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Enduring Controversies in the Medical Evidence

by Gary Aguilar MD

Ever since Josiah Thompson, in Six Seconds in Dallas, reproduced a drawing the recollection of Parkland witness Robert McClelland regarding the placement of JFK's large rear skull defect, controversy about it has not ceased.

The autopsy report described the bullet entrance close to the bottom of the rear of the skull, near the external occipital protuberance. The "exit" was described as a 13cm defect, not much larger than the palm of an adult man's hand, "on the right involving chiefly the parietal bone but extending somewhat into the temporal and occipital regions." However, a diagram prepared on the night of the autopsy by Dr. Boswell showed a "17" next to the word "missing." He explained to the HSCA and to me that the skull defect was 17cm, fore to aft, not 13cm. Whichever number is accurate (see below), the defect must have involved the right rear quadrant of JFK's skull if it was truly "parietal temporal-occipital."

Confusingly, in June, 1967, not long after Humes saw the autopsy photographs for the first time, Dan Rather asked him, "And (where was) the exit wound?" Humes said: "And the exit wound was a large irregular wound to the front and side--right side of the President's head." No witness had ever described it there. To muddy the waters further, in the third of three interviews before the HSCA, Dr. Humes seemed to change his mind on the entrance, claiming the bullet entered high, in parietal bone, rather than low, in occipital bone, as per the autopsy report. Beyond that, in testimony before the Conyers Committee on 11/17/93, Gerald Posner claimed he had interviewed Drs. Humes and Boswell and that "they have confirmed their change of testimony that they gave before the HSCA," and that the entrance wound was "correctly placed 4 inches higher" in parietal bone. (No evidence can be found that Boswell ever admitted to the "high" location, though Humes may have.) So the location of the entrance wound and exit defect may be uncertain despite the autopsy report's statements.

To add to the confusion, Posner and JAMA presented Parkland witnesses whose opinions had changed quite a bit from their original sworn testimonies and contemporaneously prepared statements, and who now endorsed a more anterior skull defect, one that would have been consistent with the Oswald hypothesis. While it is beyond the scope of this presentation, the witnesses Posner and JAMA produced to refute a rear skull defect, Drs. M.T. Jenkins, M. Perry, and C. Baxter, have given such inconsistent accounts over the years as to render any of their statements untrustworthy. Moreover, last year I presented a compilation of all the earliest descriptions which I (and Posner) believe to be the most reliable, of JFK's skull defect from both Parkland and Bethesda witnesses. I found that with the exception of Capt. John Stover, a Bethesda witness who described JFK's defect at "the top" of the skull, every one of 42 witnesses described a defect at the rear of JFK's skull, some indicating that it also extended further anteriorly. Recent statements by expert Parkland witnesses, who have given consistent accounts over 30 years, only reinforce the likelihood of a rear wound.

On 1/20/94 David Naro, a steel salesman from Tennessee, interviewed Dr. Kemp Clark, the Parkland neurosurgery professor who examined JFK's wound and who pronounced JFK dead. Naro reported Clark said,"The lower right occipital region of the head was blown out and I saw cerebellum." This conveys the same message as the document Clark prepared on 11/22/63 which read, "Thee was a large wound in the right occipitoparietal region...Both cerebral and cerebellar tissue was extruding from the wound."

Ronald C. Jones MD, Parkland witness, told the WC there was a "large defect in the back side of the head..." and "(there) appeared to be an exit wound in the posterior portion of the skull." Jones told David Lifton, "If you brought him in here today, I'd still say he was shot from the front." Jones repeated this to student Brad Parker on 8/10/92, "...if they brought him in today, I would tend--seeing what I saw, I would say that he was shot from the front." Jones told Parker that he fundamentally agreed with McClelland's drawing of the back of the head as seen in Six Seconds. Jones specifically denied to Parker that he had seen a right anterior skull defect. He said, "Yeah. I didn't think that there was any wound--I didn't appreciate any wound, anyway, in the right temporal area or on the right side of the upper part of the head, you know, over the--in front of the ear, say, or anything like that." These descriptions are fully consistent with the autopsy report of a right rear defect. If the defect did extend forward, the anterior portion was quite small. Only Gerald Posner reports Jones describing JFK's wound as "a large side wound." Posner neglected to ask Jones about his WC testimony that undermines Posner's thesis, or abut the statements attributed to Jones by Lifton, which Jones repeated to Brad Parker in 1992.

