60 Minutes (1968) s46e19 Episode Script
Season 46, Episode 19
Earlier this year, the Food and Drug Administration made an unusual and surprising announcement.
It cut the recommended dose of the most popular sleep drug in the country, Ambien, in half for women.
It turns out men and women metabolize Ambien, known generically as Zolpidem, very differently, leaving women with more of the drug in their bodies the next morning, and therefore at a greater risk of impaired driving.
Ambien, Zolpidem, is now the only prescription drug in the country with a different suggested dose for men and women.
But we've discovered it is far from an isolated example of differences between the sexes we never imagined.
More and more, scientists are realizing that the differences are dangerously understudied and that pervasively and fundamentally, sex matters.
Take aspirin.
Low-dose aspirin lowers the risk of heart attacks in healthy men; but in healthy women, turns out it doesn't though it does protect women against stroke.
And drugs are just the beginning.
Sex differences have been found in pain receptors, liver enzymes, even the wiring of the brain.
Larry Cahill: We have generated just a ton of information that suggests that there're sex differences everywhere.
Larry Cahill, a neuroscientist at the University of California Irvine, used to share his field's assumption that males and females outside the reproductive system were fundamentally the same.
But he's changed his outlook 180 degrees.
Ambien, he says, is a case in point.
Lesley Stahl: Ambien, prescribed 40 million times just last year, approved 20 years ago.
We're only now finding out that women have been prescribed-- a dose that's twice as high as they need.
Larry Cahill: That is a textbook example of what's wrong.
How did it happen that for 20 some years, women, millions of them, were essentially overdosing on Ambien? The FDA says it made the change after new driving simulation studies established what amount of Ambien or Zolpidem in the blood the next morning could be dangerous for driving.
Dr.
Sandra Kweder, deputy director of the FDA's office of new drugs, says only then did they realize women could be taking too much, since women metabolize the drug differently than men.
Dr.
Sandra Kweder: So if I took Zolpidem, and my brother took same dose, probably the maximum level of drug in my blood would be Lesley Stahl: Now that sounds substantial- Dr.
Sandra Kweder: It is substantial.
But we discovered that that 45 percent difference between men and women had been known to the FDA all along.
In the original FDA review of Ambien back in 1992, there was a page called "Effect of Gender," where the FDA reviewer noted that two key measures of how much drug is in the bloodstream "were approximately Larry Cahill: It appears to say that they found a significant difference in how this drug is being processed in the body.
And then the question is, "What did they do with that?" and the answer appears to be, "Eh.
" They rationalized it away.
Lesley Stahl: I'm gonna hand you that page, "Effect of Gender.
" Dr.
Sandra Kweder: OK.
Lesley Stahl: The FDA reviewer went on to write, "The results suggest a gender-related difference.
However, the lack of specific details such as study design and individual data make it difficult to draw a definite conclusion--" Dr.
Sandra Kweder: Exactly.
Lesley Stahl: So when you see that they didn't give you enough data, did you go back, or should you have gone back, and said, "OK, what was the study design? What was the data?" Dr.
Sandra Kweder: If I saw this today, in light of today's science, I think we would go back and try to tease this out a little bit further.
But I think at the time, this was generally consis-- this was sort of business as usual for what you saw in clinical pharmacology studies.
That's because, she says, there was no evidence at the time that the difference mattered.
That was 20 years ago, when if someone said "women's health," it usually meant what they call "bikini medicine" -- breast and ovarian cancer, pregnancy, menstrual cycles.
But for parts of the body men and women share -- hearts, kidneys, the brain -- most of the studies were done predominantly on men.
Lesley Stahl: If you want to understand me, they study you? Larry Cahill: And here's why they do that.
Because there's this assumption that you are me with pesky hormones.
Lesley Stahl: Ohwith pesky hormones.
Larry Cahill: I'm being only partially facetious.
The idea is that the fundamental things are similar between you and me.
So that ironically the best way to study you is to study me.
Lesley Stahl: Cause you don't have pesky hormones.
Larry Cahill: Right.
We're studying all the fundamental things in you without this sort of nuisance stuff.
That's literally an assumption on which all of biological medicine, especially neuroscience, which I know best, has been built.
But given what we now know, he says that assumption has to go.
Look at heart disease, which is the leading killer of both men and women.
Cardiologist Noel Bairey Merz from Cedars-Sinai Medical Center in Los Angeles says women, like her patient Pearl Grumet, can differ from men in the way they have heart attacks.
Pearl Grumet: I had this excruciating pain in between my shoulder blades.
And then I got the nauseous feeling in my stomach Lesley Stahl: So the man comes in, he has chest pain, sometimes a radiating pain down the left arm.
The woman comes in and she says- Dr.
Noel Bairey Merz: She might be having stomach upset, she might be feeling fatigue.
She might just be short of breath.
Lesley Stahl: Why does she even go? Dr.
Noel Bairey Merz: 'Cause they don't feel right.
And they know something's wrong.
Lesley Stahl: They know something's wrong.
Lesley Stahl: Did you ever have chest pain in this whole time? Pearl Grumet: No.
Dr.
Noel Bairey Merz: You can see, here's the constriction.
Typically men get clogs in major arteries that are easy to see on an angiogram.
But many women get blockages in tiny microvessels inside the heart.
So their heart disease is more often missed.
Pearl had four minor heart attacks; five different hospitals couldn't find the problem.
Pearl Grumet: Doctor comes in and he says, "When you find out what's wrong with you, would you please let me know?" Lesley Stahl: No, come on.
Pearl Grumet: "'Cause we don't have any idea what's wrong.
" Dr.
Bairey Merz says one of the reasons we haven't learned more about women goes all the way back to the beginning of the scientific pipeline, to research on animals.
Dr.
Melina Kibbe is a vascular surgeon who also runs a lab at Northwestern University Medical School, where she evaluates new therapies in mice and rats.
Lesley Stahl: If I walked into a lab anywhere in the country doing animal research, what are my chances of coming upon a study with only male animals? Melina Kibbe: Very large.
Lesley Stahl: Today? Melina Kibbe: Correct.
Turns out female rats also have those pesky hormones.
Melina Kibbe: So to control for that variable, most researchers study just males.
I was also studying just males.
Lesley Stahl: So it made sense? Or you maybe didn't even think about it? Melina Kibbe: I didn't even think about it.
And neither did Doris Taylor, a leading stem cell expert at Texas Heart Institute in Houston -- until she was designing an experiment in mice, to see if injections of stem cells could reverse plaque build-up in their arteries, and she needed a way to track the stem cells in the animals.
Doris Taylor: So what we decided to do is give female animals male stem cells, because we could track the Y chromosome.
And we said, "Let's give male animals female cells.
" Lesley Stahl: You only did it so you could track the cells.
Doris Taylor: So we could track the cells-- She was surprised to find that the results were not the same.
Doris Taylor: The male animals we gave female cells got better.
And the female animals we gave male cells actually got a little worse.
Only the female stem cells got rid of the plaque.
Doris Taylor: And you can see all this fat here, the pink-- The male mouse artery on the left had not been treated; the one on the right got female stem cells.
Doris Taylor: And look at that.
Lesley Stahl: It's clean.
Doris Taylor: I am embarrassed to admit that, as a woman, it had never really occurred to me that doing the experiment in male versus female animals would give completely different results.
And that led to further discoveries.
Taylor wanted to find out if human stem cells were different too, and she's found that.
They are.
Lesley Stahl: My stem cells are actually different stem cells from a man's? Doris Taylor: Yes.
She told me men's are less powerful to begin with; and then they start to die off.
Doris Taylor: In men as they age, they decrease pretty dramatically.
And in females, they stay relatively stable.
Now, think about that- Lesley Stahl: Wow.
Doris Taylor: Men develop heart disease much earlier than women.
Why not look at the difference and see how to make men live longer without heart disease? She speculates that ignoring this difference may be one reason stem cell treatments haven't lived up to their promise.
And on a broader level, that not studying both male and female animals results in more problems for women down the road.
Larry Cahill: If the whole darn pipeline is male dominated and sex differences truly do matter, how can it not be the case that you're going to end up with, on average, a lot more negative side effects in women than in men? I mean it basically has to happen.
And it does.
A GAO report found "8 of the market from 1997 to 2001 "posed greater health risks for women than for men.
" Today when it comes to government-funded studies on humans, women must be included by law.
But many researchers don't then take the next step and analyze the results by sex, which some argue defeats the whole purpose.
Lesley Stahl: We have come upon studies where they do use both male and female, but they then don't analyze how the two respond differently.
