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Face Transplant Patient Speaks Out; Seclusion and Silence in Massachusetts Double Murder Mystery; Alice in Wonderland Syndrome

Aired February 6, 2006 - 22:00   ET


ANDERSON COOPER, CNN ANCHOR: Good evening again.
Imagine getting your life back, but it comes with a complication. It's your life, but someone else's face. For weeks now, the world has been following the story of Isabelle Dinoire, the first human recipient of a face transplant.

In a moment, we're going to show you her new face.

But, first, here's what she looked like before her long ordeal, before her dog mauled her beyond recognition. Now here's a picture of the late woman whose lower face was transplanted on to Ms. Dinoire's. And here is the end result, neither one nor the other, not exactly. Remember, the donor face takes on the characteristics of the underlying bone structure.

We also to point out, this story is far from over -- a lot to talk about, including whether this changes how people view the idea of organ donation.

Our coverage begins tonight with CNN's Jim Bittermann.


JIM BITTERMANN, CNN CORRESPONDENT (voice-over): This is the face many around the world were waiting to see, the first transplanted face.

A woman who once looked like this, before being mauled by her dog, now looks like this, not anything like the donor, because she has different bone structure. It was the awful wounds inflicted by Isabelle Dinoire's pet Labrador that brought her to this point.

She told newsmen she had taken pills to help her sleep and help her forget a terrible week. But her nightmare began when she awoke from her drug-induced stupor to find the dog had chewed off most of her nose, lips and chin. Doctors believe it was to get her attention.

For six months, she said, she could barely eat or speak and was ashamed to be seen in public without her surgical mask. Doctors decided reconstructive surgery was not enough. She needed a new lower face. And, so, at the end of November, when the face of a donor became available, they did not hesitate to operate.

Fifteen hours later, she became one of the most famous patients in medical history. And, just a week later, she was eating and speaking.

ISABELLE DINOIRE, TRANSPLANT PATIENT (through translator): I can open my mouth and I can eat. And I can feel my lips and my nose. And, of course, I have to do a lot more exercises and work every week

BITTERMANN: There were some complications, some tissue rejection, which was treated by drugs.

But doctors say she is progressing better than expected. Gradually, her doctors say, MRI scans shows Isabelle Dinoire's brain is taking control over her new face. But what makes the transplant of a face so unique is the role the face plays in communicating emotion. Her surgeon told CNN, recovering that ability to express her emotions will be the true sign she has recovered completely.

DR. BERNARD DEVAUCHELLE, FACE TRANSPLANT SURGEON: And the question is, creative movement is a good thing, but the difference between the movement and an expressivity.

BITTERMANN (on camera): The doctors and their patients say that they hope the success of her operation holds out hope to others who might need similar surgery. Already, teams in the United States, Great Britain and elsewhere are planning for face transplants, and the teams here have applied to the Health Ministry for permission to do five more.

(voice over): As for Isabelle Dinoire, she wants to get back to a normal life and away from the media attention -- but not entirely. As she drove off in a nondescript van, her doctor told CNN she has a film deal in the works and will sit down this evening with a French philosopher who is pondering what it's like living behind another person's face.

Jim Bittermann, CNN, Amiens, France.


COOPER: With us now in Atlanta, our senior medical correspondent, Dr. Sanjay Gupta.

Sanjay, why is it that she is able to feel sensation in some parts of her face and not others?


You know, I mean, there is a lot involved in -- in a facial transplant like this. Let me -- let me show you a couple of pictures here, some of the ones that Jim just pointed out as well, the donor and the recipient.

Specifically here, you can see the part of the face that actually was transplanted, right through here, this triangular portion of the face, a little bit more of the right cheek than the left. And, then, obviously, you can see the recipient here, Isabelle, as well, this part of her face, actually, the part being transplanted.

What's in here, Anderson? Lots of nerves, lots of different blood vessels, muscles that actually make this happen.

If we can go to the next image here, you will see exactly where the scars are still. And you can actually see -- it may be not so obvious -- let me just highlight them there, this part of the face. So, the sensation, even some of the movement, you can probably tell there, Anderson, when you look at those images, she can't move all of her face. She can't smile. She can't say certain words still. That may get better. But that's essentially what happens after a transplant that we are finding out like this.

COOPER: And -- and, in the press conference today, she describes the moment that she realized that her face had actually been mauled, she says she must have passed out after the attack. Then she woke up, lifted a cigarette to her face to light it, realized something was wrong.

Now this woman is smoking again. How bad is smoking for her recovery?

GUPTA: Yes. I thought that was sort of a -- a sort of bizarre part of the story, that the first -- the way that she figured out that something was wrong, by putting a cigarette to her lips, it seems like there would have been other indicators.

But smoking is a terrible thing for her. When you think about these small blood vessels, smoking is just about the worst thing, in terms of possibly making these blood vessels close off, and threatening the entire skin transplant itself, as well as the muscle underlying it as well.

And that was something that we were sort of looking into a lot today, Anderson, trying to answer the questions of, you know, would you do this? Would you donate your own face? And what does that all entail.


