Greater Boston; Trial And placebo surgery, Christopher Hitchens, Star Wars

Good evening, tonight, would you undergo brain surgery even knowing it might not be the real thing if you thought it might help? Many people do. That's because surgery for Parkinson's disease is costly and experimental and not always covered by insurance. One new type of surgery is still in the research phase. Fetal cells are implanted into the brains of Parkinson's patients and in order to determine whether the procedure actually works, some patients get fetal cells, others don't. Researchers say this is the best way to test whether the cells actually improve a patient's condition, but others only see an ethical quagmire. 19A to August, 48 years old, and we live on the campus with our academy and we used to walk around the night around a big circle. My right leg started to dry, so we went to see a doctor. He walked in the door of this classroom where we were working and he looked at me and he said Parkinson's and bottom just fell out. George Andes has

Parkinson's disease and it has progressed in typical fashion. First there were the tremors, then the slow move motion, and now if it weren't for his medication, George wouldn't be able to move at all. A few years ago his wife Jean heard about some clinical trials at Mount Sinai in New York and convinced George to give it a try. I was scared of death. And I was right to some high operation. I was more afraid of Jean than I was of the surgeon. So on March of 1997, George was placed under anesthesia and two holes were drilled into his skull. That much he knows what he doesn't know is whether his brain surgery was placebo surgery or the real thing. I got two holes up here and I don't know where they go. They may not participate in the skull. The placebo surgery works like this. Each patient has neurosurgery. About half of the group gets an injection

of fetal cells. The other half gets nothing. All of the treatment is done for free. Only the doctor who actually performs the procedure knows who got the cells and who didn't. With neurologic diseases, particular like Parkinson's, there's a notorious problem with when you tell people, give them the impression that they're going to get better, give them placebo drug that they improve. Dr. Michael Broden was initially troubled by this new kind of Parkinson's research. But now he believes the benefits of sham surgery outweigh the risks for Parkinson's patients. Even so, he admits there are still serious ethical questions. It's a bad disease. And that's the problem with trying to do research on this particular disease because people are desperate. And when people are desperate, informed consent, a requirement for all patients entering a research trial may be meaningless. Patients have fantasies that they're going to receive drugs. And so no patient really wants to believe that they're in a research trial. George Andy's read his consent form,

but at the same time says this clinical trial was his only hope. This is very clearly in there that I'm not expecting any therapeutic diet. If I get some, that's fine. If I don't, I don't. I knew that, but nonetheless, one wish is for the best. George felt better for a few months after the surgery, but now seems to have regressed. And that's why he's anxious to find out if he actually had the fetal implant or not. But Mount Sinai is telling him he has to wait until all of the experiments results are in. How can he wait? How can they say to a man who said Parkinson's for 18 years, going on 18 years? Well, you have to wait two more years, George. Mount Sinai has offered George Andy's an alternative. The hospital will find a neurosurgeon to perform a treatment on George called deep brain stimulation, at a cost of about $50 ,000. It's money, George and Gene just don't have. I've given them two years of my life, and then Chess had worked on my brain. And

then to be told, just sit right out this storm, we don't want the story going to end, and then we'll take care of you. It is kind of my brain caring. But that seems to be the bottom line of medical research. The reality is that it's often done for the sake of science, not necessarily the sick. And with me now, our Dr. George Anis of Boston University, who started out, opposed to these kinds of surgeries, but says he's changed his mind. And James Mauer, president of the Massachusetts chapter of the American Parkinson's disease Association, who is very much opposed to the trials. And I should say you also have Parkinson's disease. Why are you opposed to the surgery? Not as opposed today as I was a few days ago, after having read some of the more recent results that came out of the Colorado fetal tissue research project that the numbers were just released recently. So they're saying that this fetal cell implant could actually

be successful, and we're just discovering that that's the possibility. Well, they discovered a couple of things. I had thought all along that with medications, you can really say the placebo effect is there, no doubt about it. But can you transfer that to surgical procedures, that same thinking? And I didn't believe you could. But the results from the Colorado study indicate that of the 20 patients that were the sham surgery or the placebo, six of them after a full year were absolutely convinced, you know, their condition was improved significantly. So that's given me a different view to it than I had. This is stunning. You've also changed your mind on this because of results like that, George? I haven't. My colleague, Dr. Grotto, was the one who was against it at the beginning. I always thought that if you can do something like a placebo -controlled

