tv Sanjay Gupta MD CNN August 21, 2011 7:30am-8:00am EDT
i'm alina cho. first, a look how cuba handles medical care. san jay gupta m.d. from havana begins, right now. good morning. welcome to a very special edition of "sgmd." i'm sanjay gupta. i'm reporting to you from a place i never get to visit. we are in havana, cuba. we have been working on the documentary of diana nyad. this for some time. a few may not know who she is. one of the most aspiring people you'll ever meet. she is a 61-year-old long distance swimmer who set out to do the impossible. something that people told her that simply could not be done. she wanted to swim from here in havana, jump in the water right over here and swim all the way to florida. more than 100 miles. no rest. no shark cage. complete exposure to the elements. the swim was planned to take over two days through day and night. more than 60 hours.
that's what the intent was going to be, and she had to do this again without any rest whatsoever. what we now know is diana lasted about half that distance. about 50 miles. 29 hours in the water. the currents were rough and the waves big. her shoulders started to bother her. it was no less inspiring to watch her near the end of that swim. the big question on a lot of people's minds now, including mine, is, diana, what is next for you? that is part of our story today. although we are 100 miles away from florida, we are a world away from the health care system here. people will tell you, if you talk about the cuban health care system, prepare for a fight. it is one of the mother controversial issues you're likely to encounter. what i can tell you this, under fidel castro, everyone has access to health care. that is very different, you know, than a lot of other countries on the planet. what critics will say that despite the fact they have
health care, oftentimes that health care is not as good and patients do not fare as well. they will tell you the resources are limited for doctors and hospitals alike. they're often operating on a shoestring budget. i came here to try to figure out what the real story was in all of this and get a glimpse to try and show you. consider this -- the life expectancy here in cuba is about 77 years. that's comparable to the united states. its infant mortality is among the lowest in the world. and the cubans do all of this at 1/14 of what e pay in the united states. how do they do it? we came to find out. you're looking at one of the better community hospitals in the capital city havana. not a lot of flash. not a lot of dazzle. stuck in time. circa 1960s. >> technologies are available in places in the world but you can't import that? >> we can't get them as donations. half our scanner, from phillips,
for example, and they can't provide service. chicago. >> dr. pedro estevez was born in chicago. he did some of his training at nyu and now practices here in cuba. >> i would like to say my commitment is here. i have a job to do. i think the u.s. has plenty of doctors. >> there is a fear here that cuba is losing its doctors. and cuba's doctors aren't just practicing in cuba. they're practicing all over the world. in fact, experts estimate anywhere between one-fifth and one-third of cuba's doctors actually practice overseas. fidel castro sent doctors from angola to haiti. we find another purpose as well. cuba has sent 14,000 doctors to venezuela over the last ten years. in exchange, venezuela has sent millions of barrels of oil. for all that we americans spend on our medical bills, you would
think that americans would be much healthier. but we're not. >> one of the things that comes up is the cost per capita here in cuba is much less than the united states. yet, life expectancy is about the same. childhood mortality rates are lower here. how? >> i think it is the way the system is organized. it is the emphasis on prevention. it's the articulation of primary health care with the family doctor. it's the way we've been forced to use resources. >> reporter: here's a key distinction. he is talking about prevention. not just catching problems early. >> for example, if i was telling you about the screening for birth defects. that is 100% of cuban mothers. the vaccination is 100% of kids. the yearly screening program for hearing loss, that's all kids that are at risk. >> reporter: so why invest so
much in a hearing screening program? because hearing loss has been connected to slower emotional development. and intellectual development. in order to have truly effective programs, it helps to have a doctor and nurse right in your neighborhood. this is a neighborhood doctor's office. quite literally. the bottom floor is the doctor's office. the doctor actually lives above the office here among the community. there's a big focus on preventive care here. that is why the doctor is here to make sure people are getting their vaccinations and general care visits. also to monitor to see if there are outbreaks or threats to the community that are eminent. doctors will make surprise visits checking up on the health the general health of any given family. you make house visits. this doctor has worked here for 20 years. she has 784 patients in this neighborhood. she knows everyone by name. many of them she has known since they were babies. the cuban health system demonstrates, prevention is not
