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CNN
10 hours ago
- Health
- CNN
The Organ Transplant Revolution Starts Here - Chasing Life with Dr. Sanjay Gupta - Podcast on CNN Audio
Dr. Sanjay Gupta 00:00:03 What you're about to hear is a story of history in the making. Dr. Sanjay Gupta 00:00:20 A medical first, a story of survival, bravery, and heroism. I'm not a hero. Dr. Sanjay Gupta 00:00:29 To try and solve a crisis. Taking the clamp off the artery. Nice and pink, yeah. You see, at any given moment, more than 100,000 people are waiting. Dr. Sanjay Gupta 00:00:56 And every day 17 people sadly will die. Speaker 2 00:01:00 For any organ that you name. Only 10% make it on the list. There's just not enough of. There's not enough. Dr. Sanjay Gupta 00:01:06 Now, the potential answer to this problem might sound crazy to many. Speaker 7 00:01:10 I have received a major, major, groundbreaking organ transplant. Dr. Sanjay Gupta 00:01:19 Controversial to some Speaker 7 00:01:21 for that animal. This is a life of deprivation. It's an early death. It is much suffering. I don't think that's ever okay. Dr. Sanjay Gupta 00:01:28 Even blasphemous to others. Speaker 5 00:01:30 Contacted the bishop and then the Vatican sent me a paper Dr. Sanjay Gupta 00:01:34 But now, more than ever, it's also incredibly promising. Could animals be the answer? Is it right? Is it wrong? Can it even work? Dr. Sanjay Gupta 00:01:49 That is an ultrasound with a pig kidney inside Tim, something that very few Dr. Sanjay Gupta 00:01:54 people ever get to see. For the last two years, we've been searching for answers. Dr. Sanjay Gupta 00:02:01 It's powerful just to be here with these pigs. Dr. Sanjay Gupta 00:02:05 I'm Dr. Sanjay Gupta, and here is part one of Animal Farm. In the remote mountains of Patagonia, about as far from civilization as you can get, Robert Montgomery almost died. Robert Montgomery 00:02:22 I had a cardiac arrest and my son was doing CPR on me and they put me in the back of a truck and drove me to a hospital and they looked at me and said we can't take care of this. They brought an ambulance up and continued resuscitation and drove five hours to the closest hospital. Dr. Sanjay Gupta 00:02:47 I've heard a lot of extraordinary stories throughout my career, but just the idea, the cardiac arrest, and then your son doing chest compressions on you. Robert Montgomery 00:02:54 Yeah, he saved my life. When I woke up I couldn't do anything, I couldn't walk or talk. Dr. Sanjay Gupta 00:03:09 That he even survived. It really is just so extraordinary. But still, the underlying problem, something known as dilated cardiomyopathy, where the heart is just too weak to adequately pump blood, that was still with him, lurking, constantly threatening his life. Robert Montgomery 00:03:28 Father died at 52 from cardiomyopathy, the same disease that I had. Brother dropped dead at 35. Another brother got a heart transplant at 39. And then me. I basically accepted that I might not live a normal lifespan. Dr. Sanjay Gupta 00:03:51 Almost every single man in his family, sick or dying of this heart disease. Was it your father's doctor who said that transplantation really wasn't going to be a solution? Robert Montgomery 00:04:04 My mother was really begging him to come up with something, and he said, you know, he's too old and... Dr. Sanjay Gupta 00:04:12 52 Robert Montgomery 00:04:13 52 and it doesn't work anyway, so you wouldn't want that. That was 1976 Dr. Sanjay Gupta 00:04:20 Even though the first successful heart transplant was back in 1967 in South Africa, it would take decades for it to become widely available. Not in time for Dr. Montgomery's dad. And so Robert Montgomery was given a mission, become a transplant surgeon, and hopefully one day save people just like his dad. Robert Montgomery 00:04:43 Alright, how does that look with the camera? Dr. Sanjay Gupta 00:04:45 'It wasn't easy. By age 56, he had had three near-catastrophic cardiac arrests himself. The only cure, he was told, was a heart transplant. Robert Montgomery 00:04:56 For any organ that you name, only 10% make it on the list. I wasn't sick enough to get on the lists. You have to get so sick before you would even qualify to be in the running to receive an organ. And it's just unacceptable. Dr. Sanjay Gupta 00:05:12 And that's all because we have to ration organs. There's just not enough of them. Robert Montgomery 00:05:17 There's just not enough. Dr. Sanjay Gupta 00:05:18 But then it was the summer of 2018 when Robert Montgomery suddenly became sick enough. Once again, he was overseas. This time it was Italy, with his wife Denise. Denise Montgomery 00:05:30 Have four heart attacks that Robert Montgomery 00:05:32 I just had one cardiac arrest after another. They gave me last rights. Denise Montgomery 00:05:39 They revived him. He said I will die if I don't get out of here. Robert Montgomery 00:05:43 They left my IVs underneath my shirt and they gave my friend a bundle of preloaded resuscitation drugs and syringes and flew back because I knew that was my ticket. Dr. Sanjay Gupta 00:05:58 The odds of survival were still not in his favor. Robert Montgomery 00:06:02 Hi sweetheart Dr. Sanjay Gupta 00:06:03 'You see, even after making it on the list, 17 people die every day while waiting. Remarkably, just three weeks later, a heart became available. But it came with a catch. His donor had died of a heroin overdose, and the heart was infected with hepatitis C. In the transplant world, that is typically a no-go. In fact, thousands of hep C-infected organs are discarded every year. But Dr. Montgomery insisted that his doctors still give it to him. Robert Montgomery 00:06:35 We had just done a study showing that you could take a hepatitis C positive organ and put it into a hepatitis C negative recipient and treat them with these new antivirals. You could successfully treat the virus. Denise Montgomery 00:06:47 Robert wasn't worried, and so I was. Dr. Sanjay Gupta 00:06:52 It was a