I’m in Dallas, Texas all week, attending the EMS EXPO Conference. I always enjoy attending the show because, since it’s not run by JEMS, so I don’t have all the onsite meetings, functions and operational responsibilities that Scott Cravens and his team at EMS Magazine have to contend with. This allows me to see old friends, advertisers, and educators, as well as, listen to lectures, hear what’s on the minds of lots of EMSers, and see what products and innovations all the vendors have to offer.
What many people don’t know about me is that, in another life, I have been a Kennedy Assassination researcher for over four decades. With a library of more than 300 books on the subject, an original copy of all volumes of the Warren Commission Report and a C2766 Mannlicher Carcano from the same source that Oswald’s was purchased from, I have immersed myself in the subject as a social scientist and interested citizen.
I will not share my theory on “who did it” because over 30 witnesses and researcher who have done so have met with strange, premature deaths. (My Mamma didn’t raise no fool!) But, since I’m here in Dallas, I, of course, spent a few hours at Dealey Plaza on Elm Street, site of the assassination, the Texas School Book Depository (and Sixth Floor Museum) where Lee Harvey Oswald fired a few of the shots that day, and the grassy knoll and fence where a second gunman fired one shot (Oops – I let the cat out of the bag!)
So I thought I would share with you an aspect of assassination history very pertinent to EMS and tell you how far EMS has progressed since November of 1963. There’s a little know book, written by Dr. Charles A. Crenshaw, one of Oswald’s attending surgeons, on the Kennedy Assassination, entitled JFK - Conspiracy of Silence.
This book provides lots of details about the Oswald shooting, his injuries, the timeline of his transport and treatment at Parkland, that most EMS and trauma center personnel find interesting and revealing.
Here are some key facts presented by Dr. Crenshaw that prompt me to tell you that the EMS “providers” that day could have changed the course of American history the day that Lee Harvey Oswald was shot in the basement of the Dallas Police Headquarters if they had the benefit of having advanced training, practices and equipment that we currently have available to us today. It’s an amazing case to review and think about in light of ewhat we know (and do) today in the field.
1. Lee Harvey Oswald was shot at 11:21 a.m. on November 24th, 1963.
2. If you know your EMS history from that day, two “attendants” from a funeral home (station wagon) ambulance hurriedly loaded Oswald into the back of the station wagon and raced him to Parkland Hospital with no hemorrhage control, bandages, suction, oxygen, IVs or other treatment performed.
3. All he got was a ride to the hospital, albeit one of the busiest and best trauma centers in the country.
4. He was in an operating room at Parkland at 11:41, just 20 minutes after being shot.
5. He was found to have damage to the following organs as a result of a single gunshot wound to the abdomen: Aorta, Vena Cava, spleen, stomach, pancreas, kidney and liver
6. The bullet was found lodged in the right body wall.
7. He died at 1:07 PM: 43 minutes after being shot
In particular, Dr. Crenshaw’s direct quotes emphasize what we all know happens when the circulatory system is allowed to sit unattended and dormant and let’s free radicals accumulate (the “settling of rust” is the way I compare and describe it).
“Had the ambulance that brought him to Parkland been furnished with equipment and emergency medical technicians to administer oxygen through an endotracheal tube and dispersed Ringers lactate through IVs, resuscitation could have occurred at the scene of the shooting.”
“Oswald did not die from damaged internal organs, He died from the chemical imbalances of hemorrhagic shock. From the time he was shot, 11:21 a.m., until the moment fluids were introduced into the body through cut downs at11:40 a.m., there was very little blood circulating in Oswald’s body.”
“As a result, he was not getting oxygen, and waste built up in his cells. Then when the fluids were started, the collection of waste from the cells was dumped into the bloodstream, suddenly increasing the acid level, and delivering these impurities to his heart.”
“When the contaminated blood reached his heart, it went into cardiac arrest, then cardiac arrhythmia, and finally fibrillation.”
“If Ringers lactate had begun flowing into Oswald when the ambulance arrived at the police station, he would not have been without circulation for twenty minutes, the waste would not have built up in his cells, and his heart in all probability, wouldn’t have stopped.”
Final thoughts for the day
When we try to start a chemically unstable heart in a patient like Oswald, or any cardiac arrest patient, you can see how the heart “rebels” and fails to respond. I believe this is more evidence as to why therapeutic hypothermia is so effective and why I believe we will be using it with most cardiac arrests (from any cause) and major traumas and spinal injuries.
These are only the personal opinions of an old EMSer and Kennedy assassination researcher who’s been watching and observing patients and innovations for a few years.
Stay tuned for more of my ramblings throughout the week. Stay safe!