03.06.2019

March 6, 2019

Christiane Amanpour speaks with U.S. Presidential Candidate Pete Buttigieg and author Emma Sky. Alicia Menendez speaks with physician and author Sunita Puri about end of life care.

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> HELLO, EVERYONE, AND WELCOME TO 'AMANPOUR' AND COMPANY.'

HERE'S WHAT'S COMING UP...

> THE DEMOCRATS CHALLENGING TRUMP IN 2020.

ONE OF THE MOST DIVERSE FIELDS EVER.

AND ONE OF THE BIGGEST OUTSIDERS, PETE BUTTIGIEG, THE SMALL CITY MAYOR FROM THE MIDWEST, ON WHY HE SHOULD BE THE YOUNGEST AND THE FIRST MILLENNIAL PRESIDENT.

> THEN THE MIDDLE EAST EXPERT EMMA SKY TELLS ME THE REGION IS TRAPPED IN A TIME OF MONSTERS.

> PLUS, THE NUANCES OF MEDICAL SUPPORT AT THE END OF LIFE.

DR. SUNITA PURI TELLS OUR ALICIA MENENDEZ ABOUT THE GROWTH OF PALLIATIVE CARE.

♪♪♪♪♪

> WELCOME TO THE PROGRAM, EVERYONE.

I'M CHRISTIANE AMANPOUR IN LONDON.

PLENTY OF DEMOCRATS ARE THROWING THEIR NAMES FORWARD AND THROWING THEIR HAT IN THE RING TO CHALLENGE TRUMP FOR THE 2020 PRESIDENCY.

AMONG THEM IS PETE BUTTIGIEG.

HE'S KNOWN AROUND TOWN IN SOUTH BEND, INDIANA AS MAYOR PETE.

HE'S THE QUINTESSENTIAL LONG SHOT AND WOULD BE A PRESIDENT OF THE FIRST TO BE ELECTED IN HIS 30s.

THE FIRST MILLENNIAL.

THE FIRST OPENLY GAY COMMANDER . AND THE FIRST MAYOR.

AND ON THAT POINT, THAT WAS A TRANSITION THAT MANY THOUGHT COULD BE MADE BY THE FORMER NEW YORK MAYOR MICHAEL BLOOMBERG.

ALTHOUGH THE BILLIONAIRE HAS ALTHOUGH THE BILLIONAIRE HAS RULED HIMSELF OUT OF THE RACE.

BUTTIGIEG BRINGS A NEW GENERATION APPROACH. VOWING HUGE STRUCTURAL CHANGES IN ORDER TO GET THE U.S. WORKING FOR A MAJORITY OF THE PEOPLE.

AND IF THAT SOUNDS AMBITIOUS AND GRAND, HE SAYS, IT'S MEANT TO.

AND IT'S WORTH CONSIDERING THIS YEAR MILLENNIALS WILL OVERTAKE BABY BOOMERS AS THE LARGEST VOTING BLOCK IN AMERICA.

PETE BUTTIGIEG IS ONLY 37 YEARS OLD. BUT HE'S BEEN A BUSINESS CONSULTANT, AN OFFICER IN THE NAVY RESERVE,

> AND HE SERVED IN IN AFGHANISTAN IN 2014 AND IS JOINING ME NOW FROM SOUTH BEND, INDIANA.

MR. MAYOR, WELCOME TO THE PROGRAM.

THANK YOU.

THANKS FOR HAVING ME ON.

WELL, YOU KNOW WHAT?

IT IS A SMALL TOWN IN THE PERHAPS IT'S ONE OF THOSE SMALL TOWNS THAT WE'RE ALL ACCUSED OF FORGETTING AND SORT OF A FLYOVER AND ONE OF THESE TOWNS THAT MADE ITSELF FELT IN THE PREVIOUS SO HOW IS IT THAT YOU IN A VERY SHORT PERIOD OF TIME MANAGED TO TURN AROUND, YOU KNOW, THE COLLAPSE OF A WHOLE AUTO INDUSTRY, HUGE SORT OF UNEMPLOYMENT, HOUSES THAT WERE FALLING INTO DISREPAIR, WHAT DID YOU FIND AND HOW DID YOU DO IT?