GUPTA (voice-over): Where there was once a gaping hole, there is now a face. Isabelle Dinoire went public for the first time today, more than two months after receiving the world's first partial face transplant.

DINOIRE (through translator): I can open my mouth and I can eat. I can feel my lips and my nose.

She says this in French, of course, and it is noticeable that she still can't purse her lips to make B-sounds or P-sounds. She went on to thank the family of the donor, reportedly a young brain-dead woman who committed suicide.

And that brings up perhaps the most controversial aspect of this whole operation. From where will the transplanted faces come?

DR. JOSEPH MCCARTHY, NEW YORK UNIVERSITY SCHOOL OF MEDICINE: There's a problem with donors -- or securing tissue for the transplant will not be easy. GUPTA: Another issue: Even with the suitable donor, should the transplant happen in the first place?

MCCARTHY: I don't think face transplants will be as common, because I think there are a lot of very good traditional reconstructive techniques to fix various facial problems.

GUPTA: Many surgeons believed Isabelle should have had more traditional methods of reconstructing her face first, such as using some of her own skin and muscle from elsewhere in her body.

For the transplant, surgeons took the nose, lips and chin from the donor, then spent 15 hours carefully reconnecting muscles, veins, arteries and nerves to her face. Now she's subjected to a lifetime of immunosuppressive drugs and the very real risk of rejection.

And whether it's donating a face, a liver or a kidney, there just aren't enough donors.

ELAINE R. BERG, PRESIDENT, NEW YORK ORGAN DONOR NETWORK: When asked about organ donation, only 56 percent of the families nationally say yes to donations. So, almost half say no.

GUPTA: And even more would probably say no to face transplants, because, in life or death, you don't want to give up your face. After all, it is your lasting identity. So, does Isabelle look like her donor?

CNN has obtained these pictures. The donor and the recipient are shown side by side. You decide.

DINOIRE (through translator): There is no comparison between the face I have today and the one I had seven months ago. Quite different.

GUPTA: A different face and a different life, that's the new hope for Isabelle Dinoire.


COOPER: So, we have now gone from could to can. It can be done, but should it? Under what circumstances?

And here's a question for you at home. Would you be willing to donate your face when you die? I posed that question on our 360 blog today. We got more of responses, more than 100, about 180 or so. A lot of people said that it was just something they just couldn't do, so, even people who are organ donators.

Let's bring in Art Caplan in to the discussion. He's director of the Center For Bioethics at the University of Pennsylvania. And Dr. Sanjay Gupta is still with us.

Art, you know, we got a lot of responses on the A.C. 360 blog today. Renee in Savannah, Georgia, wrote in: "I don't think I would donate my face. My internal organs are up for grabs. But my face represents me in a uniquely personal way, and I would be uncomfortable donating that part of myself."

How does the -- the emotional attachment associated with the face affect those who -- who may donate and those who receive it?


Well, Anderson, it's huge. People view the face as a very, very special set of tissues. It's their identity. It's how others know them. You know, no one ever fell in love with their -- with somebody else's liver. But people do say they fall in love with a face.

So, it's both a way that we identify ourselves to the world. It's a way that others, including our family members, know us. I mean, it's -- it's the recognition factor, if you will.

You have to remember, too, when you are donating something like a face, even if you're dead, your loved ones are going to have to go on knowing that that face is out there, that it's on someone else. Maybe it doesn't look quite like you, but I suspect it's going to have different psychological and emotional issues for them, than if you donated your heart, your kidney or your liver.

COOPER: It really is a psychological issue, because, once we die, ultimately, the skin on our face will -- will -- you know, we -- I have seen, you know, plenty of corpses. And...


COOPER: And the skin will all disappear anyway. It's not a pretty sight.


COOPER: We -- a couple other people on the blog had completely different viewpoints.

John in Palm Beach, Florida, wrote us this. He said: "What is the point of being an organ donor if you pick and choose your organs? I hope they can use every square inch of my body."

The face, though, is different -- for some people.

CAPLAN: It is.

You know, if you go back, the law that allowed organ donation was passed way back in the late 1960s. No one ever thought about things like the face. They were thinking about livers and kidneys, hearts. This -- this opportunity to transplant a face is not something, if you will, that was part of the original intent behind the law.

So, we have people out there with donor cards. I have one. I hope that everybody has one. I'm sure Sanjay has one. We have people out there with driver's license checkoffs. But we weren't thinking when we filled them out, did that include the face?


CAPLAN: To answer your blogger, you do have the right to pick and choose. There are people -- I have seen them -- who say, you can take my liver. I don't want you to take my corneas. Other people have emotional ideas about the heart. And they don't want that donated.


COOPER: Well -- well, let me bring in...

CAPLAN: ... it's a gift.


CAPLAN: You can -- you can pick and choose.

COOPER: Let me bring in Sanjay.

I mean, if -- if I'm an organ donor on the license, does that mean, you know, my face is fair game?

GUPTA: Absolutely not now, Anderson.

I mean, this is not even approved at all, certainly, in this country. And there's -- there's only one institution, really, in the country, the Cleveland Clinic, that has approval to possibly try a face transplant. So, this is really not on the table for now. But it's interesting.

