Trauma: Everything Was Not Enough

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Disregarding the relatively harmless bullet in the neck, the surgeons turned their attention to uncovering the damage to Kennedy's brain. The head was shaved. Overlying skin and muscle were then cut and laid back. An air-powered drill bored through the skull, and a segment of bone was removed. Then, while Reid helped control bleeding, Cuneo probed the wound. Softened and bruised brain tissue, bone fragments and clotted blood were removed by suction.

"If the bullet had hit one centimeter to the rear, the Senator would have been in fairly good condition," Cuneo explained curtly. "But it hit the mastoid, which is a spongy, honeycomb bone. Behind that is the thickest part of your head. That's solid. The little bullet would have just bounced off. But hitting the mastoid, it sent bone fragments shooting all over the Senator's brain. The bone fragments are the worst part, not the bullet fragments. The bullet is pretty sterile from the heat, and once the fragments are in the brain, they don't do any more damage. But the bone fragments are sharp and dirty, medically speaking.

"Both types of fragments went all through the right occipital lobe. There were clots, swelling of the brain in general, laceration of blood vessels. I removed multiple bullet and multiple bone fragments. I knew there was irritation of the center of the brain, the region of the brain stem. I couldn't see that bullet fragment, but I knew it was there from the X rays. Of course I had to leave it.

"I removed the blood, irrigated out bits of destroyed brain tissue, explored the occipital lobe and the right cerebellar hemisphere. The cerebellum was bruised and damaged all along one side. There were more bone and bullet fragments in it. The draining of the blood and the opening of the skull relieved the pressure in his head, and a third of the way through the operation he started to breathe on his own again, but we kept the respirator going."

Faint Hopes. Throughout the operation, life signs—pulse, blood pressure and, later, breathing—gave rise to limited optimism among many who heard the terse bulletins issued from the hospital. The fact that he had been conscious (he had reportedly asked not to be moved immediately after the shooting) was also faintly hopeful.

When the 3-hr. 40-min. operation was over, Kennedy "stabilized pretty well," said Cuneo. An electroencephalograph showed regular brain waves. Feeding him intravenously, continuing the transfusions and the monitoring of his life forces, the doctor watched for signs of consciousness. Even then, said Cuneo, "we were certain that the future would be disastrous for the Senator if he did survive. I didn't tell Ethel all this; I just told her that we were doing everything we could."

Everything was not enough. At 1:44 a.m. Thursday (P.D.T.), 25 hours after the shots rang out, Robert Kennedy died. "The family were right around him," said Cuneo. "They'd all been at his bedside for hours. Ethel was on one side of the Senator, Ted was on the other." Kennedy never regained consciousness. "It wasn't a question of sinking," reported his grief-stricken press secretary, Frank Mankiewicz. "It was a question of not rising."

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