We Need to Understand and Show
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 Lewinski 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.
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
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.
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.
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.