But what was one to make of Humes' possible reversal for the HSCA, admitting a high wound, and Humes and Boswell's possible flip-flopping for Gerald Posner, and admitting JFK's skull entrance wound was high, especially after both Humes and Boswell reaffirmed their autopsy report's low location in 1992 interviews in JAMA ?

Some of these mysteries were clarified in recent interviews I conducted with Drs. Boswell and Humes. As to Posner's claim that Boswell admitted a high entrance wound to him, Boswell said, "No, no, no, no, no. That--that's--that's--first of all, I never talked to him. Jim (Humes) talked to him." So I rephrased with, "Somebody sent me a copy of Posner's testimony before the Conyers Committee and he said that he'd talked to both you and Jim and said that both of you had changed your mind." Boswell answered, "No, that's not true. I never talked to Posner. He called me and I was out and we never got back together...Jim--they did talk over the phone..."

Boswell staunchly defended the autopsy report, "...Jim and I sat down a couple of years ago and agreed that the most valid statements are our original report, because we labored over that long and hard...And I would refer anybody back to that--and swear by it." Dr. Humes seemed annoyed to be questioned by an unknown physician on the phone. But he certainly seemed to back up Boswell when I asked him if "the statements you made to JAMA were reliable about where you said the head wound was?" Humes impatiently answered, "I would guess they're reliable, yes, sir." The he testily rushed me off the phone.

Boswell's descriptions of JFK's skull wounds have been consistent with the autopsy report over the years. He also believed one should depend less on Humes' later utterances--when they differed from the autopsy report. He said: "I think some of that testimony that Jim gave in the (HSCA) hearings--which were several years later and then without any records and were not very knowledgeable questioners (sic), I think some of that testimony might be suspect," and, "Well, I tell you-eh--what Jim and I agreed in conference with the AMA people (for the 1992 JAMA interviews) was that--eh--all of the measurements and all of the information in the (autopsy) report were the most valid. And that anything that might have been said subsequent to that had to be taken with a grain of salt. Because a lot of those people down in the Congressional inquiry, and so forth, they were not knowledgeable people, and they made some comments and so forth, and questions and statements--some of them I think Jim may have agreed with that (sic) I don't think were legitimate." To help me assess the Posner assertions which contradict the pathologists' statements in JAMA I asked, "Were you accurately quoted in JAMA ? Boswell answered, "Oh, yea, I tell you, we studied that article very well. I--eh--and those wee accurate."

Thus both Boswell and Humes endorsed their JAMA-- autopsy statements about JFK's skull wound and denied tome that they had the "new" opinions Posner alleged in Congress. Boswell twice--and unequivocally--denied to me ever having spoken with Posner, and after I specifically asked about his congressional claims. I personally believe that Drs. Humes and Boswell told me the truth, a truth which is consistent with their statements in JAMA endorsing their own autopsy report. But I cannot prove that their statements to me or JAMA are true, nor can I prove that those alleged by Posner are false. Perhaps Posner will fulfill his own promise of proof.

It was recently reported that JFK's pathologists have given sworn depositions to the ARRB. It is expected the ARRB has asked the pathologists whether they, as Posner has alleged, have now changed their minds and agree JFK's skull wound was high rather than low, as they reported to me. The depositions will be an acid test on whom one should trust--JAMA, me, and the autopsy report, or Gerald Posner. Without demanding reciprocation, I have offered to send Gerald Posner a check for $1,000 payable to the charity of his choice if Humes and Boswell admitted to the ARRB they have indeed changed their minds about JFK's skull wound, and told Posner that. I believe they will deny ever having told Posner such a thing.


On the "13 cm" vs. "17 cm" discrepancy, Boswell explained that JFK's skull defect was 17 cm long when first examined, but only 13 cm after a late-arriving fragment was replaced into the defect. I asked: "On the face sheet--was the 17cm (meant) to reflect the size of the wound before placing fragment of bone that arrived late into the autopsy into the OCCIPITAL wound, and the 13 cm to reflect the size of the wound after the fragment was in place?" He answered, "Right." I followed with, "Was there one large defect in the head from fore to aft, or was there (sic) two?" Boswell answered, "Just one defect." I pushed further, "Does the Rydberg diagram (CE 388) show the bone fragment back in place" Boswell answered, "Yeah, the-eh-that fragment--the defect--the wound of entrance was at the base of that defect and, eh, the shelving on the inner surface of the bone was half on the intact portion of the skull and half on that fragment that we received from Dallas and replaced."

