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SANJAY GUPTA MD
Fighting Cancer like a Common Cold; Prominent Pain Physician Investigated for Deaths; Healthy on a Budget
Aired December 8, 2013 - 07:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DR. SANJAY GUPTA, CNN HOST: Welcome to SGMD.
Ahead this half hour:
This unbelievable story that I'm still having a hard time wrapping my mind around -- it's about Carol Ann Bosley and all of her twists and turns and her descent into the depths of addiction. I'm going to show you what happened to her and just how many pills at one point were part of her deadly dose.
Also, I can't tell you how often I hear this -- it's too expensive to eat healthy. Do you know what? We decided to put a dollar amount on this. And I promise you, the numbers are going to surprise you.
But, first we've got news this weekend about a strategy to help cancer patients when nothing else has worked.
Here's senior medical correspondent, Elizabeth Cohen.
JOHN WILKINS, NICK'S FATHER: So, what is left for us to do as far as your learner's permit?
ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT (voice-over): A year ago, John Wilkins wasn't sure if he would ever get to teach his son to drive a real car.
NICK WILKINS, 15-YEAR-OLD: I really wanted to learn.
COHEN: Nick, who's 15, has had leukemia since he was 4 years old. He tried chemotherapy and a bone marrow transplant from his sister, both failed.
J. WILKINS: It was a moment there where I -- I thought that was it. He probably wouldn't live much longer.
COHEN: Nick's last hope was an experimental treatment, a clinical trial at the University of Pennsylvania.
J. WILKINS: When they start talking about doing clinical trials as the alternative, that's when you're really throwing Hail Marys.
COHEN (on camera): How did it feel as a mom to know this is -- this is it?
LISA WILKINS, NICK'S MOTHER: Uncertainty. A lot of uncertainty. Just not knowing what was going to happen. It's hard.
J. WILKINS: One day we're in his room, and I just wanted him to understand where we were at, that, you know, this was probably the last treatment.
COHEN: Were you in effect telling him that if this treatment didn't work --
J. WILKINS: He could -- he could die.
COHEN (voice-over): In the treatment, Nick's doctors tweaked his immune system to make his own body rid itself of cancer. It's a groundbreaking approach that's captured the attention of cancer doctors, but there were no promises. Nick received the personalized cell therapy in May. For a month, John and Lisa watched over their son.
(on camera): Do you remember that moment where they said, hey, this appears to be working?
L. WILKINS: They came back and said, "We don't see any leukemia cells." So, that was the point of, you know, I think this is working. I think we're definitely headed down the right path.
COHEN (voice-over): Exactly, how the treatment works is complicated. But Nick's pretty good at explaining it, actually.
N. WILKINS: They took out T-cells out of my body and then they engineered them to kind track down the cancer cells and kill them off.
COHEN (on camera): Did they get them?
N. WILKINS: I hope so. I'm feeling good now, so I think they did pretty well.
COHEN (voice-over): Watch as this gray cancer-killing cell on the left attacks the green cancer cell which gets smaller and eventually dies. Doctors tried this in 59 patients, 25 are now cancer free.
L. WILKINS: Our hopes are that, you know, eventually, you know, he will be cured that, you know, he can kind of put aside this and just kind of start moving forward.
J. WILKINS: I just want him to be able to enjoy a normal kid's life.
L. WILKINS: His biggest thing right now is he is looking forward to getting his learner's permit.
COHEN: And soon, instead of playing with toy cars, John will get the chance to teach his son how to drive a real one.
(on camera): You went from having cancer to now they can't even find it. How does that feel? N. WILKINS: Really great.
GUPTA: And here with me now is my good friend, senior medical correspondent Elizabeth Cohen. These are patients for whom nothing else worked.
Is there some way to characterize what this offers them?
COHEN: Right. You know, these patients had relapsed before, Nicholas had relapsed twice. So, I asked the doctors, is this relapse any different? He's in remission now for the third time. Will this one be different?
He said, Elizabeth, we can't promise it. We don't know. We can hope.
But there's some reason to be really quite hopeful, because when they look at Nicholas' bone marrow, they actually concede that the T-cells are there and active and robust and so they're really hoping that gives him --
GUPTA: Given that they're there, that's a more permanent or at least of a feeling of a more durable treatment.
COHEN: Exactly. Exactly.
GUPTA: You talked about in the piece a bit, but are essentially re- engineering your body's immune system, T-cells are, you know, the fighter cells, if will, of the body. What do they -- how do they do that at Penn?
