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SANJAY GUPTA MD
Dr. Sanjay Gupta Interviews Doctors and Medical Personnel that Triaged Victims of Tucson Shooting and Operating on Congresswoman Giffords; One Year After a Devastating Earthquake, Haiti Recovery is Assessed
Aired January 15, 2011 - 14:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Six people died in this horrible tragedy as well. I got a chance to sit down and talk to several survivors exclusively and hear details about what happened to them and the medical care that they received. Their stories are something I'll never forget.
And I also talk to Congresswoman Giffords' doctors about what exactly happened with her when she arrived at the hop and how they got her the care so quickly. Let's get started.
(BEGIN VIDEO CLIP)
UNIDENTIFIED FEMALE: Hard to believe that Gabrielle Giffords was shot.
GUPTA: According to witnesses the attacker just walked up and shot Congresswoman Giffords at point-blank range. It was ten after 10:00 in the morning and the gunfire as over almost as soon as it began. The damage in that shores burst was horrifying -- 19 people hit with bullets, six dead. Within a minute, 911 was ringing.
UNIDENTIFIED FEMALE: 911, where is your emergency?
UNIDENTIFIED FEMALE: My husband just called me and told me he was shot.
UNIDENTIFIED MALE: Shots fired.
UNIDENTIFIED MALE: There are multiple victims due to gunfire.
GUPTA: A young aide to Giffords had medical training.
DANIEL HERNANDEZ, CONGRESSWOMAN GIFFORDS' INTERN: I picked her up so she wasn't in a position where she could asphyxiate in her own blood because of the position she was originally in.
GUPTA: And kept pressure other than the wound to slow the bleeding. About ten minutes after the shooting, paramedics were there to help, and 20 minutes after that the ambulance pulled up the at the university medical center.
(END VIDEO CLIP) GUPTA: We now know that Congresswoman Giffords was brought here. This is the largest level one trauma center in the area. The first doctor to see her was Dr. Randall Friese. We'll talk to him right now.
DR. RANDALL FRIESE, CRITICAL CARE SURGEON: So it was about 10- something. I was in my office ready to have my day and the pager goes off, multiple trauma patients.
GUPTA: What did they say?
FRIESE: It was a text.
GUPTA: "Multiple traumas on the way."
FRIESE: Coming on this alphanumeric text, "multiple gunshot wounds" that's all I got. Then another text said "gunshot wound victims 10." And I just said I need to go downstairs.
And the first thing I did, walked in the room. I think I said this before, but my first response, I grabbed her hand, leaned into her and said, "Ms. Giffords you're in the hospital. We're going to care for you. Please squeeze my hand." And she did.
GUPTA: Is she -- a wrap on her head? Can you see the wounds at this point?
GUPTA: You have some idea what the obvious wounds are but look at rest of her body for another gunshot wound, right?
FRIESE: That's part of the trauma evaluation. You never assume all you see is all that's present. I saw the severe head injury, blood loss. Eyes closed. A blackened and swollen right eye and she was -- she was grunting a little bit. I got the impression she was trying to communicate but was being frustrated by the fact she could not.
GUPTA: They had put IVs in her already in the field?
FRIESE: Yes. We always put new IVs in here. I think we were putting groin IVs because of the severity of her blood loss and need large IVs, we put in several lines.
GUPTA: Talk about trauma. People talk about a, b, c. You're here now, she's grunting but clearly following commands. You're positive of that. What's your next move?
FRIESE: Incubate this patient. People began to prepare for that, get the tools necessary. After I leaned in and spoke to her I wanted to assess her before we gave her an anesthetic, and that was an important to do. Squeeze my hand. She did. I reached to the other side, squeeze my hand, and she wasn't able to. I explained we were going to give her an anesthetic. GUPTA: She was able to squeeze on the left hand, not on the right.
GUPTA: We know what occurred in 38 minutes from the time the congresswoman got to the hospital, she was in the operating room. These are the first crucial minutes. You asked her to squeeze the hand. She squeezes on the left side not the right. See an obvious injury. Ask her, breathing tube in place and then what?
FRIESE: We had to Finish our evaluation, a chest x-ray, roll and examined completely looking for any other possible wounds.
GUPTA: How long can you go from here to get a CAT scan?
FRIESE: The CAT scan is around the corner.
GUPTA: Comes through these doors around the corner. All a few minutes, we're talking about, right?
GUPTA: After the CAT scan, the neurosurgeons are present?
FRIESE: Yes. He was relaying the findings and we were all in agreement this patient needs to go right to the operating room from the CAT scanner. The nurse here suggest we do an IV contrasted head scan, an additional test so that added a few extra minutes.