Now that it has been someplace in the world, smart guys like Art Caplan are probably going to be getting together to try and figure out how best to let people choose to do this.

And I should point out as well, Anderson, the way that this works is that the person is brain-dead, but not dead. I mean, the heart is still beating. There's blood still flowing through their skin, which is imperative to make this work. So, you would actually be taking the face off someone whose -- whose heart is still beating. And that's a very, very difficult thing, obviously.

COOPER: So, that would affect whether or not they had an open cassette, perhaps. I mean, that -- that -- it would have a serious effect on -- on the funeral process.

CAPLAN: Absolutely.


CAPLAN: Absolutely. This is a -- this is a procedure where, unlike anything we have ever seen before in transplant, you're going to have to change the way the burial goes, if you become a face donor. COOPER: So -- so, Sanjay, I mean, that adds a whole other layer. I mean, for internal organs, it's different for -- for families. They -- they obviously wouldn't see that.

GUPTA: Yes. No, absolutely.

I mean, the -- the -- how -- this is all going to change the rules of -- of a lot of things. And people have been working on transplantation for a long time. It's a very dangerous procedure as well for the recipient, Anderson. You mentioned already, she is by no means out of the woods, a lifetime of immunosuppressive drugs, the real risk of rejection.

The skin is the largest organ in the body. If this rejects, she could be subjected to lots of infection risks. And those could be very, very significant -- so, on both sides, a lot of -- a lot of sort of questions still unanswered, how this is all going to play out.


Kate in Rockaway, New Jersey, wrote on the blog today. She -- she said this -- quote -- "Who could possibly be so arrogant to say that she did not deserve to be repaired? She is no Frankenstein's monster, but a mom, a victim, and now a part of history."

She's got a point. I mean, at a certain point, quality of life is -- is important, even if it's not a -- a necessary surgery to save a life.

CAPLAN: Well, let me take a jab at being slightly cruel for a minute in response to the blogger.


CAPLAN: The issue isn't whether she deserves a transplant or doctors and surgeons should make decisions about who is worthy and who isn't.

As Sanjay has pointed out, this is very experimental. So, you want to get the best shot with the first subject. And a woman who smokes and a woman who herself may have been involved in a suicide, she may not be the ideal candidate to go first, maybe 10th, maybe 20th, but we will have to see how this all goes.

But, you know, as Sanjay said earlier, you're a smoker, you're going to be damaging those blood vessels. She's at high risk of rejecting anyway. She's at high risk of getting cancer from those drugs. It's not that she doesn't deserve it. It is that she may not be the best first choice, so to speak.

COOPER: Interesting.

Art Caplan, always good to talk to you.

Dr. Sanjay Gupta, thanks as well.

GUPTA: Thank you.

COOPER: We still want to know what you think about this face transplant. So, just log on to our blog at Share your thousands. As I said, we have gotten more than 100 already. We would love to get some more. We will read some of them later on in the program tonight.

There's a lot ahead in this hour.

On the other side of the Atlantic, seclusion and silence for the man whose wife and baby were murdered. The spotlight intensifies on a Prince-Charming-turned-person-of-interest. Coming up, we are live in England for more on the shocking murder mystery, Neil Entwistle, Rachel and Lillian Rose.

Also, strange but true, Alice in Wonderland syndrome, a real-life disease that puts people in a fantasy world of another dimension. Find out more about this rare and mysterious disorder ahead on 360.


COOPER: Coming up ahead, the Entwistle murders, a husband and father, person of interest in this case, who can't escape the media spotlight, even in seclusion in England -- that's coming up.

But, first, Erica Hill from Headline News joins us with some of the other stories we are following tonight -- Erica.


At this hour, here in Atlanta, people continue to pay their final respects to Coretta Scott King. Mrs. King died last week. More than 13,000 mourners have filed past her casket at Ebenezer Baptist Church, where her late husband, the Reverend Martin Luther King Jr., preached before his assassination in 1968. President Bush and many other dignitaries are expected to attend tomorrow's funeral in Lithonia, Georgia.

On to New Bedford, Massachusetts -- a chilling prediction. A prosecutor says this teen, Jacob Robida, who is suspected of attacking three men at a gay bar last week, left a note for his mother that warned he would -- quote -- "go out with a blaze." Robida fled and was mortally wounded hundreds of miles away in Arkansas, following a high-speed police chase and after he killed a police officer and a female companion.

From Interpol, an urgent global security alert -- the hunt is now on for this man, who escaped from a Yemeni prison. He is identified as the mastermind of the deadly USS Cole attack in October of 2000. Authorities say 22 others, many convicted al Qaeda terrorists, although escaped through a tunnel dug by prisoners and co-conspirators on the outside.

On Capitol Hill today, Attorney General Alberto Gonzales in the hot seat, defending the Bush administration's domestic eavesdropping program as lawful and essential. Yet, Democrats and even several Republican senators indicated they were not convinced by Gonzales' testimony.

And, Anderson, that's a look at the headlines at this hour -- back over to you.

COOPER: Thanks, Erica. We will check in you shortly.

