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SANJAY GUPTA MD
Interview with HHS Secretary Kathleen Sebelius; Face Your Fear; Neurologist Oliver Sacks Discusses Latest Book 'The Mind's Eye'
Aired December 11, 2010 - 07:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DR. SANJAY GUPTA, HOST: Good morning. Dr. Sanjay Gupta. Welcome to the program.
First up, no one likes shots. Not even me. But we have to talk about the flu shot, what can you really expect from one. I'm going to take some of our questions straight to the highest official in the land.
And phobias, do you have one? Most people do. But what if you were a fighter pilot and you were scared on being in small places? What would you do? His lessons for all of us.
Plus, 'tis the season for holiday parties. You might be drinking. But those calories, those liquid calories can really add up. I got tips to help keep you slim and fit through the holidays. Let's get started.
GUPTA: First up, though, the flu. It still leads to tens of thousands of death every year. And yet, there is something we can do about this.
It is National Influenza Vaccination Week this week and the president issued a proclamation urging all Americans to get a flu shot -- something we all know. It's important to note, though, under the new health reform law, if you're enrolled in a new group or individual private health plan, there's not going to be no co-payment or deductible for these vaccinations.
Now, flu season hits its peak typically in January and goes all the way through March. So far, as things stand now, it's predicted that only about a third of Americans have had their shots.
The good news is this, the question I get all the time -- it's not too late to get your flu shot. Keep in mind that people are going to likely be traveling for the holidays. And it takes about two weeks for your immunity to build up. So, you may want to bring gifts, but you don't want to give people the flu.
In fact, even Health and Human Service Secretary Kathleen Sebelius, she's got in on the action.
(BEGIN VIDEO CLIP)
ELMO: I and Secretary Sebelius are here to tell you how to stay happy this flu season.
KATHLEEN SEBELIUS, HEALTH AND HUMAN SERVICE SECRETARY: First, you learn to sneeze into the bend of your arm, like this.
ELMO: Very good. Always wash your hands really well.
SEBELIUS: And remember to have a plan in case your child is too sick for school.
(END VIDEO CLIP)
GUPTA: So, Elmo didn't give you the flu, did he?
SEBELIUS: He did not. And -- no, he's been a great partner throughout last year's H1N1 flu season and again into this year. He's a good promoter of healthy activities.
GUPTA: Well, it is important to get these messages out and about because I think it's one of these things that people know intuitively that they should, but people don't always get the flu shot. You did get your flu shot, right?
SEBELIUS: I did. I got my flu shot at the end of October.
One of the things that's good about this year is we've got plenty of vaccine. It's available throughout the country. We are seeing the beginning of some flu activity, particularly in the Southeast, where numbers are really kicking up before it gets more serious in January.
It's very important that, again, people understand that, you know, the vaccine is safe. It's available and for lots of people, it's totally free without co-pays.
GUPTA: The flu shot itself is made with an inactive virus. And people always ask, they say, oh, I got sick from the flu shot. But you know this, Madam Secretary, that, in fact, it's your body's immune system sort of revving up in response to that flu shot that may make people feel like they have the flu for a day or two, but it's not the flu, it's just their body's immune system sort of --
SEBELIUS: That's right.
GUPTA: -- ramping (ph) up.
SEBELIUS: I think anybody who gets the flu knows the difference.
SEBELIUS: I mean, flu is a nasty disease. And, unfortunately, for some, as you've already said, it's a killer disease.
GUPTA: I have to ask about with the change in leadership, there's been some talk of people wanting to repeal the Affordable Care Act. This is something, obviously, you have worked on for a long time. What are your thoughts on this? I mean, do you think, first of all, that's likely to happen? What is the mood in your department over these latest, sort of, conversations regarding this?
SEBELIUS: Well, the Affordable Care Act is the law until if and when Congress, both houses of Congress, would have to pass a bill and the president would have to sign a bill that would repeal the act. I don't think that's likely to happen.
I think there will be a lot of debates and discussions with a new Congress coming in. And, frankly, we welcome that. It's one thing to say get rid of it, but get rid of it and replace it with what, and take those benefits away from constituents throughout the country who really now are looking forward to them.
GUPTA: Finally, just this week, also, there was the talk about what is known in vernacular as the Dr. Fix, the payment fix with regard to Medicare payments to doctors. There have been talks about cutting those payments to doctors. That's not going to happen at this time.
