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SANJAY GUPTA MD
Pain Without Bills; "God Has Given Me This New Life"; Playing Doctor
Aired February 10, 2013 - 07:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DR. SANJAY GUPTA, HOST: Hello, and thanks for joining us. I'm reporting from London this week. You can see the Tower Bridge over my right shoulder.
We want to start with big news with Malala, the teenaged girl who was shot Taliban gunmen for the simple crime of going to school. She just came through a critical operation.
Also, a lesson about tea. I love it. But what are the real health benefits?
Plus, an interview I did back home with "Monday Mornings" star actors Ving Rhames and Alfred Molina. They're going to talk about what it's like playing the role of surgeon.
Let's get started.
Now, as you may know from watching this program, in the United States, there is an epidemic of accidental overdoses from prescription pain killers. In fact someone dies every 19 minutes. I can tell you, those numbers, they astonish doctors here in the U.K.
So the question is, is there a British way of treating all sorts of pain that is safer?
GUPTA (voice-over): The problem this part is that here in the United States, we are being flooded with pain killers. Consider this: Americans take 80 percent of the world's pain killers, 80 percent. So how did we quietly become a country inundated with pain pills?
Some believe it all began when pain was designated the fifth vital sign.
DR. BILL HURLEY, MEDICAL DIRECTOR, WASHINGTON POISON CENTER: I think physicians around year 2000 started to get pushed to better manage pain and the physicians in our culture, that means give out more medication.
GUPTA: Doctors prescribe the drugs for legitimate reasons, but also for conditions that could be treated with much milder medications or with therapy. The result? We prescribe enough pain pills to give every man, woman and child a dose every four hours for three weeks. Remember, 80 percent of the world's opioids are used by Americans.
(on camera): Eighty percent, is that a cultural problem?
WILLIAM J. CLINTON, FORMER U.S. PRESIDENT: Yes. And I don't minimize -- there are a lot of people who live courageous lives in constant pain. But there's no question that since we represent 5 percent of the world's people, we got no business popping as many pills as we do.
GUPTA (voice-over): Problem is, misuse is rampant. In 2010, about 12 million Americans reported using painkillers without a prescription or a medical need.
(on camera): The thing is this flood of pain pills, the seemingly careless use, it doesn't have to be this way.
Here in the United Kingdom, opioid use per person is less than half of what it is in the United States. So why the difference? Some say it starts with the doctor doctors.
DR. ANTHONY ORDMAN, CONSULTANT IN PAIN MEDICINE, ROYAL FREE HOSPITAL: Narcotics are the very last option pretty much.
GUPTA (voice-over): Dr. Anthony Ordman founded the pain management clinic at London's Royal Free Hospital.
(on camera): When you give a pain prescription to somebody, tell me what you tell that patient?
ORDMAN: You must please stick to the dose I've prescribed for you. And you must not escalate it without medical permission. You must keep the medication locked up and safe so that nobody else can get their hands on it. You will please not lose your prescriptions because I'm not going to replace them. You are responsible for this powerful medication I'm giving you.
GUPTA (voice-over): But it's not easy. Some say the controls are too tight. And patients might suffer -- patients like Ian Semmons.
IAN SEMMONS, FOUNDER & CHAIRMAN, ACTION ON PAIN: I spent nine months in hospital and then 12 months in a rehab center where I was basically rebuilt. But nothing was done to treat my pain.
GUPTA: Ian broke his back, shattered his ankles and injured his head when he fried to stop a robbery in central London more than 20 years ago.
SEMMONS: When I came round, the pain, I had never experienced such pain as that. Don't know what to do with it.
GUPTA: Simmons founded the group Action on Pain to help other patients navigate the system.
SEMMONS: The services within pain clinics vary considerably within the NHS.
On this side of the road, I wasn't able to get the medication from the G.P. I've been on it for a long time and it was working for me. So I changed GPs and I went to one between miles across the road here and was prescribed the medication without any problem.
GUPTA (on camera): It can take up to 18 weeks before Dr. Ordman sees a patient who's been referred to his clinic. These wait times can be quite long.
GUPTA: And I'm sure patients get very frustrated and may even suffer during that time.
ORDMAN: Yes, yes. Well, that is true.
GUPTA (voice-over): But he also says patients may fair better in a system where doctors work on a set salary.
ORDMAN: In most sectors of medical practice in this country, the patient is not paying the physician. That takes away certain influences that the patient can have on the physician's thinking.
