November 13, 1974
Testimony of Dr. Severt Jacobson, M.D.
Scans of original transcript
I, Mary M. Ritchie, being a Notary Public in and for the State of North Carolina, was appointed to take the testimony of the following witness, Severt Harold Jacobson, before the Grand Jury, Raleigh, North Carolina, commencing at 10:00 a.m. on November 13, 1974. All Grand Jurors present.
Whereupon, SEVERT HAROLD JACOBSON, having been first duly sworn, was examined and testified as follows:
EXAMINATION BY MR. WOERHEIDE:
Q Will you state your name, sir?
A Severt Harold Jacobson.
Q Are you a medical doctor?
A Yes, I am.
Q Are you in the United States Army?
A Yes, I am.
Q Will you give us your current home address and your post of duty?
A My current home address is 6328 East Mississippi Avenue, Denver, Colorado. And, my duty station is FitzSimmon Army Hospital. I'm in the neurosurgery service.
Q And, directing your attention to February of 1970, can you tell us where your duty station was at that time?
A I was at Womack Army Hospital in Fort Bragg, North Carolina.
Q All right. Now, directing your attention specifically to the morning of February 17, 1970, were you on duty that morning?
A Yes, sir. I was. I was on duty all that night and the morning hours.
Q During that morning, did you have occasion to see a patient that was admitted to the hospital, one Captain Jeffrey MacDonald?
A Yes, I did. I was called by Dr. Straub, I believe, who was on emergency room duty that night. They said, "We have a doctor here whose family has been killed."
Q Do you recall approximately when that was that you were called?
A Well, I think it was about four o'clock in the morning as best I can recall. Around that period of time, four or five, someplace in that area.
Q All right. Now, what happened then?
A Well, I got the call. I, of course, rushed down to the emergency room. And they had brought Dr. MacDonald in, and he was sitting on a stretcher, very excited at the time. He was not in any acute distress, as one could tell. But he was continually going over the events that had occurred, describing the apparent murder scene, and multiple details about it and in trying to put that train of logic together, I guess what had happened, or just in a very -- he was jumping from one item to another item as far as the events that had occurred. And at times, we got the feeling that he was going to leave, that he was going to rush back to the scene. At least that's the feeling that I got.
And we tried to quiet him down, distract him by, oh, by talking about, number one, getting some history from him, trying to attempt to do a physical examination while he was going on talking, being upset.
Q All right. Now, before we get into the details of what he was saying to you, to others that were present, how were his vital signs?
A Stable. Obviously stable. There was no evidence that he was in any great compromise, any great physical compromise.
Q No, when you refer to his vital signs, what are you referring to?
A I'm referring to his pulse, his blood pressure, respiratory rate, and his consciousness as far as -- was he alert, bright, did he know what was happening?
Q Did you find that in all respects that his vital signs were within normal range and that he was alert and he was aware of what was happening to him and what had happened to him?
A Well, he seemed to, well, he knew what was happening to him at that time and he was recalling events which were within minutes of the period of time. Yes. He was awake, alert, knew what was happening at that time.
Q Now, your field of specialty is neurology. Is that right?
A It's neurosurgery.
Q Which is -- means you are concerned with whether there is any damage to the nervous system of a patient whom you observe. Is that correct?
A That's right.
Q As a neurosurgeon, how would you appraise his meurological condition -- if I'm using the right terminology.
A His neurological condition at that time was, other than for him being somewhat delirious about the events that occurred -- and delirious, I say going over and over, bewildered by the situation, he was neurologically intact. One can make a very good assessment of a person's general neurologic status just by how they move their arms, by how they are talking, by the flow of their speech. One does not have to go up to somebody and tap them on the knees and check their eyes and things like that. People who are neurologically compromised just don't function properly. The wouldn't do those things he was doing.
Q In other words, he was functioning properly?
Q And there was no indication of any neurological damage?
A That's right.
Q So far as he was concerned --
A His affect was appropriate for the situation.
Q Was there any indication that he was in any phase of a so-called shock cycle? I'm talking about physical shock where you lose -- unconsciousness, faint.
A Well, there wasn't any indicators by his vital signs. His blood pressure -- I don't recall his exact figures. I'm sure they are on the chart there. They were all normal. And, if we're talking about shock, we're talking about physiological shock. We're not talking about emotional shock.
