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Pfizer Says New Research Shows Celebrex May Increase Some Patients' Risk of Cardiovascular Problems

Aired December 17, 2004 - 13:30   ET

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

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


KYRA PHILLIPS, CNN ANCHOR: "Now in the News," it's a law. The much-debated, almost ill-fated 9/11 intelligence bill now has President Bush's signature. Among other things, it creates a national counterterrorism center and aligns all the country's intelligence agencies under one director. It's the most drastic overhaul of the U.S. intelligence system since the 1940s.
Celebrex stays on the shelf, for now anyway. The company that makes the prescription painkiller says new research that connects the drug with heart problems needs a closer look. The Pfizer spokesperson says they'll keep Celebrex out there while they consider new applications for it. Pfizer's stock down big today.

More decoration frustration in Cuba and what looks like an exchange of low-blows. This week the U.S. mission in Havana refused to remove holiday decorations that feature a reference to some jailed Cuban dissidents. OK. So the Cuban government erected a billboard with some now infamous photos of Abu Ghraib prisoners. A swastika and the words "Made in USA." U.S. officials insist that their decorations will stay up through the holiday season.

TONY HARRIS, CNN ANCHOR: Drugmaker Pfizer says new research shows its popular painkiller Celebrex may increase some patients' risk of cardiovascular problems. The drug has been prescribed to some 27 million Americans since being approved by the FDA in 1998 for arthritis pain. It is the most common arthritis drug on the market, with annual sales estimated at more than $3 billion. So what does this discovery mean for people using Celebrex?

Dr. Laurence Sperling is a cardiologist at Emory University in Atlanta and he joins us now to talk about this. Doctor, good to see you.

DR. LAURENCE SPERLING, CARDIOLOGIST, EMORY UNIVERSITY: Good to see you, too. Hi.

HARRIS: All right, I need you to help me, here, I need you to walk me through this. I'm a middle-aged man, I like to play tennis, I like beat up on Kyra Phillips over here on the tennis court. But when I do, my knee -- my surgically-repaired knee tends to flair up a little bit. OK, I've been prescribed Celebrex. Tell me why the drug that helps me with my inflammation, my swelling in my knee, might cause me some problems with my heart.

SPERLING: If we look at this drug, it is an anti-inflammatory agent. It also affects a certain enzyme in the body. And this enzyme blocks cicloxanase (ph), too.

HARRIS: Now what -- OK.

SPERLING: So this is cox-2, it's how it acts, by blocking up the enzyme. By doing that, there might be an increase in a parallel enzyme in the body that may cause an increase in the tone of the blood vessels. May increase the stickiness of platelets in the body and may increase problems with our blood vessels.

HARRIS: That cuts to clogging and those kinds of problems.

SPERLING: That's correct.

HARRIS: We're talking about blockage, is that what we're talking about? Blocking the...

SPERLING: Blockage and change in the blood vessels themselves, the tone of the blood vessels and maybe the reactivity of the blood vessels.

HARRIS: OK, but I am a heart healthy young man. Should I still be concerned about possible side effects that you've described here?

SPERLING: Right now with our available information, I would say that I'd be a little wary of prescribing Celebrex to you right now.

HARRIS: At this moment.

SPERLING: At this moment.

HARRIS: Because of this information?

SPERLING: Certainly because of the evolving information we've seen related to this whole class of agents right now.

HARRIS: Now these are the cox-2 inhibitors that we're talking about?

SPERLING: That is correct.

HARRIS: Talk about this evolving body of knowledge on this class of drugs.

SPERLING: Really, initially, about four years ago or so, there were questions related to the possible heart side effects of these medications. In these studies, nobody specifically asked the question about heart side effects, but these were byproducts of these studies. As you well know, one of these agents was recently taken off of the market because of the increase in heart side effects.

HARRIS: So what do you do if you have these arthritic problems, if you have this kind of swelling? What are you prescribing now?

SPERLING: Right now I certainly would work along with your doctor, but there are many garden variety anti-inflammatory agents and pain medicines that are available, like Tylenol, over-the-counter medicines that have been tried and true for a long period of time that thus far certainly have not shown an increase in heart attacks or heart blood vessel problems.

HARRIS: With the way things have gone for Vioxx, what is the evidence -- and then this alert, I guess we can qualify it as an alert today. What is the evidence likely to be that would preclude Pfizer from taking it off the market, following the path of Vioxx? If we've already been issued this kind of alert, which is kind of a pattern we saw with Vioxx.

