I am Dr. Sanjay Gupta, neurosurgeon and Chief Medical Correspondent at CNN. Ebola can be terrifying but when it comes to protecting ourselves and the world, knowledge is power. AMA!

I know that ebola is relevant at the moment, but we can't forget that you performed brain surgery with a black & decker power drill in Iraq... can you tell us more about that experience? I can't imagine the stress you must have been under.

Thanks for your question. At times, the job can be quite stressful, but I'll be the first to tell you: Whether it's the health care providers taking care of Ebola patients or the Marines with whom I was embedded. Their lives and jobs are far more stressful than mine. The patient that I operated on in Iraq was a young Lieutenant, who had been shot in the back of the head and was thought to have died in the field. When they brought him to the tent where I was embedded with the 1st Marine Expeditionary Force, we realized that he still had a pulse. I was asked to operate on him by the military team and I did not hesitate. I new I needed to remove some of the bone from his skull to reduce the pressure inside his brain. Unfortunately, there were no medical tools available to do so. So I took a Black & Decker drill and asked that the drill bit be sterilized. I used that to create an opening in the skull, relieve the pressure, remove the bullet, and stop the bleeding. I am happy to say, that the patient did well. His name is Jesus and he now lives in Southern California.

Hi Dr. Gupta! Given the attention ALS is currently receiving from social media, are there any other medical issues you would like to see receive similar attention?

As a neurosurgeon, I've always had a deep interest in neuroscience. Many of the diseases we spent time learning about are considered to be "rare" or "orphan" diseases (that is to say, diseases that affect a small part of the population - I think it affects fewer than 200,000 people). Unfortunately many of those diseases, like ALS, Huntington's Disease, some types of dementia, early-onset Parkinson's Disease or Alzheimer's, don't get the attention they deserve. Having taken care of patients who suffer from these diseases, one can understand how heartbreaking it is to feel as if the medical establishment has not paid as much attention to them. I think the ice bucket challenge helps shine a light on something that most people knew very little about, and I hope we have similar awareness (however we do it) for many of these other diseases that I have spent most of my professional life helping treat.

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I share your concerns. And context here is very important. The superbug crisis or even the common flu are much larger concerns to the planet as a whole than ebola. Media research will continue to produce newer and newer generations of antibiotics. But the real solution probably does not come from scientific laboratories, the real solution comes from stopping our incredulous use of these medications when they have no benefit. There are far too many patients taking antibiotics for a viral illness. This not only does not work, it is the genesis of creating "superbugs" that learn how to outsmart antibiotics.

Dr. Gupta, what do you think is the largest misconception about Ebola as a whole is as of now?

The biggest misconception about ebola is that it is highly contagious.

It is not.

There will be no story of a healthy person walking through an airport shaking hands and spreading ebola. That is not what happens. Here's how you should think of it:

ebola is not highly contagious, but it is highly infectious. That means when a person becomes ill, they start to shed the virus in their bodily fluids. And when even a small amount of that fluid gets into a break in somebody's skin, that can cause an infection. But keep in mind, again, it is only a sick person that is shedding the virus, somebody who is often in bed, or in a hospital, and not up and around. This is not a "Typhoid Mary" type situation. The people who are most at risk are healthcare workers who are taking care of the sick patients, or family members, if the patients don't seek medical care and get isolated. The virus can live on surfaces for up to a couple of weeks if it is under the perfect conditions, but it's susceptible to UV light, heat, and most cleaning agents.

What disease terrifies you most?

For me personally, the disease would be Alzheimer's. I feel I'm a very proactive person, and would do all I could to alleviate the symptoms of any disease for me, my patients, my family. I'm very scared, however, when I am no longer able to construct my thoughts, remember things, and be myself.

Dr. Gupta, having said that, what is your position on physician-assisted suicide? Alternatively, what would you do if you weren't yourself anymore?

