Sanjay Gupta On Medical Miracles, 'Cheating Death'

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Sanjay Gupta On Medical Miracles, 'Cheating Death'

DAVE DAVIES, host:

This is FRESH AIR. I’m Dave Davies, senior writer for the Philadelphia Daily
News, filling in for Terry Gross.

If a relative has been in a deep coma for months, how do you know when it’s
time to let go? When a team of emergency room doctors and nurses work to revive
a heart-attack victim, at what point do they give up and declare the patient
dead?

My guest, Sanjay Gupta, says those questions are getting harder to answer as
new medical treatments enable doctors to save and revive patients whose hearts
have stopped beating for long periods of time or who’ve seemed brain dead for
weeks. Gupta is a practicing neurosurgeon and associate chief of neurosurgery
at Grady Memorial Hospital and an assistant professor at Emory University
Hospital in Atlanta. He’s also a medical journalist. He’s a columnist for Time
Magazine and chief medical correspondent for CNN. His new book is “Cheating
Death: The Doctors and Medical Miracles that Are Saving Lives Against All
Odds."

Well, Sanjay Gupta, welcome to FRESH AIR. I thought we’d begin with this
remarkable story that you tell early in the book of this Norwegian skier who
takes a plunge in the mountains and gets trapped in freezing water for
something like two hours and manages somehow to recover. How?

Dr. SANJAY GUPTA (Associate Chief of Neurosurgery, Grady Memorial Hospital;
Author, “Cheating Death: The Doctors and Medical Miracles that Are Saving Lives
Against All Odds"): It is a remarkable story, even for someone like me who’s
been studying this for a couple of years, who’s had the opportunity to travel
around the world and talk to the foremost researchers in hypothermia, in
extreme survival. This story is sort of the pinnacle of even that. This was a
woman who has, I guess, the dubious honor of being the coldest-ever human being
who subsequently went on to live. This is a woman who was declared dead in a
hospital in Tromso, Norway, and now is a practicing physician at that same
hospital.

She was found after she fell into a stream, a sort of frozen stream on a very
cold place, and this is Tromso, Norway, which is north of the Arctic Circle in
one of the northern-more points of Norway. What we know now is that she
struggled for around 30 minutes or so. She was probably getting pockets of air,
which is why she could last that long. And then she just stopped, and by the
time they got her out of that frozen stream, she was dead. She had no
spontaneous respiration. She had no spontaneous heartbeat. She had no blood
pressure. Her pupils were dilated, indicating that her brain had become
swollen. She was dead, and it was at this point that I think that a critical
decision was made. The decision was to go ahead and leave her cold. The idea
was that this cold could somehow be protective. It could somehow stimulate an
almost hibernation-like reflex in the body. We know that there was no oxygen
traveling through the body, but because she was cold, the body wasn’t really
demanding oxygen, either.

DAVIES: How cold was she? How cold was her body?

Dr. GUPTA: She was 13.7 degrees Celsius, so right around 55 degrees or so. And
again, that’s the coldest recorded temperature of someone actually surviving,
someone surviving.

DAVIES: And how long did they decide to leave her in this hypothermic state?

Dr. GUPTA: Several hours. They did not warm her up at the scene, which is what
often happens, even with blankets, and then warm saline and things like that.
And they did not warm her up right away when she finally got to the hospital.
They waited a few hours and then slowly, very slowly started to re-warm her
using these temperature gradients, so just a few degrees at a time.

DAVIES: And what happened?

Dr. GUPTA: What happened is that, you know, they got her in there, and they
realized that, you know, she really had no heartbeat. And sometimes you can’t
tell in the field, you know, it’s tough to check a pulse, but now they have –
they’re doing an echocardiogram, directly looking at her heart, and she really
has no heartbeat. So now they’re very concerned, and they say we’re going to
slowly start to re-warm her, and we’re also not going to give her any extra IV
fluids.

One thing they learned is that when you start to go into this hibernation-like
state from cold, from hypothermia, all your blood vessels become very leaky.
They just leak fluid. So if you give a lot of fluid, that fluid starts to leak,
and if it leaks into the brain or into the lungs, that can cause death.

So they gave no fluids, slowly re-warmed her, and then there was just this
great moment where all of the sudden the heart, which was doing nothing - you
had true, what’s known asystole, that flat line on EKG, and all of a sudden it
started to come back. And it was a magical moment as they described it to me
when I was visiting them in Tromso, but I think they were still concerned that
her brain had gone for too long without oxygen. How could the body tolerate
this? But as I said, you know, she slowly recovered. At first, she was
paralyzed, almost, in her entire body from lack of oxygen to her brain, but
over a period of time, she continued to recover, finished her medical school,
which she was a medical student at the time, and is now a doctor in that same
hospital.

DAVIES: The subject that you discuss after this remarkable story really
involves the use of hypothermia, chilling a body as a therapy, and if I
understand what you’re saying, that in many acute cases where someone has a
heart attack or a severe trauma and looks as if, you know, they’re going to die
or maybe actually stop breathing, that deliberately lowering the body
temperature can be – I don’t want to use the word miraculous, but a remarkable
therapy, right?