COHEN: So, they take your T-cells out of your body and then they engineer them. So, what they do is take an HIV virus of all things and they disable it and they use that disabled virus to bring in almost a Trojan horse to bring new DNA into your T-cells. And that DNA makes the T-cells smarter, so the T-cell can now see cancer and once it can see cancer, it can attack cancer.
GUPTA: So it's so important because if you just make the T-cells more robust, it attacks lots of different things but here, it's designed to attack the cancer.
COHEN: That's exactly right. So, chemotherapy attacks everything, which is why people's hair fall out and they feel so sick. But this is different, you are telling the T-cells just to attack cancer and you are programming them in a really specific way.
GUPTA: It's nice to report good news every now and then.
COHEN: It is. It's very nice.
GUPTA: Hopefully, this will be something more available to people. Thank you, Elizabeth.
COHEN: Yes. Thank you. GUPTA: You know, as the world celebrates Nelson Mandela, I want to recall the work he did in his so called retirement, raising awareness and fighting AIDS in South Africa. You know, I got a chance to meet Nelson Mandela back at one of the AIDS conferences several years ago. It was all that he talked about. In fact, his own eldest son was infected with HIV when he died in 2005.
And after leaving office, Mandela started a foundation. He fought for access for treatment and affordable medicine and he talked about the disease that was at once complete taboo in his country, as it was in so many places around the world. And over the last decade, new infections in South Africa have gone down by nearly a third. But even today, nearly one in five adults still has the virus and much work still needs to be done.
Now, coming up, addiction like you've never seen it before. You're going to meet the prominent physician who some say was writing these painkiller prescriptions with reckless abandon.
GUPTA: Someone dies every 19 minutes from a prescription drug overdose and most of these deaths involve painkillers. Now, I'll tell you, part of the problem is that painkiller prescriptions in this country are being written at a furious pace.
GUPTA (voice-over): Dr. Lynn Webster is considered a leader in the field of pain management. He's president of the American Academy of Pain Medicine.
DR. LYNN WEBSTER, AMERICAN ACADEMY OF PAIN MEDICINE: We've got over 100 million Americans who are experiencing chronic pain.
GUPTA: He's the author of a scoring system used by doctors to distinguish painkiller addicts from legitimate patients. And he's the founder of this pain clinic in Salt Lake City.
(on camera): What is his reputation?
DR. ANDREW KOLODNY, PHYSICIANS FOR RESPONSIBLE OPIOID PRESCRIBING: His methods are incorporated into almost every single educational program about prescribing opioids and even accepted by the FDA.
GUPTA (voice-over): But if you start to ask around a bit, you'll learn that his reputation among some former patients and their families is astonishingly different.
ROY BOSLEY: His reputation is he's known as Dr. Death.
GUPTA: Known as Dr. Death?
UNIDENTIFIED MALE: Yes.
GUPTA: That's how your wife's doctor was described? BOSLEY: Dr. Death.
GUPTA: Multiple overdose deaths at the Life Tree Pain Clinic which Webster ran for more than a decade now hover over him.
BOSLEY: He went unconscious.
GUPTA: There are allegations of irresponsible prescribing practices and in the case of one patient, influencing what was written as the cause of death.
BOSLEY: Here's the interesting part.
GUPTA: Roy Bosley's wife Carol Ann first went to the Life Tree Pain Clinic in 2008. Years earlier, her car had been broadsided.
BOSLEY: She did not have the seat belt fastened and went through the windshield.
GUPTA: After several operations on her spine, she managed her pain with low doses of painkillers.
(on camera): She's still functioning doing everything she needs to do.
BOSLEY: Yes, yes.
GUPTA (voice-over): But that would soon change when a friend suggested Carol Ann go to the Life Tree Clinic. Within a few weeks of becoming a patient --
BOSLEY: Carol Ann was pretty much hooked.
GUPTA (on camera): When you say hooked, you mean what?
BOSLEY: She was hooked on the pain medicine. She needed it.
GUPTA (voice-over): This is what Carol Ann was prescribed a year before her death -- a painkiller and an anxiety medication, between 100 and 120 pills a month.
Now, fast-forward one year. She was prescribed seven different drugs, painkillers, anti-anxiety pills, antidepressants -- all told, about 600 pills per month. The same steep climb in medications allegedly was seen among other patients who died after getting care at Life Tree.
Like this case, described in a medical malpractice claim recently filed against Webster and Life Tree. A 42-year-old who was prescribed about 200 pills a month when she first started at life tree. That's a little more than six pills a day. Seven years later, just before she died of an overdose, she was taking 1,158 pills per month or about 40 each day.
