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SANJAY GUPTA MD

Making Sense of Murder; Expecting Better; Actor's Behind-the- Scenes Battle

Aired September 21, 2013 - 16:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


DR. SANJAY GUPTA, CNN HOST: Welcome to SGMD.

Is the conventional wisdom about pregnancy all wrong? I'm going to tell you how one woman is expecting better and how she says you can as well.

And you'd never know it, watching him on Showtime's "Ray Donovan," but actor Dash Mihok suffers from severe Tourette's. He's going to pull back the curtain and show he copes.

Plus, I'd almost guarantee you're throwing away perfectly good food. I'm going to show you how to stop doing that.

But first --

(MUSIC)

GUPTA: While his motive remains unclear, we're digging deeper into the mindset of the man who killed 12 people in Washington's Navy Yard on Monday.

And CNN's Deb Feyerick has been working his sources. She's uncovered some incredible details about this -- joining us now from New York.

Deb, I mean, is it -- so, is it true the shooter called police weeks ago, in fact, looking for help?

DEBORAH FEYERICK, CNN NATIONAL CORRESPONDENT: Yes. It really looks like he was struggling.

Just over six weeks ago, on August 7th, Aaron Alexis called the Newport, Rhode Island police. He told them that he was being followed. Three people, he didn't see them but he was convinced that these people were out to hurt him. And he believed they've been sent by someone he'd argued with while travelling from Virginia to Rhode Island.

He told police that he'd never felt anything like this and he was worried that the individuals were actually going to harm him. He said that his harassers were using some sort of microwave machine -- those are his words -- to send vibrations through the ceiling penetrating his body and keeping him from sleeping. So, he was having trouble.

GUPTA: And do we know how -- I mean, how long had those -- they sound like delusions -- how long had they been going for?

FEYERICK: Well, it appears that August was a very difficult month for him. Police say that the experiences were going on for several weeks. In fact, he changed hotels three times. He said the voices though of these people kept coming through the walls, the floor, the ceiling, they just wouldn't go away.

And even though he hadn't seen anyone specifically, Alexis told police that he believed his harassers were two men and a woman. So, he had details about who was basically stalking him. Alexis would not tell police what those voices however were saying.

GUPTA: I don't know if you know the answer, but what do police do with that sort of information? What did they do? Did they refer him for mental evaluation?

FEYERICK: No. And that's really the big question. They didn't. They told me that they asked him if he was suicidal, he said no. So, at that point, the Newport police reported the incident to the on-duty officer at the naval station where Alexis worked, alerting them that one of their contractors was behaving very strangely.

But, Sanjay, no one it appears followed up to question Alexis. No one on the naval base. No one -- not his employer.

And so, it really fell by the wayside. We called the Navy, called the FBI, they won't comment.

GUPTA: Deb, thanks so much for joining us. Appreciate it.

Well, it is an unfortunate situation that we find ourselves in time and time again, maybe trying to find answers from a tragedy like this.

And joining me to try to make some sense out of this is forensic psychiatrist, Dr. Michael Welner.

Doc, thanks for joining us.

I enjoy hearing your insights. You've been talking a lot about these topics and you alluded to this, Dr. Welner, people don't just snap certainly in a situation like this.

Looking back -- and again, this is from some of the police reports, it appears there were warning signs with Aaron Alexis, and that maybe people had missed them, to the point where he even kept security clearance. You heard this, he got a gun.

And it seems like we see that again and again. The national psyche has been sort of really hit hard over this last year, but that's the story. Signs were missed. Someone got a gun. Mass tragedy occurs.

How does this happen? How do they fall through the cracks?

DR. MICHAEL WELNER, FORENSIC PSYCHIATRIST: Well, here's the difficult dilemma that we find ourselves in, in terms of predictive questions. Folks will contemplate the idea of a mass killing for some time and they may even talk about that and share that idea with others. But when they share that idea with others, they haven't necessarily determined to do so.

And so, you try to commit someone like that to a hospital, you might be able to commit them, but you're not necessarily going to be able to commit them indefinitely because they know what to say. And they haven't determined that they're going to do it. Once the mass killer determines that he is going to embark and he figuratively lights the fuse, then the mass killer becomes invested in the idea that entitles him to destroy everyone around him and invested in the idea of concealing his actions. So, he doesn't fall into the cracks.

GUPTA: Got it.

WELNER: He crawls into the cracks because he knows he'll be stopped. And he's determined that you as a physician and the family members are not going to take it away from him.

GUPTA: But I want to -- I want to get back to this issue of stigma for a second. So, I wonder if this has some relevance here. Now, I want you to listen for a second, Dr. Welner, to our own CNN military analyst, Lieutenant Colonel Francona.

