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SANJAY GUPTA MD
Examining Medical Mistakes; How to Avoid Common Workout Injuries; Surprising Dangers Lurking in Your Kitchen
Aired March 17, 2012 - 07:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DR. SANJAY GUPTA, HOST: Good morning. I'm Dr. Sanjay Gupta.
This morning, how to avoid surprising dangers in your kitchen. Also, how to avoid the most common injuries you get from working out so we can worry your stake notes, something I paid attention to.
But first, something more important, something that I think can save lives. I'm taking a closer look at a problem that kills some say more than a quarter of a million people every year and maybe totally preventable, talking about my medical mistakes.
In my 20 years now of practicing medicine, hard to believe, I have witnessed things that will stay with me forever. And for two decades, I have been keeping notes on these meetings because I want to learn from mistakes other people have made.
There are stories I wanted to share with the world, but couldn't figure out how to do it. Eventually, I thought the best idea was make it a novel, a fictional version and it came out this week. The book is called "Monday Mornings." In the book, I put my character will no doctor enjoys being confronting errors. For obvious reasons, it is fiction, but the issues that we take on a very real. I mean, the mistakes are often avoidable. That's what I want to talk about today.
And joining me first to help talked about it is my colleague and power patient advocate, Elizabeth Cohen. I mean, you have been talking about these issues for a long time. "The Empowered Patient" book, I read it, it was terrific.
What got you interested in the first place?
ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: What originally got me interested, Sanjay, was some mistakes that happened medically in my own family, to myself and my children, and nobody talks about this. So, I wanted to talk to people to find out what their experiences are.
And that's one of the reasons your book resonated with me so much, because these mistakes really do happen. And by writing about it so beautifully and so openly, I think you are going to help people confront what's happened. Because when it happens as a patient, I mean, you really feel terrible and no one really talks to you about it.
GUPTA: Right. Right. And you know -- and I don't know if you knew about these, you probably did this morbidity and mortality meetings but -- and I read about what happened with your family. But there probably was some version of that, a sort of gathering of doctors. Not lawyers being invited or administrators, but they talk about perhaps what happened in the spirit of not letting it happen again. And also, not letting it happen to other doctors in the room as well.
COHEN: But what's interesting is that patients don't know that. So, something bad happens to you and I have spoken to, you know, probably hundreds of people at this point from across the country, where bad things happen, you don't know what the follow up is.
So, when I was reading your book, I think the person sitting on the plane next to me thought I was crazy because I was like, this is what happened. They sit around and talk about this. I knew about them. I didn't really know about the nature of the meetings. This is the first time I have seen an account of it. So, you really have pulled back the curtain. And I think it was brave of you to show what really happens.
And as a read it, I wonder, the mistakes that were made in the book, are they actual mistakes you have seen over the years or sort of an amalgam of different things?
GUPTA: Yes, a lot of them. Some of them were thing that were, frankly, in the press. I mean, for example, you know even people who had the wrong side of the body operated on. You and I both reported on stories like that. But I sort of told the story from the hospitals and doctors perspective as well. So, you saw it. You saw what a meeting might look like after a mistake like that occurs. And you know, it can be tough inside those meetings. People really can be defensive sometimes. They may use black humor to try and, you know, try to place blame somewhere else.
But I really wanted to give people a sense. And you know, simple things happen as a result of that. I mean, it's unlikely that doctor will operate on the wrong side again. But again, for the other doctors, well, they realize some simple things, strategies to prevent that from happening.
COHEN: These meetings are great and they seem to really help doctors. But, you do wonder, what next steps need to happen so everybody can learn. I mean, if one person makes a mistake, really everybody, not just that one set of doctors should learn from it.
GUPTA: Yes. And they should get that information quickly as well, as opposed to a year or two later.
Let's bring in Dr. Peter. You and I both talked to him in the past. He's a great guy to talk more about solutions. He's director of the quality and safety research group at John Hopkins University.
Welcome, doctor. Good to have you on the show.
DR. PETER PRONOVOST, JOHN HOPKINS UNIVERSITY SCHOOL OF MEDICINE: Thanks for having me, Sanjay, and Hi, Elizabeth. And Sanjay, great book, I loved it.
