Report of the President's Commission on the Assassination of President John F. Kennedy

Connally Thigh Operative Record

Dr. Tom Shires’s operative record dated November 22, 1963, documents the exploration and debridement of Governor Connally’s left thigh gunshot wound, running from 16:00 to 16:20 under general anesthesia. A 1 cm punctate missile wound was located over the juncture of the middle and lower third, medial aspect of the left thigh. X-rays revealed a bullet fragment embedded in the distal third of the femur. The wound was excised and the bullet tract explored, showing the missile coursed through subcutaneous fat into the vastus medialis. Necrotic fat and muscle were debrided down to the femur. The wound’s direction was judged not to be in the course of the femoral vessel, as it was distal and anterior to Hunter’s canal. Following complete debridement and saline irrigation, the wound was closed using three simple through-and-through stainless steel Aloe #28 wire sutures encompassing skin, subcutaneous tissue, and muscle fascia. The dorsalis pedis and posterior tibial pulses in both legs were quite good. This soft tissue repair was completed while the chest procedure had already concluded and the compound fracture debridement of the arm was still in progress.

Oswald Operative Record

Dr. Tom Shires’s operative record dated 11/24/63 for Lee Harvey Oswald (Unit # 25260, age 24) documents surgery for gunshot wound of upper abdomen and chest with massive bleeding, with post-operative diagnosis of major vascular injury in abdomen and chest. The operation (exploratory laparotomy, thoracotomy, efforts to repair aorta) ran from 1142 to 1307 under general anesthesia. Anesthesiologists were Drs. M. T. Jenkins, Gene Akin, and Curtis Spier; assistants were Drs. Perry, McClelland, and Ron Jones. Preoperative inspection revealed an entrance wound over the left lower lateral chest cage and an exit identified by subcutaneous palpation of the bullet over the right lower lateral chest cage. Preoperatively, the patient was without blood pressure, with heart beat heard infrequently at 130 beats per minute; an endotracheal tube was placed and oxygen administered via anesthesia before transfer to the operating room. Two counted sponges were noted missing when the body was closed, though the square pack count was correct. Massive pharmacological intervention included calcium chloride (3 vials), Cedilanid (12), one molar lactate (6), Isuprel (24), and Adrenalin 1:1000 (3). IV fluids included 3,000 cc of lactated Ringer’s solution, 16 units of 500 cc whole blood, and 6,000 cc of 5% dextrose in lactated Ringer’s solution. The patient expired at 1307 with a measured blood loss of 8,376 cc.