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Cleveland Doctors Perform Face Transplant
Aired December 17, 2008 - 13:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
(BEGIN VIDEOTAPE)
KYRA PHILLIPS, HOST (voice-over): Plastic surgery it's not. This is drastic surgery: the cutting edge of transplant operations. A whole new face. We'll hear live from the surgeons this hour.
In the face of astronomical losses and allegations of fraud, the feds who didn't know what this man was up to decide to investigate themselves.
UNIDENTIFIED MALE: Imagine a brilliant 85-degree, beautiful, blue skies July 4 weekend. Now, imagine at the end of that weekend everyone leaving the beach at the same time.
PHILLIPS: Inauguration day won't be a day at the beach for the wireless networks in D.C. They call it cell phone traffic for a reason. And the carriers are bracing for gridlock.
(END VIDEOTAPE)
PHILLIPS: And hello, everyone. I'm Kyra Phillips live at the CNN world headquarters in Atlanta. You're live in the CNN NEWSROOM.
Heart transplants are old hat. Lung, livers kidneys change hands every day, but faces are different. And for the first time in America, and only the fourth time in the world, surgeons have performed a near total face transplant.
It happened this month at the Cleveland Clinic, and we expect to learn more in a news conference there any minute now. Live pictures from the Cleveland Clinic.
Now, while we wait, let's get into some ethical issues. As I said, aces are different. And Art Caplan has thought a lot about that. He's chairman of the medical ethics department at the University of Pennsylvania. He joins me this hour from Philadelphia.
You know, Art, I heard you this morning, talking on "AMERICAN MORNING" with John Roberts, and it really caught my attention when you said that this patient should have the option to pursue assisted suicide if this doesn't work out, and it made us all sort of stop in our tracks. Explain this.
ART CAPLAN, CHAIRMAN, MEDICAL ETHICS DEPARTMENT, UNIVERSITY OF PENNSYLVANIA: Well, if you reject a kidney transplant, you can get another one. Heart transplant, you can get another one. With a face transplant, if this fails, it's almost impossible to go and do another one.
So you're in a situation now where, literally, if the thing goes wrong, your face is sloughing off, falling off. You're going to have to eat through a tube. You're going to have to breathe through a ventilator.
And my view is, I'm not against doing this procedure. I think it's ethically justified, but you have to be ready to allow that person to die, if they say, "I can't go on," if this thing goes wrong. So that would be up to and including giving them a lot of pain control that might kill them.
PHILLIPS: I'm sorry. The producer's talking to me, Art. I apologize. What would you like me to do, Eddie?
OK, Art, I'm being told that there's somebody at the podium there at this live news conference to talk about this procedure. Trying to figure out who that is, and if, indeed, this is going to -- so I'll just let the producers pay attention to that and let me know once we want to take it.
CAPLAN: Very good.
PHILLIPS: Do you actually see this live picture, Art? Because we...
CAPLAN: I can't see it.
PHILLIPS: There are some doctors approaching the podium, stepping up to the mike. So as soon as those doctors start talking I'm going to take it live. And if you don't mind, I'd love to listen to it together and then get your insight, if you can stick around with me for a little bit.
All right. So let me ask you this. I completely see what you're seeing about -- or saying, rather, about you would want the choice. I mean, this is probably that would not want to continue life feeling -- eating from a tube and your face sloughing -- I can't even imagine.
CAPLAN: Right. It's the worst, most gruesome thing you can think of.
PHILLIPS: And so legally, then, is that even a possibility?
CAPLAN: Well, you know, I know this Cleveland group, and I think that they have thought about this, but I don't know if they're willing to go that far. I hope they are. I hope it comes up in the press conference. But I'm not sure they've really said, "We'd allow someone to die if this didn't work."
PHILLIPS: All right. Art, stay with me. We're going to go ahead and listen in now, trying to figure out who the players are and we'd love to talk to you again.
UNIDENTIFIED MALE: ... a research scientist and whose career has been dedicated to making this day possible. The team that you see with me today represents a group of, from 12 different specialties in medicine: plastic surgery, head and neck surgery, transplant patient surgery, anesthesia, psychiatry, psychology, bioethics, nursing, social work, infectious disease, dentistry, ophthalmology and pharmacy. Truly a team effort involving many, many specialties.
And I'd like to introduce now a colleague and the leader of this team, Dr. Siemionow.
DR. MARIA SIEMIONOW, CLEVELAND CLINIC: Thank you. Thank you all for coming here to Cleveland. I'm very proud and emotional today to share with you that we have finally did it, and this procedure went well, according to the plan, and the patient is doing well.
The surgery took 22 hours. The preparation to the surgery took over 20 years of work in the field of composite tissue transplantation. The studies included technical aspects of transplantation procedure, exciting, new immunological aspects of transplantation of composite grafts and the most importantly, the ethical aspects of the procedure.
