Chapter 8, Part 2:
Assassination in the Fourth Dimension

Between the Signal and the Noise
by Roger Feinman

The Administration of Hydrocortisone

Initially, Dr. Charles Carrico received credit for the administration of the drug as “quick thinking” under pressure. Carrico somewhat ambiguously accepted the credit:

Mr Specter

Dr. Carrico, was any action taken with respect to the adrenaline insufficiency of President Kennedy?

Dr Carrico

Yes, sir; he was given 300 milligrams of hydrocortisone which is an adrenal hormone.

Mr Specter

And what was the reason for the administration of that drug?

Dr Carrico

It was recalled that the President had been said to have adrenal insufficiency.

(3H 361)

Perry clearly assumed the Carrico was responsible for the decision. He told the Warren Commission:

“It is to Dr. Carrico’s credit, I think he ordered the hydrocortisone for the President having known he suffered from adrenal insufficiency and in this particular instance being quite busy he had the presence of mind to recall this and order what could have been a lifesaving measure, I think.”

(3H 370)

Mr McCloy

You said something to the effect that, of knowing the President had an adrenalin insufficiency, is that something you could observe?

Dr Perry

This is common medical knowledge, sir, that he had in the past necessarily taken adrenalin steroids to support this insufficiency. Dr. Carrico, at this moment of great stress, recalled this, and requested this be given to him at that time, this is extremely important because people who have adrenalin insufficiency are unable to mobilize this hormone at the time of any great stress and it may be fatal without support from exogeneous drugs.

(3H 377)

And see Perry’s interview with the staff of the HSCA (from the staff summary):

Dr. Perry stated that Dr. James Carrico, then a first–year resident, recalled that the President may have had Addison’s Disease and therefore administered steroids to combat any possible shock that may have occurred…. Dr. Perry could not recall if Dr. Burkley, the President’s physician, had also given the Parkland doctor steroids to administer to JFK.

(7 HSCA 295)

Burkley has disputed this, however, claiming credit for himself in his oral history interview:

I gave them some hydrocortisone, to put in the intravenous which was being given, and also told them his blood type.

(George G. Burkley, recorded interview by William McHugh, October 17, 1967, page 16, John F. Kennedy Library Oral History Program.)

McHugh

Doctor, were the doctors in Dallas familiar with the illnesses that the President had?

Burkley

The doctors in Dallas would have no reason to have any knowledge of that, and they had no need to have any knowledge of that, because the question was one of assassination by gunshot and his previous history, other than the fact, that I gave them the neo–cortef to put in the solution, which also would be used in anyone, possibly, who had such a wound, to give them additional support. But as far as any knowledge, their need to have any previous knowledge, it was not indicated and therefore, in addition to that the inquiries concerning the medical background of the President by people who were dealing with the Warren Commission and the assassination are absolutely unfounded, because they have nothing to do with the assassination.

McHugh

I see. They did make an attempt to find out though, did they not?

Burkley

They had no time to find out. I told them, they didn’t — I went in and told them that this I wanted to put in the intravenous that was being given …

McHugh

Surely.

Burkley

And they made no questions at all. There’s a statement in one of them, that one of them ought to do this, but that is not true, because I was the one who came in and gave it to them, and the doctors in Dallas never even mentioned that I was present. As far as I’m concerned it doesn’t matter to me, because there was no reason to interject myself in a procedure which at that time was hopeless. In addition, I was not part of their team, and it would have interfered.

Dr. Paul Conrad Peters’ testimony corroborated Burkley’s version. Dr. Peters was at Parkland preparing a lecture he planned to deliver to a group of medical students and residents when he learned that President Kennedy had been shot. He went to the emergency room to offer assistance. When he entered Trauma Room 1, “Mrs. Kennedy was in the corner with someone who identified himself as the personal physician of the President — I don’t remember his name.” Assistant Warren Commission counsel Arlen Specter questioned him about this recollection:

Mr Specter

Dr. Burkley?

Dr Peters

I don’t know his name. That’s just who he said he was, because he was asking that the President be given some steroids, which was done.

Mr Specter

He requested that.

Dr Peters

That’s right, he said he should have some steroids because he was an Addisonian.

Mr Specter

What do you mean by that in lay language?