So they have the two and no analysis of the difference.
Doris Taylor: If you do the two together and you really think females are here and males are here or vice versa, [gestures with hands.]
then you're gonna get results that are right here- Lesley Stahl: And so they're almost useless- Doris Taylor: And so they're almost not predictive of either males or females.
Larry Cahill: If you're clumping men and women together in your study and there truly is a sex difference, you're not just harming the women; you're harming the men.
You're muddling up the understanding of what's going on, you're muddling up the path to clear treatment, not just for the women, but for the men as well.
The problem, he says, is that the scientific establishment hasn't caught up with its own discoveries.
Lesley Stahl: If science got Ambien so wrong, does that tell you that we really need to go back and review- Larry Cahill: Yes.
Lesley Stahl: What? Everything? Larry Cahill: Pretty much everything, yeah, 'cause once you see this difference and that difference and that difference and that difference and that difference and you see, "This thing's everywhere," you go, "Wait a minute.
So the assumption we're making that it really doesn't matter, sex, is not a valid assumption.
" It may not matter.
It may matter hugely.
It may flip your results on their head and you don't know.
So what happens is you start to realize, "Wow.
The status quo is not OK.
The way we're doing business has to change.
" Lesley Stahl: There are scientists who say the Ambien situation is like a wakeup call.
It's a tip of the iceberg.
So, should the FDA go back and look at other drugs? Dr.
Sandra Kweder: Well, you know, to say every drug-- every drug, go back and look again? Lesley Stahl: Yeah.
Dr.
Sandra Kweder: That's an enormous undertaking.
Lesley Stahl: So can women feel secure that the dosages recommended on any of their medications is proper for them? Or should they now be a little worried? Dr.
Sandra Kweder: In medical practice, there is a general awareness that there may be individual differences among patients.
And that every patient needs to have the right dose.
Lesley Stahl: How's a doctor supposed to know? Dr.
Sandra Kweder: You start at the lowest dose, and you see if it's enough.
Lesley Stahl: Yeah, but you're doing the studies.
And they're gonna rely on your recommendation.
Dr.
Sandra Kweder: Yup.
Lesley Stahl: It sounds like the FDA is being more reactive than aggressive about this.
Dr.
Sandra Kweder: I think we're being very aggressive about bringing the most sophisticated science to new drugs and being aggressive about applying the science where we have reason to believe there is a concern to older drugs.
The FDA told us it is looking at other sleep drugs for possible sex differences, but not mounting an across the board review.
As of today, Zolpidem remains the only drug on the market with different recommended doses for men and women.
Giving apartments to homeless people who've been on the streets for years before they've received treatment for drug or alcohol problems or mental illness may not sound like a wise idea.
But that's what's being done in cities across America in an approach that targets those who've been homeless the longest and are believed to be at greatest risk of dying, especially with all of this cold weather.
They're people who once might have been viewed as unreachable.
But cities and counties affiliated with a movement known as the 100,000 Homes Campaign have so far managed to get 80,000 of them off the streets.
Local governments and non-profit groups do most of the work.
The money comes mostly from existing federal programs and private donations, and there's evidence that this approach saves taxpayers money.
If it sounds too good to be true, then take a look at what's been happening in Nashville, one of the latest cities to join the 100,000 Homes Campaign.
Ingrid McIntyre: You awake, buddy? [Ingrid knocks on door.]
Ingrid McIntyre: Robert? In a storage facility on the outskirts of Nashville, outreach worker Ingrid McIntyre introduced us to Robert McMurtry.
Ingrid McIntyre: Hey good morning.
I want to introduce you to my friend Anderson.
Anderson Cooper: Hey I'm Anderson, how are you? She'd come to ask him some questions about his health.
Ingrid McIntyre: How many times have you been to the Emergency Room in the past three months? Robert McMurtry: Uh, twice.
Robert told Ingrid he had a lot of medical problems: HIV, hepatitis C, and throat cancer.
He was getting treatment at Vanderbilt University Medical Center, but living in this storage locker without a toilet or running water.
He bathed in a stream by the side of the road.
He said he'd been homeless for three years.
Anderson Cooper: How old are you? Robert McMurtry: I'm 48.
Anderson Cooper: Forty-eight? I'm 46, so we're two years apart.
Robert McMurtry: Uh-huh.
Anderson Cooper: It's nice to see someone else with gray hair.
He said he used to work in the construction business but fell on hard times after he lost his job and became ill.
A friend took pity on him and allowed him to stay in this storage locker for the past three months.
Robert McMurtry: I never imagined I'd ever be homeless, 'cause I had-- I really worked really hard my whole life and it was just devastating really when it happened because I never imagined that I would be in this condition.
Ingrid McIntyre runs a nonprofit called Open Table Nashville, that's been working with the 100,000 Homes Campaign to survey the city's homeless - and identify those at greatest medical risk.
Anderson Cooper: Do you think he's at high risk? Ingrid McIntyre: I mean he's one of the most vulnerable people that I know.
Three days after interviewing Robert, she returned with an offer that was hard to believe.
Ingrid McIntyre: If you want to, I have an apartment for you tomorrow.
Robert McMurtry: Really? Ingrid McIntyre: Do you want it? Robert McMurtry: Yes.
I do, really.
Ingrid McIntyre: Good.
The following day.
Robert McMurtry: Wow man.
Robert moved in to his very own apartment.
Robert McMurtry: This is great.
It's in a private building in downtown Nashville.
He wouldn't have to bathe in that stream anymore.
The apartment has one bathroom, one bedroom, and access to this rooftop pool.
Until fairly recently someone like Robert would have to jump through a series of bureaucratic hoops, and go through a treatment or job training program before getting permanent housing.
The 100,000 Homes Campaign advocates using an approach first developed in New York in which the homeless are given housing first.
Becky Kanis: What we're really aiming for in this movement is that person that's been on the streets, many cases for decades- who you walk past and you're like, "Oh, I can't even imagine this person being able to be in housing.
" Anderson Cooper: The hardcore homeless.
Becky Kanis: The hardest core of the hardest core- who also happen to be at the highest risk for dying on the streets.
Becky Kanis works for a group called Community Solutions, which created the 100,000 Homes Campaign.
She says most of the 600,000 people who are homeless in the United States on any given night are on the streets for relatively short periods of time, usually less than a month.
But it's the chronic cases, people homeless for more than a year, who Kanis says are most in need of help.
Becky Kanis: They're out of friends who will let them sleep on their couch.
They're out of friends who will help them get a job.
They've burned the bridges of the friends or they just didn't have 'em in the first place.
More than 60 percent of the chronically homeless have drug or alcohol addictions.
Thirty percent suffer from severe mental illness.
Kanis says many of these people have such serious medical problems, it costs taxpayers more to leave them on the street.
Anderson Cooper: How is it costing more? Becky Kanis: The inability to tend to your basic healthcare needs, results in people on the streets ending up in emergency rooms and ending up in in-patient hospitalizations.
And one night in the hospital is a whole month's rent on most places.
Anderson Cooper: So you're saying it's more expensive to allow a chronically homeless person to live on the streets than it is to actually subsidize an apartment for them? Becky Kanis: Yes, we are paying more as taxpayers to walk past that person on the street and do nothing than we would be paying to just give them an apartment.
Becky Kanis began working for the 100,000 Homes Campaign after a career in the military.
She's a West Point graduate and former Army officer who worked with the Special Operations Command.
Anderson Cooper: Do you think having a military background helps? Becky Kanis: I absolutely think it does.
It's boots on the ground intelligence that I think is one of the defining factors.
To get that boots on the ground intelligence the 100,000 Homes Campaign encourages teams of volunteers and outreach workers to spend three nights looking for and interviewing the homeless.
In late May, we joined the teams in Nashville as they headed out at three in the morning, searching in small patches of woods under highway over-passes and in caves where the homeless camp.
Will: Hey, sorry to wake you.
My name's Will.
Those who agreed to answer a series of survey questions would get a free bus pass in return.
Will: How many times have you been to the Emergency Room in the past three months? Homeless man: About five times.
The questions are mainly about their health Volunteer : HIV or AIDS? Volunteer: Liver disease? Cirrhosis? Volunteer: History of stroke or heat exhaustion? The information is used to decide who gets apartments first by giving priority to those at greatest risk of dying on the streets.
And the risk is very real.
Homeless man singing: Rocky top you will always be.
home to me.
On the steps of this church, a man froze to death last year, one of 52 homeless people who died in the city.
? Not everything the homeless told the survey teams was accurate.
