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SANJAY GUPTA MD
Dealing with PTSD; Xtreme Dream; The Reality of "Contagion"
Aired September 17, 2011 - 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: Hello. I'm Dr. Sanjay Gupta. Welcome to the program.
You know, 10 years after 9/11, a decade now at war, we're going to take a close look this morning at PTSD -- something we talk about quite a bit here. Also, how to spot the warning signs. And most importantly, get help for yourself or someone you care about.
And more than a year in the making, Diana Nyad's extreme dream. We're going to be with this endurance swimmer as she attempts to swim all the way from Cuba to Florida. Think about that.
Plus this -- that's me in a big new movie. It's called "Contagion." We're going to have the answer to a question a lot of people have been asking: could this really happen?
But we begin, though, with ensuring your health care. There's new numbers out from the Census Bureau that show the number of people without coverage was up again in 2010 to nearly 50 million. So, you know, if this doesn't affect you directly, it probably affects someone that you know.
We want to try to give you some help today. Andrew Rubin is with NYU's Langone Medical Center and he joins me now from New York.
Welcome back to the program, Andrew. Thanks for being with us.
ANDREW RUBIN, NYU LANGONE MEDICAL CENTER: Good to be here.
GUPTA: Let me ask -- first of all, does it surprise you that the number -- the numbers went up a little bit. They say it wasn't statistically that significant. Does it surprise you that it didn't go down or it is where it's at?
RUBIN: Well, it's where it's at until 2014, assuming the health reform legislation stays intact, when most people will be able to get insurance that don't have it today. It didn't surprise me so much.
But, Sanjay, think of it this way -- while it only went up 1 million people a lot lower than people expected, think of it like 12- football stadiums filled with people that lost their health insurance last year.
So, the numbers are still pretty big. They didn't grow that much because the unemployment rate between 2009 through 2010 was already pretty bad. GUPTA: And because if you have a job, if you have COBRA, it lasts for 18 months afterwards. You find another job, you can get health insurance there. But what if you don't have COBRA or you can't afford the premium?
RUBIN: Hey, that's a big problem because, you know, most employer health insurance is subsidized by the employer and when you lose your job and go on COBRA, you lose that subsidy. And in the stimulus act a few years ago, there was money available to subsidize those premiums. That money is gone.
So, a lot of people, you know, just don't have insurance. So, what they should do -- because they can't afford it, what they should do is go into the insurance market assuming they don't have a preexisting condition and a lot of people do. But if you're one of the lucky who don't, you can find a much less expensive policy, one with the higher deductible. One with, you know, higher co-pays, whatever it is. There are less expensive policies than employer-based policy.
But the key is you want to have something if you can get it.
If you're one of those unlucky people who has a preexisting condition, the options are much, much more narrow.
GUPTA: You know, along those lines, I want you to take a quick listen, Andrew, to something that just about everyone seemed to agree on at the recent CNN Tea Party Republican debate in Tampa this past Monday.
Take a listen.
(BEGIN VIDEO CLIPS)
REP. MICHELE BACHMANN (R-MN), PRESIDENTIAL CANDIDATE: The bill to repeal Obamacare.
JON HUNTSMAN (R), PRESIDENTIAL CANDIDATE: Because we cannot go forward with Obamacare.
GOV. RICK PERRY (R-TX), PRESIDENTIAL CANDIDATE: I will use an executive order to get rid of as much of Obamacare as I can on day one.
HERMAN CAIN (R), PRESIDENTIAL CANDIDATE: First, repeal Obamacare in its entirety.
MITT ROMNEY (R), PRESIDENTIAL CANDIDATE: And a waiver for Obamacare to all 50 states.
(END VIDEO CLIPS)
GUPTA: I mean, I think you get the point that we're trying to make there, Andrew, by showing that clip. I mean, they all want to appeal what they're calling Obamacare. But what is the alternative that you know of? What happens to all of these uninsured Americans if the Republicans are successful in overturning President Obama's health care reform?