Dr Peters

Well, Addison’s disease is a disease of the adrenal cortex which is characterized by a deficiency in the elaboration of certain hormones that allow an individual to respond to stress and these hormones are necessary for life, and if they cannot be replaced, the individual may succumb.

Mr Specter

And Dr. Burkley, or whoever was the President’s personal physician, made a request that you treat him as an Addisonian?

Dr Peters

That’s right — he recommended that he be given steroids because he was an Addisonian — that’s what he said.

(6H 69)

[Note: The testimony of Dr. Peters implied that, when he arrived in TR–1 the tracheostomy was in progress, suggesting perhaps that Burkley arrived after Perry made the incision. This was the only such reference I found in a search of both the official and unofficial record. In his 1992 reconstruction of the clinical details of the President’s treatment, however, Dr. Charles Crenshaw indicated that Peters arrived before the tracheostomy (Crenshaw, Charles, et. al., Conspiracy of Silence, Signet. New York: 1992, p. 79) Dr. Crenshaw saw Burkley’s open kit bag containing the steroid vials, and saw him give three 100 mm. vials of Solu–Cortef to Carrico. (Ibid., p. 82; Remarks of Dr. Crenshaw at ASK Symposium, Dallas, October 1992) “He gave the cortisone to Jim Carrico to give to him in the emergency ward.” (Livingstone, Harrison E., High Treason 2. Carroll & Graf, New York: 1991, p. 111) Crenshaw was not called to testify during the Warren Commission investigation. In view of the weight of the other evidence presented here, I have concluded that Peters was mistaken in his testimony on this point.]

Manchester also agrees that it was Burkley who provided the hydrocortisone:

Burkley, because he was acquainted with the patient’s medical history, carried his special drugs in his black bag, and knew the proper dosage levels.

(Manchester, William. The Death of a President. Harper & Row, New York: 1967, page 183.)

Carrico told the HSCA staff that Burkley gave him steroids.

Purdy/Flanagan

Why was President Kennedy given steroids?

Dr Carrico

Because we had, there had been an argument in the local papers a few weeks previously that raised the question of whether or not he had adrenal insufficiency. If one does have adrenal insufficiency and is injured, then you need extra steroids.

Purdy/Flanagan

Is there any risk to giving the person extra steroids if they don’t need it?

Dr Carrico

Very little. Virtually none. Matter of fact, the amount he was given is the amount that your or my adrenals would excrete in time of maximum stress.

Purdy/Flanagan

How harmful would it be for a person with adrenal insufficiency not to get steroids at a time like this?

Dr Carrico

No one really knows. The current medical opinion is that you need that adrenal support to respond to the stress. And without that kind of support, one could go into shock. If one really wants to get esoteric, you can argue about whether that’s really true or not. But in general, the current medical practice would be to give them. And if one were going to do an operation on someone with adrenal insufficiency, you would give steroids prior to enduring the operation.

Purdy/Flanagan

Did Dr. Berkeley [sic] give you any advice as to whether or not steroids should be given?

Dr Carrico

Sometime during the course of resuscitation, and I’ve honestly forgotten how far along, he came in, asked if the President had steroids or not, I answered something like — I’ve forgotten what. He handed me some vials and said, “give him these.”

Purdy/Flanagan

Did you give him those?

Dr Carrico

I handed those to the nurse, and said “go ahead and give them.”

Purdy/Flanagan

Did Dr. Berkeley say that President Kennedy was an Addisonian?

Dr Carrico

I don’t recall him saying that. He just asked if he’d had them or not and I answered in the affirmative.

(7 HSCA 274–276)

Conceivably, both physicians directed the administration of hydrocortisone, but the more reasonable answer is that Burkley directed it be done. If the available testimony and secondary sources did not force this conclusion, common sense might nevertheless impose it. It is doubtful that a second–year resident physician such as Carrico would have taken the responsibility for the administration of this drug in its specific dosage on the basis of some vague recollection of hearing or reading about the President’s adrenal insufficiency, which had been a secret generally well–kept from the public. Three hundred milligrams of Solu–Cortef (Hydrocortisone sodium succinate) was a massive dosage. A total dose of 300 mg of hydrocortisone over 24 hours is regarded as adequate to treat any type of stressful situation that precipitated the acute adrenal insufficiency crisis. (Himathongkam, et al., “Acute Adrenal Insufficiency”, Journal of the American Medical Association, December 2, 1974, Vol. 230, No. 9, page 1317) Consider the contemporary wisdom of the medical profession in this regard: In an adrenal crisis 200 mg. in 5% glucose solution intravenously. If intramuscularly, a total initial dose of 200 mg. (Beison & McDermott, eds., Textbook of Medicine, W. B. Saunders Company, Philadelphia: 1963, page 1393)