GUPTA: Thank you very. I appreciate that, sir. You know, Elizabeth and I were just talking, can you help set up just how big a problem medical mistakes are in the first place? We hear a lot of numbers. Again, as what I was saying, hundred thousand was in that report from 1999 that up to 250,000 now. How big of a problem is this?
PRONOVOST: You are right, Sanjay. I think one of the concerning things is we don't know how big of a problem it is. It's a travesty. But what we do know is that 100,000 people die from infections we give them. A hundred thousand people die from blood clots. A hundred thousand die from diagnostic cares. Tens of thousands die from not getting the recommended therapy or from tea more problems. You add it all up, Sanjay, and you have probably the third leading cause of death.
GUPTA: Yes. It's interesting. I mean, and a one thing, you know, with the book, I did not want to make it a hospital populated by super heroes in scrubs. That was not just the point. I did want to talk about things that work to some extent. In the operating room where I work, both Elizabeth and Peter, you may know there, this, but there's a time-out that takes place before and after the operation. Let's look at what it looks like.
(BEGIN VIDEO LIP)
GUPTA: We are about to do a time-out. We got to make sure that it's a new protocol, safety protocol in hospitals. Carolyn is going to make sure everything we are about to do is the right thing on the right patient.
UNIDENTIFIED FEMALE: Everybody time-out.
UNIDENTIFIED MALE: Time-out.
UNIDENTIFIED FEMALE: Has antibiotics been given? OK, we have four units of flood in the room. We have aneurism flipping everything is here, everybody agree?
UNIDENTIFIED FEMALE: Thank you.
(END VIDEO LIP)
GUPTA: And Elizabeth brought up an interesting point earlier. I mean, you see something like that. First of all, does it help? It seems like it would help. But do strategies like that actually reduce some of these errors, do you think Dr. Pronovost?
PRONOVOST: They absolutely do, Sanjay. Medicine has been relatively under standardized. And what you just saw in that video clip was picking out the mission critical steps in the surgery, are planning for the surgery having blood available, giving antibiotics on time, and then confirming they have been done, and allowing a forum to break down hierarchal barriers, so anybody can raise a concern, the surgeon, the nurse, the anesthesiologist. To work together as a team. To make sure the patient gets a safe operation.
GUPTA: You know, Elizabeth, I read about this in your book as well. I mean, you want to empower everyone in the hospital. And, you know, it's funny. I like to think I listen to everybody as a doctor. If a nurse says you forgot to wash your hands or you forgot this, you need to do this, I would listen. But, in your researching and you are reporting, what did you find? Do you -- dark people likely to listen?
COHEN: You know, doctors like Dr. Pronovost, tell me that that's not always the case. There sometimes when a nurse says something or a junior level doctor says something, the head doctors of the attending don't listen, and that sometimes when mistakes happen. And Peter and I talked a lot about that.
GUPTA: I hope that culture changes. Again, I think anybody would say that that doctor she's describing is not me. But, you know, you are absolutely right. And hopefully that culture does change.
Dr. Pronovost, at the end of the day, I mean, there's a lot of people watching who say look, how do I protect myself? How do I protect my family and loved ones? Are there specific tips that you give people if they find themselves in the hospital?
PRONOVOST: Yes, Sanjay. You are absolutely right. There are many things that patients and families can do to keep themselves safe.
The first is when you are selecting a hospital, make sure you select both a hospital and a doctor who does what you are going to go in for a lot. That we know that practice makes perfect and that going to a place that people are familiar with the procedure, you better more likely to have a better outcome.
The second is actively participates in your care. Join rounds with the doctor. Speak up. Ask questions. I know that it's scary for patients. So, it was scary for me when my children were sick. But there's overwhelming data you will get better faster and you get better outcomes.
And then lastly, Sanjay, when you are leaving the hospital, make sure you are very confident that you know how to care for yourself. A great strategy is to read back the instructions the doctors and nurses give you, just make sure you that understand them in your own terms and your own language, not the fancy language we use in the hospital but simple terms so you know exactly what you are going to do to get better.
GUPTA: You know it was good advice. I mean, anybody could suddenly find themselves in the role of patient. And I always tell people that. Even if you are young and healthy, it's a really good advice.
Dr. Peter Pronovost, as always, thanks for joining us.
Of course, my colleague, Elizabeth Cohen, as well. Great stuff, important stuff. Thank you so much.