(MR. WOERHEIDE HANDS WITNESS PENNELL EXHIBIT #1)
A His blood pressure was 128/70. That's very acceptable. That's a normal blood pressure, and his pulse was 88 at the time, which is a normal blood pressure and a normal pulse.
Q And he was able to sit up and --
A He was sitting up virtually the whole period of time.
Q And your concern was that he might actually leave?
Q Get up and walk out.
Q Now, at that time you examined him to find the extent of any injuries that he might have had.
A Yes. I did an general examination, appropriate to the situation. One does not go through, one does not go through the esoterics of -- esoterics that one can go through in medicine in an emergency room situation. One goes through a reasonable examination appropriate to the situation.
I recall my physical examination and it's recorded in here that he did have decreased breath sounds on the right side and he did get a chest x-ray which demonstrated a pneumothorax. Also, on his skin he had multiple, multiple punctures, lacerations primarily in the anterior part of his body. I did not see anything in the back and confined to the upper portion of his body, primarily the chest and abdomen. And I guess his left arm.
Q Now, during the course of the examination, did you observe a sort of lump with an abrasion on his head, on his forehead?
A Yes. He had what appeared to be a contusion to the forehead which was mildly, very mildly, discolored and slightly elevated and minimial amount of blood unde rit, but probably a little bit of blood like you get from bumping your head on a door if you ran into it. Something like that. Nothing. The skin was not disrupted. There was no bleeding from it.
Q In the course of the examination you made, did you check other parts of his head to observe whether there were any other --
A Yes. I did. Since -- at that time I was not a neurosurgeon, but my interest was directed in that -- specializing at the time. And, of course, you get into a routine where you routinely examine the head for anything that is not seen.
Such as you might say if a drunk comes in you can't always, he doesn't always tell you what's happening to him. So, you have to routinely check the head inch by inch by going through the hair and feeling. And I did not feel anything other than the bump up here.
Q All right, sir. I've asked our reporter to mark these three exhibits which I will show you.
[JACOBSON EXHIBITS #1, 2, 3 MARKED FOR IDENTIFICATION]
Q With reference to exhibit 1 -- this is a male torso scene on the front and the rear. Have you indicated on this diagram the injuries that you observed on the body of Captain MacDonald?
A Yes. All except the contusion to the forehead.
Q Is that represented on this exhibit here?
A That's on that. That's right.
Q Now, I take it from these markings that you observed an incision in the right chest about the seventh intercostal space. Is that right?
A That's correct.
Q And that's indicated by this mark here.
A Right. And there's a representative drawing as I can best recall it appeared like, at the time.
Q In other words, the representative drawing in this square would reflect the actual size?
A Right. Size and the shape of it to the best that I can recall. You know it's --
Q Now, as -- also above the nipple of the left chest, a series of dots and you've made a representation of a drawing there. Can you describe those?
A That was a very interesting thing. I did not report that on my physical examination. I dn't know why, but it was a very interesting thing because it was a linear -- it was a line of kind of puncture marks, very small punctures about the size of the end of a lead pencil that had been used maybe two hours. And it was a linear fashioned -- it was diagonal toward the tip of the shoulder. And it was a track of them and they just seemed to go along in a line.
Q This representation of the drawing, does that indicate the approximate size of those puncture marks that you observed?
A Yes. And that's the approximate spacing, you know, it's been several years and I can't remember.
Q In addition, you saw some superficial cuts on his left upper arm and a superficial cut on the belly to the left and above the navel. Is that correct?
A That's correct.
Q With respect to those superficial cuts, I take it they did not penetrate in the peritoneum, the skin of --
A The one on the belly did not penetrate the peritoneum. It did not go through the muscle because we are very concerned about that. If somebody gets cut on the belly, what had been described to us, one would be very concerned about this being deeper. It just went through the skin, it broke the surface of the skin, of course, but did not go to the muscle. He had a cut on his forearm. It was relatively superficial. I can't exactly recall how deep that was, but it was superficial.
Q Now, referring to exhibit 2 which is a representation of hands, seen with the backs up and the palms up. Can you explain that to us?
