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PAULA ZAHN NOW

Insurgents Hit U.S. Military Base in Iraq; FDA Approving Dangerous Drugs?

Aired December 21, 2004 - 20:00   ET

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


BILL HEMMER, CNN ANCHOR: Good evening, everyone.
Tonight, we're going to try and clear up some of the confusion over pain pills. Another medication, Aleve, the over-the-counter drug, linked to heart trouble, this news now coming in the wake of the Celebrex reports and of course the Vioxx reports.

But, first, tonight, we want to begin with the deadliest attack on Americans in the 21 months since U.S. forces have been in Iraq. Insurgents fired rockets at a military base in the northern town of Mosul. One of those rockets hit a mess hall, killing 26, 19 of them members of the U.S. Army; 57 others at least at this point were wounded. We're told that many soldiers worried that it was just a matter of time before their giant mess tent became a target. And today time ran out.

(BEGIN VIDEOTAPE)

JEREMY REDMON, "THE RICHMOND TIMES": It was really just sort of a sea of wounded and dead. There were people crying. There were folks that were numb that collapsed in grief. It really was unreal.

HEMMER (voice-over): The explosion hit at lunchtime. Witnesses describe a fireball, smoke, a spray of shrapnel. Whether a random shot or a calculated attack, it was deadly.

UNIDENTIFIED MALE: The killed include U.S. military personnel, U.S. contractors, foreign national contractors and Iraqi army. The wounded also come from those various groups.

HEMMER: Pictures from an embedded news photographer show soldiers caring for wounded comrades. One end of the compound appears to be blown out.

CNN personnel who had visited the base in the past say soldiers had specifically raised safety concerns because the canvas does not offer protection. The immediate concern now is the casualties.

UNIDENTIFIED MALE: Our hearts go out to the families, their friends and their fellow soldiers who lost comrades in arms today, who lost husbands, fathers, brothers, both American and Iraqi. It is indeed a very, very sad day.

HEMMER: Which brings to mind something President Bush said on Monday. GEORGE W. BUSH, PRESIDENT OF THE UNITED STATES: No question about it, the bombers are having an effect. You know, these people are targeting innocent Iraqis. They're trying to shake the will of the Iraqi people and, frankly, trying to shake the will of the American people.

HEMMER: There are doubts. Our latest poll released just yesterday shows only 39 percent of those surveyed in this country approve the way the U.S. has handled Iraq in the past few months; 58 percent disapprove. Compare that now with a year ago; 65 percent approved and only 34 percent disapproved.

Incidents like the attack on U.S. forces and this week's killing of an Iraqi election official and his bodyguards are expected to intensify as we get closer to Iraq's January 30 national election. In Baghdad today, some perspective. During a surprise visit, British Prime Minister Tony Blair praised Iraqis who are risking their lives for freedom.

TONY BLAIR, BRITISH PRIME MINISTER: They do not know at any point in time whether they're going to be subject to brutality or intimidation, even death. And yet they carry on doing it. Now, what a magnificent example of the human spirit. And that's the side we should be on.

HEMMER: Late this afternoon, back here in the U.S., after visiting with wounded U.S. soldiers, President Bush offered his own condolences to the families of today's victims.

BUSH: Any time of the year is a time of sorrow and sadness when we lose a loss of life. This time of year is particularly sorrowful for the families as we head into the Christmas season. We pray for them. We send our heartfelt condolences to the loved ones who suffered today. We just want them to know that the mission is a vital mission for peace.

HEMMER: The vital and dangerous mission in the new Iraq.

(END VIDEOTAPE)

HEMMER: Also late this afternoon, Halliburton says seven of those killed in today's rocket attack were employees or subcontractors working for the company in Iraq.

More tonight now from two different perspectives. Melissa Doss joins us live from Richmond Virginia. Her husband, Captain Chris (ph) Doss, is a National Guardsman stationed at the same base. Also with us from Washington, Ann Scott Tyson. She's a reporter for "The Christian Science Monitor." She has reported from that base a few months ago when she was embedded with U.S. forces.

We welcome both of you to our program tonight.

And, Melissa, I want to begin to you.

When did you hear from your husband today? MELISSA DOSS, WIFE OF NATIONAL GUARDSMAN: I heard from him probably midmorning. There was an e-mail that was sent out from him. He is the personnel officer. And he sent it to our brigade, our higher headquarters here, confirming that it was our base and it was our dining facility that had been hit.

HEMMER: Any information on how he's doing?

DOSS: As far as I know, he's doing well. I mean, I can only take from what I got from that e-mail, that he is able to e-mail. So I'm not sure anything else other than that.

HEMMER: So, just to be clear, this was one e-mail sent to the base in Virginia?

DOSS: Correct.

HEMMER: That was then relayed to folks like you, correct?

DOSS: Correct.

HEMMER: How were the other guys with him there? Did the e-mail say?

DOSS: It did not say. It was pretty short and sweet. It pretty much said -- confirmed that it had been their base and it had been their dining facility. It didn't give details on the attack or if we had injuries or anything else.

HEMMER: I can only imagine the sense of relief you have. Can you give us a sense of that tonight?