RUBIN: Hey, listen, it makes for great politics, right? But the fact of the matter is, the country without health care reform, whether you like it or not, we need it to reform the existing system. You can't allow a country of our size to have 50 million uninsured Americans. It's just dangerous for the economy, and it's dangerous for individuals who really need the health insurance in this country.
So, we actually must get some more specific and concrete answers out of these Republican candidates to actually tell us what they're going to do. Consumers need to be able to have that level of protection, Americans need that level of protection and understanding -- and we're not getting it.
As a health care executive, hospitals, doctors, we need to plan for the future. We need to know what health care in this country is going to look like. And right now, we don't have any answers.
GUPTA: Well, there are some tough questions that need to be asked and certainly I think a lot of those folks who are talking about health care are going to get those questions.
Andrew Rubin, thanks much. I hope to have you back.
Now, while health care was front and center during Monday's debate, the biggest headline perhaps came after the debate was over. Congresswoman Michele Bachmann went on NBC's "Today Show" the next morning and shared this story about the HPV vaccine.
(BEGIN VIDEO CLIP)
REP. MICHELE BACHMANN (R), PRESIDENTIAL CANDIDATE: I will tell you that I had a mother last night coming up to me here in Tampa, Florida, after the debate. She told me her little daughter took that vaccine, that injection, and she suffered from mental retardation thereafter.
(END VIDEO CLIP)
GUPTA: Now, Representative Bachmann went on to say she didn't know the woman and offered no scientific evidence connecting mental retardation to the vaccine. But we decided this is a good opportunity to give you some facts. The CDC, the American Academy of Pediatrics, the American Academy of Family Physicians, do all recommend the use of the vaccine for 11 and 12-year-old girls to protect them against forms of HPV that can develop into cervical cancer.
Now, so far, scientific studies haven't found serious side effects from the vaccine. But, obviously, a contentious issue for some time now.
Coming up on SGMD, we just marked the 10th anniversary from 9/11. But the somber truth is this -- lots of folks are still dealing with PTSD. We're going to teach you how to dial back that anxiety for yourself or for someone you love.
Stay with us.
GUPTA: Now, 10 years after 9/11 and a decade at war, I want to take a look at something that we discussed quite a bit on this show, PTSD, post-traumatic stress disorder. A lot of you have heard of this. It's an anxiety disorder that some people get after seeing or living through dangerous events.
But here's the thing: when you're in danger, of course, it's perfectly natural to feel afraid. Folks with PTSD, though, feel stressed. They feel frightened even when that danger is no longer present.
Symptoms include re-experiencing the traumatic event maybe in the form of flashbacks or bad dreams, avoidance such as feeling of strong guilt, depression, worry. You might lose interest in activities that were once enjoyable.
Also, hyper-arousal such as being easily startled, feeling tense on edge, you might have difficulty sleeping, eating, concentrating -- it is a tough, tough, existence, and it's nearly 10 percent of the U.S. population -- 10 percent will experience PTSD at some point in their lives.
So, for a lot of people, the question is how do you deal with post-traumatic stress before it turns into this disorder?
We got we're lucky to have Bob Delaney on today. He's the author of this new book, "Surviving the Shadows: A Journey of Hope into Post- Traumatic Stress."
He joins me now from Bedford, Pennsylvania. And I should point out right away that Bob is on the Ride 2 Recovery bike ride from New York to Washington by way of Shanksville, Pennsylvania. He just started riding a couple of months ago, he said.
First of all, Bob, thanks for joining us. Tell me what you're doing and what you're hoping to accomplish?
BOB DELANEY, PTSD EXPERT: Good morning, Sanjay.
On this Ride 2 Recovery, we're honoring all of the victims of the attacks of 9/11, as well as riding with the Wounded Warriors. And we know that not all wounds bleed. So, while there are Wounded Warriors that have lost limbs and are going through really tough times, there's also folks that are dealing with invisible wounds.
GUPTA: It sounds incredibly inspiring and I can see obviously some of the activity there behind you.