We checked and found some discrepancies.
But we were also surprised by the candor of some of the people we met.
Ernest Thomas who has a prosthetic leg, says he once hoped to work in a pharmacy, but ruined his job prospects by getting involved with drugs and crime.
He was on parole when we spoke.
Ernest Thomas: Look at me, man, I'm 39 years old.
And I ain't got nothing.
You know I'm sayin'? I don't even call my kids.
You know, when I do call 'em, they be, like, "Dad how you doin'?" I gotta lie and fantasize.
Oh, man, I'm straight.
Anderson Cooper: So how do you think you-- you ended up on the street? Ernest Thomas: Honest with you, man, I can't tell you.
I really don't know.
I messed up.
Somewhere, I messed up.
Yeah.
Will Connelly is director of the city's Homelessness Commission.
He is the person who decided Nashville should adopt the 100,000 Homes Campaign's approach.
He'd already lined up a number of apartments for the people identified by the survey.
Anderson Cooper: And these are fully furnished apartments, ready to go that these people can just move into? Will Connelly: Yeah.
Yeah.
Permanent housing, no strings attached really.
As long as they abide by that lease agreement, it's-- it's theirs.
The apartments are paid for mostly by the federal government which gives rental assistance subsidies for veterans and people with low income.
The homeless are expected to contribute things like part time work, social security, or disability.
Some apartments - like Robert McMurtry's - were provided by civic-minded landlords willing to accept very little rent.
Kirby Davis donated one percent of his units and has encouraged other building owners to do the same.
Anderson Cooper: And what's the push back you're getting? Kirby Davis: That-- they might harass my other residents, what are my other residents gonna think? What kinda liability do we have? Anderson Cooper: And-- and what do you say to that? Kirby Davis: None of 'em got to where they are not taking risk.
So how about taking a risk for somebody else? Kirby Davis meeting with landlords: Why don't we go around the room and introduce ourselves? No new tax dollars were required for Nashville's campaign to house the chronically homeless.
A lot was achieved by getting people who don't normally work together - such as outreach workers and private landlords -- to focus on the city's most desperate residents.
Landlord: What I'll do is try two units and we'll start with that and give it a try.
To determine who should get apartments first, the homeless who were surveyed got ranked based on their medical risk factors.
Robert McMurtry finished high on the list, but there were some in even worse shape.
Anderson Cooper: So who are some of the people you've identified? Will Connelly: The most vulnerable is-- his name's Frank.
Frank is Frank Clements, who spent more than For him and a friend, home was now this park bench.
Ingrid McIntyre: Where are you guys staying right now? Frank Clements: Right here.
Ingrid McIntyre: Right here? Jerry: Right here.
Ingrid McIntyre: Yeah There was a bottle of mouthwash by his side, which is what alcoholics sometimes drink when they can't afford liquor.
Frank was 66 years old and said he'd been treated for two types of cancer, pneumonia, and heart disease.
Ingrid McIntyre: How many times have you been to the emergency room in the past three months? Frank Clements: About three times.
Four days after he answered those questions, he was walking into his new apartment Outreach worker: This is your new home! Frank Clements: All rightMy heart is full of gratitude.
And you know, it's awesome.
I mean you don't see people like this that help people out you know.
To try and ensure the homeless don't end up back on the streets, social workers check in on them regularly.
Ashley: Do you mind if I have a seat? Frank Clements: Well of course you can.
Frank Clements needed more help than most.
The morning after he got an apartment, we found him finishing off a bottle of whiskey.
Frank Clements: I ain't no angel.
I'm a damn drunk.
In the weeks that followed, social workers tried to help Frank get treatment, they even drove him to appointments.
He'd get sober for a while, then start drinking again, then be filled with remorse.
He was so disruptive when drunk he had to be moved out of two different apartments.
Some critics of the 100,000 Homes Campaign question whether scarce housing resources would be better spent on homeless kids or working-poor families rather than somebody like Frank.
Anderson Cooper: Is it fair to give somebody an apartment who's made bad choices and is being irresponsible? Becky Kanis: I don't think fairness is the right way to look at it.
What I would prefer to look at it is what's good for everybody.
So having somebody on the streets, fair or not fair, is costing us as a society as taxpayers more than it would cost to have them in housing.
Anderson Cooper: It does seem like you're rewarding somebody though, who's-- you know, drinking or doing drugs or just being irresponsible.
Becky Kanis: I see it as giving them a second chance.
And most people, given that second chance, do something about those behaviors.
So far, Robert McMurtry has made the most of his second chance.
He made friends in his building, and three months after he got his own apartment, we were amazed to see him jogging in a nearby park.
Researchers at the University of Pennsylvania found that when homeless people in Philadelphia were given housing and support, more than 85 percent were still in housing two years laterand were unlikely to become homeless again.
Ingrid McIntyre: How's it going? Everything went great this morning? I'm so glad, you look awesome.
Man playing guitar at luncheon: 2,3,4 everywhere that I go In September, homeless advocates in Nashville held a luncheon for some of the people they had helped.
In 100 days, they had gotten nearly were still in their apartments.
But there weren't enough apartments for everyone.
Ernest Thomas didn't get one.
He ended up back in prison on a parole violation and then homeless once again.
By this summer, Nashville and other communities across the country that have joined the 100,000 Homes Campaign expect to reach their goal of getting 100,000 people off the streets.
That won't completely solve the problem, but Becky Kanis says it will prove that it can be solved, and that no one is unreachable.
Becky Kanis: We have an amazing collection now of before pictures and after pictures that just captures the transformation that's possible once someone's in housing.
There is something that's really dehumanizing about living on the streets in so many ways.
And then, really, in a matter of days, from having housing, the physical transformation is almost immediate.
And they're unrecognizable from their former selves.
And I don't think that there's anybody, once they see that, that would-- say, "Well, let's put them back on the streets again.
" When the actor Philip Seymour Hoffman was found dead in his apartment last week from an apparent heroin overdose it came as a shock to all but his closest friends and family.
How he came to die that way, at the height of his fame, is still a mystery, although this was not Hoffman's first battle with drug addiction.
He was only 46 years old, but he had already created a lifetime's worth of memorable characters and the New York Times, in a front page obituary, called him perhaps the greatest actor of his generation.
He was in talent, in temperament and commitment a true artistintense, introspective, sensitive, and obsessed with his work.
He did not often sit still for long interviews, but he did for us back in 2006, as his career was taking off.
He had just received an Academy Award nomination for best actor in the film "Capote" and we spent several days in New York and L.
A.
talking about his life, his work and his demons.
Philip Seymour Hoffman: If you can go to the theater and you're in a room with a bunch of other people and what's happening in front of you is not happening, but you actually believe it is, if I can do that, I've done my job.
And that's the thing that is a drug.
That's a drug.
That's something you get addicted to.
When we talked to Philip Seymour Hoffman eight years ago he told us he'd rather people remember the characters he'd played than remember him.
He insisted on meeting us at 8 a.
m.
in the heart of New York's Greenwich Village, which was the center of his world for nearly 30 years.
He went to drama school here at New York University and never really left the neighborhood.
Steve Kroft: So why did you want to do this at 8? Philip Seymour Hoffman: I thought it'd be easier to talk and stuff and there wouldn't be as many people around.
He came dressed as though he might have slept in this park or wandered out of a homeless shelter.
Yet we still got stopped by an admiring fan.
Unidentified Woman: You deserve the Oscar, Mr.
Hoffman.
Philip Seymour Hoffman: Thank you.
He was already a familiar face, having appeared in 40 films in just 14 years.
Working with major stars and A-list directors, he'd become famous taking small roles and transforming them into memorable characters.
Like the trust fund playboy in "The Talented Mr.
Ripley" or the pernicious preppie in "Scent of a Woman.
" Or the gay, curious sound man in "Boogie Nights.
" Not to mention various turns as the obnoxious, overweight friend and a pre-op transsexual, all of which beg the question about his scruffy wardrobe.
Steve Kroft: Is this the real Phil Hoffman or are you now preparing for some other role? Philip Seymour Hoffman: No, this is me.
He was totally without vanity unless the role called for it and despite his success at age artist, consumed with the craft of being an actor, and grateful for the recognition.
Yet suspicious of fame and celebrity and how it might change him and what he did.
Philip Seymour Hoffman: I think part of being an actor is staying private.
I do think it's important.
Part of doing my job is that they believe I'm someone else, you know? That's part of my job.
And if they start watching me and thinking about the fact that I got a divorce or something in my real life or these things, I don't think I'm doing my job.