Based on the 20 years of work, extensively published in the most reputable journals of plastic surgery, transplantation and bioethics, we were granted by Cleveland Clinic IRB first in the world approval to go ahead with the procedure of face transplantation in humans.
I just want to remind all that we were granted this IRB approval four years ago. The procedure didn't happen overnight. We were very careful to work for the four years on development of multidisciplinary team, the training and the techniques of facial transplantation in the laboratories, as well as working on -- very thoroughly on the screening process of the patients who were potential candidates for this procedure.
Our approach from the very beginning was that only patients who are the most disfigured and exhausted already all existing procedures, which are conventional procedures, will be the potential candidate. And this patient exhausted all conventional means of reconstruction, and is the right patient.
After the surgery we know that there are so many patients there, in their houses, where they are hiding from the society because they are afraid to walk to the grocery stores. They are afraid to go to the streets, because they're called names, and they're humiliated.
Our patient was called names, and was humiliated in many countries with the patients and going out to the social situations. So we very much hope that for this very special group of patients, there is a hope that one day they will be able to go comfortably from their houses and enjoy the things which we take for granted. We need the face to face the world.
So I think, with that, I would like to thank the team of great surgeons and friends, and there will be never possibility to pull it out without them. Thank you.
And I would like Dr. Eric Kodish from antibiotics to please, come.
DR. ERIC KODISH, CHAIRMAN, CLEVELAND CLINIC BIOETHICS DEPARTMENT: Thank you Maria.
Good afternoon. I'm on the podium today because we are aware of and responsive to the ethical challenges in surgical innovation here at Cleveland Clinic, and we integrate ethics consultation into the function of every transplant team.
My goal in these brief remarks is to emphasize the ethical basis of our decision to go forward with this first-of-its-kind procedure.
I also want to reinforce the fact, as Maria did, that we did this under IRB protocol. We consider it to be human subjects research in which the patient was appropriately protected.
Finally, and most importantly, I want to underscore the moral obligation we have, and we hope that you and the press will also recognize, to respect the right to privacy for both the recipient and the donor family.
This is not cosmetic surgery in any conventional sense. The face is the physical embodiment of personal identity, and human beings are inherently social creatures. A person who has sustained trauma or other devastation to the face is generally isolated and suffers tremendously. The damage to the quality of life cannot even be put into words.
In addition to the profound social implications of a devastating facial injury, there are functional considerations. We have hope that our patient will begin to smile again, will be able to smell again. And we hope that other similarly injured patients, if they undergo this technique, will get function back.
The relief of suffering is at the core of medical ethics, and provides abundant moral justification for this procedure.
To protect the patient's privacy, I do not wish to disclose too much about the informed consent process, only enough to reassure the public. I will tell you that it involved the entire team, including surgeons, mental health professionals and two ethicists.
My colleague, Dr. Carmen Parati (ph) is an experienced ethics consultant and a former plastic surgeon. And both Doctor Parati (ph) and I met with this patient. We know that she has a clear understanding of the risk of rejection, the risk of immunosuppression, including cancer and infection, and the experimental nature of this procedure. She has agreed to proceed with hope that this will help her and will help others in the future.
The Cleveland Clinic IRB approved this in late 2004. This is a multidisciplinary group. It has representation from law, medicine, regulatory expertise, nursing and ethics, among others. The process of IRB review is extended. It was a ten-month process, and there were multiple and in-depth ethics discussion. Consultation with our bioethics department was part of the due diligence that was done. The committee struggled with the British and French opinions at that time that expressed deep reservations about going forward. In the four years that have passed, the British have recently published a paper that's more permissive in its approach to face transplantation, and the French have gone ahead and done a partial face transplant.
The team has followed the protocol set forth by the IRB, and we're confident that human subjects protections were followed from a regulatory perspective.
More importantly, we believe that the ethical basis for this endeavor is beyond reproach.
We want to protect the privacy of the recipient and the donor. Please imagine yourself as the patient who's received a facial transplant. Imagine yourself as a family member who has decided to give this very special gift from a deceased loved one. Now use your moral imagination, and I think it will be obvious to you that this is a very sensitive situation. And this is the reason we urge you to use restraint.
For the families, friends and loved ones of the deceased donor, this team has a very special message. We hope that you are listening so that we can publicly say thank you on behalf of our patient, and on behalf of all who may benefit from this in the future.
Having made the decision out of a desire to help in this remarkable way, we hope that everyone will use good judgment and avoid sensationalizing this milestone of medical progress.
And I'd like to point out now that Mr. Gordon Bowen, who is the CEO of our organ procurement agency life bank, is with us today and will be available for questions.
In conclusion, a word about the slippery slope. No one has a crystal ball. We cannot predict the future. Having said that, we anticipate that some may be concerned the facial transplantation will lead to the use of this procedure as a cosmetic enhancement technique, or as a means of identity transfer. We will do our best to prevent this from happening, and we believe that our society can reach consensus and put safeguards in place to prevent -- prevent this from happening.
