Review Widowmaker Documentary

Hi, Jeff Nelson. Thanks for tuning in. I want to talk about and recommend a film called The Widowmaker. The Widowmaker is about the cardiology field and spotlights how cardiology is motivated by money but not by the desire to save lives or prevent heart disease. Now this isn't me saying this. This is what's in the film which I'm going to talk about. But this movie is a good companion piece to the video that I did recently called Do Plant-Based Diets Reverse Heart Disease? And they do. In that video of mine one of the things I showed is compelling research that stents and bypass surgery are largely useless for a period of time in the 1980s. It was thought that stents might save lives or prevent heart attacks or prevent angina. Over the past several years though this theory has been thoroughly debunked in a number of high quality studies. You can see some of those studies in my last video. But what stents did accomplish was to make a lot of money for cardiologists and hospitals where the procedures were done. Now a couple of people have said that the studies I talked about in my last video, blind randomized controlled trials, which show that stents and bypass provided no benefit beyond a placebo, they claim that the I showed only applies to certain patients but that some other patients do benefit. And I would just say show me the randomized controlled trial that backs up your position. Anyhow this film, The Widowmaker, I'm going to recommend for people interested in learning more about the subject. The film's on YouTube. The term widowmaker refers to a certain kind of heart attack. It's a blockage in the left anterior descending artery, an artery that supplies a lot of blood to your heart. When you deprive a large chunk of heart muscle from oxygen, sudden cardiac death is usually what occurs. Most people suffering at Widowmaker don't have time to make it to the hospital before they die. Only 12% survive. Tim Russert, a famous NBC commentator, was killed by a Widowmaker at age 58. James Gandolfini, who played Tony Soprano, killed at 51 by a Widowmaker. Other high-profile people who died from this, Tom Petty, Luther Vandross, Michael Clark Duncan, Jerry Garcia. Kevin Smith was very lucky to have gotten help fast and he didn't die of his Widowmaker. My own father had one but he was very lucky. He was in the ER at the time because he had been having chest pains and while talking to the doctor he had his Widowmaker. They rushed my mom and sister out of the room, got paddles and restarted his heart, then rushed him to the cath lab which was about 50 feet away. They went in his artery, they opened up within minutes of the attack starting, so he lived. And I remember being with him the next day when his cardiologist came to check on him and the doctor said you were very lucky. That heart attack should have killed you but you were in the right place at the right time. Now the Widowmaker term is kind of sexist. It implies that only men get sudden death from heart attacks and they're married. But the truth is the Widowmaker is slaughtering women in huge numbers too. Women die five times more often from heart disease than from breast cancer. So the film the Widowmaker is about a test called the coronary calcium scan that was invented in the early 1980s. A physicist and a cardiologist working together came up with an idea of basically a mammogram for the heart. They found that you could see calcium in your heart using a scan and then over many years of tracking they came up with a system to very accurately predict your risk of heart attack based on your calcium score. Up until this point there was really no reliable way for people to judge your heart disease risk. Bill Clinton, he aced his stress test, a treadmill test given by a cardiologist. He was told he was fine. A month later he had chest pains and had to have surgery on four blocked arteries. Before the calcium score there were risk factors that were used to estimate your heart's health like smoking, stress test, your weight, your cholesterol, and so on. But none of these were really that strongly predictive like the calcium score test is. Hundreds of thousands of Americans die every year from a sudden heart attack. They had no idea they had heart disease. A cardiologist may have told them they were fine. Then a month later they had a massive heart attack while playing tennis or taking out the garbage and they died. A coronary calcium scan can accurately predict your chances of dying from heart attack in the next 10 years. Maybe you have a 10 percent risk. Maybe you have an 80 percent risk. But the cardiologist field rejected this test and that's what this film is about. Why did they reject the test? If you watch the film it was because of greed. See at the time the treatment of choice was stents. Cardiology was about waiting for someone to have chest pain or to have a heart attack and survive. Then go up an artery, inflate a balloon, and insert a stent. This cost around $50,000 and was lucrative for both the doctor and the hospital. This was the guideline directed therapy from cardiology because it was a big money maker. The calcium score test costs maybe a couple hundred bucks at most. No real profit for anyone. They show this in the film with multiple sources. Calcium scoring wasn't rejected because it was inaccurate. Cardiologists who looked at it acknowledged it was accurate. Here is Dr. Steve Nissen who