Dr. Sanjay Gupta Now Knows the World Better by Seeing How People Evaluate Risk
Dr. Sanjay Gupta Now Knows the World Better by Seeing How People Evaluate Risk
By Pallabi Munsi
WHY YOU SHOULD CARE
Because the next best thing to being a doctor, if you're sick, is listening to one.
By Pallabi Munsi
Dr. Sanjay Gupta, associate professor of neurosurgery at the Emory University School of Medicine and chief medical correspondent for CNN, became a household name for his analytical breakdown of the medical world for people around the world since 9/11. He pops into The Carlos Watson Show to talk about the takeaways from COVID-19 and how to stay sharp. You can find excerpts below or listen to the full interview on the show’s podcast feed.
On the Lessons From COVID-19
Carlos Watson: Last year has people thinking about a whole lot of things, including location and whether or not they’re in the right place. Would you ever live anywhere else? I know you’ve been in Atlanta for a good while.
Sanjay Gupta: About 20 years now. Yeah. It’s funny. I’m not from here. In fact, I had never even been here before I decided to move. I came for an interview at Emory and it just sort of went from there. But I think I could live just about anywhere. I think it’s amazing what this year has taught us in terms of … I got a little studio in the house because of COVID, and can really … I mean, you got good connectivity and good camera and stuff like that, you can broadcast from anywhere. I’d still want to be obviously close to a big hospital because I’m still operating. But, yeah, besides that, be anywhere.
Watson: Did you find that your work slowed in any meaningful or tangible way during the heat of COVID?
Gupta: I think it was most of April and some of May where essentially our hospital became a COVID hospital. So elective operations were not happening. Now, it’s interesting. We also do a lot of trauma. I’m a neurosurgeon, but a lot of the trauma comes from car accidents, and people weren’t driving. So you had this sort of reduction of both elective and traumatic and urgent. Everything sort of went down at the same time COVID was happening. So, yeah, it was really sort of shut down. And it was sort of a little bit like this: We’d come back and then have to sort of slow down again.
Watson: Will this year change anything about how you practice neurosurgery?
Gupta: I think it absolutely will. I mean, it’s funny because there was surprisingly slow acceptance and sort of embracing of telehealth. And I really never understood why, because there are so many advantages. This [COVID-19] really accelerated it. In fact, I can tell you, I did a story about this. There were 80, 8-0, telehealth visits between January 1 of 2020 and March 1 of 2020. Between March to the end of May, there were 80,000 telehealth visits at our … What’s amazing to me is now all these people who are reticent to embrace it, they can see patients. The patients don’t have to come to the hospital and park, and, “Am I in hallway 2F or 2K? I can’t find my clinic.” It’s ridiculous. It’s a terrible user experience for patients. Telehealth can be great. There’s obviously some things you still have to come in for. But a lot we can do via telehealth.
Watson: When did you know that COVID was going to be a really serious, impactful, dramatic event?
Gupta: I never anticipated this, Carlos, to be fair. I really didn’t. I think we always sort of are thinking of the 1918 flu pandemic and other smaller pandemics since then. And always wonder in the back of our minds, I mean, 1918 there was a pandemic; 1968 there was a pandemic—that’s 50 years later; 2018, is there going to be another one? There are all of these various sorts of iterations that go into people’s minds, some logical, some sort of more superstitious almost. But I’ve covered a lot of these stories. I was in west Africa for Ebola. I was in Vietnam and Laos for avian flu. I was in Mexico for H1N1, SARS, MERS. I’ve covered all of these.
I think my antenna went up earlier because of that. And whenever you hear about something emanating, that’s spreading so quickly in China, you know it’s going to be traveling all over the world. I mean, there’s so many people moving in and out of China at any given time. So I think sort of mid-January, it was becoming pretty clear. Hospitals were being built in China, they were buying all this personal protective equipment. So even though there wasn’t this outward concern, their actions were clearly showing that there was a lot of concern. I was following it very closely, Carlos, from that time on.
Watson: Years from now when you look back, what do you expect will be your two or three biggest takeaways or most interesting takeaways when you think about this period?
Gupta: There were two things. One, is how we as human beings really evaluate risk. If I tell you something is 0.5% lethal, a certain segment of the population is going to say 1 in 200 people are going to die, “We better be careful, we better really protect ourselves.” Another group will say, “So I’m 99.5% good. What’s the big deal?” It’s the same objective data. If you’re going to be honest and serious about communicating, the objective data is the currency, but you have to understand the subjective interpretation of that. And people’s subjective interpretations are very much dependent on who they are, their lives. So it sounds fundamental, but that was a real sort of takeaway.
The second thing is this is a novel coronavirus. Everyone knows coronavirus; sometimes you may gloss over the word and “novel.” Novel means something new, we’ve never seen this before. When was the last time you experienced something for the first time? If you were a knowledgeable person, it can almost get in your way. And here’s why: Because you hear coronavirus from China and right away, a knowledgeable person will say, well that’s going to be SARS. SARS was a coronavirus from China, we’re going to put this in the SARS box and right away you start treating it as if it’s SARS. Or, it’s looking like a pandemic, I’m going to put this in the H1N1 box and start treating it like that.