The public record sheds only a dim light on Burkley’s activities. In 1975, Harold Weisberg published copies of the Secret Service’s original versions of Warren Commission exhibits related to the autopsy. Burkley verified those originals with handwritten notations. (Weisberg, Harold. Post Mortem. Privately published. Frederick, MD.: 1975) Burkley’s notations were redacted from the exhibits admitted and published by the Commission. Upon what or whose authority, and on what basis did he certify the original records, and why were his verifications redacted from the printed exhibits? Lifton does not bother to ask. On the theory that someone was interested in suppressing Burkley’s role in the events of that day, it would be interesting to know whether Carrico was requested by officials to assume public responsibility for the administration of hydrocortisone to the President. This is only, however, a theory.

Regardless of whether Burkley or Carrico was responsible, however, the hydrocortisone was administered at the beginning of the emergency treatment, before Perry arrived. Carrico’s testimony:

“At the beginning of the resuscitation attempt intravenous infusions had been started using polyethylene catheters by venesection, lactated ringer solution, and uncross–matched type O RH negative bloods were administered and 300 mg. of hydrocortisone were administered.”

(6H 4)

Dr Carrico

At the same time we had been getting the airway inserted Dr. Curtis and Dr. White were doing a cutdown, venous section using polyethylene catheters through which fluid, medicine and blood could be administered.

Mr Specter

Will you describe in lay language what you mean by a cutdown in relationship to what they did in this case?

Dr Carrico

This was a small incision over his ankle and a tube was inserted into one of his veins through which blood could be given, fluid.

(3H 360)

Perry asserted this shortly after the weekend of the assassination. In his interview with United Press International at his home in McAllen, Texas on November 27, 1963, he confirmed his belief that Carrico had given hydrocortisone before he arrived. (New York Times, November 28, 1963). He implied as much to the Warren Commission. Describing the scene he confronted upon his arrival in TR 1, Perry testified:

“Blood transfusions and fluid transfusions were being given at this time, and through the previous venesections that had been done by Dr. Jones and Dr. Carrico.

“Also, the President had received 300 mg of Solucortef [sic] in order to support his adrenal glands, since it was common medical knowledge that he suffered from adrenal insufficiency.”

(6H 10–11)

[In fact, it was not common medical knowledge, and Perry’s Warren Commission testimony reveals no personal knowledge.]

He confirmed this three years later in an interview with CBS News:

“He had been previously started on intravenous fluids and blood, and given hydrocortisone by Dr. Carrico; and assisted respiration was in progress.”

(CBS News, Eddie Barker Interview with Dr. Malcolm Perry, 1967, page 2.)

In a written report on the resuscitative efforts for President Kennedy written on the day of the assassination, one of the treating physicians, Dr. Marion T. Jenkins, wrote: “the patient received 300 mg. hydrocortisone intravenously in the first few minutes.” (20H 252; Exhibit No. 36)

Appraisal of the Facts:

Burkley arrived at the President’s side earlier than is commonly understood. He arrived before Dr. Perry entered TR 1. It was Dr. Perry who performed the tracheotomy incision across the wound. Therefore, the wound was undisturbed when Burkley arrived. He had an opportunity to personally observe the wound.

Further Thoughts on Burkley at Parkland

Burkley also had the opportunity to observe the wound in the President’s back. Manchester tells us that Burkley supervised the transfer of the body from carriage stretcher to casket. He was in the room with only the nurses and an orderly at the time. Furthermore, there are tantalizing hints in the record that Dr. Burkley, complying with Assistant Press Secretary Malcolm Kilduff’s suggestion that a treating physician brief the news media, personally conferred with Malcolm Perry after the President’s death, and also reconnoitered Governor John Connally’s situation, perhaps even visiting the second–floor operating room where the Governor was treated. Burkley later spoke to Kellerman as though he had knowledge of Connally’s medical condition, telling Kellerman that Connally still had a bullet in his body. Kellerman, in his Warren Commission testimony, said Burkley referred to “the missile that hasn’t been removed from Governor Connally.” (2H 90)

Mr Specter

You mentioned a missile which was not removed from Governor Connally. Specifically, what did you refer to there?

