HOW FIVE INVESTIGATIONS INTO JFK’S MEDICAL/AUTOPSY EVIDENCE GOT IT WRONG
Gary L. Aguilar, MD and Kathy
I-A. The First Investigation - The Warren Commission
I-B. The Warren Commission Examines Kennedy's Medical/Autopsy Evidence
II. The Justice Department Investigates JFK's Autopsy
III. The Clark Panel
IV. The Rockefeller Commission
V. The 'Last' Investigation - The House Select Committee on Assassinations
Appendix - Tables and Figures
III. THE CLARK PANEL
Introduction: A Rebuke of JFK’s Autopsy Findings, but a Reaffirmation of Two Shots, From the Rear
The Clark Panel, whose four members were indeed accomplished and respected authorities, were chosen by the Justice Department to review the autopsy evidence in 1968. Their report endorsed the Warren Commission’s central conclusions about a single assassin. However, the Panel did take some key exceptions to the autopsy report’s findings. The panelists’s major contribution to the controversy was that they placed the inshoot of JFK’s fatal wound not ‘just above’ the EOP, as per the autopsy report, but 4 & 1/2 inches higher, a location that was later endorsed by the Rockefeller Commission and the HSCA’s forensic panel.
There were four members, William H. Carnes, MD, professor of pathology, University of Utah, Russell S. Fisher, MD, the famed Baltimore medical examiner, Russell H. Morgan, MD, the head of the radiology department at Johns Hopkins University, and Alan R. Moritz, MD, professor of pathology at Case Western Reserve University.
The members met in Washington on February 26-27, 1968 and drafted their report on February 27, 1968, submitting the report to the Justice Department a short time later after editing was completed. Though such a review had the potential to quell the doubts that were then swirling, the government oddly elected to keep the “Clark Panel’s” report secret until the next year. As pathology professor John Nichols, MD, pointed out, “The existence of the 1968 Experts Review Panel was not made public until January 16, 1969, when a copy of its report (published in full as an appendix to article by Mr. Blaine Taylor) (sic) was deposited with the Washington, DC, District Court.” Nichols claimed that the delay was “part of a futile attempt by Attorney General Clark to forestall issuance of a subpoena requiring the Archivist of the US to take artifacts of the assassination to New Orleans for use in the case of Louisiana vs. Shaw.”
Although Nichols may have been right about the reason the Panel’s report was late, the report itself suggests Ramsey Clark may have had other reasons for keeping it out of sight: despite the estimable professional credentials of the panelists, their report is an peculiarly unprofessional product. Had these Justice Department appointees really wished to appear to be acting with, as they put it themselves, “complete and unbiased independence free of preconceived views as to the correctness of the medical conclusions reached in the 1963 Autopsy Report,” they did not promote their cause by couching their phrasing in language better suited to a prosecutor’s brief than to a detached, scientific analysis, especially since they repeated many of the same errors of the original autopsy team, all the while making no few new and substantial errors of their own.
Errors and Omissions
1) The Lateral X-rays
The Clark Panel asserted, for example, that both lateral X-rays were “left lateral,” meaning that both were shot with the X-ray beam shooting from the right side toward the left side of JFK’s head, which was placed against the X-ray film. As was apparent to one of the authors when he examined the originals (Aguilar), and as the HSCA’s experts later pointed out, one of the X-rays is left-lateral, the other is right-lateral.
2) The Trail of Fragments on the Lateral X-rays
The Panel also said that all of the fragments on the lateral skull X-ray were above “a horizontal plane through the floor of the anterior fossa of the skull,” a horizontal line that is parallel with the EOP and so consistent with the autopsy report’s description of “along a line corresponding with a line joining the above described small occipital wound and the right supra-orbital ridge.” This also missed the mark.
Worse yet, the Panel incorrectly described the trail’s true position as, “on lateral film #2 this (fragment) formation(’s) long axis, if extended posteriorly, passes through the above-mentioned (new entrance) hole.” That fragment trail does not line up with the presumed higher entrance hole. As one of the authors (Aguilar) determined by looking at the original X-rays, the trail lies noticeably higher than that level. This is not a new discovery. In 1978, HSCA expert radiologist David O. Davis, MD reported that the trail extended, “anteriorly from the inner table of the skull at a point approximately 6-cm. antero-superiorly from the previously described embedded metallic fragment.”
