On Call with Dr. Gupta

The metro Detroit native chats about having H1N1, dieting, more effective CPR, and ‘cheating death’
4199
On the set of CNN’s “House Call with Dr. Sanjay Gupta.” // Photograph by Mark Hill

With the possible exception of Dr. Mehmet Oz, there’s no other doctor with a higher profile in the country than neurosurgeon Sanjay Gupta. The Michigan native, who turned 40 in October, grew up in Novi and attended U-M. He’s gone on to a crowded career. He’s a surgeon at two Atlanta hospitals, is chief medical correspondent for CNN, hosts CNN’s weekend show House Call with Dr. Sanjay Gupta, reports for the CBS Evening News with Katie Couric, writes a column for Time magazine, has made several documentaries, blogs for CNN.com, Twitters regularly on medical topics, was embedded with the “Devil Docs” in Iraq, and, as a White House Fellow, was an adviser to former First Lady Hillary Clinton.

As if that résumé weren’t impressive enough, Gupta was chosen as one of People magazine’s Sexiest Men of the Year in 2003. To the consternation of his admirers, the handsome doc, the son of East Indian immigrants who were both engineers for Ford Motor Co., is married to family-law attorney Rebecca Olson Gupta. They have three daughters and live in Atlanta.

He’s also the author of Chasing Life, about delaying aging, and the recent Cheating Death (Wellness Central, $24.99), which concerns stories of people who made astonishing recoveries from the jaws of death.

President Obama offered the office of surgeon general to Gupta, but the doctor declined the position last March.

We caught up with the busy doc in late September via phone from Philadelphia, where he was filming an accompanying documentary to Cheating Death (available on DVD and iTunes).

So, irony of ironies, you, a doctor, recently contracted H1N1 in Afghanistan.

Yeah — go figure.

I read the account on your CNN blog, but in a nutshell, explain for our readers what you went through.

I was covering the war in Afghanistan, and this thing just wouldn’t go away. It started as a cough, then came the body aches. But the chills were the most memorable. It was over 100 degrees there in the desert, but I was walking around in sweatshirts and blankets. And I don’t get sick very often. There was also a complete lack of appetite. I think I realized that I should stop working when I got out of my sleeping bag one day and couldn’t take more than a couple of steps without feeling that I had complete disequilibrium. … I’m doing fine now.

You grew up in Novi and went to the University of Michigan for your undergrad degree and med school. Where did you typically go when you lived here?

My family is Indian, so we did a lot of things that revolved around our culture. We went to the Indian festival, and those of other cultures, too [in Hart Plaza]. And every summer, we’d go to the Renaissance Festival. My mom is a big cook, and a lot of the things we did as kids revolved around food. We’d also go to Tiger Stadium, but also to culturally related performances downtown. In college, I had friends who went to Wayne State University or were residents at hospitals around there, and we would go to Detroit jazz clubs and restaurants. But most of my adult life in Michigan, I was very, very busy. As a neurosurgeon resident, I was working about 110 hours a week, and as a med student, you don’t have a lot of time to play, so to speak.

Did you meet your wife in Ann Arbor?

Yes, I did. I met her through some mutual friends, and it went from there.

Some information in Cheating Death seems counter-intuitive. Hypothermia is something we link with danger, but it can actually be beneficial because it buys time for the patient and doctors. So why aren’t more health professionals advocating therapeutic hypothermia?

Let me preface the answer by saying that, as I’m talking to you, I’m at the University of Pennsylvania. I’m making a documentary related to Cheating Death, and one of the issues I was specifically looking at today is hypothermia. So I’m at U-Penn, which is a major academic hospital where they’re doing hypothermia every day. … It’s not really that complicated. Literally, you’re cooling the patient. So, you take this simple device that wraps around the torso with cold saline in it, and it cools them down.

To about 90 degrees?

Well, it varies a few degrees — 90 to 93 degrees, around there, depending on their age and their specific health issue. What’s striking to me is that all the literature I’ve looked at says that hypothermia can absolutely improve the likelihood of survival after cardiac arrest. The concept is pretty simple. Hypothermia slows down your body’s metabolism, and it decreases the body’s need for oxygenated blood.
But to your point of why aren’t more hospitals doing it — there’s not a good answer. And I wish there were, because it’s a simple device and it’s not costly. This technique just requires a good advocate in hospitals, good spokespeople who’ll say, ‘Hey, there’s no champion for this, but it makes a huge difference in terms of survival. Let’s start doing it.’

One of the stunners in your book is that conventional mouth-to-mouth in CPR is virtually useless, but rapid chest compressions are far more effective. Why is that?

It is startling, and the answer’s pretty simple. That is, if you’re walking through the streets of Detroit today and a guy or gal were to collapse in front of you — sudden cardiac arrest — what we know is that, from a purely physiological standpoint, they were breathing right before they arrested, and they have plenty of oxygen in their blood for several minutes, maybe even 10 or 12. The real key is to get that oxygenated blood moving. Anything that stops that process — stopping, for example, to give mouth-to-mouth — is simply not moving the blood through the body. … The survival rates can actually be worse if someone stops to perform mouth-to-mouth resuscitation, as opposed to just pushing hard on the sternum, 100 pushes every minute, until the paramedics get there. The average person [a bystander] could save a life.

Gupta explores environmental concerns in Chad for CNN’s “Planet in Peril.”
Photograph by Jeff Hutchens

It’s startling to read in Cheating Death about the benefits of hydrogen sulfide, even though it’s highly toxic. You write about a rat put in an enclosure with hydrogen sulfide and it goes into a kind of stupor. Then the poison is flushed out and replaced with oxygen, and it’s fine. Is this too risky to try on humans; is it possible?