A Well, when Jeff came in, he was going through all these things and he was describing how people thrust at him with this, whatever it was, a knife or a ice pick and he said that -- "Oh, I've got a cut on my hand. I must have gotten that when I reached to stop the blow." And he had -- now, I can't be one hundred percent sure, but it was -- and I'm not sure which hand it was, but he had a very superficial cut, like one would get from a very sharp object going along your skin and just taking off a slight sliver of skin. And he had it between the web space of the index and long finger or it could have been in this area. And it seems to me, and it seems quite firm, that it was between the web space of the index and long finger. And I know that that was a definite injury at the time.
Q Was that a matter of any particular concern to you?
A No. It was very superficial. Very superficial and there wasn't any particular bleeding. There was some blood associated with it, but it wasn't on-going bleeding.
Q Now, you described that he had a lump on his forehead. Is that illustrated by this exhibit 3?
A Yes. It wasn't even a lump. It was kind of a just slightly elevated area from being contused. It wasn't a lump like one might see from --
Q From the observations that you made of him at that time, did you have any concern about any possible consequences from that head injury?
A The -- what one sees on a head injury does not necessarily reflect the seriousness of the injury to the patient, but when a patient is awake and able to recall all events that surrounds his injury the chances are, statistically, that he has had a more minor injury. So I was not particularly alarmed by his meurological status at that time.
Q In other words, he had no difficulty recalling any of the events.
A No. There's avery important thing that we utilize in neurosurgery. It's, of course, not one hundred percent, but it's very pertinent. And if somebody has an injury to their head or an injury to their brain, the seriousness of that injury or the amount of damage to the brain is highly correlated in proportional to the period of time that they are not able to remember after the insult to their brain. In other words, if somebody were in a car accident and knocked unconscious or contused, that individual may not be able to tell you anything for two days after that accident. In other words, he may wake up two days later and recall. He may say the first thing I remember after the accidnt is, if the accident occurred on the 14th of February, the 16th of February will be the first thing he can recall. But Jeff could recall everything.
Q By the way, have you known Jeffrey MacDonald from any previous encounter with him or any previous meeting?
A Yes. I didn't know him very well. I only know him primarily on a professional basis. It had been, and I don't know exactly how long prior to him coming into the emergency room to this situation, but he had been in the hospital and had watched me put a chest tube in a patient from the special forces who had been drunk or fallen out of a second or third story window in the special forces area and had a pneumothorax and I had treated him. And I can't give you the period of time, but Jeff had been there when I had done it and talked at that time and that's how I met him.
Q On the morning of the 17th did he elude to this previous incident?
A Welll, you know, we actually kind of did, because Jeff made a remark -- whether it was a pun remark, I don't know, but he said, "I hope I don't need a chest tube." And I thought it was kind of funny because I'd put a chest tube in this other young man and it had not gone so well. It was very uncomfortable for the young man as chest tubes are. And he said, "I hope I don't need a chest tube." And he also did mention to me that he had had some leakage from his chest and it was obviously pertinent that he should mention that, "I hope I don't need a chest tube."
Q Now, that leakage from the incision that was on the right side, seventh intercostal space.
A That's right. Some bubbles.
Q Now, before we get to the x-rays and treatment, would you give us as best as you can recall the details that he gave you concerning the incident which he said resulted in thse injuries to himself?
A Well, when Jeff was brought into the emergency room, he was going over all the events while trying apparently to compose a picture of what had happened at his residence. And he described that he had been awakened by a blow to the head and by his wife screaming, "Why are they doing this to us." He had been sleeping on the couch. Said that he apparently had been hit on the head or hit some place and that had awakened him.
Then he recalled tthat there were four people in the room or four people in the area and that there was a blonde-head, long hair woman with a candle, walking around holding a candle, and three guys, one of them being black. And he said that he avoided getting stabbed and he avoided being hit further. Although, I believe, he said he stopped a blow from a bat, or wood, or whatever it was. Then he recalled checking on -- then he said, "Maybe I was unconscious, maybe I was knocked unconscious." The he said he went and checked on the children and described them as being bludgeoned and that they had no pulses. He checked and they had no pulses. He checked his wife and she -- he said she looked terrible. And he thought that they were all dead. And then I think he said he went to call the MPs or called somebody. And that's, in essence, and as he went on he described -- am I going into too much --
Q No. I want all the details you can give us.
