In the absence of any neurological, muscular, or heart response, the doctors concluded that efforts to revive the President were hopeless.[C2-215] This was verified by Admiral Burkley, the President’s physician, who arrived at the hospital after emergency treatment was underway and concluded that “my direct services to him at that moment would have interfered with the action of the team which was in progress.”[C2-216] At approximately 1 p.m., after last rites were administered to the President by Father Oscar L. Huber, Dr. Clark pronounced the President dead. He made the official determination because the ultimate cause of death, the severe head injury, was within his sphere of specialization.[C2-217] The time was fixed at 1 p.m., as an approximation, since it was impossible to determine the precise moment when life left the President.[C2-218] President Kennedy could have survived the neck injury, but the head wound was fatal.[C2-219] From a medical viewpoint, President Kennedy was alive when he arrived at Parkland Hospital; the doctors observed that he had a heart beat and was making some respiratory efforts.[C2-220] But his condition was hopeless, and the extraordinary efforts of the doctors to save him could not help but to have been unavailing. Since the Dallas doctors directed all their efforts to controlling the massive bleeding caused by the head wound, and to reconstructing an airway to his lungs, the President remained on his back throughout his medical treatment at Parkland.[C2-221] When asked why he did not turn the President over, Dr. Carrico testified as follows: A. This man was in obvious extreme distress and any more thorough inspection would have involved several minutes--well, several--considerable time which at this juncture was not available. A thorough inspection would have involved washing and cleansing the back, and this is not practical in treating an acutely injured patient. You have to determine which things, which are immediately life threatening and cope with them, before attempting to evaluate the full extent of the injuries. Q. Did you ever have occasion to look at the President’s back? A. No, sir. Before--well, in trying to treat an acutely injured patient, you have to establish an airway, adequate ventilation and you have to establish adequate circulation. Before this was accomplished the President’s cardiac activity had ceased and closed cardiac massage was instituted, which made it impossible to inspect his back. Q. Was any effort made to inspect the President’s back after he had expired? A. No, sir. Q. And why was no effort made at that time to inspect his back? A. I suppose nobody really had the heart to do it.[C2-222] Moreover, the Parkland doctors took no further action after the President had expired because they concluded that it was beyond the scope of their permissible duties.[C2-223]