GUPTA: Now the congresswoman is in the CAT scanner, obviously, a gunshot wound to the head. What's the level of tension among the team?
FRIESE: All focused on getting patient what she required. While the patient was in the cat scanner I left for probably a few minutes to assess the new patients arriving. Giving direction, what this patient would need, what that patient would need. Come back to the cat scar scanner on the phone with Dr. Lemole and Dr. Rhee.
GUPTA: Were you triaging the whole time? If somebody came in that needed neurosurgical care that was more dire, what would you have done at that point?
FRIESE: I would have done the same thing. If someone needed more critical care, the doctor position is go to the operating room. They will come to the operating room.
GUPTA: Next, I'm going to talk to Dr. Peter Rhee who was overseeing all the care the day of that horrible tragedy. Exactly how did he take care of patients? We'll ask him.
DR. PETER RHEE, TRAUMA SURGEON: What he did, called me and said Congresswoman Giffords is one of these. You want to get here right away. When I got here, funny, because we had literally I think about 80 people in here and they were all residents and pending and trauma pending and everything, and there were in less than a minute, quick update and brief.
The ED physicians and attendants also heard about this and starting calling each other. The guys who were supposed to come in earlier just did. We just had plenty of people.
GUPTA: When did you talk to her husband for the first time?
RHEE: That day.
GUPTA: After the surgery?
GUPTA: What exactly did you tell him?
RHEE: Well I mean, I think for me, I knew when I was called and told what was going on that we were going to be good to go. You know?
GUPTA: You knew?
RHEE: Yes. She wasn't going to die. She was alive here communicating.
GUPTA: When you walk into the operating room, she's got arterial line, central line that goes into one of her big blood vessels.
RHEE: Already incubated.
GUPTA: A breathing tube in, asleep.
RHEE: Anesthesia, the gases.
GUPTA: And they're started. Starting the operation?
RHEE: Yes. The residents there are prepping and so -- so going to the operating room that quickly means she hasn't blood bled out and for her to be squeezing hands, 30 minutes ago, I think I can get her back at least to that state. So I was more concerned about disability later on but not whether she was going to die.
GUPTA: At no point were you worried about that? At any point since this all happened almost a week later?
RHEE: I was actually kind of excited about the fact we have somebody with a head shot that's going to survive and might have a good recovery.
GUPTA: A couple hours after the surgery you came out and said "I'm as optimistic as I can be."
GUPTA: That's a strong statement.
RHEE: I don't think so. I don't think so.
GUPTA: Someone had just been shot in the head.
RHEE: I didn't think so then. I mean --
GUPTA: You were confident?
RHEE: Yes. This wasn't, you know, went through, side to side. She didn't come in densely comatose. It was not an organ donation, going brain dead or anything. I know things can go backwards but I know my system and we'll get her back to the way she was when she went into the OR at least.
GUPTA: Dr. Peter Rhee, the chief of trauma surgery here at the University Medical Center.
When we come back, we have exclusive access to the husband of Congresswoman Giffords. He's a captain, Captain Mark Kelly, a pilot. We'll talk to him about how he found out about his wife and how he thinks she's doing.
And also Dr. Lemole, chief neurosurgeon, what exactly happened in the emergency room and what are his predictions for recovery? Stay with "SGMD."
GUPTA: We are back with "SGMD." I had a chance to sit down and talk to the husband of Congresswoman Giffords. His name is Captain Mark Kelly. He is a pilot, a Navy pilot, and also an astronaut, actually planning a mission to go into space.
He told me some remarkable details. First of all, he was in Houston when this all happened. He got call from the chief of staff from the congresswoman's office who told him basically his wife suffered an injury. He got on a plane, a private plane as it were, and was here in Tucson, Arizona about 45 minutes after he got on that plane. So he got here very quickly, right around the time his wife was being taken into the intensive care unit. Imagine what a difficult plane ride that must have been for him.
When he arrived he was take boon a private room and Dr. Lemole and Dr. Rhee both came out to speak to him, basically giving him details for the first time what exactly happened to his wife, telling him she been shot in the head. Although also painting an optimistic picture, Dr. Rhee did, specifically what had happened and how he thought she was going to do.
And I'll tell you Dr. Lemole paint add different pick color for Captain Kelly. According to Mark, Dr. Lemole said count on the fact she's going to have backwards days where she moves backwards, where things aren't going to go well. And then Captain Kelly looked at me and said, we haven't had those days yet. It seems like a miraculous thing.