A Okay. And then as he was going along -- as I said, he was trying to compose a logical picture and he talked about a fellow named Badger, Beaver, Badger, something like that. This fellow by that name, he was a dopey, LSD guy and he mentioned his name and said that he refused to -- I don't know what the thing was. They were going to court-martial him or something. I don't know about all those details. He brought up that name specifically. He said he'd been involved in some drug rehabilitation, drub problems. He brought up that name. He said, "I wonder if it was some hippies." And then he mentioned the thing about, mentioned something written in -- okay. Well. He also mentioned about this blonde-head girl -- that she said, "Kill the pigs, kill the pigs." And then he said there was something written in blood on the wall. And, as I said, he heard his wife call out, Jeff, why are they doing this to us?" or "Why are they doing this to us?" And the children were crying. And I guess that is about all the events that I can recall that he had interjected into --
Q did he say something about a knife?
A Yes. He did. Because -- oh, yes. He said he pulled a knife out of his wife's chest. He said be sure to tell them that I pulled a knife out of her chest. I don't know what he did with it, but he said, "I pulled a knife out of her chest." And that's it.
Q Well, when he referred to the MPs, did he also refer to the CID at that time?
A I believe he did. Yes.
Q Do you recall that he said he threw the knife on the floor? Pulled it out of her chest and threw it on the floor.
A Yes. Threw it on the floor. I think that's what he said.
Q Now, with respect to his wife, do you remember --
A Yes. He did mention -- oh, about his wife, he did mention that she was, he said she never hurt anybody and she was six, I believe she was six months pregnant. And he mentioned that during that emergency room situation. Never hurt anybody, the kids were dead.
Q Now, did he refer to the club in any way?
A Only that he avoided it. He avoided it when this fellow was apparently swinging at him.
Q Well, did he refer to it as a baseball bat or as a club or how did he refer to it?
A I do not recall specificallly. I thought he said a baseball bat or something like a baseball bat when he was in the emergency room, but I do not recall how he identified it, specifically. I think it was a baseball bat, though.
Q Did he state whether or not he checked the pulse on his wife or not?
A Yes. He did. He did. And he said -- I couldn't get any pulse on the kids. And I think -- I don't know if he said he checked his wife's pulse. He did say he couldn't get any pulses on the kids and his wife -- he said she looked terrible. That's what he said and I inferred from that that he had apparently checked her pulse.
Q Did he explain why he was sleeping on the couch?
A One of the children were supposed to have wet the bed and that's how he ended up on the couch.
Q Did he specify which one?
A I think the little girl.
Q The little girl?
A Yes. The baby girl had wet the bed and --
Q They were both girls, but one was about -- she was already of school age, about six.
A The smaller one, I believe. He said the little girl, I believe, that's what he said to me.
Q Nothing about the doors? Whether they were open or closed?
A I don't recall that. He may have said something -- they must have come in through the back door, but I -- I can't say for sure. I don't remember.
Q Now, these statements that he made to you were made -- taken prior to the time that he was x-rayed and --
A Yes. Most of them were, you know, it was kind of an on-going conversation. He was talking all the time. He was just going on incessantly. And we let him talk because we thought that would settle him down. But I suppose some of this was said when we went to the x-ray department. I went to the x-ray department when we took the chest x-ray.
Q I take it in the course of the examination you listened to his respiration and --
A (Interposing) Yes.
Q -- you made a determination that on the left side the respiration appeared to be normal but the sounds on the right side were somewhat --
A (Interposing) Increased.
Q -- increased.
Q And that indicated to you a possible pneumothorax. Is that correct?
Q And Dr. Straub was there. He's a radiologist.
A Yes. Dr. Straub was there. We looked at the films. I believe the original films did not show a pneumothorax very well, and we got a repeat film and it showed a pneumothorax. Some of that can be just a matter of technique.
Q Would you make an estimate as to the extent of the pneumothorax.
A Well, it would be an estimate of 20 percent. I'd say this is a --
Q Maybe you can come down here and refer to the film. You know the order. I take it these were the first two films that were made?
A Yes. They are. Here you can't -- This is the first film that was taken and you really can't see a pneumothorax. You could question it up here. But you cannot from the details on this film define that there's a definite pneumothorax. There's a -- this is an inspiratory film. This is an expiratory film. This is taken -- and you can see right -- you can see a line here which shows a pneumothorax. We call this 20 percent. It would be very controversial. I think one could call this up to 40 percent pneumothorax. You know as one looks in retrospect you could say that. At the time we called it 20 percent.