risk, transplanting an infected organ into someone who had his immune system suppressed. But you're probably starting to see a pattern here. Montgomery was once again willing to take the chance and prove that these infected hearts could be used safely. Robert Montgomery 00:07:09 Hello to all my friends. And it worked. Thank you for your kind thoughts and your prayers, and I'm making a very nice recovery. Dr. Sanjay Gupta 00:07:18 Within weeks, he was able to walk out of the hospital. Today, he wants to show me the place he comes to treat patients, just like him. Robert Montgomery 00:07:27 I was in this room right around the corner, so I have good feelings about this place actually. It's like hope. Yeah, it's hope. It represents hope. Behind that door, yeah. Denise Montgomery 00:07:37 He is a man on a mission. He wants to see this eradicated. Robert Montgomery 00:07:43 If this were like a cancer drug, we wouldn't allow something to be rationed like this, right? We just don't have any choice right now. So we need another choice. Dr. Sanjay Gupta 00:07:52 Another choice which Montgomery is now racing to find. Tim Andrews 00:07:57 I'll help you down. Dr. Sanjay Gupta 00:07:58 Another choice, hopefully, for this man. Tim Andrews has been living with diabetes since the 1990s, successfully managing it with insulin. Retired and happily married to his second wife, Karen, these empty nesters had big plans for their new life together, traveling the world, until one day in 2022. Tim Andrews 00:08:19 I got tired, I was like, oh my god, I'm gonna fall asleep or something. So I was checked and they said, oh yeah, stage three, kidney failure. Oh, okay. And a month later they're telling me, I am at end stage. Wow, just one month. Just one month, just quit on it. Dr. Sanjay Gupta 00:08:38 And what were you feeling like at that point? Tim Andrews 00:08:40 I mean, I was told, literally told, you have dialysis or you pick a box. Dr. Sanjay Gupta 00:08:50 It was a false choice, certain death or dialysis, meaning being dependent on a machine for the rest of his life. Tim Andrews 00:08:59 The first couple of months was like, hey, this is not gonna be so bad. As time went on, like six months in, I had a heart attack. It takes a toll on you emotionally and physically. Tim Andrews 00:09:29 This is where I get to sit. Without it, six weeks, eight weeks later, I'd be dead. It's a necessary evil. Dr. Sanjay Gupta 00:09:37 Necessary at least until he could get a kidney transplant. But again, just as with Montgomery, he knew that could take a while, might never happen, and the clock was ticking. I was ready to die in this chair. And that is when he learned about another option, brand new, still relatively untested. Speaker 11 00:09:58 Some people said, there's not enough information. Don't do this yet. Don't this yet." Dr. Sanjay Gupta 00:10:09 You can't really tell by looking at them, but these tiny piglets have been genetically engineered to make their organs more acceptable for transplantation into humans. It's something known as xenotransplantation. Dr. Sanjay Gupta 00:10:22 So Mike, how unusual is it for us to even be here? Mike Curtis 00:10:25 This is very unusual. We usually try to limit this to only the staff that takes care of the animals. Dr. Sanjay Gupta 00:10:31 Mike Curtis is the CEO of biotech company eGenesis. Never before has he let cameras onto this very special pig farm. Mike Curtis 00:10:40 Everything's controlled, like all of the feed is clean, water's clean, the staff is clean. Dr. Sanjay Gupta 00:10:45 And I should just point out that I walked into a room, turned on a filter, essentially cleaned the air for five minutes before I could then go shower. That's why my hair is wet. I put on everything new here, including underwear, socks, shoes. Dr. Sanjay Gupta 00:10:59 The goal is to protect the pigs from us. Dr. Sanjay Gupta 00:11:14 You know, I got to tell you, I did not know what to expect, but it's powerful just to be here with these pigs. Dr. Sanjay Gupta 00:11:23 After all, these pigs are among the most genetically modified mammals on the planet. Mike Curtis 00:11:29 These piglets carry a total of 69 edits to the genome. Dr. Sanjay Gupta 00:11:34 Alterations to their DNA. Mike Curtis 00:11:37 We're trying to reduce the risk of disease transmission from the porcine donor to human, we're editing in a way that reduces or eliminates hypercute rejection, and then we add human regulatory trans genes to control rejection. Dr. Sanjay Gupta 00:11:50 'To do that, scientists take the unedited pig cells and use a gene editing tool called CRISPR. They add special CRISPR fluids to the cells, which splices out certain genes and adds other genes. You can't really see anything with the naked eye and it takes only seconds, but what is happening in this vial is truly remarkable. Let me take a second and explain. First of all, remember that all DNA is made up of four chemical bases, A, C, G and T. Think of that as your genetic blueprint. Now, a pig's DNA and a human's DNA, they actually look pretty similar, but there are some important differences. For example, the GGTA1 gene that is responsible for a carbohydrate that forms around a pig cell known as alpha-gal. Now if you put that into a human, it would cause almost instantaneous rejection. But by knocking out that specific sequence and then adding in others. Scientists can make the pig's organs much more compatible for humans. Mike Curtis 00:12:55 So in the freezer are all these cells that we've edited. We thaw that vial, we grow those cells, and then we take the nucleus from that edited cell and we transfer it. It's akin to what was done with Dolly back in the 90s, cloning. Dr. Sanjay Gupta 00:13:09 'And that is the process by which they have created a modern-day assembly line of genetically modified pigs. Mike Curtis 00:13:17 We've selected the Yucatan Mini Pig because fully grown, they're about 70 kilos, 150 pounds. Right, so the organs are correctly sized for a human recipient. Dr. Sanjay