Dr. GUPTA: It really can, and you know, with this particular skier, obviously
it wasn’t intentional, but in some ways it was actually almost a perfectly
executed form of hypothermia. The way her body chilled, at the rate that it
chilled, they were able to piece that together, actually worked very much in
her favor. They figured that out in retrospect. But every day, hospitals use
hypothermia, for example when people are having certain types of open-heart
procedures, having certain types of brain procedures, it is used. The idea is
that, look, we know for a period of time, we’re going to put the body in a
state where it can’t deliver. It can’t do what it’s supposed to do, at least
the heart can’t pump oxygenated blood throughout the body.

So we have a couple of choices here. One is – one of those choices is to reduce
the demands of the body. Oh, not enough oxygen there? Well, let’s make it so
the body doesn’t need as much oxygen. And that’s sort of where hypothermia,
among other things, sort of comes in.

DAVIES: Now, is this a technique that can be used by paramedics as they arrive
in, you know, at medical emergencies around the country? Are they starting to
use hypothermia as a therapy?

Dr. GUPTA: There’s great literature on this now. If you’re walking down the
street, and you see someone have a sudden cardiac arrest, their chances of
survival is very much related to a couple of different things.

One is if someone helps them. That greatly improves their chance of survival as
you might imagine, a bystander, but also this idea of hypothermia. So
paramedics now, in addition to having their medication bag and their medication
bag and their defibrillators, and several cities now around the country are
carrying these ice chests filled with cold saline, ice-cold saline, and as part
of their therapy, right in the field, is to immediately start infusing this
ice-cold saline to start to bring the temperature down.

So when you think about things like hypothermia, what you’re really doing more
than anything else is stealing away some time from death. You know, death and
life are sort of battling it out at this point in some critical situation,
perhaps after a cardiac arrest, and what you’re saying is, you know, if we
could only have a few more minutes, if we could only have a few more hours, the
body’s going to be able to recover from this. So let’s buy a few more hours
using something like hypothermia. That’s one way to do it.

DAVIES: You also write that one thing that emergency medical personnel have
learned is that you actually get better results when administering CPR if you
leave out the mouth-to-mouth resuscitation. Why?

Dr. GUPTA: I found this to be one of the most fascinating things that I’ve
really covered for a few different reasons. If I can back up for one second and
just say that if you, you know, ask people, if they see someone, you know,
collapse in front of them on the street, would they help? And most people will
say yes in poll after poll, but that doesn’t seem to translate to what actually
happens.

People seem to not help as much as they say they’d like to. What we know is if
someone has a sudden cardiac arrest and there’s no bystander help, their chance
of survival is around three percent. If someone helps, just jumps in and helps,
that survival rate can go up by four to 500 percent, so a significant
improvement.

When they ask people: Why wouldn’t they help, what was the concern? And the
concern really seemed to be more about mouth-to-mouth resuscitation. They were
concerned A, that they didn’t know how to do it, or they just didn’t feel
comfortable doing mouth-to-mouth resuscitation.

So these researchers say okay, well, let’s sort of think about this and figure
out models. Can we just create a chest-compression-only model, and if so, how
would it work, and how effective would it be? And cutting to the chase here,
after years of research, they figured out not only was it as effective as
cardiopulmonary resuscitation where you’re giving breaths, they found it was
actually more effective.

And the reason is pretty simple. The reason is that if someone has a sudden
cardiac arrest, they probably have a fair amount of oxygen already in their
blood. After all, they were just breathing. So the oxygen is there. The key
now, more than anything else, is to get that oxygenated blood moving through
the body. So just call 911, push on the chest 100 times a minute and don’t stop
for anything. That seems to be the key. Move that oxygenated blood throughout
the body, and then when the paramedics get there, you know, they continue the
process until they get to the hospital.

DAVIES: Dr. Sanjay Gupta’s new book is called “Cheating Death: The Doctors and
Medical Miracles that Are Saving Lives Against All Odds.” We’ll talk more after
a break. This is FRESH AIR.

(Soundbite of music)

DAVIES: If you’re just joining us, our guest is Dr. Sanjay Gupta. He is a
neurosurgeon and medical journalist. He’s written a new book about the line
between life and death and medical efforts to reverse the effects of dying
called “Cheating Death."

One of the more fascinating parts of this book involves brain death. You know,
we’ve come to regard death as less a function of the heart stopping its beats
than when the brain ceases to function. And you describe some treatments that
have shown some remarkable results in reversing these, you know, persistent
vegetative states that some patients are in. Give us an example of a case that
illustrates some of these, you know, some of these new treatments.

Dr. GUPTA: Yeah, what we sort of realize is that this idea that the brain is
really dead, you know, looking at an EEG, for example, which measures
electrical activity of the brain and seeing it as silent or not having any
activity, may be not that good of a measure after all, or even showing low
blood flow to the brain or no blood flow to the brain, may be not a very good
measure. There’s a few stories in here that I think really gave me a lot to
think about when I heard them and then researched them and then validated them,
where patients could describe with surprising accuracy exactly what was
happening around them and to them at a time when doctors thought that they were
brain dead.

The hypothermia, which we talked about earlier, was something that seemed to
make a difference with patients who we thought were brain dead and subsequently
made a recovery. Putting the brain to sleep again, with the combination of cold
and some medications, really seemed to make a difference.

DAVIES: Just to - we’re talking about cases where someone has had a severe head
injury or perhaps a heart attack and have lost blood flow to the brain, and
their brains appear not to be functioning. You’re saying that in cases like
this, where it appears there is no hope, and this person lying in the bed,
maybe on a ventilator, is never going to come back, we’re never going to see
them, there are cases where interventions have actually produced a reversal of
these? And you said one of them is hypothermia? I mean, they chill the body,
chill the brain? How does that work?

