The McDougall Newsletter

April 2008

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Vol. 7, No. 04

John McDougall, MD

Readers’ Comments on Bill Clinton’s Madness 

The following are readers’ comments on my article sent April 12, 2008—Breaking News: Bill Clinton’s Madness: A Consequence of Heart-bypass Surgery Brain Damage.  This article has received worldwide attention through the powers of the Internet. So far I have received no serious objections to my claim that bypass surgery has caused our former president an obvious decline in his mental and emotional functions.  I wrote this article because of sincere concern for the Clintons and because brain damage from bypass surgery needs to be brought to the public’s attention.  My intentions were not politically motivated.  As a result of this article there has been talk of enacting informed consent laws forcing physicians to disclose this expected effect.

I have placed comments critical of my position (mixed with supportive comments) up front for your review.  Some of the responses refer to a letter I sent to the Clintons two days prior to his original surgery (September 4, 2004), warning him of the lack of benefits and the risks of this major operation, including the near certainty of brain damage. More comments on this subject are found in my September 2004 newsletter

McDougall Breaking News

Bill Clinton’s Madness: A Consequence of Heart-Bypass
Surgery Brain Damage

We Need to Understand and Show Some Compassion

One of the savviest politicians of our generation, known for his wit, charm, and calm under extreme pressure, Bill Clinton appears out of character in the speeches and interviews televised since his bypass surgery September 6, 2004—and his mental deterioration may be accelerating.  Remember, this is the president who withstood public impeachment before the entire world for his relationship with Monica Lewinsky without once losing control.  Now, he is easily angered by hecklers, and makes factual mistakes and racial slurs while aggressively defending his wife’s campaign for presidency. Everyone sees his mental and emotional decline, yet to date, no medical professionals have spoken out about the cause or offered help.

Bill Clinton SpeakingNot a single one—not one bypass surgeon, cardiologist or psychiatrist—has stepped forward in his defense; even though all of them are trained to recognize “post bypass surgery cognitive dysfunction.” One of the best-kept secrets in medicine is the brain damage caused during bypass surgery.  During my 40 years of medical practice I have never heard a doctor warn a patient before bypass surgery that an expected complication is memory loss.  After surgery when the family complains of dad’s fits of anger, I have never heard a doctor admit that personality change is a common consequence of surgery. Yet these well-recognized side effects have been reported in medical journals since 1969.1

Brain damage during bypass surgery is so common that hospital personnel refer to it as “pump head.” The primary cause is emboli produced during surgery from clamping the aorta and from the “heart-lung machine.” This machine pumps blood to keep the patient alive while the heart is stopped during the operation. Unfortunately, this pump also introduces toxic gases, fat globules, and bits of plastic debris into the bloodstream of the patient under anesthesia. Once they are in the bloodstream, these particles migrate to the brain where they can clog capillaries and prevent adequate amounts of blood and oxygen from flowing to the brain. Essentially, all patients experience brain emboli during surgery and for many the damage is permanent.

In 2001, an article in the New England Journal of Medicine reported that 5-years after bypass surgery 42% of patients showed decline in mental function of approximately 20 percent or more.2 A study published this year (2008) in the Annals of Thoracic Surgery using MRI testing just after bypass surgery found brain damage in 51% of patients.3   Three years after their time on the bypass pump, significant permanent reduction in mental capacity was identified in 31% of patients.  I am not talking major stroke here; but these patients can't remember names or numbers as they once did, experience sleep disturbances (including nightmares), suffer mood swings, and lose intellectual acuity. Approximately 30 percent of people suffer persistent depression and some even contemplate suicide.

Our former president needs our understanding and support.  A simple explanation by his doctors of the cause of his recent aberrant behaviors should bring peace of mind to Hillary and her campaign staff.  If Mr. Clinton better understood his current limitations, he and his staff could take precautionary steps to avoid embarrassments.  A long-overdue explanation would help his adoring public more easily accept his mistakes and readily forgive him. It is not your fault, Mr. Clinton.

As importantly, public recognition of the harm done to Bill Clinton by the heart surgery business would help the patients who undergo bypass surgery, and their families, to better understand similar changes they have experienced.  A little attention from the media could also shine some light on the lack of survival benefits from this $90,000 procedure performed nearly half-a-million times annually in the US, and the superior benefits coming from diet and lifestyle changes.

