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Speaker 1: Now here's a highlight from Coast to Coast AM on

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Speaker 1: iHeartRadio and welcome back to Coast to Coast doctor Matt

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Speaker 1: McCarthy with us. Of course, we're talking about his latest work, Superbugs. Matt,

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Speaker 1: you were talking about how some pharmaceutical companies are a

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Speaker 1: little hesitant and trying to develop further any antibiotics. If

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Speaker 1: that's the case, what happens do these superbugs run rampant? Well,

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Speaker 1: this is the most important medical issue that no one

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Speaker 1: is talking about. We have relied on the pharmaceutical industry

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Speaker 1: for the past seventy five years to make antibiotics, and

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Speaker 1: they have recently decided collectively that they're not making enough

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Speaker 1: money off of these drugs and are choosing to do

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Speaker 1: other things. And I'll tell you why. Imagine a blood

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Speaker 1: pressure drug. A doctor prescribes it to a patient and says,

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Speaker 1: take it every day for the rest of your life.

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Speaker 1: That's a good business model. Think about an antibiotic. They're

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Speaker 1: only prescribed in short courses. Doctors are stingy about doling

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Speaker 1: them out, and even the best new drug eventually wears

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Speaker 1: itself out when the bacterium you take. So it's a

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Speaker 1: really spin profit margin for a pharmaceutical company, and increasingly

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Speaker 1: they're saying, you know what, the money's just not there.

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Speaker 1: It's too risky. It takes about a billion dollars and

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Speaker 1: ten years of studies to bring any new discovery from

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Speaker 1: the laboratory to patients. We're not going to do it.

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Speaker 1: And one of the most important political issues that no

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Speaker 1: one's talking about are there are a number of proposals

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Speaker 1: on the table to entice these pharmaceutical companies to start

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Speaker 1: making the antibiotics again. And that's what I wanted to

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Speaker 1: get readers to understand, is that you're going to be

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Speaker 1: hearing politicians come forward with proposals to sweeten the deal

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Speaker 1: for pharmaceutical companies. And I want people to know what's

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Speaker 1: a good idea and what's a bad idea. In your career,

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Speaker 1: what has been one of the worst infections you've had

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Speaker 1: to deal with because you're an infectious disease specialist. Yes, yes, Well,

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Speaker 1: the one that they tell you to never google, and

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Speaker 1: so I'll give you that warning is something called Fornier

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Speaker 1: gang green fo U R n I E. R. Fournier's

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Speaker 1: gang green, which is a flesh eating infection of the

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Speaker 1: scrotum or of the groin area. I typically see that. No,

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Speaker 1: don't google that. Yeah, don't trust me, but it's um

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Speaker 1: you know, a patient who has poorly controlled diabetes, which

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Speaker 1: can weaken your immune system. Somebody may try to pop

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Speaker 1: a ZiT or pop a pimple in the in the

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Speaker 1: groin area, and it allows the bacteria to get under

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Speaker 1: the skin and it rapidly spreads, and it can be

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Speaker 1: something that can only be cured not with antibiotics but

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Speaker 1: with actually with surgery. Oh my god. One of the

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Speaker 1: most distressing things you can see as a clinician and

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Speaker 1: as a patient. It's it's just the shocking um no, no.

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Speaker 1: And that's why it's so important for us to have new,

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Speaker 1: you know, new treatment options available because I spend my days.

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Speaker 1: I wake up, I walk in the hospital, and the

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Speaker 1: first thing I do is I see patients who are

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Speaker 1: suffering from infections. So this is what I spend my

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Speaker 1: time thinking about, how are we going to do a

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Speaker 1: better job with these patients. Well, we take calls next

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Speaker 1: hour with Matt McCarthy one. You will take your questions, obviously,

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Speaker 1: but if you have had some kind of infection, jump

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Speaker 1: aboard and let's talk about it. Don't be sure either,

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Speaker 1: we'll get some thoughts on that. Do they experiment on

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Speaker 1: people with these new formulas? Yes? You know what I

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Speaker 1: spend my time doing as a researcher is I do

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Speaker 1: human experimentation. That I will take a drug that was