We would suggest that this procedure must be limited to the medical context. That's what we do here at Cleveland Clinic. And we do not think this should be used for cosmetic enhancement.
As we go forward, we must and we will do everything within our power to prevent the misuse of this important event. I'd like to thank you for your attention. And I'm really pleased now to introduce Dr. Frank Papay, who is the chair of the Dermatology and Plastic Surgery Institute.
PHILLIPS: We're going to continue to monitor this live news conference that's taking place, but it's a historic moment with regard to bioethics, plastic surgery, transplantation. You're listening to the doctors there are the Cleveland Clinic talk about the first-ever face transplant.
And Art Caplan, chairman of the medical ethics department at the University of Pennsylvania, he's actually got to get on to an important faculty meeting. And I wanted to thank you so much, Art, for just giving me a couple more minutes, because it's really a fascinating discussion.
And we just heard from the doctor there, with regard to the bioethical side of this. There were a couple of things that he said that I found interesting in that you have to think about moral justification here, and use your moral imagination. There's a moral obligation. He said that, you know, three -- he said it in three different ways, using the word "moral." Talk to me about this.
CAPLAN: Well, the -- part of the reason he's trying to make the case so insistently is that transplants up until now have been life saving. If your heart's failing, liver's failing, you're going to die. And so the risks involved with the transplant: drugs that can cause cancer, drugs that can cause kidney failure, all kinds of complications, you don't worry about them. You're going to face death.
With a face transplant you're doing it to improve quality of life. You're trying to make the person both social, able to go outside, see others, and to suffer less. That's not the same as saving their lives. And so there will be those who say, shouldn't take those risks unless you're going to try to save a life.
I don't agree. I agree with the clinic. I think the case can be made, given the misery people with disfigured faces have, severely disfigured faces, that it is justified to at least try.
PHILLIPS: OK. So here's my -- here's my question then, and can you even define this and legally print it out this way, because if you think about it, she wasn't going to die. Right?
CAPLAN: Correct.
PHILLIPS: This was something that was about her looks. And you listen to the doctor, the head of plastic surgery. And she said that this patient was called names, humiliated in public. She'd gone through her whole life -- or since the injury, she went through, you know, being humiliated like this.
And so even though it wasn't life threatening, let's think about how this could completely change somebody's life. I mean, you would think, because you don't want this to become a form of plastic surgery like, "Oh, you know what, Art? I am so unhappy with my mouth. Find a cadaver..."
CAPLAN: Yes, yes, yes.
PHILLIPS: "... and give me a new mouth," when you already have a very nice mouth. So -- so can you use this now, and differentiate, if it's not life-saving that, OK, maybe there's a clause you can put in there, if it would change the quality of life in a different perspective, just other than physical.
CAPLAN: I think you can. I think you can. Remember, you'd only try this on someone who the plastic surgeon said, "We can't fix that. We can't repair that." And that's not a nose job. And that's not liposuction. And that's not putting something in your lips to make them bigger. This is serious surgical intervention.
Trust me, also, you wouldn't want this done ever for aesthetic reasons. I know that was brought up. It's so invasive, so traumatic a surgery. You've got to take drugs the rest of your life. Only the truly needy, someone who had no other option but to go through this, I think, would be thinking about it, and it could fail.
Let me add, too, it's difficult for others, because they're going to look at you and know that you had the transplant. If I had a kidney transplant, if I don't tell you, you don't know. Everybody will know that this person had a face transplant. It's going to have emotional and psychological impacts that we don't even understand yet on both the recipient and the people that they know. Hopefully, it will be positive, but we're not sure.
So we're in a zone here where risks are huge. I don't think there's any argument to use this in a trivial sense. But there are people who are so hurt, so damaged, that I do think it's worth trying this experiment today.
PHILLIPS: I've got 50 seconds with you. She's still not out of the woods, though, right?
CAPLAN: Still not out of the woods. No acute rejection. She's about two weeks out. So, so far, so good. She didn't immediately reject the face, but in the other transplants done in France, there have been chronic rejection problems. They've had to change the dose. We've got more tissue transplanted here than ever before. There still is a danger that face could fail, and if it does, it's going to be one heck of a nightmare.
PHILLIPS: Because then we've got to talk about her life.
CAPLAN: Correct.
PHILLIPS: That's the second part. Art Caplan, sure appreciate it. Thank you so much for making time for us.
CAPLAN: My pleasure.
PHILLIPS: Elizabeth Cohen, our medical correspondent, also following this for us.
Now, I know there's a lot we don't know about her, because of privacy issue, but do we know what the injury was, how old she was when she got the injury, and how it got to this point?