By all accounts, including that of the HSCA’s expert Davis, that “embedded metal fragment” is visibly lodged 1-cm below the supposed higher “hole” of entrance. Therefore, the trail of fragments is 5-cm higher than the “above-mentioned hole.” And so, if extended posteriorly, the fragment trail does not pass through the “above-mentioned hole,” but 5-cm above it. (Warren loyalist, John Lattimer, MD, who examined the restricted X-rays himself, made the same mistake. In his 1980 book, written after Dr. Davis’ letter had been published by the HSCA, Lattimer reported that the trail of bullet fragments, “were arranged roughly in a line that would pass, if extended posteriorly, thorugh the wound of entry.” As Milicent Cranor has pointed out, Lattimer has made other, significant errors in X-ray interpretation.)
The relevance of this issue is that the original autopsy team had cited the trail of bullet fragments as evidence the fatal shot had passed from a low entry point in the rear of JFK’s skull to a high exit point in front, up near the eye. Clark’s experts never acknowledged the fragment trail that had been described in the original autopsy report, one that had wrongly placed the trail much lower than the “correct” trail they identified. Instead, the experts introduced their own mistaken interpretation of the X-ray films, raising the trail’s level to support their theory of where the bullet had entered. But this higher trail was still far too low to be accurate. Only when the HSCA reported out – 10 years later – did it emerge that the actual fragment trail is higher than both the Warren Commission and the Clark Panel had said it was. So only then was it clear that both the original autopsy team and the Clark Panel had misinterpreted important features of the X-rays in a way that allowed them to arrive at quite different conclusions about precisely where the fatal bullet had struck JFK in the head. The actual fragment trail, however, doesn’t help either reconstruction.
3. No Bullet Fragments on the Left Side, or the Lower Portion, of JFK’s Skull X-rays
The Clark Panel also determined that, on the X-rays, no bullet fragments “can be visualized on the left side of (JFK’s) brain and none below a horizontal plane through the floor of the anterior fossa of the skull.” Both portions of this statement are untrue. As Allegheny coroner Cyril Wecht, MD, JD first pointed out, there indeed are fragments on the left side of JFK’s skull, a point confirmed directly by one of the authors who has seen the original X-rays (Aguilar), and also by David Mantik, MD, Ph.D. Moreover, there are fragments lying below the “horizontal plane” of the floor of the anterior fossa on both the left and right sides of the skull.
4. Metal Fragments Present in JFK’s Neck X-rays
The Panel reported that, “just to the right of the cervical spine immediately
above the apex of the right lung … several small metallic fragments
are present in this region [of the X-ray].”
There would have been forensic implications if metallic fragments had
indeed been present in JFK’s neck region. But the Panel erred again;
the “fragments” turned out to be artifacts. HSCA consulting radiologist,
David O. Davis, MD, concluded they were “[X-ray] artifacts, partly because
of their marked density” – they are denser than a true, small fragment
of bone would be. He also noted that “there is a similar artifact overlying
the body of C7” – meaning that another “fragment” was lying at some
distance from the supposed path near T1, “and because these metallic-like
densities were not present on the previous, pre-autopsy film … Therefore,
I assume that these are screen artifacts from debris present in the
cassette at the time that this film was exposed.” Davis was endorsed
by HSCA radiology consultant G. M. McDonnel, MD,
and the entire HSCA panel. Among radiologists and other
physicians who have seen the X-rays since 1968, there is no longer any
doubt the Clark Panel wrong here. [As Milicent Cranor has noted,
In a 1972 published report, celebrated Warren loyalist, John Lattimer,
MD, repeated the Clark Panel’s error that there were metal fragments
near JFK’s spine. Two years later, Lattimer reported that the fragments
were bone, not metal,
and three years after that, he again reported there were bone fragments
near JFK’s spine. There are no such fragments, bone or metal.]
5. The Location of the Greatest Skull Damage on JFK’s X-rays vs. the Autopsy Report
Clark’s experts also reported that JFK’s X-rays revealed that in “the right fronto-parietal region of the skull, the traumatic damage is particularly severe.” This time, the panelists were correct, yet they failed to note an important conflict. The autopsy report described no such frontal damage, but only skull damage to the parietal, temporal and occipital areas. So the autopsy report (and myriad witnesses) specified posterior parietal, temporal and occipital damage, but no frontal damage. By contrast, the Clark Panel concluded the frontal damage was particularly severe, but found nothing to report about occipital injury, not even that the autopsy report had been wrong about the occiput. These discrepancies are hardly negligible forensically.
6. X-rays Prove Conclusively the Fatal Shot Was Fired From Behind JFK
The Panel concluded that, “The absence of metallic fragments in the left cerebral hemisphere or below the level of the frontal fossa on the right side together with the absence of any holes in the skull to the left of the midline or in its base and the absence of any penetrating injury of the left hemisphere eliminate with reasonable certainty the possibility of a projectile having passed through the head in any direction other than from back to front as described in preceding sections of this report.”