WELL, THE VERY FIRST THING WE HAD TO DO WAS HAVE AN HONEST CONVERSATION ABOUT CHANGE.

I DIDN'T GO AROUND SAYING THAT I ALONE CAN FIX IT.

I DIDN'T BEAT MY CHEST AND SAY WE WERE GOING TO MAKE SOUTH BEND GREAT AGAIN.

AN HONEST POLITICS THAT REVOLVES AROUND THE WORD AGAIN.

WHEN I BECAME MAYOR WAS TO HAVE A DIALOGUE WITH THE COMMUNITY ABOUT HOW WE COULD STILL SUCCEED AND THRIVE WITHOUT PRETENDING THAT WE COULD TURN BACK TO THE 1960s WHEN SO MANY PEOPLE WERE EMPLOYED HERE IN AUTO FACTORIES.

WE STILL HAVE ADVANCED MANUFACTURING.PROUD OF IT.

BUT WE ALSO RECOGNIZE THAT IT'S LESS LABOR INTENSIVE THAN IT USED TO BE AND HAS TO BE AUGMENTED WITH OTHER SOURCES OF ECONOMIC GROWTH, INCLUDING THINGS LIKE DATA ANALYTICS AND INDUSTRIES THAT DIDN'T EVEN EXIST WHEN THE LAST CAR ROLLED OFF THE LINE HERE IN 1963.

I'M AFRAID THAT MY PARTY REALLY HAS FAILED TO ENGAGE THE INDUSTRIAL MIDWEST AND OTHER SMALLER COMMUNITIES.

I THINK WE LEARNED TO DO A BETTER JOB OF THAT IN 2018 IN THE MIDTERM ELECTIONS.

NOW IT'S TIME TO DO THAT AT THE HIGHEST LEVEL IN THIS PRESIDENTIAL NOMINATING PROCESS IN 2020. I MEAN, YOU ARE TALKINT BIG IDEAS, BIG PROJECTS.

IT'S DIFFERENT THAN AN INCREMENTAL APPROACH PERHAPS WE HEAR FROM OTHERS.

BUT, AGAIN, YOU KNOW, YOUR UNEMPLOYMENT LEVEL IS NOW ON PAR WITH THE NATIONAL AVERAGE.

IT'S LOW.

IT'S LIKE 4% OR SO.

YOU DID TURN IT AROUND, INCLUDING YOU HAD THIS PROJECT TO REVITALIZE, REBUILD OR DO SOMETHING WITH WHAT YOU CALLED 1,000 USELESS HOMES, 1,000, YOU KNOW, DERELICT HOMES.

VACANT AND ABANDONED, YEAH.

YEAH, HOW DID YOU GET PEOPLE BACK TO WORK AND IN SUCH A SHORT PERIOD OF TIME REPLACE ONE ECONOMY WITH ANOTHER?

WELL, LOOK, THE REALITY IS YOU CAN'T JUST INVENT A NEW ECONOMIC FUTURE OUT OF WHOLE YOU HAVE TO TAKE THE ELEMENTS YOU ALREADY HAVE AND BE CREATIVE ABOUT HOW TO WORK WITH THEM IN NEW WAYS.

FOR EXAMPLE, IT TURNED OUT THAT POWER SUBSTATIONS THAT WERE ALMOST IRRELEVANT AROUND HERE HAD NEW UTILITY NOT POWERS FACTORIES.

THEY HAD NOTHING LEFT TO POWER.

BUT POWERING DATA CENTERS, WHICH IS HOW SOME OF THE NEW JOBS WERE CREATED.