a passive thing, but in case you're curious, a doctor like her makes on average between $20 and $30, u.s. dollars, a month. you have to take side jobs to make ends meet because they are not getting paid enough. true? >> yes. it's true. >> does that make it hard to actually incentivize people to go into medicine? >> this is public knowledge. we have economic difficulties. >> to swim across the ocean. all the way to florida. >> later in the day, we were filming on the beach and called over to help a man swimming. i was asked to help in any way i could. >> your leg. relax. wiggle your toes. >> is somebody coming? >> is there an ambulance coming? >> the young man turned out to be all right, but that ambulance never came, and even if it did, the question remains -- in a system with scarce
resources, could this man have gotten treatment he needed? it's also part of the reality cubans face every day. hopefully that gives you a glimpse into the cuban health care systems. we're going to follow health care systems around the world and show you comparisons to the united states in the months and years to come. i do want to talk about something that's become a real american problem, though. the biggest killer of men and women alike in the united states. it's heart disease. many people believe that this is a lifestyle problem. it's decided by the choices that we make in our lives, whether or not to have this heart disease. i decided i wanted to become heart attack-proof. to be convinced i would never have a heart attack. my doctors now say that i've achieved that. you're probably wondering how. that's next. three out of four doctors recommend the ensure brand for extra nutrition. ensure clinical strength has revigor and thirteen grams of protein to protect, preserve, and promote muscle health.
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we are back from havana, cuba with the special report for "sgmd." i have been taking a close look at heart disease for some time now. i can tell you that the american culture, especially the american diet, has been exported to just about every country in the world. and they're starting to pay the price. heart disease is the biggest killer in the united states of men and women alike. now they say about one in three american adults has some version of it.
what i think is so remarkable is that we know that with no new money spent on heart research, no new resources, no new breakthroughs, right now we could have a shot at virtually eliminating heart attacks. sounds pretty remarkable, i know. think about it for a second. for example, take a look at the food that you eat. think about that. now think about it again. sharon kintz is 66 years old. a retired private investigator from canton, ohio. a year ago, she had a heart attack after one of her coronary arteries beam completely blocked. >> he said for someone who had what you have, the only warning you usually get is death. at that point, i really knew how lucky i was. >> like a lot of women, kintz did not experience the classic chest pain, but rather fatigue and a pain in her jaw. >> he said you will have to have
open heart surgery. he said i can fix you today. i can just take you right down in the o.r. and operate on you right now. my son was in there. he was ready to wheel me down to the operating room. because he was frantic. you know. it's terrifying. >> reporter: what kinltz did next may surprise you. she turned the surgeon down cold. said no to open heart surgery. decided to take a chance. >> i bought parsnips. always have sweet potatoes on hand. >> using food as medicine. >> i love these. they are wonderful. so i love these. >> kintz is betting her life on a controversial diet. created by a general surgeon by training. >> you have easy to remember adages of what you should and should not eat. >> we know what they should not eat. oil, dairy, meat, fish and chicken. we want them to eat all of those whole grains for their cereal, bread, pasta. beans, vegetables.
yellow, red, green and fruit. now what particular vegetables do we want them to have? bok choy, brussel sprouts and beets, green beans, parsley, spinach, aruba and asparagus and i'm out of breath. i'm out of breath. >> nothing with a mother. nothing with a face. you can imagine the meat, egg and dairy associations think that is a terrible idea. >> incorporating lean beef can help you stick to a healthy diet. because it's a food people enjoy. >> it is a source of 13 vitamins and minerals. eggs are the gold standard for protein. >> dairy foods are nutrient rich. you get a lot of nutrients for every calorie that you consume. >> the doctor is not a cardiology. he has no special degree in nutrition, but when it comes to food as medicine, he's a true believer. >> she had a heart attack. >> yes.
