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HOUSE CALL WITH DR. SANJAY GUPTA

Brain Trauma in Iraq; Keeping College Kids Sober; Medicare Professionals Using Your Tax Dollars; Weight Loss Surgery; "Grady's Anatomy"

Aired March 24, 2007 - 0830   ET

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


REYNOLDS: ...great nephew said it's time to take a second look. And he's not the only one.
(BEGIN VIDEO CLIP)

JOSEPH TACOPINA, HOUDINI FAMILY ATTORNEY: The Houdini case is a mystery because the suspicious circumstances surrounding his death, the unanswered questions surrounding his death, and the medical impossibilities attributed to his death have caused this family to want answers. And not only the family of Harry Houdini, but the family of his arch nemesis and someone who we believe to be potentially responsible for Mr. Houdini's death, Marjorie and Dr. Leroy Crandon.

(END VIDEO CLIP)

(BEGIN VIDEO CLIP)

ANNA THURLOW, CRANDON'S GREAT-GRANDDAUGHTER: I'm humbled by the fact that my family may have provided documents that could shed light on the life of its important figure. I support the use of modern technology to confirm or correct historical fact. And I'm committed to any effort that seeks to place in scientific context the assumptions of the past.

(END VIDEO CLIP)

REYNOLDS: Houdini is buried at this cemetery in Queens. And Monday, the family plans to file legal papers to exhume his body. Top legal forensic investigators are standing by. So the mystery goes on.

BETTY NGUYEN, CNN ANCHOR: Yes, it does. Well, pet owners are on alert after a chemical used in rat poison is found in recalled pet food. And there's more coverage on this story at the top of the hour.

REYNOLDS: But first, Dr. Sanjay Gupta tackles this week's top medical stories. "HOUSECALL" starts right now.

SANJAY GUPTA: Thanks, guys. This is HOUSECALL. We're making the rounds this morning of some of the most intriguing medical stories of the week.

First up, coming home -- the signature injury of this war and its lasting effects. Can we be doing more to help? Then, battling the norm on campus - how addicts stay dry at college. And keeping them honest, doctors being paid by the government, but not paying taxes? Costing us plenty. Finally, an exclusive look at doctors' lives inside a level one trauma center. I'm going to take you there.

We start, though, with the health of our veterans. This week marked the fourth anniversary of the war in Iraq. It has left more than 24,000 American fighters wounded. One of the most common injuries? Brain trauma.

Now while I was reporting from Iraq back in 2003, the military doctors I was embedded with, knowing I was a brain surgeon, asked me to help them with a difficult case, a traumatic brain injury. So here's a story of Jesus Vidana.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): This is where it began, on a battlefield in Iraq. 52 minutes after a sniper's bullet sent shrapnel exploding into his brain, my path would converge with 24-year old Jesus Vidana. We first met in a dusty desert tent in a makeshift OR.

Yes, I feel like giving you a hug. How are you?

We've reunited since that night, but this was the first time I told him in detail how he was saved.

These over here are just staples. That's where they actually closed the skin. But all this area of brain around here was hit.

JESUS VIDANA, MARINE SHOT IN IRAQ: Yes.

GUPTA: And blasted, if you will, a bit by the bullet. We were able to get this blood collection off, remove some of the damaged brain, and get that bullet out of there, and stop all the bleeding.

We have nothing to cover up the outside of your brain with. So we found the only sterile thing in that entire dusty desert camp, which was an IV bag. And they basically put the sterile part against your brain. And I sewed it all the way around here.

I didn't think you were going to survive that. I didn't think you were going to live through that.

VIDANA: I mean, they told me I had two operations. And...

GUPTA: Four years later, Jesus is no longer haunted by that gunfight, but something worse.

VIDANA: I do consider myself lucky to be alive, you know? But I have felt like, you know, it would have been better had I not lived just because, you know, like every day's a struggle with the depression. Depression just comes, you know, unexpectedly and with a fury.