ELIZABETH COHEN, CNN CORRESPONDENT: We don't know. We know major trauma, severe trauma. That's what we were told. So we don't know if she was in a car accident. We don't know if, like with another face transplant patient, perhaps a dog mauled her. We just don't know. But we do know was that it was severe. She was most likely severely, severely disfigured.
PHILLIPS: Do we know how she got to be -- how she was selected to come to this point? I mean, there's a lot of people that have horrible disfiguration. Why her?
COHEN: Part of it was probably that they could, as Art Caplan said, they couldn't do anything else. There was no other avenue for her to get a face that was even vaguely normal.
Another thing is that maybe that's who they found a match for. I mean, you can't just take anybody's face and put it on her. You have to match for all sorts of immune issues, and you also have to match cosmetically. For kidneys, it doesn't matter what they look like. You wouldn't want to put a black face on a white woman, or vice versa. So you've got to match cosmetically, as well.
PHILLIPS: Well, that's interesting. Have we heard from her at all? Has she made any kind of statement or...
COHEN: You know, we've haven't heard from her, but we have heard from a sibling. They issued -- Cleveland Clinic actually released a statement from one of her siblings.
And in this statement it says, "We never thought for a moment that our sister would ever have a chance at normal life again after the trauma she endured. There are tears of joy and tears of pain that it took one to pass." In other words, that it took someone to pass away for her to have life.
So, again, stating that this face that she got came from a cadaver. Someone died, and she now has that person's face.
PHILLIPS: And I know we have an animation. So can you tell us exactly, was it the whole entire -- what part of the face?
COHEN: It was not the whole entire face.
PHILLIPS: OK.
COHEN: Let's take a look at this. This comes to us, courtesy of the Cleveland Clinic. They just took off that portion and put on that portion. So she still has her forehead and part of her chin and lower lip. So they just took off one portion. It's not like a whole face. It's not like an entire mask.
PHILLIPS: Now, I think in -- I hope I'm getting my facts right -- it sounds like in 2004 that this type of procedure was approved. So why did it take to this point for us to finally see something happen?
COHEN: Right, and it was approved for them to do as an experiment. And the reason the Cleveland Clinic says it took them four years was that they wanted to get it right, not just from a technical point of view but from an ethical point of view. So a technical point of view, there's a lot of working parts in your face. I mean, you need to make sure that she can smell, that she can taste, that all the muscles move, that all the nerves are working.
And ethically speaking, you want to make sure that you get a patient who understands the risks that she is taking. Before this transplant, she was alive. This transplant could theoretically have killed her. So you've got to explain to her, this new face might be fabulous for you, but you know what? It might also be a disaster. And you have to get someone who understands those pros and cons.
PHILLIPS: Well, it's definitely a fascinating story.
COHEN: It is.
PHILLIPS: We're going to talk about it all afternoon.
COHEN: Thanks.
PHILLIPS: Thanks so much, Elizabeth.
Well, winter is still four days away, but it feels like it's been here forever. Chicago, Detroit, even Arizona gets a big dose of snow and ice. We're going to tell you what's in the forecast.
(COMMERCIAL BREAK)
PHILLIPS: Rod Blagojevich said that he can't wait to speak out about those incriminating wiretaps and the bombshell charges against him. The scandal-ridden Illinois governor spoke briefly today to reporters who staked out his home in Chicago ever since his arrest by the FBI just eight days ago.
(BEGIN VIDEO CLIP)
GOV. ROD BLAGOJEVICH (D), ILLINOIS: I can't wait to begin to tell my side of the story, and to address you guys and, most importantly, the people of Illinois. That's who I'm dying to talk to. There's a time and place for everything. That day will soon be here, and you might know more about that today, maybe no later than tomorrow.
(END VIDEO CLIP)
PHILLIPS: Well, down in Springfield a legislative panel is back at work on a process that could lead to impeachment. This time, Blagojevich's newly hired lawyer is front and center.
Barack Obama is two steps closer to putting the finishing touches on his cabinet. Just a short time ago in Chicago, the president-elect announced that he's picked former Iowa governor, Tom Vilsack, as agriculture secretary and Colorado Senator Ken Salazar as interior secretary.
(BEGIN VIDEO CLIP) SEN. BARACK OBAMA (D-IL), PRESIDENT-ELECT: It is time for a new kind of leadership in Washington that's committed to using our lands in a responsible way to benefit all of our families. That means ensuring that, even as we are promoting development where it makes sense, we are also fulfilling our obligation to protect our natural resources.
TOM VILSACK, AGRICULTURE SECRETARY NOMINEE: I look forward to working with congressional leaders who share the president-elect's vision of bringing hope to rural America, of being good stewards of our natural resources, of providing American leadership on climate change, and making America a nation truly dedicated to health and...