Boswell's face sheet diagram was prepared on 11/22/63. As it was prepared closer to the event that even the autopsy report, the diagram should be considered at least as reliable. If there was a 17cm continuous skull defect extending to the external occipital protuberance, it seems very unlikely Oswald was responsible.


While the HSCA claimed the autopsy photographs were "authenticated," there are problems with the extant photographic record. All of JFK's pathologists and photographers, as well as Bethesda pathologist-witness Dr. Robert Karnai, recalled the taking of photographs that do not now exist. The major argument that the photographic file is inviolate and dependable is the 11/10/66 statement regarding the x-ray and photographic inventory which was signed by Humes, Boswell, Ebersole, and Stringer after they examined the materials. it read, "The X-rays and photographs described and listed above include all the X-rays and photographs taken by us during the autopsy, and we have no reason to believe that any other photographs or X-rays were made during the autopsy." It seems unlikely that anyone would write such a statement abut a group of photographs they took three years before and never saw. But the signatories did not write the document; they merely signed this statement, which was prepared for them by a government agent. This is proved in a recently released document which reads, "On the afternoon of November 10, 1966, I (Carl W. Belcher) took the original and one carbon copy of the document entitled 'Report of Inspection by Naval Medical Staff on November 10, 1966 at National Archives of X-Rays and Photographs of Autopsy of President John f. Kennedy' to the Naval Medical Center, Bethesda, Md., where it was read and signed by Captain Humes, Dr. Boswell, Captain Ebersole and Mr. John T. Stringer. Certain ink corrections were made in the document before they signed it..."

Much evidence exists that autopsy photographs are missing. Finck, for only one example, was certain he never saw the photos of the skull (not scalp) wound, internal and external aspects, whose taking he'd directed. In addition to noting the absence in his own notes, Dr. Finck had the following exchange before the HSCA: Charles Petty MD: "If I understand you correctly, Dr. Finck, you wanted particularly to have a photograph made of the external aspect of the skull from the back to show that there was no cratering to the outside of the skull." Finck: "Absolutely." Petty: "Did you ever see such a photograph?" Finck: "I don't think so and I brought with me the memorandum referring to the examination of photographs in 1967...and as I can recall I never saw pictures of the outer aspect of the wound of entry in the back of the head and inner aspect in the skull in order to show a crater although I was there asking for photographs. I don't remember seeing those photographs."

It was Andy Purdy himself who reported, "STRINGER said it was his recollection that all the photographs he had taken were not present in 1966 (when he first saw the photos). No photographs now exist of the interior of JFK's chest, but it was unanimous that such photographs were taken. (Finck was apparently never asked about interior chest photos.) As Mr. Purdy conducted many of these interviews, and should have known the content of all of them, he apparently never explored this important controversy. The records speak for themselves: "STRINGER remembers taking 'at least two exposures of the body cavity.'" HUMES: "...specifically recall (ed photographs) ... were taken of the President's chest...(these photos) do not exist." BOSWELL: "..he (Boswell) thought they photographed '...the exposed thoracic cavity and lung...' but doesn't remember ever seeing those photographs."

ROBERT F. KARNAI MD: "He (Karnai) recalls them putting the probe in and taking pictures (the body was on the side at the time) (sic)." FLOYD REIBE: "he thought he took about six pictures--'I think it was three film packs'--of internal portions of the body."

It appears far from certain that an undiminished photographic record now exists. It seems certain, however, that someone gave Mr. Carl W. Belcher of the Criminal Division of the US Justice Department the completed memo for the witnesses to sign. That person may have wished the photo and X-ray record to appear undiminished. It is not surprising some believe there was also additional photo tampering.