Gupta 00:13:27 Ultimately, you've got to get the size right. Dr. Sanjay Gupta 00:13:31 Now, if the idea of using animals for human transplants sounds familiar to you, it's because the concept has been around for a long time. There have been at least 48 cases reported in the medical literature since the 1900s. You may remember one of the most famous. Robert Montgomery 00:13:46 This is Baby Faye. Dr. Sanjay Gupta 00:13:47 Little baby Faye in 1984. She had a baboon heart that kept her alive for 20 days. But there was always the stubborn issue of rejection. And so for a long time, xenotransplants faded into the background. Robert Montgomery 00:14:01 I think we've turned up the throttle significantly. Dr. Sanjay Gupta 00:14:05 What's led to that? Robert Montgomery 00:14:06 What we did is transplanted one of these organs into someone who had wanted to donate their organs was brain dead. Dr. Sanjay Gupta 00:14:14 'You heard that right. The first human patients to receive the gene-edited pig kidneys were brain dead. Why? In order to move the field forward without moving too fast. First, the scientists just wanted to prove that pig organs could survive in a human body. Dr. Robert Montgomery performed that operation on Maurice Miller, who was brain dead Robert Montgomery 00:14:39 We took the clamps off to let the blood go into the organ and it turned this beautiful pink color and started to make urine immediately. Robert Montgomery 00:14:48 Pretty looking kidney. Robert Montgomery 00:14:49 'That was mind-blowing. So it looks a lot like a human kidney. Dr. Sanjay Gupta 00:14:54 In fact, when I first met Dr. Montgomery a few years ago, he was reviewing Maurice Miller's kidney biopsy. Here's what they learned. About a month into the transplant, the pig kidney did begin to show signs of rejection. Robert Montgomery 00:15:08 See that red? Yes. That's hemorrhage. Dr. Sanjay Gupta 00:15:11 'But importantly, standard anti-rejection drugs did work. And the kidney function is okay? Robert Montgomery 00:15:18 It's back to normal. Robert Montgomery 00:15:20 It gave, I think, the FDA some confidence that this was going to work in humans. Dr. Sanjay Gupta 00:15:27 'With all that research in the background, in 2022, the University of Maryland School of Medicine announced the first xenotransplant into a living recipient, someone who is not brain dead. It would be a pig heart into 57-year-old David Bennett. Give me a high five, buddy. That was awesome. David Ayers 00:15:46 We saw two months survival of that patient and now incrementally seeing longer and longer survival in these compassionate use patients. Dr. Sanjay Gupta 00:15:55 David Ayers is a giant of a man. Seeing him on this farm in Blacksburg, Virginia, you may not know that he is also considered one of the most widely regarded geneticists in the world. David Ayers 00:16:06 We have about 300 research animals here. We grow the designated pathogen free pigs that were ultimately used for the decedent studies, as well as the patients that have received our organs for transplant, both hearts and kidneys. Dr. Sanjay Gupta 00:16:23 He's taking me to meet some of the farm's newest arrivals. David Ayers 00:16:28 Watch your head, maybe that's just me. Dr. Sanjay Gupta 00:16:34 There's a lot of piglets David Ayers 00:16:37 Do you want to hold one? Yeah, sure. So these are ten gene Clone Piglets. Dr. Sanjay Gupta 00:16:44 Here at United Therapeutics, they perform 10 gene edits on their pigs. Now remember, eGenesis in Wisconsin perform more than 60. Dr. Sanjay Gupta 00:16:57 If you're doing 6 times as many edits does that make it much better? David Ayers 00:16:58 I don't think more edits is necessarily better or worse. The additional 50 edits that eGenesis has done are to inactivate an endogenous pig virus. We've actually addressed that by breeding. Dr. Sanjay Gupta 00:17:12 In 2024, the first pig kidney transplant was announced. Speaker 14 00:17:16 My name is Dr. Leo Riella. I'm medical director of the kidney transplant program Mass General. Today, we announce the successful gene added to pay kidney transplant into a living human. Dr. Sanjay Gupta 00:17:28 Tim Andrews, still on dialysis, was watching all of this unfold. Tim Andrews 00:17:34 I'm like, oh, they're doing it at Mass General. And I was like, I have to be part of this. I'm not gonna make it, but I'll make it to this. And I'll tell you right up front, if it's one day and you learn something, thank God. Dr. Riella 00:17:50 His eyes really sparked up and he said, tell me what I need to do. Speaker 11 00:17:56 And they said, prepare your body for battle, because it's gonna be a battle. He had to do dental work, he had to go to physical therapy. We signed up for the gym. When he came back to see Dr. Riella, he had lost 22 pounds. Dr. Sanjay Gupta 00:18:13 Did you have any doubts along the way? Tim Andrews 00:18:16 You know, there's always doubt with it, but I'm like, this is my chance to do something. Dr. Sanjay Gupta 00:18:23 You're going to be in medical history books forever. Tim Andrews 00:18:27 Kids are going to be taught how to do it, watching me have one put in me. Dr. Sanjay Gupta 00:18:33 They'll know your name. Dr. Sanjay Gupta 00:18:38 It's a crisp January morning back at the Egenesis Pig Farm in Wisconsin. Dr. Sanjay Gupta 00:18:44 It's been more than a year since our first visit. Speaker 3 00:18:47 This is many years in the making. So Raphael, she'll be able to donate one of her kidneys to a man who's in dire need. And essentially, she's saving his life. Speaker 15 00:18:59 Go, Raphael! It's a really big moment. There's a lot of emotions. We love our piglets like our own. Thinking about the purpose that Raphael is serving, like getting to go and give someone a new lease on life is just such a gift. Dr. Sanjay Gupta 00:19:18 That someone is Tim Andrews. Raphael will be his donor. Tim Andrews 00:19:25 What a gift. Dr. Sanjay Gupta 00:19:30 'As Rafael departs for the 17-hour trip to Boston, Tim settles in at Mass General. Tim