GUPTA (on camera): It sounds like you're suggesting, because of the financial incentives, that doctors may be more likely in the United States to write a prescription because they don't want to lose that patient.
ORDMAN: Well, I just feel that that may be part of the picture.
GUPTA: Now, there is something else that may surprise you. I bought this 400 count bottle of acetaminophen at a drug store in the United States. But here in the U.K., bottles like this simply don't exist. If you need over-the-counter pain relief, this is what's available, just 16 pills.
(BEGIN VIDEO CLIP)
GUPTA: Now, would it surprise you if I told you that I bought this, 400 Tylenol, 500 milligrams each, 400 Tylenol, in one fell swoop?
HOWARD SILVER, PHARMACIST, GATEWAY CHEMIST: May I have a look?
It frankly would astonish me.
GUPTA: It's just --
SILVER: It's a bottle of death.
(END VIDEO CLIP)
GUPTA: Buy more than 16 pills and you need a pharmacist's approval. And even then, the most you can buy is 32 pills.
You know, there was also big news this week regarding Malala Yousafzai. As you remember, she is a human rights campaigner from Pakistan. She's just 15 years old.
In October, she was shot point blank in the head by Taliban militants. And she was left for dead. Her crime was telling girls to go to school.
Now, she survived and was flown here to England where doctors have performed a critical operation.
MALALA YOUSUFZAI, PAKISTANI TEEN ACTIVIST: I have rights. I have the right of education. I have the right to play. I have the right to sing. I have the right to talk. I have the right to go to market. I have the right to speak up.
GUPTA (voice-over): It was those words that made Malala a target of the Taliban. In October, she was on her way to school when gunman stopped the van and shot her at point blank range. Amazingly, she survived and was flown here to Queen Elizabeth Hospital in Birmingham, England.
As you can see, the bullet struck Malala in the left side of the head, but then it went into her neck. And if you look from the side, you see the bullet went right by her ear and damaged her hearing. The hand-sized, open part of the skull, that's the part doctors removed so as to relieve pressure on the brain as it swelled.
And in this latest operation, doctors patched that up. They used a custom-made piece of titanium. Malala's skin would go over it, so she'll have a normal curvature to her head.
DR. DAVE ROSSER, QUEEN ELIZABETH HOSPITAL: This is primary to offer physical protection to her brain in the same way a normal skull was.
GUPTA: Doctors also gave her a hearing implant. It won't fix her hearing completely, but they say it will help significantly.
YOUSUFZAI: I'm feeling all right. And I'm happy that the operations are successful. And, you know, it was that kind of success that now they have removed everything from me and I can -- I can also walk a little bit. I can talk. And I'm feeling better.
GUPTA: And for more on Malala's story and ways that you can help her efforts, you can visit our "Impact Your World" page at CNN.com/impact.
Coming up, the exotic world of tea. What's healthy, what's tradition, and what's just weird?
(BEGIN VIDEO CLIP)
RICHARD QUEST, CNN CORRESPONDENT: A nice cup of tea.
(END VIDEO CLIP)
GUPTA: Remember that old song, tea for two and two for tea?
A trip to London just wouldn't be complete without a taste of Britain's most popular drink. And who better to teach me about the tradition of afternoon tea than CNN's very own Richard Quest.
QUEST: How do we hold our cup?
GUPTA: I'm going to hold it like you do.
QUEST: Well --
GUPTA: Now, well, OK. Go ahead. Like this?
QUEST: Right. So --
GUPTA: You want to be able to grab the handle.
QUEST: You take the handle like that. That's -- now, you don't have to have the pinky up.
GUPTA: You don't? I've been doing that for years.
QUEST: You may well have been, but it's not necessarily part of the routine. We have this wonderful phrase. We haven't even had a scone yet. Aah. That's the phrase. Aah, a nice cup of tea.
And when you say that phrase, a nice cup of tea, you are connoting more than just drink.
GUPTA: Aah, a nice of cup of tea, yes.
QUEST: You're often hear people say, oh, I could murder a nice cup of tea.
The important thing to remember about afternoon tea is that it's not just about the sandwiches or the tea or the scones. It's about the occasion. And the nearest analogy I can give you it's like brunch. If invite you to brunch --
QUEST: -- we both know that we're going to have eggs and something. That we're going to have a muffin. And we're going to have -- but that's not really what it's about, is it?
GUPTA: Yes. QUEST: It's about that moment, that sense of occasion.
QUEST: So when I say -- when somebody says come to afternoon tea, you're bringing in an event, a moment. A moment, more tea?