Speaking of miraculous things, she opened her eyes right around the time the president was visiting. A lot of people talk about that. Captain Kelly was in the room and said he doesn't strike me as the kind of guy who uses the world "miracle" easily. He said it truly was a miraculous thing that she opened her eyes had a sense of was going on around her.
I asked her, does she know the president of the United States was visiting her? He sort of paused for a second and said, well, I think she did. I think she really did know that the president was visiting her, but she wasn't sure why. That was the sense that Captain Kelly left me with in terms of what her mental state is now.
She was able to dangle her feet over the side of the bed today, move both right and left leg. It's a little unclear just how well she moving her right arm. One the beg areas of concern that Captain Kelly talked about along with his doctors, might she have right arm weakness, difficulties with her speech?
It was also what I talked to Dr. Lemole about, chief of neurosurgery who operated on her. He gave me some insight what happened that day in the operating room and how he expects things to go from here. Take a listen.
GUPTA: I think people are generally surprised as a starting point someone could even survive a gunshot wound to the head. How often has that happened?
DR. MICHAEL LEMOLE, NEUROSURGEON: It's similar to the literature, which is when you have a bullet enter not just the skull but traverses the brain, probably five percent, 10 percent survive.
GUPTA: Do you have a plan in your mind, an idea what you want to accomplish?
LEMOLE: Sure, absolutely. The things that will get you in trouble in this case are bleeding uncontrollably. So if that bullet cut a major artery in the brain, that's hard to clean up that kind of trouble. And fortunately, here, that was not the case.
And then, of course, the brain swelling we worry about. Our goal is not to try and reverse any the initial damage. We can't fix the damage caused by that bullet, but we can stop secondary damage.
And, again, for disclosure, we all know we're talking about the left side. We're talking about potential injury to speech and right side strength or sensation. But when operating, again, the whole idea, it's hard to tell what brain is going to come back online and what brain has been damaged. It all looks pretty bad. There's sometimes clearly dead brain and sometimes very clearly alive brain but a whole spectrum in between. We just basically have to respect it all.
GUPTA: One of the big concerns you talked about is brain swelling. LEMOLE: Correct.
GUPTA: I think back when we were both residents, we did this operation from time to time called the hemi-craniectomy, taking off half of the entire skull. Sometimes for strokes or people you thought would have uncontrollable swelling.
GUPTA: In this case what made you think about it? First of all what was your decision process?
LEMOLE: Once we've taken the bone off. You have to do that to inspect for bleeding.
GUPTA: Taking bone around the --
LEMOLE: This is a perfect example. This patient had a hemicraniectomy. This is not the congresswoman's. We're constantly looking for whether the brain is starting to swell out on us. Actually it is at this point. We had to do maneuvers. We learned in residency the maneuvers to think about when the brain starts swelling.
First, raise the head. Let gravity start to let that brain relax. We did that. And fortunately that was enough.
GUPTA: Do you feel she understand all that happened to her?
LEMOLE: I'm starting to think so. It's -- it's really -- I was there when the congresswoman and the senator were in the room. And to see her open her eye and look at themes there's no question in my mind. And she's done that for her husband as well. Those glimmers of recognition, that tracking ever the eyes tells you a lot more. That she is aware of surroundings to some extent coming in and out and trying to engage that reality as well.
GUPTA: Do you think she knows she's been shot, though?
LEMOLE: Hard to say. Hard to say. There are times she reaches up to her breathing tube, or maybe even to her head, and I wonder if she's trying to understand why she's the way she is.
GUPTA: The chief of neurosurgery Dr. Lemole there explaining a little about what happened to Congresswoman Giffords. He'll keep an eye on her.
But there was another big story was in the news, something that has been close to my heart, and It's the one-year mark of the earthquake in Haiti. How exactly are things going down there? Sometimes there are glimmers of hope. We found a couple of them we want to share with you. Stay with "SGMD."
(COMMERCIAL BREAK) GUPTA: We're back with "SGMD" outside University Medical Center. A makeshift memorial is going on behind for so many victims of the horrible tragedy here.
There was other news, though, the one-year mark for the big earthquake in Haiti. It's something we talked about a lot and as we've done stories over the last several moss we found stories that offered people a lot of hope as well.
My paih intersected way 12-year-old girl in Haiti. What her story represents is not only a country in collapse, but the hope of a country to rebuild as well. Take a look.
GUPTA (voice-over): January 18, 2010. We got a call. Come quickly. A 12-year-old girl broken by the rubble, cement embedded in her brain. The U.S. military asked me to help. A month later, we received word Kimberly is alive, doing well, and in fact ready to go home. It was time for a follow-up visit, a house call.