Edit: A word

I've given a lot of thought to assisted suicide. in fact I did the last television interview with Jack Kevorkian before he died. Interestingly, Dr. Kevorkian's position and rationale for assisted suicide had more to do with 9th Amendment rights versus the humane treatment of patients. That is not to say, that Kevorkian didn't believe he wasn't doing something humane. But what drove him, was his belief that people should be allowed to choose when they want to die without governmental interference: ttp://www.cnn.com/2010/HEALTH/06/14/kevorkian.gupta/

I think many advocates of assisted suicide do believe that they are helping end suffering when a patient's condition has become terminal. Perhaps, because I'm an optimist and I work in a field where we take of some of the sickest patients, I always remain hopeful that help could be right around the corner. It is very hard to say what is terminal in today's day and age. In some ways, we are all terminal, as Dr. Kevorkian once told me. That is not a reason however, in my opinion, to end a life prematurely. http://transcripts.cnn.com/TRANSCRIPTS/1206/23/hcsg.01.html

Dr.Gupta Mental illness is something that is becoming more of an issue in America and across the world. With how the mental institute system is currently broken and makes it difficult for patients to even receive treatment, what would you recommend that someone that suffers from depression can do themselves without using antidepressants to help their mental health?

That's a great question. I would like to remind people that depression is a brain disease. If I substituted the word "diabetes" or "cancer," this would be an entirely different discussion. However, many still don't think of depression in that way. We know objectively in a measurable way the changes that happen in the brain when someone is suffering from depression. We also know that while medications can work, they are not the only therapy. CBT - or cognitive behavioral therapy - can be very effective, especially if started early in the course of someone's illness. Despite the stigma that may prevent you from going to the doctor, or seeking help, please know that it is your best chance at getting effective therapy that could avoid medications.

How nervous should we be about an Ebola outbreak in the US?

Despite some scary headlines, I would not worry about a mass outbreak in the United States. First of all, we have the ability to isolate patients quickly, and make a diagnosis. Second of all, humans don’t spread ebola -- until they are sick themselves. So, healthy people wont unwittingly spread the disease without being ill. I do worry about health care workers. They are the ones who have close contact with sick patients, and are at the highest risk. That is why you see them wearing the "space" suits when they care for patients.

Also, while there isnt a proven treatment, the ability to replace fluids quickly can make a big difference in survival.

Dr. Gupta,

I often see you on CNN and reporting in the field. Do you still practice hands on medicine or has your career taken you to strictly journalism?

Thanks so much. Yes! I still consider medicine, and specifically neurosurgery, my day job. My split is close to 50/50 nowadays between medicine and media. I have been interested in medicine since I was a kid and can't imagine not practicing. Balancing two careers is tough at times. It involves being very efficient, not many vacations or weekends. I do love my job(s) however!

Good Morning, Dr. Gupta!

I've always more or less enjoyed your work and find the way you're able to explain complex medical matters very informative and enlightening.

How much of a threat would you say that Ebola poses to world health? I grew rather concerned after hearing that it had made it to Lagos, Nigeria, as that is a huge international hub. If it were to spread elsewhere from Nigeria, at what point would we have to treat it as a very serious threat on a global level?

Secondly, I remember watching your special on medical marijuana with fascination! I remember you spoke about what caused you to change your mind on the matter, but would you care to further explain why exactly you changed your mind on medical marijuana?

Are you in favor of completely legalizing it, or do you believe it should only remain as a medical treatment?

Thank you very much for everything! Please stay safe over there!

It was disconcerting to hear about the patient who became sick after landing in Lagos, Nigeria. We now know that he likely had contact with a patient who was sick with ebola beforehand. Clearly, the screening system that should have prevented him from getting on an international flight did not work. The fact is, there's always going to be the possibility of human errors leading to this sort of situation. Still, however, I am not worried about this becoming a global pandemic. I do think we will have patients with ebola in many countries around the world, but I don't think it will spread in those countries, as we've all become more aware of ebola, the lay and medical communities alike have a better idea of how to control it.