SPERLING: Right now I certainly think, if we look at the evidence, we can say that if you have known heart disease, if you're an individual with high risk for heart problems, that you should shy away from this class of agents at this present time. If we see further evidence after looking at these studies that there is an increased problem, even in people who are the average joes with knee problems, and we really are not sure about that question right now, clearly, that would indicate the need to take these off the market.

HARRIS: OK. Let me -- just a little -- throw a little programming note in here. Tomorrow at 8:30, Elizabeth Cohen will be hosting "HOUSE CALL" and she will take your phone calls on the question of Celebrex and so you can call and get all your questions answered on Celebrex.

Doctor, good to see you, thanks for taking the time to talk to us.

SPERLING: Thank you very much.

PHILLIPS: So is political correctness giving you the holiday blues? We've got the cure, the holiday greeting that will either get you elected president of the politically correct club or offend everyone you've ever known.

And just after a break, a military doctor who made a list about her experiences in the battle zone. Trust me, you won't want to miss this piece.

(COMMERCIAL BREAK)

PHILLIPS: It's a deceptively simple concept. Keep a list of all the good things and all the bad things about your tour of duty in Iraq. But in reading the list compiled by one eloquent Marine doctor, CNN's Beth Nissen finds a simplicity that packs a breathtaking punch.

(BEGIN VIDEOTAPE)

BETH NISSEN, CNN CORRESPONDENT (voice-over): It was a tough deployment for Alpha Surgical Company starting in February near Falluja. Trauma surgeons worked in 24-hour ORs stabilizing Marines with blast wounds. Navy Lieutenant Commander Heidi Craft, a clinical psychologist, worked in the combat stress platoon on trauma of another kind.

UNIDENTIFIED FEMALE: Normal people in this abnormal situation of combat can experience very significant symptoms of shock and sometimes even shutting down psychologically.

NISSEN: Seeing so many, so young, so shattered over seven months was hard on the healers too. Alone in her barracks room, Dr. Craft started a list of things that were good and things that were not good about her time in Iraq.

UNIDENTIFIED FEMALE: It was partially a self therapy. I was struggling towards the end of the deployment with how to process everything that we had been through and done and survived together.

NISSEN: The not good list came easily.

UNIDENTIFIED FEMALE: Things that were not good: terrifying camel spiders, poisonous scorpions, 132 degrees, sweating in places I didn't know I could sweat, like wrists and ears, the roar of helicopters overhead, the popping of gunfire, the cracking sound of giant artillery rounds splitting open against rock and dirt, the shattering of the windows, hiding away from the broken windows.

Waiting to be told we can come to the hospital to treat the ones who were not so lucky. Watching the black helicopter with the big red cross on the side landing at our pad, telling a room full of stunned Marines in blood-soaked uniforms that their comrade that they had just tried to save had died of his wounds.

Washing blood off the boots of one of our young nurses while she told me about the one who bled out in the trauma bay.

NISSEN: She struggled at first to find the positive but slowly that list formed.

UNIDENTIFIED FEMALE: Things that were good: sunset over the desert, almost always orange, sunrise over the desert almost always red, the childlike excitement of having fresh fruit at dinner after going weeks without it. My comrades, some of the things witnesses will traumatize them forever but they still provided outstanding care to these Marines.

But, most of all, the United States Marines, our patients, having them tell us one after another through blinding pain or morphine- induced euphoria "When can I get out of here, I just want to get back to my unit?"

NISSEN: There was the young sergeant who lost one eye but asked for help sitting up so he could check on the members of his fire team being treated for minor shrapnel wounds.

UNIDENTIFIED FEMALE: He smiles, lay back down and said, "I only have one good eye doc but I can see that my Marines are OK."

NISSEN: And there was the young corporal known to the whole company as Heidi's Marine.

UNIDENTIFIED FEMALE: The one who threw himself on a grenade to save the men at his side, who will likely be the first Medal of Honor recipient in over 11 years. NISSEN: That was Corporal Jason Dunham (ph), age 22. He arrived in the trauma bay on April 14th with a severe head wound. Craft took his hand, talked to him, comforted him.

UNIDENTIFIED FEMALE: I told him we were proud of him and that the Marines were proud of him and that he was brave.

NISSEN: Dunham could not speak, could only squeeze her hand in response.

UNIDENTIFIED FEMALE: I stayed with him as long as I could and I held his hand all the way to the point where we got to the helicopter. It was the most wonderful moment of my life and the most horrible moment of my life at the same time.