I am saddened to see our former president suffer from public humiliation, but I am disgraced that my profession has thus far failed to come forward with a long over-due explanation and an apology to the Clintons and our nation for the harm they have done and the secrets they have kept.

John McDougall, MD

1) Hill JD, Aguilar MJ, Baranco A, de Lanerolle P, Gerbode F. Neuropathological manifestations of cardiac surgery. Ann Thorac Surg. 1969 May;7(5):409-19.

2) Newman MF, Kirchner JL, Phillips-Bute B, Gaver V, Grocott H, Jones RH, Mark DB, Reves JG, Blumenthal JA;  Longitudinal assessment of neurocognitive function after coronary-artery bypass surgery. N Engl J Med. 2001 Feb 8;344(6):395-402. 9Link:

3) Knipp SC, Matatko N, Wilhelm H, Schlamann M, Thielmann M, Lösch C, Diener HC, Jakob H.  Cognitive outcomes three years after coronary artery bypass surgery: relation to diffusion-weighted magnetic resonance imaging. Ann Thorac Surg. 2008 Mar;85(3):872-9.


Thank you for the article on Bill Clinton’s Madness, This is the first time I have read of what I KNOW is a result of Bypass surgery. I have mentioned what I felt might be a "side effect " of this surgery to MD's through the years and was dismissed for even thinking this could be a result. So I have kept my mouth shut. I am an RN. I have experienced this first hand, observing my fathers emotional and cognitive and behavior after bypass surgery. He never returned to himself.  Through the years I have quietly taken it upon my self to gently tell my patients wives, their husbands may not be themselves after surgery, especially the first year."  I was well aware not to speak negatively against their MD, nor introduce new choices . I felt I could only help in the moment. DY

Thanks for your recent article about Bill Clinton and his post-bypass surgery emotional changes. As a pastor, I have seen this exact phenomenon with many of my parishioners who have undergone this surgery.   One very common thing I've observed is that many men are confused by the fact that they are suddenly much more emotional. For some of them, their inability to control their tears is a source of real embarrassment. In knowing what to expect, it is easier for me to counsel patients and family members who are often taken aback by unexpected emotional changes. Thanks again for bringing this important subject to the forefront. Hopefully, we can all be more understanding to those around us. Rev. LP

I am deeply saddened and angered by your portrayal of President Clinton. Contrary to what you assert, the President and Senator Clinton have shown great restraint in their dealing with the most egregiously bad media coverage of an election in memory. What factual mistakes?  What racial slurs?  What public humiliation?  And for you to promote the notion that, "everyone sees his mental and emotional decline", is outrageous. And for what?  To advance the idea that doctors are lying to their patients about post surgical depression?  That's been common knowledge since the first artificial heart operations. Perhaps I'm most troubled by the use of the title "Breaking News – Bill Clinton's Madness" It tells me that you have most likely distributed this to the media - to feed their insatiable desire to denigrate the Clintons. I was a patient of yours many years ago in Kailua.  You have been a hero to me, and you and Mary changed my life for the better.  Even at my age, it's hard to give up heroes. CF

…you tried to tell him....Great article...thanks. Marianne

Bill Clinton's Madness. Thank you Dr. McDougall.  My husband had a 4-way bypass 2 years ago and I have been publicly humiliated by his outbursts at me (very uncharacteristic before surgery) and have been stressed by all of this.   Now I know the cause and I am going to give this to his doctor. EC

I would question your judgment with this public announcement about Bill Clinton at this time.  Of course, you may be putting this forth now, in a back door attempt to support a candidate, other than Hillary Clinton. Hmmmm.....TKT

Hello, My name is Wanda. In 2000 I had a double bypass, plus the next day they had to open me up again. I was told by 2 doctors in the last 2 years that nothing was wrong with my memory except I was getting old. I had asked the doctors because over quite a few years my memory was getting worst. Also my friends and family are always laughing and saying how funny I am. When I don't feel that I did something funny. So Thank You for your newsletter. Also my spelling has gotten real bad. I have to double check every word. Sincerely, WH

Thanks for the ballsy article about Bill Clinton. I appreciate your voice, even though it remains crying in the wilderness of American corporate - owned media. I have benefited from your & Mary's work, and wish you the best in the future. –jms

