The Pneumothorax in JFK's Right Lung

[Bob Prudhomme]

https://www.youtube.com/watch?v=DX58vrL5ZiA

It is interesting to note that, at about 4:22 of this interview, Dr. Jenkins describes the insertion of a chest drainage tube into JFK's left chest. The reason he gives for this is, according to Dr. Jenkins, the fact that one doctor had listened to that side of the chest, while Dr. Jenkins was performing artificial respiration with a bag valve mask, and had heard no breath sounds.

As this oration by Dr. Jenkins is obviously many years after the assassination, he can be forgiven a certain degree of confusion but, the fact remains that in his medical report (Appendix VIII of the WCR) Dr. Jenkins clearly states the chest tube was inserted in the RIGHT chest.

"Doctors Charles Baxter, Malcolm Perry, and Robert McClelland arrived at the same time and began a tracheostomy and started the insertion of a right chest tube, since there was also obvious tracheal and chest damage. Doctors Paul Peters and Kemp Clark arrived simultaneously and immediately thereafter assisted respectively with the insertion of the right chest tube and with manual closed chest cardiac compression to assure circulation."

Note also he states there was "obvious chest damage".

From the Warren Commission testimony of Dr. Marion T. Jenkins:

"About this time Drs. Kemp Clark and Paul Peters came in, and Dr. Peters because of the appearance of the right chest, the obvious physical characteristics of a pneumothorax, put in a closed chest drainage chest tube. Because I felt no peripheral pulse and was not aware of any pulse, I reported this to Dr. Clark and he started closed chest cardiac massage."

A pneumothorax is usually an indication of serious damage to a lung, and results in the collapse of that lung. This is why the doctors were unable to hear breath sounds, and elected to insert a drainage tube in the right chest.

While it is likely that JFK was also suffering a haemothorax of the right lung (accumulation of blood and fluid), the most serious condition of the lungs was the pneumothorax. As JFK was lying on his back, the back entrance wound, unknown to the Parkland doctors, was likely sealed by the back being in contact with the table. As the lung was compromised (ruptured) each breath, assisted or otherwise, would be pulled through the rupture in the lung, and the lung would not inflate. Instead, the air would pass into the pleural cavity between the lung and the chest wall and be trapped there, as the lung would flatten out on expiration and not allow the air to be expelled. With each breath, the amount of air in this cavity, with the back wound sealed off, would increase, until the pressure began exerting itself on the heart, major blood vessels and the left lung.

This condition is known as a "tension" pneumothorax and, unless the pressure in the pleural cavity is relieved with a chest tube, this condition is invariably fatal as the function of the other organs of the chest is so badly impaired. The chest tube is connected to a water seal chamber that prevents air returning through the tube to the pleural cavity during inspiration. In the field, first responders use the Asherman Chest Seal to seal off punctures of the chest. It seals off the wound, preventing air from entering the pleural cavity during inspiration (open pneumothorax) but has a one way valve that allows any pressure built up in the pleural cavity (tension pneumothorax) to escape.



Another classic sign of a tension pneumothorax is deviation of the trachea (windpipe) away from the affected lung. Several doctors noted this on JFK when he arrived at Trauma Room One, and I believe this to be one of the "obvious physical characteristics of a pneumothorax" Dr. Jenkins was referring to.

Of course, everyone realizes that the type of damage to the right lung indicated here was contrary to the findings at the autopsy.