GUPTA (on camera): We expected her father to actually come leer and meet us for this reunion, but we're told he didn't have enough money to get transportation to come down to this port. So instead the rescue worker who helped rescue Kimberly was going to come and collect her and take her back to her father.
GUPTA (voice-over): Kimberly was healed. It was so good to see that smile. Aboard the world class "USS Comfort," just a typical 12-year- old, showing off all the new toys she's received. Truth is, I wish I could end the story right here, but that would be unfair to Kimberly and thousands more like her.
This is part of what happens here in Haiti. You know, Kimberly obviously is doing well medically, but now this is really about the rest of her life and what's going to happen to her, how she recovers from all this. They used to have a home, now they don't. He used to have a job, now he doesn't.
What we're looking at was her new home, her recovery room. Confusion sets in. Her eyes shift with the tragic realization. You see, because she's been in the hospital the last month, she doesn't even remember the quake, the quake that she now learns took away her home, her sister, her mother.
This was a remarkable day for Kimberly. Full of moments like this. But the image I'm left with is this one, a young girl with a brain operation room struggling to recover in a place, in a country so devastated.
A year later I had no idea what to expect or even where to find her. We ended up finding her living here, in temporary housing in Port-au- Prince. You could tell right away she gained weight and those painful reminders of what happen add year ago where they had healed.
She's making progress in other ways as well. She's now one of the 50 percent of Haitian children attending school. Her goal, to be a doctor and help save kids. Today Kimberly is optimistic about her future, and after we saw her, so are we.
So good to see Kimberly doing so well.
Coming up, we're going to take you to an orphanage that is literally down to its last bag of food. So what happened to you all money that you gave? We're going to tell you. Stay with "SGMD."
GUPTA: We're back with "SGMD." Here's a statics for you, about one in two Americans actually gave money to help relief efforts in Haiti, about $5 billion around the world, to try and help the million people homeless and 350,000 orphans still living in Haiti today. Yet there are children still starving, children still so malnourished.
So what happened to all the money? I'm going to show you what a few dollars can do in Haiti. We saw it with our own eye, thanks to you.
GUPTA: Hard forget these faces. We first met them six months ago, smiles amid squalor, 350,000 orphans, best guess, and many like this little guy don't even have a name.
GUPTA (on camera): You know how old he is? He's an orphan in this orphanage amid lots of other children, 40 to 50 at any given time, that's how many kids are being taken care of. Look at this particular building. Just look at the floor over here. That's where they sleep. There are no bedrooms. Find a place, and sleep for the night.
GUPTA (voice-over): This is the kitchen. For all those children, this pot of beans is their food for the entire day. Simply not enough. I decided to call a contact of mine.
ERIC KLEIN, CAN-DO.ORG: Hello.
GUPTA (on camera): Eric, it's Sanjay.
KLEIN: Hey, Sanjay. How are you?
GUPTA: We got some happy kids.
GUPTA (voice-over): Eric is with Can-Do.org. He found a warehouse full of supplies willing to stock a truck full of food. Since then Can Do has received donations from CNN viewers, they took that money and stocked up on supplies and hired locals to revitalize the orphanage. Today for less than $6,000 the kids have new beds to sleep in, electricity, for the first time, a kitchen.
KLEIN: Kitchen cabinets maybe cost us around $500 just for the material. This is a water filtration system. Pour the water in here, it filters clean water through. GUPTA: The thing about all of these changes is they didn't take very much money -- $20 for buckets of paint, $60 for cement floors, A few hundred for the beds.
KLEIN: Two bathrooms, plumbing, septic.
GUPTA: So a total of two bathrooms for under $400. But despite all think, the kids are still living on the edge. Remember, this little guy? He's no longer on the floor. We found his new bed. But it was empty. He was so malnourished he was taken to the hospital for care.
KLEIN: This is what they have for food here.
GUPTA: Once more down to their last bag of rice and beans. One year later, an orphanage of kids still smiling, but still waiting for something as basic as a regular meal.
GUPTA: Watching that, you're probably inspired and frustrated all at the same time, but it is the reality of the third world, supplies getting into the country but unable to get to the people who really need it. It can be frustrating.
You see people at their best and at their worst, just like we saw here in Tucson as well. We saw some real heroes among the horror. And I want you to think about those still in the hospital behind me and hopefully keep them in your thoughts and prayers today and tonight.
That's it for now. More news on CNN continues in just a moment.