Bill Clinton's Bypass Operation: A Mass Advertisement for a Questionable Procedure © By Peter Barry Chowka
(October 1, 2004) On Friday September 3, it was reported that former President Bill Clinton had been hospitalized in New York and would soon undergo coronary bypass surgery for advanced heart disease. Over that Labor Day weekend and into the next week, the topic of Clinton's health dominated the cable news channels. On Monday September 6, Clinton underwent quadruple bypass surgery at New York's Columbia Presbyterian Medical Center. The extensive news coverage amounted to a virtual non-stop advertisement for bypass operations. The pro-bypass spin reached its peak on the Larry King show on CNN (September 6) in which Clinton's doctors appeared for an hour. King introduced the program: "That successful quadruple bypass heart surgery may have prevented America's 42nd president from having a heart attack. "Here, and only here, for the hour: Dr. Craig Smith, the lead surgeon operating on President Clinton today. He's chief of cardiac surgery at New York Presbyterian Hospital, Columbia University Medical Center. Dr. Allan Schwartz, chief of the hospital's cardiology division, also in the operating room today. Dr. Robert Kelly, senior vice president, chief operating officer at New York Presbyterian. He, too, was there for the president's surgery, and Dr. Herbert Pardes, the hospital's president and chief executive officer." Twenty-four years ago, I wrote several feature articles, including a cover story for East West Journal, about the relatively new bypass procedure. Even back then, there was evidence that the procedure was extremely flawed, with mounting questions about its effectiveness and high cost. In subsequent years, large negative studies were published and a number of alternative medicine practitioners, like Nathan Pritikin and Dean Ornish, MD, claimed success in treating advanced heart disease by dietary and lifestyle modification alone and without resorting to bypass. Nonetheless, bypass operations are now performed on over 600,000 Americans every year at an average cost exceeding $50,000. In order to gain some clarity on the issue today, I contacted Charles McGee, MD. McGee received his Medical Degree from Northwestern University in Chicago in 1961, worked for the Centers for Disease Control for two years, and did his Internship and Residency in Obstetrics and Gynecology at Highland Hospital in Oakland, California in 1965. He began using alt med therapies starting in 1974, he said, and soon focused on general practice alternative medicine. The therapies he used included acupuncture, environmental medicine, chelation therapy, homeopathy, and clinical nutrition. McGee made six trips to China where he was introduced to Qigong. Back in the U.S., he developed a synergistic healing program with Qigong master/inventor Roger Estes of Spokane, Washington. McGee retired from clinical practice in 1996 but he remains active in the medical field as the principal in Chee Energy, a company that provides innovative healing products. McGee is the author of several books including Heart Frauds: The Misapplication of High Technology in Heart Disease, Healing Energies of Heat and Light, and Miracle Healing From China - Qigong co-written with Effie Poy Yew Chow, PhD, RN, CA. Charles McGee, MD: I'm an obstetrician by background. When I was into alternative medicine, I started adding things and subtracting things and molding a practice to what things have worked best in my own hands. I started getting all these stories of people having had a heart attack and being rushed to the hospital and then they get an angiogram, then they're told they have a widow maker and are going to be dead in the morning if they don't get the [bypass] procedure done. And how they argued their way out of the hospital and now they're alive 15 and 20 years later and doing fine. Peter Barry Chowka : It does seem that in the area of heart disease and its conventional management today we have the clearest example of the failure of orthodox medicine but at the same time the ability of conventional medicine to perpetuate a flawed if not failed therapy and to foist it on a largely gullible public that is easily scared. The example of Clinton is the most recent example. I wanted to ask you about some of the reporting about Clinton's surgery in the New York Times article by Lawrence Altman, MD, "Clinton Is Given Bypass Surgery for 4 Arteries." Altman writes, "Former President Bill Clinton. . . underwent successful quadruple coronary bypass surgery yesterday." McGee: You know what the definition of "success" means? Chowka: The patient survived the operation. McGee: No, it's not even that. It's not patient-oriented at all. The doctors got in there and were able to get the four vessels attached and sewn and not leak and get the patient sewn up and the procedure was a "success." Like a "successful" balloon angioplasty means they got the balloon in the right spot and were able to stretch it like they wanted to and got the balloon back out. It has nothing to do with what happens to the patient. Chowka : It's not patient-centric at all. McGee: It's doctor-centric. Chowka: In the next paragraph of the Times article, it says "He was expected to make a complete recovery." How can they estimate that same day as the surgery that Clinton would make a complete recovery when, according to the statistics, it's a hard case to make that these kinds of procedures are linked with any kind of extended longevity? McGee: Yes. There were three large studies - the Veterans study came first in 1977. The C A S S [Coronary Artery Surgery Study] came out in '84 and there was also the European study that came out in 1982. They all showed that survival at ten or eleven years was the same whether patients had the bypass or they didn't. And the quality of life was the same. The number of things the patients could do, their activity level, was the same. So in these three major studies it could not be shown that there was any benefit to having the bypass surgery at all. In "Coronary artery surgery at the crossroads," an editorial in the New England Journal of Medicine - in the same issue that published the Veterans study - Eugene Braunwald, professor of medicine at Harvard Medical School, pointed out, "An increasing number of patients are being operated on, not because of the presence of intractable angina but because of the hope, largely without objective supporting evidence at present that coronary bypass surgery prolongs life or diminishes the frequency of subsequent heart attack." He further stated that this rapidly growing enterprise is developing a momentum and constituency of its own and as time passes it will be progressively more difficult and costly to curtail it materially if the results of carefully designed studies of its efficacy prove this step to be necessary. He further stated that “this rapidly growing enterprise is developing a momentum and constituency of its own, and as time passes, it will be progressively more difficult and costly to curtail it materially ...” He wrote “I believe that this operation should and increasingly will be restricted to patients in whom intensive medical therapy has