The films themselves refute this flat statement. There are fragments on the left side of JFK’s skull, and some below the level of the frontal fossa as well. Moreover, it appears that little consideration was given to any scenario involving shots from any location but behind, a conclusion that does not necessarily follow from the ambiguous autopsy evidence. Cyril Wecht was the first to make the commonsense observation that, “the fractured calvarium [skull], the hemorrhagic brain, and the bullet fragmentation are no more indicative of a shot fired from the rear than one fired from the front.”
For example, a shot from the right front entering JFK’s skull above, or in front of, JFK’s right ear might easily have delivered a ‘glancing’ blow to the skull as it passed rearward, exiting the right rear. Such a shot would be fully compatible with the X-ray evidence, especially if this was the second of two shots, as first proposed by Josiah Thompson. Yet Thompson’s hypothesis, which as we’ve seen the Attorney General was keen to refute, was ignored a priori by the experts Clark chose. Such a path, incidentally, might also explain the peculiarly high trail of bullet fragments the Warren Report and Clark Panel had misdescribed if in fact such a bullet had been travelling rearward when it struck JFK high in the skull.
7. The damage caused to JFK’s skin supports shots struck from behind and exited the front
The Clark Panel made a finding that supported the back shot had come from above JFK. Based on the autopsy photographs, it wrote that “a well defined zone of discoloration of the edge of the back wound, most pronounced on its upper and outer margin, identifies it as having the characteristics of the entrance wound of a bullet.”
The forensic implications of this observation derive from how bullets damage skin. When a bullet strikes skin from any direction off the perfectly perpendicular, it tends to create a greater zone of skin scraping and bruising – a so-called “zone of discoloration” or “abrasion collar” – in the direction from which it flew. In other words, if a bullet was shot from a victim’s right side, it would tend to create a larger “zone of discoloration” on the right edge of the wound because that’s the point the bullet hits first, and it tends to stretch the skin more at that point as it goes in at an angle. Similarly, a bullet fired from below tends to leave an abrasion collar toward the bottom of the skin wound.
Although an abrasion collar at the upper edge of the skin wound carries solid forensic implications of a shot from above, the Clark panelists are in a distinct minority that that is really where it was. As we will see, Rockefeller Commission consultant, Werner Spitz, MD, and the entire forensic panel of the House Select Committee looked at the same photographs a few years later and said that the abrasion collar was in the lower half of the wound (see below). The Clark panel wasn’t entirely alone, however. Rockefeller Commission consultant, Richard Lindenberg, MD, also said the abrasion collar was along the upper margin of JFK’s back wound. As will be explored, one must view Lindenberg’s minority opinion in context of his having made some other substantial errors, all of which just happened to promote the government’s conclusions. [After examining the original autopsy photographs at the National Archives, author Aguilar sides with Dr. Spitz and the HSCA that the slight abrasion collar, such as it was, was present along the lower edge of the wound.]
Finally, as Milicent Cranor has astutely observed, the Clark Panel made an important observation that has no factual basis whatsoever: “At the site of and above the tracheotomy incision in the front of the neck, there can be identified the upper half of the circumference of a circular cutaneous wound the appearance of which is characteristic of that of the exit wound of a bullet.” As previously discussed, within a few hours of his death, JFK’s throat wound was describes as looking like an entrance wound by the Dallas doctor who cut into it to perform a tracheotomy precisely because it lacked the features that typify exit wounds. Moreover, none of the experts who subsequently examined JFK’s autopsy photographs have said JFK’s throat wound is typical of exit wounds. To the contrary. As we will see, explanations have been sought to explain why this wound, accepted by officials as an exit wound, looked so much like an entrance wound in its appearance.
An Incurious Inquiry
While space constraints preclude a compilation of every single Clark Panel shortcoming, there is one oversight that deserves mention. The Panel should have proffered a plausible explanation for how JFK’s three “professor pathologists,” actively engaged in teaching “anatomic pathology” to resident physicians in an academic center, could have made so many astounding errors, especially in simple anatomy. A few obvious ones come to mind.
In an anatomic region – the back of the human skull – that measures but 12-cm, top to bottom, how was it that in 1963 two professors of anatomic pathology and a forensic pathologist missed the correct location for JFK’s skull wound by a whopping 10-cm? How had they forgotten to mention that there was frontal bone damage in the autopsy report, damage that is abundantly obvious in what are said to be the original X-rays? How did they find occipital bone damage that, if the Clark Panel is to be believed, was not there? When such images would have been a minimal requirement in photographing the autopsy of even the most undistinguished murder victim, why did they fail to photograph the evidence that proved the nature and direction of the wounding – the internal and external aspects of JFK’s fatal skull wound and bruising at the top of JFK’s lung cage?