Dr. GUPTA: Yeah, that’s exactly right. They chill the brain, and it works in a
sort of amazingly simple way. I mean, they literally take ice packs and wrap it
around the person’s body. They use cold saline, injecting it into the
bloodstream, and they sort of put the brain into a deep chill. That’s
essentially what they’re doing. And with that, they’re hoping for two things.
One is that the brain will repair itself, if there was some sort of traumatic
injury during that time, but also they’re sort of turning the brain off for a
while. You know, they know that the brain doesn’t like even a small amount of
time without getting lots of nutrient-rich blood bathing it, and if you, you
know, turn it off, it doesn’t really need that blood anymore. So those are sort
of the two basic principles of that.

But I think, you know, this idea that there are patients that we say okay,
they’re brain dead, and in the United States that means they’re dead. In
different countries, it means different things, but we use brain death as a
criteria here in the United States. And then I go talk to these patients. I’ve
looked through their charts. They were declared brain dead. It was written in
their chart as such. And here they are, sitting up talking to me. Hypothermia
probably played a role. Medications probably played a role, but I think the
larger message to me, and what I really spent the last couple years thinking
about was we don’t really know when to give up. And we really don’t know what
dead really means. We thought we did, but here this guy is talking to me, and
you know, a bunch of people with crisp, white coats and hundreds of years of
medical experience combined all urged this man’s wife to pull the plug because
they didn’t think he’d ever recover, and here he is talking to me. What is
dead? That’s what I kept sort of stumbling upon and trying to figure out.

DAVIES: Yeah, I mean, that really has very profound implications. I mean,
anyone who is lying there and appears to be gone, I mean, you know, if their
body is in shape, but the brain isn’t functioning, how would you know when to
ever give up treatment?

Dr. GUPTA: And that was a really difficult thing for me to tangle with in the
book because I’m not trying to malign doctors or certainly indict anybody.
That’s not the purpose at all, and obviously, there are lots of patients who
really won’t recover. I think for the most part, the system works well, but
there are patients who do make these really astounding recoveries, and the
question – you could just call them a miracle or an outlier or say, you know,
we don’t know and chalk it up to that, or you could say let’s really dissect
down why this person lived and is functioning so well when so many others
wouldn’t. What is it about them? Is it about them, or is it about the
techniques, or you know, what were all those micro pieces that came together to
create this remarkable recovery?

DAVIES: And do you feel like, you know – you’re a neuroscientist. I mean, are
folks getting a better handle on what’s happening and how they can tell when
someone will recover and when they won’t?

Dr. GUPTA: They’re starting to get a better handle on it, but I think that
there’s – you know, as often happens in medicine, with some more answers come a
lot more questions. This idea that people’s brains continue to work and
continue to process things, even at a time when we think it doesn’t or that we
even think that it’s dead, really I think in many ways is blowing the lid off
of what we know about neuroscience.

There was a great story of a woman in England who was, you know, essentially
considered to be in a persistent vegetative state. And they put this woman in
what’s known as a functional MRI scanner. That’s a scanner that measures the
activity of brain. It shows where certain parts of the brain are lighting up,
and as you’d expect when they first did this MRI scan, there was nothing
lighting up. This woman was in a persistent vegetative state. Then the doctors,
the researchers in this case, decided to ask her a few questions, and one of
the questions they asked her was about tennis. They knew that she liked to play
tennis. So they said to her – again, this woman who to the world was doing
nothing. She was, you know, just lying there. They said imagine playing tennis.
What would you do? How would you hold the ball? How would you hold the racquet?
What would you do exactly?

And they saw something that I think probably stunned them into silence, and
that is that the motor areas of the brain started to light up. This woman, who
they thought couldn’t hear a thing, was doing nothing, she was imagining
playing tennis because they asked her to do it. The motor areas, the exact area
that you’d expect to light up, was doing just that, and I think that we’re just
starting to learn more and more about what the brain is capable of doing, even
when we think it’s doing nothing.

DAVIES: Right. That also meant that she was hearing and comprehending what they
were telling her when she could do nothing in response.

Dr. GUPTA: Yeah, that’s exactly right, which shows an executive level of
function of the brain. When I delved into it, and I talked to these researchers
specifically about it, they said look, you know, you go around to any place in
the world and look at these diagnoses, persistent vegetative state, you know,
coma, all that sort of stuff, you go to nursing homes where elderly people are
given this diagnosis, and you’ll find that about a third of the time, the
diagnosis is wrong.

I mean, inherent within the definition of persistent vegetative state is some
idea of permanence, this idea that it’s persistent, but in fact, these patients
can recover. We don’t know why for sure, and we don’t know exactly how, but
they can. I think these terms are probably terms that we shouldn’t be using
because we don’t know exactly what’s persistent or permanent by any means.

DAVIES: Do you speak to patients differently now that you know some may be
hearing you that you didn’t think weren’t?