Q You mentioned one as an inspiratory film and one as an expiratory film. Would you explain to the Grand Jury the difference between and inspiratory film and an expiratory film and why a pneumothorax might show up a little bit better on one than the other?
A When one, if you will look here, you will see here this is a rather significant difference in the volume of the lung, the amount of air. This dense darkness is the air. You see there is a difference and the diaphragm is different shaped. When you are expiring you are compressing, you are compressing the lung, so it collapses. In this situation the air should be very much more apparent because its relative volume in this situation is greater than it is in this situation where there is actually more volume within the chest cavity at the time. Because of that it's just easier to see a pneumothorax, just easier, also, because in this one there's a relative facuum. There's a relative vacuum and the lungs are filling up the spaces better. That's about it.
And, as I said before, this film you can't really identify a pneumothorax, but this film you can. It's right here.
Q And you determined that that was at the seventh intercostal space, is that correct, sir?
A That's --
Q Are these the intercostal spaces?
A Yes, sir. The spaces between the ribs are the intercostal --
Q So this would be one, two, three, four, five, six, seven, and it would be approximately in this area?
Q Right at the very bottom of the pleural cavity which is occupied by the lungs. Is that correct?
Q I take it that Dr. Gemma was called for to participate in the treatment in the surgery that was performed on him?
A Yes. Dr. Gemma was the Chief of General Surgery. Dr. Bronstein -- I was a resident at this time, general surgery resident. And I called Dr. Bronstein and we elected not to treat Dr. MacDonald initially as far as putting chest tubes in him because we felt that perhaps, as many of these do, the pneumothorax would resolve and would get better on its own. So we elected to put him to bed just to observe his vital signs. Well, he was not in any sort of distress as far as breath was concerned, short breath.
Q Now, at this time there had been a Vaseline bandage put over his --
A (Interposing) Right.
Q -- the incision in his chest and I take it that was standard procedure.
A That's the standard procedure for --
Q And has the affect of sealing that off and no additional air would get in the pleural cavity.
Q Now, were you present -- did you participate in the placing of the chest tube when that was done ultimately?
A I was there in the placing of one of those chest tubes, I believe. One of them I can recall specificallly. The other I cannot. The upper anterior one I cannot recall. The latter one I can. The one at the seventh intercostal space I can recall.
Q That was the one that was done on the morning of February 17?
A Boy! I'm not sure. I'm really not sure of the sequence of events.
Q According to the records it was done on the morning of February 17.
Q And was done by Dr. Gemma.
A Right. I know there was a chest tube placed that morning. I just do not recall which one it was. I believe it was that one.
Q Did you participate in that surgical procedure?
A Yes. I just kind of stood by and handed him the equipment and he was doing it, essentially.
Q Was it a procedure that went according to the book and without any particular problem?
A Yes. It went very satisfactorily. It's not a particular [sic] difficult procedure. It's uncomfortable to the patient.
MR. WOERHEIDE: You might as well mark these separately.
Q Do these reflect the observations and the notes that you made on the morning of February 17?
A Yes. They are. They are the history and physical that I did on that morning as best as I can remember -- I thought there was a drawing, I thought there was a drawing, but apparently there isn't. Nobody has ever been able to find it. I thought I may be mistaken whether I made one or not.
Q Let's mark these collectively as Jacobson exhibit #4 of the state.
(JACOBSON EXHIBIT #4 MARKED FOR IDENTIFICATION)
Q Just to sum up. He was -- he had some superficial injuries, but the only serious injury that he had was this incision in approximately this area, in the seventh intercostal space.
Q There was a -- an unresolved pneumothorax condition that you diagnosed as being approximately 20 percent that he might recover spontaneously from it.
A (Nods affirmatively)
Q And, was later decided to enter chest tube that, apart from this, physically and -- physically he appeared to be normal. However, he was in a state of some excitement and he manifested concern about his family.
Q But he had a good recollection of the events proceeding his admission to the hospital, including the events that had occurred in his home, what transpired from then on. And you were satisfied that as a result your observation of his movements, his affect, the examination you made of his head and other tests that you administered and other observations that you made, that he was in good condition.