(BEGIN VIDEO CLIP)

LT. COL. RICK FRANCONA (RET.), U.S. AIR FORCE: Anytime you talk about mental health, that always raises flags, but it also raises cautions, because if you as a security officer, you as a supervisor, bring this to the attention of the security people, then they refer him to a mental health review. And that for several career fields is a career- ending event.

(END VIDEO CLIP)

GUPTA: What he seemed to be saying, Dr. Welner, is there may have been this interest in not representing everything about Aaron Alexis because they also knew that by doing that, it would be a career ender. He would not get any of the upward mobility, certainly in the military.

And so, that was part of the problem here. What do you think of that?

WELNER: The toll of folks who are laboring with psychiatric problems right now in the military is so huge and it's required such a great sensitivity to folks that I think there may be some truth to a person's perception --

GUPTA: Yes.

WELNER: -- of whether it will damage his military career. But the reality is what I see in my experience of the military is that the doctors are very sensitive and they want to try to patch people up and make them better rather than say we've got to get this person out of our organization. Because if we don't, they're going to cause us some kind of liability issue, the way one would see in a local police department, for example.

GUPTA: Yes. I think it's so important because, again, I think mental illness gets short rift as it is and incidents like these, and there have been too many of them, as you know, over the past year, can worsen that stigma. So, I think I appreciate you coming on presenting some facts. I think it's so important.

WELNER: Thank you.

GUPTA: And coming up on SGMD, why conventional wisdom about pregnancy is all wrong.

(COMMERCIAL BREAK)

GUPTA: I heard some Republicans in Congress are threatening to shut down the government unless the president agrees to strip out funding for Obamacare. Here's a taste.

(BEGIN VIDEO CLIP)

SEN. MIKE LEE (R), UTAH: Encourage your senators and your congressmen, do not vote for any piece of spending, any funding mechanism that includes funding for additional implementation and enforcement of Obamacare.

REP. JOHN BOEHNER (R-OH), SPEAKER OF THE HOUSE: It is a train wreck. It has to go. We're -- we've done everything humanly possible over the two and a half years to make our point. And we're going to continue to make our point.

(END VIDEO CLIP)

GUPTA: The question a lot of people are asking, how likely is a government shutdown? Is it even remotely possible? It's pretty confusing stuff.

So I asked CNN chief national correspondent John King the question.

(BEGIN VIDEO CLIP)

JOHN KING, CNN CHIEF NATIONAL CORRESPONDENT: Is it remotely possible the government will shutdown? Yes, it's remotely possible. Underline remotely.

There's a principle being espoused by these conservatives, but in the math of Washington, can they do it? No, can they shut down the government temporarily as part of the fight? Possibly.

(END VIDEO CLIP)

GUPTA: So, what does all that political talk really mean for you? Well, the first week of October, I'm going to be hitting the road with the CNN healthcare express trying to answer some of these questions. Traveling around the country to see how Obamacare sign-up is really going and what problems are starting to crop up.

We'll answer your questions. We'll make sure you understand what's really going on with your health care.

Going under the microscope now, there's this new book out and it's making a lot of waves. It's by economist Emily Oster. It's called "Expecting Better: Why the Conventional Pregnancy Wisdom is Wrong." That's some pretty strong claims in this book.

So, we decided to investigate. We asked Dr. Jeanne Conry, president of the American College of Obstetricians and Gynecologists, to take a closer look.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Most people love their morning caffeine jolt, but how much is too much? Oster says much of the evidence supports three to four cups as being OK. But Dr. Conley says hold up.

DR. JEANNE CONRY, AMERICAN COLLEGE OF OBSTTETRICIANS AND GYNECOLOGISTS: Caffeine can be associated with miscarriages. So, our recommendation is against any consumption over 200 milligrams of caffeine a day.

GUPTA: Those caffeine milligrams add up pretty quickly. Eight ounces of Starbucks has 165. A small McDonald's coffee, 100. A can of regular coke, 35.

And what about foods? Many pregnant women are warned about listeria, Oster says don't worry too much about sushi and raw eggs. She ate sushi. Oster does says avoid raw, rare meat, unpasteurized cheese and deli turkey sandwiches.

Conry says why risk it?

CONRY: Listeria is a bacteria that can cause miscarriages, stillbirths and infections in infants.

GUPTA: Should pregnant women worry about gaining weight? Oster says you should probably be more concerned about gaining too little weight than too much.

Conry disagrees.

CONRY: Obesity is associated with birth defects, diabetes, hypertension, increased C-sections, a number of different things.

GUPTA: When it comes to pregnancy, maybe the biggest taboo is alcohol. But Oster says relax, quote, "There is virtually no evidence that drinking a glass a wine a day has negative impacts on pregnancy or child outcomes."

She does suggest a limit of one to two drinks a week in the first trimester.

Conry says don't even think about it.