Steve Kroft: You want to be a mystery? Philip Seymour Hoffman: Well, you just want to be--you don't want people to know everything about your personal life or they're going to project that also on the work you do.
It's impossible not to.
If you know enough about somebody, it's impossible not to--like my friends who I've grown up with and know me very well, I know they watch my films different than anyone else.
I know they come up to you like, "Oh, that thing you did, that's just like that thing you do," you know? They'll say that.
And you know, you want to find a way even to get them to think you're someone else.
And when you get that person that knows you that well to think you're actually someone else and lose themselves, then you've really done your job.
It was a challenge he faced every day in what is perhaps his most famous role.
His portrayal of Truman Capote, who for 20 years was not only America's most famous writer, but one of its most recognizable celebrities.
[Philip Seymour Hoffman as Capote: Have you read the article about the killings in Kansas in the front section of the New York Times? I think that's what I want to write about.
.]
The film deals with the six years that Capote spent writing "In Cold Blood," which would make him famous and in the process, ruin his life.
The project was developed by two of Hoffman's oldest friends, Bennett Miller, the film's director, and screenwriter Dan Futterman.
The three had met when they were 16 years old and knew each other so well they were concerned the film might end their friendship.
Steve Kroft: This is what Bennett Miller says about you: "He works himself into a state of crisis and distress worrying that people are going to know he's a fraud.
And that his career is over.
" Philip Seymour Hoffman: He talks too much that guy.
Well, you do think your career is going to be over all the time I mean that-- that's pretty common.
Part of my job is actually that it's me.
I'm not a painter, I'm not a musician, I'm not these things where actually I'm creating something that then I can distance myself-- and you can actually experience it.
I'm actually the one.
It's me.
My body, my head, my mind, my voice.
It's right here.
You know, and there is something about people criticizing that, or failing in that realm, and it's actually you they're talking about, that is-- that's hard.
That's hard to take.
And I do fear that, definitely.
Hoffman spent a huge amount of time at Miller's apartment studying old film.
(Footage of Truman Capote) Truman Capote: You know that it had that effect on you, personally Philip Seymour Hoffman: He leans right in there.
I mean, the guy's not even looking at him but he's (Footage of Truman Capote) Truman Capote: .
It had that effect on me.
Bennett Miller: I mean, look at how he adjusts himself to the guy, you know.
Plumbing the depths of Capote's life and his own to try and capture the character and get inside his head.
He was worried that the line between parody and perfection was razor thin.
Philip Seymour Hoffman: I knew that this was going to be something that the risk quotient was high.
Steve Kroft: Why was it high risk? Bennett Miller: Just the possibility of humiliation.
Philip Seymour Hoffman: Yeah, failing was high.
Yeah, it was huge.
People knew who he was.
He's an iconic figure.
I--just the fear, the nightmare or the fear of just being embarrassingly bad in the role was--was very real.
[Philip Seymour Hoffman in "Capote:" This research and this work have changed my life.]
Steve Kroft: How did you identify with him? Philip Seymour Hoffman: The ambition, the drive, the wanting to be the center of attention, the wanting to succeed.
Steve Kroft: Those are all you? Philip Seymour Hoffman: Yeah.
They're all inside me somewhere.
Hoffman grew up in a middle-class household near Rochester, N.
Y.
In high school, he was a clean-cut, competitive jock who excelled in baseball and wrestling until a neck injury cut short his athletic career and his hormones led him to acting.
Philip Seymour Hoffman: This woman that I was just--had a mad crush on--woman, girl.
She was in high school, walked by the other way.
I said, "Where are you going?" And she's going, "I'm going to go audition for a play.
" You know, and kept walking.
"I think I'll go, too," and I turned around and I followed her in.
And I auditioned for the play and I got to be with her every day, you know what I mean? It was like you're a teenager and you have a crush, you know.
And then, all of a sudden, it's not about the crush.
All of a sudden, you realize you like doing theater and you like being an actor and you like hanging out with these people.
Over time, he applied the same competitive drive he had with wrestling to grappling with roles on stage and screen, steadily building an impressive resume with a stubborn, single-minded zeal for perfection that he was never entirely comfortable with.
Philip Seymour Hoffman: If I don't think I'm doing well, I'm unpleasant.
That's my neurosis.
You know what I mean? If I don't feel like I'm doing the job well and I don't know how to get there or I'm too scared or whatever, I'm--I'm not a happy guy, and I'm not pleasant.
I'm not pleasant to be around.
Steve Kroft: You feeling all right about this? Philip Seymour Hoffman: Oh, yeah, yeah.
Yeah, yeah.
Steve Kroft: Yeah, yeah.
Is it going alright? Philip Seymour Hoffman: But I--I think that that--yes, actually I do feel right about it.
I mean, this is me being pleasant, I hope.
The depth of Hoffman's commitment and his talent are apparent in one of the final scenes of "Capote.
" After six years of cajoling, befriending and seducing two killers into telling him a story that will make him famous, the author says his final goodbyes as they head off to the gallows.
[Philip Seymour Hoffman in "Capote:" I did everything I could Character: OK.
Philip Seymour Hoffman in "Capote:" I truly did.
.]
It took Hoffman nine months of his life to get the performance just right and when the shooting was over he was tapped out and done being Truman Capote.
Philip Seymour Hoffman: I remember I immediately started talking like myself, like that, and I--and I thought to myself, I'm never going--I'm never going to do that again.
I'm not going to act like him anymore.
Steve Kroft: Why? Philip Seymour Hoffman: Because I was free, first off.
So the minute you're able to walk away from that, separate yourself, you do.
I do.
Steve Kroft: So you can't even do it like one more time? Philip Seymour Hoffman: No.
Steve Kroft: Like drunk at a party? Philip Seymour Hoffman: Yeah.
That might be, you know, if I start drinking again, you might be able to get me to do it.
That last comment was a small slip for someone who guarded his privacy as closely as Hoffman did.
But it told us something about his past.
Steve Kroft: You said you don't drink.
Philip Seymour Hoffman: No, I don't.
Steve Kroft: In fact you went into rehab at a fairly early age.
Philip Seymour Hoffman: Yeah, I did, I did.
I went--I got sober when I was 22 years old.
Yeah.
Steve Kroft: So this was drugs or alcohol or both? Philip Seymour Hoffman: Yeah, it was all--all that stuff, yeah.
It was anything I could get my hands on, yeah.
Yeah.
I liked it all.
Yeah.
Steve Kroft: And why did you decide to stop? Philip Seymour Hoffman: You get panicked.
You get panicked.
It was--I was 22 and I got panicked for my life.
It really was.
It was just bad.
I was putting myself in situations and predicaments that were dangerous.
Even now I think about it, I was so young, I was I-- there's things I want to do.
You know, there's things I want to do.
And I'm not gonna do them if I keep doing this.
It's not gonna happen.
Steve Kroft: So what was rehab like? Philip Seymour Hoffman: It's a lot of things.
It is a lot of things.
But-- but I do-- don't-- I-- wouldn't really get into too much.
But- Steve Kroft: It changed you.
Philip Seymour Hoffman: It did, yeah.
Yeah.
It did.
Meaning it was a-- it was a respite.
It was a break.
There was something about it that I remember it just-- it just-- it-- it so-- drastically pulled me out of my life.
It changed something.
It made me see things differently.
It made me see things differently.
Gave me this idea that those-- you know, those things you want to do Phil? Those things you-- you want to get done, you can do them And he managed to do a lot of them.
He won the Oscar for "Capote," and would be nominated three more times.
And there were the triumphs on the New York stage.
["Death of a Salesman" ad: Philip Seymour Hoffman is magnificent, I beg you not to miss it.
.]
Friends believe Hoffman began drinking again in 2012, while losing himself in the physically and emotionally exhausting role of Willie Loman in "Death of a Salesman" and then he eventually sought escape revisiting heroin.
He was trying to quit, but unable to muster the discipline he found in his work to save his own life.
When he was found dead last week, people remembered not just the characters Philip Seymour Hoffman created, they remembered him.
Especially on the Great White Way which went dark in his honor.
Philip Seymour Hoffman: The best you'll ever feel is when you've done a good job.
That's the best you'll ever feel.
And that satisfaction is wonderful because it's a job well done.
And I'm grateful for all of it.
But I know at the end of the day that when I was shooting "Capote" or I was shooting any film I've done or done any play that the day that ended where I felt like I acted well and I went home and I was able to breathe a free breath that was long and deep, you know, and will go to bed and my eyes shut and I went to sleep peacefully.