Andrews 00:19:37 I knew I was in great hands, these guys are just so good. Dr. Sanjay Gupta 00:19:42 Were you nervous the morning of? Dr. Riella 00:19:45 And we'll see you on the other side, getting ready. As a new man. We're all anxious and nervous about going through a procedure that has not been done before. And having that reassurance from him also brings a lot of positivity to the entire team. Dr. Sanjay Gupta 00:20:02 It's early morning, January 25th, when Dr. Riella and the surgical team travel about 50 miles outside of Boston to meet Rafael. Dr. Riella 00:20:11 It was an OR, very similar to what we see in the hospital, and the surgery to retrieve the organs occur there. They look very similar to how we do procurements. I think uniqueness is really that, who was a donor, who was coming, yeah, it was a pig. Dr. Sanjay Gupta 00:20:29 It's go time! Speaker 11 00:20:30 It's a dance to get the pig kidney there and get him in the operating room. Dr. Sanjay Gupta 00:20:37 They gotta coordinate it. Speaker 11 00:20:37 So a nurse came and said, okay, good to go. I'm like, wait, wait. We haven't said goodbye. You can't say goodbye. Oh, yes, I can. So, I actually made them wait and they said, we've got to go, I'm saying goodbye to my husband before he leaves for surgery and he may not come back. Speaker 17 00:21:00 It's a little chilly in here, okay, Tim? Tim Andrews 00:21:01 I like cold. Dr. Sanjay Gupta 00:21:02 The operation lasts a little over two hours, around the same as a traditional transplant, and the big kidney. It looks, feels, and functions very much like a human kidney. And here is when surgeons connect the pig kidney to Tim's artery and vein. After that, the moment of truth. Surgeons release the clamp so blood can flow into the kidneys and the organ turns pink. And now this, urine, successfully flowing through the kidneys. Dr. Riella 00:21:36 Wow, look at that. We were very surprised. We were hoping that we would start making urine within a day or two, but seeing the urine being produced right away was not what at least I expected to be happening that close. Everything went well. Speaker 11 00:21:53 They said, they put the kidney on the table and started connecting him to the kidney and he actually peed across the room. So they were very, very excited. Of course, I started bawling like a baby. We were all crying. I mean, we were all. oh my goodness, I mean, this is not the end, but we're getting there, we're getting there. Tim Andrews 00:22:19 'I felt great and all of a sudden I had energy and I was like, this is beyond what I thought I was going to get. So right away you felt that coming? Right away I felt that. I was, like, look at me, I'm a new man, it was like a new birth, I said, I have a new birthday, 125-25 is my new birthday. Because I was alive and I hadn't been for a long time and I'm like, this is amazing. Dr. Sanjay Gupta 00:22:57 But there was still a long way to go. This is still so experimental after all. And Tim and Karen knew how quickly things could change. It was just a year earlier that Lisa Passano also needed a kidney. Her daughter, Brittany Rydell, remembers just how sick her mother was. Brittany Rydell 00:23:17 It means no more dialysis, hopefully. Dr. Sanjay Gupta 00:23:20 'Like Tim, she was an end-stage kidney disease, but Lisa's heart was also failing. And that is why a traditional kidney transplant was not an option for her. Dr. Sanjay Gupta 00:23:30 She was too sick. Brittany Rydell 00:23:32 Yeah, absolutely. Robert Montgomery 00:23:34 Lisa Passano was on death's door. I mean, she was not gonna live. You know, days to weeks from dying. Dr. Sanjay Gupta 00:23:44 So Dr. Montgomery, who was her surgeon, suggested a pig kidney. Robert Montgomery 00:23:48 But there are some people who are willing to take that chance, and she was one of them. Dr. Sanjay Gupta 00:23:54 'In the spring of 2024, Lisa Pisano became one of the first two patients in the world to receive a gene-edited pig kidney transplant. Brittany Rydell 00:24:02 I got more energy. I feel energized. After her kidney transplant, I have to say she looked the best that she looked in so I've seen her so happy. It was definitely the healthiest I had seen her in a while. Dr. Sanjay Gupta 00:24:15 She was doing well at that point. Brittany Rydell 00:24:17 Yeah, we were so hopeful, because I had seen her so much better, and I figured if anything was going to go wrong, it would have went wrong at that moment, and not months later. Dr. Sanjay Gupta 00:24:28 Pesano developed several infections and never recovered enough to leave the hospital. Brittany Rydell 00:24:33 I don't have regrets about the surgery, I just wish that she could have had the opportunity to really enjoy it more. Dr. Sanjay Gupta 00:24:40 I know it's probably hard to sort of think of it this way, but she was a real pioneer. Brittany Rydell 00:24:45 One of the first things she said to me was even if this doesn't work for me, it can work for someone else. And I think about that a lot. Robert Montgomery 00:24:52 The first patient that we did was in this bed, in the bed that I was in, Lisa Passano. You know, taking care of that one life. And if they were just that, that would be great, but then you have this opportunity to really impact maybe thousands, maybe millions of lives. Dr. Sanjay Gupta 00:25:11 Now Tim knew Lisa's story. He knew that there was a tremendous amount of uncertainty. Tim Andrews 00:25:17 Stepping forward, you're gonna do something for humanity. This is a way that we can bring this forward. And this is the hope for all these people that it's gonna be okay. We're gonna find a way, which is amazing to me. It was just, I have to be part of this. Dr. Sanjay Gupta 00:25:40 So would this be a success for Tim, and what does it all mean for the 100,000 people currently waiting? Tim Andrews 00:25:47 There's bumps in the road. Dr. Sanjay Gupta 00:25:48 We'll dive into that when we come back next week with part two of Animal Farm. Thanks for listening.