failed, or in whom improved survival after surgery has been unambiguously demonstrated, rather than as a panacea for coronary artery disease.” So he was seeing the future right there, that this thing, bypass, is going to get out of control. . . that this was going to grow into a major industry for surgeons. And there was no evidence behind it. Chowka: I'm challenged to find accurate statistics about bypass, even on how many bypass procedures are currently being performed. I'm also finding wildly varying estimates of what they cost. Clinton's doctors said the price tag was $25,000. Yet, in the mid-'90s, according to many reports, the average cost back then was already $44,000. McGee: Now it's over $50,000. Chowka: You mentioned no improvement in longevity after bypass. There is also evidence of diminished quality of life after bypass, especially in terms of cognitive impairment, right? McGee: That's true. Any time you get on a heart lung machine, you lose some gray cells. Chowka: So, arguably, if somebody can stay alive for the same period of time without bypass, they might be doing better simply because their brain is intact. McGee: Oh, I agree with that. That's been pretty well shown, that you lose cognitive ability - anybody that goes on a heart lung machine loses it. Chowka: Quoting further from the New York Times article about Bill Clinton: "'There was a substantial likelihood that he would have had a substantial heart attack in the near future,' Dr. Allan Schwartz, the hospital's chief of cardiology, said." That gets into the scare tactics. From your research, is that kind of prediction legitimate at all - that if you don't have the bypass operation tomorrow, you're going to have a heart attack in the next week or two? McGee: I don't think they have any way to predict that at all. Chowka: So they're just winging it when they say those things. McGee: They're just winging it. It's part of the sales pitch. According to the rupture theory of how you get a heart attack, whatever it is that gets built up in the wall, the plaque, is happening in many different little arteries all over the heart. And what initiates a heart attack is, one of these little plaques will degenerate and the surface will actually crack and material may come out or not. The body senses this as if it's a cut in the skin and so it sends platelets there to start the healing process and if the platelets get clumped up and plug up the whole artery, then you've shut off the blood flow downstream and then you lose heart muscle cells. And that's a heart attack itself. If this happens in a large major artery and plugs it up pretty fully, these are the people who drop dead on the street. They don't make it to the hospital. About half of the people who have a heart attack die before they get to a hospital. And once they get to the hospital they probably had the event in some tiny little artery that doesn't show up in an angiogram anyway. So when they do these bypasses, they can only do them on the major arteries that they can see on an angiogram and those are probably not the ones that are having the involvement. The damage is really done by some little guy [artery] that they can't fix. Chowka: Would an analogy be that they're in effect repaving the interstate while the secondary roads are remaining potholed or obstructed? McGee: They've got a problem off on a secondary road and they can't do anything about it so they fix the main road. Chowka: Are there natural therapies, in addition to chelation, that can prevent the problem you've just described? McGee: The whole disease process relates very strongly to diet. Before we changed our food supply in the late 1800s, there were no heart attacks. The first one ever described in the medical literature was in 1878 in England. An autopsy of a man who dropped dead on the street described finding dead heart muscle. That had never been described before in thousands and thousands of autopsies done in Europe during the 1800s. Paul Dudley White didn't see his first one until he was out of medical school for eleven years in 1921. By 1950 it was the leading cause of death. Weston Price and TL Cleave pieced it together. They found that if you leave a primitive society alone, eating the fresh food of the area that they adapt to, they won't get degeneration illnesses unless there's malnutrition. When the modern food comes in, and part of the diet becomes that, the next babies born will end up with crooked teeth and a high decay rate because their jaws don't form fully. And then twenty or thirty years later you see the first heart attacks and diabetics and high blood pressure and strokes and things like that. About 80 diseases show up that were never there before in these primitive societies. There is a connection with junk food but it isn't just plain junk food. Historically, it was the introduction of refined carbohydrates, what Price called the "foods of modern commerce." When you get some of these modern diet gurus together, like four years ago they had Ornish and Atkins and three other guys pushing their own diets, and they all could point to good results. I looked at that and thought they're missing the common factor, that they all go into but they don't think is important; the common factor is that they get all of the people to stop eating sugar, white flour, white rice, and processed food and make them cook their food from scratch. When they do that, it probably doesn't matter how much fat there is, they patients will probably do fine on it. Chowka: In the same way, an approach like macrobiotics and a raw foods diet can both work because they each involve getting away from the modern, industrialized, civilized diet. McGee: Thomas Graboys, a Harvard cardiologist, had a second opinion clinic that was running in Boston in the early 1980s. He published several papers including one in JAMA in 1987. His clinic treated people who had been advised to have bypass surgery elsewhere. After doing tests, some of Graboys' patients - actually 84 percent of them - were recommended not to have the procedure. Eighty-one percent of those people followed the advice. There were no deaths among them in the next two years. And all of these people had been told originally that they needed to have bypass. They had had the pressure put on them. But Graboys' statistics were a good example of their survival without the bypass.
On September 28, Clinton's office announced that the former president would make his first formal public appearance after his surgery on November 16 in Little Rock, AK. Given Clinton's penchant for highlighting his own personal experiences (he called Larry King's CNN show on September 3 live from his hospital room as he awaited surgery the following Monday), a lot more discussion of his case, and bypass surgery in general, can be expected in the weeks to come.
For further information, Alternative Medicine Review
Savvy Patients: Coronary Disease
Life Extension Foundation Cardiovascular Disease: Comprehensive Analysis
The NonInvasive Heart Center Comparison of Invasive vs. Noninvasive Therapies and Related Studies
By James J. Kenney, PhD, RD, FACN, LD
Blocked Arteries: Clean Them Out Naturally
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