NISSEN: She wept when she learned that Corporal Dunham had died at Bethesda Naval Hospital in Maryland eight days later, wept again when Dunham's mother wrote to thank her.

UNIDENTIFIED FEMALE: Her biggest fear was that her son had been alone and that no one had been with him.

UNIDENTIFIED FEMALE: For me basically the whole deployment, all of it, all of it wrapped up at that moment.

NISSEN: The sorrow for the wounded and damaged, the grief for the lost, gratitude for being able to ease another's pain, pride in the U.S. troops for their courage and sacrifice. For Dr. Craft it was all that was good and not good about Iraq. The ending of both lists is the same.

UNIDENTIFIED FEMALE: And finally, above all else, holding the hand of that dying Marine.

NISSEN: Beth Nissen, CNN, New York.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

PHILLIPS: When he was orphaned at 18, the young Howard Hughes set three goals for his future. He wanted to become the best golfer in the world, the best pilot and the most famous producer of motion pictures. Well, the last two goals were all, we all know about of course, and they're also well documented in the new film "The Aviator," which opens today. But for more on the lesser known Howard Hughes, we turn to the author of "Hughes: The Private Diary and Memos and Letters: The Definitive Biography of the First American Billionaire."

Richard Hack joins me now live from Boston. Good to see you, Richard.

RICHARD HACK, HUGHES BIOGRAPHER: Thank you, Kyra. Nice to be here. PHILLIPS: Well, I guess I know that this movie was based on a big chunk of your book. We'll talk about the other part of your book in a minute. But if you were to pick, say, one or two things that fascinated you the most about Howard Hughes as you were putting this book together, what would they be?

HACK: Well, for one thing, I was fascinated by the fact that he had absolutely no intention of living by any rule book that certainly has been known to me or any other man that's lived on the Earth. This is a guy that started with a lot of money. He was pampered from the very earliest of age, and he thought no rule applied to him. And in fact, it didn't. He traveled around the world without benefit of a passport. He never thought he needed one. He was called in to (INAUDIBLE), and he said no, I don't think Tuesday's a good day for me. I'll let you know when I'm free. He lived by his own rules.

PHILLIPS: And I understand that even this island that he owned, he couldn't get TV, so that's why satellites are in space now?

HACK: Well, what happened was he had Hughes Aviation, and he was living in the Bahamas for a few months, and he wanted to get TV reception, which they didn't have. The early-bird satellite was in development for the government, but it raced along and put up so that he was the benefit of the technology.

Cell phones, too, by the way, Kyra.

PHILLIPS: Really?

HACK: He needed to have his employees be available at the touch of a button. In the '50s, he had cell phones in their cars.

PHILLIPS: So let me ask you this. I want to see if you have maybe a different theory about Howard Hughes. You know, so many people talk about the later years in his life. Of course, the years we remember hearing about, and the movies been based about it, the fact that he lived in this hotel room isolated,he became overly compulsive. He was freaked out by germs. He had long hair, long nails. Everyone thought he went crazy, thought he was a madman. Do you have maybe a theory that since he had no rules, no rules to live by, he could do whatever he wanted, that this maybe led to this existence?

HACK: Well, it certainly did. I never considered him a madman at all. He made most of his money during that period of time, and certainly multiplied the inheritance he got by two or three hundred times and ended up richer than he started. But during that period of time, he did let his hair grow and his nails and he didn't wash. He didn't dress. But the fact was, he didn't have to. He didn't even walk to the bathroom. He was carried, because he didn't feel like it.

But unless you have more money than anyone else on Earth, none of us can really understand what that's like, unless you cannot go outside of your doorway without being besieged by lawsuits and people who want sex, and to borrow money or to get a job. It is difficult to put yourself in those shoes. And he finally figured out that he really didn't need to move to do his job; he could do it over the telephone, and did. He was definitely not crazy. He was very active right up until the day he died, and was writing memos, all of which contained many, many business deals that were very lucid.

So madness isn't a word I'd use for Howard Hughes. He was the most unique person, for sure, the most unique person I have ever written about, but not crazy.

PHILLIPS: Interesting. And we talk about how rich he was. Put it into perspective. How much money did he bring in by the day, by the hour, by the minute, and does that even compare to, say, a Bill Gates?

HACK: Well, during his time, first of all, he was the first American billionaire. At a time that he had a billion dollars, all of the Rockefellers put together had about $500 million, so half as much. He was one individual with more money than anyone in the United States, and this was back in the '50s. At the time of his death in the '70s, he was earning about $175,000 every hour doing absolutely nothing. And in today's terms, well, let me put it this way. He left 32 relatives that inherited his estate, all of which became billionaires. And in today's dollars, he would probably be about one and a half times as rich as Bill Gates, and that's if he did nothing else than he did.