Those-- that's-- that's as good as it gets.
It cut the recommended dose of the most popular sleep drug in the country, Ambien, in half for women.
It turns out men and women metabolize Ambien, known generically as Zolpidem, very differently, leaving women with more of the drug in their bodies the next morning, and therefore at a greater risk of impaired driving.
Ambien, Zolpidem, is now the only prescription drug in the country with a different suggested dose for men and women.
But we've discovered it is far from an isolated example of differences between the sexes we never imagined.
More and more, scientists are realizing that the differences are dangerously understudied and that pervasively and fundamentally, sex matters.
Take aspirin.
Low-dose aspirin lowers the risk of heart attacks in healthy men; but in healthy women, turns out it doesn't though it does protect women against stroke.
And drugs are just the beginning.
Sex differences have been found in pain receptors, liver enzymes, even the wiring of the brain.
Larry Cahill: We have generated just a ton of information that suggests that there're sex differences everywhere.
Larry Cahill, a neuroscientist at the University of California Irvine, used to share his field's assumption that males and females outside the reproductive system were fundamentally the same.
But he's changed his outlook 180 degrees.
Ambien, he says, is a case in point.
Lesley Stahl: Ambien, prescribed 40 million times just last year, approved 20 years ago.
We're only now finding out that women have been prescribed-- a dose that's twice as high as they need.
Larry Cahill: That is a textbook example of what's wrong.
How did it happen that for 20 some years, women, millions of them, were essentially overdosing on Ambien? The FDA says it made the change after new driving simulation studies established what amount of Ambien or Zolpidem in the blood the next morning could be dangerous for driving.
Dr.
Sandra Kweder, deputy director of the FDA's office of new drugs, says only then did they realize women could be taking too much, since women metabolize the drug differently than men.
Dr.
Sandra Kweder: So if I took Zolpidem, and my brother took same dose, probably the maximum level of drug in my blood would be Lesley Stahl: Now that sounds substantial- Dr.
Sandra Kweder: It is substantial.
But we discovered that that 45 percent difference between men and women had been known to the FDA all along.
In the original FDA review of Ambien back in 1992, there was a page called "Effect of Gender," where the FDA reviewer noted that two key measures of how much drug is in the bloodstream "were approximately Larry Cahill: It appears to say that they found a significant difference in how this drug is being processed in the body.
And then the question is, "What did they do with that?" and the answer appears to be, "Eh.
" They rationalized it away.
Lesley Stahl: I'm gonna hand you that page, "Effect of Gender.
" Dr.
Sandra Kweder: OK.
Lesley Stahl: The FDA reviewer went on to write, "The results suggest a gender-related difference.
However, the lack of specific details such as study design and individual data make it difficult to draw a definite conclusion--" Dr.
Sandra Kweder: Exactly.
Lesley Stahl: So when you see that they didn't give you enough data, did you go back, or should you have gone back, and said, "OK, what was the study design? What was the data?" Dr.
Sandra Kweder: If I saw this today, in light of today's science, I think we would go back and try to tease this out a little bit further.
But I think at the time, this was generally consis-- this was sort of business as usual for what you saw in clinical pharmacology studies.
That's because, she says, there was no evidence at the time that the difference mattered.
That was 20 years ago, when if someone said "women's health," it usually meant what they call "bikini medicine" -- breast and ovarian cancer, pregnancy, menstrual cycles.
But for parts of the body men and women share -- hearts, kidneys, the brain -- most of the studies were done predominantly on men.
Lesley Stahl: If you want to understand me, they study you? Larry Cahill: And here's why they do that.
Because there's this assumption that you are me with pesky hormones.
Lesley Stahl: Ohwith pesky hormones.
Larry Cahill: I'm being only partially facetious.
The idea is that the fundamental things are similar between you and me.
So that ironically the best way to study you is to study me.
Lesley Stahl: Cause you don't have pesky hormones.
Larry Cahill: Right.
We're studying all the fundamental things in you without this sort of nuisance stuff.
That's literally an assumption on which all of biological medicine, especially neuroscience, which I know best, has been built.
But given what we now know, he says that assumption has to go.
Look at heart disease, which is the leading killer of both men and women.
Cardiologist Noel Bairey Merz from Cedars-Sinai Medical Center in Los Angeles says women, like her patient Pearl Grumet, can differ from men in the way they have heart attacks.
Pearl Grumet: I had this excruciating pain in between my shoulder blades.
And then I got the nauseous feeling in my stomach Lesley Stahl: So the man comes in, he has chest pain, sometimes a radiating pain down the left arm.
The woman comes in and she says- Dr.
Noel Bairey Merz: She might be having stomach upset, she might be feeling fatigue.
She might just be short of breath.
Lesley Stahl: Why does she even go? Dr.
Noel Bairey Merz: 'Cause they don't feel right.
And they know something's wrong.
Lesley Stahl: They know something's wrong.
Lesley Stahl: Did you ever have chest pain in this whole time? Pearl Grumet: No.
Dr.
Noel Bairey Merz: You can see, here's the constriction.
Typically men get clogs in major arteries that are easy to see on an angiogram.
But many women get blockages in tiny microvessels inside the heart.
So their heart disease is more often missed.
Pearl had four minor heart attacks; five different hospitals couldn't find the problem.
Pearl Grumet: Doctor comes in and he says, "When you find out what's wrong with you, would you please let me know?" Lesley Stahl: No, come on.
Pearl Grumet: "'Cause we don't have any idea what's wrong.
" Dr.
Bairey Merz says one of the reasons we haven't learned more about women goes all the way back to the beginning of the scientific pipeline, to research on animals.
Dr.
Melina Kibbe is a vascular surgeon who also runs a lab at Northwestern University Medical School, where she evaluates new therapies in mice and rats.
Lesley Stahl: If I walked into a lab anywhere in the country doing animal research, what are my chances of coming upon a study with only male animals? Melina Kibbe: Very large.
Lesley Stahl: Today? Melina Kibbe: Correct.
Turns out female rats also have those pesky hormones.
Melina Kibbe: So to control for that variable, most researchers study just males.
I was also studying just males.
Lesley Stahl: So it made sense? Or you maybe didn't even think about it? Melina Kibbe: I didn't even think about it.
And neither did Doris Taylor, a leading stem cell expert at Texas Heart Institute in Houston -- until she was designing an experiment in mice, to see if injections of stem cells could reverse plaque build-up in their arteries, and she needed a way to track the stem cells in the animals.
Doris Taylor: So what we decided to do is give female animals male stem cells, because we could track the Y chromosome.
And we said, "Let's give male animals female cells.
" Lesley Stahl: You only did it so you could track the cells.
Doris Taylor: So we could track the cells-- She was surprised to find that the results were not the same.
Doris Taylor: The male animals we gave female cells got better.
And the female animals we gave male cells actually got a little worse.
Only the female stem cells got rid of the plaque.
Doris Taylor: And you can see all this fat here, the pink-- The male mouse artery on the left had not been treated; the one on the right got female stem cells.
Doris Taylor: And look at that.
Lesley Stahl: It's clean.
Doris Taylor: I am embarrassed to admit that, as a woman, it had never really occurred to me that doing the experiment in male versus female animals would give completely different results.
And that led to further discoveries.
Taylor wanted to find out if human stem cells were different too, and she's found that.
They are.
Lesley Stahl: My stem cells are actually different stem cells from a man's? Doris Taylor: Yes.
She told me men's are less powerful to begin with; and then they start to die off.
Doris Taylor: In men as they age, they decrease pretty dramatically.
And in females, they stay relatively stable.
Now, think about that- Lesley Stahl: Wow.
Doris Taylor: Men develop heart disease much earlier than women.
Why not look at the difference and see how to make men live longer without heart disease? She speculates that ignoring this difference may be one reason stem cell treatments haven't lived up to their promise.
And on a broader level, that not studying both male and female animals results in more problems for women down the road.
Larry Cahill: If the whole darn pipeline is male dominated and sex differences truly do matter, how can it not be the case that you're going to end up with, on average, a lot more negative side effects in women than in men? I mean it basically has to happen.
And it does.
A GAO report found "8 of the market from 1997 to 2001 "posed greater health risks for women than for men.
" Today when it comes to government-funded studies on humans, women must be included by law.
But many researchers don't then take the next step and analyze the results by sex, which some argue defeats the whole purpose.
Lesley Stahl: We have come upon studies where they do use both male and female, but they then don't analyze how the two respond differently.
So they have the two and no analysis of the difference.