SEBELIUS: We need to ensure Medicare beneficiaries, the 45 million adults who count on Medicare year in and year out, that their doctors will be paid for the services they render. And that's really a commitment and a promise that the president takes very seriously, that we take very seriously. But the good news is, Congress has resolved this debate until the end of 2011, and given us a little time to actually work on a permanent fix.
GUPTA: And will there be more discussions with Congress in upcoming months then about what happens in 2012 and forward then?
SEBELIUS: You bet. This is a strategy that was put into place with a formula based on medical inflation and it worked well for a couple of years. Into the late '90s, it was -- it was just fine. From the late '90s now until 2010, it has not worked so well because medical inflation has been way ahead of consumer inflation.
So, there's been a bigger and bigger gap. And what we have to do is go back and correct the underlying problem and make sure, you know, it's one thing to have Medicare benefits. That's great. It doesn't really matter if you have the benefits and can't have access to a doctor.
GUPTA: All right. We're going to have a lot more discussions on this. I hope you will join us again, because people are so interested in this.
GUPTA: And it's sometimes, it's wonkish but it's important as well. I'm also glad you got your flu shot. I hope you have happy and healthy holidays, Madam Secretary. Thanks so much.
And if you want some more information about the flu shot, you can go to flu.gov, you can put in your zip code, you can find out where to get flu shots, for example, in your area. Also, how much they might cost. And if you are wondering if you have the flu or a cold, another question we get all the time, some of the symptoms that are going to be common to both -- fever, fatigue, muscle aches, headaches. If it's a cold, you're more likely to have a runny nose with green or yellow discharge for example, sore throat or sneezing. If it's the flu, it's going to be lasting longer. You may have nausea associated, chills, sweats, also a loss of appetite.
So, stay healthy this season, really.
Now, if you ever wondered what's the best way to face your fears, your phobias? We all have them, tackle them head-on, right? Well, perhaps.
Coming up: we're going to a fighter pilot who flies at top speeds over 1,500 miles an hour wild he battles claustrophobia. That's next.
GUPTA: Welcome back to the program.
If you were severely claustrophobic, afraid of small and tight spaces, maybe the last place you'd want to be is in the cockpit of a fighter plane. But that's just where Lieutenant Colonel Rob "Waldo" Waldman found himself, having no choice in the situation but to face his fears.
GUPTA (voice-over): Screaming engines, mind-numbing speeds of over 1,500 miles an hour. This was Lieutenant Colonel Rob "Waldo" Waldman daily ride. He had what one would consider one of the coolest jobs in the world.
LT. COL. ROB "WALDO" WALDMAN, CLAUSTROPHOBIC FIGHTER PILOT: It's an amazing jet, F-16.
GUPTA: But an innocent diving trip would change everything.
WALDMAN: Three years into my 11-year flying career, I almost died in a scuba diving accident in the Caribbean.
GUPTA: Thirty feet under water, Rob's scuba mask broke. Physically, he was fine. But mentally, he was shaken to the core. He developed severe claustrophobia.
WALDMAN: So, if you can imagine barely being able to move with this helmet and mask on, gloves, your head two inches from the top of the canopy, you're like in a little coffin, enough for a guy with claustrophobia to really feel panicky. For every single mission I flew, I had to deal with this fear of having a panic attack.
GUPTA: But panic attack while going mach two could be devastating.
WALDMAN: When you are strapped into a jet, you just can't say, pause -- I mean, just get out and deal with it. On combat missions where there was a job to do and my wing that needed me, there was "no abort" option for me.
GUPTA: Ultimately, Rob says it was planning, family and faith that helped him overcome his fears.
WALDMAN: I would simulate the environment that I would be on the ground before the flight. I'd say, OK, I may have a panic attack here. How am I going to deal with it? I would look down on my checklist and see a picture of my niece and nephew, and it reminded me of what I love. Then I said I've got to get home for them.
GUPTA: Now, after 56 combat missions over Iraq and Serbia, Waldo says he's kicked claustrophobia for good.
WALDMAN: I think about all the challenge and the personal growth that I had because I took a risk to fly that plane. I didn't want to look back and say if I only had the courage to take action, I could have flown the coolest jet in the world, which in my opinion is the Lockheed Martin F-16.
GUPTA: You know, it is important to point out there are different types of help for phobias. Psychologists, psychiatrists, they're going to say often if you visualize your fear ahead of time, you may overcome it. That's one strategy.
Sometimes, recommendation may be medications, for example, beta- blockers. Now, the theory is that if you have something that frightens you, one of the body's responses is sweating, your heart rate goes up, your blood pressure can go up. With the beta-blocker, you may be able to reduce those feelings. Some of those things can help.
