Behind the Scenes in the O.R. With Dr. Oz

Aug. 25, 2009— -- Dr. Mehmet Oz calls the operating room where he performs 300 heart surgeries each year "the temple," but says he wishes he spent a lot less time there.

Oz is on a mission to inspire Americans to get healthy so he never needs to treat them.

Oz gave Diane Sawyer a rare look inside the operating room at New York-Presbyterian Hospital/Columbia Medical Center to see just what happens during open heart surgery.

"In every case, every single operation, there is one moment where the patient could die," he said. "I don't remember ever in my whole life not having that be part of an operation. It's not that I think it's going to happen, but I realize if I go left rather than go right, we'll have a catastrophe."

For surgeons, the preparation starts before they make a single cut, when they're scrubbing in.

"The ritual starts off with the fingernails," Oz said. "I only point this out because there's a lot of superstition in surgery. The good surgeons would spend the time meditating about what they're about to do, actually going through it in their mind. So when you're in there and everyone's wondering what you're going to do next, you've already thought about it three times while you were scrubbing."

Oz, who treats patients with the highest-tech heart surgery and care, knows 70 percent of his patients could have lived differently and never had to be lying on his table. And that's why he says he doesn't favor one health care plan over another.

"The big debate right now in Washington is health care finance," he said. "It's how are you going to pay for it. I don't care which program we pick. I'll tell you why. Because none of them are going to work."

Oz says the health care plans are all doomed unless Americans create a new way of thinking about health.

He says there have to be incentives for healthy behavior at the workplace, in families, with our children, with each other and points out that Americans have, on average, twice as much chronic disease than Europeans.

"What we haven't done is get to the very root reality of the flaws we have in the health care system," he said. "True health care reform cannot happen in Washington. It has to happen in our kitchens, in our homes, in our communities. All health care is personal."

And it also complicated.

"I don't think the solution is as simple as saying, 'walk 30 minutes a day,'" he said. "The solution is much more profound than me barking out orders about how much you have to exercise."

Healthy Lifestyle Key to Avoiding Heart Surgery

The solution will come, he says, when it's easier to make the healthy choice than the unhealthy choice.

"If I make your workplace conducive to walking at lunch, or working out at some time during the day, or I get people to use the stairs more by creating incentives to do such, then people will start doing it naturally," Oz said.

"We don't walk," he continued. "We overeat because we've made it easy to overeat. We have fast-food joints on every corner. By the way, the 'we' is all of us. It's not the government. It's all of us doing this together."

Oz says that while one-third of health issues are genetic, two-thirds are the result of factors that we have the ability to alter, like walking regularly, eating plenty of leafy green vegetables and fruits, and losing weight.

In the operating room, Oz showed Sawyer a heart valve he removed from the patient. It stopped working because of calcium deposits.

Many of the patients he sees are suffering the effects of smoking.

"I don't operate on smokers," he said. "I tell cigarette smokers that I can operate on you, I get paid the same. And you might even do well. But it's the wrong thing to do. So I refuse to operate on you until you stop smoking."

He promises to do whatever he can to help patients stop smoking.

"In my entire career, I've never had a patient not stop," he said.

Unfortunately, many resume smoking after surgery despite follow-up treatment.

"I recognize that the average smoker stops and then starts again six times before they succeed," he said. "At least I took care of one of 'em."

Oz says the hardest thing for a surgeon to come to terms with is someone who's been through surgery and still hasn't responded to the message about exercise and weight.

Dr. Oz: 'Put Me Out of Business'

Peter Calafati, a 52-year-old who had a coronary bypass five months ago, still has trouble with exercise -- and some of that stomach is back.

"I look at you and I blame myself," Oz told him. "I say, I must have walked him through all the details of open heart surgery but … I didn't get into his heart and get him to appreciate why I feel so passionately about doing these things."

"It's laziness on that area, you know?" Calafati said. "It wasn't like a life-shattering moment for me, it was almost somewhat expected."

"That is actually the most cogent answer I have ever gotten to that question," Oz said, adding that coronary bypass never used to be done on patients as young as Calafati or others he treats.

"It's being done on 25-year-olds," he said.

The rise in surgical procedures may be good for business for a surgeon, but Oz is hoping for the opposite.

"The main reason that I really wanted you to come is to put me out of business," Oz said in the operating room. "Because although this is extremely fulfilling and I really do enjoy it a lot at its very foundation, you walk in there and you realize my goodness, this didn't have to happen."

Preventative medicine will be the focus of "The Dr. Oz Show," which premieres on Sept. 14, 2009.