CONRY: We can't predict which mother's going to give birth to a child with fetal alcohol syndrome. It's safer to recommend against any alcohol consumption during pregnancy.

(END VIDEOTAPE)

GUPTA: And joining me now from Chicago is Emily Oster. Welcome to the program. Thanks for joining us.

EMILY OSTER, AUTHOR, "EXPECTING BETTER": Thank you so much for having me.

GUPTA: Sure.

I'll preface by saying I think about this topic as a father and as a doctor, both. You know, it's an intriguing book that you've written here. And I want to dive into a couple of these topics. When you talk about alcohol, first of all, I think that got a lot of people's attention. You say the bottom line is that women should be comfortable with one to two drinks in the first trimester.

You're an economist, you're not a doctor. What do you think people are going to take away from what you've written in this book?

OSTER: I think one of the things I was most -- that pushed me to do this research is that I think that there's a lot of disagreement in practice. So many obstetricians will tell you, you know, a couple of drinks are fine. I think we're all sort of more cautious about the first trimester, but when you get into later trimesters there's a lot of disagreement. And much of what I'm trying to do in the book is show women here is what the evidence says and I think the evidence in some ways speaks for it.

I think many women will read this and think, you know, maybe I'm not going to have a drink, but I think when you look at the evidence on the outcomes for children of women who drink in moderation, they don't look any different than the children of women who abstain.

GUPTA: But to your point, the head of ACOG sort of says, look, we don't know for sure, but the risk is there. So why take that risk? Is that a reasonable approach?

OSTER: I think that's very reasonable. I think that many women do take that approach. We take that approach in many things. So, I think it's worth remember, we're talking about alcohol. But there are many things in pregnancy that we don't have perfect evidence on and people evaluate the evidence for themselves and they try to think about the right risk. And really all that I'm trying to do here is really sort of show women here is what the evidence is and why don't you think about some of these decisions for yourself.

GUPTA: Finally, let me just ask philosophically almost. I mean, the idea of mitigating risk -- I mean, you know, I wear my seat belt every day. If I don't wear my seat belt, it's not likely I'm going to get in a wreck and be injured, but it could happen. So I wear my seat belt.

This idea of mitigating risk, especially for a woman who is pregnant, do you worry at all that this could send the wrong message, that it's OK to do things that might carry even a little bit of risk?

OSTER: So I think one thing we have to recognize is that we're always taking risks all the time. And that we -- things we don't even think about. Like every time you get in the car and go on the highway, we know that's really risky. And a lot of people during pregnancy are taking nonessential car trips and therefore we're living with some level of risk.

And I think all I'm kind of suggesting here is that a lot of these situations you want to be thinking about what is the risk, what is the benefit, how do I -- how do I weigh them? And we need to recognize we're thinking about those choices all the time whether or not we have kind of consciously accepted it and there are maybe some situations in which we haven't thought about that explicitly but we should.

GUPTA: You know, my mom -- when my wife was pregnant, my mom would always say, look, we've literally been doing this since the beginning of mankind. And, you know, for the most part, it works out OK.

It's remarkable that babies are born as healthy as they are with all the various things that could go wrong, but I hope your babies healthy. My three are. And thanks for joining us on the program.

OSTER: Thanks so much.

GUPTA: And up next, do you recognize this guy? His name is Dash Mihok. He stars in Showtime's "Ray Donovan". But it's his battles behind the scenes that got our attention and we're going to shed some light on it, right after this.

(COMMERCIAL BREAK)

GUPTA: You know, the big season finale for Showtime's hit series "Ray Donovan," it's Sunday night. If you're a big fan, you're definitely going to recognize this next guy.

But even if you've never heard or seen Dash Mihok, you're going to be inspired by his struggles behind the scenes.

(BEGIN VIDEOTAPE)

DASH MIHOK, ACTOR, "RAY DONOVAN": I was a fighter. Why didn't I try and stop them?

GUPTA (voice-over): Dash Mihok is a fighter, both on and off the screen.

ANNOUNCER: With the Donovan family, boxing is a part of life.

GUPTA: On Showtime's "Ray Donovan," the fighting takes place in the ring.

UNIDENTIFIED MALE: When a Donovan goes down, he comes back harder.

GUPTA: But when the cameras stop rolling, Dash fights for something quite real. MIHOK: I've had Tourette's syndrome since I was six years old. Part of reasons I became an actor was probably because I was experienced so well in hiding it, that I was acting all the time.

GUPTA: When Dash is acting, you barely notice his Tourette's. But look what happens when he loses that focus or he becomes distracted.

Tourette's is a neurological disorder that causes repetitive, involuntary movements, even sounds sometimes that are called ticks.

MIHOK: Growing up in New York City can be a very tough place. And, you know, schools are tough enough. But New York, there's so many people around that there's people looking at you all the time.