DOSS: I do. I have a sense of -- just I'm overwhelmed knowing that he's OK. But then I feel guilty that I do know that my soldier is OK and other families don't, because they are in the process of doing the notification of the families of the injured and the soldiers that were killed in action.

HEMMER: You have two young children, too. Will you inform them of the news today, Melissa?

DOSS: I have not. Our oldest is 8. And she's taking everything else so hard, and with it being Christmas and being away from her daddy, that I just don't think that it would benefit her in any way to let her know what is going on.

HEMMER: I want to get to Ann Scott Tyson in a moment here.

Did your husband ever express any concern for his safety or security at that base?

DOSS: There has been some concern. That base has been hit off and on. During Ramadan, it did take some substantial mortar attacks. But Mosul is not known to be a safe city. I don't think anywhere in Iraq is safe. So I don't think it's just that city and I don't think it was just that dining facility. HEMMER: Let me bring Ann Scott Tyson into this discussion, too.

I think you better than most probably can answer that question. When you were there, did soldiers express a concern that they had about their safety and security either inside that mess tent or at the base itself?

ANN SCOTT TYSON, "THE CHRISTIAN SCIENCE MONITOR": You know, this -- I want to stress that this type of attack, these rocket and mortar attacks, are a daily occurrence all around Iraq.

I mean, this must happen dozens of times a day. And in some times, different camps can be attacked multiple times from many directions. And the sort of amazing thing is, they almost never hit their targets. The aim just isn't that great. And so what sort of, you know, is amazing about this is that they hit at the right time.

And I think the fact that it's a very large target, this large mess hall, they may have gotten closer and closer to it. And today was just the day that they hit it. So there's a sense among the soldiers there while I was there. There's sort of this constant background noise, this constant feeling that an attack or strike could come every minute.

But people aren't sitting on the edge of their chairs. There's sort of a fatalism about it, because, you know, you can't be in the bunker when it's going to happen.

HEMMER: Ann, listening to your answer there, it seems to me that you believe that this was just a lucky shot by the insurgents. Would you agree with that?

(CROSSTALK)

TYSON: Yes, I do. I think it was probably a lucky shot, because there - I mean, I've been at different bases in Iraq that have been attacked by, you know, 10, 12 rockets several times a day. And oftentimes, they -- most of the time, they don't hit anything. And yet, it's impossible to defend against these, because they can attack -- they can use timers and set up their mortars and rockets, attack from different directions.

And even if, within seconds, the U.S. military has a grid coordinate on where those attacks came from, the guys are already gone. They can't track them down. So it's almost impossible to do anything about it. But, yet, people aren't walking around with their body armor and helmets on all the time inside these camps, because they don't feel that they can -- you know, they just don't feel like they have to do that all the time.

HEMMER: There was another reporter, Ann, who was on CNN earlier today. He says the only time the entire camp is together is at lunchtime at noon. So, if there was inside information coming from that base, it's a prime target for insurgents.

TYSON: Definitely. And there are a lot of Iraqis inside that camp. They train Iraqi forces inside that camp. There's no question that the insurgents could have had good information on a good time and a good place to attack.

I mean, I'm not saying that they weren't trying for that or aiming for it. I'm just saying that they've been trying and trying and trying. And today, they actually hit it.

HEMMER: Well, listen, thanks for your time tonight, to both of you, for discussing this topic with us.

But there is one other perspective in this that we need to get to tonight all too much, the human aspect of it, too.

By telephone with us, Jonesville, Virginia, a woman by the name of Marsha Stanford. Her husband, Specialist Kenny Ray (ph) Stanford, is stationed at that base at the site of today's attack.

And we appreciate your time, Marsha, for coming on with us tonight. It's my understanding you have not heard from your husband to this point. Is that still the case?

MARSHA STANFORD, WIFE OF U.S. SOLDIER: No, I haven't heard from him yet.

HEMMER: Can you give us an idea about what this day has been like for you, the agonizing, the waiting, the hours passing?

STANFORD: Well, I talked to my husband this morning about 2:00 a.m. our time. And the next news I heard was on CNN.

And since that time we've just been sitting by the phone, on the Internet, watching TV, just trying to find something and waiting for the call.

HEMMER: How often would you hear from your husband?

STANFORD: I usually talk to him twice a day.

HEMMER: Twice a day. By telephone, correct?

STANFORD: Yes.

HEMMER: Yes. Ever get e-mails or do you have that sort of communication with him in Iraq?

STANFORD: Yes. He does e-mail from time to time.

HEMMER: Twice a day seems pretty good. How is that possible, Marsha?

STANFORD: Well, there are times that they are around the base. And then, on the days when he's out doing security, he's able to call in between the shifts of security. We do have the days when he's out on a trip and he'll call me and say, I'll be out for a few days. And then I'll know not to expect him to call. HEMMER: Yes. And one of the things we're trying to pick up on tonight is how much concern was expressed by the U.S. military stationed at that base. Did your husband ever share that with you?

STANFORD: No. My husband has probably shielded me from a lot of what goes on. There are times that I can tell in his voice that he is worried about something.