Tonight, the man who didn't attend the funeral for his own murdered wife and baby is still refusing to answer key questions about a crime that has attracted worldwide attention on -- attention. Rachel Entwistle and her 9-month-old daughter, Lillian, were found shot to death inside their Massachusetts home last month. They were buried just last week in one casket.

The husband, Neil Entwistle, flew home to England shortly before the bodies were discovered. Entwistle remains in seclusion. He's not far from the public eye, however. He's a man under the microscope, hounded by the media and tracked by police as a person of interest.

CNN's Paul Newton is live in Entwistle's hometown of Worksop, England -- Paula.

PAULA NEWTON, CNN CORRESPONDENT: Anderson, you know, if he came here to get any kind of comfort or protection, he's in the wrong place. His parents' home, his childhood home, has really turned into more of a prison for him.

The media shows up here daily. We, like a lot of other media outlets, approach the home. We knock on the door. We are wondering if he's going to change his mind, if anyone from his family are going to change their minds, and come out, and make a statement, try and explain, really, what he's doing here.

Above all else, though, this is a family that, as you said, is under the media glare, and they really just seem like they want all this to end. While police here in the town don't have any kind of jurisdiction, they're not investigating, they did show up earlier today, as they do every two days or so. They say that they're checking up on the Entwistles, making sure that they're OK.

They have had no request for any other cooperation from Massachusetts, at least not so far. When the officer came out, he did indicate, in fact, that he thought that they were doing OK, under the circumstances. And that's about all he said.

It was very peculiar, Anderson. What happened just after that is that Yvonne Entwistle, Neil's mother, came out. She was looking just utterly drained and very, very sad. She has done that a couple times. She has been up at her window, even tonight, looking down on us.

And you have got to imagine that, at this point, they just want this to all go away -- Anderson.

COOPER: Now, he has returned to the house. He kind of disappeared for a couple days. Is it known where he went?

NEWTON: It was just two or throw days. No, no one from the media found them. Police knew where the family was, but weren't saying. They did return here, though, however. And, again, the media spotlight has been intense.

No indication of where they went, expect to say that he did not make any contact with anyone while he was gone, and no one was able to track him down. Right now, he has had very little contact, even with his own lawyer here in London.

It is really difficult to predict at this point, to see where the case is going to go next. They're looking for a break in the case.

COOPER: Paula, thanks very much. You're gathering evidence.

The case continues to make headlines both here and across the Atlantic, and there's a reason why. After all, this is a story about a senseless crime. Why would anyone -- how could anyone murder a mother and her little baby?

And then there's the husband. Why would he leave the country so quickly? Why wouldn't he come back. Right now, all police have are pieces to a puzzle. And, tonight, so will you.


COOPER (voice-over): Since news broke of this mother-daughter murder, it seems the world has gotten to know their smiling faces.

UNIDENTIFIED FEMALE: On the surface, they appeared to be living the perfect American dream.


MARK GERAGOS, ATTORNEY: Mary's already accusing this guy. Mary has already got this guy accused as the suspect.



COOPER: But in the small town in Hopkinton, Massachusetts, where they lived and died, they were strangers.

ROBERT FALCIONE, EDITOR IN CHIEF, "THE HOPKINTON NEWS": No one in town knew them. I haven't spoken with anyone who's had any words with any of them.

COOPER: Neil, Rachel and Lillian had moved to Hopkinton on January 12, just 10 days before the bodies of Rachel and Lillian were found.

Neil and Rachel met in England during her junior year abroad. They married, and Rachel became a teacher, Neil, a computer programmer. After becoming parents, they moved to Massachusetts last summer, living first with Rachel's mother and stepfather, and then moving to nearby Hopkinton. By the looks of it, they were a picture-perfect family. But, more than two weeks since the murders, many questions remain unanswered. First, when were Rachel and little Lillian Rose murdered? Their bodies were discovered in their rented home in Rachel and Neil's bed Sunday January, 22, at 6:30 p.m. Rachel had been shot once in the head, Lillian Rose, once in the stomach. the murder weapon, a small- caliber gun, has not been found.

Second, when did Neil Entwistle fly to England? According to "The Boston Globe," he was on the passenger list for a flight to London Saturday at 8:15 a.m. The paper says it was a one-way ticket purchased that morning. His car was found at Logan Airport.

Third, why did it take so long to find Rachel and Lillian? When friends arrived Saturday evening for dinner, no one answered the door. A light was on. So was a television. Police say they only did a brief check of the house and, without a search warrant, couldn't have done more.

It wasn't until a missing-persons report was filed Sunday afternoon that they were able to do a more thorough search. Fourth, is there a Web connection? Prosecutors say Neil was running a get- rich-quick Internet scheme called "Million Maker," which encouraged customers to start Internet porn sites and $6,000 profit a month.

A software business the couple ran on eBay was shut down when customers complained the goods weren't being delivered. More than a dozen customers posted angry notes on their site, one calling Rachel a thieving liar.

Prosecutors say they're looking at all facets of the Entwistles' lives, including their business dealings.

And perhaps the most puzzling answer of all unanswered questions, why won't Neil Entwistle return to America? He has been spotted at his parents' home in Worksop, England. According to the "Sun" newspaper, he called Rachel's stepfather and said -- quote -- "I can't remember how I got to England. Is it true Rachel and Lillian are dead?"