GUPTA: Yes, please. What the heck. Yes.
QUEST: More tea, Dr. Gupta?
GUPTA: So is it the taste you like, the invigoration are there ones that you consider more healthy?
QUEST: No idea. You've got me all confused.
GUPTA: Do you ever think about it in that sense? Because some teas are higher this antioxidants. Is that something you think about?
QUEST: Not in the slightest. I find a herb tea or chamomile in the evening, a ginger maybe in the mid-morning to give a bit of a boost.
GUPTA: Oh, that's interesting. And then a chamomile at night.
QUEST: Yes. But I do find that rose flavored lemon hipped ginger nonsense --
GUPTA: How is that?
QUEST: It's very good.
The other big question of which nobody will ever agree at afternoon tea is which goes on first, the cream or the jam. You cut the scone and you can either put the cream on first and then the jam on top.
QUEST: Or the jam and then the cream. And nobody seems to be able to agree on what it should be.
GUPTA: So this is the cream. Do you care how much cream you put on?
QUEST: Well, I'm sure you do, my cholesterol, but I don't.
GUPTA: Notice how well my scone is cut there, by the way.
QUEST: You're not committing surgery now. You're making afternoon tea.
GUPTA: Just pointing it out. And, is that too -- is that an adequate amount of cream there?
QUEST: No. A bit more. GUPTA: All right, just for you, Richard.
QUEST: Enjoy yourself.
GUPTA: Are there absolute no-nos when it comes to that? Is there anything completely violates the rule?
QUEST: Any type of tea will do. I wouldn't go for coffee. You really should go for tea. And I think the only rule I would say is you've got to enjoy it. You've got to remember what you're about.
You're about -- oh, I needed that nice cup of tea.
GUPTA: You didn't put any sugar in your tea. No lumps. Just because I'm sitting here or --
QUEST: No. And I gave up sugar a few years ago.
GUPTA: You did?
QUEST: I did.
GUPTA: For health reasons?
QUEST: I just found I was drinking too much of it. I was having two or three lumps here and a lump there and a lump there. Before long --
QUEST: I was a lump everywhere. Here a lump, there a lump, everywhere a lump, lump.
GUPTA: Now, all jokes as side, in addition to its fascinating history, tea is really good for you. Green, white, oolong, even black tea, like the popular British breakfast blend, they all contain powerful poly phenols and antioxidants that can protect your immune system.
Some studies have shown they can lower your risk of heart disease, as well. Try for example one cup of green tea a day to help keep your cognitive function sharp.
Now, this is important. If you are making tea yourself, steep it for at least five minutes. That's what's going to help release most of those antioxidants.
They call him "The Weirwolf". It's because of his hunger to win. So, I'm going to share with you now the courage and the determination of British Paralympics champion David Weir.
GUPTA (voice-over): Two Olympics, six gold medals, Beijing, London, a handful of world records, world championship titles and six London marathon wins.
David Weir is one of the top Paralympian athletes in the world, competing in long distance races. He's also confined to a wheelchair. All of it, pure upper body strength.
DAVID WEIR, 6-TIME PARALYMPIC GOLD MEDALIST: I can feel my legs, but they can't move. It's called spinal cord transection, which it was damage to the nerves in my spine. And the doctors don't know how, when or why. So, it was a disability from birth really.
GUPTA: He was just a young boy when he decided not to let his disability keep him from his dreams of being an athlete.
WEIR: I was into sport very early. At school, it was my best subject, P.E. I wasn't very good at anything else. So, I knew that I had to get the sport right if I wanted to succeed in life. And I was very lucky and I was talented at an early age and wheelchair racing took over my life.
GUPTA: He began training in earnest at age eight, joining team Great Britain by age 11, and started earning medals at the age of 25.
WEIR: I've done a lot really and a short space of time.
GUPTA: And he's also starting to give back, helping to train the Paralympics athletes of tomorrow.
WEIR: And just encourage them, really, give them advice and tactics and a way to push and way to sit in their racing chair, because I've got a lot of knowledge over the years.
GUPTA: David says it's too soon to say for sure whether he's going to make a push for the 2016 games in Rio. But I can tell you, after sitting and talking with him, it's clear the fire still burns bright.
Up next, I sit down with two Hollywood greats, Alfred Molina and Ving Rhames. They're going to talk about their new role as doctors.
GUPTA: Ever wonder what happens when something goes wrong in a hospital? A lot of people may think a mistake happens and the story ends there.