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Speaker 1: discovered in a laboratory somewhere or found in the soil somewhere,

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Speaker 1: and I will bring it into my hospital and I'll

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Speaker 1: study it. And what I've really enjoyed writing about in

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Speaker 1: my book is what it's like to try to do

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Speaker 1: an experiment on a human being. And we have a

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Speaker 1: number of safeguards in place to make sure that patients

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Speaker 1: are protected and that a guy like me can't walk

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Speaker 1: into the hospital with a dangerous drug. We have something

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Speaker 1: called an Institutional Review Board an IRB that reviews any

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Speaker 1: proposal for a study. Before anyone can do an experiment

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Speaker 1: on you, it has to be approved by an IRB.

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Speaker 1: And then if a doctor walks up to you and says, hey,

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Speaker 1: I've got this new clinical trial, you might be a

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Speaker 1: candidate for it. You don't have to join that. You

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Speaker 1: can just say no, thank you, and many patients do,

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Speaker 1: but some are interested or intrigued. And when it comes

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Speaker 1: to clinical research, we're eager to get more volunteers, and

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Speaker 1: people will get paid a little bit for their participation.

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Speaker 1: And that's a big part of how we bring drugs

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Speaker 1: to market, as we have to test them on humans

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Speaker 1: to make sure they're safe, and I assume these people

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Speaker 1: sign off on that in case something goes awry. Yes,

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Speaker 1: there's a lot of paperwork to be done for this,

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Speaker 1: but this is the essence of how the FDA approves drugs.

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Speaker 1: Is we test them on in a test tube, and

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Speaker 1: then we test them on animals, and then we test

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Speaker 1: them on healthy human volunteers, and then lastly we test

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Speaker 1: them on patients who have the infection that we're studying,

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Speaker 1: and if all of that goes well, it can be approved.

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Speaker 1: The drug can be approved by the FDA. But that takes,

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Speaker 1: as I said, close to a billion dollars done, and

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Speaker 1: companies don't want to risk it. They want to do

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Speaker 1: a botox or a blood pressure medication where they can

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Speaker 1: make more money. I've always been a believer in natural

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Speaker 1: things if you can do it first, and I think

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Speaker 1: that this planet has an incredible ability to create its

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Speaker 1: own antidotes for things on the planet, and I mean

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Speaker 1: things like apple, cider, vinegar, they're good for infections and

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Speaker 1: things like that. What do you think of just going natural? Well,

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Speaker 1: this is one of the coolest parts of doing the

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Speaker 1: kind of work that I do is we are always

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Speaker 1: looking for new cures for infections, and a place that

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Speaker 1: we're finding them is actually in the soil beneath our feet.

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Speaker 1: And it turns out that bacteria in the soil are

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Speaker 1: engaged in this molecular warfare where they are all producing

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Speaker 1: these chemicals that they shoot out into the environment trying

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Speaker 1: to kill all of the bacteria that are around them.

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Speaker 1: And if we can harness those chemicals bacteria trying to

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Speaker 1: kill other bacteria, that's exactly right. They're fighting each other,

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Speaker 1: and the way they do it is they secrete chemicals,

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Speaker 1: and if we can find those chemicals, we can turn

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Speaker 1: them into medicines. And that's actually what a lot of

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Speaker 1: scientists are trying to do now. They're sifting through the

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Speaker 1: haystack of soil looking for new drugs that we can

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Speaker 1: use to cure infections. And part of the next twenty

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Speaker 1: five years of science is going to be figuring out

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Speaker 1: how to use artificial intelligence and big data so that

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Speaker 1: people don't have to sift through the soil and we

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Speaker 1: can just go into the haystack and pull out that medication,

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Speaker 1: and that's going to be the big challenge of medicine

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Speaker 1: move forward. Are they successful in finding some of these

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Speaker 1: possible abilities? Yeah, And you know that's where our first antibiotic, penicillin,

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Speaker 1: Where that came from, is there was a fungus that

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Speaker 1: was just pumping out penicillin trying to kill the bacteria

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Speaker 1: in its environment. And we've got scientists now who are

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Speaker 1: very good at finding these new chemicals. The problem is

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Speaker 1: when they find it, they need a pharmaceutical partner to

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Speaker 1: help bring that to market, and they're having trouble finding

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Speaker 1: companies that are willing to spend the money to do

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Speaker 1: the clinical trials on animals and in humans to bring

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Speaker 1: that incredible discovery to the patients who need it most.