Next up: a famed doctor and an author loses sight, suddenly, in his right eye and awaits his diagnosis. Would his worse fears come true?
(BEGIN VIDEO CLIP)
DR. OLIVER SACKS, AUTHOR, "THE MIND'S EYE": I sort of couldn't hear what he said after that, but a voice inside started shouting cancer, cancer.
(END VIDEO CLIP)
GUPTA: We are back with SGMD.
You know, every now and then in medicine, there's a discovery that does seem like a true miracle. That's how it was in the 1960s, when they're all just all over sex, tried the Parkinson's drug L-dopa on a group of patients with this rare disease, a sort of sleeping sickness, patients who were virtually frozen in a complete stupor for decades.
The amazing affects of the treatment were depicted in the movie "Awakenings," starring Robert DeNiro and Robin Williams, based on Dr. Sacks' groundbreaking memoir. Since then, Sacks has written several bestsellers all about the sort of strange, terrifying and amazing things the mind can do.
His new book, it's called "The Mind's Eye." It's about vision and the patient at its heart is Dr. Sacks himself. We met at his home and he told his incredible story.
GUPTA: Five years ago now, almost exactly, you were in a movie theater, watching a movie. And what happened then?
SACKS: Well, I became conscious of a sort of fluttering and light far over to the left. My first thought was that it was sort of a migraine. But then it became very clear that it was occurring in one eye and one eye was involved, not the brain. It's not a migraine.
GUPTA: Looking across your nose?
SACKS: And then I realized that a line of lights going to the exit door was missing. And I became suddenly alarmed. I was never alarmed by a visual migraine. I have had them all my life.
But this was something new. I wondered if I was bleeding of the eye, detached from the retina, if I were to go blind. And I was hoping it would go away and foolishly spent another 20 minutes in fact testing my visual fields all the while.
GUPTA: In the movie theater going like this.
SACKS: That sort of thing. I was in the back row. And then I burst out of the theater. It was obvious, a pie-shaped wedge of my visual field was missing and it was sort of boiling and incandescent in one corner.
GUPTA: But what happened next? You go to see your doctor --
SACKS: I tell him my story. He listens. He nods. He takes his ophthalmoscope. He looks into my eye and then he sits back. His head slightly tilted.
I feel he's looking at me in a different way. I'm no longer just his colleague or his usual patient. Something -- he has something to tell me.
And he says that I have a swelling behind the retina. He's not sure what it is. It could be a blood clot, it could be a tumor. If a tumor, it could be benign or malignant. And he said, let's look at the worst case scenario. And I sort of couldn't hear what he said after that, but a voice inside started shouting cancer, cancer.
GUPTA: Obviously, you have your eye. But you ended up getting radiation treatment to the melanoma?
SACKS: Yes, I had radiation treatment, and then lasering to kill any surviving cells. Although the lasering was only to part of the tumor. The Dr. Abramson wanted to spare part next to the fovea. But finally, that part grew and persisted and he had to laser it.
And with that, I lost central vision in the eye. But, by that time, vision had become so, with that eye, had become so distorted and sometimes so surreal that I, towards the end, for example, people looked attenuated and elongated and tilted to one side like --
GUPTA: The house of mirrors.
SACKS: I still had a crescent of peripheral vision, which was -- I don't know that I appreciated that fully until about a year ago. I had a hemorrhage in the eye and lost the peripheral vision.
Since losing the right eye completely, I can't see my hand. I can't see anything to the right of my nose. So, I'm continually startled when people pass me on the right.
And at first, I would have Kate (ph), my assistant walk with me on the right to prevent collisions. Although, in a way which amazed me on the first day I went for a walk with Kate, we came back, I got into the elevator and she didn't. And I thought she might be talking to the doorman. And I waited.
And then a voice, her voice said, what are we waiting for? Now, it wasn't just that I hadn't seen her come in, but it had occurred to me that she could come in. It doesn't entirely occur to me that anything can happen over here. Now, I've learned to be hyperconscious and to look to the right.
GUPTA: And coming up, what Dr. Sacks learned from being a patient.
GUPTA: Welcome back to SGMD.
I've been talking with a neurologist Dr. Oliver Sacks. He's got this new book. It's called "The Mind's Eye."
Among the case studies is Dr. Sacks himself, diagnosed with a life-threatening tumor that cost him the sight in his right eye.