And remember, this is a guy that not only was an aviator, he flew and set world records, but it's because of Howard Hughes we have a retractable landing gear on a plane, because he thought, why should these wheels stay down here. They have this new fuselage because he didn't want rivets out there. They have the enclosed cockpit, autopilot. He just dreamt up all these things out of the -- you know, out of his scientific mind. Even though he had no training, he knew how to hire the people that really could do the job and that's where his brilliance lay.

PHILLIPS: The first...

HACK: He's a fascinating guy.

PHILLIPS: No, he is. Your book, I mean, hits on all these terrific stories, and the big chunk of your book is -- helped with "The Aviator." You were telling me Jim Carrey bought the rights to another section of your book for another film on Howard Hughes. What will that be about?

HACK: Exactly. Well, "The Aviator" is about early Howard Hughes up until the '40s, when he was really a glamour puss. He was of course very attractive, very tall, very rich, and he dated everyone -- I mean, Katharine Hepburn, Bette Davis, Ginger Rogers, Ava Gardner, all in the same week, and propose proposed to them all. After he matured and went into seclusion, Hughes became more of well, a relative unknown. He certainly never certainly was photographed, and that was the Hughes that we'll see in the Jim Carrey movie from Castlerock.

PHILLIPS: Richard Hack, the book is "Hughes: The Private Diaries, Memos and Letters, the Definitive Biography of the First American Billionaire." You can also catch a great article by Richard in this month's "Golf" magazine. That's how we found out about you, Richard, about his golf game, yes, and all kinds of neat stories about Howard Hughes on the golf course.

HACK: Inventing the sand wedge.

PHILLIPS: That's right. He and Gene Serenson (ph), there you go. That's how the wedge came about.

Thank goodness for the wedge, especially in the sand.

Thanks, Richard.

HACK: Yes, you got it. My pleasure, Kyra.

HARRIS: Well, the topic of Christmas greenery has residents in one Florida county seeing red. Christmas trees have been banned from public buildings in Pasco (ph) County after the county attorney decided they were religious symbols. But as the American Center of Law and Justice points out, to -- well, any druid scholar will tell you this, the Christmas tree tradition began long before the official start of Christianity. In the U.S., they are legally considered a secular symbol for the observance of a national holiday.

PHILLIPS: Speaking of mixing up your seasonal metaphors, CNN's Tom Foreman weighs in with an ecumenical proposal for getting through the holidays.

(BEGIN VIDEOTAPE)

TOM FOREMAN, CNN CORRESPONDENT (voice-over): During the most celebrated holiday in America, are you, like so many businesses, not sure how to greet people? Are you embarrassed by misplaced "merry Christmases" and ill-targeted "happy Hanukkahs"? But are you already tired of the lukewarm "happy holidays"?

(on camera) Have no fear. A new seasonal greeting is here, and I call it "happy Chrismakwanhanudan." A little hard to say, but it has a nice swing to it, and I think it could catch on, allowing us to greet and offend everyone all at once.

(voice-over) It's not a fairly balanced greeting. After all, despite declines in organized religion, about 76 percent of Americans still call themselves Christians.

Thirteen percent profess no faith; 1.3 percent are Jewish. And Buddhists, Muslims and agnostics are a half percent each.

(on camera) But "Chrismakwanhanudan" covers almost all the bases. The Buddhists get a little short changed, but I think they're pretty easy going. We'll have to iron out some of the details anyway.

(voice-over) The postal service might struggle to fit "Chrismakwanhanudan" onto a stamp. And I'm not sure St. Rabbi Mohammed Mbuto will be all that popular or even fit into a chimney. There could be unintended consequences, too, movements to combine other holidays, "The Fourth of Thanksgiving" and "Valenoween" come to mind.

(on camera) But we have to do something. With more schools, offices and local governments giving up Christmas parties in favor of winter celebrations, nobody knows what to say.

I don't "throw merry Christmas" at friends of differing faiths. Rather, I wish them the best of their own holidays, but as a practicing Christian, I do say "merry Christmas" a lot. I don't think respecting other people's beliefs means hiding your own.