Doris Taylor: If you do the two together and you really think females are here and males are here or vice versa, [gestures with hands.]
then you're gonna get results that are right here- Lesley Stahl: And so they're almost useless- Doris Taylor: And so they're almost not predictive of either males or females.
Larry Cahill: If you're clumping men and women together in your study and there truly is a sex difference, you're not just harming the women; you're harming the men.
You're muddling up the understanding of what's going on, you're muddling up the path to clear treatment, not just for the women, but for the men as well.
The problem, he says, is that the scientific establishment hasn't caught up with its own discoveries.
Lesley Stahl: If science got Ambien so wrong, does that tell you that we really need to go back and review- Larry Cahill: Yes.
Lesley Stahl: What? Everything? Larry Cahill: Pretty much everything, yeah, 'cause once you see this difference and that difference and that difference and that difference and that difference and you see, "This thing's everywhere," you go, "Wait a minute.
So the assumption we're making that it really doesn't matter, sex, is not a valid assumption.
" It may not matter.
It may matter hugely.
It may flip your results on their head and you don't know.
So what happens is you start to realize, "Wow.
The status quo is not OK.
The way we're doing business has to change.
" Lesley Stahl: There are scientists who say the Ambien situation is like a wakeup call.
It's a tip of the iceberg.
So, should the FDA go back and look at other drugs? Dr.
Sandra Kweder: Well, you know, to say every drug-- every drug, go back and look again? Lesley Stahl: Yeah.
Dr.
Sandra Kweder: That's an enormous undertaking.
Lesley Stahl: So can women feel secure that the dosages recommended on any of their medications is proper for them? Or should they now be a little worried? Dr.
Sandra Kweder: In medical practice, there is a general awareness that there may be individual differences among patients.
And that every patient needs to have the right dose.
Lesley Stahl: How's a doctor supposed to know? Dr.
Sandra Kweder: You start at the lowest dose, and you see if it's enough.
Lesley Stahl: Yeah, but you're doing the studies.
And they're gonna rely on your recommendation.
Dr.
Sandra Kweder: Yup.
Lesley Stahl: It sounds like the FDA is being more reactive than aggressive about this.
Dr.
Sandra Kweder: I think we're being very aggressive about bringing the most sophisticated science to new drugs and being aggressive about applying the science where we have reason to believe there is a concern to older drugs.
The FDA told us it is looking at other sleep drugs for possible sex differences, but not mounting an across the board review.
As of today, Zolpidem remains the only drug on the market with different recommended doses for men and women.
Giving apartments to homeless people who've been on the streets for years before they've received treatment for drug or alcohol problems or mental illness may not sound like a wise idea.
But that's what's being done in cities across America in an approach that targets those who've been homeless the longest and are believed to be at greatest risk of dying, especially with all of this cold weather.
They're people who once might have been viewed as unreachable.
But cities and counties affiliated with a movement known as the 100,000 Homes Campaign have so far managed to get 80,000 of them off the streets.
Local governments and non-profit groups do most of the work.
The money comes mostly from existing federal programs and private donations, and there's evidence that this approach saves taxpayers money.
If it sounds too good to be true, then take a look at what's been happening in Nashville, one of the latest cities to join the 100,000 Homes Campaign.
Ingrid McIntyre: You awake, buddy? [Ingrid knocks on door.]
Ingrid McIntyre: Robert? In a storage facility on the outskirts of Nashville, outreach worker Ingrid McIntyre introduced us to Robert McMurtry.
Ingrid McIntyre: Hey good morning.
I want to introduce you to my friend Anderson.
Anderson Cooper: Hey I'm Anderson, how are you? She'd come to ask him some questions about his health.
Ingrid McIntyre: How many times have you been to the Emergency Room in the past three months? Robert McMurtry: Uh, twice.
Robert told Ingrid he had a lot of medical problems: HIV, hepatitis C, and throat cancer.
He was getting treatment at Vanderbilt University Medical Center, but living in this storage locker without a toilet or running water.
He bathed in a stream by the side of the road.
He said he'd been homeless for three years.
Anderson Cooper: How old are you? Robert McMurtry: I'm 48.
Anderson Cooper: Forty-eight? I'm 46, so we're two years apart.
Robert McMurtry: Uh-huh.
Anderson Cooper: It's nice to see someone else with gray hair.
He said he used to work in the construction business but fell on hard times after he lost his job and became ill.
A friend took pity on him and allowed him to stay in this storage locker for the past three months.
Robert McMurtry: I never imagined I'd ever be homeless, 'cause I had-- I really worked really hard my whole life and it was just devastating really when it happened because I never imagined that I would be in this condition.
Ingrid McIntyre runs a nonprofit called Open Table Nashville, that's been working with the 100,000 Homes Campaign to survey the city's homeless - and identify those at greatest medical risk.
Anderson Cooper: Do you think he's at high risk? Ingrid McIntyre: I mean he's one of the most vulnerable people that I know.
Three days after interviewing Robert, she returned with an offer that was hard to believe.
Ingrid McIntyre: If you want to, I have an apartment for you tomorrow.
Robert McMurtry: Really? Ingrid McIntyre: Do you want it? Robert McMurtry: Yes.
I do, really.
Ingrid McIntyre: Good.
The following day.
Robert McMurtry: Wow man.
Robert moved in to his very own apartment.
Robert McMurtry: This is great.
It's in a private building in downtown Nashville.
He wouldn't have to bathe in that stream anymore.
The apartment has one bathroom, one bedroom, and access to this rooftop pool.
Until fairly recently someone like Robert would have to jump through a series of bureaucratic hoops, and go through a treatment or job training program before getting permanent housing.
The 100,000 Homes Campaign advocates using an approach first developed in New York in which the homeless are given housing first.
Becky Kanis: What we're really aiming for in this movement is that person that's been on the streets, many cases for decades- who you walk past and you're like, "Oh, I can't even imagine this person being able to be in housing.
" Anderson Cooper: The hardcore homeless.
Becky Kanis: The hardest core of the hardest core- who also happen to be at the highest risk for dying on the streets.
Becky Kanis works for a group called Community Solutions, which created the 100,000 Homes Campaign.
She says most of the 600,000 people who are homeless in the United States on any given night are on the streets for relatively short periods of time, usually less than a month.
But it's the chronic cases, people homeless for more than a year, who Kanis says are most in need of help.
Becky Kanis: They're out of friends who will let them sleep on their couch.
They're out of friends who will help them get a job.
They've burned the bridges of the friends or they just didn't have 'em in the first place.
More than 60 percent of the chronically homeless have drug or alcohol addictions.
Thirty percent suffer from severe mental illness.
Kanis says many of these people have such serious medical problems, it costs taxpayers more to leave them on the street.
Anderson Cooper: How is it costing more? Becky Kanis: The inability to tend to your basic healthcare needs, results in people on the streets ending up in emergency rooms and ending up in in-patient hospitalizations.
And one night in the hospital is a whole month's rent on most places.
Anderson Cooper: So you're saying it's more expensive to allow a chronically homeless person to live on the streets than it is to actually subsidize an apartment for them? Becky Kanis: Yes, we are paying more as taxpayers to walk past that person on the street and do nothing than we would be paying to just give them an apartment.
Becky Kanis began working for the 100,000 Homes Campaign after a career in the military.
She's a West Point graduate and former Army officer who worked with the Special Operations Command.
Anderson Cooper: Do you think having a military background helps? Becky Kanis: I absolutely think it does.
It's boots on the ground intelligence that I think is one of the defining factors.
To get that boots on the ground intelligence the 100,000 Homes Campaign encourages teams of volunteers and outreach workers to spend three nights looking for and interviewing the homeless.
In late May, we joined the teams in Nashville as they headed out at three in the morning, searching in small patches of woods under highway over-passes and in caves where the homeless camp.
Will: Hey, sorry to wake you.
My name's Will.
Those who agreed to answer a series of survey questions would get a free bus pass in return.
Will: How many times have you been to the Emergency Room in the past three months? Homeless man: About five times.
The questions are mainly about their health Volunteer : HIV or AIDS? Volunteer: Liver disease? Cirrhosis? Volunteer: History of stroke or heat exhaustion? The information is used to decide who gets apartments first by giving priority to those at greatest risk of dying on the streets.
And the risk is very real.
Homeless man singing: Rocky top you will always be.
home to me.
On the steps of this church, a man froze to death last year, one of 52 homeless people who died in the city.
? Not everything the homeless told the survey teams was accurate.
We checked and found some discrepancies.
