‘I. Can’t. Breathe:’ Georgia physician shares an untold perspective on the Reagan assassination attempt

President Ronald Reagan moments before he was shot in an assassination attempt, March 30, 1981. (Michael Evans/White House Photographic Collection)

If you’re about 50 or older, you probably remember where you were when you learned President Ronald Reagan was shot in an assassination attempt 40 years ago on March 30, 1981.

Savannah cardiologist Dr. Randy Bottner definitely does.

Bottner was a 27-year-old fourth year medical student at George Washington University when he started his Emergency Room rotation that Monday. In the morning, a woman who came in with a broken wrist turned out to be one of the people who had been taken hostage from the American embassy in Iran and freed just two months earlier. It was the buzz of the ER and Bottner thought he’d have a good story to tell his fiancée, Sheree, who worked upstairs as a medical technician.

Then at 2:29 p.m., the phone rang. The charge nurse reached for it, recalled Bottner, who is now chief of cardiology at Memorial University Medical Center.

“She picks it up, and it keeps ringing,” he said on Monday, nearly 40 years after the historic day. “And she puts it down, and she pulls out a princess phone from behind some books on the counter. And she goes, ‘Oh, my God, it’s the White House.’

“So we all stopped to look at her. And she picks up the phone. She turns bright red, she doesn’t say anything. She puts the phone back down. And she says ‘The President’s motorcade is coming. We’ve got three gunshot wounds.'”

The president was Ronald Reagan.

Moments before Reagan had been exiting the Washington Hilton when would-be assassin John Hinckley pulled out a recently purchased Raum .22 long rifle and fired in rapid succession six “Devastator” bullets designed to explode on impact.

The first shot hit Press Secretary James Brady right above the temple.

“It exploded and took the fragments and part of his skull into his brain,” Bottner said.

“The second shot hit (D.C. police officer) Thomas Delahanty in the back of the head and lodge next to his spine. It did not explode, but it was lodged next to the spine. The third shot missed completely. The fourth shot hit (Secret Service) Agent (Timothy) McCarthy in the upper abdomen on the right side as he spread himself out to protect the president. The fifth shot hit the side of the limousine and didn’t do any damage.”

The sixth shot ricocheted off the limousine and hit Reagan, fracturing a rib and lodging in the left side of his chest. But the fact that the 70-year-old Reagan was shot wasn’t immediately apparent. The president thought at first he had cracked a rib as he was rushed into the limo.

In the vehicle, the chief of the Secret Service detail checked Reagan for injuries and finding none headed toward the White House. Then Reagan coughed up blood. They diverted to the George Washington University Hospital just a few blocks away.

There, the charge nurse told Bottner and another medical student, each dressed in a shirt and tie covered by a short white lab coat, to clear the ER waiting room.

“As he and I walked to the door on the ambulance side of the emergency room where the waiting room was, we stepped on the magnetic mat that opened the doors,” Bottner recalled. “And there, standing three feet in front of us, was President Reagan.”

A Secret Service agent held him on either side. Bottner, standing on the president’s left, could see a spot of blood under Reagan’s left armpit.

“He was ashen. He was as white as a sheet,” Bottner recalled. “And he was bent forward just a little bit. And this is the part where my wife says I overdramatize it, but I was there and this is how it happened. He looked up at us and he said: ‘I. Can’t. Breathe.’ And he started to collapse. His right leg started to go down and he pitched to his right.”

The other med student caught him and along with Bottner, the Secret Service agents and a nurse, carried him to the trauma bay and laid the president down on a gurney.

Bottner got out of the way but stayed nearby as Dr. Joseph Giordano started to work on the president, inserting a chest tube that drained blood from his chest cavity.

“I didn’t see him actually insert the chest tube. The bottle that the chest tube was attached to was beneath the gurney and I could see that very clearly when people’s feet weren’t in the way,” Bottner said. “And within a couple of minutes that two-liter bottle had filled nearly to the top with blood, which meant that he probably had lost at that point about 40% of his blood volume, which is why he basically collapsed coming into the emergency room.”

The bullet had struck a pulmonary artery and the president’s heart was pumping blood into his chest under pressure, causing the left lung to collapse and collapsing veins, preventing blood from returning to the heart.

“At one time, three bags of blood were being squeezed into President Reagan all simultaneously just trying to get more blood into him to compensate for what he had already lost,” Bottner said.

Hospital staffers started to crowd the area.

“This was now a very dangerous situation from a Secret Service perspective and they had to get control of it, so Agent (Roger) Wanko climbed up on the desk in the center of the island and he was holding that Uzi machine gun and he said ‘If you don’t belong here and you don’t get the — out of here there’s going to be hell to pay.’ And I’m standing there looking up at that machine gun listen looking at him saying that, wondering if I belong there as a fourth year medical student. Fortunately, I decided to stay.”

Shortly thereafter Bottner saw First Lady Nancy Reagan arrive.

“I just happened to be on the right side of the work area when they brought her in, and I just happened to look up, and it was direct eye contact from me to her, but I’m sure she didn’t see me,” he said. “The look was, as you might expect, just sheer terror and disbelief on her face. She was brought around to where President Reagan was, I didn’t see their interaction at all.”

Because he stayed, Bottner was put to work. X-rays weren’t digitized in 1981, so he fetched the film from the radiology department of Reagan’s chest and of Press Secretary James Brady’s critically injured head, catching a glimpse of the internal damage in each man before handing the X-rays over to the attending physician.

On Reagan’s X-ray it was unclear if the bullet had entered the heart.

“I saw his x ray and that was a big point of concern because the bullet had entered in and fractured the left seventh rib, he said. “It didn’t tumble, it just went straight in. …The tip of the bullet was overlapping the heart border so they couldn’t tell for sure if it had actually hit the heart.”

Reagan underwent surgery. The surgical staff wore bulletproof vests because the bullet that was inside of Reagan was explosive.

Two other shooting victims, Agent McCarthy and Press Secretary Brady, were also treated at GW that day. Both survived. Brady’s injuries left him paralyzed.

“And how (Brady) survived was a miracle because I saw his chest and his skull X ray,” Bottner said. “And there were dozens of bullet fragments and bone fragments scattered throughout his brain. So how he managed to ever recover in any meaningful way is amazing.”

After 13 days, Reagan returned to the White House.

Bottner finished his ER rotation and graduated from medical school that spring. He completed a cardiology fellowship at Georgetown University Medical Center several years later and began practicing at Memorial in 1992.

He’s told his story to friends, family and colleagues over the years, but never as completely as Monday when he sat down with reporters and spoke uninterrupted as a Memorial staffer videotaped him. Typically the published accounts of the assassination attempt stop at the Emergency Room door, he said. He wanted to offer his perspective from inside the ER.

“There were 20 or 30 minutes or so of one of the most tense periods of my life,” he said. “And I think everybody else’s as well.”


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