(voice-over) That's why even if it "Chrismakwanhanudan" does not work in the long run, I'm not sure "happy holidays" does either. Not when what we mean is happy Hanukkah, a joyous Kwanzaa, a peaceful Ramadan, and a merry Christmas.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

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Aired December 17, 2004 - 13:30   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
KYRA PHILLIPS, CNN ANCHOR: "Now in the News," it's a law. The much-debated, almost ill-fated 9/11 intelligence bill now has President Bush's signature. Among other things, it creates a national counterterrorism center and aligns all the country's intelligence agencies under one director. It's the most drastic overhaul of the U.S. intelligence system since the 1940s.
Celebrex stays on the shelf, for now anyway. The company that makes the prescription painkiller says new research that connects the drug with heart problems needs a closer look. The Pfizer spokesperson says they'll keep Celebrex out there while they consider new applications for it. Pfizer's stock down big today.

More decoration frustration in Cuba and what looks like an exchange of low-blows. This week the U.S. mission in Havana refused to remove holiday decorations that feature a reference to some jailed Cuban dissidents. OK. So the Cuban government erected a billboard with some now infamous photos of Abu Ghraib prisoners. A swastika and the words "Made in USA." U.S. officials insist that their decorations will stay up through the holiday season.

TONY HARRIS, CNN ANCHOR: Drugmaker Pfizer says new research shows its popular painkiller Celebrex may increase some patients' risk of cardiovascular problems. The drug has been prescribed to some 27 million Americans since being approved by the FDA in 1998 for arthritis pain. It is the most common arthritis drug on the market, with annual sales estimated at more than $3 billion. So what does this discovery mean for people using Celebrex?

Dr. Laurence Sperling is a cardiologist at Emory University in Atlanta and he joins us now to talk about this. Doctor, good to see you.

DR. LAURENCE SPERLING, CARDIOLOGIST, EMORY UNIVERSITY: Good to see you, too. Hi.

HARRIS: All right, I need you to help me, here, I need you to walk me through this. I'm a middle-aged man, I like to play tennis, I like beat up on Kyra Phillips over here on the tennis court. But when I do, my knee -- my surgically-repaired knee tends to flair up a little bit. OK, I've been prescribed Celebrex. Tell me why the drug that helps me with my inflammation, my swelling in my knee, might cause me some problems with my heart.

SPERLING: If we look at this drug, it is an anti-inflammatory agent. It also affects a certain enzyme in the body. And this enzyme blocks cicloxanase (ph), too.

HARRIS: Now what -- OK.

SPERLING: So this is cox-2, it's how it acts, by blocking up the enzyme. By doing that, there might be an increase in a parallel enzyme in the body that may cause an increase in the tone of the blood vessels. May increase the stickiness of platelets in the body and may increase problems with our blood vessels.

HARRIS: That cuts to clogging and those kinds of problems.

SPERLING: That's correct.

HARRIS: We're talking about blockage, is that what we're talking about? Blocking the...

SPERLING: Blockage and change in the blood vessels themselves, the tone of the blood vessels and maybe the reactivity of the blood vessels.

HARRIS: OK, but I am a heart healthy young man. Should I still be concerned about possible side effects that you've described here?

SPERLING: Right now with our available information, I would say that I'd be a little wary of prescribing Celebrex to you right now.

HARRIS: At this moment.

SPERLING: At this moment.

HARRIS: Because of this information?

SPERLING: Certainly because of the evolving information we've seen related to this whole class of agents right now.

HARRIS: Now these are the cox-2 inhibitors that we're talking about?

SPERLING: That is correct.

HARRIS: Talk about this evolving body of knowledge on this class of drugs.

SPERLING: Really, initially, about four years ago or so, there were questions related to the possible heart side effects of these medications. In these studies, nobody specifically asked the question about heart side effects, but these were byproducts of these studies. As you well know, one of these agents was recently taken off of the market because of the increase in heart side effects.

HARRIS: So what do you do if you have these arthritic problems, if you have this kind of swelling? What are you prescribing now?

SPERLING: Right now I certainly would work along with your doctor, but there are many garden variety anti-inflammatory agents and pain medicines that are available, like Tylenol, over-the-counter medicines that have been tried and true for a long period of time that thus far certainly have not shown an increase in heart attacks or heart blood vessel problems.

HARRIS: With the way things have gone for Vioxx, what is the evidence -- and then this alert, I guess we can qualify it as an alert today. What is the evidence likely to be that would preclude Pfizer from taking it off the market, following the path of Vioxx? If we've already been issued this kind of alert, which is kind of a pattern we saw with Vioxx.