But we were also surprised by the candor of some of the people we met.
Ernest Thomas who has a prosthetic leg, says he once hoped to work in a pharmacy, but ruined his job prospects by getting involved with drugs and crime.
He was on parole when we spoke.
Ernest Thomas: Look at me, man, I'm 39 years old.
And I ain't got nothing.
You know I'm sayin'? I don't even call my kids.
You know, when I do call 'em, they be, like, "Dad how you doin'?" I gotta lie and fantasize.
Oh, man, I'm straight.
Anderson Cooper: So how do you think you-- you ended up on the street? Ernest Thomas: Honest with you, man, I can't tell you.
I really don't know.
I messed up.
Somewhere, I messed up.
Yeah.
Will Connelly is director of the city's Homelessness Commission.
He is the person who decided Nashville should adopt the 100,000 Homes Campaign's approach.
He'd already lined up a number of apartments for the people identified by the survey.
Anderson Cooper: And these are fully furnished apartments, ready to go that these people can just move into? Will Connelly: Yeah.
Yeah.
Permanent housing, no strings attached really.
As long as they abide by that lease agreement, it's-- it's theirs.
The apartments are paid for mostly by the federal government which gives rental assistance subsidies for veterans and people with low income.
The homeless are expected to contribute things like part time work, social security, or disability.
Some apartments - like Robert McMurtry's - were provided by civic-minded landlords willing to accept very little rent.
Kirby Davis donated one percent of his units and has encouraged other building owners to do the same.
Anderson Cooper: And what's the push back you're getting? Kirby Davis: That-- they might harass my other residents, what are my other residents gonna think? What kinda liability do we have? Anderson Cooper: And-- and what do you say to that? Kirby Davis: None of 'em got to where they are not taking risk.
So how about taking a risk for somebody else? Kirby Davis meeting with landlords: Why don't we go around the room and introduce ourselves? No new tax dollars were required for Nashville's campaign to house the chronically homeless.
A lot was achieved by getting people who don't normally work together - such as outreach workers and private landlords -- to focus on the city's most desperate residents.
Landlord: What I'll do is try two units and we'll start with that and give it a try.
To determine who should get apartments first, the homeless who were surveyed got ranked based on their medical risk factors.
Robert McMurtry finished high on the list, but there were some in even worse shape.
Anderson Cooper: So who are some of the people you've identified? Will Connelly: The most vulnerable is-- his name's Frank.
Frank is Frank Clements, who spent more than For him and a friend, home was now this park bench.
Ingrid McIntyre: Where are you guys staying right now? Frank Clements: Right here.
Ingrid McIntyre: Right here? Jerry: Right here.
Ingrid McIntyre: Yeah There was a bottle of mouthwash by his side, which is what alcoholics sometimes drink when they can't afford liquor.
Frank was 66 years old and said he'd been treated for two types of cancer, pneumonia, and heart disease.
Ingrid McIntyre: How many times have you been to the emergency room in the past three months? Frank Clements: About three times.
Four days after he answered those questions, he was walking into his new apartment Outreach worker: This is your new home! Frank Clements: All rightMy heart is full of gratitude.
And you know, it's awesome.
I mean you don't see people like this that help people out you know.
To try and ensure the homeless don't end up back on the streets, social workers check in on them regularly.
Ashley: Do you mind if I have a seat? Frank Clements: Well of course you can.
Frank Clements needed more help than most.
The morning after he got an apartment, we found him finishing off a bottle of whiskey.
Frank Clements: I ain't no angel.
I'm a damn drunk.
In the weeks that followed, social workers tried to help Frank get treatment, they even drove him to appointments.
He'd get sober for a while, then start drinking again, then be filled with remorse.
He was so disruptive when drunk he had to be moved out of two different apartments.
Some critics of the 100,000 Homes Campaign question whether scarce housing resources would be better spent on homeless kids or working-poor families rather than somebody like Frank.
Anderson Cooper: Is it fair to give somebody an apartment who's made bad choices and is being irresponsible? Becky Kanis: I don't think fairness is the right way to look at it.
What I would prefer to look at it is what's good for everybody.
So having somebody on the streets, fair or not fair, is costing us as a society as taxpayers more than it would cost to have them in housing.
Anderson Cooper: It does seem like you're rewarding somebody though, who's-- you know, drinking or doing drugs or just being irresponsible.
Becky Kanis: I see it as giving them a second chance.
And most people, given that second chance, do something about those behaviors.
So far, Robert McMurtry has made the most of his second chance.
He made friends in his building, and three months after he got his own apartment, we were amazed to see him jogging in a nearby park.
Researchers at the University of Pennsylvania found that when homeless people in Philadelphia were given housing and support, more than 85 percent were still in housing two years laterand were unlikely to become homeless again.
Ingrid McIntyre: How's it going? Everything went great this morning? I'm so glad, you look awesome.
Man playing guitar at luncheon: 2,3,4 everywhere that I go In September, homeless advocates in Nashville held a luncheon for some of the people they had helped.
In 100 days, they had gotten nearly were still in their apartments.
But there weren't enough apartments for everyone.
Ernest Thomas didn't get one.
He ended up back in prison on a parole violation and then homeless once again.
By this summer, Nashville and other communities across the country that have joined the 100,000 Homes Campaign expect to reach their goal of getting 100,000 people off the streets.
That won't completely solve the problem, but Becky Kanis says it will prove that it can be solved, and that no one is unreachable.
Becky Kanis: We have an amazing collection now of before pictures and after pictures that just captures the transformation that's possible once someone's in housing.
There is something that's really dehumanizing about living on the streets in so many ways.
And then, really, in a matter of days, from having housing, the physical transformation is almost immediate.
And they're unrecognizable from their former selves.
And I don't think that there's anybody, once they see that, that would-- say, "Well, let's put them back on the streets again.
" When the actor Philip Seymour Hoffman was found dead in his apartment last week from an apparent heroin overdose it came as a shock to all but his closest friends and family.
How he came to die that way, at the height of his fame, is still a mystery, although this was not Hoffman's first battle with drug addiction.
He was only 46 years old, but he had already created a lifetime's worth of memorable characters and the New York Times, in a front page obituary, called him perhaps the greatest actor of his generation.
He was in talent, in temperament and commitment a true artistintense, introspective, sensitive, and obsessed with his work.
He did not often sit still for long interviews, but he did for us back in 2006, as his career was taking off.
He had just received an Academy Award nomination for best actor in the film "Capote" and we spent several days in New York and L.
A.
talking about his life, his work and his demons.
Philip Seymour Hoffman: If you can go to the theater and you're in a room with a bunch of other people and what's happening in front of you is not happening, but you actually believe it is, if I can do that, I've done my job.
And that's the thing that is a drug.
That's a drug.
That's something you get addicted to.
When we talked to Philip Seymour Hoffman eight years ago he told us he'd rather people remember the characters he'd played than remember him.
He insisted on meeting us at 8 a.
m.
in the heart of New York's Greenwich Village, which was the center of his world for nearly 30 years.
He went to drama school here at New York University and never really left the neighborhood.
Steve Kroft: So why did you want to do this at 8? Philip Seymour Hoffman: I thought it'd be easier to talk and stuff and there wouldn't be as many people around.
He came dressed as though he might have slept in this park or wandered out of a homeless shelter.
Yet we still got stopped by an admiring fan.
Unidentified Woman: You deserve the Oscar, Mr.
Hoffman.
Philip Seymour Hoffman: Thank you.
He was already a familiar face, having appeared in 40 films in just 14 years.
Working with major stars and A-list directors, he'd become famous taking small roles and transforming them into memorable characters.
Like the trust fund playboy in "The Talented Mr.
Ripley" or the pernicious preppie in "Scent of a Woman.
" Or the gay, curious sound man in "Boogie Nights.
" Not to mention various turns as the obnoxious, overweight friend and a pre-op transsexual, all of which beg the question about his scruffy wardrobe.
Steve Kroft: Is this the real Phil Hoffman or are you now preparing for some other role? Philip Seymour Hoffman: No, this is me.
He was totally without vanity unless the role called for it and despite his success at age artist, consumed with the craft of being an actor, and grateful for the recognition.
Yet suspicious of fame and celebrity and how it might change him and what he did.
Philip Seymour Hoffman: I think part of being an actor is staying private.
I do think it's important.
Part of doing my job is that they believe I'm someone else, you know? That's part of my job.
And if they start watching me and thinking about the fact that I got a divorce or something in my real life or these things, I don't think I'm doing my job.