Finally, the Panel apparently gave little consideration to the possibility the photographic and X-ray inventory was either incomplete, or that it had been tampered with, a possibility that might have suggested itself given the “proven” autopsy errors as well as the obvious absence from the file of images that would normally have been taken to document any killing, even of a President.
Given those enormous ‘errors,’ perhaps one can better comprehend the reluctance the Justice Department exhibited to making public the Clark Panel’s report. It was suppressed for over a year after completion. It was only released when Jim Garrison (unsuccessfully) petitioned to have the restricted autopsy materials produced for Shaw’s trial. However, instead of releasing the original materials for trial, the government gave Garrison only the Clark Panel’s report as a substitute, a report that was produced as a consequence of Ramsey Clark’s desire to refute Josiah Thompson’s book. Intriguingly, when the report was finally released, the New York Times only emphasized that the Clark Panel had ‘upheld’ the Warren Report; it made no mention of what we have discussed here, what historian Michael Kurtz has accurately described as the “many serious discrepancies between its review of the autopsy materials and the autopsy itself.”
 The Clark Panel’s members included pathologists William H. Carnes, MD, Russell S. Fisher, MD and Alan R. Moritz, MD, as well as radiologist Russell H. Morgan, MD. Their estimable credentials are detailed in the 1968 “PANEL REVIEW OF PHOTOGRAPHS, X-RAY FILMS, DOCUMENTS AND OTHER EVIDENCE PERTAINING TO THE FATAL WOUNDING OF PRESIDENT JOHN F. KENNEDY ON NOVEMBER 22, 1963 IN DALLAS, TEXAS.” In: Weisberg, Harold Weisberg’s Post Mortem, p. 580-581. The Clark Panel's report is also reproduced in ARRB Medical Document #59, see p. 1.
 Clark Panelist, Russell S. Fisher, MD, specified these dates in a letter to Harold Weisberg dated March 4, 1970 and reproduced in: Weisberg, Harold. Post Mortem. Frederick Maryland: 1975, p. 596.
 Nichols, John. The Wounding of Governor John Connally of Texas, November 22, 1963. Maryland State Medical Journal, October, 1977, p. 62.
 Nichols, John. The Wounding of Governor John Connally of Texas, November 22, 1963. Maryland State Medical Journal, October, 1977, p. 62.
 John K. Lattimer. Kennedy and Lincoln. New York: Harcourt Brace Jovanovich, 1980, p. 218.
 Milicent Cranor. Neck and Torso X-rays: Selectivity in Reporting. Available online at history-matters.com: www.history-matters.com/essays/jfkmed/NeckAndTorsoXrays/NeckAndTorsoXrays.htm.
 1968 Panel Review of Photographs, X-Ray Films, Documents and Other Evidence Pertaining to the Fatal Wounding of President John F. Kennedy on November 22, 1963 in Dallas, Texas, p. 11. Available from the National Archives. Reproduced in: Harold Weisberg, Post Mortem, Frederick, Maryland 1975, p. 590. Also reproduced in ARRB Medical Document #59, see p.11
 Michael Kurtz. Crime of the Century – The Kennedy Assassination from a Historian’s Perspective. Knoxville: University of Tennessee Press, 1993, p. 98 – 99.
 See David Mantik’s essay entitled “The JFK Autopsy Materials: Twenty Conclusions after Nine Visits.” In: DiEugenio J., ed. The Assassinations. Los Angeles: Feral House Press, 2003.
 Lattimer J K. Observations based on a review of the autopsy photographs, X-rays and related materials of the late President John F. Kennedy. Resident and Staff Physician 1972; 18:4 – 63.
 Lattimer G, Lattimer JK. The Kennedy-Connally One-Bullet Theory. Medical Times 1974; 102, November: 33 – 56.
 Lattimer JK, Schleshinger EB, Merritt, HH. President Kennedy’s spine hit by first bullet. Bull NY Acad Med 1977; 53:281 – 291.
 Michael Kurtz. Crime of the Century – The Kennedy Assassination from a Historian’s Perspective. Knoxville: University of Tennessee Press, 1993, p. 99.
 Josiah Thompson. Six Seconds in Dallas. New York: Bernard Geis Associates for Random House, 1967.
 Personal communication, Milicent Cranor, New York.
 New York Times, January 17, 1969, p. 17.
 Michael Kurtz. Crime of the Century – The Kennedy Assassination from a Historian’s Perspective. Knoxville: University of Tennessee Press, 1993, p. 87.