Now, you write about in the book you didn't develop PTSD about 9/11, but rather a few decades before in the 1970s. You're a young New Jersey state trooper at the time undercover trying to infiltrate the mafia, the mob.
I don't know how comfortable you are talking about it. I'm sure it's tough. But what was that like?
DELANEY: Yes. What I experienced and it was a long-term undercover job, I thought it would be a six-month job -- that was we were told. And it ended up close to three years.
What I experienced at the conclusion of it, I thought it was going to be the greatest day of my life when the job was over and probably was the worst. I went through post-traumatic stress. I didn't know what I was experiencing. We didn't understand it back then. It wasn't even a diagnosis until 1981.
I understand peer-to-peer therapy as a result. Louis Freeh who became director of the FBI, I was a street agent back then, and he introduced me to Joe Pistone, who's the real Donnie Brasco. And he and I, because we went through similar circumstances, similar experiences, were able to relate to each other, that was my first introduction to peer-to-peer therapy.
GUPTA: You know, really quickly, if someone who is watching who is suffering from this, are there some crucial first steps? You talked about peer-to-peer therapy, cops talking to cops, firefighters talking to firefighters, combat spouses talking to other combat spouses. Is that the crucial first step here?
DELANEY: I really believe that peer-to-peer therapy is the first line of defense and keeping post traumatic stress at post traumatic stress and not allowing it to come to disorder.
But we also believe that we need an education and awareness in our society. We did it with HIV/AIDS. We've done it with alcohol and tobacco. We need to do the same thing here. We need an education and awareness program to bring more information to people so that the stigma is not something that causes for people not to want to speak about what they're experiencing.
GUPTA: Well, hopefully, you know, interviews like this and certainly your book which, again, "Surviving the Shadows: Journey of Hope into Post Traumatic Stress" -- hopefully those will work to do some of that, Bob Delaney. But thanks so much for joining us.
DELANEY: Well, stay safe. Thank you.
GUPTA: Thank you.
And still ahead this morning, on SGMD, Diana Nyad's extreme dream. Get this some 103 miles from Cuba to Florida.
Plus, Kate Winslet will be by as well to talk about her new movie "Contagion." And answer to a question everyone's been asking me: could this really happen?
Stay with us.
(BEGIN VIDEO CLIP)
DIANA NYAD, ENDURANCE SWIMMER: I said to myself I've got it. I have it in my spirit. I have it in my body. This summer, I'm swimming from Florida to Cuba.
(END VIDEO CLIP)
GUPTA: Get ready to be inspired. You know, we set goals for ourselves every year, resolutions to lose weight, quit smoking, be nicer to our family members.
But few people set goals like Diana Nyad does. On her 60th birthday she decided she was going to start training for that swim again from Cuba to Florida.
GUPTA (voice-over): Over 100 miles of open ocean stretch between Cuba and Florida. These are waters surging with currents and teaming with shark. So far, it would take a swimmer two and a half days to cross. If you think that sounds too crazy to even consider, then you've never met Diana Nyad.
NYAD: I feel very centered about it. It's going to be difficult. It could be close to impossible. It's going to be a lot, a lot of long hours.
GUPTA: Just look at that ocean, and emergency swimming in it, for so far and so long. It would be a challenge for anyone, even a 20-year-old. Diana is three times that age. She's going to train harder. She's going to have to train better, to even have a chance.
DR. KEN KAMLER, EXTREME MEDICINE EXPERT: When Diana enters the water, she's entering a very hostile environment.
GUPTA: Dr. Ken Kamler is a surgeon who specializes in extreme medicine, and he knows exactly what Diana's body will go through.
KAMLER: She's swimming alone, but she's actually in a race. She has to swim to Florida before her body deteriorates to the point where she can no longer swim at all.
GUPTA: To prepare, she pushes herself farther and longer, and by July 2010, Diana is ready for her first true test. A 24-hour training swim, her longest swim in 30 years. If she fails, it means the end of her extreme dream.
Now, the team gathers.