Dr. GUPTA: Yes, I do, and it’s been a conscious decision really over the last
several months because I needed to convince myself. You know, I wasn’t cynical
about whether this could be happening, but I was a bit skeptical. And I started
to read a lot about this, and more than reading the scientific literature,
which I, you know, spent a lot of time doing, just talking to these patients
and really convincing myself that look, this wasn’t by chance. Some of the
stories - it just couldn’t be. I mean, someone remembering exactly where a
doctor placed his glasses when he was thought to be brain dead. They couldn’t
find his glasses. When he finally recovers, he says: I know where my glasses
are. They’re over here. How could he have known that? You know, the only way he
could’ve known that is if he was actually processing things at the time that
the doctor in a rush, sort of, hid those.

So after I convinced myself, I do talk to patients now who otherwise would be
considered either in a persistent vegetative state or having a really, really
low coma scale, meaning that, you know, they’re not interacting or able to
process anything as far as we know. I behave differently around them now.

DAVIES: I can’t let you go without asking you what it feels like not to be the
nation’s surgeon general.

(Soundbite of laughter)

DAVIES: You were – you know, it was widely reported that President Obama spoke
to you about becoming surgeon general earlier this year.

Dr. GUPTA: Right.

DAVIES: And it was reported you looked as if you might be taking it, and in the
end, you said, you know, the demands of your professional life and a desire to
be with your family kept you from serving. Do you look back and wonder what you
might be doing? I mean, you know, never has health care been a more – you know,
more of a public issue than it is today.

Dr. GUPTA: Yeah, well, you know, I’m a big fan of public service. I have been a
public servant before. I’ve worked at the White House. You know, I don’t live
in the world of regrets by any means, and for me, this was a very personal
decision. You know, I have three young children. I would’ve been a commuting
dad for a few years.

One of the things that I didn’t realize as I was going into the process was
that the surgeon general cannot practice surgery anymore. You know, I’m 39
years old. I thought that, you know, if I didn’t practice for four years or
eight years - depending on what happens with President Obama - then I wouldn’t
be going back to being a neurosurgeon, and I just didn’t think it was the right
thing for me. I like being a doctor. I like taking care of patients, and sure,
you know, there’s sometimes a little bit of wistfulness, but I don’t think
there’s any regrets about it. This was a personal decision, and you know, my
family and – we’re very happy with it.

DAVIES: Well, Sanjay Gupta, thanks so much for spending some time with us.

Dr. GUPTA: It was a lot of fun. Thanks for having me.

DAVIES: Sanjay Gupta is a neurosurgeon at Grady Memorial Hospital in Atlanta.
He’s also a columnist for Time Magazine and chief medical correspondent for
CNN. His new book is “Cheating Death: Doctors and Medical Miracles that are
Saving Lives Against All Odds." I’m Dave Davies, and this is FRESH AIR.
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Reggie Jackson, Bob Gibson Slug It Out

DAVE DAVIES, host:

This is FRESH AIR. I’m Dave Davies filling in for Terry Gross.

Few confrontations in sports are as personal and dramatic as a batter standing
in against a pitcher with a baseball game on the line. The batter adjusts his
helmet, tightens his batting gloves, digs into the batter's box and looks
toward the mound. The pitcher fingers a rosin bag and drops it, stares at the
catcher for a sign, then grips the ball in his glove and begins his windup. If
his pitch is a Major League fastball, it will reach the plate in less than half
a second.

The strategies, emotions and sometimes explosive confrontations that arise from
that duel are at the heart of a new book by two legends of Major League
Baseball: Reggie Jackson and Bob Gibson. Jackson was a homerun hitter who won
five World Series rings with Oakland and New York, and earned the nickname Mr.
October for his post season heroics. Gibson was one of the most intimidating
pitchers who ever played, an eight-time All Star who won two championships with
the St. Louis Cardinals. Both were extraordinary performers in the World Series
and both are in baseball's Hall of Fame. Their new book is based on a series of
recorded conversations with writer Lonnie Wheeler. It takes its name from the
distance between the pitcher's mound and home plate. It's called "Sixty Feet,
Six Inches."

Well, Reggie Jackson, Bob Gibson, welcome to FRESH AIR.

Now Bob Gibson, you say in this book that if you were a pitcher today there are
a lot more coaches and trainers and video analysis and they would get you to
try and change your windup and make it more economical, fewer moving parts. You
had a lot of movement in your windup. Was that conscious?

Mr. BOB GIBSON (Former Professional Baseball Player): Well, it was the way I
learned to pitch. And my idea - it wasn’t just my idea – is that I think back
in the days, and even before I pitched, guys would windup and they’d go through
all types of gyrations and the hitter pretty much had to look for the ball.
Where's it going to come from? And I think the more that he has to look for the
better off you are. They started pitching with no windup and as little movement
as possible and more guys started hitting the ball 550 feet. I think that the
hitter needs to look and try to figure out where that ball's coming from.

DAVIES: You write in the book, and this book is a collection of conversations
with you guys, and at one point you say I had a violent delivery. I wanted to
be a gathering storm and blow that fastball in there with all the force and
fury I could muster. Was that Bob Gibson just really being an intimidating
force out there with that windup?

Mr. GIBSON: Well, yeah. Kind of, except I had just more than a fastball and I
think what made me such a good pitcher...

DAVIES: Right.

Mr. GIBSON: ...was that my slider was just as good as my fastball and I had
just as good a control with my slider as a fastball. And what makes you really
effective is that you get guys up there looking for a 95 - 97 mile an hour
fastball and you throw them a slider that's 89 and 90, and I think that's why I
did so well in the Series because those guys were looking for all fastballs.