GUPTA: So, you kept very detailed journals throughout your illness?
SACKS: Yes, I -- well, I've been keeping journals on one thing or another all my life, on things that are happening. But here, well, these are just a few of them.
GUPTA: There you have a -- I mean, this is your tumor.
SACKS: That's my tumor.
GUPTA: So, this is a picture just of the back of your eye?
GUPTA: How does it feel to look at that?
SACKS: It's my enemy at close quarters.
GUPTA: I saw this page over here and I think you wrote at the top "cancer," and exclamation mark and large print. And here you wrote metastasis: horrible death.
SACKS: OK. Well, but I was so worried about flatness (ph). So, some is -- some is to do with phenomena, and some is to do with feelings, which were very, very strong at the time. I think that feeling of -- even of death mercifully has -- well, I -- but this feeling of death has gone away, for the moment.
GUPTA: It seems that most -- a lot of what you've written about has to do with things that are not curable. They may be treatable, but not curable. And as a result, the whole process by which someone compensates, lives with this particular -- not disease but disorder -- or, you know, unusual thing, it seems that's been a theme, as well. Is that fair?
SACKS: Yes, I think so. Still, often the person will have to live with something and adjust to it. And, they may be able to adjust. Their brain may be able to adjust in very unexpected and creative and delightful ways.
GUPTA: But what is "The Mind's Eye"? How did you -- why did you decide on this title?
SACKS: I liked the phrase. Of course, it's used from Hamlet. Hamlet sees a ghost or sees something and Horatio asks about it, was he really there? He says, "In the mind's eye, Horatio." So, the mind's eye is visual imagination or visual imagery.
GUPTA: So, with regard to the ocular melanoma, are you cured? Are you -- are you -- do you have a clean bill now?
SACKS: No, one never knows if one has a clean bill. The melanoma itself seems to be flat and destroyed. But probably I have a few melanoma cells in my blood, which escaped into the bloodstream before the diagnosis. That's OK if they don't settle anywhere. And the chances are that they won't settle anywhere. So, one (INAUDIBLE) or whatever, hopes one will be among the 99 percent of people with ocular melanoma who have no metastasis.
GUPTA: That's great news. And you're a master diagnostician and clinician, but has this experience changed the way you practice medicine at all?
SACKS: I hope I try to understand how it was for people before. But, no, I think this experience of being a patient and being uncertain and hope and anxiety have all become more strongly defined for me. So, I think I can get into other people's skin maybe more easily.
GUPTA: Just an amazing doctor, terrific writer. And I got a chance to tell him that he's one of the reasons I chose neuroscience as a career. Thanks, Dr. Sacks.
Here's a question, beer, wine, a shot of liquor, or eggnog with rum? Holiday season is here. Which of those tops the calories chart? We'll ask the doctor. That's next.
GUPTA: And we are back with SGMD.
The holidays are here. And it's a season for some to overindulge.
One quick tip: it's important to keep track of those liquid calories. When it comes to counting calories overall, a lot of nutrition experts will say beverages are often ignored when you tally everything up.
So question is: which drinks offer the least amount of calories per serving? So we wanted an answer today. Let me quiz you: bottle of beer, glass of wine, a shot of liquor, or perhaps some eggnog?
Well, let me tell you a few things you should know. First of all, if you want your best bet overall, a light beer is probably going to be your best alternative. Twelve ounces of a light beer, about 100 calories. If you get a regular beer, 12 ounces, about 150 calories.
If you want to drink wine, for example, a glass of red wine is about 100 calories. But keep in mind that's 4 ounces. So, a much smaller serving there.
Experts will also talk about mixed drinks as being the biggest diet busters of all. For example, mixed drink like a daiquiri, eight ounce glass here, 400 calories. Margaritas are probably going to be the biggest diet buster altogether, 800 calories for an 8-ounce glass there.
What is it about alcohol? The thing that people sort of forget sometimes is that you gain weight because of those extra calories, but also, they're loaded with a lot of carbohydrates and sugar, as well. So, it's not just the calories, it's what those calories are. You can't not talk about eggnog, as well -- a lot of people drinking this. One cup, for example, is about 340 calories, if you add a shot of rum, 440 calories for just one cup. Again, a lot of sugar in that; a lot of fat, as well. Little tasty. So, again, just a little bit, perhaps.
If you missed any part of today's show, be sure to check out my podcast, CNN.com/podcasting. Thanks for watching.
I'm Dr. Sanjay Gupta. More news on CNN starts right now.