HEMMER: Our best to you tonight, especially now.

Marsha Stanford, thank you for your time. And we will certainly be in touch. And, if you get word, please pass it along to us.

STANFORD: Thank you.

HEMMER: Marsha Stanford there from Virginia tonight.

There is much more ahead. We'll continue our topic again that we started our program tonight, including the new questions about what yet another popular painkiller and the news it may bring.

(BEGIN VIDEOTAPE)

HEMMER (voice-over): Pain and confusion, another pill tied to heart attacks and strokes, Vioxx, Celebrex and now Aleve. How do you know what's safe?

And Shakespeare's words...

UNIDENTIFIED MALE: Canst thou remember a time before we came into this cell?

HEMMER: ... never rang so true, at the prison where the play is the thing and the actors are the inmates.

Also, our PZN meter question tonight: Do the recent warnings make you think twice before taking medications? Let us know at CNN.com/Paula. The results and much more tonight on PAULA ZAHN NOW.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

HEMMER: There is more fear and confusion tonight about yet another popular drug. This time, it's the pain reliever naproxen, better known as Aleve. It's been linked in one study to a possible increased risk of heart attack.

Unlike Vioxx and Celebrex, which are the subject of similar concerns, naproxen is available over the counter. With this bewildering flood of bad news this past week, you might just wonder what in your medicine chest is safe after all?

More tonight from our medical correspondent Elizabeth Cohen on this story.

(BEGIN VIDEOTAPE)

ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT (voice-over): Lucy Peterson (ph) had a painful decision to make today. Should she keep taking the drug Aleve? It really helps her headaches, but she was worried about a study that says it might cause heart attacks and strokes.

UNIDENTIFIED FEMALE: I took the bottle of Aleve that I carry in my purse every single day out of my purse this morning.

COHEN: In the end, Aleve was out for her. Now she's thinking, what drug is safe to take? And so is her mother. Celebrex worked for her hip pain, but a study announced last week linked it, too, to heart attacks and strokes.

UNIDENTIFIED FEMALE: I quit it immediately. It scared me to death.

COHEN: Peterson, her mother and sister have come to this pain clinic in Manhattan for answers. Their doctor, Norman Marcus, says he's been bombarded over the past few days by questions about what drugs to take, when fewer and fewer seem to be safe.

DR. NORMAN MARCUS, PAIN MEDICINE SPECIALIST: People are afraid. They're sad because, a lot of times, they got a great result from some of these drugs that are now problematic.

COHEN (on camera): All of this news about three blockbuster drugs has put a lot of people in, well, a lot of pain. People even wrote e-mails to CNN asking for advice. For example, Mike wrote us wanting to know: "I've been taking Celebrex for 18 months. I have a family history of cardiovascular disease. What should I do?"

And then Rick in California. He says he was taking Celebrex, too, but then had heart palpitations. He told us, "Any advice you could give me would be greatly appreciated."

(voice-over): Of course, we can't offer advice. And Dr. Marcus says it's tough for even physicians to know what to say when drugs they trusted for years turn out to have side effects.

MARCUS: I think there should have been more information.

COHEN: And that is what angers the Petersons. They wonder, why didn't someone see these dangers before?

UNIDENTIFIED FEMALE: I just don't think they take long enough to really look into these medicines. I think it comes on the market too quickly.

COHEN: Now the Petersons are left searching for something else to treat their pain that won't, like Celebrex and Aleve, turn out years later to possibly have serious side effects.

(END VIDEOTAPE) HEMMER: So, Elizabeth, then, how concerned should people be, whether they have Aleve in their medicine chest or any of the medicine they have for that matter inside that medicine cabinet?

COHEN: Well, Bill, it's important to remember that the Food and Drug Administration has not taken these drugs off the market and the FDA has given very specific advice. They say if you're taking Aleve, don't take it for any longer than 10 days. If you need more pain relief than that, go see your doctor.

And as far as Celebrex goes, they say that doctors should try other medicine first and if Celebrex really is the only thing that is going to help a patient, then the patient should take it at the lowest possible dose.

HEMMER: Well, there's three cards out in a week, a lot of attention, too. Thanks, Elizabeth. See you a bit later tonight.

And we'll get two views on this from inside the FDA, including one critic who says the agency is not doing what it should to protect the public.

Also, Elizabeth is back with us later tonight telling us why women may be equal when it comes to having medical problems, but are often second-class citizens when it comes to getting medical care.

Back in a moment.

(COMMERCIAL BREAK)

HEMMER: Welcome back.

We've been talking about the fear and confusion surrounding some of the most popular painkillers. We've now learned that naproxen sold over the counter as Aleve joins Celebrex and Vioxx on the list of drugs that may increase patients' risk of heart trouble. The flood of warnings has left many people wondering, is the FDA now doing its job?

We'll talk about that this evening now with the FDA deputy associate commissioner. Dr. Janet Woodcock is my guest this my evening.

Doctor, good evening to you. I'm certain it's been a busy day for you. And thank you for your time here.

This is our understanding, Doctor. Naproxen has been available by prescription for 30 years. Aleve has been available more than 10 years over the counter. Why is it just now that we're hearing about the problems here with Aleve?