trial in surgery, you should do it, especially in conditions like this, where people want to get better so bad, the doctor wants people to get better so bad, and it's very hard to measure improvement except on self -assessment. So that makes sense. The only issue was, is the sham surgery itself dangerous? Is that placebo effect, which we always do in drug trials? Is that dangerous in surgery? And the neurosurgeon's convinced me, actually, that even though it sounds dangerous, drilling burls in your skulls? So they only do the drilling, they're not actually in surgery, they need to win. At least from a neurosurgeon's perspective, this is a trivial procedure. So given that, and given that, you really want to find out if this works. You know, you have to have some control group. Oh, wait a second. Why do you have to have a control group? Well, because... You're not going to do that with chemotherapy, are you? Well, you actually do. I mean, the control is not going to be a placebo there. It's going to be the next best treatment, next available treatment. Yeah, but why do you need... That's the part I don't understand. Well, why do you need a control group? If I'm willing to be part of the experiment and say, okay, go ahead, give me the fetal cells, I'm willing to test my brain

with it. Because this gem was pointed out, and it was surprising to him, and that gets to a lot of people, significant number, 30 % of the patients who got just the burls and nothing else, got better, and they were convinced they got better, and they were convinced they got the surgery, actually. But what does that tell you then, maybe about the disease? Well, it tells you that there's a lot, some part of it is, you know, is the assessment, your personal assessment of how you're doing. My concern is that the population with Parkinson's in the United States is about a million, in 500 ,000 people, potentially maybe 20 % are candidates, or will be candidates for surgery. I would hate to see that happen without having thoroughly tested, and I also found out, George, which I didn't know, is that I had thought, in fact, I think the original protocol read that they were going to completely drill the hole through the skull, and actually run the needle in. Yeah, well that probe. That'll be going too far, if they don't do that. In fact, they don't

even complete the drill. The drill? It's cosmetic, so they fool you. Well, that's the point. That's what they wanted to fool you, that's the idea. Now, George Andes says that he actually can find out. It's just that the experiment will drop him. They won't give him the operation after the fact, the deep brain massage. He could find out tomorrow through an MRI. Why not do that? He's in a quandary, he really is. He's invested an awful lot of time and energy. He had to fly down to Tampa to have the procedure done. He's been back and forth to New York any number of times, and he can't just can the whole thing now. Okay, but yeah, okay, I guess that's it. I mean, he's asking for our sympathy, and he's saying, in a sense, he's saying, why they're telling me I have to wait another two years. But that's really what he signed on to. That's part of the explanation. And if he wants to end this right now,

he could, and I don't know how he could raise the money, but perhaps get money for the surgery he needs. I don't know how the doctors are making the correlation between having had fetal tissue and the deep brain stimulation. They're really separate issues. One doesn't relate necessarily to the other. I think what they're saying is, if the fetal brain, if the fetal cell experiment doesn't work, they'll offer him, and he was one of the ones who got a placebo. They'll offer it till and if he pays for it. If he got, no, look at him to free, if he got the placebo, and if he completes the two years without breaking the code. Yeah, that's right. But you're right, he could break it today. Nobody can force you to stay in an experiment. You can end it at any time. No, he's got a 50 -50 chance that he did get. Do you have problems at all with some of this experimental surgery with placebo effect in general? Do you have any problems with, in a sense, fooling people? You aren't fooling people. Number one, this is experiment. And you have

to know that going in, the likelihood of this working is very speculative. I'm probably quite low now, at least from the Colorado stuff. So people shouldn't expect this to be a treatment, because it's not a treatment. No, not only that. I was hard, Mr. Andrews said. It's hard not to think that I'm going to benefit from this, because I'm going through all this stuff flying around the country. I would my brain expose. I hope I'm doing this for my benefit. But secondly, if you don't do this experiment, what's the alternative? That means that you either don't do any of it, or you open it up to everybody who wants it. Not only would it be dangerous, I think, because for a lot of people, but it would be intolerably expensive. If you're doing something that doesn't work or that we have no evidence that works, even though some people, even from a placebo effect, would come out of this and say, this is great. And you'd have to test the modules in the whole bit. Fascinating, I have to say I didn't even know what was happening. James Mauer, thanks so much for being here. Thank you. Dr. George N .S. As always, thanks for joining us. And when we return, the author Christopher Hitchens joins us to talk about his new book on President Clinton.

