the President, and asked him had he in fact done a tracheotomy which was somewhat redundant because I was somewhat certain he had.
He said, yes; he had done a tracheotomy and that as the point to perform his tracheotomy he used a wound which he had interpreted as a missile wound in the low neck, as the point through which to make the tracheotomy incision.

Mr. Specter.

When did you have that conversation with him, Dr. Humes?
Commander HUMES. I had that conversation early on Saturday morning, sir.

Mr. Specter.

On Saturday morning, November 23d?
Commander HUMES. That is correct, sir.

Mr. Specter.

And have you had occasion since to examine the report of Parkland Hospital which I made available to you?
Commander HUMES. Yes, sir; I have.

Mr. Specter.

May it please the Commission, I would like to note this as Commission Exhibit No. 392, and subject to later technical proof, to have it admitted into evidence at this time for the purpose of having the doctor comment about it.

The Chairman.

It may be so marked.
(The document referred to was marked Commission Exhibit No. 392, for identification.)

Mr. Specter.

What did your examination of the Parkland Hospital records disclose with respect to this wound on the front side of the President's body?
Commander HUMES. The examination of this record from Parkland Hospital revealed that Doctor Perry had observed this wound as had other physicians in attendance upon the President, and actually before a tracheotomy, was performed surgically, an endotracheal tube was placed through the President's mouth and down his larynx and into his trachea which is the first step in giving satisfactory airway to a person injured in such fashion and unconscious.
The President was unconscious and it is most difficult to pass such a tube when the person is unconscious.
The person who performed that procedure, that is instilled the endotrachea tube noted that there was a wound of the trachea below the larynx, which corresponded in essence with the wound of the skin which they had observed from the exterior.

Mr. Specter.

How is that wound described, while you are mentioning the wound?
Commander HUMES. Yes, sir.

Mr. Specter.

I think you will find that on the first page of the summary sheet, Dr. Humes.
Commander HUMES. Yes, sir. Thank you. This report was written by doctor--or the activities of Dr. James Carrico, Doctor Carrico in inserting the endotracheal tube noted a ragged wound of trachea immediately below the larynx.
The report, as I recall it, and I have not studied it in minute detail, would indicate to me that Doctor Perry realizing from Doctor Carrico's observation that there was a wound of the trachea would quite logically use the wound which he had observed as a point to enter the trachea since the trachea was almost damaged, that would be a logical place in which to put his incision.
In speaking of that wound in the neck, Doctor Perry told me that before he enlarged it to make the tracheotomy wound it was a "few millimeters in diameter."
Of course by the time we saw it, as my associates and as you have heard, it was considerably larger and no longer at all obvious as a missile wound.
The report states, and Doctor Perry told me in telephone conversation that there was bubbling of air and blood in the vicinity of this wound when he made the tracheotomy. This caused him to believe that perhaps there had been a violation of one of the one or other of the pleural cavities by a missile. He, therefore, asked one of his associates, and the record is to me somewhat confused as to which of his associates, he asked one of his associates to put in a chest tube. This is a maneuver which is, was quite logical under the circumstances, and which would, if a tube that were placed through all layers of the wall of the chest, and the chest cavity had been violated one could remove air that had gotten in there and greatly assist respiration.
So when we examined the President in addition to the large wound which

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