Neil has made no public statements and did not answer extensive questions asked to him by U.S. law enforcement. He didn't return for his wife and daughter's funeral last week, and his name was not mentioned in their death notices.


COOPER: Well, it began in love, ended in death. We will have more on the Entwistle murder mystery and why some believe the man at the center of the case, this person of interest, may just have something to hide.

Also tonight, mind games, Alice in Wonderland, it's not just a children's book. It's a disease. That's actually the name of it, one that turns everything upside down, inside out. 360 M.D. Sanjay Gupta goes behind this medical mystery when we continue. (COMMERCIAL BREAK)

COOPER: Profile of a person of interest -- what a reporter discovered about Neil Entwistle, whose wife and baby were shot to death in Massachusetts.

That's next on 360.


COOPER: So, a friend says he was her knight in shining armor. And now he's a person of interest in an unspeakable crime. Take a look at this photograph. It's of Neil Entwistle, his wife, Rachel, and their baby girl, Lillian.

Last month, someone murdered Rachel and Lillian, shot them to death, close up, small-caliber handgun, she in the head, Lillian in the stomach.

Police wanted to talk to Neil, but he flew to England, reportedly taking the family's only car to the airport. He didn't attend his wife and baby's funeral, and he is refusing to answer police questions.

As the investigation continues, people who know Entwistle are speaking out, and, in doing so, painting different pictures of someone at the center of a horrific mystery.

Donovan Slack is a reporter with "The Boston Globe." And she joins me now from Boston.

Donna, thanks for being with us.

You know, a lot of people are struck by the fact that Neil Entwistle didn't go back to the funeral, didn't come back to the United States for his own wife and daughter's funeral. You found that was not terribly surprising to -- to some of those who know his family. Why?

DONOVAN SLACK, "THE BOSTON GLOBE": Well, that's right.

Some of them who have known the family for -- for many years say that they are a fiercely private family, and -- and that the mom, Yvonne, who is a school cook in that city...

COOPER: Now, this is Neil's mom?

SLACK: Yes, that's right...

COOPER: ... in -- in England.

SLACK: ... Neil's mother, correct. I'm sorry about that.

Anyway, that she ran a very private household, almost like a cocoon, a protective place, where he could return home and feel safe. And many neighbors say that's what he's doing. It's not extremely perplexing to some of those friends that he would run to her for protection.

COOPER: You -- you also looked into how Neil and Rachel Entwistle met and how others perceived them as a couple. What did you find out?

SLACK: That's right.

By most accounts, it was an absolute fairy-tale romance. As you have already said, they met at the University of York, perhaps ironically, at a little boathouse on Love Lane, which is just down the street from a 12th century chapel where the victims of the Black Plague are buried.

COOPER: And -- and they were both rowers; is that right?

SLACK: That's right.

Actually, she was a coxswain, and he was a stroke, so to speak. She directed the boats, and he sat facing her, handling the oars.

COOPER: And, then, how long were they in -- in -- I mean, did they get married in England?

SLACK: No, actually, they got married in Massachusetts.

But during their year-long romance in York, they -- friends say that it wasn't really love at first sight, that they got to know each other over a number of weeks, and it was a slow-building relationship.

She actually returned to Massachusetts to finish out her university degree, before going back to England and being reunited with Neil. They ended up getting married in 2003 in Plymouth, Massachusetts, in a very romantic ceremony. Friends described them dancing to the soundtrack from "Moulin Rouge." I don't know if you know the song, Anderson. It's called "Come What May."

COOPER: Sure, yes.

SLACK: It's rather tragic.

COOPER: Wait. So, the -- the song they danced to was "Come What May"?


COOPER: That's interesting. Did people know -- I mean, the people you talked to, the friends, did they know about these Internet businesses of his?

SLACK: Not very many. I didn't really know of anybody that knew about the Internet businesses ahead of time. They all, of course, know about them now. It appeared that Neil and Rachel managed to keep that to themselves for the most part.

COOPER: I mean, Hopkinton, there are about 14,000 people there. How are they reacting? SLACK: Well, it's quite something there. They haven't had a homicide in Hopkinton for more than 10 years, and people are confused, obviously not just in Hopkinton but elsewhere, about the size, the immensity of this mystery.

COOPER: And a mystery, it is. Donovan, appreciate you joining us. Donovan Slack with "The Boston Globe," thanks very much.

SLACK: No problem. Thanks for having me.

COOPER: Coming up ahead tonight on 360, chaos over cartoons. Have you been watching this all weekend long? The protests following the caricatures of the profit Muhammad are spreading and with deadly results. We'll show you the latest.

Also tonight, forget about reading "Alice in Wonderland." There are people in America who are living it, a disease, a rare disorder that alters space and time and puts patients into a world of fantasy. Dr. Sanjay Gupta investigates.

And a reminder, Dr. Gupta wants to -- well, we can call him Sanjay. He wants your medical questions. He'll report on some of them. Just log on to our Web site, Click on the e-mail link.


COOPER: Well, imagine what it would be like to never feel any pain. Or what if you spent your entire life without ever being in the sun? For some people in this country, those aren't hypothetical questions; they are the reality of living with a very rare disease.