A Yes. He was in good condition.
Q No matter for concern.
A Well, a pneumothorax -- as I said, one cannot be absolutely sure when one sees a head injury, but considering all his responsiveness, considering all of that, it would be of a very low grade of concern.
MR. WOERHEIDE: Mr. Foreman, Grand Jurors.
JUROR: I have one. The charts showing his wounds, his body, head and hands. When were those made in relation to your initial examination of him?
A These were only made yesterday. These were only made yesterday.
Q (Mr. Woerheide): But they do reflect your recollection. Let me ask you this. I have some -- another photograph here. Do they correspond to the photograph insofar as they show up at all on the photograph?
A Yes. They do. Some of them you can't see, of course. There are a couple of things here, some photographs of scars that I do not recall. I just do not recall this one down here.
Q A normal, active boy who engaged in contact sports would normally be expected to have a number of scars on his body, would he not?
Q This -- is this the scar?
A This is the chest scar. This is from the chest puncture. And that's from the tube.
Q That's the site of the pneumothorax.
A That is the site. This is the cause of the pneumothorax. This is the site of the chest tube. The reason that I can recall this is that I went to this Article 32 investigation, and I was asked specifically many times about these punctures, cuts, and things by his lawyers, and, also, the other lawyers. And I recall them very well. You know, it's one of those kind of emotionally charged things that has been repeated many times and that's why, you know, there are some things that I cannot remember, but those things I can, because I've been asked so many times.
MR. WOERHEIDE: May he be excused, Mr. Foreman?
FOREMAN: No. I've got a couple of questions. Did you examine him again after that morning after that tube was inserted?
A No. I didn't. I did not examine him because, well, he was a doctor, the Chief of General Surgery was taking care of him, and too many cooks type of thing. So, it's better to have one person taking care of somebody than to have three our four people come running in and out of the room.
FOREMAN: I understand. But you just had no cause to examine him again after that morning?
A No. I did not. I went in to see him, say hello, purely personal-professional type thing.
FOREMAN: You said his, did you say 120/70? Was that the reading you got?
A Yes. 128/70.
FOREMAN: That's pretty cool, isn't it?
A Yes. But you see, Jeff was in good physical shape. Jeff was a very athletic individual and I believe was the coach for boxing -- not one of the coaches, but the doc for the boxing team. And he was in Special Forces and that's a reasonable blood pressure for his status. He's got a lot of compliance.
FOREMAN: What's the relation between a person's normal pulse rate and that figure you just quoted? 128/70.
A That's the blood pressure. That's a normal blood pressure.
FOREMAN: How about a person that is excited. Do these figures ever vary?
A They may. It would depend on your condition. Just from my own personal opinion, in Jeff's status -- I know he was in good shape. I just know he was in good shape. I don't know what his pulse ran, but I would say that Jeff's pulse was not normally 88.
FOREMAN: More like 68?
A More like 60. In good shape. I don't know that for a fact, but I would suspect that's the situation. I don't know what his blood pressure would be normally, but it may be lower than this. He may just, he may just have the compliance that when he needs that extra output that his blood pressure will come up or when he needs that extra --
FOREMAN: Would you say he was exceptionally excited or quite excited at the time you were talking to him?
A He wasn't exceptionally excited, but he was excited. Yes.
FOREMAN: Some excitement can elevate you up to about a hundred on your pulse rate.
A Yes. It would depend on your condition.
FOREMAN: But it was a traumatic experience for him.
FOREMAN: Without any question about that.
A Sure. This would be, I would say that this pulse would be real high for him. At least, it was certainly compatible with the situation.
FOREMAN: You think so?
A Yes. I would think so. Like I said, I don't know what his pulse was before, but knowing his physical condition I suspect that's so.
FOREMAN: Anybody else?
JUROR: I was wondering. You said you were there when they put the first chest tube in.
JUROR: Was that sufficient? They went back later and inserted another?
A Yes. He did not expand -- his chest did not expand and the first chest tube just wasn't sufficient. It didn't work. They blocked -- they clot with fiber or tissue and so they don't always work. And they had to put another one in. That's not real uncommon.
FOREMAN: Okay. Thank you, Doctor.
[JACOBSON IS DISMISSED]