CNN
4 days ago
- Health
- CNN
How AI Might Be Helping Your Doctor Treat You - Chasing Life with Dr. Sanjay Gupta - Podcast on CNN Audio
Dr. Sanjay Gupta 00:00:03 Welcome to Paging Dr. Gupta. You know, I really love these episodes in large part because they're all about you. Your questions, your concerns, your curiosity, about health and medicine, topics that are near and dear to my heart. Whether it's something in the headlines or something that's happening in your own life, share it and I'll try my best to try and help break it down. New week, new questions, Kyra is back. Who do we have first? Kyra Dahring 00:00:31 Okay, we're kicking things off today with a question from Kim. She's a nurse out in Los Angeles, and she's thinking ahead about how tech might change her day to day. Here's her question: Listener Kim 00:00:41 Hi, Dr. Gupta, my name is Kim and I'm a nurse. Um, with the incoming era of AI, what's in store for the medical community, whether that's medical procedure, a surgical procedure, diagnostics, or even as simple as making our notes on the patient's medical chart. Looking forward to hear what we have. Thank you so much. Dr. Sanjay Gupta 00:01:10 'Okay, Kim, thank you very much for this. This is a topic that I think about a lot. In full disclosure, I sit on the National Academy of Medicine, and there is a subcommittee on artificial intelligence that I sit on that as well, so I've been pretty immersed in the intersection of AI and healthcare for a while. And I'll tell you two things as top lines. One is that I'm bullish on it. It's here, it's definitely here to stay. And it's already being transformative. And two is that you have probably already been affected by AI in healthcare. If you've had any kind of recent visits to the doctor, to a hospital, to a clinic, your care was probably already impacted by AI in some way. Let me break down a few basics as I often do. You will hear about two main types of AI in health care: Predictive AI and Generative AI. Okay, so predictive AI is basically analyzing large sets of data, everything from age of patients, symptoms, test results, and that can help doctors make more informed decisions. It looks at lots and lots of data. Maybe it finds lots and lot of people who are just like the person they are investigating and they say, okay, here's the problem this person had. Here's the outcomes that we see in thousands, hundreds of thousands of people around the country around the world and that helps predict what we should do best. During colonoscopies AI can for example flag polyps that might otherwise be deemed inconsequential. With mammograms, the FDA has already cleared two dozen AI tools to help spot early signs of breast cancer, predicting breast cancer. In Stroke care AI models now pinpoint the timing of a stroke sometimes twice as accurately as humans, which is really crucial because that will determine in part if someone can receive certain life-saving or life-altering treatments. Hospitals are using AI to catch signs of sepsis before they become obvious. There are also tools a company say can now detect things like bone fractures that may go undetected by the patient, signs of over a thousand diseases that may exist even before symptoms show up. And then there is generative AI, and I think that's what people often think of when they think of the ChatGPT style stuff. It's mostly happening behind the scenes. One big use case for generative AI is documentation. So maybe you've heard of Microsoft's Dragon Copilot, so this is a platform that kind of listens in during a visit and then writes up the clinical note that is generated afterwards, helps draft letters that are sent to insurance companies to get medications or procedures approved. More advanced versions combine AI with real world medical data, that's called ChatRWD, and they are continuously being tested to reliably answer doctor's clinical questions. There's a platform that I use quite a bit and I think about a quarter of physicians in the country now use it called OpenEvidence, which again is looking at these large sets of data and then using that data in real time to answer questions. How long do we wait to start aspirin after a person has had a procedure, had an operation? These are tools that I'm already using. Now, I will tell you one thing that's interesting about these platforms is that there is very high expectations of how well they will work. You know, I think a lot of people think of AI platforms like they think of a computer. If you go to your computer and you ask your computer, you know, any question you might ask... You get an answer, you sort of expect that that answer is accurate. You don't then go to another computer and ask another computer to verify what the first computer said. But AI is a little bit different in this regard. In some ways, it's less like a computer and more like a tool that is trying to replicate human consciousness, which can falter, right? So there's a trust gap. There was this 2023 survey that found most Americans feel discomfort with doctors using AI to manage their care. So high expectations, low trust. There aren't many things in society like that. I would think, for example, autonomous vehicles might fall into that category. Even though there are car accidents all the time, it's one of the leading causes of preventable death in the United States, if an autonomous vehicle gets into an accident, it almost feels existential because the expectations are so much higher. So high expectations, low trust, when it comes to things like AI. AI can make mistakes. It can hallucinate, that's how it's often referred to, especially if the platform's been trained on incomplete data or biased data. Privacy is still an issue. I mean, HIPAA applies to AI platforms and healthcare, but I think that there's concerns about how might that information be stored or shared. So bottom line, Kim, AI is here. I'm bullish on it. I think it's already making an impact. It's already working in the background. It's improving diagnostics, documentation, access. But with many things in life, we often adopt a trust but verify model. And I think AI and healthcare should be treated the same way. Dr. Sanjay Gupta 00:06:48 Coming up, there are a lot of pain medications out there, but not all of them are right for every kind of pain. It's sometimes surprising what works best for what. I'll break it down after the break. Dr. Sanjay Gupta 00:07:03 Last week, I told you that I've been working on a book all about pain, it's called "It Doesn't Have to Hurt". It comes out September 2nd. It's something I've thinking about for a long time. Big part of writing a book like this is to try and give you some real takeaways when dealing with pain. And I thought I would start here, this podcast, Paging Dr. Gupta podcast, to share some of what I've learned. And I asked Kyra, in this case, just to give me the first question that came to her mind. Kyra Dahring 00:07:31 All right, Sanjay, well, you know what this sound means. I just had to do it, considering this is my first official page to Dr. Gupta. So my question, I'm asking this for myself and hopefully a lot of the people listening, you know, there are so many pain medications out there with all these different brand names and it's hard to know which ones are alike or when to take what. So my questions is, are they basically all the same and created equal? Or should we actually be picking different ones for different kinds of pain? Dr. Sanjay Gupta 00:08:00 'Okay, that is a good place to start, Kyra, thank you. First of all, let me just preface by saying, again, that 20% roughly of the country, one in five people suffers with chronic pain. It's an enormous number. I mean, when you have chronic pain, that is your whole life. You are defined by it. So they're thinking about pain all the time, they're suffering with pain all of the time. Their mood is different, they eat differently. Everything is different because of chronic pain so this is a big issue. But let's break down the different categories. The common ones, acetaminophen, Tylenol reduces