>> you know sharon. doctors recommend she had an intervention. she's not doing it. is there a down side? could she be putting herself at risk? >> no. i think that's an excellent question. in hundreds of patients, the data going back over 20 years and the most recent study over the last decade, once you eat this way, you will make yourself heart attack-proof. >> why's that? >> we know if people are eating this way, they are not going to have a heart attack. it is a food-borne illness. we're never going to end the epidemic with stents, with bypasses, with the drugs, because none of it is treating causation of the illness. >> his food-based prescription puts him squarely against conventional wisdom, which says diet is only part of a heart-healthy lifestyle. if a doctor said heart disease is a food-borne illness and you follow this diet and in the exchange, you will not have a heart attack. what would you say?
do you agee with that? >> i would say that is an overstatement. an oversimplification of what we are able to do. even though i know there are people who say it. >> i was curious about the science behind the doctor's claims. i dug up the peer review journals. the results of impressive. in one study, patients on the diet and medication had no heart attacks and no coronary events after five years of any sort. three-quarter of patients saw the blockages get smaller. a year after her heart attack, sharon kintz says she feels great. check out those moves. a year ago, simply walking was enough to wear herrous. with the diet, you have to ask one question. can she keep it up? i asked sharon to meet me in new york city. cooking at home is one thing, but eating on the road or on the run, well, that's quite another. as the old saying goes,
if her diet can make it here, it can make it anywhere. 46th and broadway. please. sharon, how are you? when you cook at home, it is more under your control. what's the most difficult thing when you're on the road? >> i see pizza, which is not. i'm sure there is oil in it. and that looks like pepperoni. when i like up here i see pasta. so my question would be, when i go in, do you have whole wheat pasta? and then, my second question is can you prepare it without oil? that is not. that's a not. >> that's a not. >> but they have pasta and they have salad. >> here is another restaurant. i'm going to take advice from you. you look at a menu like this, and tell me what comes to your mind. >> the majority on there i will not eat. >> you focus on salads? >> no. not really. i could have the baby spinach leaves without the chicken and peaches and strawberries.
forget the walnuts. >> is this a restaurant you would come in? >> oh, yeah. if i was hungry, you bet. you bet i could. >> you could get a meal here? >> you bet i could. >> you think this diet will make you live longer? >> i hope so. i hope i get to see you retire. >> i have a feeling that will be a very long time, which i hope you do. >> i hope i do, too. >> nothing with a mother. nothing with a face. no dairy. no oil. not easy to do, i can tell you from personal experience, but one person who is giving it a go is former president bill clinton. he went through his presidency never even knowing he was on the verge of a heart attack, but he was. it took quadruple bypass surgery to open up his eyes and now he is starting to do lots of things to reduce his risk. including bringing his weight down to almost what it was when he was a teenager. how's he doing it? i sat down with him one-on-one.
