During the AAOS 2024 Annual Meeting in San Francisco, the Your Academy event featured a “fireside chat” between AAOS Past President Kevin J. Bozic, MD, MBA, FAAOS, and Presidential Guest Speaker Sanjay Gupta, MD, neurosurgeon and Emmy-winning correspondent for CNN. Dr. Gupta shared reflections on his career as a journalist and physician and talked about issues impacting the current healthcare landscape. Off stage, Stuart J. Fischer, MD, FAAOS, spoke with Dr. Gupta about some of the major historical events he has covered on the ground for CNN, COVID-19 and how to prepare for future pandemics, and one of his biggest sources of inspiration.

Dr. Fischer: As a neurosurgeon, how does it feel to be surrounded by orthopods in a big convention hall?
Dr. Gupta: That’s a good question. It sort of feels like I’ve been invited to the “cool kids’ table,” to be honest. The orthopaedic surgeons where I trained at Michigan, they were kind of the cool surgical subspecialty. The neurosurgeons were a bit more eccentric, so it feels like I’ve arrived maybe.

You finished your residency around 2000, 2001, and then transitioned right to media reporting and journalism. Did you have any prior experience that gave you a hand with that?
No prior experience in journalism and certainly nothing in broadcast. Only experience that I had was in writing, and primarily writing for small magazines, for peer-reviewed journals. Then I worked as a White House Fellow, so I got an experience of trying to craft messages for a broader audience through speech writing at the White House. But no specific journalism training.

Were you writing speeches on healthcare?
Yeah, a lot of it was on healthcare, and it was for the first lady and the president. But I found in that world, as in many worlds, you end up being short-staffed. So I had a broader sort of umbrella of topics that I was covering than I anticipated.

You’ve covered a lot of natural disasters and crises—Hurricanes Katrina and Maria, tsunamis in Sri Lanka and Japan, earthquakes, then Ebola. Which of these was the most difficult humanitarian crisis you had to report on? And how did that affect you both professionally and emotionally?
I’ve covered many natural disasters, but I’ve also covered a lot of conflicts. And I think covering conflicts is challenging, in part because people are being targeted. There’s obviously all the destruction, but then there’s a sense of constant fear. Whereas with natural disasters … there’s often the sense that this was an act of God, an act of nature, we’re all in it together to rebuild, so there’s a camaraderie and a galvanizing that happens around natural disasters.

I will say that I think the earthquake in Haiti was maybe personally the worst thing that I’ve ever seen. We were the first people to arrive there. Journalists can get into these places very quickly, before the military, before relief organizations, and so we came upon a gigantic mass casualty scene.

A hundred thousand people had died and were still there in the streets. A hundred thousand more people were injured, roughly. I’d never seen anything like it, and I think those [moments] sort of stick with you.

Was it physically the most difficult event you’ve had to cover?
I think so. Whenever you’re covering these things, it’s kind of like residency in some ways. You’re not getting much sleep, you’re not eating much, you have very little contact with your family. In some ways, maybe the surgical training prepares you for that. But as you know … there’s so much adrenaline, I think for long periods of time that you kind of forget the physical toll.

Is there one story or event where you feel that your reporting made the most difference?
Hurricane Katrina may have been one of those examples. You’d like to think that [you make a difference] just by raising awareness, shining a light, especially on places that are hard for people to even find on a map. With Katrina in particular, there was a situation where people assumed that hospitals had been evacuated and things like that, and they hadn’t, and there was no communication, so we were able to get on the ground and actually show what was happening in the hospitals. I think it led to real-time evacuations, which was very gratifying.

You wrote a book, World War C, about the COVID crisis, and at CNN, you were one of the first to use the term “pandemic.” How did you come to do that?
What constitutes a pandemic in many ways, from a public health perspective, is almost more of a math issue than it is a public health issue, meaning that if you have countries in every continent in the world where there is evidence of sustained human-to-human transmission of the virus, that constitutes pandemic.