is chairman of cardiovascular medicine at the Cleveland Clinic. In the film he's explaining why he didn't believe cardiologists should use this test and that it shouldn't be approved for wide use. For these people the scan offers the only hope but the medical establishment shun it. The nation's top doctors pour scorn on the claims the Calcium Club make for their new technique. Most vociferously the one man they expect to support it. Steve Nissen, the most prominent preventionist in the U.S. based at the world famous Cleveland Clinic. Well I'm not a fan of it. To date no one's been able to show that knowing how much calcium is in the arteries actually allows you to change the outcome for patients. So it tells you who's at risk but it doesn't tell you what to do for them. I would say that there are some people who still believe the world is flat but clearly it's not. We know that it identifies high-risk patients. We know that treating high-risk patients saves lives. Therefore identification of the high-risk patient will save lives. Do you agree with Dr. Nissen's reasoning here that there's little or no value to a test that alerts people if they have a very high risk of heart attack? He's essentially saying don't tell someone that they're a walking heart attack time bomb because we don't know what to do about it. I think we do know what to do and I think most people would want to know if they were likely to die from a heart attack in the not distant future and that cardiologists would want to focus on helping these people before they had that heart attack. Certainly these people should be given a chance to learn about lifestyle and diet changes that could reverse their risk like Ornish and Esselstyn. We know from Esselstyn's study that his patients had less than a one percent risk of a major cardiac event over four years if they followed his diet. That would be of interest to someone with an 80 or 90 percent risk of a heart attack in five years. Don't you think? By the way I should mention that Dr. Nissen is the doctor at the Cleveland Clinic who a couple of years ago said it's okay to eat butter, bacon, and meat. People with heart disease shouldn't be afraid to eat these foods. The Widowmaker film goes through a lot of stories of different individuals and their heart attacks like Larry King from CNN, some famous politicians, people who lost their spouses. It plays 911 calls of people calling because their spouse is having a heart attack and the operator is trying to tell them what to do while they're frantically waiting for an ambulance. I'm now going to play a clip and put a link to where you can watch the full film on YouTube. It made me want to get a calcium scan myself and I see that there are places who do it for around $150 where I am in LA. It's not covered on your insurance though and in this clip that I'm about to play you're going to learn why not. But this is just a further illustration of why you do not want to rely on cardiologists and their profit-driven business model, but should take things into your own hands. Embrace the kind of diets that cut your risk, not just the Esselstyn and Orange diets that are, you know, great for people who are trying to arrest and reverse heart disease, but for the rest of us to follow a Forks Over Knives or an Engine 2 or a McDougall or PCRM or these other diets that are lower in fat and actually heart healthy. The reality that movie exposes, cardiology treatments are largely focused around profits for doctors, hospitals, and drug companies and these expensive treatments don't work very well. That said, not all cardiologists are bad by any means. There are some great ones who get it, but many unfortunately are uninformed or poorly informed, misguided, and they get their marching orders from drug and food companies probably without realizing it. Okay, here's the clip. The calcium is actually part of the healing process. When we develop deposits of cholesterol in the wall of the artery, one of the body's natural defense mechanisms is to put down calcium to try to heal this sort of bubble. So in and of itself, it doesn't cause the disease. What it does, though, is it doesn't occur there unless there is plaque there. You could have all the risk factors and not have any coronary disease. You could have none of the risk factors and have coronary disease. But if you have a coronary skin and you see calcium, you know you have disease. It's not a risk factor. It is looking at the disease, part of the disease process. Very exciting, very exciting. You know, the number one killer today is heart. And number one killer in 1940 was tuberculosis. And that was completely eliminated by x-ray screening of the chest, the famous chest film. So to me, being a poor physicist, it was the same. Let's get rid of heart disease because heart attacks are completely preventable. So let's find out who is on the road to having a heart attack, screen them, and eliminate it. The new technique can pick out the patients that conventional risk analysis cannot. Thin, fit, and outwardly healthy. And that's a lot of people. In the four years after coronary artery scanning is invented, over half a million people die of a heart attack with absolutely no warning. The scores go zero. It can go as high as four or five thousand. So I call it zero, mild, moderate, extensive, and oh my god. Zero is the best I can do for you. One to a hundred is called mild. 101 to 399 or 400 is considered moderate. 