GUPTA: Depression could be a consequence of his injury or the remnants of post traumatic stress disorder. His doctors aren't sure. What they do know, traumatic brain injuries, PTSD, are persistent, elusive injuries in this war. And many vets with those injuries feel the VA system is ill equipped to handle them.

Is there a premium at all placed on mental illness by the VA?

VIDANA: I don't know how much importance they place on it, to be honest.

GUPTA: A new report by the American Psychological Association points to major shortcomings in the military mental health system in caring for troops and their families.

Jesus is an exception. His mental healthcare is good for now. It's the future that worries him.

You're a guy who was shot in the head in Iraq.

VIDANA: Yes.

GUPTA: I guess, you know, Jesus I mean part of me just as a citizen would say whatever the cost, whatever it takes, we're going to take care of this guy.

VIDANA: Yes.

GUPTA: And he did everything for his country, including almost die. What does this country owe you?

VIDANA: I wouldn't say just me, but just like returning vets. You know, and just respect and dignity that, you know, people with disability would like to receive, you know?

GUPTA: Are you not getting that?

VIDANA: I would say I am, but it's just like I said just dealing with the bureaucracy, it's sometimes a little taxing.

GUPTA: Jesus' is lucky. He's in relatively good physical health. He fends off depression by attending a VA sponsored support group for victims of traumatic brain injury. And he also takes an antidepressant.

Are you optimistic about the future?

VIDANA: I am, actually. I am optimistic.

GUPTA: His hope for that future? A relationship, maybe children, a return to a normal life.

(END VIDEOTAPE)

GUPTA: Now we are going to keep in touch with Jesus. It's a remarkable story. And I want to thank you as well for all of your e- mails on veterans health. Your response have been overwhelming. Be assured of this. We're working with the VA to get all of your questions and your concerns addressed. You deserve the best of care. And we're going to do our part to make that happen.

The numbers are staggering, almost half of all full-time college students binge drink or abuse prescription or illegal drugs. That abuse often starts at a shockingly young age.

Get this. 20 percent of 14-year-olds say they've been drunk at least once. 14 years old. Keith Oppenheim now with a unique program trying to keep college students sober.

(BEGIN VIDEOTAPE)

KEITH OPPENHEIM: Her name is Brooke. At 14, she says she started with marijuana. By 20, she was a hard-core alcoholic.

BROOKE: I would go to the bar. When I got off work, I'd stop at the gas station, get a six-pack to get ready to go out for the evening.

JOE PARKER: Hey, come on, boy.

OPPENHEIM: His name is Joe Parker. He says he was an addict by the age of 11.

PARKER: There's really not too much I didn't try. I mean, everything from weed to acid, X, coke, a lot of cocaine.

OPPENHEIM: Today, both Joe and Brooke are sober. In fact, getting sober was a requirement for them to get accepted as students in a unique program at Texas Tech University, a program that's essential to their survival.

KITTY HARRIS, CTR. FOR ADDICTION AND RECOVERY: To be in recovery from substance abuse and to be on a college campus is an absolute catastrophe without support.

OPPENHEIM: Kitty Harris directs Texas Tech's Center for the Study of Addiction and Recovery. She says the program is designed to support former addicts like Brooke, Joe, and some 80 other students and help them get through college with sobriety counseling.

BROOKE: There are about 80 students that I can call, hang out with, study with, tutor me, or I can tutor at any point.

OPPENHEIM: And be sober with.

BROOKE: And be sober with.

OPPENHEIM: Brooke says the pressure to drink and take drugs stems from the pressure of school and from a culture that values getting high.

BROOKE: It feels good to be high. You don't have to think about your test the next day. You don't have to think about your papers due the following week.

OPPENHEIM: For students in recovery, staying sober is hard. Two years ago, Brooke had a relapse, egged on by friends who drank.

BROOKE: I had full access. It's not like when I lived at home, like I could go to the bar there. But when I was here, you know, I can go next door and start drinking with my friends...

OPPENHEIM: It's right there.

BROOKE: It's right there.

OPPENHEIM: Once again, Brooke got help and turned her life around. Kitty Harris says one factor in the rise of consumption, more kids are getting addicted younger, as early as elementary and middle school.

