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Sanjay Gupta MD

Botched Execution; Building Better Brains; First MERS Case in U.S.

Aired May 04, 2014 - 07:30   ET

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


DR. SANJAY GUPTA, CNN HOST: Today, I want to talk about one of the most ethically challenging things in medicine, something I thought about since I was a first year medical student. Should we use the tools of our trade, the years of our training, our skills not to prolong life or improve life but to end it, to put people to death?

This question came into sharp focus this week in Oklahoma. There were two lethal injections planned, two murderers, the same night. But the first one didn't go as planned, so they called off the second one.

So, I ask again, should these medications that are commonly used in hospitals to prolong life also be used to kill? It's a dilemma no matter how you feel about the death penalty. The goal of capital punishment is to remove a criminal from society. It's not supposed to be torture or cruel and unusual punishment. That appears to be exactly what happened.

(BEGIN VIDEOTAPE)

COURTNEY FRANCISCO, WITNESS TO EXECUTION: He was struggling to talk. Those are words we got out. Man, I'm not and something's wrong.

GUPTA (voice-over): They may be the last words spoken by Oklahoma inmate, Clayton Lockett, uttered during his botched execution. What happened is his vein gave out during the lethal injection, prompting authorities to quickly halt the procedure. The drugs weren't getting to his blood but rather soft tissues.

ROBERT PATTON, DIRECTOR, OKLAHOMA DEPARTMENT OF CORRECTION: It was my decision at that time to stop the execution.

GUPTA: The first drug in the lethal injection cocktail is supposed to render a person senseless and sedate, but witnesses say Lockett was still conscious seven minutes after that first injection. At 16 minutes, he seemingly tried to get up and talk. It was then that prison officials closed the blinds, shutting out the media gathered to witness.

FRANCISCO: We didn't know what was happening on the other side of the blinds. We didn't know if he was still dying or if they were still pumping drugs in him.

GUPTA: Forty-three minutes after the first injection, Lockett died.

PATTON: The inmate suffered what appears to be a massive heart attack and passed away.

GUPTA: That botched execution prompted a stay on another execution scheduled for later that day. And it's quickly sparked controversy across the nation.

(END VIDEOTAPE)

GUPTA: And here with me now is Dr. Joel Zivot. He's an anesthesiologist at Emory University, actually a colleague of mine. And he studied and written about the death penalty and how it's carried out.

Welcome to the program.

DR. JOEL ZIVOT, EMORY UNIVERSITY: Thanks for having me.

GUPTA: You know, this is one of the philosophically sticky areas. I am curious, you have written you don't think this can be done humanely. It's a propagation of fiction to suggest that these lethal injections are humane process. What did you mean by these propagation of fiction?

ZIVOT: Well, people ask me and they ask physicians, they ask us when they see these, why can't this be made better? Why -- what's the problem here? And I was struggling for an analogy.

Maybe the way to think about this is it is a bit like asking a lifeguard, how can you help someone drown better? You know, they move their arms and legs around, it just doesn't look good. Can you please advise us?

So whenever we get engaged in these sorts of conversations how can you make lethal injection better and is lethal injection botched, even that I find to be an odd sort of question.

GUPTA: From what we know about some of these medications, this is obviously based on data, in the operating room where you put patients to sleep, there's a medication given first in this case, midazolam, which is supposed to make someone sort of senseless, right? Not only are they not aware of their surroundings, but if they were to be aroused after, they wouldn't remember it. It causes amnesia.

If that's given, I mean, would the -- I mean, based on your -- would the patient have any knowledge of the paralytic and other medications being given to stop the heart?

ZIVOT: Well, you're talking about a patient now. So, if you're talking about a patient, then we're talking about something different than an inmate who is not a patient.

GUPTA: But just in terms of what the drugs do to the body.

ZIVOT: Well, what midazolam will do -- you're right. Midazolam can create amnesia. Now, what's interesting about midazolam is that when I give a patient midazolam, I can have a conversation with them after giving it to them, and afterwards, say we go ahead and we conduct an anesthetic, later on, I ask them, do you recall the conversation that we had, they will say no. Not completely, but it can create that kind of amnesia.

But they still experience it in the moment. So, the advantage of midazolam in an anesthetic, of course, is it's amnesia in the moment. But afterwards, you know, that's the point, and I can't ask an executed person, the amnesia they would have is useless to them, isn't it?

GUPTA: That's a fascinating point. The idea that someone could still experience other things, despite being under the influence of that medication I think is a really important point. As you point out, we don't have the opportunity to go back and reevaluate.

ZIVOT: No.