All this week, we're going to be taking a close look at medical mysteries and the strange disorders that often leave doctors baffled. It's certainly true with our first case tonight.

It's named after "Alice in Wonderland." It's about a disease that puts patients into an altered sate, distorting both of their sense of time and also space. 360 M.D. Sanjay Gupta investigates Alice in Wonderland Syndrome.


ROSE MATHIS, EPILEPTIC: We had, like, a geometrical design in the floor tiles. So I was just sitting there gazing at the design in the tiles. And all of a sudden, the very place that I was looking, it looked like the whole design suddenly got smaller.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT (voice-over): Rose Mathis was just 8 years old when she had an unusual vision. Suddenly, her entire world started changing in size.

MATHIS: And it just stayed that way for a short period. And then I noticed it started to seem to be coming up again or getting larger. So it kind of seemed like the floor was getting closer to me or I was getting closer to the floor. I was afraid, if I suddenly got off the chair, if it was a change in distance, I wouldn't know how far down I was going to drop.

GUPTA: Subsequently, she was diagnose with epilepsy. But Rose's doctors say she also suffered from a rare condition known as Alice in Wonderland Syndrome. Now, it's a form of hallucinations that, for about a minute, causes some people to see certain distortions, much like Alice did when she ventured through the pages of Lewis Carroll's fairy tale.

DR. MICHAEL BATIPPS, WASHINGTON HOSPITAL CENTER, NEUROLOGY: Usually, it's more of a visual distortion so that a person would look around and it seems as if objects that are large appear to be small, far away, like you're looking through the wrong end of a telescope, or it can be just the opposite.

GUPTA: We know more about Alice in Wonderland Syndrome than ever before. And to be clear, it's not simply a mental disorder. It usually affects some people who have epilepsy or migraine headaches. Neurologists say these are in fact hallucinations or auras. Something in their brain triggers an electrical reaction that distorts their vision.

BATIPPS: There's abnormal electrical activity in the visual area of the brain, and the visual area of the brain hooks up to where it's connected to the temporal lobe. And where there's interaction between the visual area and the temporal lobe, you can get a rich variety of unusual visual symptoms.

GUPTA: Doctors say it's difficult to tell how many people actually suffer from Alice in Wonderland Syndrome. That's because the symptoms may very and the frequency of symptoms vary, as well. Some people may have just one or two visions. Others have these visions their entire lives. And even with modern technology, the diagnosis is still difficult to pinpoint.

DR. STUART STARK, NEUROLOGY AND HEADACHE TREATMENT CENTER: Patients can describe it -- well, it's very unique to them. They've not had an experience like it before. So when they talk about it, it should ring to a neurologist's mind any number of conditions, migraine being the most common.

GUPTA: For certain, Alice in Wonderland is not a typical condition, yet some visions are more common than others. Physicians talk of patients seeing lights that flicker across their line of sight. Other patients say they see peculiar shapes or animals.

One woman told her doctor she used to see a goat in a red hat right before she had an epileptic seizure. And those visions aren't much different than a Cheshire cat or Tweedle-Dum and Tweedle-Dee.

And get this: All of these characters were created by an author who also suffered from serious migraines.

STARK: It's understandable that a lot of people with migraine take their own experiences and put it into some artistic venue.

GUPTA: Although the visions are alarming to patients, doctors say bouts of Alice in Wonderland Syndrome are relatively harmless and there's no real treatment. Even though the episodes may be frightening, Rose Mathis says the best thing to do is learn how to cope with them.

MATHIS: Even though it was kind of scary, I figured, just like with the other spells, if I just sit there and wait for it to pass, you know, there was really nothing to be too scared about.


COOPER: It's fascinating. Is this just people who suffer from epilepsy and severe migraines who have these hallucinations?

GUPTA: Well, you know, the vast majority of people, Anderson, as children will have these episodes and then they go away and they never come back. And it's unclear why they had them in the first place.

But this is another thing actually known as the Epstein-Barr virus. This is a virus that causes mono, the kissing infection. And people who have that infection as well seem to get these bouts occasionally of Alice in Wonderland Syndrome.

COOPER: There's a lot of artwork in your segment. Who were the artists?

GUPTA: This actually came from the headache and neurology clinic in Northern Virginia, a neurology and headache clinic. So a lot of the patients over there who have suffered from these bouts of Alice in Wonderland Syndrome were asked to sort of draw what it was that they were seeing.

And something that's been interesting this weekend, while working on this series, you see this real connection between some of these illnesses, hallucinations and creativity. I guess not surprisingly so, Lewis Carroll, as we mentioned. Van Gogh may have had this, as well, some of these bouts of Alice in Wonderland, as a result of migraines. So there's a real connection there, which I find fascinating.

COOPER: It is. All week, we're going to be looking at these medical mysteries. Thanks very much, Sanjay.

GUPTA: Thank you.

COOPER: Coming up, what happens when free speech goes up against religious taboos in the Muslim world? People are dying, that's what's happening, and killing and threatening to kill others. Stay with us. You're watching 360.