Your email regarding President Bill Clinton is out of line. You have a lot of nerve making this "judgment" based on nothing more than your observations from afar. You are spreading malicious rumors and I am aghast. You lead me to the conclusion that you are not the person you portray yourself to be. I have unsubscribed from your email list and will offer this opinion of you whenever your name or your products are mentioned to me. NG

Thanks so very much for this news alert about the consequence of heart bypass surgery that affects many people.  As much as I admired our former President while he was in office and even after for all the adjectives you mentioned...even bought one of his books, I started to turn aloof from all the negative remarks and uncontrollable behavior he exhibited during this long campaign.  I thought his un-witty expression of extreme aggression has been distasteful and harmful.  I really thought it was all due to his denial of how the results of the caucuses and primary elections were favoring and going on an attack mode was the only way he could release his emotions.  You actually opened my eyes with your report. So I will forgive him for all the embarrassments he is causing his family and the party. J

Thank you Doctor McDougall for the article on open-heart surgery. My Mother was on the heart-lung machine nine hours and did indeed have memory loss that plagued her for the last 7 years of her life. I am glad she had the surgery because it saved her life…KB

Thank you Dr. McDougall.  I, too, have witnessed President Clinton speaking and have seen signs of the results of heart bypass surgery in his conversations.  Why would I know?  My mother had “emergency” bypass surgery 6 years ago; we will be celebrating her 80th birthday this week.  But, as you probably guessed, the mother we have with us now is not the mother we had 6 years ago.  She gets confused, befuddled, starts to ramble in her conversations.  Her eyes are vacant; she has lost most of the passion for life that she once had. Thank you for your compassion and work to get the word out.  I hope people start to listen. DW

Good point of view, John, I will take some time this evening to see if how much I agree. Of course, I'm one of those Republicans who can't like this formerly likable guy, so let's think about compassion. JJ

What left field did your article come out of?  What brought forth this type of article?  In this election year, was your article written to have some sort of impact against the Clintons.  I think your "Bill Clinton Madness" article was inappropriate.  LC

BRAVO! John, for bringing this little known fact about heart surgery to the attention of the yet uninformed American  public. GC

Is there similar data that you are aware of when the Cardio Bypass has been without the pump? It is commonly referred to as beating heart bypass. I had quadruple beating heart in July of 2004. I know a number of others including my close colleague, Dr. William N., who have experienced beating heart bypass. We interact most every day and have been on guard to observe cognitive changes in one and other's behavior. Your concern for "Bill Clinton's Madness" has also had my concern. Thank you for calling it to our attention. PS

Bravo yet again!   Such important thoughts.    And as usual so clearly and eloquently and cogently expressed. When will they listen? A

I have sent this to about a dozen people I thought it was so interesting. Several experts mentioned that the Statins also may be causing these symptoms! JR

I'm so glad (yet really saddened) that you have stated the reason why President Clinton has been faltering lately.  I'm no doctor but thought this very same thing when he first started saying things on the campaign trail that seemed so out of character for him.  It's really so sad.  Thanks for continuing your "campaign" to better health.  ES

Congratulations!!!!!!!  This is an excellent article and most of all..................................  kind to the Clintons.  Thank you! RMGM

Thanks for the enlightenment on this widely used procedure and its adverse consequences. You stated that your profession has not come forward and explained to the Clintons as to Bill Clinton's being out of character in his speeches and interviews since his 2004 heart by-pass surgery.  Since you know what the problem is, have you notified the Clintons and others of this adverse permanent effect of having by-pass surgery? Just last night, we were watching "Your Total Health" program on television and they had a segment on Stents vs. Heart By-pass Surgery and doctors agreed that the Heart By-pass Surgery was better for the patient than putting in stents.  Evidently, as you stated in your "breaking news", these doctors probably don't warn the patient or their families of the possible permanent brain damage. This recommendation for heart by-pass surgery was probably because there is more money in it and people wonder why medical costs are going up all the time. MF

This is outstanding.  Who but you would do it and so well. Congratulations!!! AE

Just a short e-mail to tell you how much I appreciate the information in your recent "Breaking News on Results of Heart Surgery". I had bypass surgery about six years ago and EECP about a year and a half later. I have been on The McDougall Weight Loss Plan since Jan 2006. The results have been excellent, no more pills and I feel and look great. I am 84 years old next month. I do experience memory loss a bit and wondered if that was just old age. RA