DAVIES: And coming out of that all that different motion, they're worried about
the speed and then suddenly the ball's curving, it’s dipping, it's off-speed...

Mr. GIBSON: Oh yeah. They're looking for the ball off of me. You know, what the
hitter likes to do is to see where that point of release is coming from, and I
think it's more difficult if your arms are waving and flapping and not that
everybody can do that. I was fortunate enough to be able to do that. But I
think the more he has to look at or look for, the better off you are.

DAVIES: Reggie Jackson, would you be bothered by a pitcher's windup if there
was a lot of motion there?

Mr. REGGIE JACKSON (Former Professional Baseball Player): You try not to. I
know that I liked it when a guy had almost a pitching motion of a catcher, just
kind of a nice easy throw, not too much movement. It made it a lot easier to
follow. But following a Gibson, following a Tiant, a Juan Marichal, a Warren
Spahn, a Vida Blue, Jim Palmer, guys with big high kicks like Steve Carlton, it
makes it tougher. Nolan Ryan had a big kick. Burt Blyleven had a big kick. And
when these guys had all that going on and then threw in the high 90’s to go
along with it with a 12 to 6 breaking ball, it made it an awful lot tougher I
thought.

DAVIES: You guys are both in the Hall of Fame because you were great players in
the regular season, but you really really stood out in championship games when
it was all on the line. You both were incredible performers in the World
Series. Reggie Jackson, nobody else in the game has hit four homers on four
consecutive swings in the World Series like you did in 1977. You have five
World Series championships. What were those big games like for you? Did it feel
different? Was your focus different?

Mr. JACKSON: It was a battle between me and the guy on the mound. And I knew
everything about who I was facing, even in the other league, we had scouting
reports. I paid attention to them. I watched. I learned. I understood. I felt
prepared. And I really wanted the guy that I was facing to be at his best
because then it made the thinking easy because you understood what a guy had,
what was his best pitch or, say, like facing a guy like Bob Gibson in the World
Series, be proud of what you got because then I know what I'm going to get. I
may not be able to handle it, but the thinking gets simple.

DAVIES: Mm-hmm.

Mr. JACKSON: He's not going around me unless the situation calls for it,
meaning pitch around me and face another hitter depending on the score or the
situation. I felt I was going to have a good swing. I felt prepared, so the
game got a little more simple. I didn’t have any clutter in my mind. It's me
and you. I’m ready and so are you. I hope you had a good night's rest. I hope
you had a big breakfast.

(Soundbite of laughter)

Mr. JACKSON: Kiss your wife and your baby goodbye. Get your insurance paid up.

DAVIES: Because here it comes.

(Soundbite of laughter)

Mr. JACKSON: Grab that can over there before you come in here.

Mr. GIBSON: Well, he's right about that because when we got into the Series, he
was going to get what I had unless there was a situation where I needed to
pitch him and I didn’t have the problem…

DAVIES: That meaning walk him and face the next guy, right?

Mr. GIBSON: Sure. Yeah. Yeah. And you know, Reggie’s up there and Reggie's not
going to get a hit every time he's up there, nor is he going to hit a homerun
every time he's up there. But he's probably more capable of hitting one than
the guy behind him, so why do a silly thing, especially if you’re in a
situation where he could win - he could beat you a ballgame, you would pitch
around him, that meaning pitch to the next hitter, a guy that you know you can
get out or you suspect you can get out a lot better than him. If I don’t make a
mistake on Reggie I'm going to get him out. I don’t know whether I'm going to
make a mistake. If I do make a mistake, he's going to hit it. So let's try
somebody else and that's the way I looked at it.

DAVIES: The fascinating thing hearing you two talk is that you never faced each
other either in the postseason or in the regular season, right?

Mr. JACKSON: All Star game.

DAVIES: In the All Star game, right? And...

Mr. GIBSON: Yeah. He keeps telling me he hit a double off of me and I don’t
remember.

(Soundbite of laughter)

DAVIES: We're speaking with Bob Gibson and Reggie Jackson. They collaborated
with Lonnie Wheeler on the new book "Sixty Feet, Six Inches." We'll talk more
after a break. This is FRESH AIR.

(Soundbite of music)

DAVIES: If you’re just joining us, our guests are Hall of Fame ballplayers
Reggie Jackson and Bob Gibson. They collaborated with Lonnie Wheeler on a new
book called "Sixty Feet, Six Inches."

Bob Gibson, I’ve got to ask you about the 1964 World Series where you pitched
in game seven on only two day's rest – that’s very little rest - after having
won game five, took the game all the way into the ninth inning with a 7-3 lead,
then gave up two homers, and your Manager Johnny King left you in. You
finished. You won the game. You were the most valuable player of the series.
And afterward, when Johnny King asked why he left Gibson in, who seemed to be
tired after pitching nine endings on only two days rest he said, I never
considered taking him out. I had a commitment to his heart. Tell me about that
day and that relationship.

Mr. GIBSON: Well, first you’ve got to - I blame Johnny King for those last two
homeruns that they hit off of me.

(Soundbite of laughter)

Mr. GIBSON: I go out and Johnny says Bob, I don’t want you to get fancy out
there. I want you to just throw the ball, every pitch a fastball right over the
middle of the plate. He says I don’t think that they're going to hit four
homeruns. And so after the second one, I looked into the dugout and Johnny was
getting a drink of water. I was looking to see where are you John? Are you sure
they're not going to hit four?