(END VIDEO CLIP)
PHILLIPS: Well, Obama's transition team says that more announcements are expected this week before the president-elect heads to Hawaii for Christmas vacation. And with today's picks, there are still two more cabinet posts to fill: labor and transportation. And Obama still hasn't named a CIA director or national intelligence director.
ANNOUNCER: You're watching CNN, your severe weather headquarters.
PHILLIPS: Well, you can take your pick today. Ice, snow, rain, fog, some nasty weather across much of the U.S. And these scenes, a bit much, though, even for Chicago in this week before winter begins. A big storm yesterday added a new layer of snow and ice across that city. Schools shut down. Traffic was snarled at O'Hare International Airport.
And then in Michigan, similar scenes as the storm moved through. Heavy snow fell in Detroit and other areas, making travel pretty dangerous.
And check out this scene in Arizona. A lot of heavy snow there, as well. Warnings of more snow in place in the state's higher elevations. Desert areas are under a flood watch now. Wow.
Chad Myers keeping track of all that nasty stuff for us. But in a way, I guess that's what we have to expect for this time of year.
CHAD MYERS, CNN METEOROLOGIST: The only thing I don't have is a hurricane.
PHILLIPS: Thank goodness.
MYERS: I mean, literally. Snow, rain, flooding, all kinds of stuff. Potential for mudslides across Southern California.
(WEATHER REPORT)
PHILLIPS: Wow. OK, Chad, thanks.
MYERS: You got it. PHILLIPS: Well, a lot of activity on Wall Street. A look at the markets just ahead. And we'll look at the continuing chaos caused by the Iraqi journalist who tossed his shoes at President Bush.
(COMMERCIAL BREAK)
PHILLIPS: Steve Jobs is considered the last of the rock star CEOs credited with putting Apple back into the spotlight. So what he says and does matters to investors. Susan Lisovicz at the New York Stock Exchange to tell us why Wall Street is so concerned about Steve Jobs today.
Hey, Susan.
SUSAN LISOVICZ, CNN CORRESPONDENT: Kyra, Steve Jobs is in a league all his own, and we have word from Apple that he will not be giving the keynote speech at -- early next month at the MacWorld event, which is a huge tech event. And it has been a place where Apple has unveiled some of its most successful products, like say the iPhone, the Mac Air laptop computer, things like that.
Apple shares as a result are down about 7 percent, and so is the market, but we're off the lows. Right now the Dow is off 19 points. Nasdaq is down 3 points, of course, we had a huge rally yesterday.
Jobs' keynote address is widely followed. Basically what the company is saying is that -- that they prefer to do their own events as opposed to having him or other top executives appear at these industry events.
What the concern is, Kyra, is that Jobs is a pancreatic cancer survivor, he has appeared anyone recent months, the company is not talking about it. It's just one of those things that investors get very concerned about when there's a sudden change in something that has been a long-running event. Jobs appeared there for more than a decade -- Kyra.
PHILLIPS: Oh, we don't follow too many CEOs except when they get into trouble. So what makes Steve Jobs so important?
LISOVICZ: Because he really is -- he has got a cult of personality, and he has got just an incredibly successful track record, not only co-founding Apple way back in the 1970s, creating one of the first commercially successful PCs, he was also CEO of Pixar Animation Studios.
And think about the track record there between "A Bug's Life," "Toy Story," "Finding Nemo," and so on. His hallmark is basically creating things that are practical yet elegant.
Think about the iPod, think about the profound changes that has been, and his impact on technology and really on our lifestyle is such that "Fortune" magazine, one of our corporate cousins, said he was the most powerful businessman in America, that was just last year.
So concerns about succession, things like that, whether he's appearing or not, he's just really considered in a league of his own. And there's enough worries from Wall Street anyway, something like that just shakes things up a little bit more -- Kyra.
PHILLIPS: Oh, yes. We always like to shake things up, don't we, Susan?
LISOVICZ: We do.
PHILLIPS: All right. I'll see you in a little bit.
Well, more fallout from that shoe-throwing incident that almost knocked out the prez. One of Iraq's leading lawmakers now says he wants to quit because of the uproar in parliament.
Plus, already bruised by charges of voter registration fraud, ACORN is now facing internal scandal that could mean its downfall. Our special investigations correspondent Drew Griffin ready to give the scoop.
(COMMERCIAL BREAK)
PHILLIPS: A court date delayed for an Iraqi journalist heralded as a nut by some and a hero by others for throwing his shoes at President Bush. He had been scheduled to be in court today. But it had been postponed until next week. And now Iraqi lawmakers are squabbling over how to deal with the journalist, prompting the parliament speaker to actually threaten to resign. Jill Dougherty in Baghdad with quite a different bit of an assignment this time around.
Hi, Jill.
JILL DOUGHERTY, CNN CORRESPONDENT: It is. Hey, Kyra. Well, you know, there's a lot going on now, but one of the main things is we did expect there to be a court case today, or at least a hearing, but they actually did it last night. And that was confirmed by the judicial authorities that a judge actually heard this journalist. The journalist apparently explained what happened in that shoe-throwing incident, and the judge was there.