400 to a thousand is considered extensive. And above a thousand is in the oh my god category. Every time we tried to redo the experiments, we got the same answers. It was just remarkable. The more plaque you had, the more your risk was going to be. It was independent of your cholesterol, independent of your smoking history, independent of virtually anything. It was the most powerful predictor of risk. Look, what are your alternatives? You say to a person, well you're at low risk, and then if the patient dies, oh I was wrong, sorry. Why guess? Why base your decision on a score derived from a compilation of risk factors when you can look directly at the heart and see how much plaque there is there. As the unexpected deaths pile up, the way forward seems clear in the battle of the stent and the scan. The scan helps prevent heart attacks and costs only a few hundred bucks. The stent is risky, expensive at tens of thousands of dollars, and the patient has to either have or be on the brink of having a heart attack. But that analysis neglects the During the late 1990s, the Mayo Clinic was reporting about 50% of its coronary angiograms were normal. That's equivalent to saying unnecessary. The Mayo Clinic is still a major research center with excellent researchers, the best in the world, and Mayo Clinic had done some research studies showing that coronary calcium could predict who needs a coronary angiogram and who doesn't. So the researchers said, well we have this test with almost 100% accuracy for predicting who should have an angiogram and who shouldn't. Why don't we offer this to our patients? And the administration shut it down because the cath lab generates 25% of the revenue of the Mayo Clinic, and that would have been cut in half if they started not doing unnecessary angiograms. More women die of heart disease than men in the states every year since 1983. So it's a huge problem among women. Five times as many women die of heart attack as breast cancer, yet very few women have any knowledge of that or any inkling of concern about heart disease compared to breast cancer. So we talk about the mammogram of the heart, that's at least five times more important to women than the mammogram of the breast. With heart deaths stubbornly high and stent overuse discredited, you'd think the mammogram of the heart would be on its way back, but you'd be wrong. So we are going to put a stent there now, okay? Give me a 2.25. There's one last key opponent, the insurance industry. They won't pay for the test. Ironically, the headquarters of giant health insurer Kaiser Permanente are just across the bay from the where the very first scanners are installed. In the early 1980s, the Kaiser board come calling. We met with the Kaiser executives, of course they all, most of them came in to be scanned, and some of the Kaiser researchers did some excellent research on coronary calcium screening, published research. But that didn't mean they'd pay out for their policyholders to have one. They said we're not interested because our typical patients are only in the plan for five years or less, and this is a long-term cost savings. So the cost savings will go to our competitor, and no need to single out one particular health maintenance organization. All the insurance companies told us basically the same story, that their patients are not long-term holders of that plan, so if they reduce cost over the long term, it means nothing to them, it only goes to their competitor. We contact the big insurance companies, Kaiser and the rest, to find out why they will still pay for a $50,000 stent, but not unless you're very lucky, a hundred buck test. But they won't talk. Then one man is brave enough to break the wall of silence. He's been the public face of two of the big five as their media spokesmen. I was a journalist, a newspaper reporter for some time, but then I got into public relations work, and I realized toward the end of my career that something had happened to what I was doing for a living, and it just dawned on me that in many cases I was doing the exact opposite of what I was trying to do as a journalist, which was to try to find truth and as best I could report it to do that. It sounds kind of trite, but I did look in the mirror and say, what happened to you? How did this happen to you? The system is not set up to reward prevention. The system is set up so that doctors are well compensated for treating conditions. So are pharmaceutical companies. We mainly have a disease industry in this country. We've got a healthcare system that's out of control, spending an incredible amount of our national wealth, not making people better. We've developed a system that's based upon putting out the fires, taking people with chronic diseases and doing all these things to them. There is just not nearly enough attention paid to trying to help keep people from getting sick, from getting congestive heart failure, from getting the kinds of illnesses that require stents and being put on maintenance drugs and having expensive care for the rest of their lives. They don't want them to die, but they don't necessarily want them to get better. Well, that's where the money is. It's like the Willie Sutton law. It's Sutton's law. When asked Willie Sutton, why do we rob banks? He said, that's where the money is. So the insurance companies are following Sutton's law. You don't get to be CEO of a company because you've saved lives.