At the Bosley home, a sad spectacle filled with denial and overdoses began unfolding. BOSLEY: There were numerous times that we ended up in the emergency room for fear that she was going to die.
GUPTA: Bosley said he would regularly return home from work with Carol Ann unconscious and barely breathing. You took pictures of your wife essentially unconscious.
GUPTA (on camera): Must have been a hard thing to do.
BOSLEY: Very hard.
GUPTA (voice-over): Bosley says he tried to show the photos to Dr. Webster and other staff members and he tried calling the clinic to vent his concerns. He was shut down, with staff citing patient privacy or HIPAA.
(on camera): You weren't so much as asking for information as you wanted to provide it.
BOSLEY: I said, I am not asking for information. And I was given the HIPAA excuse and that was the end of it.
GUPTA (voice-over): So, what does Dr. Webster have to say about the claims against him and his clinic?
Well, despite our best efforts, not much. He did, however, respond to lawsuits filed against him and his clinic and denied responsibility for the deaths. We called his spokesperson.
(on camera): We certainly want to give him an opportunity to comment and to respond to some of this.
(voice-over): But he declined our interview. So, we decided to go straight to him.
(on camera): I'm in Boston at an event where Dr. Lynn Webster is going to be speaking.
You know, we've repeatedly asked him for an interview and through his spokesman he was repeatedly declined. So, we decided to come here and ask him ourselves in person.
Dr. Webster? Sanjay Gupta, with CNN, I'm wearing a microphone. I wonder if I could ask you a couple of questions. I've been trying to reach out to your team --
WEBSTER: I've got an appointment right now.
GUPTA: Will you sit down and talk to us afterward?
WEBSTER: I've got an appointment right now. Thank you.
GUPTA: After the appointment, will you sit down and talk to us?
WEBSTER: I've got an appointment.
GUPTA: Can I walk with you? Are you walking to your appointment here? Will you answer a couple of questions for us?
GUPTA: You don't want to answer any questions?
GUPTA: OK, all right.
(voice-over): We did get a statement ultimately. In it, Dr. Webster says the clinic treated difficult and complicated people with pain, with the highest standard of care. He went on to call the deaths a tragedy of the worst kind for patients to die not from a result of treatment but in spite of it.
BOSLEY: She was doing great. She was up to walking almost five miles a day.
GUPTA: Several months after starting at Life Tree, Carol Ann Bosley kicked the opioids and she went to rehab.
BOSLEY: She had lost weight. She was managing her pain on Tylenol, only.
GUPTA: Soon afterward, he says Carol Ann got a call.
BOSLEY: She said, Dr. Webster has requested that we come down both of us come down and meet with him.
GUPTA: To Roy Bosley's surprise, during the appointment, he says Webster suggested Carol Ann get back on narcotic painkillers.
BOSLEY: And my response to him was, my wife is addicted.
GUPTA: About a year after that appointment, after taking his advice, Carol Ann Bosley overdosed again. This time, it was fatal.
But Carol Ann's story does not end there. Weeks after her death, the medical examiner had ruled her death a suicide.
BOSLEY: I said, why did you label it suicide? And he says, well, I called Dr. Webster. He told me that she committed suicide. Why do you have to call Dr. Webster to get a diagnosis? Shouldn't the diagnosis be based on the evidence in front of you?
GUPTA: The Utah medical examiner's office say that Webster didn't have any influence over Carol Ann's stated cause of death -- which makes what happened next even more puzzling.
BOSLEY: Maybe five weeks later, I get a revised autopsy report. Cause of death, undetermined.
GUPTA: (on camera): When it came back undetermined, was there an explanation? They just changed it?
(voice-over): It's been four years since Carol Ann Bosley died. Her husband still wonders why his pleas for help to the staff at Life Tree and especially Lynn Webster fell on deaf ears.
(on camera): You blame Dr. Webster for your wife's death?
BOSLEY: I do. To this day, I regret that I did not go down there and find him. I would have pinned him to the wall, and I would have made him listen, and then I would have warned him with his life. Leave my wife alone.
GUPTA: Now, I'll tell you some of the family members of patients who died of overdoses after receiving treatment at Life Tree did file lawsuits against Dr. Lynn Webster. And in response to those cases, Dr. Webster continues to deny all the allegations against him.
Now, up next, healthy eating. A lot of people tell me that it's simply too expensive to do. So, we're going to show you how you can do it without breaking the bank.
GUPTA: Welcome back to the program.
You know, we say this all the time, eating healthy is the key to preventing chronic diseases like obesity, diabetes and heart disease. A new study out there finds it also comes with a price, $1.50 per day. That, of course, adds up to $550 more per year.