[There was an] incredible team at CNN, we had like a dozen producers who had these whiteboards all around our offices for months. There was no sort of universal collection system. We were doing it on our own. We were able to identify countries all over the world. And once we got to that point where it was sustained human-to-human [transmission], so not just within a certain household but within a community, in countries in all continents of the world—that is the definition of pandemic. We were just surprised, frankly, why the [World Health Organization] and the [Centers for Disease Control] had not already done it.

And in some ways, you were ahead of them.
Yeah, I think that’s what we can do really, really well as an international journalism organization.

In the book you write, “We cannot get pandemic amnesia.” You note that there have been as many plagues in human history as wars. What can the United States and the world do to anticipate and prepare for any possible future pandemic?
In some ways I think we do have to think about viruses as a national security threat. But I think we see them as these sorts of acts of nature, like a hurricane, that will happen. We don’t necessarily know when. Everyone takes cover when it happens, hopes that it passes, and then surveys the damage afterward.

One thing that I found out as I was writing that book was that in 2004, we had a very good pandemic-preparedness plan in the United States. George W. Bush had put it together, and it sort of fell apart over the years. … We hadn’t really had a pandemic, why would we keep continuing to fund this pandemic-preparedness plan? And eventually it just becomes ignored or marginalized.

Right now, there are 17 U.S. aircraft carriers that are circumnavigating the globe. For half the price of one of those carriers, we could essentially have a pandemic-preparedness plan that would ensure that we would be pandemic-proof. The viruses will emerge, but they would never get to that point again, to cause the sort of destruction this one did in the United States.

So we would have a viral national defense?
Yeah, I think so. I don’t think you have to create a separate sort of institution for this. But I think the framing of how we think about this—as a legitimate natural security threat—is what I think would make a huge difference.

You also note in the book that during the pandemic, having wealth and an advanced healthcare system didn’t necessarily give a country or an area an advantage when trying to control the virus.
Some of the wealthiest countries in the world did the worst in terms of the metrics that you’d measure: how many people died, how many people got sick. We’ve known this for some time, that wealth does not buy health. But what I think is interesting is that the connective tissue here is that, with all that wealth, we have bought ourselves a lot of comorbidities that put us at increased risk when a virus like this comes about. We have higher rates of chronic disease, heart disease, diabetes, and typically these things sort of layer out over decades in terms of the impact on mortality. The virus really accelerated that, so people who had underlying problems, … this ended up becoming a much more acute issue for them.

And wealthier countries just did not do as well. There’s the likelihood that they’re less likely to abide by basic public health practices. We saw that even in the 1918–1919 flu pandemic. But I think a lot of it is that we just weren’t that healthy in the first place, and I think that that’s what really hurt us.

You wrote about your mother, and I was very impressed that she became the first female engineer in India and the first female engineer at Ford. How much did you learn from her?
I learned a lot, and thank you for asking the question. My mom is still living, and she’s hugely inspiring for all of us. She’s not someone who’s very sentimental or emotional about these things at all.

But … if you’re presenting a challenge to her and say, “Hey, I’m not sure that I can do this,” she may remind you, “I was 5 years old and I survived the largest human migration in human history. I lived in a refugee camp, and I became the first woman ever hired as an automotive engineer at Ford.” It’s pretty inspiring just by that alone.

In 2003, People magazine named you one of the sexiest men alive. What did you have to do to beat the competition?
I just had to keep my head down, keep my wife happy, and not get in the way. Look, no one was more surprised than me. It’s funny to me that you are who you are, and then all of a sudden, you do television and people think you are somebody else. I don’t think anybody would have ever said I was some sexy guy before I started doing TV.

Is this the advice you would give to orthopaedic surgeons looking to do TV and media part-time?
No, I would not give them that advice. Do not aspire to get in People magazine. Be really good at what you do. That’s why people will come to you. Most docs have done a lot of homework to get to where they are in life now, and I think if you’re translating that for a larger audience, it’s the same skill set.

Stuart J. Fischer, MD, FAAOS, is an orthopaedic surgeon in private practice in Watchung, New Jersey. He also serves on the AAOS Membership Council, Board of Councilors, and Committee on Evidence-Based Quality and Value.