A court-appointed lawyer was there, and also the prosecutor. Now, the thing that's important about this is the brother of the journalist has been accusing authorities, specifically the security forces of the prime minister of beating the journalist up. In fact, he says they broke his arm, they broke his rib.
He hasn't offered any proof and he has been citing some type of sources, he wouldn't say who, but today the judicial authorities told CNN that in fact the journalist was healthy in that hearing, and that he made no complaint. He's not going to file any charges of his own, and didn't appear to want to.
So in essence, they're saying that is not true. But in something interesting that just -- we just heard. There was a case in Fallujah where the military -- U.S. military was there at an event at the business school, 200 people started throwing stones and rocks and guess what else, shoes at them -- Kyra. PHILLIPS: So it looks like it's becoming, I guess, a way of life now. I guess that's a lot better than anything that could be a little more destructive.
DOUGHERTY: Could be.
PHILLIPS: Jill Dougherty, appreciate it.
Well, all investments are risky, and the more you put up, the more you can lose it. Got it? Got it. But don't think the rich and the powerful are the only big losers in the Bernard Madoff mess.
CNN's Deb Feyerick looks at who else was caught in the rubble when the alleged pyramid collapsed.
(BEGIN VIDEOTAPE)
DEBORAH FEYERICK, CNN CORRESPONDENT (voice-over): They have all taken a hit: hospitals, universities and religious schools, senior centers, even human rights programs providing legal help to Guantanamo detainees. All relied on money from Jewish charities.
All are now tallying their losses, figuring out how to survive the alleged Bernie Madoff Ponzi scheme.
MORT ZUCKERMAN, EDITOR-IN-CHIEF, "US NEWS & WORLD REPORT": The purpose of all of the money in this charitable fund was to do good work, not to have it siphoned away by some crook.
FEYERICK: The charity run by real estate mogul Mort Zuckerman lost $30 million, about 10 percent of its value, because of the alleged fraud. He is one of several prominent Jewish donors, including filmmaker Steven Spielberg and Holocaust survivor and humanitarian Elie Wiesel, whose charities have been hurt, if not devastated, by the Madoff scandal.
(on camera): So these are the offices that you were planning on selling back here.
ROBERT CRANE, JEHT FOUNDATION. They're not filled yet.
FEYERICK: They're not going to be filled.
CRANE: Not by us, anyway.
FEYERICK (voice-over): Robert Crane of the Levy-Church JEHT Foundation in Manhattan got the devastating news the charity was done the same day investors learned they lost virtually everything.
CRANE: We spent all weekend figuring out how we could reasonably put an end to the -- cease the work of the foundation in a way that was respectful to all the people that we fund, and to the staff and to our colleagues in philanthropy.
FEYERICK: The JEHT Foundation, which operated on money supposedly invested by Madoff, was distributing $20 million to $30 million a year to more than 150 organizations dedicated to human rights. Now all of those charities will suffer as well, charities like the Innocence Project to free wrongly imprisoned individuals and groups helping Guantanamo detainees.
Yeshiva University reportedly lost more than $100 million on investments in Madoff's funds, a scandal likely to affect wealthy donors in the future.
PAULETTE MAEHARA, ASSN. OF FUNDRAISING PROFESSIONALS: It shakes their trust and their willingness -- potentially, their willingness to give to those organizations which they've been supporting for a long time.
FEYERICK (on camera): Many of these charities are now trying to figure out the extent of the damage. Several will close. Others are trying to see if they can recoup their losses. And of course, they're taking a close look at their investment strategies. The biggest impact is likely to be felt by people who never even heard the name Bernard Madoff, people who benefited from the charity of strangers.
Deborah Feyerick, CNN, New York.
(END VIDEOTAPE)
PHILLIPS: And coming up in the next hour we're going to talk to a former FBI agent that has investigated cases like this. And wait until you hear what he has to say about the SEC and its lack of investigations.
Well, a group dogged by allegations of voter registration fraud in a dozen states is now threatened by its own internal scandal. ACORN was vilified by Republicans this year for its sloppy voter drives which led to several investigations. Now ACORN is being cut off by its own funders who fear an embezzlement scandal and lax accounting could mean criminal charges for board members or execs.
CNN "SPECIAL INVESTIGATIONS UNIT" has probing ACORN's problems. Here's SIU correspondent Drew Griffin.
(BEGIN VIDEOTAPE)
DREW GRIFFIN, CNN SPECIAL INVESTIGATIONS UNIT CORRESPONDENT (voice-over): The problems became very political this fall when ACORN canvassers began showing up at election offices with these.
(on camera): These?
UNIDENTIFIED FEMALE: These.
GRIFFIN: These?