Both of those would be totally wrong. I really think the idea of, can you actually treat something as novel, like, clear your preconceived notions. It’s a surmountable task, but it’s an audacious thing to sort of get over. I’m going to cast away those things and really approach this tabula rasa. We don’t do that … but that was a takeaway.
On Rising to the Top — And Staying Sharp
Watson: Were you predestined to be a doctor?
Gupta: I think once I decided this, it seemed pretty likely. I mean, neither one of my parents are doctors. There’s no medical people in my family, so there wasn’t that sort of … from a very young childhood … that pushed toward that. In fact, if anything, it was going to be either more math … mathematics professor, my father; or engineering — my mom’s the first woman ever hired as an engineer in the automotive industry. So that’s a big part of our family.
But I fell in love with medicine. My grandfather, my mom’s father, had a stroke when I was 13 years old. We’re very close; I spent a lot of time in the hospital, sort of realized that this was a sort of profession, this was a thing that you could do. And the doctors who took care of them were really empathetic people who made an impression on me. So I think at that point, I sort of decided I wanted to be a doctor.
Watson: And how did you decide to go on TV?
Gupta: It was kind of serendipitous in some ways. I was obviously going to medical school and doing my residency. I was also very interested in health policy and I was writing a lot of health policy papers. And I went to work at the White House for a period of time as a White House fellow with health care policy sort of in mind … this is mid- to late-’90s. And at that time I was writing speeches.
Tom Johnson, who used to run CNN, had also been a White House fellow. He had come to me at some point during that time in 1997 and said, “What do you think about trying to talk about some of these issues on television?” I thought that was interesting but not quite what I had in mind. I was back in my practice residency at Michigan, and then came to Atlanta to take a job in neurosurgery and ran into Tom Johnson.
This is August of 2001, so just think about what time in the world this is. And I was going to come on to basically do commentary on health policy. That was it. It was the first year of the first term of W’s presidency. Talk about health care, how it’s going to change, that was it. And then three and a half weeks later, 9/11 happens. Then, all of a sudden, you’re the doctor working at an international news network. They’re probably not going to be talking about health policy for a while: Do you want to cover and talk about some of these other things that are happening in the world? And that was sort of it.
Watson: So what made you decide to write this new book on staying sharp?
Gupta: Well, the brain is my first love. In some ways, it’s a longstanding love of the brain. I sort of straddle these two worlds — of journalism, but also neuroscience, neurosurgery, all of that. And I’m constantly learning things in the neuroscience world that are happening at a pretty high scientific level but are really fascinating things that have not yet been translated to the lay audience.
Now there is very clear evidence that at any age, a healthy brain, whatever, could grow new brain cells. It’s an audacious sort of thing. So that just inspired me as I hear more and more of these researchers talk about that at neuroscience meetings. It was about a two-and-a-half-year journey to go talk to many of these scientists. “What do you mean exactly? By the way, if you can grow new brain cells, how do you do it?” That was the follow-up part of the conversation. And eventually, it felt like a book first.
Watson: It’s good to hear there’s such a thing as neurogenesis …
Gupta: So when we talk about neurogenesis, there are two things. One is, are you going to keep driving the same road and really learn that road well? Or are you going to start to build new roads, new cities, new towns, new countries in your brain and get to visit those places? That’s what neurogenesis really is. People call it cognitive resilience. But it’s this idea of really increasing the function of that other 90 percent of your brain.
Why do that?
Well, two primary reasons. One is that it’s kind of fun, first of all. It’s joyous to actually be able to visit these other cities. But I think more tangibly, you connect dots that you would otherwise miss. And that’s connected. No one else sees it. I do. That’s how it comes together. The second thing, I think, more tangible as you get older, people think about dementia and Alzheimer’s disease. So if the metaphor is that city, you’re driving those roads and then one day there’s a blockage in the form of an amyloid plaque associated with Alzheimer’s. You know that road well, but it’s blocked. What are you going to do now?
Well, if you spent the earlier parts of your life building a bunch of other roads, other cities, other destinations, you essentially can get around that. So you still may even have plaque, but you don’t have cognitive dysfunction. I just find that so inspiring. We spent $500 million trying to figure out a drug that could get rid of the amyloid plaque. But what if you really didn’t need to get rid of it; you just needed to figure out how to keep your cognitive function?
On Serving the Public
Watson: Sanjay, I know a couple of years ago, President Obama was new in office and was interested in you joining him as surgeon general. Have you thought about service in public service in some way, either running for office or accepting a cabinet appointment?
Gupta: I love public service. I would definitely get back into public service. I don’t think I would run for office. I really salute the people who do that. I think it’s such a huge endeavor. I’m still a doctor. I still practice medicine.
Watson: What would thrill you? Are you thinking about a health and human services kind of thing?
Gupta: I think so. You know, I mean, I think the only downside of certain jobs is that you don’t necessarily have mandate teeth. I think, as a journalist, what’s important is that we are often the first to see a problem emerge, and we are often the first to talk to the people who understand this problem, and even see solutions emerge. But I don’t have policy teeth to do anything about it. So, you know, I’m in my 50s now, and I think I’ve seen a lot, and I feel like I know a lot. Could I take some of that to a public service position? Yeah, I think … a job where you had some ability to actually execute solutions.
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