DR. JANET WOODCOCK, FDA DEPUTY ASSOCIATE COMMISSIONER: Well, we have some preliminary data based on a study that the NIH conducted looking at prevention with Aleve.

They were studying naproxen against placebo. And they were looking at it for long-term use in people who are completely healthy. And what came out of that is potentially that there may be increased risk in that setting.

HEMMER: Can you understand how Americans may be a bit concerned about what they're putting in their bodies out of the medicine cabinet now, Doctor?

WOODCOCK: Well, I think people ought to step back and look at the big picture. Every medicine has risks. But these medicines, most of them have tremendous benefit for our population.

However, each one of these carries risks. And that's why they're prescription drugs. People, if they're concerned, should talk to their doctors about potential side effects of drugs.

HEMMER: A fellow colleague of yours at the FDA by the name of David Graham, here's what he told us on my other program, "AMERICAN MORNING," earlier today. Listen here.

(BEGIN VIDEO CLIP)

DR. DAVID GRAHAM, FDA DRUG SAFETY OFFICE: I think the American people need to be somewhat concerned about the safety of all of the pain relievers. FDA is still in denial that there's a problem with the way they go about evaluating and approving drugs. Until that changes, we will continue to get killer drugs approved and on the market.

(END VIDEO CLIP)

HEMMER: He says killer drugs. He also says over the counter supposed to be the safest. How do you respond to that?

WOODCOCK: Well, as you pointed out, Bill, naproxen has been studied and on the market for a very long time, short-term use over the counter in many studies, and shown to be safe. This new finding from NIH is preliminary and we're going to have to evaluate it.

HEMMER: Thirty-six percent of the agency's own scientists say they were only somewhat confident about the drugs approved or not confident at all in decisions regarding drug safety. Is that a fact?

WOODCOCK: We have done many surveys both before that survey was done and subsequently. We've done very in-depth surveys. Most of the respondents to our surveys say they're extremely confident in their work environment, in the quality of work that's done here and the decisions that are made. We have over...

(CROSSTALK)

HEMMER: Yes, I apologize for the interruption, but to try to cut through this for it, where does the burden lie? Is it with the manufacturer or is it with the FDA, Doctor?

WOODCOCK: Manufacturers have to show to the satisfaction of the FDA and its advisory committees that their drug is safe and effective before it's allowed to be on the market.

HEMMER: Doctor (AUDIO GAP) time tonight. We'll be talking about this more.

We want to turn now to an FDA official who has been a outspoken critic of the agency's drug approval process. With me live tonight, Dr. David Graham, associate director for science in the Drug Safety Office. He's not speaking on behalf of the FDA, by the way, in this interview.

Doctor, we talked this morning at 8:00 a.m. We're talking again tonight at 8:00 p.m. Good evening to you.

GRAHAM: Well, good evening.

HEMMER: You heard the statement from the FDA. They're saying look at the big picture. You have more options and more choices than ever before as a result of the work of the FDA. Should that not give Americans assurances when it comes to medicine?

GRAHAM: I don't think that it necessarily should.

If a drug isn't properly evaluated before it comes to the market in terms of safety, then regardless of what its benefit is, it's a big unknown of how toxic the drug may be. It was mentioned in the piece that we just watched that these drugs have tremendous benefits. Well, if you were to look how FDA assesses benefit in its clinical trials, it actually don't measure the benefit. That is, what is the value to the patient?

It measures an effect. Does it lower your blood pressure? Does it lower your blood sugar? What you really want to know is, is, does it help you to live longer. Does it help you to live longer better? And FDA doesn't measure that when it does clinical trials. But then they say, oh, it has a marvelous benefit. But they don't have a way of measuring that benefit and weighing that against a substantial risk or real risk such as heart attack.

HEMMER: Well, the other big picture they point out, as you just heard in that interview that we taped a few hours ago, there are risks with everything, the FDA says, but look at all the medicines that have been developed to help heart disease, arthritis, cancer.

If you put that into this equation, does that help change the picture right now that we're hearing?

GRAHAM: I don't think that it does. It's true that all drugs have risks. But what's an acceptable risk and what's an unacceptable risk?

If I have an over-the-counter pain reliever, I don't expect to die of a heart attack from it. So there has to be some proportionality. And I think that FDA has missed the boat on this in the way they go about assessing drugs, that they do not adequately assess the safety of a product before it comes to the market.

HEMMER: But is it acceptable to put this drug out for consumers and allow them to take advantage of it for a period of time, in this case just about 10 years, before you start to find issues with it? Because the point the FDA makes is that sometimes some drugs need a bigger sample and a longer period of time before you determine their effectiveness. I see you shaking your head yes.

GRAHAM: Right. No, that is certainly the case.

And maybe with naproxen, maybe that is appropriate, although one could make the argument that a drug that you know is going to be used by millions of people, that it should be studied quite extensively before it comes to the market. Now, naproxen was approved, I think in the piece I heard, 20 years ago. And, certainly, things have changed over these past 20 years.

So, the standards that FDA applied 20 years ago are certainly not the same standards that are applied today.