And coming up, we are putting your kitchen under the micro scope. How to avoid hidden toxins? It gets dangerous sometimes when I'm in the kitchen. We got good tips from "this old house." Stay with us.
GUPTA: We are going under the micro scope this morning, toxic America. Today, we are going focus on your kitchen. No, there's no way to completely eliminate harmful substances but there are a lot of ways and minimize your exposure by finding alternative products and practices.
Here to help us, "this old house" senior editor, Deborah Snoonian. Thanks for joining us.
DEBORAH SNOONIAN, SENIOR EDITOR, THIS OLD HOUSE: Thank you.
GUPTA: It gets more dangerous in the kitchen simply by my presence often.
SNOONIAN: I'm sure that's not true.
GUPTA: This is something that everybody needs to pay attention to. Not just talking product that is can be harmful but what you can do instead.
SNOONIAN: Sure, yes. There are everyday things that we use that sometimes just have, you know, a potentially harmful side effect. So, we are going through alternatives this morning.
GUPTA: Pans. I like the Teflon because it's easier to cook when I did cook.
SNOONIAN: It's very easy to clean up. The concern is with older Teflon pans, ten years or more older. They were made with a chemical class coat (INAUDIBLE) compound and these have linked to birth defects and reproductive problems.
So, if you have 10-year-old Teflon pans, it's probably time to get rid of them anyway. Now, newer Teflon is actually has been deep safe, but if you are concerned, you can use stainless steel with a cooking spray, you are going to get same effect.
GUPTA: What about cleaners. You like the smell of ammonia, it feels like you have actually gotten your kitchen is clean.
SNOONIAN: That's true. And you know, things like ammonia and chlorine bleach, these are just -- these are harsh synthetic chemicals. And ammonia in particular can be very irritating to the eyes, the throat.
SNOONIAN: Really, the danger is, particularly with chlorine bleach and ammonia, if they accidentally mixed, they form a toxic gas. So, just be -- you have to be careful about that. And it's better to look for alternatives. There are all kinds of commercial cleaners on the marker that are labeled VOC free, phosphate free, Chlorine free. These are little easier and alien or health but on the environment. And -- so, they are always good options. And, you know, in the kitchen, we often have, you know, lemon juice, white vinegar, baking soda. You can actually make cleaning products out of these.
GUPTA: What about dish washing soap. Because this one I was a little bit surprised by this. You say the antibacterial dish washing soap, may not be a good idea.
SNOONIAN: Well, the antibacterial soaps, and you may know this from your background, there are really developed to kill germs in a hospital setting, not in a home setting. And they do this with a chemical called triclosan (ph).
GUPTA: That's right.
SNOONIAN: Now, the studies are showing that bacteria are actually becoming resistant to it. So, the more that we use these products, the less they work. And frankly, the stronger the germs become.
SNOONIAN: So, in your household, you are perfectly fine using regular soap and water. Studies show and doctors agree, it's just as safe and kills germs just as effectively at home as antibacterial products.
GUPTA: Here, you are describing resistance which could be problems for large communities and people not just individuals.
SNOONIAN: Exactly. It can be a public health problem, exactly.
GUPTA: Can fruits and vegetables, things like that, again, these products develop because they are so easy to use, people like it because of that, but, what about the canned foods?
SNOONIAN: Well, canned foods -- vegetables in soups in particular, the cans align with in a plastic that contains EPA. This is something that's been in the news a lot lately.
SNOONIAN: It's a class of chemical that is are endocrine disrupters. Meaning, they mimic our body's hormones and that can lead to health problems, you know, they have been linked to higher incidence of heart disease, problems with the reproductive system, with your thyroid.
And so, really, there are good alternatives here. If you are buying soup, you can look for soups packaged in a tetra pack paper box that does not have the lining. And you can also, you know, rely on frozen vegetables instead of canned. Of course, you can always buy fresh. You can always, you know, cook your own soups and such. But there are, you know, there are convenience products out there that don't, you know, that don't have this concern.
GUPTA: And there is that option, right, to actually go buy some real food.
SNOONIAN: Always, if you have the time.
GUPTA: Thanks so much.
SNOONIAN: Nice to see you. Thank you.
GUPTA: Yes, thank you. I really appreciate it.
I'm going to have much more in terms of tips next week as well right here SGMD about making your entire home as healthy as can be.