GUPTA: And Tourette's is also genetic. As it turns out, both of Dash's older sisters have it as well. Here he is as age 11 talking about Tourette's with his sister Gwen. This was a video for the Tourette's Syndrome Association.

MIHOK: I have to like look at it in a funny way or I just can't concentrate.

GUPTA: Dash has come a long way since then, appearing in films like "Romeo & Juliet", "The Thin Red Line", and "Silver Linings Playbook".

MIHOK: What are you doing?

GUPTA: And while his career was taking off it was this report on CNN.com that caught Mihok's eye.

MIHOK: His name is Jaylen Arnold --

REPORTER: His mother taped him ticking to show others how severe the condition can be.

MIHOK: He's a young man with Tourette's syndrome, who was brave enough to start his own Web site to educate people about Tourette's Syndrome.

GUPTA: Together, Jaylen and Dash captivate their student audience working with Jaylen's Challenge Foundation to put a stop to bullying.

MIHOK: Can we get a "bullying no way"?

KIDS: No way!

GUPTA: And when they're not raising awareness about an often misunderstood disorder, they hang out, like brothers.

MIHOK: I'd like to say to anybody who's watching this that I'm just like you, just a little bit different, and you're a little bit different from me, I have nothing but love for you.

(END VIDEOTAPE)

GUPTA: That's a pretty terrific story. And I want to show you something else here. I don't know if you can see these bracelets here, but they say bullying no way. And that's the organization they were just talking about.

We're going to have much more about Jaylen as well in the weeks to come.

You know, it's not every week that we can offer food for life that's good for you body and your wallet. But here it goes.

You know those expiration dates on the food that you buy? They can be confusing. And as a result most people end up throwing out tons of perfectly good food. So I'm going to give you a few clues here. If the label says "used by" or "best by", doesn't mean that the food will be spoiled or unsafe after that date. It's just the date that the manufacturer thinks that the food will taste best.

The sell by date, that one's for retailers. That one isn't for you. It's to encourage faster turnover on store shelves. Your food is good for a long time even after that sell by date. Those are just two examples.

Eggs can be consumed three to five weeks after purchase. And a box of mac and cheese with a used by date of March 2013 should be fine in a March 2014.

You can read much more about this, even find a link to the full report at CNN.com/health.

(COMMERCIAL BREAK)

GUPTA: Safety in high school sports, it's a big topic of conversation. We know a lot of you think about this. And it's because of incidents in part like the one we're about to show you, the tragic death of a high school football player in New York.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): A New York school is mourning the death of one of its students after a fatal injury during a football game last Friday.

Sixteen-year-old Damon Janes, he is a junior on the varsity football team at Brocton High School, took a direct hit to the head during the third quarter of the game. He was knocked unconscious and then he was immediately taken to a nearby hospital.

Three days later, at Women and Children's Hospital in Buffalo, he died from his injuries. It was the third death of a high school athlete in New York in as many years.

JOHN HERTLEIN, BROCTON SCHOOL SUPERINTENDENT: The kids are supporting each other. Our staff is supporting the kids and the kids are supporting the staff. And we do have counselors, you know, in and around the school.

GUPTA: Helmet-to-helmet hits have been banned in all levels of football from peewee to the NFL. But they do still happen. In fact, just last week, Tampa Bay safety Dashon Goldson was fined $30,000 for a similar tackle, hitting New York Jets tight end Jeff Cumberland with his helmet. Janes' death comes just a month after Deantre Thurman (ph), another high school junior, died in Fairburn, Georgia, when he fractured a vertebrae during a scrimmage.

(END VIDEOTAPE)

GUPTA: Now, it's worth pointing out its unclear whether Damon's death was caused by concussion or even an injury to the spinal cord or a bleed on the brain. But, you know, no matter the cause, it's obviously a sad story. And as a parent, I think my first question is, what can I learn from this? What can I do to make sure it doesn't happen to my own child?

So I want to give you a few tips I've learned over the years in this week's chasing your life. First, if your child isn't hot on playing football to begin with, don't force them. But if they are set on it, talk to the coaches, talk to the trainers. Make sure they're taking some very appropriate on field safety seriously. Ask about getting baseline concussion testing for your child in case of a concussion. That's also to help ensure that they don't return to play until they've cleared that testing.

For you at home, keep an eye out for any signs of a head injury. They might be headaches, changes in mood or behavior, withdrawing from family and friends, anxiety, forgetfulness or even a general sense of malaise. Look, that's more malaise than the average teenager of course. I know this can sometimes be hard to parse out.

Hopefully, it helps.

That's going to wrap things up for SGMD, but stay connected with me at CNN.com/Sanjay, and let's get the conversation going on Twitter @DrSanjayGupta.

Time now, though, to get you back into CNN NEWSROOM with Martin Savidge.