HEMMER: In a word, Doctor, would you say whether or not the FDA is favoring the pharmaceutical companies?

GRAHAM: My own view is, is that, whether it's by intention or accident, that the way FDA goes about its assessment of drugs in the approval process, that there is an institutionalized bias that favors drug companies when it comes to safety. And this has to do with the way FDA uses statistics to assess whether a drug is safe or not.

HEMMER: We have to leave it there. Thank you, Doctor. David Graham with us this evening in Washington.

GRAHAM: Thank you very much.

HEMMER: Thank you, Doctor.

Once again, our PZN meter question tonight: Do the recent warnings make you think twice before taking medications? Let us know at CNN.com/Paula. We'll get the results a bit later this hour.

We'll stay on the medical beat. In a moment, a revealing look tonight at why the American medical system often treats women like second-class patients -- that when we continue after this.

(COMMERCIAL BREAK)

HEMMER: If you're a man and you go to the doctor, there's a pretty good chance he'll listen carefully to your complaints and then prescribe the right treatment. But if you're a woman it might be a completely different story. It turns out many doctors are just starting to realize that women are medically different from men. For example, women have very different symptoms during a heart attack. What is more, some doctors even tune their women patients out. More on that again with Elizabeth Cohen.

(BEGIN VIDEOTAPE)

COHEN (voice-over): When Phyllis Cruz had a heart attack last year she went to the emergency room and sat there and sat there and sat there. No EKG, no blood tests, no nothing. Just a nurse telling her to be patient. PHYLLIS CRUZ, HEART ATTACK SURVIVOR: And I said to her, but I have pain, you know -- chest pain. I can't breathe.

She said, well, there's a lot of people here. Sit down.

COHEN: After six hours of waiting Phyllis finally had an EKG, which showed that she had had a heart attack. Now she sees cardiologist Dr. Nieca Goldberg who specializes in women and heart disease. When women come to you, what's the most common complaint they have?

DR. NIECA GOLDBERG, AUTHOR, "WOMEN ARE NOT SMALL MEN": They think they're not being taken seriously in the doctor's office. And you know what? Most of the time, they're right.

COHEN: Phyllis says her previous doctor attributed her breathlessness and fatigue to hormones. Jean Horgan (ph) says her former doctor said here heart palpitations were due to nerves. Debbie Tillis was told the answer to her chest pain was tranquilizers and an antidepressant but all three had heart disease. Why would doctors take women less seriously? Some of it, women health experts say, is just plain old-fashioned sexism. Dr. Marianne Legato is director of the Partnership for Gender-Specific Medicine at Columbia University.

DR. MARIANNE LEGATO, AUTHOR, "EVE'S RIB": I think women are often disrespected and their symptoms attributed to hysteria.

COHEN: But it's more complicated than that. Male and female bodies are different, not just in the obvious ways but in the ways they experience disease. For example, women don't always have the crushing chest pain men have when they have a heart attack. Instead, they just feel tired and short of breath. But today's doctors weren't taught that difference in medical school.

GOLDBERG: They showed us a picture of the typical patient with heart disease and it was a middle aged businessman clutching his chest on a cold winter's night carrying a briefcase.

COHEN: A recent published study shows that women who don't have this male style heart attack are three times more likely to die probably because doctors don't recognize their symptoms. It's not just heart disease. Consider this. Men and women metabolize drugs differently. Women have stronger immune responses. The male and female brains react differently to dopamine, a brain chemical that regulates mood and pain. Lung cancer is different in men and women. Dr. Legato says women's tumors are often on the edges of the lungs and harder to see.

Why would men and women have different forms of lung cancer?

LEGATO: Like many differences in human biology, we're just beginning to note that they are there. Why is the $64 million question that we're all trying to find out.

COHEN: Some theories -- men and women differ genetically. Women are born with two X chromosomes, men have an X and a Y. LEGATO: And on that Y chromosome are at least 21 unique genes unique to males that control many of the body's operations down to the level of the cell.

COHEN: For example she says genes, not body size, are the reason why men can drink more alcohol than women without becoming intoxicated.

LEGATO: Women do not have the enzyme in their stomach that degrades alcohol which men have.

COHEN: Another reason for the difference between the sexes, women's hormones fluctuate during the course of the month. So, for example, some asthma and seizure medications can be less effective around the time of a woman's period.

LEGATO: Some women will tell the doctor they only get the seizures around the time of their menstrual cycle. Many women are told that's because they have premenstrual tension.

COHEN: These male/female differences aren't always appreciated.

LEGATO: Most physicians, myself included, were trained to study only males. We assumed women were close enough or smaller versions of men, but certainly not qualitatively different.

COHEN: Already, though, there are signs of improvement. Researchers are studying women more than they did in the past and women like Debbie Tillis are speaking out and taking their health into their own hands.

UNIDENTIFIED FEMALE: I just fired my last doctor.

UNIDENTIFIED FEMALE: How long has that been going on?

COHEN: And they're not taking hormones or hysteria as explanations anymore for their real health problems.