Carter in HDTV, you know him. He is going to show some pretty simple changes you can make inside your house to try and breathe easier.
But, up next right here this morning, the most common sports injuries. These are problems anyone can have. I have had them myself. Now it's time to show you how to avoid them. Stay with us.
GUPTA: A little update now on a fit nation challenge participants.
You know, Glenn Keller, he came to Atlanta for the kick off weekend last month. He weighed more than 300 pounds, you remember him. That extra weigh took its toll especially when we all climbed the mountain. By the end of that hype, one of Glen's hamstring was really hurting him. Our trainer did try to help him with some stretching and he was gradually working himself back in the shape. We are also happy that bother Glen has now lost more than 20 pounds. He's stretching after every workout and says hamstring feels better.
It's a perfect segway to my next guest. He is Dr. Jordan Metzl. In his sports medicine practice, he sees patients like Glenn all the time. And you know, we have got few things in common. Among them, you have a book out which is a great book. It's, you know, the athlete's book of home remedies. This should be on everybody's shelf, especially, if you are thinking about athletics. Thanks for being on the show.
JORDAN METZL, SPORTS MEDICINE, PHYSICIAN, THERAPIST FOR SPECIAL SURGERY: Great to see you, Sanjay. Pleasure to be here.
GUPTA: I have to ask about Glenn right away. Stretching the way he was doing there, is that something you recommend? What is the skinny on stretching?
METZL: In the book, I go through how to make your body active and keep active. And somebody like the guy you talked about, Glenn, he is, you know, really fighting with his weight and trying to be active. So, stretching is helpful. Strengthening is more helpful. And what I try to do is teach people exercises to strengthen their muscles do they can do activities like climb stone mountaineer to do whatever they want.
GUPTA: You know, the thing that people always seem to worry about when I talked to people, I'm sure you do as well that I can't do that, I'm going to get injured, I'm going to hurt myself in some way. What are things people can do to prevent injury? METZL: That's right, Sanjay. So, the key is to really build the muscles around the joints. Your anatomy, your bony anatomy is basically fixed. If you have arthritis, or you have bouncing disk in your back, that's kind of who you are.
And what we want to do is say, listen, that's who you are. But if you use that as appear excuse not to exercise because your knee aches and your backaches, you're never going to do anything. So I want you to basically set yourself a goal and then make your body the strongest body you can have so you can do that goal and meet this goal.
GUPTA: You know, what I like about this book, Jordan is that, is people say that kind of stuff all the time. You really have a lot of examples and pictures, as well, of how to do these types of exercises. I think that really helps. And you, you know, you practice what you preach.
I got to say, you and I both know a lot of doctors who are perfectly fine preaching this stuff but don't do it. I mean, so tell us, you've done, what, nine iron mans now, is that right, 29 marathons? How do you do it? I mean, -- you are a busy guy as well. How do you stated all it?
METZL: First of all, I believe that people make goal and so, I'm a huge believer in goal setting. And for me, it's doing the iron man or maybe. For somebody else, maybe climbing a mountain or doing a 5K walks.
But I think that key is, that fitness and setting a fitness goal for yourself is so hugely important. And fitting it all in is just, you know, scheduling at the way you can make it work. The thing I like about what I've tried to do in the book, anyway, is to give people examples of things they can do at home so they don't have to go to the gym and buy a trainer. They can do the exercises we have at home.
GUPTA: If someone is, feels like they're injured, or they are hurting in some way, how do they know, you know, look, a home remedy is not enough that actually need to make a doctor's appointment?
METZL: That's right. So, I really triangular to every -- pretty much every injury that I see. What's the injury? Your knee hurts, your back hurts. What can you do? If that's not working, what kind of doctor should you see and when should you see the doctor? And lastly, if you need surgery, how do you make that decision, as well.
GUPTA: You know, the other question, people talk about simple things, like ice versus heat, for example. Best strategy.
GUPTA: If you have a sore knee or sore ankle or something after a run, best strategy?
METZL: Yes. So, the ice is a major inflammatory. So, icing for about 15 minutes is great. You know, cold plunge if you can tolerate that, most of us can't. But, I like frozen vegetables like peas because nobody eats them because they kind of nasty in the freezer. Those can -- a great way to ice them down in the freezer. About 15 minutes after exercise if you're achy helps a lot.