HARRIS: And they oftentimes are already really sick. They come to the campus, and the whole world is opened up to them to continue that behavior.

OPPENHEIM: Brooke and Joe know they're addicts, but they believe a growing number of college students around them are becoming addicts and don't realize it yet. A few colleges have what Texas Tech has, a recovery center dedicated to keeping addicted students straight.

Keith Oppenheim, CNN, Lubbock, Texas.

(END VIDEOTAPE)

GUPTA: All right, Keith, thanks.

And while not everyone who drinks or experiments with drugs becomes an addict, many do. So the question is how do you know if you or someone you care about needs help?

Well, if you need to drink or take drugs regularly, you feel a need to maintain a supply, those could be some signs. If you ever failed repeatedly to stop using as well, feel like you need the drug to deal with problems. If you have any of those issues, talk to your doctor. You can also call the Substance Abuse Helpline at 1-800-622- help, that's 4357.

And this week also marks the beginning of spring. And for many, that means sniffing, sneezing, and itchy eyes. I had them myself. It's awful. So check out an excerpt of this week's podcast to figure out spring cold or spring allergies.

So how can you tell if your symptoms are allergy-related and not from a cold? This is one of the most common questions I get.

Well, the easiest way to tell, the symptoms come and go. They may stay for weeks at a time or just hours, but there is a common theme. You've got to look for it when the symptoms start to occur. Maybe you're in the car, maybe you're near a dog, maybe the symptoms only go away when you're on vacation. Well, these are all indications that you might have an allergy. And when you get closer to or farther away from the source, your symptoms can change.

Either way, it's best to see a doctor before your symptoms get the best of you.

Now for more of this week's podcast, including ways to combat those allergens, you've got to fix them, right? Click over to iTunes or cnn.com/podcast. Also remember every Wednesday, I give you a new podcast. That's when my new podcast is downloadable.

Don't go away now. Just ahead, you already pay for Medicare every pay period, you know that. You look at your paycheck. But did you know that you may be paying for it twice? How some health professionals are billing the system and you as well.

And later, an exclusive look at my other job. Give you some behind the scenes look at how new doctors are trained.

Plus, new research shows doctors often are treating sinus infections all wrong. Stay tuned to HOUSECALL. Stay healthy.

(COMMERCIAL BREAK)

GUPTA: We are back with HOUSECALL. The Medicare system provides healthcare for more than 42 million Americans, and we're all paying into it every single paycheck. So how would you feel if you knew you were paying once with your tax dollars and then paying for it again with your tax dollars? Joe Johns explains.

(BEGIN VIDEOTAPE)

JOE JOHNS, CNN CORRESPONDENT (voice-over): Twenty-one thousand doctors, healthcare professionals, suppliers who get paid by the Medicare program -- that's your tax dollars -- didn't pay their income taxes or payroll taxes in 2005. And if that's a tough pill to swallow, how about this? An audit by the Government Accountability Office found some of them are using your tax money for the good life -- luxury automobiles, fancy homes. One doctor even bought this pleasure boat.

If it sounds like taxpayers are getting taken for a ride, listen to what one senator says.

SEN. NORM COLEMAN (R), MINNESOTA: They should be angry that the federal government is putting money in the pockets of folks who are thumbing their nose at the rest of us and simply not paying their tax obligations.

JOHNS: And we're not talking about chump change. Those 21,000 healthcare professionals owed the government more than $1 billion. That's right, $1 billion. But to be clear, it's not only about the money. It's also about the quality of service some of these tax cheats have been providing Medicare patients. (on camera): The GAO also said some doctors received Medicare payments even though they've gotten into serious trouble, like being reprimanded, or having their license suspended, or their hospital privileges revoked.

UNIDENTIFIED MALE: Sub-standard care, drug abuse, lack of moral character, embezzlement, abusive prescription-writing. That doesn't sound to me like people we should have doing business with the federal government.