GUPTA: You suggest in a "USA Today" editorial, firing squad, guillotine, something like that. Are you being facetious or are you being honest?

ZIVOT: Look, my view of the death penalty, the rightness and wrongness of death penalty is really not at issue. I will tell you that lethal injection won't work. It won't work. Even if it looks like it works, it won't. It won't satisfy the question of cruelty.

So, if states choose to execute, how they choose to execute is their business, but they can't use medicine to do it. That's my position.

GUPTA: Is it the least sort of cruel, least, you know, the most humane?

ZIVOT: To my view it is no less cruel than any other method per se.

GUPTA: Firing squad?

ZIVOT: The only reason why lethal injection appears to be less cruel is because of how it appears, and it appears like that because of paralyzing drugs, for example, where they just don't move around, and maybe there's no spilling of blood or there's no sounds. You know, it's really like I think as I've said, this is honestly a little bit of theater is the appearance that is being created here. The curtain goes down, the curtain it feels very unseemly.

GUPTA: As a first year medical student, it seems like we have these conversations, it's always philosophically sticky. But I think most people in the medical profession, you know, share your concerns about this. I mean, there's nothing ideal about this at all. So, I appreciate. I appreciate your perspective.

ZIVOT: Thank you. Thank you so much.

GUPTA: Next, we're going to shift gears here a little bit to the neuroscience of happiness.

And also, unlikely champion, someone I have gotten to know well. Goldie Hawn, she is bringing it to the classroom. We'll explain. (COMMERCIAL BREAK)

GUPTA: Mindfulness is something that a lot of people talk about in the context of religion. Other people think about it as the science of de-stressing. It is a popular topic, a topic at the World Economic Forum. Arianna Huffington has written a book about it. Employees at the insurance company Aetna as well as other companies practice it. And now actress Goldie Hawn is bringing it to schools all over the world.

(BEGIN VIDEOTAPE)

UNIDENTIFIED FEMALE: One breath through your nose. Feel it go all the way through your body.

GUPTA (voice-over): On any given day.

UNIDENTIFIED FEMALE: Hold it and release it.

GUPTA: At any given time, at Basalt Elementary nestled in Colorado's Roaring Fork Valley.

UNIDENTIFIED FEMALE: Two more big breaths on your own.

GUPTA: You can find students taking a brain break. It's a cornerstone of MindUP. A program dedicated to bringing mindfulness into the classroom.

STUDENT: We're not worried about anything because we're just focused on breathing.

GUPTA: Basalt Elementary is one of thousands of schools that have adopted MindUP over the past 10 years. MindUP founder and creator, actress Goldie Hawn, believes when children better understand how their brains work, they can better handle their emotions.

GOLDIE HAWN, ACTRESS: We felt teaching them about their brain and how that would work and how they actually know that a brain is plastic and you can really move it by thinking about things long enough that they would feel more optimistic. And then realizing that an ability to be optimistic opens the brain up and children can learn better.

GUPTA: So, MindUP classes integrate learning about different parts of the brain into their lessons.

STUDENTS: We need to learn about our brains. Amygdala passes information to the cranial cortex.

GUPTA: As a neuroscientist myself, I was intrigued by all of this. I decided to meet Hawn and the principal Suzanne Wheeler-Del Piccolo to see how it works.

(on camera): The idea of weaving it through these students' day, that was important to you, right?

HAWN: I want it woven into the tapestry of their day. UNIDENTIFIED FEMALE: So, today, we're going to practice just slowing down.

GUPTA (voice-over): It is even present when they eat.

UNIDENTIFIED FEMALE: We're going to eat a little bitty raisin, you're not going to do anything with it except hold it in your hand and really look at it. Examine it and feel it.

GUPTA: What do you think a child will take away from that?

HAWN: So, that is activating the brain, calming the brain down, but keeping it in a single point focus. Then they learn how to eat. They know how to savor, to learn how their taste buds are alive, they learn about how the body works.

UNIDENTIFIED FEMALE: When you taste, what are you using?

STUDENT: Your tongue.

UNIDENTIFIED FEMALE: Your tongue, very good. And are you going to be eating dirt and rocks?

STUDENTS: No!

UNIDENTIFIED FEMALE: No, what are you going to eat?

STUDENTS: Food.

UNIDENTIFIED FEMALE: Food, and why?

STUDENT: Because when you eat, it makes you have energy, and when you have energy, it makes your blood flow, and when your blood flows, you can think better.

UNIDENTIFIED FEMALE: Let's take a moment now and enjoy.