NYAD: My buddy.
GUPTA: To meet and to plan, with Diana leading the charge.
NYAD: Tomorrow is a tremendous, important test of me and my confidence, I want to get out saying you know what? Yes, I'm tired and I'm a little woozy and I need some whatever, but I feel OK.
GUPTA: Next morning, she plunges into the ocean. With Diana in the water, Bonnie Stoll assumes command.
BONNIE STOLL, DIANA'S BEST FRIEND & CHIEF HANDLER: Diana, don't worry about it at all.
GUPTA: Best friend.
STOLL: One hour.
GUPTA: Drill sergeant. Bonnie will lead an army of handlers that will follow Diana's every stroke to nourish, encourage.
GUPTA: And protect her.
One of their biggest concerns -- sharks.
LUKE TIPPLE, MARINE BIOLOGIST: These are great waters for sharks.
GUPTA: Luke Tipple is the team's lead shark diver. He knows just how dangerous these waters can be.
TIPPLE: For these particular waters we'd be looking for oceanic white tips, hammerheads, tiger sharks, Caribbean reef sharks. This animal has evolved to dominate the ocean.
They have a sixth sense. They can feel the electricity in the water. They know that we're there.
GUPTA: And that's why in 1978, Diana swam in a shark cage. Today, she just uses this.
NYAD: Sharks are tremendously sensitive to this. This is actually in the kayak.
GUPTA: It's called a "shark shield." And off the coast of the Bahamas, Tipple shows us how it works.
It's a shark feeding frenzy at this block of chum, until Tipple approaches and turns on the shark shield that hangs above it. Now, the device emits a strong but harmless signal that overwhelms the shark's senses and forces them to the ocean floor.
We're now thousands of strokes into her 24-hour swim. Diana looked strong, but there's a problem. She's swimming in circles.
STOLL: You veer off a little and then you veer off a little more and you veer off a little more, and you end up in Jamaica.
NYAD: So after a while I count every stroke look at that it boat for hours and say, stay closer, stay here, stay here, so I drift. Every time I swim 30, 40, 50 yards that way, you know, we're adding, we're adding miles and miles.
GUPTA: And that could mean the difference between successes and failure.
GUPTA: This woman literally just exudes inspiration. We spent the past year and a half following Diana as she prepared to do something no human has ever done before. You can see how it all went down. It's our special CNN presents, "Diana Nyad: Xtreme Dream."
And last but not least for us this morning here on SGMD, a real thrill for me. I got to try my hand at acting in the new movie "Contagion." I was myself, of course. And right after the break, a candid conversation with my co-star Kate Winslet. Did I say co-star? Yes, I can.
Also, a virus expert Laurie Garrett who consulted on the film -- she'll join us as well. The question is this: could an outbreak like the one depicted in this movie actually happen?
(BEGIN VIDEO CLIP)
GUPTA: The drug Ribavirin has been shown to be effective against this virus. Yet Homeland Security is telling the CDC not to make any announcements until stockpiles of the drug can be secured.
LAURENCE FISBURNE, ACTOR: Dr. Gupta, there continued to be evaluations of several drugs. Ribavirin is among them.
(END VIDEO CLIP)
GUPTA: That's a new movie out. It's called "Contagion." It's about a virus that practically wipes out the globe.
Now, I'm lucky because I get to play myself and get to be on the screen as Kate Winslet, one of my favorite actors. She plays this flaky detective who tries to corral this virus down. And I spoke with her earlier from London.
GUPTA: I wonder, when you spent time at the CDC and spent time with these scientists and these epidemiologists, what did you take away from who they are, what their lives are like, everything -- from the clothes that they wear, to the jobs that they do?
KATE WINSLET, ACTRESS: They are extraordinarily brave people, and highly skilled, highly intelligent, and somewhat intimidating, I found them to be -- just simply because they have so much knowledge and they care so much about the job that they do. They operate in kind of isolated little bubbles really. It's just them, their backpack and their Dell computer. And they just have to get on with it and work tirelessly all hours round-the-clock to do whatever they need to do in order to find that index patient. And I just really admire them. You know, no (INAUDIBLE), no hair, no makeup, brush teeth, wash face, back up go.