Parkland witnesses to JFK's skull wound virtually unanimously described a defect in the right rear of JFK's skull. For example, neurosurgery professor Kemp Clark closely examined the skull and wrote, on 11/22/63, "Thee was a large wound beginning in the right occiput extending into the parietal region...Much of the skull appeared gone at the brief examination..." Dr. Clark's claim of a rearward skull defect was also repeated by Parkland Drs. M.T.Jenkins, Malcolm Perry, Robert McClelland, Charles Carrico, Ronald Coy Jones, Gene Aiken, Paul Peters, Charles R. Baxter, Robert Grossman, Richard B. Dulaney, Fouad Bashour, and others. Such a defect is not inconsistent with the autopsy report's description of a parietal-temporal-occipital skull defect. However, a defect in the right rear quadrant seems incongruous with a bullet entering the rear of the skull and supposedly exiting the front, as is alleged to have resulted from Oswald's fatal shot. The autopsy photographs contradict the Parkland witnesses--they show an "anterolateral" defect; that is, a defect on the right side toward the front, with no defect behind the ear. The inconsistencies have raised the question of possible photographic tampering.
Regarding this dilemma, The HSCA wrote, "Critics of the Warren Commission's medical evidence findings have found (sic) on the observations recorded by the Parkland Hospital doctors. They believe it is unlikely that trained medical personnel could be so consistently in error regarding the nature of the wound, even though their recollections were not based on careful examinations of the wounds...." In disagreement with the observations of the Parkland doctors are the 26 people present at the autopsy. All of those interviewed who attended the autopsy corroborated the general location of the wounds as depicted in the photographs; none had differing appears more probable that the observations of the Parkland doctors are incorrect." The statement is supported by reference to " 'staff interviews' with persons present at the autopsy."

Recently released documents reveal for the first time that the HSCA misrepresented both the WC statements of the Bethesda witnesses, as well as its own "staff interviews" on the location of JFK's skull defect. Rather than contradicting Parkland witnesses that there was a rear defect in JFK's skull, Bethesda corroborated them. Bethesda witnesses not only described a rear defect to HSCA, they also drew diagrams that overwhelmingly showed a defect at the rear, or right rear of JFK's skull. By falsely representing the data, including its own, HSCA writers inaccurately portrayed Bethesda witnesses as contesting the observations of Parkland witnesses whom, in fact, they supported. They apparently also sought to quell the controversy regarding the autopsy images which show no defect where Parkland, and now incontestably Bethesda, witnesses saw it. Discouragingly public access to these inconvenient interviews and diagrams, which were of no national security value whatsoever, was ordered to be kept secret from the very public whose doubts about the WC's investigation led to the formation of the HSCA in the first place.

In preparing its report, the HSCA failed to acknowledge the WC testimonies of credible Bethesda witnesses who described a rear defect. Secret Service agent Clint Hill reported a wound on "the right rear portion of the skull." SS agent Roy Kellerman told Commission counsel Arlen Specter that JFK's skull defect was "To the left of the (right) ear, sir, and a little high; yes...("indicating the rear portion of the head") was absent when I saw him." After SS agent William Greer manually demonstrated the defect's location to the Commission, Specter asked, "Upper right side, going toward the rear, and what was the condition of the skull at that point?" Greer: "The skull was completely--this part was completely gone." Moreover, other Bethesda witnesses interviewed by authors David Lifton, Harrison Livingstone, and Robert Groden, as well as others, also described a rear defect in the skull much like that given to the WC and the HSCA by its Bethesda witnesses. (Available on request-space limits prevent full list...)

The HSCA's interviews demonstrated a remarkable consistency between the Bethesda witnesses claims to the WC, to authors, and to the HSCA, as well as the recollection of Parkland witnesses. James C. Jenkins, in Pathology Ph.D. program at the time of the autopsy, was a laboratory technician who worked with the autopsists on JFK. The HSCA's Jim Kelly and Andy Purdy reported that Jenkins "said he saw a head wound in the '...middle temporal region back to the occipital.'" Jenkins prepared a diagram for the HSCA that was only recently released. It confirms his verbal description of a defect in the right rear of the skull.

FBI S/A James Sibert was interviewed by the HSCA's Jim Kelly and Andy Purdy, who reported, "Regarding the head wound, Sibert said it was in the 'upper back of the head.'" In an affidavit prepared for the HSCA Sibert claimed, "The head wound was in the upper back of the head," and "a large head wound in the upper back of the head with a section of the scull (sic) bone missing." Sibert sketched a drawing of the skull wound and traced a small wound square in the central rear portion of the skull, slightly above the level depicted for the ears but well below the level depicted for the top of the skull.