UNIDENTIFIED FEMALE: Those.
GRIFFIN (voice-over): Thousands of fraudulent voter registration forms, causing havoc and calls for investigations in more than a dozen states. For the first time, many of us were learning the mainly low income housing advocacy group had a very real political arm.
The Association of Community Organizers for Reform Now, ACORN, is actually not one group but centered out of one building in New Orleans, nearly 200 different agencies, corporations, nonprofits, voter registration efforts, and yes, partisan political action committees.
In 2008, ACORN's voter registration drives reached into 21 states, but behind the scenes, a huge scandal was brewing, a million- dollar embezzlement hidden from ACORN's board of directors for eight years.
KAREN INMAN, FIRED ACORN BOARD MEMBER: A million dollars is a lot of money.
GRIFFIN: According to this now fired ACORN board member, Karen Inman, the crime which she learned about in June was never reported to the authorities. She says partly to hide internal problems from donors, and also to make sure the loss wouldn't become a quote, "political situation."
INMAN: That the Republican Party would use it to tear us apart. And that's exactly what they said.
GRIFFIN: ACORN, she says, is instead tearing apart from the inside. She and other board members, she says, were fired after they went to court to force open the records of the embezzlement. Some no longer allowed even to step foot in an ACORN office.
UNIDENTIFIED FEMALE: We're not allowed to let you in.
GRIFFIN: ACORN's chief organizer said many major donors, the group's economic lifeblood, have withheld funding. The Catholic Church, which has given millions to ACORN over the last decade, has severed ties all together.
The extent of the mess came to light in this confidential memo from ACORN's attorney Beth Kingsley back in June. A 14-page document warning ACORN's board about the lack of transparency and accountability in an organization she says "may be necessary to downsize."
The attorney also worried that ACORN's nonpartisan work could get mixed up with its political campaign work. The exact warning that ACORN, quote, "lacks the protective walls needed to insure that various types of activity are kept sufficiently separate."
At ACORN's headquarters in Brooklyn, New York, CNN met with ACORN's chief organizer and four board members who have all been critical of CNN's reporting. They said the former board members had been removed because they went in a direction opposed by the rest of the board. And these board members denied the confidential memo from attorney Beth Kingsley painted a bleak picture.
(on camera): But I think you can't deny there's some turmoil going on. BERTHA LEWIS, ACORN CHIEF ORGANIZER: You're misquoting from a confidential report that was given to the board saying, listen, here is what you're going to need to look at, here are things that you need to consider, just to make sure that you are able to protect yourself.
GRIFFIN (voice-over): ACORN has hired attorneys, accountants, and even a former anti-trust prosecutor from the Justice Department, all trying to find out how an embezzlement was covered up and to untangle the accounting of the nearly 200 organizations and affiliates that operate under the ACORN umbrella, a task that the current ACORN board admits will be daunting.
(END VIDEOTAPE)
GRIFFIN: And, Kyra, ACORN chief leader there told me just a little while ago that they are continuing with their internal review but wanted to make it clear that ACORN will survive this inner turmoil, even though that eight or nine people ousted from ACORN now calling themselves the ACORN eight will go ahead with their lawsuit trying to force this group to open up the books and look at all this accounting mess.
PHILLIPS: Well, at the very beginning of the investigation, you were the one that exposed how this group was ridiculed for its sloppy voter registration drive. Did its leaders say anything about changing the way ACORN registers its voters?
GRIFFIN: You know, after admitting all of this kind of inner turmoil is going on with the accounting in the organization, I did ask them, what about that sloppy registration drive? They were aghast that I even asked the question. They thought that voter registration drive was terrific, that they did great work, and didn't offer any real plans for any kind of changing.
So the one publicly, you know, illuminated sloppy thing that ACORN was doing with those voter registration drives they think was terrific and inspired and got a lot of people wouldn't vote to vote.
PHILLIPS: Did you remind them that Elvis Presley had registered to vote a couple of times?
GRIFFIN: And Jimmy Johns sausage (sic) shop.
PHILLIPS: It's the subway shop, right.
(LAUGHTER)
GRIFFIN: And Mickey Mouse, and the Dallas Cowboys, yes, I reminded them of all of that. They said, you know, that's just -- blame somebody else.
PHILLIPS: Drew, thanks.
Well, laid off, freaked out. Not only are paychecks stopping, so is health insurance. Gerri Willis has today's "Layoff Survival Guide" tip on finding new coverage. Stay with us. (COMMERCIAL BREAK)
PHILLIPS: Well, you have just been told you are being laid off and that sick feeling in your belly is just the start of your health worries. In today's "Layoff Survival Guide," personal finance editor Gerri Willis has some tips on finding medical coverage once you are unemployed.
I will tell you what, Gerri, it's expensive because I have seen friends go through it.