COOPER: So protests over the editorial cartoons of the prophet Muhammad, what's really at issue here? We're going to take a look at that, coming up.

But first, Erica Hill from Headline News joins us with some of the business stories we're following tonight -- Erica?

HILL: Hi again, Anderson.

In Houston, Texas, it is week two of the Enron trial. The company's former head of investor relations testified against Enron founder Kenneth Lay and former CEO Jeffrey Skilling today.

Mark Koenig said that, in 2001, as the company was imploding, Lay wanted a press release to ignore the fact that the company had written down the value of shareholder equity by $1.2 billion. But in testimony about Skilling, Koenig admitted he couldn't know what was in the executive's mind when Skilling made misstatements.

Things going pretty well over at Disney. The Walt Disney Company's profits rose by 7 percent in its most recent quarter. Other units helped to compensate for a weak performance, though, by Disney's movie division.

And the Super Bowl telecast by Disney, owned by ABC, was the most-watched Super Bowl in a decade. On average, some 91 million viewers saw the Steelers whip the Seahawks.

And, Anderson, well, of course, we love sponsors in general, since they pay our bills. Some of the reactions to this year's Super Bowl commercials really kind of ho-hum.

COOPER: Seems that way, Erica. Thanks.

Some serious stuff next, life and death. We're going to look at the deadly anger exploding in the Muslim world over some newspaper cartoons. Rioting, death threats, intimidation, and a debate in the West over when and whether free speech ought to yield. That, when 360 continues.


COOPER: Well, the Muslim world is on fire tonight, and rest of the world is on guard. At issue, something that to many would be trivial, but to some is enough to kill over, 12 political cartoons published in a Danish newspaper at the end of last September.

They show the prophet Muhammad. One shows him wearing a turban in the form of a bomb, again, published September 30th.

The first complaint came about two weeks later. The first demonstrations and death threats about two weeks after that. Now, that was November. Then last Wednesday, a French paper reprinted the cartoons and all hell broke loose, which brings us to today.


COOPER (voice-over): Chanting "Death to America" and "God is great," protestors affiliate with Iran's hard-line Islamic militia stormed the Danish and Austrian embassies in Tehran. Pen and ink drawings published four months ago in a Danish newspaper being answered by Molotov cocktails and calls for blood. The buildings were empty, diplomats warned. But again, a message was sent. And after cutting trade ties with Denmark, Iranian lawmakers issued a statement: "Remember the author, Salman Rushdie. Remember the fatwa against him."

In New Delhi, the capital of his native country today, echoes of the threats he received for his alleged blasphemy about Islam. "Hang the culprits," they said, "Behead them."

From India to Indonesia, where protestors turned on the American consulate in Surabaya, to Afghanistan, where a call for tolerance from President Karzai was ignored and four people were killed, to Pakistan, the Muslim world in a single chaotic day.

UNIDENTIFIED FEMALE: This is an issue on which there can be no overreaction. Of course, we are not in favor of people resorting to violence, but naturally the entire Muslim world is very dismayed and disappointed. And we all condemn it.

COOPER: It being the 12 cartoons, not the outrage, though in Britain today the beginnings of a backlash to demonstrations last week that saw radicals threatening new bombings and calling for a new Holocaust.

UNIDENTIFIED MALE: These elements are not representative of the Muslim community. They are simply fringe elements, mischievous elements who want to bring the good name of Islam into disrepute.

COOPER: And in Lebanon, scene of mayhem yesterday in a bitter sectarian war not so long ago, Christian and Muslim leaders appealed for calm.

UNIDENTIFIED MALE: What happened today in Beirut and especially to the Christian community is something that is totally unacceptable. And we are one people, and we will not let this thing go by.

COOPER: But it has. And so far, this thing, about 12 cartoons published four months ago and one prophet born hundreds of years ago has now taken five lives around the world and threatened millions more.


COOPER: A few more items to set the stage. A radical cleric in Lebanon today said those responsible for the offending cartoon should be tried under Islamic law and executed.

And a mainstream cleric, Pope Benedict, said this: "The right to freedom of thought and expression cannot entail the right to offend the religious sentiment of believers."

Our guests tonight might beg to differ. Blogger and writer Andrew Sullivan, his latest column in "Time" magazine is titled "Your Taboo, Not Mine." His Web site is He joins us now. Andrew, good to have you on the program. In your column in "Time," you argue that the Muslims who are protesting this blasphemy are being hypocritical. Why?

ANDREW SULLIVAN, BLOGGER, ANDREWSULLIVAN.COM: Well, when you think of all the appalling atrocities and blasphemies that are being committed by Muslim radicals -- I mean, in Iraq, they have attacked and bombed mosques, holy places.

COOPER: And there's no protests about that.

SULLIVAN: They behead these people. There's no protest about that, which is clearly, it seems to me, a blasphemy against Islam as a religion of peace. There are no protests against the most disgusting anti-Semitic Nazi cartoons published all the time in the Arab government-run media.

But this, which was entirely innocent exercise of freedom of speech, which was in the first place done to protest the intimidation of free writers from exercising -- an artist from exercising their right to depict the prophet Muhammad in a free country, is really intolerable.