JOHNS: But they have been. And they're getting away with it because the government has no policy to prevent people who owe tax debts from getting Medicare money. Even the administration says it's unbelievable.

UNIDENTIFIED FEMALE: I am outraged that there are Medicare providers out there right now harming our beneficiaries.

COLEMAN: I get a sense that this issue has, for whatever the outrage doesn't filter down.

JOHNS: In fact, keeping them honest, the Health and Human Services Department already has a way to collect some of those back taxes. It's called a levy program. And some on Capitol Hill are wondering, why doesn't Medicare just go after the money?

SEN. CLAIRE MCCASKILL (D), MISSOURI: You came to a hearing on how to collect unpaid taxes. And you don't even know how many levies you've collected. I think, you know, that's, you know, that's pretty much in the category of the dog ate my homework.

JOHNS: But even with the Senate howling, let's be clear. This has been going on for at least 10 years and no one's fixed it yet. More than anything else, it's the bureaucracy that makes it hard to catch Medicare tax cheats and force them to pay.

Joe Johns, CNN, Washington.

(END VIDEOTAPE)

GUPTA: And you can watch more of the series "Keeping Them Honest" on "Anderson Cooper 360" weeknights from 10:00 p.m. till midnight.

But first, experts predict it will skyrocket. Next up, Alzheimer's Disease and what the numbers could mean for you.

And popular weight loss operations. Find out why some insurance companies are making them difficult to have.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSECALL.

Let's check in with Judy Fortin. She's here with this week's medical headlines. Judy, what's going on? JUDY FORTIN, CNN CORRESPONDENT: Hey, Sanjay. Antibiotics may not be the best cure for a sinus infection after all. New findings show doctors overprescribe the medicines. Acute sinusitis is caused by a virus. And over-the-counter medications typically do the trick, but statistics show antibiotics were ordered in 83 percent of those cases studies.

Now chronic sinusitis lasts longer. And experts say that's when antibiotics are needed.

And Sanjay, yet another reason to quit smoking. Parts of the body not normally exposed to sunlight age significantly faster in people who smoke. A new study says the more people who light up, the more areas like the upper arm and the bottom show severe wrinkling and decreased elasticity.

And new estimates show one American every 72 seconds is diagnosed with Alzheimer's. More than 5 million people are living with the disease in the U.S. And that number is expected to rise as baby boomers age.

There's no cure, but early detection and treatment can significantly increase the survival rate of patients. So Sanjay, the earlier you know, apparently the better.

GUPTA: Yes, Judy, thanks. And there's obviously brain exercises they say you can do for that, try and keep that brain as strong as possible.

FORTIN: Good advice.

Thank you very much, Judy. And hopefully, a cure will be found some time soon.

Just ahead, weight loss surgery. Some insurance companies are trying to cut back. Doctors say it's unethical. You decide.

And you've seen "ER" and you've seen "Grey's Anatomy." Follow me inside the real deal. That's coming up on HOUSECALL.

(COMMERCIAL BREAK)

GUPTA: Weight loss surgeries to treat obesity are becoming increasingly common. Everyone's heard of this now. The results can be amazing, but so can the cost, upward of $20,000 per operation. Now some insurance companies are starting to balk at those numbers.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Last year, Ann Durand was twice her current size. You see, she was immobilized by an illness that caused her constant pain, and her weight went up to 287 pounds. Why? Because she couldn't exercise. Her doctor suggested she have gastric bypass surgery. For her, the operation was a success.

ANN DURAND, GASTRIC BYPASS PATIENT: I became mobile again. I became healthy. My autoimmune disease went into remission.

GUPTA: The American Society of Bariatric Surgery says more than 177,000 patients had gastric bypass or stomach banding procedures last year. Designed for people who are considered severely obese or suffer from complications due to their weight, the surgery can be expensive as well as dangerous.

That's two things insurance companies don't like to hear.

SUSAN PISANO, AMERICA'S HEALTH INSURANCE PLANS: What the healthcare system is trying to do is to get people not to think of this as a quick fix, but to look at this surgery thoughtfully.