GERRI WILLIS, CNN PERSONAL FINANCE EDITOR: It is indeed. Well, you know, there are options though if you are laid off. The first choice is getting on a working family members plan through a process called special enrollment. This is the cheapest of the options, but you only have 30 days to sign up for it before you lose eligibility for coverage. So you have to act quickly -- Kyra.
PHILLIPS: All right. Give me -- I know we have a very -- we're limited on time, but could you give some exact tips of what individuals can do when they are put into this position?
WILLIS: Yes. Job number one, look for special enrollment. Job number two, go to COBRA if you can't get on a family members plan. COBRA is a state-mandated program that allows people to continue their existing company coverage, unfortunately, though, you pay the full cost of the program. So here are the numbers that you are looking at, here is the kind of increase you would see in your costs.
Typically, if you have employer-sponsored health care, it is pretty affordable, $4,700 for an individual policy. Let's look now though at the COBRA coverage, 12,000 for a family policy, generally your benefits here will last for 18 months. Again, there are important deadlines. You have 60 days to elect COBRA and 44 days to make the first premium.
Now if you want to get some state help, there is Medicaid, SCHIP programs, these are options for people who meet income guidelines, this will really help cover the kids and adults. These are state programs administered by the state that you can sign up for -- Kyra.
PHILLIPS: All right, Gerri, appreciate it.
2008, it was a very good year. A very good year for TIME's cover boy, that's for sure. We are going to have the magazine's not-so- surprising choice for "Person of the Year."
(COMMERCIAL BREAK)
PHILLIPS: Well, the presidency is nice and all, but this was the honor that Barack Obama really coveted, well, maybe not. But TIME magazine has just named him its "Person of the Year." The runners up include Treasury Secretary Henry Paulson, French President Nicolas Sarkozy, and Alaska Governor Sarah Palin.
TIME's managing editor says that sometimes the staff has a tough decision, this year, not so much.
(BEGIN VIDEO CLIP)
RICHARD STENGEL, MANAGING EDITOR, TIME: In some ways, the whole convention of "Person of the Year" was invented for someone like Barack Obama, someone who dominated the news, someone who was a transformational figure in American life and American politics, someone who is coming to the presidency at a time -- at a perilous time in American history, at a critical time in American history. He is our "Person of the Year" for all of those reasons.
(END VIDEO CLIP)
PHILLIPS: Well, if you have got a good memory or a stack of old TIMEs, you will remember that last year's "Person," Russian President now Prime Minister Vladimir Putin was on the cover.
And if you're planning on calling home with a play-by-play of next month's inauguration, or sending a picture of the event, your plans may hit a snag. With a million people or more expected to crowd into the National Mall, wireless providers are warning callers beware, demand may exceed capacity.
CNN's Jeanne Meserve explains.
(BEGIN VIDEOTAPE)
JEANNE MESERVE, CNN HOMELAND SECURITY CORRESPONDENT (voice-over): At the stroke of midnight last December 31st, revelers texting holiday greetings via cell phone overwhelmed the system.
Messages weren't received until hours into the New Year. But just wait until the inauguration, which could millions of cell phone users to downtown D.C.: calling, texting, surfing the Web, sending photos, and sharing video.
JOE FARREN, CTIA SPOKESMAN: Imagine a brilliant, 85-degree, beautiful blue sky, July 4th weekend. Now, imagine at the end of that weekend everyone leaving the beach at the same time. Picture what the roadways would look like in that scenario. That could be what our wireless network looks like.
MESERVE: The bottom line: expect delays and disruptions, even though the wireless industry is spending millions to boost capacity in Washington. More lines are being installed, so existing towers can accommodate more traffic and portable cell phone towers will also be brought in to enable more calls to get through.
Emergency personnel communicate by radio. But as a backup, thousands are being outfitted with point-to-point cell phones which don't need towers to work. And some first responders will be given priority access so their cell phone calls will go through first.
But a cell phone can have a different role in a security incident. In Iraq, cell phones have been used as detonators. A former Homeland Security official says in certain circumstances that means cell service could be intentionally disrupted.
GEORGE FORESMAN, FORMER DHS OFFICIAL: You could find yourself in a situation where if there is a credible threat, the federal authorities have no other choice but to disable all but the essential first responders' communications equipment.
MESERVE (on camera): But even if the inauguration goes without a hitch, there are things attendees can do to ease the strain on the wireless system. Text, don't call. Texting takes less bandwidth and your message is more likely to go through. And if you shoot pictures or video, save it, don't send it, share it later.
Jeanne Meserve, CNN, Washington.
(END VIDEOTAPE)
PHILLIPS: Oops, our bad. The head of the Securities and Exchange Commission admitting the agency screwed up. Tipped off about Bernie Madoff's shady deals many years and many billions ago.
A surgery to save face, doctors reveal details of a ground- breaking and life-threatening transplant; a woman now walking around with the face of a cadaver.