Tom Robinson was a mortician who prepared John Kennedy's remains for his coffin. Robinson assisted with the preparations for a open casket funeral so preparation of the skull was especially meticulous. Robertson described the skull wound in a 1/12/77 HSCA interview with Andy Purdy and Jim Conzelman. Purdy: "Approximately where was this wound (the skull wound) located?" Robinson: "Directly behind the back of his head." Purdy: "Approximately between the ears or higher up?" Robinson: "No, I would say pretty much between them." On the day of this interview, Purdy and Conzelman signed a diagram prepared and also signed by Robinson. The sketch depicts a defect directly in the central, lower rear portion of the skull. Jan Gail Rudnicki was Dr. Boswell's lab assistant on the night of the autopsy. Rudnicki was interviewed by the HSCA's Mark Flanagan on 5/2/78. Flanagan reported Rudnicki said the "back-right quadrant of the head was missing." The author is unaware of any diagram Rudnicki might have prepared.

John Ebersole MD was the attending radiologist at JFK's autopsy. IN HSCA testimony recently released, Ebersole claimed, "The back of the head was missing..." (HSCA interview, 3/11/78, p.3) and when shown the autopsy photograph with the back of the scalp intact, Ebersole commented, "You know, my recollection is more of a gaping occipital wound than this, but I can certainly not stat that this is the way it looked. Again, we are relying on a 15 year old recollection. But had you asked me without seeing these or seeing the pictures, you know, I would have put the wound here rather than more forward." Yet Ebersole claimed that "I had the opportunity (to examine the back of JFK's head while positioning the head for X-rays.") Later Ebersole said, "...perhaps about 12:30 (am) a large fragment of the occipital bone was received from Dallas and at Dr. Finck's request I x-rayed these (sic)...." If an occipital bone fragment did arrive late for the autopsy, the defect must indeed have been posterior. The occipital bone is at the base of the rear of the skull.

Philip C. Wehle--then commanding officer of the Military District of Washington, DC, described the head wound to the HSCA's Andy Purdy on 8-19-77, who reported, "(Wehle) noticed a slight bruise over the right temple of the President but did not see any significant damage to any other part of the head. He noted that the wound was in the back of the head so he would not see it because the President was lying face up; he also said he did not see an damage to the top of the head, but said the President had a lot of hair which could have hidden that...." The author is unaware of any diagram Wehle might have prepared for the HSCA. If the photographs depicting a skull defect anterolaterally are accurate, it is hard to imagine how such a defect would have been invisible to Wehle with JFK lying face up.

Chester H. Boyers "was stationed at Bethesda Naval Hospital and was the Chief Petty Officer in charge of the Pathology Department in November, 1963." Flanagan reported, "In regard to the wounds Boyers recalls an entrance wound in the rear of the head to the right of the external occipital protuberance which exited along the top, right side of the head toward the rear and just above the right eyebrow."

FBI agent Francis X. O'Neill prepared a diagram for the HSCA showing a defect in the right rear quadrant of JFK's skull. The author is unaware of a report of an interview with O'Neill among the files released by the HSCA.

The only state I found in HSCA interviews that is not frankly incompatible with the photographic images, which only imperfectly suggest an anterolateral defect (personal opinion, having seen the original images at the Archives by permission of the Kennedy family), is that attributed to Captain John Stover, then Commanding Officer of the National Naval Medical School. The HSCA's Mark Flanagan reported, "Stover observed...a wound on the top of the head..." Stover's description is so ambiguous as to be of no use to either side of the debate.
Whether over forty witnesses at both Parkland and Bethesda miraculously made the identical error in describing a right-rear defect, rather than an antero-lateral defect, is problematic to say the least. Whatever the truth, the HSCA apparently misrepresented WC testimony, as well as its own witnesses' descriptions, to give false assurances the question was non conspiratorially laid to rest. The interviews themselves will now unavoidably heighten the controversy of where JFK's skull defect truly was, and public confidence in the HSCA's work will inevitably suffer. That both Parkland and Bethesda witnesses supported the autopsy report's description of JFK's skull defect--a 'parietotemporooccipital' loss of bone and scalp is unreconciled with the photographic and X-ray evidence which has been interpreted by showing a "parietofrontotemporal" defect, incompatibly forward of the location given by over 40 witnesses.

Used by permission of the author. All rights reserved. JFK/DPQ PO Box 174 Hillsdale, NJ 07642 USA

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