But, you know, I have a commitment to his heart. I can't tell you exactly what
he had in mind when he said that. I know that he had plenty of confidence in me
and he felt that he was going to just go down the line with me win, lose, or
draw. Now, that's saying something for him. I didn’t want to let him down
period. And I was tired. I was really tired out there. But he was going to
leave me in there and so I was going to give it everything I had.

DAVIES: Yeah. I think what he meant was that this man has a will to win like no
other.

Mr. GIBSON: Yeah, but you keep throwing that fastball over the middle of the
plate...

(Soundbite of laughter)

Mr. GIBSON: ...that will might dwindle.

DAVIES: I want to talk about throwing inside and guys getting hit by pitches
because you guys are both on opposite ends of this. And Bob Gibson, with your
permission, I'm going to read a section from the book that you’ve collaborated
with Reggie here, where you’re talking about - you’re saying basically that you
liked to pitch on the outside part of the plate, that is the part - pitch away
from the batter and you say that nobody's really going to square on a pitch and
hit you when you pitch it outside. And then you write, unless he cheats. What I
mean is unless he leans in and dives at that outside corner. Obviously, I can't
let him do that because that's where I'm trying to pitch. So if he tries it, I
have to stand him up a little bit. Think of the hitter as dog with an
electronic collar. You just administer a slight correction, as they call it, if
he tries to get out of his yard. Throw the ball inside and he can't wander into
the wrong area. That's what you were doing when you pitched inside, right?

Mr. GIBSON: Pretty much. Yeah. I was getting him to think about the ball
inside. Now Reggie - Reggie likes to hit the ball out away from him. That's
where I want to get him out. So what do I do to keep him from hitting that ball
out away from him? I pitch him inside. And I don't just pitch him inside once,
I come in there often. And so now, he's going to think about me pitching him
inside. If he's thinking about that ball inside, then I can get him out away.
If he's thinking outside and I throw outside, he's more capable of hitting the
ball. But if I get inside, and do it often enough, he's not going to go leaning
out there because sometimes when I'm pitching inside and he's thinking outside,
you know, the ball comes inside and I'll hit him.

(Soundbite of laughter)

Mr. GIBSON: So - and he knows it. So, he says well, maybe he's going to come in
here. More often than not I'm going to be away from him. But it just might be
that one time that I'm not away from him and he's going to get hurt. It'll come
in and bite him.

DAVIES: Well, and a Bob Gibson fastball can hurt you, no doubt. Reggie Jackson,
you know, the lore is that pitchers now throw at and throw close to hitters a
lot less than they did years ago. Back when you played, how did you feel when a
pitcher, you know, knocked you down, threw it were in so that you had to jump
out of the way? What were the circumstances under which that was okay?

Mr. JACKSON: Well, you added something there that's very important.

DAVIES: Okay.

Mr. JACKSON: There were circumstances where it was okay. If you hit a good
hitter on the other ball club and somebody on our club was going to get hit
and, you know, certain pitchers would make sure they hit either the most
important guy or if you hit the second most important guy over there you’d hit
the second most important guy on our club. And they may just single out and say
okay, we're going to knock Reggie down.

DAVIES: Right.

Mr. JACKSON: We're going to hit him. And you understood it at times, especially
if we started and a guy hit a couple of homeruns against us and the pitcher had
to hit the guy in order to just, you know, get him to respect him a little bit.

DAVIES: Now I've got to interrupt you there because that's one thing that I
never did understand. If someone hits two homeruns fair and square, is having a
great day, that's a reason to throw at him?

Mr. JACKSON: Yeah. Go ahead, Bob.

DAVIES: Bob Gibson, yeah.

Mr. GIBSON: Well, and let me say this: A guy hitting a homerun off of me is not
a reason for me to throw at the guy. If the guy hits my best pitch in a good
location and he hits a homerun that's a reason for me to throw at him. You know
what I mean? I don’t want him getting my best pitch. There's a lot of mistakes
that I'm going to make and when I make a mistake, he's capable of hitting a
homerun. Well, that's my fault. But when he goes out and get my really, really
good pitch and hits a homerun off it, hmm, he might have to get hit the next
time.

DAVIES: Now when you say hit, you’re talking about not just coming close,
you’re talking about drilling him in the ribs?

Mr. GIBSON: Hit you in the back, in the butt.

Mr. JACKSON: Well, yeah, in the ribs or somewhere in there. Somewhere where
it’s not bad. If you through at a guy's head, then we all feel, pitcher as well
as hitter that, you know, you’re trying to do some damage or you’re affecting -
you’re messing with my livelihood.

DAVIES: Yeah.

Mr. JACKSON: But there are times in baseball when I was coming along and Bobby
too that you just hit guys and that was part of the game. There is no question
that in the '50s and '60s black players got thrown at more. That’s not a
negative comment. It may come out that, way but that’s the way it was. Hitting
another player was part of the game, hitting a player in the head is not. When
you hit a player in the head, you’re more apt to get some fisticuffs or, you
know, bring both teams out on the field, but it was more accepted that – in the
‘50, ‘60s and ‘70s. I think nowadays it’s a little over-policed because I will
always believe that knocking a hitter down, even hitting a hitter at, sometimes
is part of baseball.