GUPTA: They are forced to slow down and focus when they eat. Hardly anybody, adults or children, does that any more.

(on camera): Do you think you would eat as much if you ate it the way you just did?

STUDENT: Instead of just putting it in your mouth and just like eating it, you're like savoring it and you're actually making good use out of it.

GUPTA: How do you describe mindfulness?

HAWN: Mindfulness is very simple really. It's the ability to focus but it also allows you to live in the moment. You feel like a child. Your eyes actually can look like a child because you're seeing things you've never seen before.

GUPTA: It sounds really good. I mean, who doesn't want that, right?

HAWN: I think that a lot of people don't know how because it's a technique.

GUPTA (voice-over): Goldie Hawn says she was always a happy person growing up, but she hit a roadblock herself when she stumbled into stardom.

HAWN: I mean, life at 21, suddenly you're a star overnight -- I mean, it's not easy. I was a dancer five minutes ago, now where am I, you know? So I went to the areas I needed in order to continue to develop.

GUPTA: But 13 years ago after 9/11, she saw children undergoing undue amounts of stress.

HAWN: And I thought what am I going to do? Just me. But I have to do something for children so they can basically handle this very troubled world.

GUPTA: Then, after hearing about school shooting after school shooting, this all became urgent.

HAWN: And when I see kids killing other kids and I see them killing themselves, which I still can't tolerate because it still makes me weep, it's not acceptable in the United States of America. We're better than that.

GUPTA: So, Hawn decided to collaborate with neuroscientists. She gave a ted talk about how we can achieve happiness through science.

HAWN: They learn about their brains. They're learning also how to quiet their mind, because stress blocks learning.

GUPTA: Principal Wheeler-Del Piccolo credits MindUP with helping her school achieve its highest scores in reading, writing and math last year. More importantly, she sees it building the character of students.

SUZANNE WHEELER-DEL PICCOLO, PRINCIPAL: So I think it is a great way to build some good character skills to help kids not choose to bully and to help kids who are bullying to help them be better people.

GUPTA: In a world of bottom lines, some schools are going to balk at the initial $5,000 training, but Hawn is passionate about it, that MindUP is not a luxury.

(on camera): How do you convince people this is a priority?

HAWN: What are we doing about their stress factor? What are we doing about movement, energy, joy, excitement, games? This builds neurons. Firing neurons in the brain that literally create a healthy brain. You cannot take these things away from our children.

(END VIDEOTAPE)

GUPTA: Now, MindUP is just one of a handful of mindfulness programs in schools across the country. Some studies found these schools promote a lasting reduction in depression, hyperactivity and also ADHD symptoms.

Now, up next, jumping back on the exercise wagon after an injury or even an operation and doing it better than before. We have something for you.

And later, check this out. What is that? That's our medical mystery, still ahead.

(COMMERCIAL BREAK)

GUPTA: You know, an injury can really put a dent in your workout routine. What about trying to rebound after an operation? I'll tell you, people do this every day. In fact, our Fit Nation athlete Jamil Nathoo is recovering from abdominal surgery to remove the last remnants of testicular cancer.

So, we decided to send him to work out in Central Park with our good friend and sports medicine expert, Dr. Jordan Metzl.

(BEGIN VIDEO CLIP)>

DR. JORDAN METZL, SPORTS MEDICINE EXPET: So, I'm going to show you a couple different exercises that you're going to do a few times a week, right?

JAMIL NATHOO, FIT NATION: OK.

METZL: The first one is just a simple squat. I want you to spread your feet wider than shoulder width, put your arms straight out here. I want to keep your chest up like me. You're going to squat below the knees. Get lower if you can, good man.

So, with this one, watch me first. I am going to come down, do an easy jump and come right back down. The benefit of these is that you're both strengthening your muscles and starting to strengthen the heart. Give me five more, see what happens to your heart and breathing as you start to go.

Number two exercise I am going to give you is what we call an isometric. We introduce an exercise, the plank, great to exercise core muscles in the front and back of the spine.

NATHOO: OK.

METZL: I want you to basically get right into plank position like this. What's happening is the muscles in front and back of the spine are being worked, even though they're not moving. Can you feel that?

NATHOO: Oh, yes.

METZL: Watch me. You turn this way, give me 30 seconds like this. Try this, face this way, see what that is like. There you go. Maybe a minute forward and 30 seconds on each side. You can do these every day. All right?

And then finally, talk about exercising muscles around the chest. And I think there's nothing as good as a pushup with a little rotation.

So, for this one, let's kind of face this way. The classic pushup, down to the ground, back up. Let's put in a rotation in this. If you get better, you can start using weights, too. I am going to have you rotate left, push up, rotate right. Push up.