WHEN IT CAME TO OUR NEIGHBORHOODS AND THE ISSUE OF RESOLVING VACANT AND ABANDONED HOMES, AN ISSUE THAT PLAGUES SO MANY RURAL AND INDUSTRIAL PARTS OF THE MIDWEST.

WE HAD TO MOBILIZE RESOURCES, GET CREATIVE ABOUT DIFFERENT OPTIONS, ENGAGE WITH FEDERAL PARTNERS AND REASSURE THE PEOPLE IN THE NEIGHBORHOODS IMPACTED THIS WAS GOING TO BE DONE WITH THEM AND NOT TO THEM.

THIS IS TRUE WHETHER WE'RE TALKING ABOUT PEOPLE'S RELATIONSHIP TO THE LOCAL CITY GOVERNMENT OR THE NATIONAL GOVERNMENT.

A GREAT MANY PEOPLE HAVE GIVEN UP ON THE IDEA THAT THE GOVERNMENT HAS THEIR BEST INTERESTS AT HEART.

WE FOUND WAYS TO REBUILD TRUST THROUGH BOTH TECHNOLOGICAL MEANS, GATHERING MORE DATA ABOUT WHAT WAS HAPPENING IN OUR CITY TO SERVE RESIDENTS BETTER, BUT ALSO LOW-TECH MEANS.

SIMPLE ENGAGEMENT AND TRUST BUILDING THAT I BELIEVE NOW NEEDS TO BE RESTORED AT THE NATIONAL LEVEL.

I GET THAT IT'S UP CONVENTIONAL FOR SOMEONE WITH A MAYORAL BACKGROUND TO TALK ABOUT THE HIGHEST OFFICE IN THE LAND WHEN A MORE TYPICAL BACKGROUND WOULD HAVE BEEN HAVING BEEN IN WASHINGTON KIND OF MARINADING IN THAT ENVIRONMENT, MAYBE IN THE CONGRESS FOR MANY YEARS.

WERE YOU --UT I BELIEVE WE AG OUT OF TIME TO MAKE SURE OUR NATIONAL POLITICS IN THE CONGRESS LOOKS LIKE OUR BEST RUN CITIES AND TOWNS INSTEAD OF THE OTHER WAY AROUND.

SO YOU BROUGHT UP YOUR LOCAL LEVEL ELECTION, AND PRESUMABLY A LITTLE BIT YOUR AGE.

YOU OBVIOUSLY ARE ANTICIPATING YOU'RE GOING TO GET PUSHBACK FROM THE OPPOSITION AND ALSO FROM WITHIN YOUR OWN, YOU KNOW, DEMOCRATIC PRIMARY CANDIDATES.

ON AGE, ON BEING A NEOFIGHT, ON ALL OF THAT.

ARE YOU ANTICIPATING AND ARE YOU GEARING FOR UP GROWING SOME TEFLON ON THOSE PARTICULAR ISSUES?

LOOK, IF THE PRESIDENT WANTS TO CHALLENGE MY EXPERIENCE, I WOULD JUST POINT OUT THAT I HAVE MORE YEARS OF GOVERNMENT EXPERIENCE THAN THE PRESIDENT HIMSELF.

AND IF THAT'S A LOW BAR, I ALSO HAVE MORE YEARS OF EXECUTIVE EXPERIENCE IN GOVERNMENT THAN THE VICE PRESIDENT.

AND MORE MILITARY EXPERIENCE THAN ANYBODY WHO HAS ARRIVED IN THAT OFFICE ON DAY ONE SINCE GEORGE H.W. BUSH.

SO IT MAY SOUND A LITTLE CHEEKY AS THE YOUNGEST PERSON IN THE CONVERSATION, BUT I WOULD SAY EXPERIENCE IS ONE OF THE MAIN REASONS I BELONG AT THE TABLE.