Researchers did find that some food groups like meat were more expensive for the healthier versions, while grains and dairy, they did have less of a price difference between healthy and unhealthy versions.
So, what about all this? How can you eat healthy on the cheap?
(BEGIN VIDEO CLIP)
ANN DUNAWAY TEH, REGISTERED DIETITIAN: One way to make your meat dollars go further is by adding beans to the meat. That way you can use less meat for more food.
(END VIDEO CLIP)
GUPTA: That's one strategy. And, of course, it's worth pointing out that money is only one challenge as well. Cooking healthy also takes time. But this is a surefire way, again, to get more bang for your buck.
Now, on Tuesday a federal judge ruled the city of Detroit is eligible for the largest municipal bankruptcy in U.S. history. I'll tell you something you may not think about -- this is a decision that could affect the pensions of thousands of former public servants, including retired firefighter Brendan Milewski.
UNIDENTIFIED CALLER: We need multiple EMS, multiple firemen down.
GUPTA (voice-over): You're listening to the actual 911 call from August 13th, 2010.
UNIDENTIFIED CALLER: We need everybody here now.
GUPTA: It's a day that began like any other, but one that would change firefighter Brendan Milewski's life forever.
BRENDAN MILEWSKI, RETIRED DETROIT FIREFIGHTER: I remember we were working on the facade of the building, and somebody had yelled some sort of caution. And the bricks were kind of raining down in front of my face. And you're taught in a collapse situation to run towards the collapse, but your human instincts take over. I thought I had it beat has what caught to me and hit me on the back.
GUPTA: Brendan knew right away his career as one of Detroit's bravest was over.
MILEWSKI: You see these war movies like "Saving Private Ryan" when these guys are in combat, and you lose sound. You can't hear anything and it was exactly like that.
I tried to place my hands on the ground in front of me and do a push- up, and when I did that push-up, I couldn't slide my knees to my chest. And I knew instantly what had happened, I was paralyzed and had a spinal cord injury.
GUPTA: Brendan now spends three hours a day, three days a week here at the Rehabilitation Institute of Michigan working to make the most of what muscles he still has control over.
MILEWSKI: It's perfect. There are days when I question whether or not I'm OK mentally, but to me it's simple. I learned early on that I have a voice through this, and I have something to say, and I have a message.
GUPTA: Doogie, as he's known to his firefighting family, because he joined the department when he was just 20 years old, was even featured in the award-winning documentary "Burn" from executive producer Denis Leary.
DENIS LEARY, EXECUTIVE PRODUCER, "BURN": Well, what happened to Doogie in the movie is something that I think a lot of people would consider tragic. His response to what happens to him is heroic.
MILEWSKI: As much as I hate it's me and my story, I think it's something we need to open up people's eyes to.
GUPTA: You know, Michigan is my home and I can tell you arson is really an all-too-common problem especially in Detroit. The two men who started that fire received eight and 15-year prison sentences, so they're going to be released this decade, whereas Brendan will still more than likely be confined to his wheelchair.
Take a few minutes this weekend if you can and logon to CNNHealth.com and you can read Brandon's inspirational blog there.
Got a check of your top stories just minutes away. But still ahead on SGMD, you know, better health, it's not just about Obamacare. It's about you. I'll explain.
GUPTA: Does health insurance actually make you healthier? Well, the truth is that really you're the only person who can truly make yourself healthier.
Insurance can help. Doctors can help. But unless you listen to them, it really is not going to make a difference.
There was this fascinating study that came out of Oregon, where they compared people who recently got Medicaid health insurance to people who were uninsured. What they found is that people who had insurance, they did go to the doctor more often, they even got more care. But when they studied these two populations, they did not find that the people with insurance were, in fact, any healthier.
But I think there's something else as well as a doctor, the peace of mind that people have when they have insurance, I don't know how you can substitute for that. It's something that allows people to sleep at night, make sure they can put food on the table for their families and live a more productive life.
But just consider this for a second, if all of us Americans exercised 30 minutes a day, that's it, 30 minutes a day, we all did that, we could cut down the risk of heart disease and strokes by a third. Just think about that. There's no drug. There's no insurance. There's really nothing else in our society that's going to have that kind of impact.
But, again, it's us. I'm not asking you to turn your whole life on your head. I'm asking for 30 minutes a day to make America a more healthy place.
You can get my whole take on this topic, making America a more healthy place, at CNNHealth.com. Go there. Let me hear from you as well.
Got much more news now with Deb Feyerick in the "CNN NEWSROOM."