was no palpable pulse beat".

Assassination of John F. Kennedy Encyclopedia

Mr. Kilduff announced the President's death, with choked voice and red-rimmed eyes, at about 1:36 p.m.

"President John F. Kennedy died at approximately 1 o'clock Central standard time today here in Dallas," Mr. Kilduff said at the hospital. "He died of a gunshot wound in the brain. I have no other details regarding the assassination of the President."

Mr. Kilduff also announced that Governor Connally had been hit by a bullet or bullets and that Mr. Johnson, who had not yet been sworn in, was safe in the protective custody of the Secret Service at an unannounced place, presumably the airplane at Love Field.

Mr. Kilduff indicated that the President had been shot once. Later medical reports raised the possibility that there had been two wounds. But the death was caused, as far as could be learned, by a massive wound in the brain.

Later in the afternoon, Dr. Malcolm Perry, an attending surgeon, and Dr. Kemp Clark, chief of neurosurgery at Parkland Hospital, gave more details.

Mr. Kennedy was hit by a bullet in the throat, just below the Adam's apple, they said. This wound had the appearance of a bullet's entry.

Mr. Kennedy also had a massive, gaping wound in the back and one on the right side of the head. However, the doctors said it was impossible to determine immediately whether the wounds had been caused by one bullet or two.

About four o'clock Saturday morning, Doctor James Humes felt relieved as the hearse bearing John Kennedy's embalmed body and reconstructed head departed from Bethesda Naval Hospital. It had been a grueling night for Commander Humes, made all the more demanding on his professional skills by the prestigious nature of his autopsy victim and by all the high-ranking military and naval brass present to witness and supervise his work. Now that it was all over, Humes could relax. He had just one minor detail to complete before he could go home. He telephoned Dr. Malcolm Perry in Dallas, since Dr. Perry had been the surgeon in charge of President Kennedy's emergency treatment at Parkland Hospital.

Dr. Perry's revelation that the president had a bullet hole in his throat must have astounded Dr. Humes. At the autopsy, the three pathologists observed only the large tracheotomy incision in the neck. The reason was simple. Dr. Perry had sliced right through the bullet hole as he made the tracheotomy. Thus, no bullet hole was visible by the time the autopsy began. But now, James Humes faced a serious dilemma. He and his colleagues had failed to include one of Kennedy's wounds in their autopsy findings. Dr. Perry's description of the wound as very small and round sounded like the description of an entrance wound. But with no exit wounds anywhere in the body and no bullets found still in the body, Humes was puzzled. It appeared that both the bullet that entered the president's back and the one that entered his throat had not exited, yet had somehow disappeared.

After thinking about this, Dr. Humes telephoned Dr. Perry again to obtain a more precise description of the throat wound. During their conversation, Humes had a sudden inspiration and shouted, "so that's it!" He went home, attended a school function with his son, and slept for several hours. Then he took his original autopsy notes, stained with John Kennedy's blood, and burned them in his fireplace. Then he drew up a new autopsy protocol based on the new information he had gleaned from Dr. Perry The new report stated that a bullet had entered Kennedy's neck and exited from his throat. Even though there was only slight medical evidence to confirm this, Dr. Humes concluded that it provided the only reasonable explanation for the wounds in Kennedy's body.

Malcolm Perry: I noted a wound when I came into the room, which was of the right posterior portion of the head. Of course, I did not examine it. Again, there was no time for cursory examination. And if a patent airway cannot be secured, and the bleeding cannot be controlled - it really made very little difference. Some things must take precedence and priority, and in this instance the airway and the bleeding must be controlled initially.

Eddie Barker: What about this wound that you observed in the - in the front of the President's neck? Would you tell me about that?

Malcolm Perry: Yes, of course. It was a very cursory examination. The emergency proceedings at hand necessitated immediate action. There was not time to do more than an extremely light examination.

Eddie Barker: There's been a lot said and written about was this an exit wound or an entry wound? Would you discuss that with me, sir?

Malcolm Perry: Well, this is a difficult problem. The determination of entrance or exit frequently requires the ascertation of trajectory. And, of course, this I did not do. None of us did at the time. There was no time for such things.

The differentiation between an entrance and exit wound is often made on a disparity in sizes, the exit wound generally being larger, in the case of an expanding bullet. If, however, the bullet does not expand - if it is a full jacketed bullet, for example, such as used commonly in the military, the caliber of the bullet on entrance and exit will frequently be the same. And without deformation of the bullet, and without tumbling, the wounds would be very similar - and in many instances, even a trained observer could not distinguish between the two.

Eddie Barker: Did it occur to you at the time, or did you think, was this an entry wound, or was this an exit wound?

Malcolm Perry: Actually, I didn't really give it much thought. And I realize that perhaps it would have been better had I done so. But I actually applied my energies, and those of us there all did, to the problem at hand, and I didn't really concern myself too much with how it happened, or why. And for that reason, of course, I didn't think about cutting through the wound-which, of course rendered it invalid as regards further examination and inspection. But it didn't even occur to me. I did what was expedient and what was necessary, and I didn't think much about it.

Arlen Specter: Upon your arrival in the room, where President Kennedy was situated, what did you observe as to his condition?

Malcolm Perry: At the time I entered the door, Dr. Carrico was attending him. He was attaching the Bennett apparatus to an endotracheal tube in place to assist his respiration. The President was lying supine on the carriage, underneath the overhead lamp. His shirt, coat, had been removed. There was a sheet over his lower extremities and the lower portion of his trunk. He was unresponsive. There was no evidence of voluntary motion. His eyes were open, deviated up and outward, and the pupils were dilated and fixed. I did not detect a heart beat and was told there was no blood pressure obtainable. He was, however, having ineffective spasmodic respiratory efforts. There was blood on the carriage.