SPERLING: Right now I certainly think, if we look at the evidence, we can say that if you have known heart disease, if you're an individual with high risk for heart problems, that you should shy away from this class of agents at this present time. If we see further evidence after looking at these studies that there is an increased problem, even in people who are the average joes with knee problems, and we really are not sure about that question right now, clearly, that would indicate the need to take these off the market.

HARRIS: OK. Let me -- just a little -- throw a little programming note in here. Tomorrow at 8:30, Elizabeth Cohen will be hosting "HOUSE CALL" and she will take your phone calls on the question of Celebrex and so you can call and get all your questions answered on Celebrex.

Doctor, good to see you, thanks for taking the time to talk to us.

SPERLING: Thank you very much.

PHILLIPS: So is political correctness giving you the holiday blues? We've got the cure, the holiday greeting that will either get you elected president of the politically correct club or offend everyone you've ever known.

And just after a break, a military doctor who made a list about her experiences in the battle zone. Trust me, you won't want to miss this piece.

(COMMERCIAL BREAK)

PHILLIPS: It's a deceptively simple concept. Keep a list of all the good things and all the bad things about your tour of duty in Iraq. But in reading the list compiled by one eloquent Marine doctor, CNN's Beth Nissen finds a simplicity that packs a breathtaking punch.

(BEGIN VIDEOTAPE)

BETH NISSEN, CNN CORRESPONDENT (voice-over): It was a tough deployment for Alpha Surgical Company starting in February near Falluja. Trauma surgeons worked in 24-hour ORs stabilizing Marines with blast wounds. Navy Lieutenant Commander Heidi Craft, a clinical psychologist, worked in the combat stress platoon on trauma of another kind.

UNIDENTIFIED FEMALE: Normal people in this abnormal situation of combat can experience very significant symptoms of shock and sometimes even shutting down psychologically.

NISSEN: Seeing so many, so young, so shattered over seven months was hard on the healers too. Alone in her barracks room, Dr. Craft started a list of things that were good and things that were not good about her time in Iraq.

UNIDENTIFIED FEMALE: It was partially a self therapy. I was struggling towards the end of the deployment with how to process everything that we had been through and done and survived together.

NISSEN: The not good list came easily.

UNIDENTIFIED FEMALE: Things that were not good: terrifying camel spiders, poisonous scorpions, 132 degrees, sweating in places I didn't know I could sweat, like wrists and ears, the roar of helicopters overhead, the popping of gunfire, the cracking sound of giant artillery rounds splitting open against rock and dirt, the shattering of the windows, hiding away from the broken windows.

Waiting to be told we can come to the hospital to treat the ones who were not so lucky. Watching the black helicopter with the big red cross on the side landing at our pad, telling a room full of stunned Marines in blood-soaked uniforms that their comrade that they had just tried to save had died of his wounds.

Washing blood off the boots of one of our young nurses while she told me about the one who bled out in the trauma bay.

NISSEN: She struggled at first to find the positive but slowly that list formed.

UNIDENTIFIED FEMALE: Things that were good: sunset over the desert, almost always orange, sunrise over the desert almost always red, the childlike excitement of having fresh fruit at dinner after going weeks without it. My comrades, some of the things witnesses will traumatize them forever but they still provided outstanding care to these Marines.

But, most of all, the United States Marines, our patients, having them tell us one after another through blinding pain or morphine- induced euphoria "When can I get out of here, I just want to get back to my unit?"

NISSEN: There was the young sergeant who lost one eye but asked for help sitting up so he could check on the members of his fire team being treated for minor shrapnel wounds.

UNIDENTIFIED FEMALE: He smiles, lay back down and said, "I only have one good eye doc but I can see that my Marines are OK."

NISSEN: And there was the young corporal known to the whole company as Heidi's Marine.

UNIDENTIFIED FEMALE: The one who threw himself on a grenade to save the men at his side, who will likely be the first Medal of Honor recipient in over 11 years. NISSEN: That was Corporal Jason Dunham (ph), age 22. He arrived in the trauma bay on April 14th with a severe head wound. Craft took his hand, talked to him, comforted him.

UNIDENTIFIED FEMALE: I told him we were proud of him and that the Marines were proud of him and that he was brave.

NISSEN: Dunham could not speak, could only squeeze her hand in response.

UNIDENTIFIED FEMALE: I stayed with him as long as I could and I held his hand all the way to the point where we got to the helicopter. It was the most wonderful moment of my life and the most horrible moment of my life at the same time.

NISSEN: She wept when she learned that Corporal Dunham had died at Bethesda Naval Hospital in Maryland eight days later, wept again when Dunham's mother wrote to thank her.