Christopher Hitchens is here. He's an author and regular columnist for a vanity fair and the nation. And he's got a new book. No one left to lie to the triangulation of William Jefferson Clinton. Do you have anything nice to say about our president? No, I leave that all to other people. He has a staff for that kind of thing, actually paid for by public money, which I don't think you'd ought to be, to pump out lies in his favor and defamation about people who don't like him. So I feel that there's no need for volunteers to say kind things about the president. Why would you, what would you select as his greatest achievement? Well, I'm not here to talk about that. Okay. Not bad on Ireland, but... On Ireland? And I speak as someone who you could probably tell is born in England. I think he's right in Costa Rica. My wrong thought that it was absurd for the British government to maintain that the six partition counties of Elster were their internal affair. But actually, that

was over before Clinton came to office. When it came to a small crunch on Jerry Adams, I thought he did the right thing and he offended the right British government too. But it's not very hard for a sitting Democrat to be okay on Ireland. Well, that's a point that you raised frequently in the book, which is that he equivocates and doesn't really say what he believes or we don't know what he believes. We have a question. The triangulation theory, which really came from his one -time consultant, Dick Morris. Describe what that means, triangulating his... Well, it's a fancy name for a very old idea. And it's a slight spin on an old idea too. If you can understand three -card mounting, you can understand triangulation. It's a three -card trick. You pretend you're moving to the middle ground while you actually move into the right. You steal the more attractive bits of the Republican program and you hope to bring the big donors along with. You poll to see in what order you. And next these things.

And then you have the job of selling it to the Liberals to make sure that they're still on side. And if they can't be charming to agree with you, you bully them and tell them there's nowhere else to go. And the last two bits are actually Clinton's particular skill and what my book is largely about is a reproach to American liberalism for selling itself so cheap. But what's wrong with that? And in a sense, he's gotten some things through which probably needed a hard luck. Even if they are Republican idealism. You refer to the Star Wars program. Welfare reform? Well, it didn't. Welfare needs some... Welfare is the very thing I start with. You see, Robert Reich. Reich brilliantly article the other day which I quote from and the other research to the same effect. He said, everyone wanted people to move from welfare to work. That was agreed. Call it welfare as we know it. It was Clinton dead or call it vodka -soaked Welfare mothers as Reagan dead. One was down, both were down a gadget. But Clinton promised that the transition would be made with a package of health care, education and

retraining. He broke all the last three promises and then under some pressure just dumped the people who had been on the federally insured minimum off the rolls. Trimmed them as it's called. Many towns and cities and states we don't know where they've gone. It was done in a very cruel and very crude way just to deprive the Republicans of an issue and just to show that he could be ruthless. Well, that means that a new Democrat has brought about the end of the new deal. What's to love about that? Well, why is it that his allies and even some of the people who were affected by some of these draconian changes still seem to support him, seem to like what he's done? I think it's mammals mesmerized by reptiles myself. I honestly think this is an element. I think this is an element of mass. People who can be kicked in the face and he said, long look at how many times Jesse Jackson has been angry with him because he's been badly treated. Started forning again, done the best he can for him. Got kicked in the face and come crawling back. It's not a pretty sight.

The same with the national organization for women. The same with the gay organizations, with the organized labor. It's partly because they're used to it. They have a culture of defeat and of being on the losing side. So they feel that anything's better than nothing. But here, I say my book, this is where they made their really big mistake because they're up against someone who doesn't care about anything at all. It's completely hollow and nihilistic and selfish and corrupt. And it doesn't, it certainly care about itself, but is prepared to use public power and to safeguard his personality. You're known for your sharp wit, your funny phrases, as we've heard of you here today. Some of the reviews of your book are not in that. I'm actually very solid person. Some of the reviews of the book have not been all that kind, including the one, yes, Philip Weiss's review, saying that you've lost sight of your goal because you drink too much. Do you think some of the reviews are in retaliation

