Interview With Dr. Benjamin Aaron

QUESTIONS

1. What were your first thoughts when you realized that President Reagan had been shot and you would have to operate on him?

2. Describe what you saw when you first examined the President. What did Reagan say?

3. How hard was it to find and remove the bullet? Did you think at any time you wouldn't be able to get it out?

4. Do you believe the President would have died if he hadn't been taken directly to George Washington University Hospital and instead taken back to the White House?

5. Do you ever think that you changed the course of history by saving his life?

6. What was it about your training and experience as a surgeon that best prepared you for that moment?

7. Where were you born? What are you doing now? And where do you live?

ANSWERS

1 and 2. When I got the page to go to the emergency room right away,
all I knew was that an attempt had been made on the President's life
and that some of his party had been injured. The radio had declared
that "it was believed that the President had not been hurt", so I
supposed that the call was a general one for all the surgical help they
could get. When I saw the President lying on the ER table, obviously
in difficulty, I went into full alert mode and began to evaluate the
situation. I was immediately told that the President had been shot in
the chest, that a chest tube had been inserted, and that a chest x-ray
had been taken. I saw that he was breathing without a tube inserted in
his windpipe (a really good sign), and that his vital signs (pulse,
blood pressure and heart trace) were stable. I also saw that he had
blood running in intravenously, and that the chest tube was returning a
large volume of very dark red blood. This latter observation was very
important, because the dark color of the blood indicated that the blood
was coming from some injury to the pulmonary artery or its branches,
and usually represents a more dangerous condition. When the chest
x-ray arrived, the one view we had showed the bullet lying either in
the heart or somewhere behind the heart in the left side of the chest
in the region of the pulmonary artery and aorta. When asked what we
should do at this point, the answer was easy for me. The bullet was in
a very dangerous location, the chest tube continued to deliver blood at
a rapid rate, and by my calculation, the President had lost to this
point 35-40% of his blood volume. In a 70 year old man, even though
the blood had been replaced, this was not a scenario for a successful
outcome, and surgical exploration to stop the bleeding and hopefully
remove the bullet was the safest and most predictable course in my
judgment.

President Reagan said, among many things, "it hurts to breathe",
"Doctor, do what you think is best", "all in all, I would rather be in
Philadelphia" (a famous quote), "honey, I guess I forgot to duck" (to
his wife, Nancy).

My thoughts throughout this time were strictly professional, mandated
by the gravity of the situation, and I had no time, or inclination, to
indulge in the peripheral aspects of the case, such as "this is the
President!" or "what will the press think and report" or "what if
something goes wrong".

3. The bullet was located in the "root" or central part of the left
lung where all the large blood vessels are, immediately behind the
heart, and was at first difficult to locate in the spongy mass of the
lung. After 10 minutes or so, and with a certain maneuver, I was able
to locate and remove the bullet from the lung and close the bleeding
blood vessel with suture.

For a time, when I couldn't locate the bullet, I was concerned that the
bullet had escaped from the lung by way of the large blood vessels that
lead to the heart, and that would have been a very grave event for the
patient. Getting the bullet out took some time, but it was worth it,
especially since it was the only direct evidence linking the assailant
to the shooting.

4. Time was clearly of the essence in this injury. The President went
into shock when he first arrived at our emergency room, an event which
coincides with the loss of 30-35% of his blood volume. Shock
progresses to loss of all vital functions and death if not immediately
corrected (as happened in our ER). Considering that the distance to
the White House from the Hilton Hotel was the same as the distance to
George Washington Hospital, he would have gone into shock on arrival at
the White House without any of the state-of-the-art resuscitation
available at our ER. Logic would indicate that death or major debility
such as stroke or brain injury would have been a likely outcome if he
had not been taken immediately to GW Hospital.

5. There is no doubt in my mind that the course of history would have
played out differently had President Reagan not survived. I do not,
however, accept that "I changed history". I did my job well and the
President survived. It is quite likely that in my absence, one of the
other well qualified thoracic surgeons available would have done just
as well and the outcome would have been the same.

6. As a board certified Thoracic and Cardiovascular Surgeon, I had
spent 4 years in medical school, 5 years in surgical training and 3
additional years of specialty training in diseases and conditions of
the heart, lungs and blood vessels. The training is difficult,
intense, and rigorous and intended to produce a quality of surgeon that
can handle any problem in the field of training. I had enough training
and experience by this time to be Chief of Thoracic and Cardiovascular
Surgery at a major academic medical center and that is why the Reagans
and their White House physician decided that I could handle the case
from beginning to end.

7. I was born in Jefferson City, Missouri. I retired as Professor
Emeritus of George Washington University in 1996, and have spent my
retirement flying my airplane, playing golf and volunteering for
medical things and church related activities. I live in San Diego, California.