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Speaker 1: You had written a piece called why does the flu

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Speaker 1: vaccine suck? This year? To put it bluntly, I have

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Speaker 1: not gotten a flu vaccine in god, I don't know

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Speaker 1: how long. I can't remember, and I haven't gotten the flu.

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Speaker 1: Knock on wood. What do you think of the vaccines? Well, well,

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Speaker 1: this is a one of those conversations where every every

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Speaker 1: time I talk about vaccines with somebody. It's a little

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Speaker 1: bit different. When a patient says to me, doctor McCarthy,

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Speaker 1: what do you think of vaccines? I typically say to them,

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Speaker 1: what do you think of vaccines? And that opens a

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Speaker 1: dialogue with people. But the piece that I wrote was

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Speaker 1: about how every year for the flu vaccine, we have

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Speaker 1: to guess what's the which of the different stereotypes we're

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Speaker 1: going to put in our vaccine, and sometimes we guessed wrong.

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Speaker 1: And that year I wrote about how we guessed wrong

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Speaker 1: and we made a pretty weak influenza vaccine. It still worked,

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Speaker 1: but not as well as we would like. I am

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Speaker 1: somebody who subscribes to the belief that antibiot that vaccines work.

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Speaker 1: And the problem I'm seeing where I practice in New

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Speaker 1: York is we have this measles outbreak where we have

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Speaker 1: nearly a thousand cases of measles, and it's because people

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Speaker 1: aren't getting vaccinated. And what I've found is that there

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Speaker 1: are two groups of people who aren't vaccinating. There are

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Speaker 1: the anti vaccers, which are a well described group, but

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Speaker 1: there's also a group of people who say, I believe

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Speaker 1: the vaccine works, I just don't want to give it

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Speaker 1: to my kid. And that's a group that hasn't been

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Speaker 1: talked about very much. They say, we believe it's safe,

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Speaker 1: we believe it works, just not for my kid, and

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Speaker 1: we haven't figured out a way to convey to these

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Speaker 1: patients of these parents that it's a potentially dangerous thing

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Speaker 1: to expose your kid the measles. And let me ask

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Speaker 1: you this too, math because the parents who are pro vaccine,

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Speaker 1: and everybody's entitled to their own views, but the parents

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Speaker 1: that are pro vaccine go ballistic if their child is

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Speaker 1: around the kid who hasn't been vaccinated. My question is, medically,

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Speaker 1: if your kid has been vaccinated, why do you care

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Speaker 1: who's ease with because he should be immune? Right, Yes,

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Speaker 1: if your kid has been vaccinated, then your kid's immune.

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Speaker 1: There's a concept called herd community, which is that if

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Speaker 1: everyone's vaccinated, the disease goes away and we've lost this

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Speaker 1: herd immunity, And so I think people get really worked

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Speaker 1: up about this. The other group that I see getting

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Speaker 1: really worked up are people who have babies who are

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Speaker 1: less than twelve months old, so they haven't been able

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Speaker 1: to vaccinate their baby yet because it's so young, and

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Speaker 1: they get militant about it. There's no other way to

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Speaker 1: describe it. You know, the work that I do is

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Speaker 1: largely with antibiotics and not with vaccines, so I'm usually

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Speaker 1: coming in trying to figure out how do I treat

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Speaker 1: the infection after it's already occurred, and the vaccines are

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Speaker 1: much more effective for preventing the infections. But you know,

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Speaker 1: this is a contentious topic, and you're right. I've written

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Speaker 1: about how sometimes the vaccines that we try to design

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Speaker 1: aren't as good as we would like them to be.