UNIDENTIFIED FEMALE: Her biggest fear was that her son had been alone and that no one had been with him.

UNIDENTIFIED FEMALE: For me basically the whole deployment, all of it, all of it wrapped up at that moment.

NISSEN: The sorrow for the wounded and damaged, the grief for the lost, gratitude for being able to ease another's pain, pride in the U.S. troops for their courage and sacrifice. For Dr. Craft it was all that was good and not good about Iraq. The ending of both lists is the same.

UNIDENTIFIED FEMALE: And finally, above all else, holding the hand of that dying Marine.

NISSEN: Beth Nissen, CNN, New York.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

PHILLIPS: When he was orphaned at 18, the young Howard Hughes set three goals for his future. He wanted to become the best golfer in the world, the best pilot and the most famous producer of motion pictures. Well, the last two goals were all, we all know about of course, and they're also well documented in the new film "The Aviator," which opens today. But for more on the lesser known Howard Hughes, we turn to the author of "Hughes: The Private Diary and Memos and Letters: The Definitive Biography of the First American Billionaire."

Richard Hack joins me now live from Boston. Good to see you, Richard.

RICHARD HACK, HUGHES BIOGRAPHER: Thank you, Kyra. Nice to be here. PHILLIPS: Well, I guess I know that this movie was based on a big chunk of your book. We'll talk about the other part of your book in a minute. But if you were to pick, say, one or two things that fascinated you the most about Howard Hughes as you were putting this book together, what would they be?

HACK: Well, for one thing, I was fascinated by the fact that he had absolutely no intention of living by any rule book that certainly has been known to me or any other man that's lived on the Earth. This is a guy that started with a lot of money. He was pampered from the very earliest of age, and he thought no rule applied to him. And in fact, it didn't. He traveled around the world without benefit of a passport. He never thought he needed one. He was called in to (INAUDIBLE), and he said no, I don't think Tuesday's a good day for me. I'll let you know when I'm free. He lived by his own rules.

PHILLIPS: And I understand that even this island that he owned, he couldn't get TV, so that's why satellites are in space now?

HACK: Well, what happened was he had Hughes Aviation, and he was living in the Bahamas for a few months, and he wanted to get TV reception, which they didn't have. The early-bird satellite was in development for the government, but it raced along and put up so that he was the benefit of the technology.

Cell phones, too, by the way, Kyra.

PHILLIPS: Really?

HACK: He needed to have his employees be available at the touch of a button. In the '50s, he had cell phones in their cars.

PHILLIPS: So let me ask you this. I want to see if you have maybe a different theory about Howard Hughes. You know, so many people talk about the later years in his life. Of course, the years we remember hearing about, and the movies been based about it, the fact that he lived in this hotel room isolated,he became overly compulsive. He was freaked out by germs. He had long hair, long nails. Everyone thought he went crazy, thought he was a madman. Do you have maybe a theory that since he had no rules, no rules to live by, he could do whatever he wanted, that this maybe led to this existence?

HACK: Well, it certainly did. I never considered him a madman at all. He made most of his money during that period of time, and certainly multiplied the inheritance he got by two or three hundred times and ended up richer than he started. But during that period of time, he did let his hair grow and his nails and he didn't wash. He didn't dress. But the fact was, he didn't have to. He didn't even walk to the bathroom. He was carried, because he didn't feel like it.

But unless you have more money than anyone else on Earth, none of us can really understand what that's like, unless you cannot go outside of your doorway without being besieged by lawsuits and people who want sex, and to borrow money or to get a job. It is difficult to put yourself in those shoes. And he finally figured out that he really didn't need to move to do his job; he could do it over the telephone, and did. He was definitely not crazy. He was very active right up until the day he died, and was writing memos, all of which contained many, many business deals that were very lucid.

So madness isn't a word I'd use for Howard Hughes. He was the most unique person, for sure, the most unique person I have ever written about, but not crazy.

PHILLIPS: Interesting. And we talk about how rich he was. Put it into perspective. How much money did he bring in by the day, by the hour, by the minute, and does that even compare to, say, a Bill Gates?

HACK: Well, during his time, first of all, he was the first American billionaire. At a time that he had a billion dollars, all of the Rockefellers put together had about $500 million, so half as much. He was one individual with more money than anyone in the United States, and this was back in the '50s. At the time of his death in the '70s, he was earning about $175,000 every hour doing absolutely nothing. And in today's terms, well, let me put it this way. He left 32 relatives that inherited his estate, all of which became billionaires. And in today's dollars, he would probably be about one and a half times as rich as Bill Gates, and that's if he did nothing else than he did.