DAVIES: Right. And there was this tradition of retaliation, which still happens
today, where a pitcher from one team hits a guy on another team. Then the
batting team’s pitcher, when they get back out on the field, will be expected
to hit one of their hitters. And then, Bob Gibson that might have put you in
the position then sometimes of having to plunk somebody, who, because of
something that had happened while your team was at bat - how did you feel about
that? Having to go out there - they call it protecting your team, right?

Mr. GIBSON: Yeah. I had no problem with it at all. Now, they used to say, well,
wait for the pitcher and get him. I said, no. The pitcher might not even be in
the game when, you know, it’s his time to hit. So, I would usually, the next
inning I’d pitch I’d hit the first guy up and then maybe I would get the best
hitter on their team. But I wanted to retaliate so they wouldn’t forget, you
know, and I just wouldn’t wait. And they knew this, the first guy that came up
to the plate, he was really…

Mr. JACKSON: (unintelligible)

Mr. GIBSON: …light slippers.

(Soundbite of laughter)

DAVIES: And…

Mr. JACKSON: Yeah. Nowadays they promote, wait till the right time, wait till
you have two outs, wait till you have a lead. And so, pick your spot is what
it’s called.

DAVIES: Well, and umpires will throw you out. They will warn both benches, and
then when you hit somebody you get tossed out, which didn’t happen…

Mr. GIBSON: Oh, I don’t like that. I had a situation, it was in San Diego. Lee
Wire(ph) happened to be the umpire. And we got somebody hit on our ball club.
And they knew my reputation as retaliating, you know, I wasn’t – I’m not trying
to hurt anybody. I’m only going to hit him. And after the inning - the half
inning was over and I’m walking to the mound, Lee Wire was walking along with
me. Now, Bobby…

DAVIES: Said the umpire…

Mr. GIBSON: Now, Bobby, if you hit somebody it’s going to cost you $50. It’s
going to cost you $50. And I said Lee - and at that time I was making pretty
good money - I said, Lee, I have a whole bunch of $50, so you start adding them

up.

(Soundbite of laughter)

Mr. GIBSON: And he didn’t kick me out. First guy up, I didn’t hit him. I
knocked him down.

DAVIES: Okay.

Mr. GIBSON: And he didn’t kick me out of a ballgame.

DAVIES: Sent the message. You know, one thing that I’ve always – it’s always
fascinated me is when ballplayers get hit, and I know it hurts, they never rub
it. What’s that about, Reggie Jackson?

Mr. GIBSON: Oh, that’s not true.

(Soundbite of laughter)

Mr. JACKSON: If you get hit, and it hurts, I’m going to rub it.

Mr. GIBSON: Willie Davis…

DAVIES: I see guys just walk it off and I don’t how they do it.

Mr. GIBSON: Willie Davies was hitting off of me and my slider was 89, 90 miles
an hour. And he swung at a slider of mine and it hit him in the knee…

(Soundbite of laughter)

Mr. GIBSON: …and he didn’t rub it. And I was wondering, oh, I wonder what
that’s all about? And he hit a ground ball and he got halfway to first and
fell. I said, now, that’s more I like it.

(Soundbite of laughter)

Mr. GIBSON: Now I knew.

Mr. JACKSON: He’s got to rub his finger or something.

DAVIES: You know, Reggie Jackson, I know that you were hit in the head a few
times and hit once in the face by Dock Ellis. And I’m just wondering, after
something like that, how do you stand in ever again 60 feet away from a guy
that can throw a fastball? How– does it affect your nerves?

Mr. JACKSON: Well, I went out to the ballpark after I got hit in the head one
time - in the face by Dock Ellis - and around 1 o’clock because I was – I sat
out two days. And I went out to the ballpark the next day with a big swollen
face and almost a closed eye because I was going to play that night. And I had
the batting practice pitcher, a guy by the name of Jimmy Frey, who was manager
for the Cubs, throw at me in batting practice. And I hit for about 45 minutes
and got over that. There was another time in Texas, a guy had hit me in the
head by the name of Mike Paul, a left-hander for Cleveland, I played against
him in college. He hit me in college and then we got together in the pros. I
hit a home run off him in Cleveland, and then about four or five years later he
was pitching for Texas. And I came up to the plate and there were two guys on
and the catcher was kid named Kenny Suarez, who was about five-foot-seven and
the umpire was Bill Haller(ph). And I got in the batter’s box and the first

pitch that this guy threw to me was up and in. And I turned around to Ken
Suarez and I said, I’m not going to be able to get to the pitcher’s mound, but
if he hits me I’m going to rip your face mask off and whoop you right here at
home plate.

(Soundbite of laughter)

Mr. JACKSON: He called time and went to the pitcher’s mound and he looked at
the umpire and the umpire looked at me and he went to the pitcher’s mound and
said something to Mike Paul(ph) and the next four pitches – the next three
pitches was over in the right hand - batter’s box.

(Soundbite of laughter)

Mr. JACKSON: I got walked.

Mr. GIBSON: I like that, I like that. I’m going to fight you. I think though if
I had been catching, you and I would have been rolling in the dirt.

Mr. JACKSON: (Unintelligible).

Mr. GIBSON: Oh, yeah.

(Soundbite of laughter)

DAVIES: We’re speaking with Reggie Jackson and Bob Gibson, both Hall of Fame
ballplayers who have collaborated on a new book called, “Sixty Feet, Six
Inches.” We’ll talk more right after a break. This is FRESH AIR.