(END VIDEOTAPE)

HEMMER: Joining me tonight is Debbie Tillis, a heart attack survivor who says that for years doctors completely missed her condition. Finally one diagnosed her with an irregular heartbeat. Also with us again tonight medical correspondent Elizabeth Cohen. Debbie, good evening.

For eight years they misdiagnosed you?

DEBBIE TILLIS, HEART ATTACK SURVIVOR: Yes.

HEMMER: How did that happen?

TILLIS: Well, I think because doctors and women don't realize heart disease is their number one killer and because I didn't have typical male symptoms I was misdiagnosed.

HEMMER: How many doctors, how many specialists, how many hospitals can you count during that period?

TILLIS: I think at least ten doctors and at least four hospitals.

HEMMER: Had you given up at that point on doctors altogether? What was going through your mind?

TILLIS: I am so Type A that I would not give up. I think once you've had a heart attack, it's such an horrendous experience, it does such a thing to your head that I was not going to give up. I was going to find an answer.

HEMMER: So it was your pursuit that eventually led you to the answer that you finally received?

TILLIS: Yes.

HEMMER: Elizabeth, what explains why doctors are missing the symptoms in women?

COHEN: Bill, there are a couple of explanations. One is that men have just been studied more than women have. So a lot of the data is based on male study subjects. But also doctors were not trained in medical school to look for physiological differences like these. For example they weren't taught to say there's a drug and that drug may have different side effects in women than men. That just wasn't the way they were trained.

HEMMER: What's changed though? What changed their awareness?

COHEN: There have been some changes. For example, there's a textbook out now about gender specific medicine. There are two journals that are devoted to gender specific medicine. Slowly there is this realization and slowly it's working its way into medical school curricula.

HEMMER: Back here with Debbie. You think you just got lucky?

COHEN: I think I was very fortunate to find the doctor I did. I don't know if lucky is the correct word. I happen to have a very excellent doctor now. But it took a lot of searching.

HEMMER: Did you believe or can you even answer this, because you're just one case. Do you believe doctors are getting better now at diagnosing the cases and the symptoms in women than before?

COHEN: See, that's very difficult for me to answer because based on my own experiences I would have to say no. And I happen to have gone to three women doctors.

HEMMER: Wow. But you're Type A.

TILLIS: I'm very Type A. there was no way. Proper diagnosis, proper treatment, I was going to get it no matter what.

HEMMER: Have a great holiday, OK? Something to celebrate there. TILLIS: You, too.

HEMMER: Thank you, Debbie. Elizabeth Cohen, thanks to you as well at the CNN Center.

We'll have more next on a story about oil, food, the U.N., and Saddam Hussein. Why American drivers may have helped line Saddam's pockets during the '90s. That story is up after a break.

(COMMERCIAL BREAK)

HEMMER: United Nations Secretary-General Kofi Annan today asserted again that he will not step down amid the widening oil-for- food scandal. Committees both in Congress and the U.N. investigating allegations of bribes and kickbacks that netted Saddam Hussein millions of dollars.

Some Republicans on Capitol Hill, they say they want Annan out. The secretary-general says he is determined as anyone now to get to the bottom of the scandal.

(BEGIN VIDEO CLIP)

KOFI ANNAN, SECRETARY-GENERAL, UNITED NATIONS: Our global mission has advanced on many fronts, but the allegations about the oil-for-food program have cast a shadow over the operation that brought relief to millions of Iraqis. We must find out the truth as quickly as possible.

(END VIDEO CLIP)

HEMMER: And while much of the outcry in Washington has been directed at the U.N., some American companies now are also coming under scrutiny. Our report tonight from Chris Huntington.

(BEGIN VIDEOTAPE)

CHRIS HUNTINGTON, CNN CORRESPONDENT (voice-over): The man shaking hands with Saddam Hussein at a meeting in Baghdad in 1990 is Houston oil tycoon Oscar Wyatt. Wyatt's former company, Coastal Oil, was a major buyer of Iraqi crude in the 1980s while Wyatt opposed trade sanctions against Saddam.

That relationship apparently paid off under the U.N.'s oil-for- food program. According to a classified CIA report received by CNN, describing how Saddam siphoned billions of dollars from the program, Wyatt and Coastal took delivery of more Iraqi oil and turned a bigger profit than all other U.S. companies combined in the seven years of oil-for-food.

The authority to grant the lucrative rights to buy Iraqi oil rested solely with Saddam Hussein.

John Ruggie was a senior advisor to U.N. Secretary-General Kofi Annan. JOHN RUGGIE, FORMER SENIOR ADVISER TO KOFI ANNAN: We wanted for him to import humanitarian goods so that people didn't starve and children had medicine that they required. He didn't care.

We sort of thrust the oil-for-food program on him, and the bargaining that took place, he would only accept the oil-for-food program if he got to pick the contractors.

HUNTINGTON: A spokeswoman for Oscar Wyatt tells CNN he never personally held contracts for Iraqi oil and did not violate U.S. law. In 2001, Wyatt sold Coastal Oil to the El Paso Corporation. An El Paso spokesman tells CNN Coastal's business with Iraq was perfectly legal.