for you having turned on a one -time journalist and now Clinton administration guy, Sydney Blumenthal, for the luncheon. No, I think some of the reviews, as the Philip Weiss, were in retaliation from people who have been out drunk by me. And if all the reviews were... He did say that one of us saw it, that you left him lying on the floor of a restaurant. I thought, what? If everyone could say that review my book, I'd get the West Press in the history of the United States. So you don't think that there has been any... Some of it, sure. I mean, if you decide to... I mean, I work at Herb, and I'm a post in Star Wars, a business in the bombing of Sudan, and the welfare bill, and the Chinese carve -up that's just being exposed in Washington. I think it's going to be the biggest money politics scandal in American history by far, over which all the President of Sweden will be. And Sydney works in the White House and defends all these things. But it's as if I'm in power and he's not the way people talk. It's true we had a quarrel, and it's true that he was betrayed by Clinton into believing and repeating a series of lies. And Clinton, who could have

helped him, prevented him from getting in trouble, Is it true then? And did it turn that you betrayed him? No, I just said Sydney, look. I mean, that you can't ask me to lie for you and never did. I wish very, very much, of course, that there would be another Clinton night who I could have ratted on, instead of someone I knew. But no one has the right to ask me, and he never did, to carry on spreading a chain letter of lies that everyone knew, everyone knows. They were sending me around Washington. And though I regret a bad moment, Sydney had, I never put him in any jeopardy. And I'm very proud that one of Clinton's lies anyway, just one, died, expired in my own personal arms, and I put it to sleep. What will his legacy be? Will it be the President of Lies? President of Lies would about cover it. I would say the legacy, well, it could be much worse than it looks like now, because I think things are going to go very badly with China. Not just mainland China, per se, but the appalling transfer of proliferation technology and exchange for dirty money. I think his heart is not in the Balkans and never was, and he's

allowed himself to make some irrevocable mistakes. And I used to think that the verdict would be nothingness punctuated by nastiness. But now I think it may be nastiness interrupted by nothingness. But history's verdict is already in. We shall see. It's a very interesting book. Thank you. And it is punctuated with also, you may be solemn, but it's humorous too. Christopher Hagen. That's a virtual thing. Thank you so much for the drink talking. Thanks for being with us. And when we continue, people were out in, well, full force today, buying tickets to the new Star Wars movie. The movie actually opens May 19th, but the marketing of the movie, Star Wars Episode 1, the Phantom Menace, has reached warp speed. FAO Schwartz had a special midnight sale last Saturday night, selling out to adults a number of menace characters. And today, people, mostly adults, were lined up to buy tickets,

tickets selling at a premium. Tom Aroney has a story. And here they come. At three o 'clock this afternoon, the doors opened and in -streamed Star Wars fans. Fans like 17 -year -old Tony Piantadoci, who camped out to be first in line. Does your mother know you're out here? Oh, she knows. I keep calling during different updates and everything. So, you're a high school student. Yeah, I'm a junior. Don't you have anything better to do with your time? Absolutely not. Apparently, neither did any of the other more than 200 people who were lined up by this noon. Ah, I just quit my job. To come here? Yeah, yeah. Really? Yeah. When I picked up my paycheck and I'm here. Sometime this morning, things got so hectic that one person in line drew up a list. To make it as fair as possible, we started running down names when people showed up, so everyone wouldn't lose their place in line. Cinema officials said they weren't surprised by the numbers. We've actually been expecting this. We've had crowds lining up since

yesterday. General cinema even used this movie as a pretext for introducing a 25 cent price hike in all movie tickets. The prices went up mostly due to the fact that we were going to be incurring more costs for security and running the theaters around the clock. How much is this going for? Four dollars. And I get to keep the cup. Yes you do. Four bucks for a drink. Y 'all get a refill though. No thanks. Despite the high prices, some people were taking all this quite seriously. What more valuable thing, an important thing can we be doing than coming to an event like this. This father and son were watching the original Star Wars as they waited in line. Well for me, it's reliving something we did 20 years ago when he was a young kid. So dad passed in it. Yeah. It's always the way. Some things never change.