Thank you for your question regarding marijuana, as well. I have stayed focused on medicinal marijuana and have approached this as a journalist and a scientist. In part, I changed my mind because I realized that the scientific studies coming out of the United States painted a very distorted picture about the benefits of medical marijuana. The studies in the U.S. seemed more designed to find the harms as opposed to the potential benefits. When I started looking at studies from other countries and from places that were not dependent on government funding, a clearer picture emerged for me. I became more & more convinced that not only could marijuana have benefits, but it could work at times when nothing else had. I am still a bit baffled as to why politics seems to have trumped science when it comes to this particular substance. there are people out there who could benefit from medical marijuana today, and that is why we continue to try and educate and beat the drum on this issue.

Do you think the experimental drugs approved by the CDC to administer will work?

First, before I answer that, let me point out that the CDC did not necessarily approved this drug that was given to the 2 Americans in West Africa. This medication was obtained by the charitable group where the health care workers were working.

Having said that, there's a fair amount of optimism about these medications.
The medication is a triple monoclonal antibody. This medication seems to work by preventing new cells from getting infected. By report, Dr. Brantly went from feeling he was about to die to being up and walking independently within a few hours.

Was it the medication or something else? We still don't know. That is why scientific trials are now being conducted.

The whole story of how these 2 Americans received the medication reads like a medical thriller. Take a look here: http://www.cnn.com/2014/08/04/health/experimental-ebola-serum

First, before I answer that, let me point out that the CDC did not necessarily approve this drug, which was given to the 2 Americans in West Africa. This medication was obtained by the charitable group where the health care workers were working.

Having said that, there's a fair amount of optimism about these medications.
The medication is a triple monoclonal antibody. This medication seems to work by preventing new cells from getting infected. By report, Dr. Brantly went from feeling he was about to die, to being up and walking independently within a few hours.

Was it the medication or something else? We still don't know. That is why scientific trials are now being conducted.

The whole story of how these 2 Americans received the medication reads like a medical thriller. Take a look here: http://www.cnn.com/2014/08/04/health/experimental-ebola-serum

Hey Dr Gupta! Thanks for doing this AMA! Very appreciated.

So, my question is, now that Ebola is up to 2000 known cases, what do you think are the odds of this virus mutating? Maybe becoming airborne? Are any of the doctors worried about this? Or is it still highly unlikely?

Based on the situation that you've seen, do you think this can really be controlled by late fall or early winter, or do you think it'll take long than that to get under control?

Various strains of Ebola have been around for decades; the first was discovered in 1976. We’ve identified at least 5 strains. So it’s safe to say that at some point in the past the virus DID undergo mutations. It’s less than something like the common flu virus undergoes significant mutations almost every year. With regard to mutating into something airborne: this could happen, but the bigger question would be – would it still be as lethal? There is one known strain that is airborne, but doesn’t make people sick. If Ebola Zaire mutates to become airborne, it might become less deadly.

Why would it become less deadly?

Less deadly is generally better for a virus. Dead host means no more means to replicate. The longer a virus keeps its host alive, the more it can replicate.

Geda has the right idea.. We don’t know for sure what would happen if Ebola mutated, but it’s harder for a virus to become more global, if it quickly kills its host. A virus wants to keep spreading. So often – though not always - a mutation that makes it spread more easily, will make a virus less virulent.

Hi Dr. Gupta! I'm a big admirer of your work. 2 questions: Are the Americans infected with Ebola on track to make a full recovery and how much longer will they need to be quarantined? And, do you forsee an Ebola vaccine ever becoming a reality?

Thank you!

Thank you. I really appreciate that. We don’t know yet if the two Americans will make a full recovery but there are patients who survive Ebola without any long-term ill effects. We also know that the mortality rate for Ebola (60-90 percent in past outbreaks) has always reflected medical conditions in some very remote areas of Africa. With more advanced supportive care, and possibly due to new experimental therapies, the two Americans seem to have a good chance of a great recovery. The reason they remain in isolation is to prevent other people from becoming infected. They will be released once testing shows they no longer have virus in their bodies. That can take a few weeks. I do foresee a vaccine becoming a reality. Keep in mind Ebola is a relatively simple, single-stranded virus with just a handful of genes. This may make a vaccine easier to develop. Some experimental versions have already done well, protecting animals.