(Soundbite of music)

DAVIES: If you’re just joining us, our guests are Hall of Fame ballplayers
Reggie Jackson and Bob Gibson. They collaborated with Lonnie Wheeler on a new
book called, “Sixty Feet, Six Inches.” Reggie Jackson, I have to ask you one
thing that I’ve always wanted to ask a great hitter. And that is, when a
pitcher releases the ball, it’s on top of you so quickly and you have a much
better chance if you can tell whether it’s a fastball or a slider or a curve.
Can you actually see the rotation of the ball and tell what kind of pitch it
is?

Mr. JACKSON: Dave, if you can’t see the rotation and tell if it’s a sink - a
fastball, then you have to be able to tell whether that fastball is a two
seamer or a four seamer. You have to be able to recognize if it’s a slider or a
curveball. You have to be able to recognize if it’s a changeup or a split-
finger. And if you can’t, you’re not going to be a Major League player. You’re
not going to be a good player. Any other player that’s playing everyday, that’s
hitting above .275 or .260, he can see what’s coming when it leaves the
pitcher’s hand.

DAVIES: So that – in that spilt second you can pick up the rotation?

Mr. JACKSON: Yes, you better.

DAVIES: That’s amazing.

Mr. JACKSON: You better.

DAVIES: That’s amazing.

Mr. JACKSON: A guy with a slider like Bob, you’d see a dot, you’d see a dot in
the ball and you would – yeah, you’d see that dot. If that dot got big and you
saw it too clear, it was a bad slider and it was going to leave the ballpark
when you swung at it.

DAVIES: You saw a dot. What do you mean by the dot?

Mr. JACKSON: Just the spin of the baseball with a slider…

DAVIES: Mm-hmm.

Mr. JACKSON: …the rotations in the seams form a dot, a red dot, you know, on
the ball as it comes at you…

DAVIES: Right.

Mr. JACKSON: …when it’s a real good slider. The guys will say, boy it’s tight,
it’s electric. If it got sloppy, the dot got big and then it became a hanger.
It became a bad fastball.

DAVIES: And Bob Gibson, I have to ask you about one more moment. I don’t
remember the year but you always talked about how Roberto Clemente was the kind
of player that would just leap at and lunge at pitches away from him wherever.
And he once hit a line drive at you that hit you so hard it broke your leg,
right?

Mr. GIBSON: Yes, that happened.

DAVIES: And you pitched for three more batters before you left the game?

Mr. GIBSON: Well, I pitched to two more, anyway. And I used to get Clemente out
fairly easily and it was because of him jumping and leaping out at that ball
away. And I used to throw the first pitch inside, knock him down. I mean, knock
him down on purpose. Didn’t hit him, I don’t think I ever hit him. But it would
make him so mad that he would swing at everything. And then the next pitches, I
wouldn’t even throw a strike. I would track him out. I’d get him out. He’d hit
ground balls.

And this one time in particular was in 1967, it was right before the All Star
break. And I got a ball up and away. You could get Clemente out if it was down
and away, down and away. And they’d tell you to pitch guys low and away, and
high and tight. And that means pitching them up and in, and low and away. And
if you get it up and away to Clemente, he’d hit the ball to right field like a
left-handed pull hitter. I mean, he just really smashed it.

And so, I got the ball up a little bit but it wasn’t letter high, it was about
belt high. And he hit a line drive and about the time my right leg hit the
ground, I wasn’t able to get my glove down quick enough and the line drive hit
me right on the ankle, broke my fibula. I didn’t know it was broken. I just
knew it hurt a lot and so, our trainer came out. And back in those days, they
would spray this ethyl chloride on your leg and it would freeze it. And you
wouldn’t feel anything.

And our trainer freezed it. He put that stuff on it and I said - he says, how
you feel? Well, I felt fine. I couldn’t feel it. And so they – I threw a couple
of pitches and I said, yeah, it’s okay. They went back away and I started
pitching. And I ended up getting three and two on Donn Clendenon. And I knew
that he was going to look for a fastball, so I was going to put a little bit
extra on it. And I put a lot of weight on that bone and it popped and it
snapped in half. And it was really kind of scary. I looked behind me because I
thought somebody walked up and hit me with a stick. But I fell over and I
passed out. Next thing I know, everybody was looking at my face. But I didn’t
know it was broken. I just thought I’d gotten a little bruise on it. Today,
that would never happen. You get hit like that and they take you out. They take
a little better of care of you.

DAVIES: So, that’s how you get Bob Gibson out of a game?

(Soundbite of laughter)

Mr. GIBSON: Well, it certainly got me out of our game that day.

DAVIES: Well, Bob Gibson, Reggie Jackson thanks so much. It’s been fun.

Mr. JACKSON: Okay, my friend, thanks for having us.

DAVIES: Bob, thanks a lot.

Mr. GIBSON: Well, you’re very welcome.

DAVIES: Bob Gibson and Reggie Jackson are both Hall of Famers who have seven
World Series titles between them. Their new book with writer Lonnie Wheeler is
called, “Sixty Feet Six Inches.”

(Soundbite of song, “Take Me Out to the Ballgame”)

Unidentified Man (Musician): (singing) Take me out to the ballgame. Take me out
to the crowd.

DAVIES: You can download podcast of our show at freshair.npr.org. For Terry
Gross, I’m Dave Davies.
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