Clinton stopped here in Charleston SC in JAN 08 and guess what and where he ate??? Hot dogs and French fries! I fear our president will not be with us much longer. Many Thanks, RP

I cannot thank you enough for this article. Not only does it help me understand (rather than judge) a president who I have had admiration for, but it helps me understand my father who lives with me. He was an eye doctor, mathematician and engineer, but after his surgery he began hearing voices and insisting that a spirit was bothering him. He went from the most grounded person to sounding psychotic at times after his surgery. Psychotropic medication did nothing for him, so thank you once more for helping me with my understanding! Gratefully,NE

Bill Clinton's Madness. Wow, this is pretty scary!  Altho, I remember attending a lecture Dr. Mueller gave at his office one evening on ... uuhh, what is that procedure called where a healthy mixture of amino acids and other things (I think) are injected intravenously to prevent the clogging of the arteries???  Well, anyway, in that lecture, he said he would die a hundred deaths before he would ever undergo bypass surgery because of the damage it does to the brain while under the anesthesia.  I'll never forget that. Wonder if Mother was affected by that? ... remember she had that bypass after returning to Knoxville, and that could have been just an additional cause of her mental decline. Scary. SW

These are such important insights. People need to know these things. I hope you forwarded your article to a number of newspapers? I wonder whether they would refuse to publish it, fearing angry reactions from cardiologists and the bypass industry? Thank you for keeping us abreast of research-based health facts. You are a gem. A.

My mother forward to me the article that you wrote concerning President Clinton current state of health.  I am deeply impressed by the information that you have provided to us about the consequences of Bypass surgery. Since I was little I knew that type of surgery is extremely dangerous; however, I never knew about the aftermath. I am a SDA and a registered Republican but I do agree about showing Mr. Clinton compassion. About his recent behavior despite he can handle in a more professional manner but it shows me that he loves his wife deeply and wants her to win. You should be the one to tell him about the danger of the surgery and offer him advise about getting his health back to normal. His doctors won't tell him anything because they want his money. That is why health care is really bad in this country. Thank you for taking the time in writing such awesome articles. Keep up the great work and always stand up in what you believe in. GR

Please send this letter to Mrs. Clinton and the President. It is so sad to think of his strong mind being compromised.  You would do all a huge service if those around them could help the Clintons understand his problem.  Thank you.   SC

…interesting, this is what you said would happen in your book !.....thanks for the insight...MA

Funny thing, my father had this surgery. He's changed a lot since then. He used to be short-tempered and pretty mean some times. I think he's actually mellowed out a lot. I think the surgery had the opposite effect on him. :-) :-) :-) A

I am so proud of you for speaking the truth!!  Many blessings on the good work that you do. J

Thanks so much for the article on Bill Clinton.  I have to confess that I am so sick of all the Obama slobbering on TV, that I have not seen any of Bill Clinton's speeches or interviews lately (TV avoidance).  However, I do read transcripts of what he's reported to have said.  As far as racists remarks, I have not found anything remotely racist in any of his remarks. It seems to me that it is the Obama camp who are constantly "playing the race card".  I sometimes feel that it is at the point where any public figure who does not make comments praising Obama is deemed a racist!!!!  OK, so I might be the exception among those not having love for Obama.  I am African-American, and a vegetarian. Naturally, Kucinich was my choice.  Not only is he totally anti-war (unlike all 3 of the remaining candidates), but he was also the only one who does not take pleasure in eating the flesh of slaughtered animals!!!! Thanks again for the article. I have forwarded it to my family and friends. BBF

Wow!!!  That’s interesting … you are right ….  Don’t mention it or else we will then have worsened blood pressure problems!!! P&M

I had a triple bypass done seven years ago and I don't have any of these problems mentioned.  I don't seem to have the same "drive" system that I used to have, but that may be a natural result of aging.  But, I do get a lot of exercise (ride a bike five days a week for an hour per trip – both hills and flat) and I eat well -- stick fairly close to Dr. Fuhrman's diet -- and keep my brain busy -- still in business (  But, I have noticed that Clinton does seem to be "losing it" fairly often. JB

An excellent article, Dr., I had heard about this problem but never associated it with Clintons situation. BH


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