fever very well. That is a analgesic pain medication that essentially works in the brain to reduce mild to moderate pain by increasing the body's pain threshold and also changing to some extent how the body senses pain. So it actually makes the threshold at which you experience pain higher and changes the way that you actually sense it. Then you have a very large category of what are called NSAIDs, non-steroidal anti-inflammatory drugs. That's ibuprofen, Advil, Motrin, Naprosyn, Aleve. They reduce fever and they also block something known as prostaglandins, which are compounds that cause pain and inflammation. So they work in a different part of the pain cascade. Aspirin is also considered an NSAID, reduces pain, reduces inflammation, also reduces blood clotting. That's why a lot of people will use that as a sort of mild blood thinner. You're gonna wanna avoid NSAIDs like aspirin and ibuprofen if you are already taking blood thinners, okay? Because if you have uncontrolled high blood pressure, if you've ulcers, if you're other bleeding risks, they may thin your blood even a little bit more, probably avoid the non-steroidals. And generally speaking, ibupropin's gonna be a safer choice than aspirin for those with bleeding risks. And then after that, just in the over the counter sort of categories, you have topical pain relievers. These are anesthetics that temporary relief pain at the skin surface. Think of things like Voltaren. Obviously don't use it on open wounds or sores, but a lot of the topical pain relievers are gonna have some component of lidocaine in them. If you've ever had an allergy to lidocain, probably want to avoid this. Now, when should you use each one? So headaches, that's one of the most common sources of pain. Any of these oral painkillers could work for that. Some people will have better luck with some of them other than others. As I mentioned earlier, when it comes to fevers, Tylenol is gonna be probably a better bet. One little pro tip, if you have a headache because you've had a little too much to drink the night before, too much alcohol, then Tylenols not a good option because alcohol and Tylenol both are pretty hard on the liver. So I would avoid Tylenol certainly after a hangover. Really if you can avoid most of those medications for hangover type pain better get hydrated and the pain will pass. Now if you're talking about pain that's caused by things like arthritis, non-steroidal anti-inflammatories is what you should use. They're also best by the way for sunburn. Acetaminophen best for people who. May have gastrointestinal issues because the non-steroidal anti-inflammatories are pretty hard on the stomach. Neuropathic pain or nerve pain. So that's the sort of lancinating pain that might go down your arms or your legs, sort of stabbing or even electric-like pain sometimes. Sometimes the topical pain relievers can help there. Then there are different medications for neuropathetic pain that may require prescription as well. And those types of medications typically change the way the nerve is conducting a signal. And sometimes it just disrupts the conduction of the signal. Sometimes it slows it. But there are different medications that are totally different class of drugs than Tylenol or non-steroidal anti-inflammatories that can help with that nerve sort of pain. You know, a lot of what I write about in the book is how to best choose these medications. But a lot what the book is about is creating strategies where you hopefully never need any of these medications. Obviously everyone's going to have some pain in their life, but you can have a lot less pain, a lot less intense pain, and a much shorter duration of pain, with some pretty simple strategies. And I hope that everyone can get a better understanding of that, how to control pain, how to understand it when my book comes out, September 2nd, "It Doesn't Have To Hurt". Dr. Sanjay Gupta 00:12:43 'Big thanks to everyone who sent in the questions, Kyra, thank you. We're still building the show. We're doing it together and I'm glad you're part of it. If there's something health-related you've been curious about, don't be shy, share it, record a voice memo, email it to AskSanjay@ or give us a call at 470-396-0832 and leave a message. Thanks for listening, I'll be back next Tuesday. Chasing Life is a production of CNN Audio. Our podcast is produced by Eryn Mathewson, Jennifer Lai, Grace Walker, Lori Galaretta, Jesse Remedios, Sofia Sanchez, Kyra Dahring, and Madeleine Thompson. Andrea Kane is our medical writer, our senior producer is Dan Bloom, Amanda Sealy is our showrunner, Dan Dzula is our technical director, and the executive producer of CNN Audio is Steve Lickteig. With support from JJamus Andrest, Jon Dianora, Haley Thomas, Alex Manasseri, Robert Mathers, Leni Steinhardt, Nichole Pesaru, and Lisa Namerow. Special thanks to Ben Tinker and Nadia Kounang of CNN Health and Wendy Brundige.
CNN
12-06-2025
- Health
- CNN
Humans aren't built to remember everything. 5 tips to remember the important stuff
Editor's note: The podcast Chasing Life With Dr. Sanjay Gupta explores the medical science behind some of life's mysteries big and small. You can listen to episodes here. (CNN) — Most of us are familiar with the frustration of forgetting — whether it's struggling with a word on the tip of the tongue, misplacing important items such as keys or glasses, or even disremembering why you came into a room. How can we do anything but forget — especially in a time in which we are subjected to a firehose of information every waking minute, between our life in the physical world and what comes at us electronically via smartphones, TVs, computers and more? The average American is exposed to an estimated 34 gigabytes — or 11.8 hours' worth — of information every day, Dr. Charan Ranganath wrote in his most recent book, 'Why We Remember: Unlocking Memory's Power to Hold on to What Matters.' That figure came from a 2009 report by the Global Information Industry Center at the University of California, San Diego. 'Last time I looked it up, the estimate increased even more since,' Ranganath told CNN Chief Medical Correspondent Dr. Sanjay Gupta recently on his podcast Chasing Life. Ranganath directs the Dynamic Memory Lab at the University of California, Davis, where he is also a professor of psychology and neuroscience. Far from remembering all this information, he said the science of memory shows that humans are designed to forget. In fact, Ranganath's book references the work of cognitive psychologist George Miller, who concluded in a 1956 paper that we can only keep seven items (plus or minus two) in mind at a time. (Subsequent research, Ranganath wrote, shows the number to be closer to three or four items.) 'I think one of the misconceptions out there … is that we're supposed to be taking everything in that's around us,' he said. 'In fact, our brains really operate on this principle of economy: to get as little information in as possible and to make as much of that information.' You can learn more about the nature of memory by listening to the podcast's full episode here. 'It's all about this economy and being able to use attention as this big filter, to be able to focus on the things that are most important,' he said. 'Sometimes it's the things that you expect, and sometimes it's the stuff that violates your expectations — and that's where there's the most meaning,' he said. 'But it also means that we miss things sometimes, and we end up with frustration because our attention was directed at the wrong place at the wrong time.' Improving memory isn't about trying to stuff more information inside your head. 'The thing that I like to say is: Don't try to remember more, remember better,' Ranganath said. 