How does being on CNN affect the way that you present medical advice? Does having a bigger audience alter your message or presentation style? Do you have any concerns about perceptions regarding a lack of credibility from those who would consider CNN to be unreliable?

In some ways I am lucky as a journalist because I report on an area that is very important to people, very intimate but at its core, scientifically and factually based. There is less opinion and more objectivity in medical and science reporting than perhaps any other. While we don’t advise patients on television, I do recognize the importance of offering something that is useful to people. My job is to take sometimes complicated medical content, and make it understandable and actionable. Make no mistake: even a few-minute segment that you may watch on television, can take hours to prepare by myself and the CNN Medical Unit. In some ways, practicing medicine and being a medical journalist are much more similar than people realize; it’s critical to be clear, accurate and useful.

How much the infrastructure of the West African countries affected the spread of Ebola? What was the biggest challenge concerning it?

I think the infrastructure of the West African countries is a big challenge with controlling Ebola. I was there in Guinea in April of this year, a couple of weeks into the outbreak. Simply getting patients into isolation, which is something we take for granted, was a very challenging task. Picture big fields with rudimentary tents and primitive facilities. Nearly all the patient care was done by Doctors Without Borders and the World Health Organization. An even bigger challenge is the distrust of doctors by the patients. From the patients’ perspective, whenever they see the doctors in "space suits" show up, it means people are going to get sick and die. Given the fact that these doctors don't have a medicine or a vaccine, it makes that suspicion even worse. Many patients never seek out a doctor and as a result, we really have no idea how many patients are infected or have died from Ebola. While these problems would exist in other countries as well, I think they are more pronounced in these West African countries for those reasons.

I think the infrastructure of the Wes African countries is a big challenge with controlling Ebola. I was there in Guinea in April of this year, a couple of weeks into the outbreak. Simply getting patients into isolation, which is something we take for granted, was a very challenging task. Picture big fields with rudimentary tents and primitive facilities. Nearly all the patient care was done by Doctors Without Borders and the World Health Organization. An even bigger challenge is the distrust of doctors by the patients. From the patients’ perspective, whenever they see the doctors in "space suits" show up, it means people are going to get sick and die. Given the fact that these doctors don't have a medicine or a vaccine, it makes that suspicion even worse. Many patients never seek out a doctor and as a result, we really have no idea how many patients are infected or have died from Ebola. While these problems would exist in other countries as well, I think they are more pronounced in these West African countries for those reasons.

If Ebola spread like the H1N1 virus did, what would the repurcussions be for us? Also, what was it like, watching patients being treated in Guinea?

I think if you ask most reporters, they will tell you they are far more terrified of covering an outbreak than even being in a war zone. In an outbreak, the potential attackers are small, invisible and indiscriminate. While I was very careful to protect myself and my team, there is always a slight sense of fear when you are coming close to one of the deadliest pathogens on the planet. I know, however, that the safeguards work, because I studied the science and understood the disease. Besides being a doctor, I am also a dad to 3 little girls and I would obviously never do anything to jeopardize their health. So while it was frightening to cover the story, that was more psychological strain than a truly significant danger.

Hello Dr. Gupta!

First off I'd like to say thank you for doing this AMA whenever someone takes time to do one of these its a great thing. My question is do you think there is more America and other countries can be doing for African countries being destroyed by Ebola?

I was stunned to learn that in the countries of Guinea, Sierra Leone and Liberia, that Doctors Without Borders or Samaritan’s purse were doing almost all of the clinical work taking care of patients. While the World Health Organization helps organize such relief efforts, you may be surprised to know that 80% of the countries who are responsible for funding WHO have not made good on their commitments. While we typically pay more attention to organizations like WHO in the wake of a health disaster, it is necessary for the world community to support it all the time, so they can be ready to handle an outbreak like this. Keep in mind that right now, the World Health Organization is dealing with several humanitarian disasters, not just Ebola.