Mr Kellerman

There was in the early — this was on the day in Parkland Memorial Hospital, and this information comes from Dr. George Burkley, the President’s physician, when, I believe, I asked him the condition of Governor Connally, and have they removed the bullet from him.

Mr Specter

What did Dr. Burkley say?

Mr Kellerman

Dr. Burkley said that to his knowledge he still has the bullet in him.

Mr Specter

And what time on November 22 was that?

Mr Kellerman

This was after we got into the hospital after the shooting, sir, between then and 2 o’clock.

Mr Specter

So that the operation on Governor Connally had not been completed at that point?

Mr Kellerman

That is correct, sir.

(2H 91)

In the immediate aftermath of Kennedy death, Dr. Perry’s movements appear murky. He has said that he sat down in the emergency room for about ten or fifteen minutes, then went to the second–floor operating suite to assist briefly with Governor Connally. (6H 10) Presumably that was around 1:15 or 1:20 p.m. Burkley remained busy in the emergency room, making arrangements for the removal of the President’s body to Washington. Dr. Kemp Clark completed and signed a death certificate for Kennedy in Dr. Burkley’s presence. (6H 20, 25)

Perry testified that he arrived in the second–floor operating suite just before Dr. Thomas Shires began operating on the Governor’s left leg. He indicated that while he was in the Connally operating suite, he was called and asked to participate in a press conference. He testified this request came at “around 2 o’clock” (3H 374), and that he left the operating suite shortly after Shires incised Connally’s thigh wound. (3H 390).

Perry’s testimony did not, however, jibe with the facts. According to the operative record of Governor Connally (CE 392), Dr. Robert Shaw presided over the thoracic surgery to repair Connally’s chest. Anesthesia began at 1:00 p.m. and the actual surgery started at 1:35 p.m. While the 1:00 p.m. operative record lists three assisting physicians, Perry is not among those named. Later in the day, beginning at 3:20 p.m., Dr. Shires and Dr. Charles Gregory operated on the Governor’s left leg and right wrist. In questioning Dr. Perry, Arlen Specter caught this error in his testimony, but failed to pursue it. (3H 383) The questions that remain are, where was Dr. Perry and with whom did he speak between the time of Kennedy’s death and the time he began his news conference?

How Lifton Murdered the Truth

Except for the oral history interview of Burkley, the CBS interview with Perry, and Crenshaw’s book (all of which are merely corroborative of what was long ago in the public record), each resource that I have cited in this analysis was readily available to David Lifton during the 15 years that he says he researched and wrote his book, and he also worked with each of those resources. He acknowledges that I tipped him off during our discussions in the late–Seventies. Nevertheless, he discusses none of the above primary or secondary source material in his book.

Other than by vacuous ridicule, how does he refute this reconstruction? By throwing dust in his reader’s eyes.

Lifton and Burkley — The UPI copy

Lifton absolves Burkley of knowledge of the throat wound on the specious basis that his death certificate does not mention it. This is evidence for nothing more than Burkley’s failure, for whatever reason, to record the throat wound on the certificate. The death certificate’s purpose, however, is not to detail the wounds but to state the cause of death. (See Best Evidence, Chap 14, p. 478)

[Note: There are undoubtedly more substantial issues relating to Burkley’s death certificate for Kennedy that Lifton never addressed. E.g., Why did Burkley prepare his own death certificate for the President when he already had received a death certificate from Dr. Kemp Clark of Parkland Hospital? Why was Burkley’s death certificate never filed with any probate court or health agency? Why did Burkley include in his death certificate material that reached beyond the mere cause of death? What was the source for the statement in the Burkley death certificate that there was a wound in the President’s back at about the level of the third thoracic vertebra?]