'Sometimes remembering better means memorizing less.' One way to do so, Ranganath said, is with a process called chunking — or grouping many things into one. We remember the alphabet this way as well as our Social Security number and the names of the Great Lakes (the acronym HOMES for Huron, Ontario, Michigan, Erie and Superior). By grouping these items, you reduce the number of things you have to remember: Instead of 26 separate items, the alphabet becomes one. Similarly, memory athletes — who compete to memorize as many digits of pi as possible or the order of a deck of cards — 'develop strategies that allow them to meaningfully slot the information that they're trying to remember into this larger structure so that 10 things can become one thing,' Ranganath said. What can you do if you struggle with forgetfulness? Here are Ranganath's five tricks to help form memories for events that matter. All you have to is remember to 'call a MEDIC!' he said via email. Attach what you want to remember to something of importance. 'You can remember information like names if you can tie them into information that has meaning to you,' he said. For instance, if you are a fan of Greek mythology, you can link Ranganath's first name, Charan, to Charon, the ferryman of the underworld who, for a price, transports the souls of the dead across the River Styx. 'And (you can) imagine me ferrying people across the river of the dead,' he said. Such vivid imagery can help you remember a name. Test yourself. Even if you make a mistake, Ranganath said trial and error is one of the best ways to remember something. 'If you're learning a new name or foreign language word, take a guess about what the name could be or guess about the meaning of the word,' he said. When you learn the answer, he said, the brain can 'tweak that memory to make sure it is more closely associated with the right answer and less likely to be associated with competing answers.' Make it pop. 'Just as it's easier to find a hot pink Post-it note on a desk full of yellow notes, it's easier to find memories that have features (that) stand out from other memories,' Ranganath said. For example, 'When you put down your keys, take a moment to attend to a detail like a sound or a unique visual cue,' he said. It will go a long way toward helping you remember where you put them, he said, as you're frantically scrambling to get out the door. Take advantage of the fact that the brain has adapted to flag moments that are significant. 'We retain memories for events that are important — in a biological sense,' Ranganath said. 'When we have experiences that are rewarding, scary or embarrassing, chemicals like dopamine, noradrenaline or serotonin are released, promoting plasticity.' These neurotransmitters help cement the experience in your memory a bit more. Curiosity can also play a role. 'We have found that being curious has a similar effect on memory,' he said, noting that curiosity activates 'dopamine-carrying areas of the brain' and promotes learning. 'So, before you learn, get curious about the subject!' he said. Use your senses to do a little time traveling. 'Our memories for events, or episodic memories, are tied to where and when the event took place,' Ranganath said. 'That's why hearing a song that played during your summer abroad in college or smelling food that your grandmother used to make can immediately transport you back in time.' 'If you are trying to recall a past event, imagine yourself in that place and time — how you felt, what you were thinking about, the sights and sounds of the place — and you'll find yourself pulling up a lot,' he said. We hope these five tips help you remember more and memorize less. Listen to the full episode here. And join us next Tuesday for a new episode of the Chasing Life. CNN Audio's Sofía Sanchez contributed to this report.
Time of India
11-06-2025
- Business
- Time of India
Policy to help promote sale of ‘Made in UP' wines in retail stores soon
Lucknow: The state excise department is planning to make it mandatory for retailers to start stocking indigenous wines produced from fruits grown in UP on their shelves. Acting on the representation forwarded by the vintners (winery owners and operators), the department will soon present the proposal before the state cabinet to amend the existing policy and rules to create a minimum quota to promote its retail trade. Tired of too many ads? go ad free now The four winery operators in Lucknow, Muzaffarnagar, Saharanpur, and Noida would benefit from the move, as would hundreds of local farmers within the catchment area. Though provisions were made in the excise policy to start manufacturing wine from locally produced fruits in March 2022, the commercial operations of the wineries are yet to begin in the state. "The idea behind introducing local wine was to help farmers generate increased income. But until our products find space in the retail ecosystem, achieving financial viability will not be possible," said Muzaffarnagar-based Sanjay Gupta, who desperately wants to enter the retail market with five different local wines produced from mango, litchi, jamun, grapes, and mixed fruits for a year. Since the UP govt decided not to impose excise duty on 'Made in UP' wines, retailers showed no interest in stocking the products in the stores. "Every retailer has to provide a fixed income to the excise department through the liquor trade. Called MGQ (minimum guarantee quota), it is mandatory for retailers to purchase a minimum quantity of liquor bottles in a month to assure a certain fixed revenue to the state," said a Lucknow-based retailer. Over the sale of country liquor, English wine, and beer bottles, a hefty portion of the price is paid as excise duty to the state coffers, helping retailers achieve the MGQ. Tired of too many ads? go ad free now As the sale of local wine would not generate any excise duty for the state, retailers will not be able to achieve MGQ in return. "That is why no retailer shows interest in stocking local wines and instead focuses on the products which have higher demand," the retailer added. A senior excise officer said provisions need to be made in the existing policy to create a sub-quota within the MGQ to promote local wine. Lucknow: The state excise department is planning to make it mandatory for retailers to start stocking indigenous wines produced from fruits grown in UP on their shelves. Acting on the representation forwarded by the vintners (winery owners and operators), the department will soon present the proposal before the state cabinet to amend the existing policy and rules to create a minimum quota to promote its retail trade. The four winery operators in Lucknow, Muzaffarnagar, Saharanpur, and Noida would benefit from the move, as would hundreds of local farmers within the catchment area. Though provisions were made in the excise policy to start manufacturing wine from locally produced fruits in March 2022, the commercial operations of the wineries are yet to begin in the state. "The idea behind introducing local wine was to help farmers generate increased income. But until our products find space in the retail ecosystem, achieving financial viability will not be possible," said Muzaffarnagar-based Sanjay Gupta, who desperately wants to enter the retail market with five different local wines produced from mango, litchi, jamun, grapes, and mixed fruits for a year. Since the UP govt decided not to impose excise duty on 'Made in UP' wines, retailers showed no interest in stocking the products in the stores. "Every retailer has to provide a fixed income to the excise department through the liquor trade. Called MGQ (minimum guarantee quota), it is mandatory for retailers to purchase a minimum quantity of liquor bottles in a month to assure a certain fixed revenue to the state," said a Lucknow-based retailer. Over the sale of country liquor, English wine, and beer bottles, a hefty portion of the price is paid as excise duty to the state coffers, helping retailers achieve the MGQ. As the sale of local wine would not generate any excise duty for the state, retailers will not be able to achieve MGQ in return. "That is why no retailer shows interest in stocking local wines and instead focuses on the products which have higher demand," the retailer added. A senior excise officer said provisions need to be made in the existing policy to create a sub-quota within the MGQ to promote local wine.