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we're back with a special "sgmd." according to the american heart association 40% of americans believe they're in ideal heart health. the real number, fewer than 1%. those numbers starting to ring true in places like havana, cuba, where we are now. former president clinton thought he was in ideal heart health but it took a quadruple heart bypass surgery to save his life. i sat down with him as he is a changed man now, even a vegan. that's right, a vegan. he told me how he did it. >> i was lucky i didn't die. of a heart attack. >> reporter: former president clinton, like too many people, was busy. and for years, he ignored warning signs of his heart. but in 2004, during an exhausting book tour, there was something different. >> i had a real tightness in my chest when i was getting off the airplane and it was the no pain,
but tight, only time i had it unrelated it to exercise. i immediately went down to our local hospital and they did a test and said you got real problems. they hustled me down to columbia presbyterian and they confirmed the determination that i had serious blockage and needed surgery. >> reporter: the doctors immediately knew, options were limited. the 58-year-old clinton needed to have his chest opened, his heart stopped, and surgery performed. >> there's no medical treatment for reversing the obstructions that already formed in his blood vessels. >> so, i got hillary and chelsea there and all i remember it was happening fast and everybody who cared about me was scared and i felt rather serene. >> reporter: on labor day in 2004, mr. clinton had four blood
vessels bypassed. >> starting this morning around 8:00, he had a relatively routine quadruple bypass operation. we left the operating room around noon and he is recovering normally. >> it hurt like the devil for about three weeks, it hurt so much i had a hard time even watching movies much less reading. and then when i started again, to exercise, and i forced myself out, i mean like the first day, tried to just walk a half a block, one way or the other, trying to push myself into doing the therapy, there was that period when you're just not sure you can come back. >> how do you know that you're healthy now? would you call yourself healthy now? >> well, i think i'm healthier than i was. i'm -- i lost 20 something pounds and i feel good and i have, believe it or not, more energy. i seem to need -- when i do sleep, i sleep better, but i
seem to need less sleep to function at a reasonably high level than i did. >> you've talked about the fact you love to eat. this is -- >> you know, i like the stuff i eat. i like the vegetables, the fruits, the beans, the stuff i eat now i like. i like it. >> do you call yourself a vegan now then? >> well, i suppose i am, if i don't eat dairy or meat or fish, you know. >> you've cut all that out? do you -- >> only thing -- once in a while, literally in well over a year now, at thanksgiving i had one bite of turkey. >> you're doing this for your health? >> yes. >> is that why you're doing it? >> absolutely. >> mr. president. how are you? >> great. >> last time we spoke, a few weeks ago, you said you were going to be really strict on the diet. you were doing a pretty good job, you said? >> i'm more strict now. >> are you? >> uh-huh.
by the time i have my 65th birthday, i want to weigh what i did when i went home from law school in 1973. >> wow. >> that's what i'm working on. >> that's a grand ambition. how much is that? will you tell us? >> i got down to 185. >> wow. >> i got down when chelsea was married, i weighed about 192. which is what i weighed when i graduate from high school. anything under 195 was my optimum weight my whole life. in the summer of '73 we had a scorching hot summer and i ran three miles a day at the hottest hour of the day which i could do back then in order to make the pounds go off and it was the first time since i was 13 years old that i weighed 185 pounds. i'm going to try one more time to make it. >> much more with former president clinton, also all the studies out there that can potentially make you heart attack proof. that's what doctors have told me i now am.
i want to share it with you. come watch our special called "the last heart attack" this sunday, 8:00 p.m. and 11:00 p.m. eastern. i'm dr. sanjay gupta reporting to you from havana, cuba. we'll be right back. [ jack ] what's for breakfast? um... try the number one! [ jack ] yeah, this is pretty good. [ male announcer ] half a day's worth of fiber. fiber one. if you have painful, swollen joints, i've been in your shoes. one day i'm on p of the world... the next i'm saying... i have this thing called psoriatic arthritis. i had some intense pain. it progressively got worse. my rheumatologist told me about enbrel. i'm surprised how quickly my symptoms have been managed. [ male announcer ] because enbrel suppresses your immune system, it may lower your ability to fight infections. serious, sometimes fatal events including infections, tuberculosis, lymphoma, other cancers, and nervous system and blood disorders have occurred. before starting enbrel, your doctor should test you for tuberculosis and discuss whether you've been to a region
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♪ we are winding our time down here in havana, cuba. i can tell you that it's been a really fascinating trip to a place i had never been before. we came here to see an icon, die yanna nyad trying to do something no human being has done before, swim from cuba to florida without any sort of protection. we know how her story ends but we walked away in some ways more inspired than possible. we looked at this place of havana, cuba, looked at the buildings, the throwback feeling you get when you're here, the cars from the 1960s and 1970s.