COOPER: What does it say about -- and maybe it doesn't say anything -- but, if it does, what does it say about the Muslim world's ability and willingness to look at itself and to critique itself?

SULLIVAN: Well, it's hard to generalize about the Muslim world altogether. It's obviously a very diverse community. And it's very gratifying to hear many American Muslims, many British Muslims, and Western Muslims saying, "These people don't represent us."

At the same time, this appalling violence and intimidation is not just appalling in itself. It's an attempt to intimidate everybody who writes or draws or has any form of expression from discussing and talking about Islam and talking about the subject on the table. And that's what's so alarming about this. It's an act of -- it's bullying, basically. And these people are bullying.

COOPER: But those who are demonstrating, some of them will say, "Well, look, it is against our beliefs to have any visual representation of the prophet Muhammad."

SULLIVAN: Well, first of all, that's not true, in the sense that the prophet Muhammad has been drawn and depicted in many, many cultures and in Muslim culture for many years.

But even if it is, so what? We live in the West. We can depict anybody. The cover of "Rolling Stone" right now is of Kanye West dressed up as Jesus Christ. Now, many Christians find that offensive and blasphemous, but they're not killing about it. They can protest, and argue, and debate. That's what it's about. But they're not actually threatening violence, which is why this is so disturbing.

COOPER: So what makes the difference though? I mean, why do some cultures resort to violence and why here is it something that, you know, you might raise your eyebrows about but, you know, you move on?

SULLIVAN: Well, Christianity, for one, has come a long way. And Christianity once had the Inquisition, once had the Crusades, once did treat any sort of blasphemy as a capital offense. But Christianity had a reformation, and the West had an enlightenment, and we have democratic liberal regimes in the West.

Islam has never had that process or it hasn't had it enough. And we need more people within the Muslim world to talk about discussing, for example, the providence of the text of the Koran, who exactly Muhammad was, what exactly they're supposed to believe, to have a debate within the Muslim world and, indeed, outside the Muslim world about what this religion is really about and what it's trying to build in the world.

And right now, we're seeing these images that surely do not give a good impression of what Islam is about.

COOPER: But it seems like anyone who tries to engage in that debate or, you know, tentatively dips their toe in those waters, you know, doesn't end up very well. I mean, Salman Rushdie lived in fear of his life for years.

SULLIVAN: And it sounds as if they are reinstating that fatwa, at least some people in Iran. I think we have to face this down. We have to keep publishing, and writing, and editing, and drawing what we like and how we like to do it, because in the West that freedom is nonnegotiable. This isn't something we can be intimidated out of.

And this is the crux of our civilization, that we are free to debate, and write, and think without fear of violence. And that is what these people are deliberately trying to stop and intimidate.

COOPER: Well, you're also one of the few writers who really focused a lot on the murder of Theo van Gogh earlier. And this is certainly just a continuation of that.

SULLIVAN: There are people in Holland, politicians who have dared criticize, for example, Islam's treatment of women or of homosexuals who have been murdered and people who have had knives stuck in their chests with -- pinned to a note threatening other parliamentarians. There was a woman in parliament in Holland who lives under constant police protection because of these thugs.

It seems to me that one of the things that's problematic is the State Department apologized and said this offense should not be given, that many mainstream media in the West have not rallied to the defense of the Danish paper, in which people are suddenly kowtowing to religious taboos instead of forthrightly defending the right to freedom of expression.

That's what we stand for, regardless of offense. And if you're offended, sorry. Offense and being offended is part of what freedom is about. We're offended, I'm offended, you're offended every day by stuff we see in the media and elsewhere. But that's part of being grown-up, part of being free and democratic. COOPER: Andrew Sullivan, it is, and the article is in "Time" magazine this week. Andrew, thanks. Good to talk to you.

SULLIVAN: Thank you very much.

COOPER: So just three days ago, this Al Qaeda terrorist -- take a look -- was behind bars in Yemen for help plan the USS Cole bombing. Now, after a daring prison break, he's on the loose along with 22 others guys. How worried should we be? We'll talk to Peter Bergen ahead.

Also, the battle over trailers for Katrina victims. In one Louisiana parish, officials are tired of waiting for FEMA. They have taken a step, a bold step, some might say, because of a tangle of red tape you will not believe.

Also, when the war half a world away comes home, too close to home, the students at a Connecticut school are saying extra prayers for injured ABC News anchor Bob Woodward. That's next on 360.


COOPER: Good evening. A brazen prison escape and a race to find more than a dozen Al Qaeda terrorists before they strike again.


ANNOUNCER (voice-over): On the run. The man who put the bombs on the USS Cole killing American sailors, now he's tunneled out of prison with other Al Qaeda members. Tonight, was it an inside job?

Two network stars, close friends covering the war and covering for each other. Now two casualties and one community hurting.

And Oprah honors Coretta Scott King.

OPRAH WINFREY, TALK SHOW HOST: To me, she embodied royalty. She was the queen.

ANNOUNCER: Tonight on 360, the queen of daytime TV on the civil rights pioneer.

From across the U.S. and around the world, this is ANDERSON COOPER 360. Live from the CNN studios in New York, here's Anderson Cooper.



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