GUPTA: I'm wondering, when you look at the world, everything from washing your own hands to worrying about, you know, your own safety, your own health -- do you look at things differently as a result of your work on this film?
WINSLET: Yes, I definitely do look at things differently because of having been involved in "Contagion." I mean, I certainly wash my hands probably more than I need to these days and I've become a little bit obsessive about taking shoes on and off before going into other people's houses and having people come into our home.
It does make you much more germ conscious for sure.
GUPTA: You know, you have children. You're doing a movie about a pandemic where people will die including children. Was it something you were immediately, you know, sort of drawn to? How do you go through that process for yourself?
WINSLET: I just did find the story incredibly compelling. And also, I think very timely as well. You know, we do exist in a world where we are seeing a lot of these superbugs. And -- I mean, in "Contagion" obviously, it goes one, two, maybe even 10 steps further than just your common superbug.
But it's something that is in people's minds. We are growing more accustomed to sudden panic. So, I'm just like anybody else, you know? I responded to the material that came in, in the same way that any human being would, just, like, God, that could happen. My gosh!
GUPTA: Real pleasure. Kate Winslet, thanks so much. Watch the movie. Thank you.
WINSLET: Thank you. You're welcome. Thank you.
GUPTA: So, question I think a lot of people are asking themselves is: could this actually happen?
Laurie Garrett is the author of the new book "I Heard the Sirens Scream."
I got a chance to sit down with her earlier it from New York.
GUPTA: So, Laurie, you were a scientific consultant on the movie "Contagion." You spent a lot of time with the writers and the researchers. I guess the question a lot of people are asking, me, I'm sure, asking you is -- did they get it right? Is this a realistic scenario? LAURIE GARRETT, SENIOR FELLOW FOR GLOBAL HEALTH, COUNCIL ON FOREIGN RELATIONS: I think it's as realistic as we can be about something that hasn't actually happened. So, we're trying to come up with a whole set of facts, statistics, character portrayals, what happens to society, how the virus behaves -- all based on a hypothetical, but well grounded in experiences that I had with SARS, with the early days of HIV, with plague in India, with, oh, at least 25, 30 epidemics I've been in.
GUPTA: You communicate these types of issues to the public a lot. This is your area of expertise.
Do you think a movie like this is helpful in terms of your mission? I know that's not what they specifically set out to do. But does it help you or hurt you?
GARRETT: I think it helps a great deal. I think people will watch it and realize, you know, there's a lot more at stake here than a virus, than whether or not you get sick, which is bad enough. But you'll see societies fall apart. You'll see the deterioration of the entire infrastructure.
And at a time when the budget acts as you're falling squarely on public health all over America, on hospitals all over America, I hope this is a wake-up call. Preparedness means keeping that infrastructure sound and functional.
GUPTA: Final question -- is there a message for the layperson out there? Aside from hospitals, aside from doctors who work in this area or scientists, just for the average person, what should they learn from this?
GARRETT: I think the most important thing I come away with, after eight years of scrutinizing every single detail of 9/11, of anthrax and then reflecting on other epidemics I've been in, on the impact of Katrina and so on, is that we have to get much better at understanding what "community" means and how individuals know their neighbors, care for their neighbors, and recognize the importance of government in their lives.
There's a tendency in America today to be very antigovernment, whether it's anti-city council, anti-governor, anti-Congress, anti- president -- but in a crisis, it's government that must correctly lead the response.
GUPTA: Thanks so much for joining us. I feel like I always learn something from you and I always consider it a real privilege to spend time with you.
Laurie Garrett, thanks so much.
GARRETT: My honor back at you.
GUPTA: That's going to do it for SGMD this morning. Thanks so much for being with us.
Time now to get a check of your top stories with a guy who's the best in the business, T.J. Holmes, in the "CNN NEWSROOM."