And remember, this is a guy that not only was an aviator, he flew and set world records, but it's because of Howard Hughes we have a retractable landing gear on a plane, because he thought, why should these wheels stay down here. They have this new fuselage because he didn't want rivets out there. They have the enclosed cockpit, autopilot. He just dreamt up all these things out of the -- you know, out of his scientific mind. Even though he had no training, he knew how to hire the people that really could do the job and that's where his brilliance lay.

PHILLIPS: The first...

HACK: He's a fascinating guy.

PHILLIPS: No, he is. Your book, I mean, hits on all these terrific stories, and the big chunk of your book is -- helped with "The Aviator." You were telling me Jim Carrey bought the rights to another section of your book for another film on Howard Hughes. What will that be about?

HACK: Exactly. Well, "The Aviator" is about early Howard Hughes up until the '40s, when he was really a glamour puss. He was of course very attractive, very tall, very rich, and he dated everyone -- I mean, Katharine Hepburn, Bette Davis, Ginger Rogers, Ava Gardner, all in the same week, and propose proposed to them all. After he matured and went into seclusion, Hughes became more of well, a relative unknown. He certainly never certainly was photographed, and that was the Hughes that we'll see in the Jim Carrey movie from Castlerock.

PHILLIPS: Richard Hack, the book is "Hughes: The Private Diaries, Memos and Letters, the Definitive Biography of the First American Billionaire." You can also catch a great article by Richard in this month's "Golf" magazine. That's how we found out about you, Richard, about his golf game, yes, and all kinds of neat stories about Howard Hughes on the golf course.

HACK: Inventing the sand wedge.

PHILLIPS: That's right. He and Gene Serenson (ph), there you go. That's how the wedge came about.

Thank goodness for the wedge, especially in the sand.

Thanks, Richard.

HACK: Yes, you got it. My pleasure, Kyra.

HARRIS: Well, the topic of Christmas greenery has residents in one Florida county seeing red. Christmas trees have been banned from public buildings in Pasco (ph) County after the county attorney decided they were religious symbols. But as the American Center of Law and Justice points out, to -- well, any druid scholar will tell you this, the Christmas tree tradition began long before the official start of Christianity. In the U.S., they are legally considered a secular symbol for the observance of a national holiday.

PHILLIPS: Speaking of mixing up your seasonal metaphors, CNN's Tom Foreman weighs in with an ecumenical proposal for getting through the holidays.

(BEGIN VIDEOTAPE)

TOM FOREMAN, CNN CORRESPONDENT (voice-over): During the most celebrated holiday in America, are you, like so many businesses, not sure how to greet people? Are you embarrassed by misplaced "merry Christmases" and ill-targeted "happy Hanukkahs"? But are you already tired of the lukewarm "happy holidays"?

(on camera) Have no fear. A new seasonal greeting is here, and I call it "happy Chrismakwanhanudan." A little hard to say, but it has a nice swing to it, and I think it could catch on, allowing us to greet and offend everyone all at once.

(voice-over) It's not a fairly balanced greeting. After all, despite declines in organized religion, about 76 percent of Americans still call themselves Christians.

Thirteen percent profess no faith; 1.3 percent are Jewish. And Buddhists, Muslims and agnostics are a half percent each.

(on camera) But "Chrismakwanhanudan" covers almost all the bases. The Buddhists get a little short changed, but I think they're pretty easy going. We'll have to iron out some of the details anyway.

(voice-over) The postal service might struggle to fit "Chrismakwanhanudan" onto a stamp. And I'm not sure St. Rabbi Mohammed Mbuto will be all that popular or even fit into a chimney. There could be unintended consequences, too, movements to combine other holidays, "The Fourth of Thanksgiving" and "Valenoween" come to mind.

(on camera) But we have to do something. With more schools, offices and local governments giving up Christmas parties in favor of winter celebrations, nobody knows what to say.

I don't "throw merry Christmas" at friends of differing faiths. Rather, I wish them the best of their own holidays, but as a practicing Christian, I do say "merry Christmas" a lot. I don't think respecting other people's beliefs means hiding your own.

(voice-over) That's why even if it "Chrismakwanhanudan" does not work in the long run, I'm not sure "happy holidays" does either. Not when what we mean is happy Hanukkah, a joyous Kwanzaa, a peaceful Ramadan, and a merry Christmas.

(END VIDEOTAPE)

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