Lifton also cites a teletype dispatch by UPI’s Merriman Smith. “Since each UPI transmission had a time stamp, the UPI ticker tape is an accurate source of chronological data.” (Best Evidence, p. 479) Under Lifton’s interpretation, a UPI dispatch timed at 12:53 PM reporting Burkley’s arrival at Parkland means that Burkley arrived at the door of the emergency room about fifteen minutes after Kennedy’s logged–in arrival at 12:38 PM. Lifton states:

At 12:53 pm, UPI reported: “A few minutes later [referring to ‘12:50’ mentioned in the previous sentence] Rear Admiral George Burkley, USN, the White House Physician, rushed into the hospital. He headed for the emergency room …”

A single piece of UPI wire copy, dictated by a man whom Lifton did not even interview (Merriman Smith is now dead), a piece of evidence that Lifton either doesn’t understand or has deliberately thrown up as a smoke screen to protect his precious theory and murder the truth — this is what he proclaims as scholarly precision in his work. The facts, however, reveal the shoddiness of this device.

First, Manchester tells us that, when Smith entered the Parkland Emergency Room, he commandeered a telephone in the cashier’s cage. (Manchester, William. The Death of a President, Harper & Row, New York: 1967, p. 168) This stakeout was 25 yards removed from the entrance to the Emergency Room. In the crush of officials, newsmen and others, Smith could not abandon his line for fear of being unable to find another. Therefore, while keeping his phone connection, he had to rely upon the advices he received from random passersby for the news that he dictated to the teletype operator at the other end of the line. In other words, he was relying on hearsay rather than personal observation. (Manchester, op. cit., p. 191)

Second, contrary to Mr. Lifton’s assertions, the time stamp on a wire service story does not indicate the time that an event occurred. Rather, it represents the time that the teletype operator transmits the story to subscribers of the service (e.g., newspapers, radio and television stations). Moreover, wire services do not transmit stories in the order that they occurred. Therefore, the tape is not an accurate source of chronological data.

Finally, I have examined a complete set of the wire copy to which Mr. Lifton refers. His statement, “‘A few minutes later [referring to ‘12:50’ mentioned in the previous sentence]…”’ is one of the most artful fabrications in the entire book. There is no “previous sentence” in the transmission that he cites. That transmission is a single sentence. The wire copy consists of a number of separate, short transmissions containing fragments of information that would later be combined and edited by a rewrite man into a coherent story, and there is no clear reference in the sentence Mr. Lifton quotes to what comes before or after on the tape.

Impeaching His Own Witness

Some might wish to excuse Lifton’s UPI gaffe as merely sloppy research were it not for his treatment of George A. Barnum. Barnum was a Coast Guard Yeoman and a member of the casket honor guard at Bethesda on the night of the assassination. After his participation in the events of the weekend, his superior at Coast Guard Headquarters directed him to write a report for the historical record of his unit. Barnum saved a copy of his November 29, 1963 personal file memorandum–report for his children.

Because Lifton tries to use Barnum in support of his “ambulance chase” scenario, he cannot comfortably ignore a much more significant aspect of Barnum’s memo. In Chapter 30 of Best Evidence, Lifton reports that, sometime after midnight, Barnum had an encounter with Dr. Burkley in the hospital cafeteria. During their conversation, Burkley spoke about the President’s wounds and evidenced a knowledge of the throat wound that, if Dr. Humes’ repeated statements are to be believed, Burkley should not have had. Lifton attempts to discredit Barnum on the ground that he reported Burkley as describing a shot “striking him above and to the rear of the right ear, this shot not coming out …,” a statement in conflict with the official autopsy report, wherein the head shot exited the skull.

Once more, however, Lifton misleads his readers, a feat made possible only by his omission to print the entire Sibert and O’Neill report. The head shot conclusion that Burkley imparted to Barnum was the same conclusion reported by Sibert & O’Neill in their “real–time” narrative of the autopsy. Barnum’s report of Burkley’s remarks on the head wound accurately mirrored the autopsy pathologists’ tentative conclusion regarding the head wound, as reported by Sibert and O’Neill, before a skull fragment was delivered to the morgue late in the evening.

As we have seen, and others have noted, Mr. Lifton is highly selective in his use of evidence, emphasizing what supports his case and discounting conflicting facts and possibilities. (“Television” (column), San Francisco Chronicle, November 18, 1988, p. E1) Whereas a genuine scholar accepts his obligation to deal as honestly with the facts as he knows how, Mr. Lifton displays the same ability to disregard facts without feeling any sense of inconsistency that allows a devout religious mind to believe in miracles or a child to believe in fairy tales. Mr. Lifton, however is no monk, and he is no child.

• Chapter 9: I Had to Have that Document
• Chapter 8, Part 1: Assassination in the 4th Dimension