And Tom Aroney is here, along with Stephen Mindich, the publisher of the Boston Phoenix and one of the lucky few who have actually already seen the movie. Now Stephen, did they make you sign a little waiver that promised that you wouldn't say anything? Actually the security to get in was more than it it is to get into the Israeli embassy. They took the ticket, scam the ticket, put tape around, wristbands around us and they were pretty secure. We actually heard that they were asking people to sign waivers. And you had to bring photo IDs. I'm serious. Wow. And you were sworn in a secrecy. I don't think it was anything. Was it worth it? Is what we're getting at? I don't think it was worth why. It was worth what I paid for it. It was not. Actually it's a wonderful visual experience. The effects are phenomenal. And the star is absolutely the computer. As a film, as something that brings you in, and you're waiting to learn

how all these characters are involved, I think it's very flat, very cardboard -like. And there's one new character. This, I don't know, fish character, jaja, yaya, yaya, whatever the name is, that just as a big place in the film and just is really poor, really poor. Should be cut. I think so. Okay. Yeah, I heard it here first. I'll tell you. I mean, when you walk around that long line, this is a whole new world. I knew it was popular. But we had, they had games going on with trivial pursuit with this stuff. They knew everything, the name of the engine, and some starship, and the first one, and now this one. They know a lot about it. It was way beyond art, too, D2, and Yoda, and all this. Is this the biggest marketing for a film ever? Apparently, and my belief. I heard they've already sold, by the way, $4 billion. Where's the paraphernalia? Yes, I heard $2 billion about a week ago. But here's the interesting thing is,

to me, I don't think they needed any of the marketing to sell the movie. I mean, I think the anticipation was so extraordinary. I wouldn't have known about it. Here's the question you and my wife. Here's the Star Wars what? No, but here's the question. What is it, do you think, in our society, in our culture? Remember, this is over a generation long now. 22 years. Yeah, 77, it came up. 22 years. What is it that brings people to get so into something that they literally will sit on the street for hours. I don't worry about adults, not kids. Well, and I think that has a lot to do with it. The time period, you know, we've been waiting for this for 20 years, and it's been pitched to us this way. I can't help feel a little sad about, I'm feeling manipulated by all this, you know, the product placement. Well, we haven't been manipulated, or do we allow ourselves to be manipulated? I mean, this is, I always think about that. I mean, Jared's Park hooked me in the same way. Remember, people were running out trying to find ancient dinosaur eggs to see if they could hatch one? I mean, that kind of stuff was going on back for Jurassic Park. But at least with Jurassic Park, we were

dealing with something that had some relevance in science and it extended it. This is pure fantasy, and it's fantasy. It's fine. There's nothing wrong with fantasy. But I think to the people who are sitting in line, it's not fantasy. What is it? I don't know. I'm trying to understand it as I was walking out. And thinking about, and the people into who applauded at every nuance when this character was introduced, when they recognize that. Okay, does it have trades of star trek to his... I think it does. There's the same culture there. I mean, the kids, the typical fan standing in line today was 17 -year -old, 17 -years -old, and a male. And the first guy in line, camped out the night before a skip school for this typical. In fact, he said, this is a guy thing. No girls allowed. Of course, we found girls down the line who absolutely live it at the remark. But I think that... You see these kids today with these... Yeah, right. And I worried about

that, too. But there were these cards. They have these cards, magic cards, and the dungeons and dragons. There's this whole world of fantasy that this kind of hooks into. But as I said, you know, you saw... No, and also you took a 12 -year -old and a 16 -year -old? A 14 -year -old and a 16 -year -old. 14 and a 16 -year -old. So we're around for the first string. No, and I've seen the movies. I've seen the first string. But aren't... I mean, like, fanatics. Michael R. 16 -year -old loved it. Awesome. David was much less odd by it. And enjoyed it. And they are... They really like movies, too, which is interesting. I don't know. It is a phenomenon. I think it may be a... An especially American phenomenon, although this is worldwide. This movie will do extraordinary. I think the guy is a genius. It's better than how he knew. No way. Stephen Mindich, thank you very much for coming on. Talking. Sharing is a wonderful experience. It was worth it. Yes, it was worth it. Timoroni, as always. And that's it for Greater Boston. Tomorrow

night, Dr. Gilbert Mudge defends his treatment of former Celtic star Regi Lewis. He takes the stand. The new mayor of Somerville, Dorothy Kelly Gay joins us. And Chuck Ramer at large. That's tomorrow at 7 on Emily Rooney. Good night. Good night. Good

night. Good night. Good night. Good night. Good night. Good night. Good night. Good night. Good night. Good night. Good night. Good night. Good night. Good night. Good night. Good night. Good night. Good night. Good night. Good night. Good night. Good night. Good night.