CNN
10-06-2025
- Health
- CNN
Are you forgetful? 5 tips to remember the things that matter
FacebookTweetLink Follow Editor's note: The podcast Chasing Life With Dr. Sanjay Gupta explores the medical science behind some of life's mysteries big and small. You can listen to episodes here. (CNN) — Most of us are familiar with the frustration of forgetting — whether it's struggling with a word on the tip of the tongue, misplacing important items such as keys or glasses, or even disremembering why you came into a room. How can we do anything but forget — especially in a time in which we are subjected to a firehose of information every waking minute, between our life in the physical world and what comes at us electronically via smartphones, TVs, computers and more? The average American is exposed to an estimated 34 gigabytes — or 11.8 hours' worth — of information every day, Dr. Charan Ranganath wrote in his most recent book, 'Why We Remember: Unlocking Memory's Power to Hold on to What Matters.' That figure came from a 2009 report by the Global Information Industry Center at the University of California, San Diego. 'Last time I looked it up, the estimate increased even more since,' Ranganath told CNN Chief Medical Correspondent Dr. Sanjay Gupta recently on his podcast Chasing Life. Ranganath directs the Dynamic Memory Lab at the University of California, Davis, where he is also a professor of psychology and neuroscience. Far from remembering all this information, he said the science of memory shows that humans are designed to forget. In fact, Ranganath's book references the work of cognitive psychologist George Miller, who concluded in a 1956 paper that we can only keep seven items (plus or minus two) in mind at a time. (Subsequent research, Ranganath wrote, shows the number to be closer to three or four items.) 'I think one of the misconceptions out there … is that we're supposed to be taking everything in that's around us,' he said. 'In fact, our brains really operate on this principle of economy: to get as little information in as possible and to make as much of that information.' You can learn more about the nature of memory by listening to the podcast's full episode here. 'It's all about this economy and being able to use attention as this big filter, to be able to focus on the things that are most important,' he said. 'Sometimes it's the things that you expect, and sometimes it's the stuff that violates your expectations — and that's where there's the most meaning,' he said. 'But it also means that we miss things sometimes, and we end up with frustration because our attention was directed at the wrong place at the wrong time.' Improving memory isn't about trying to stuff more information inside your head. 'The thing that I like to say is: Don't try to remember more, remember better,' Ranganath said. 'Sometimes remembering better means memorizing less.' One way to do so, Ranganath said, is with a process called chunking — or grouping many things into one. We remember the alphabet this way as well as our Social Security number and the names of the Great Lakes (the acronym HOMES for Huron, Ontario, Michigan, Erie and Superior). By grouping these items, you reduce the number of things you have to remember: Instead of 26 separate items, the alphabet becomes one. Similarly, memory athletes — who compete to memorize as many digits of pi as possible or the order of a deck of cards — 'develop strategies that allow them to meaningfully slot the information that they're trying to remember into this larger structure so that 10 things can become one thing,' Ranganath said. What can you do if you struggle with forgetfulness? Here are Ranganath's five tricks to help form memories for events that matter. All you have to is remember to 'call a MEDIC!' he said via email. Attach what you want to remember to something of importance. 'You can remember information like names if you can tie them into information that has meaning to you,' he said. For instance, if you are a fan of Greek mythology, you can link Ranganath's first name, Charan, to Charon, the ferryman of the underworld who, for a price, transports the souls of the dead across the River Styx. 'And (you can) imagine me ferrying people across the river of the dead,' he said. Such vivid imagery can help you remember a name. Test yourself. Even if you make a mistake, Ranganath said trial and error is one of the best ways to remember something. 'If you're learning a new name or foreign language word, take a guess about what the name could be or guess about the meaning of the word,' he said. When you learn the answer, he said, the brain can 'tweak that memory to make sure it is more closely associated with the right answer and less likely to be associated with competing answers.' Make it pop. 'Just as it's easier to find a hot pink Post-it note on a desk full of yellow notes, it's easier to find memories that have features (that) stand out from other memories,' Ranganath said. For example, 'When you put down your keys, take a moment to attend to a detail like a sound or a unique visual cue,' he said. It will go a long way toward helping you remember where you put them, he said, as you're frantically scrambling to get out the door. Take advantage of the fact that the brain has adapted to flag moments that are significant. 'We retain memories for events that are important — in a biological sense,' Ranganath said. 'When we have experiences that are rewarding, scary or embarrassing, chemicals like dopamine, noradrenaline or serotonin are released, promoting plasticity.' These neurotransmitters help cement the experience in your memory a bit more. Curiosity can also play a role. 'We have found that being curious has a similar effect on memory,' he said, noting that curiosity activates 'dopamine-carrying areas of the brain' and promotes learning. 'So, before you learn, get curious about the subject!' he said. Use your senses to do a little time traveling. 'Our memories for events, or episodic memories, are tied to where and when the event took place,' Ranganath said. 'That's why hearing a song that played during your summer abroad in college or smelling food that your grandmother used to make can immediately transport you back in time.' 'If you are trying to recall a past event, imagine yourself in that place and time — how you felt, what you were thinking about, the sights and sounds of the place — and you'll find yourself pulling up a lot,' he said. We hope these five tips help you remember more and memorize less. Listen to the full episode here. And join us next Tuesday for a new episode of the Chasing Life. CNN Audio's Sofía Sanchez contributed to this report.