Allen Dulles: What does that mean to the amateur, to the unprofessional?

Malcolm Perry: Short, rather jerky contractions of his chest and diaphragm, pulling for air.

Allen Dulles: I see.

Arlen Specter: Were those respiratory efforts on his part alone or was he being aided in his breathing at that tame?

Malcolm Perry: He had just attached the machine and at this point it was not turned on. He was attempting to breathe.

Arlen Specter: So that those efforts were being made at that juncture at least without mechanical aid?

Malcolm Perry: Those were spontaneous efforts on the part of the President.

Arlen Specter: Will you continue, then, Dr. Perry, as to what you observed of his condition?

Malcolm Perry: Yes, there was blood noted on the carriage and a large avulsive wound on the right posterior cranium.

I cannot state the size, I did not examine it at all. I just noted the presence of lacerated brain tissue. In the lower part of the neck below the Adams apple was a small, roughly circular wound of perhaps 5 mm. in diameter from which blood was exuding slowly. I did not see any other wounds. I examined the chest briefly, and from the anterior portion did not see any thing. I pushed up the brace on the left side very briefly to feel for his femoral pulse, but did not obtain any. I did no further examination because it was obvious that if any treatment were to be carried out with any success a secure effective airway must be obtained immediately. I asked Dr. Carrico if the wound on the neck was actually a wound or had he begun a tracheotomy and he replied in the negative, that it was a wound, and at that point... I asked someone to secure a tracheotomy tray but there was one already there. Apparently Dr. Carrico had already asked them to set up the tray...

Arlen Specter: Why did you elect to make the tracheotomy incision through the wound in the neck, Dr. Perry?

Malcolm Perry: The area of the wound, as pointed out to you in the lower third of the neck anteriorly is customarily the spot one would electively perform the tracheotomy. This is one of the safest and easiest spots to reach the trachea. In addition the presence of the wound indicated to me there was possibly an underlaying wound to the neck muscles in the neck, the carotid artery or the jugular vein. If you are going to control these it is necessary that the incision be as low, that is toward the heart or lungs as the wound if you are going to obtain adequate control. Therefore, for expediency's sake I went directly to that level to obtain control of the airway.

Malcolm Perry listens to the wind coming through the trees with a low roar, or a whistle, or suddenly, a shriek that sometimes is familiar with him.

The shrieks of Parkland Memorial Hospital have run through all the hallways and rooms and arenas of all the years, softening now, diminishing, but burrowing into the wind and reaching the unwilling consciousness of Dr. Malcolm Perry. He was working on John F. Kennedy's heart when he died in Parkland Hospital on the fall day in 1963.

"It was a bad weekend," he remembers. Kennedy was on Friday. On Sunday, he operated on Lee Harvey Oswald. "A bad weekend and a bad aftermath."

The trouble at the end came when he walked into a large, writhing news conference, something in which he never had been involved. And for good reason, this was the only one like it since Lincoln.

He observed that a throat hole looked like an entrance wound. He had qualified the observation in the next sentence but virtually nobody paid attention. They took that throat wound and carried it over the years into proof of a conspiracy. Somebody shot Kennedy from the front, in the throat. Somebody else shot him in the back of the head. So many wanted to believe the worst.

Malcolm Perry then slipped away from questioning and walked into his own world of surgery and silence. He never spoke to news reporters. He mentioned his experience to practically nobody. He wanted to be known as a fine doctor.

In his long career, Dr. Perry was chief of vascular surgery or professor of surgery, or both, at the University of Washington in Seattle; Cornell Medical College in New York City; Vanderbilt University School of Medicine in Nashville, and the Texas Tech Health Sciences Center in Lubbock, as well as the University of Texas Southwestern Medical School in Dallas.

But he was arguably most famous for the emergency procedure he performed on the dying 35th president of the United States at Parkland Memorial Hospital, and for a few words Dr. Perry uttered soon afterward.

Arriving in the operating room just moments after President Kennedy was brought in, Dr. Perry determined at once that an effective airway was vital if the president were to have even a remote chance of survival. Dr. Perry used the bullet hole in Kennedy’s neck to perform the procedure, concluding, as the Warren Commission noted, that “it was one of the safest and easiest spots from which to reach the trachea.”

But in doing so the doctor changed the appearance of the wound, thereby making it far less valuable as evidence. Even more fatefully, when he was asked by commission investigators if he thought the bullet hole was an entrance or an exit wound, he replied, “It could have been either.”

Later, when the autopsy findings were complete and the characteristics of the rifle used by Lee Harvey Oswald were known in detail, Dr. Perry told commission investigators, “I believe that it was an exit wound.”

The Warren Commission concluded that Oswald, who had had rifle training in the Marine Corps, fired three shots at the presidential motorcade. One shot missed, the commission said, and another struck the president in the upper back, exiting through his neck and then wounding Gov. John B. Connally of Texas, who was sitting in front of the president.

A third bullet struck the president in the head, inflicting the lethal wound, the commission found.

Dr. McClelland said on Monday that from 1963 onward, whenever the subject of the assassination came up, Dr. Perry “just refused to talk about it with anybody,” perhaps because he regretted contributing, however inadvertently, to the various conspiracy theories that have sprung up despite the Warren Commission’s conclusion that Oswald acted alone.

An obituary on Tuesday about Dr. Malcolm O. Perry 2nd, who performed a tracheotomy on President John F. Kennedy after the president was shot, referred incorrectly to his remark that based on appearance alone, a hole in the president’s neck could have been either an entrance or an exit wound. The remark was made to the Warren Commission, which investigated the assassination; it was not made to reporters. Dr. Perry also told the commission that based on autopsy findings and other factors, he later concluded that the hole was an exit wound.