GUPTA: Tufts Health Plan in Massachusetts is requiring that some obese patients enter a year-long diet and counseling program before undergoing surgery. Their hope is to have patients lose their weight naturally without an operation. But some doctors feel the Tufts policy just postpones the inevitable.

FREDERICK FINELLI, DR., WASHINGTON HOSPITAL CTR.: The NIH published this 15 years ago, that only about 5 percent of patients that are morbidly obese is going to be able to lose weight by will power alone.

GUPTA: Tufts Health Plan is not the only insurance company making these changes in order to keep costs under control, but some bariatric surgeons say it's none of the insurance company's business.

SCOTT SHIKORA, DR., TUFTS: NEW ENGLAND MEDICAL CTR.: I think it's unethical for people outside of the clinical arena to make those decisions for us.

GUPTA: Decisions that Ann Durand says she was happy she made without having to wait.

(END VIDEOTAPE)

GUPTA: Stay where you are. An exclusive behind the scenes look at trauma in the ER. It's my other job. And it's just ahead.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSECALL. In addition to working here at CNN, I'm also a practicing neurosurgeon at one of the southeast's busiest trauma centers. It's called Grady Memorial Hospital here in Atlanta. And for three weeks, CNN was given exclusive access to follow me and four residents at Grady. What you're about to see is something remarkable, my fifth-year neurosurgery resident, Dr. Lou Miallen, rushing to save a life.

(BEGIN VIDEOTAPE)

UNIDENTIFIED MALE: Guy got hit by a car.

UNIDENTIFIED MALE: He needs to go to the OR within the hour or he's going to die. GUPTA: He's got a big bleed on his brain.

UNIDENTIFIED MALE: I'm down here in the red zone and there's a guy who needs to go to the OR now. He has an epidural hematoma.

I saw that scan. And then my entire day just completely shifted. Jess, open up that other door. I'm looking at the patient's head and I visualize that blood clot getting bigger.

UNIDENTIFIED MALE: What are you going to do, Jess?

UNIDENTIFIED MALE: Drain the epidural. Drain the sub dura. He's going to need an EBD.

UNIDENTIFIED MALE: EBD's going to be fun.

UNIDENTIFIED MALE: Did you talk to the mom?

UNIDENTIFIED MALE: I did. I talked to mom.

UNIDENTIFIED MALE: We know what's going to happen to this guy, and so we're kind of pushing people out of the way, maybe being a little bit rude. Hey, guys, we're coming through.

If there was a blood clot on my brain, and a guy was making a big deal about rushing, I'd appreciate that. This is what they call the golden hour of trauma.

UNIDENTIFIED MALE: Trauma's not something you want to make up as you go along.

UNIDENTIFIED MALE: Give Jess a marking pen.

GUPTA: So Jess already has already got the head position. Moves shades ahead. Jess makes the marks. Jessica is scrubbing his hands already, while Lou's finishing up (INAUDIBLE) hands. And it's all just a - it's an orchestrated dance.

UNIDENTIFIED MALE: I can do this.

GUPTA: Jess was here all day yesterday. And we are going to basically let him deal with the operating hand, which is a case that he will typically do.

UNIDENTIFIED MALE: Kelly clamp.

GUPTA: He's got a chief resident showing him things.

UNIDENTIFIED MALE: Let me show you a trick.

GUPTA: I'll show him things as well.

Really get down low and scrape that.

UNIDENTIFIED MALE: Memorize the look of this.

UNIDENTIFIED MALE: Lou is very intense, but he's also someone who openly praises you when you do good things.

UNIDENTIFIED MALE: That's what I like to see.

UNIDENTIFIED MALE: He's a natural leader.

UNIDENTIFIED MALE: We're closing. A lot of blood in there.

GUPTA: Now how he's going to do, we'll know over the next few days. But the pressure's off his brain, and that's the key.

UNIDENTIFIED MALE: It's a traumatic brain injury. And so we've given him the best shot that he has to recover.

(END VIDEOTAPE)

GUPTA: It's incredible stuff. See more of what goes on ...

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