It’s completely possible, and I think the trials in humans are going to start sometime soon. The premise is fascinating, although a counter-intuitive one. Right now, as I’m speaking to you, you’re breathing in 21-percent oxygen. If I were to suddenly reduce the concentration of oxygen that you’re breathing to 2 percent, you would likely die. But if I were to take it down to .00002 percent, and also make sure that your cells and your body were getting some sort of nutrition, you would likely live, but in a state of suspended animation. We have methods of sustaining our body without oxygen, and if we can figure it out now, it can make a huge difference in buying time after cardiac arrest, or after traumatic injury. Suspended animation is more than just a science-fiction concept. These trials are going on as we speak.

Of all these stories of people cheating death in the book, which one was the most astonishing to you as a doctor?

Well, take the story of Anna Bagenholm, the Norwegian skier. She crashes into a frozen pond, and her head is under a block of ice, and her legs stop moving; she’s been like this for about 90 minutes before they got her out of there. If I heard that story, I would have said, ‘There’s no way someone can survive that.’  Suffocating, no air, those low temperatures for 90 minutes? But you had these doctors who said, ‘Instead of warming her up right away, we’re going to leave her cold. We’re going to essentially allow her body to remain hypothermic, because we think our bodies have a natural ability to protect themselves.’ She’s now a doctor at the same hospital where she was declared dead. She had no heart rate, but she came back. That was an incredible story, but for me as a doctor, every time I talk to one these patients [who cheated death], I say, ‘So what am I to learn from you?’ And they all look at me — some of them grab my hand — and say, ‘You should never give up. Never, ever give up.’ And that’s the interesting thing. We don’t know when dead is dead. You’d think that as a medical community in 2009, we’d know when someone’s dead and when someone’s alive. But I can tell you, we don’t. And it changes everything.

How is the way you look at mortality now different from when you were in medical school?

It’s changed in part because of the book [Cheating Death], but in larger part because of my family and my own desire to be around and be more functional for my children. … What we thought was dead is reversible. We know that. I don’t want to sound Pollyanna-ish in terms of what is possible. But I do know that we are capable of living life much more like an incandescent light bulb than a fluorescent light. We can burn brightly our entire lives, and suddenly go out, as opposed to all the flickering at the end that represents disease and time in hospitals and nursing homes. It doesn’t have to be that way. We know so much more than we did a decade ago. I couldn’t have written Cheating Death 10 years ago. The things I write about didn’t exist.

It must make you feel better about turning 40.

[Laughs] Right. That just kind of creeps up.

You had a dust-up with another Michigan native, Michael Moore, when you criticized some of his figures in the movie Sicko. You locked horns with him on Larry King Live. Have you kissed and made up with him?

I think we were saying things that actually weren’t that different, but I can see why people might have interpreted it as a dust-up. Michael and I were talking about the deficiencies in the health-care system, and I’ve been talking about that for a long time. During the commercial breaks, Michael was saying to me, ‘I’m just so glad we’re having this discussion.’ … I wish people would look back on these conversations we had in a broader way, as a discussion about health care, not just as a dust-up. So there really wasn’t much to kiss and make up about. I think we’re fine.

One of your tweets from last month said you had cut 25 percent of your daily calories. How did you do it?

I just came to the determination, not through strict calorie counting, that I eat more than I need. I was eating more than my energy expenditure. So I figured about 25 percent was the right amount to cut out. I take smaller portions, but I also practice something I talk about in Chasing Life, which is called Hari Hachi Bu [an Okinawan technique of eating until you’re 80-percent full]. So before I’m full, I’ll stop eating, because it takes about 15 minutes for the brain to catch up with the stomach. I think that’s made a huge difference. The thing I find most striking about the Four Months to Fitness Initiative I do on Twitter is that I’ve always been a gym guy; I like exercising and running. But the thing that made the biggest difference for me had very little to do with exercising and almost everything to do with diet. … You can’t do fitness without diet.

A couple of years ago, you spoke with Dr. Thomas Perls, an expert on aging, about your routine. He said you weren’t getting enough sleep. You have a really full schedule. Are you managing to get more shut-eye these days?

No, I’m not. It’s a persistent fault. I was in Afghanistan covering a war. I’m in Philadelphia today, and now I’m going on the train to New York, and I’m going to Norway on Monday. I have a very busy life. And even when I am home, I have three kids under the age of 4, so that doesn’t make it any easier. I wish I could be better about getting sleep.

Health-care reform has been at the top of news reports lately, but so few people are talking about the primary-care doctors we’ll need if everyone is insured. How many more will we need?

We’ll be about 16,000 short. You make a very good point. We’ve had a primary-care doctor shortage for some time, and I think we’re going to feel it more profoundly as more people get health-care insurance.

In March, you pulled your name out of consideration for the post of surgeon general. Do you have any regrets?

No. I’m not someone who lives in the world of regrets. It was a very personal decision. I talked to the people who mean the most to me in my life about it. What I realized when I talked with President Obama about it — and he was great about the whole thing, by the way — was that I wouldn’t be able to practice as a neurosurgeon anymore while being surgeon general. If you’re in a non-surgical specialty, you have some leeway, and you might be able to go back to your medical practice at some point. But as a surgeon, you have to be doing it with some degree of regularity.

The other part of it was that with family and kids, I realized that I would probably be a commuting dad. I don’t see my kids enough as it is.