Steve Kroft: You want to be a mystery? Philip Seymour Hoffman: Well, you just want to be--you don't want people to know everything about your personal life or they're going to project that also on the work you do.
It's impossible not to.
If you know enough about somebody, it's impossible not to--like my friends who I've grown up with and know me very well, I know they watch my films different than anyone else.
I know they come up to you like, "Oh, that thing you did, that's just like that thing you do," you know? They'll say that.
And you know, you want to find a way even to get them to think you're someone else.
And when you get that person that knows you that well to think you're actually someone else and lose themselves, then you've really done your job.
It was a challenge he faced every day in what is perhaps his most famous role.
His portrayal of Truman Capote, who for 20 years was not only America's most famous writer, but one of its most recognizable celebrities.
[Philip Seymour Hoffman as Capote: Have you read the article about the killings in Kansas in the front section of the New York Times? I think that's what I want to write about.
.]
The film deals with the six years that Capote spent writing "In Cold Blood," which would make him famous and in the process, ruin his life.
The project was developed by two of Hoffman's oldest friends, Bennett Miller, the film's director, and screenwriter Dan Futterman.
The three had met when they were 16 years old and knew each other so well they were concerned the film might end their friendship.
Steve Kroft: This is what Bennett Miller says about you: "He works himself into a state of crisis and distress worrying that people are going to know he's a fraud.
And that his career is over.
" Philip Seymour Hoffman: He talks too much that guy.
Well, you do think your career is going to be over all the time I mean that-- that's pretty common.
Part of my job is actually that it's me.
I'm not a painter, I'm not a musician, I'm not these things where actually I'm creating something that then I can distance myself-- and you can actually experience it.
I'm actually the one.
It's me.
My body, my head, my mind, my voice.
It's right here.
You know, and there is something about people criticizing that, or failing in that realm, and it's actually you they're talking about, that is-- that's hard.
That's hard to take.
And I do fear that, definitely.
Hoffman spent a huge amount of time at Miller's apartment studying old film.
(Footage of Truman Capote) Truman Capote: You know that it had that effect on you, personally Philip Seymour Hoffman: He leans right in there.
I mean, the guy's not even looking at him but he's (Footage of Truman Capote) Truman Capote: .
It had that effect on me.
Bennett Miller: I mean, look at how he adjusts himself to the guy, you know.
Plumbing the depths of Capote's life and his own to try and capture the character and get inside his head.
He was worried that the line between parody and perfection was razor thin.
Philip Seymour Hoffman: I knew that this was going to be something that the risk quotient was high.
Steve Kroft: Why was it high risk? Bennett Miller: Just the possibility of humiliation.
Philip Seymour Hoffman: Yeah, failing was high.
Yeah, it was huge.
People knew who he was.
He's an iconic figure.
I--just the fear, the nightmare or the fear of just being embarrassingly bad in the role was--was very real.
[Philip Seymour Hoffman in "Capote:" This research and this work have changed my life.]
Steve Kroft: How did you identify with him? Philip Seymour Hoffman: The ambition, the drive, the wanting to be the center of attention, the wanting to succeed.
Steve Kroft: Those are all you? Philip Seymour Hoffman: Yeah.
They're all inside me somewhere.
Hoffman grew up in a middle-class household near Rochester, N.
Y.
In high school, he was a clean-cut, competitive jock who excelled in baseball and wrestling until a neck injury cut short his athletic career and his hormones led him to acting.
Philip Seymour Hoffman: This woman that I was just--had a mad crush on--woman, girl.
She was in high school, walked by the other way.
I said, "Where are you going?" And she's going, "I'm going to go audition for a play.
" You know, and kept walking.
"I think I'll go, too," and I turned around and I followed her in.
And I auditioned for the play and I got to be with her every day, you know what I mean? It was like you're a teenager and you have a crush, you know.
And then, all of a sudden, it's not about the crush.
All of a sudden, you realize you like doing theater and you like being an actor and you like hanging out with these people.
Over time, he applied the same competitive drive he had with wrestling to grappling with roles on stage and screen, steadily building an impressive resume with a stubborn, single-minded zeal for perfection that he was never entirely comfortable with.
Philip Seymour Hoffman: If I don't think I'm doing well, I'm unpleasant.
That's my neurosis.
You know what I mean? If I don't feel like I'm doing the job well and I don't know how to get there or I'm too scared or whatever, I'm--I'm not a happy guy, and I'm not pleasant.
I'm not pleasant to be around.
Steve Kroft: You feeling all right about this? Philip Seymour Hoffman: Oh, yeah, yeah.
Yeah, yeah.
Steve Kroft: Yeah, yeah.
Is it going alright? Philip Seymour Hoffman: But I--I think that that--yes, actually I do feel right about it.
I mean, this is me being pleasant, I hope.
The depth of Hoffman's commitment and his talent are apparent in one of the final scenes of "Capote.
" After six years of cajoling, befriending and seducing two killers into telling him a story that will make him famous, the author says his final goodbyes as they head off to the gallows.
[Philip Seymour Hoffman in "Capote:" I did everything I could Character: OK.
Philip Seymour Hoffman in "Capote:" I truly did.
.]
It took Hoffman nine months of his life to get the performance just right and when the shooting was over he was tapped out and done being Truman Capote.
Philip Seymour Hoffman: I remember I immediately started talking like myself, like that, and I--and I thought to myself, I'm never going--I'm never going to do that again.
I'm not going to act like him anymore.
Steve Kroft: Why? Philip Seymour Hoffman: Because I was free, first off.
So the minute you're able to walk away from that, separate yourself, you do.
I do.
Steve Kroft: So you can't even do it like one more time? Philip Seymour Hoffman: No.
Steve Kroft: Like drunk at a party? Philip Seymour Hoffman: Yeah.
That might be, you know, if I start drinking again, you might be able to get me to do it.
That last comment was a small slip for someone who guarded his privacy as closely as Hoffman did.
But it told us something about his past.
Steve Kroft: You said you don't drink.
Philip Seymour Hoffman: No, I don't.
Steve Kroft: In fact you went into rehab at a fairly early age.
Philip Seymour Hoffman: Yeah, I did, I did.
I went--I got sober when I was 22 years old.
Yeah.
Steve Kroft: So this was drugs or alcohol or both? Philip Seymour Hoffman: Yeah, it was all--all that stuff, yeah.
It was anything I could get my hands on, yeah.
Yeah.
I liked it all.
Yeah.
Steve Kroft: And why did you decide to stop? Philip Seymour Hoffman: You get panicked.
You get panicked.
It was--I was 22 and I got panicked for my life.
It really was.
It was just bad.
I was putting myself in situations and predicaments that were dangerous.
Even now I think about it, I was so young, I was I-- there's things I want to do.
You know, there's things I want to do.
And I'm not gonna do them if I keep doing this.
It's not gonna happen.
Steve Kroft: So what was rehab like? Philip Seymour Hoffman: It's a lot of things.
It is a lot of things.
But-- but I do-- don't-- I-- wouldn't really get into too much.
But- Steve Kroft: It changed you.
Philip Seymour Hoffman: It did, yeah.
Yeah.
It did.
Meaning it was a-- it was a respite.
It was a break.
There was something about it that I remember it just-- it just-- it-- it so-- drastically pulled me out of my life.
It changed something.
It made me see things differently.
It made me see things differently.
Gave me this idea that those-- you know, those things you want to do Phil? Those things you-- you want to get done, you can do them And he managed to do a lot of them.
He won the Oscar for "Capote," and would be nominated three more times.
And there were the triumphs on the New York stage.
["Death of a Salesman" ad: Philip Seymour Hoffman is magnificent, I beg you not to miss it.
.]
Friends believe Hoffman began drinking again in 2012, while losing himself in the physically and emotionally exhausting role of Willie Loman in "Death of a Salesman" and then he eventually sought escape revisiting heroin.
He was trying to quit, but unable to muster the discipline he found in his work to save his own life.
When he was found dead last week, people remembered not just the characters Philip Seymour Hoffman created, they remembered him.
Especially on the Great White Way which went dark in his honor.
Philip Seymour Hoffman: The best you'll ever feel is when you've done a good job.
That's the best you'll ever feel.
And that satisfaction is wonderful because it's a job well done.
And I'm grateful for all of it.
But I know at the end of the day that when I was shooting "Capote" or I was shooting any film I've done or done any play that the day that ended where I felt like I acted well and I went home and I was able to breathe a free breath that was long and deep, you know, and will go to bed and my eyes shut and I went to sleep peacefully.
Those-- that's-- that's as good as it gets.