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Speaker 1: You're on the New York Presbyterian Hospital Ethics Committee. What

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Speaker 1: do you folks look at? Oh, this is one of

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Speaker 1: the most fascinating jobs you could possibly have, which is

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Speaker 1: that when doctors find that they're doing something that they

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Speaker 1: don't feel comfortable with, or a patient thinks something is

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Speaker 1: happening that doesn't seem right, they can ask an ethicist

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Speaker 1: like me to come in and to produce a judgment

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Speaker 1: of what's right and what's wrong. And what's fascinating about

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Speaker 1: that is that it's not always what's legal. So there,

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Speaker 1: you know, there are times where I'll say, well, legally

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Speaker 1: you're allowed to do this, they say, They would say

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Speaker 1: to me, I'm not asking you for a legal opinion.

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Speaker 1: I'm asking you for an ethical opinion, and I'll give

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Speaker 1: you an example of it, and let me ask you Andy,

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Speaker 1: I'll due respect here, I mean, I mean nothing derogatory.

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Speaker 1: But are you playing God when you do this? Well,

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Speaker 1: I'll give you an example and I'll let you decide.

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Speaker 1: A twelve year old boy has liver cancer and he

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Speaker 1: needs to have his tumor removed, and the parents say,

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Speaker 1: we don't want the tumor removed, we want to pray

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Speaker 1: the tumor away. What should happen in the third and

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Speaker 1: says I can cure this, but I need to operate

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Speaker 1: on this child, And the family says no. They turn

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Speaker 1: to an ethicist and say, what do we do here?

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Speaker 1: And what you have to take into account are all

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Speaker 1: kinds of you know, value judgments and legal precedents and

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Speaker 1: trying to figure out what's a solution that's in the

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Speaker 1: best interest of the child, but also you know, respects

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Speaker 1: the religious views of the family, make sure that the

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Speaker 1: surgeon is doing what's right. And sometimes, yeah, you feel

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Speaker 1: like you're playing God. It's a really important and powerful

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Speaker 1: position to be in. See the position I would have taken,

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Speaker 1: I would have prayed that the operation went, well, yes, exactly,

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Speaker 1: You're exactly right. We got a seat for you on

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Speaker 1: the Ethics Committee. Absolutely. I mean, I think a blend

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Speaker 1: of mainstream medicine and prayer, in pharmacy, in you know,

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Speaker 1: natural supplements, a combination of them probably is the best

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Speaker 1: way to do something. I think you're probably right, and

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Speaker 1: I'll tell you pray with patients. I talk to them

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Speaker 1: about supplements, I talk to them about mainstream medicine. Clearly

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Speaker 1: not you know, we don't have all the answers, and

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Speaker 1: I think that it's good to have a blend of approaches.

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Speaker 1: This statistic I had before you came on, that twenty

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Speaker 1: three thousand people die each year from antibiotic resistant infections.

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Speaker 1: Is that number going to go up or down? That

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Speaker 1: number is going to skyrocket. In fact, the prediction from

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Speaker 1: the World Health Organization is that by twenty fifty it's

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Speaker 1: going to be ten million people worldwide every year dying

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Speaker 1: from superbugs worldwide, and yes, worldwide, and it's going to

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Speaker 1: be a bigger issue than heart disease or cancer. And

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Speaker 1: this is why I felt such urgency writing about superbugs

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Speaker 1: is because people don't really talk about it that much.

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Speaker 1: They think about it or they'll get an article forwarded

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Speaker 1: to them. But this is really important because at the

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Speaker 1: time when we need new antibiotics, the companies that make

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Speaker 1: them are getting out of the business. The pharmaceutical industry

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Speaker 1: has decided that this market is broken. And one of

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Speaker 1: the proposals that's on the table that you're going to

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Speaker 1: be hearing about from politicians is something called a push incentive,

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Speaker 1: where we can give tax breaks to the pharmaceutical industry

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Speaker 1: if they promise to invest some of the excess profits

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Speaker 1: into new antibiotics. People think that's a great idea. Some

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Speaker 1: don't listen to more Coast to Coast AM every weeknight

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Speaker 1: at one am Eastern and go to Coast to Coast

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Speaker 1: am dot com for more