We are going to strengthen the whole body. Again, it is not strength training or cardio, we can do those together.

If you do that a few times a week, we're going to get you ready for the race. All right? You're going to be great.

NATHOO: Thank you. I appreciate it.

METZL: My pleasure.

(END VIDEOTAPE)

GUPTA: Some pretty good tips there.

Also, no excuses. If you can do this after an abdominal operation, you can get up today and do something, anything.

Also if you're looking for an all natural no pill prescription for better health and longer life, pick up Jordan's book. You just met him there. It's called "The Exercise Cure."

You know, another person that didn't let an injury slow her down, painter Natalie Irish. She's got this method of making art. But I'll guarantee you, she's going to put a smile on your face.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): For as long as she can remember, Natalie Irish has been passionate about art. But when she was diagnosed with Type 1 diabetes at age 18, even that become a struggle for her.

NATALIE IRISH, TYPE 1 DIABETIC: I can't keep my eyes open. I can't focus on my art classes.

GUPTA: Turns out her blood sugar was seven times higher than normal. Doctors were surprised she hadn't lapsed into a diabetic coma.

IRISH: Everything changed. My priorities, the way I ate, the way I lived my life, just starting from scratch.

GUPTA: Not long after, something else changed, too, her style of art.

IRISH: I put on my red lipstick and I blotted it on a piece of tissue and saw a lip print. And I was like, ah, I can paint with that.

GUPTA: That's right, she paints with her lips.

IRISH: This is just - this is just a different paint brush.

GUPTA: Natalie creates masterpieces. She says some of them sell for thousands of dollars. And she's using that attention to help raise awareness about Type 1 diabetes. She says her biggest message, fix the physical, but don't forget about the mental.

IRISH: Every day is going to be different. You're going to have good days and bad days. But it's not, you know, hell, it's not our fault.

(END VIDEOTAPE)

GUPTA: I don't know how she does with her lips. Actually makes those amazing paintings.

Good luck, Natalie.

Up next, though, we have a medical mystery. What this picture shows and why it's so dangerous.

Stay with us.

(COMMERCIAL BREAK)

GUPTA: Got my eye on medical mysteries this week. This is a disease that's killing about a third of people that get infected. And there were more than two dozen new cases reported just this past week.

It's called MERS. It's not a sexy name, M-E-R-S. In all the cases, more than 300 total, are linked to the Middle East, mostly Saudi Arabia.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): MERS is short for Middle East Respiratory Syndrome. It's a virus that causes fever, shortness of breath, often pneumonia.

And on Friday, the CDC reported the first patient in the United States. He's a health care worker who recently flew from Saudi Arabia through London to Chicago, and then rode a bus to Indiana.

They do say the general public in the United States isn't at risk.

DR. ANNE SHUCHAT, DIRECTOR, CDC NATL CENTER FOR IMMUNIZATION & RESPIRATORY DISEASES: But we think it is important for the public to know if they have traveled to the Arabian peninsula and developed respiratory symptoms with fever within two weeks after returning home, they should see their provider and let their doctor or nurse know about their travel history.

GUPTA: The outbreak started in 2012, and a big question has been, where did it come from? Well, now, you're looking at a prime suspect, a one humped camel.

This week, scientists say they found a live MERS virus in two of these animals. It's a strain that's identical to what's been found in people.

DR. IAN LIPKIN, MAILMAN SCHOOL OF PUBLIC HEALTH, COLUMBIA UNIVERSITY: Now, the camel finding indicates that cam else are a very likely source of human infection.

GUPTA: They also say nearly three-quarters of the camels have antibodies to the MERS virus, meaning they have been exposed. But we still don't know how it spread and who is most at risk. Do you have to touch the camel or a spot where the camel has been? What about camel milk and camel meat?

LIPKIN: Sufficient for us to say that some practices, such as eating raw camel meat, or drinking raw camel milk are almost certainly unsafe.

GUPTA: Of course, it's not just camels. This does spread from person to person.

Doctors and nurses have caught it from patients. Family members have caught it from each other.

(END VIDEOTAPE)

GUPTA: Now, we do hear that they're working on plans to keep people safe during this year's Hajj. That's the pilgrimage that's going to be bring millions of people for this part of the world, in October. We are going to stay on top of the story.

Also, stay connected with me at CNN.com/Sanjay. Let's keep the conversation going on Twitter. I want to hear from you @DrSanjayGupta.

Time now, though, to get you back to the "CNN NEWSROOM" with Randi Kaye.