But TNT's new primetime medical drama, "Monday Mornings", pulls back the curtain on these errors and holds the doctors responsible. It's based on my novel by the same name. And I'm a writer and an executive producer for the show.
So, today, I want to give you something a little special -- a conversation with two of the show's doctors, Ving Rhames and Alfred Molina.
VHING RHAMES, ACTOR: It's been more than a medical show for me. It's a microcosm of life.
ALFRED MOLINA, ACTOR: The relationship between the doctors, the relationships between discuss our patients, the relationships between us and the building -- all those that kind of things. I think that all feels very, very authentic.
RHAMES: I don't know if we ever knew -- I know I didn't know -- that doctors were questioned on things by their superiors.
MOLINA: What a day, Doctor. Saving a baby, maybe saving a soldier, we don't know, because you never bothered to follow up.
GUPTA: How would you describe this Harding Hooten?
MOLINA: I don't -- I think he's not fooled by any notions that his job is in any way democratic. I think he understands that he doesn't have to be liked. He doesn't have to be everyone's friend. He's got to get this job done for the benefit of everybody and how we feel about him is neither here nor there as far as he's concerned.
RHAMES: This show is refreshing to me and to play a character, look, I will give it to you straight, love me or hate me.
Just had a bomb go off in her head, let's get on the ventilator and give him more fluids.
GUPTA: And he works really hard, and he's really good at it, so people listen to him as a result of that.
RHAMES: On this show, yes, but Ving Rhames is like that in Hollywood. They don't always listen. It's been my trick (ph), little old good, nice Ving Rhames. They don't always listen.
GUPTA: Is there a lot of overlap, you're saying, between Ving Rhames and Jorge Villanueva?
RHAMES: I think so. And someone made a joke like, you know, has David E. Kelly bugged our dressings rooms, because there's too many parallels. Are there?
Like I'm not joking, I'm very serious. There's too many parallels come along and then sometimes like -- even, you know, like I'll use the word "brother". You know, not too many people use that word. Gotto (ph) uses it, you know what I'm saying? So, it's just things like that. Or you're my man.
So I'm like -- I really think, man, it's really been a joy working on something that has substance and truth in it. And that's really what I'm proud of with this show.
GUPTA: The scripted drama shows are supposed to be entertaining and engaging and maybe to some degree educational. I mean, you think people will learn something from the slow? RHAMES: Well, I'll say I learned a lot from it, and that's why I keep saying this is like a microcosm of life, and we just happen to be doctors. But if you --you know, you change a couple of circumstances, it could be any job. It could be America. This hospital, you know, Chelsea General, could be representing America, and looking at some of our actions and our foreign policies. Maybe we need a 311 Monday morning meet.
GUPTA: I admit a case of every organization or bureaucracy should have -- if for no other reason, to say, let's be candid here, let's close the doors and just really be candid with each other.
MOLINA: I think if we had a 311 for actors, it would be pandemonium.
GUPTA: The ultimate goal of those meetings that Alfred and Ving were just talking about is to learn from the mistakes. That's how medicine moves forward. It's a lesson I think for all of us.
You can watch "Monday Mornings" on Monday nights. It's on our sister network TNT at 10:00 p.m. Eastern.
Still ahead, though, chasing life. What alcohol might be able to do for us.
GUPTA: We've already talked tea. So, in this week's "Chasing Life", we decide to talk about Britain's second favorite liquid -- alcohol.
You know, it's one of the hardest drinking countries in the world here. There's a pub on almost every corner.
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: Probably between have 25 drinks, depending on a good or bad week.
UNIDENTIFIED FEMALE: Well, he comes (ph) to the pub on a Friday or Saturday night and have five or six drinks.
(END VIDEO CLIP)
GUPTA: So, here's what you need to know -- one drink a day can help your heart, specifically by raising good cholesterol, reducing blood clot. It could even reduce the risk of some cancers.
But as you might imagine, there are down sides. And one big one -- a lot of extra calories. This is important. A six-ounce glass of red wine, a 12-ounce beer, two ounces of vodka, they each have 150 calories. Have one a day. That's almost 1,000 extra calories a week, and that doesn't include any mixers.
So, think twice before you drink, as always. All those extra calories could outweigh any benefits.
That's going to do it for SGMD from London. Let us know what you think, CNN.com/Sanjay. And also, follow me on Twitter @DrSanjayGupta.
Now, let's give it back to Atlanta for a check of your top stories in "THE CNN NEWSROOM."