GUPTA: Broccoli, do you like broccoli?
METZL: I think I'm more likely to eat broccoli.
GUPTA: You know, I'm going to keep this book. I really appreciate that you wrote it. But I think that, you know, again this whole idea that we need to practice what we preach, that people watch you, they watch me, and hopefully, you know, they'll start doing some of this on their own. So, appreciate it.
METZL: Exercise is medicine, you know?
GUPTA: It is. It is. Food can be, as well, maybe not peas, but lots of different foods.
Dr. Jordan Metzl, thanks so much.
And great tips, obviously, to keep you fit and injury free at any age. I hope you will follow some of them. After the break we have been another inspiring story of a fisherman who proves you're never too old to learn. We'll explain. Stay with us.
GUPTA: Welcome back ON "SGMD."
Imagine hiding something from your family and your friends your whole life, something you know would change the way they thought about you. And then one day in your 90s you decide to come clean.
GUPTA (voice-over): For 90 mostly sea faring years, Jim Henry harbored a secret. The lobster man and fishing boat captain couldn't read or write.
JIM HENRY, AUTHOR, IN A FISHERMAN'S LANGUAGE: I was so ashamed at myself that I never told anyone.
GUPTA: Growing up with a strict Portuguese father, Henry was put to work as a young child. His father didn't care about school so Henry seldom went to class.
HENRY: I didn't learn a thing. I did know nothing, absolutely nothing.
GUPTA: And yet his teachers kept promoting him to the next grade. Henry eventually dropped out of school, kept working. He got married and he used street smarts to get by. His wife knew he couldn't read a word. Friends and family had suspicions, but never asked.
It wasn't until his wife became ill that he finally openly admitted he was ill literate. I said, I have to do something. I said I can't go on all my life this way. GUPTA: With the help of family and friends, Henry began to teach himself.
MARLISA MCLAUGHLIN, JIM'S GRANDDAUGHTER: He went through the entire dictionary from back to front reading.
GUPTA: Studies show as the human brain ages, it becomes more difficult for someone to learn a new skill, especially at the age of 90. But Henry thought time must be running out so he hired a tutor to help him. And two years later, He succeeded.
But Henry decided to take it a step further. He had all these stories in his head with no way to pass the alone. So, now armed with a written word, he put them in a book called "in a fisherman's language." It's a reflection of his life. He published it at the age of 96 that become very popular especially among people with learning disabilities.
MARK MORGAN, JIM'S TUTOR: I always thought that he would draw on something in his life. I never realized that this would happen, that this book could be so popular.
Today, Henry shakes his head when someone calls his an author. It's hard for him to process the last two years. But he says it's been a journey like no other.
HENRY: Here I am.
GUPTA: And just one month from Monday, April 19th, Jim Henry will turn 100. Jim is chasing life to 100. And he is so close. He says one of his secrets is getting eight hours of sleep every single night. That's pretty good advice. It varies from person to person, but most people need seven hours. Chronic sleep deprivation can cause you a year of life, the side effects as well.
Sleep deprived people for example, on average, eat an extra 300 calories a days. I know, some nights it's tempting to miss some sleep. I grabbed that rest if you can.
Speaking of chasing life, you know, we measure our lives in different ways. Sometimes we think about our life linearly, sort of from beginning to end. But most of us think about our lives in a series of moments. I think that helps me chase life.
One of the things I wanted to share with you is introducing you to my own mother and father who for years have been helping me to chase life. You know, it's interesting, we're in town this week for a book party and my parents were nice enough to come, as well, and join me on the set. It's a moment I'll never forget. So, you know, hug your mom, hug your dad. That will help you chase life.
Have you got any great tips? How do you guys -- you guys look great. How do you keep chasing life? SANJAY GUPTA'S MOTHER: We've been retired over ten years now and have been enjoying the sons and the two beautiful daughter-in-laws and three granddaughters and fourth one on the way.
GUPTA: Not me, my brother.
SANJAY GUPTA'S MOTHER: Fourth one on the way. So we are very happy.
GUPTA: Dad, have you got any advice.
SANJAY GUPTA'S FATHER: Wonderful. Life is wonderful.
GUPTA: Life is good. That's the way you chase life. Keep that attitude.
Thanks for joining us and we'll see you back next week.