They are now among a growing list of individuals and U.S. companies that have been subpoenaed by federal law enforcement agencies or contacted by congressional committees investigating the oil-for-food program.

Among them, oil giants Exxon Mobil, ChevronTexaco, oil field equipment supplier Baker Hughes, drug maker Wyeth and the conglomerate Tyco International.

(on camera) All of these companies tell CNN that they are cooperating with the various investigations and that their business with Iraq under the U.N.'s oil-for-food program was in compliance with U.S. law and licensed by the U.S. government.

(voice-over) New Jersey Representative Scott Garrett is one of the congressional investigators.

REP. SCOTT GARRETT (R-NJ), HOUSE FINANCE COMMITTEE: Right now, there's absolutely no allegations by anyone that there's any wrongdoing by the American companies involved here.

HUNTINGTON: The CIA and the U.S. Government Accountability Office estimate Saddam Hussein skimmed between $2 billion and $4.4 billion from oil-for-food in two principal ways: surcharges that he demanded on the oil Iraq sold and kickbacks that he extracted on the goods Iraq purchased.

Iraq's new ambassador to the United Nations says it was common knowledge that Saddam demanded the extra payments.

SAMIR SHAKIR SUMAIDAE, IRAQI AMBASSADOR TO U.S.: They got a contract which included, say, 10 percent, which was not part of the original bid price, which was then creamed off.

HUNTINGTON: On the oil sales Saddam would demand a surcharge of between 10 and 35 cents a barrel. Some companies refused to pay it, but many, mostly from Russia, France and China, agreed to the surcharges because they could resell the oil at a profit on the world market.

Kickbacks from companies selling food, medicine and supplies to Iraq typically amounted to 10 percent. For example, a vendor would submit a bill to the United Nations for $110 worth of goods, when in fact only $100 worth had been delivered. The extra $10 would be deposited in another bank account controlled by Baghdad.

U.S. companies directly purchased only about one percent of all the Iraqi crude sold under the oil-for-food program. But most of the oil sold under the program, about three quarters of it, in fact, ultimately made it to the United States, the bulk of it refined into gasoline and diesel fuel, making American motorists unsuspecting contributors to the enrichment of Saddam Hussein.

(END VIDEOTAPE)

HEMMER: That was Chris Huntington reporting tonight.

Next, the power of performing to change lives in prison. Inmates interpreting Shakespeare when we come back.

(COMMERCIAL BREAK)

HEMMER: All the world is a stage. That's what Shakespeare once wrote. But prison can be one of the bleakest of worlds.

In the state of Kentucky, one man is bringing Shakespeare to life behind bars and, hopefully, helping inmates get ready for life on the outside.

Bruce Burkhardt tonight has an update on the story we brought a few months back.

(BEGIN VIDEOTAPE)

UNIDENTIFIED MALE: Canst thou remember a time before we came into this cell?

I killed my wife.

UNIDENTIFIED MALE: When they will not give a deutsche to relieve a lame beggar, they'll lay out 10 to see a dead Indian.

I'm doing a life sentence for murder.

JERRY GUENTHNER, INMATE: Pitch me the mire. Lead me like a firebrand in the dark out of my way.

Sixty-five years: 45 years for murder and 20 years for armed robbery.

UNIDENTIFIED MALE: Oh, I suffer with those and I still suffer.

BRUCE BURKHARDT, CNN CORRESPONDENT (voice-over): They are murderers, thieves and sex offenders. But in this room, the visitors' room of the Luther Lockett correctional facility near Louisville, Kentucky, in this room they're Shakespearian actors.

UNIDENTIFIED MALE: Temperance was a delicate wench. GUENTHNER: In "Hamlet" there's a line that says to hold the mirror up to nature. And I believe that when you inhabit one of these characters, that you can look at that character's mistakes and see your mistakes that you made in that character.

UNIDENTIFIED MALE: Shakespeare is like a beacon of light maybe in a big, dark ocean.

BURKHARDT (on camera): Long have we known the power of Shakespeare, its power to speak through the ages and elevate the human spirit. But here, here among people who have done just horrible things, maybe that's the ultimate power of Shakespeare, redemption in iambic pentameter.

That plus Curt Tofteland.

CURT TOFTELAND, DIRECTORY, KENTUCKY SHAKESPEARE FESTIVAL: What do I want at the moment of performance? The truth. I want the truth.

BURKHARDT (voice-over): The truth. Thanks to Curt, the longtime director of the Kentucky Shakespeare festival, many of these inmates are confronting the truth for the first time: the truth of what they did and why they did it. It's called Shakespeare Behind Bars.

UNIDENTIFIED MALE: But for your conscience...

UNIDENTIFIED MALE: Aye, sir, where lies that?

BURKHARDT: Tofteland, with the support of the Kentucky Shakespeare Festival, volunteers his time here. It costs the prison nothing. Free. And it works.

UNIDENTIFIED MALE: The master, the swabber, the boatswain and I.

TOFTELAND: A lot of them discover that they have an intellect, that they're not stupid. They've been told that they were stupid. And for a lot of the guys, they discover they're -- they're intelligent. And that discovery is a huge epiphany for them. And they get hungry.

BURKHARDT: But should that hunger be satisfied? This is a prison, after all, and these people are being punished for what they did. But as Curt reasons, most of them will also be leaving here at some point.

TOFTELAND: So the question that we have to ask -- I have to ask is if they're coming out to a mall near you and me, a neighborhood near you and me, who do I want to live next to?

UNIDENTIFIED MALE: Curt doesn't excuse any of our actions in the past. But he realizes that they're in the past. And he also realizes that change is a possibility.

UNIDENTIFIED MALE: Oh!

UNIDENTIFIED MALE: I know it by the trembling. UNIDENTIFIED MALE: Calm thy ways.

BURKHARDT: Gary and Demond (ph) and some 20 other inmates are rehearsing "The Tempest." They started in September. As in Shakespearian times, male actors have to take on the female roles.

The finished play will be presented in May here before fellow inmates and another performance for family and friends.

TOFTELAND: Wipe thou. Wipe thou thy eyes.

BURKHARDT: For this Shakespeare company, the play is not the thing. It's the process and Curt, more therapist than director, is prepping these inmates for the real opening night, the day they walk out of here.

RON KIPER, FORMER INMATE: I'm sure glad I did what I did.

BURKHARDT: Ron Kiper did just that after serving 11 years for manslaughter.

(on camera) What difference has it made to you now and then in adjusting to being a free man?

KIPER: Oh, it's -- the coping skills, the reasoning skills, the thinking skills that I've acquired in that group, I did not have anything close to that.

UNIDENTIFIED MALE: Allaying both their theory and my passion with its sweet air.

BURKHARDT: For many of us on the outside, Shakespeare might be great literature, great art. But here, this is not about art appreciation. It's about self-knowledge.

SAMMY BYRON, INMATE: When I did -- the death scene was just almost identical to the crime that I committed, to the murder that I committed.

BURKHARDT: In 1983 Sammy Byron strangled to death his mistress. Then a few seasons ago, he played the part of Othello. His best friend played the female role of Desdemona.

BYRON: And so what the program allowed me to do is, in Othello's rage, I was able to look at -- to see my friend as Desdemona and see the sheer terror in his eyes as Othello is strangling her.

GUENTHNER: Oh, the sun sucks up.

BURKHARDT: Love, hate, fear, revenge, all the great Shakespearian themes acted out by most of these prisoners while they were on the outside but never thought about, not until the bard and Curt Tofteland came inside.

TOFTELAND: Good work, guys. That was good work.

(END VIDEOTAPE)

HEMMER: Bruce Burkhardt reporting tonight for us. Want to mention that Shakespeare Behind Bars is the subject a -- subject, rather, of a documentary film to be shown at the Sundance Film Festival next month in the state of Utah.

Back in a moment here with some late night humor.

(COMMERCIAL BREAK)

HEMMER: Right now I'm going to get a preview of what's coming up later tonight on "NEWSNIGHT." Here's my colleague, Aaron Brown.

Hey, Aaron. Good evening to you.

AARON BROWN, HOST, "NEWSNIGHT": Good evening to you, Bill. Thank you.

Much of the program tonight centers around today's tragedy in Mosul. We'll put the pieces together as best we know them. And there are still some missing pieces in the attack, which killed at least 20 and wounded more than 60.

We'll talk to a reporter just back from the region. We'll go to Fort Lewis, Washington, and Richmond, Virginia, where many of the troops and their families were living. That and two military experts who will try and answer the question is Mosul one of the most confused cities in all of Iraq ethnically, is it destined to become the next Falluja?

That and more tonight on "NEWSNIGHT" about an hour from now.

HEMMER: See you then, Aaron. Thanks.

Results now of tonight's "PZN Meter." We asked you a bit earlier if the recent warnings make you think twice before taking medications. Seventy-nine percent say yes. Twenty-one percent say no.

Remember this is not scientific, just a taste of what visitors to our web site are thinking about that topic tonight.

"TIME's" Man of the Year and the secretary of defense, Donald Rumsfeld. They've been on the mind of late night comedians lately, too. Here's a sample from David Letterman.

(BEGIN VIDEO CLIP)

DAVID LETTERMAN, HOST, "LATE NIGHT WITH DAVID LETTERMAN": This was great. I received a Christmas card from Donald Rumsfeld. Would have been nice if he actually signed it. But you know, the rubber stamp was a nice touch.

You know, the Republican senators now, they've turned against Rumsfeld. They want Rumsfeld to resign. And so here's what Rumsfeld did. He found out who was behind this movement, and he's stripping these senators naked and running them around on a leash. Get over there.

(END VIDEO CLIP)

HEMMER: We end on a laugh tonight. And thanks for being with us this evening.

Tomorrow night marriages destroyed by computer. Cyber sex and cyber infidelity. We'll see you again tomorrow night.

Until then, I'm Bill Hemmer. See you again tomorrow morning, 7 a.m. Eastern Time, on "AMERICAN MORNING."

"LARRY KING LIVE" is next. Guests tonight include former Death Row inmates who were wrongly convicted. Larry's up now. Good night and have a good evening.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com


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