I WOULD ALSO SAY THAT GENERATIONAL CHANGE IS SOMETHING THAT CAN HELP US APPEAL TO MORE PEOPLE OF EVERY GENERATION.

YOU KNOW, THREE OUT OF THE LAST FOUR PRESIDENTS ARE EXACTLY THE SAME AGE.

PRESIDENTS BUSH, CLINTON AND TRUMP WERE ALL BORN WITHIN A FEW WEEKS OF EACH OTHER IN THE SUMMER OF 1946.

NOW I DON'T MEAN TO SAY THAT YOU NEED TO BE A CERTAIN AGE OR NOT BE A CERTAIN AGE IN ORDER TO SERVE, BUT I DO THINK THAT A LOT OF PEOPLE ARE EMERGING FROM MY GENERATION, YOU SEE SOME OF THEM CHANGING THE CHARACTER OF THE UNITED STATES CONGRESS RIGHT NOW, AND I THINK WE NEED THAT IN EXECUTIVE LEADERSHIP BECAUSE I BELONG TO THE GENERATION THAT EXPERIENCED SCHOOL SHOOTINGS AS THE NORM.

I WAS IN HIGH SCHOOL WHEN THE COLUMBINE SHOOTING HAPPENED.

I BELONG TO THE GENERATION THAT PROVIDES MOST OF THE TROOPS, INCLUDING MYSELF, IN THE CONFLICTS AFTER 9/11 AND IS BEARING THE BURDEN OF THE FOREVER WARS.

AND I BELONG TO THE GENERATION THAT IS GOING TO BE ON THE BUSINESS END OF ISSUES LIKE CLIMATE CHANGE FOR THE REST OF OUR LIVES.OULD EVEN STATISTICALE ON TRACK TO BE THE FIRST GENERATION IN AMERICAN HISTORY TO MAKE LESS THAN OUR PARENTS IF SOMETHING ISN'T DONE.

I THINK CLEARLY THERE IS A LOT WRONG AND PEOPLE ARE TRYING TO KIND OF BRING BIG PICTURE, BOLD SOLUTIONS TO THE FORE, BUT ON THE GENERATIONAL ISSUE, YOU KNOW, YOU'VE TALKED ABOUT AND OTHERS ARE SAYING, PARTICULARLY GIVEN THE SWEEP BY DEMOCRATS OF CONGRESS, THAT THERE IS A MUCH MORE SORT OF PROGRESSIVE, MORE LEFT-WING, SOME PEOPLE MIGHT EVEN SAY SOCIALIST CHARACTER TO THE DEMOCRATIC PARTY.

DRIVEN IN PART BY THE MILLENNIAL GENERATION WHO ARE COMFORTABLE WITH THOSE LABELS AND DON'T FIND THEM TO BE PEJORATIVE.

ARE YOU -- TELL ME ABOUT WHERE THE MAJORITY OF THE VOTERS ARE GOING TO COME FROM IN THE NEXT ABOUT GENERATIONAL.YOU TALKED ARE YOU SAYING FOR INSTANCE SENATORS SANDERS AND WARREN ARE MAYBE TOO OLD FOR THIS RACE NOW?

IT'S NOT MY PLACE TO ASSESS ANY OF THE OTHERS.

I DO THINK THAT IT IS TIME FOR THE GENERATION THAT HAS SO MUCH ON THE LINE TO STEP FORWARD AND HAVE A DIFFERENT KIND OF VOICE.

YOU KNOW, I THINK ABOUT THESE ISSUES AS PERSONAL ONES.

I THINK ABOUT WHAT THE WORLD WILL LOOK LIKE WHEN I REACH THE CURRENT AGE OF THE CURRENT PRESIDENT, WHICH IS THE YEAR AND I THINK IF YOU REGARD THE CONDITION OF THE COUNTRY OR THE WORLD IN THAT YEAR, NOT AS SOMEBODY ELSE'S PROBLEM BUT AS SOMETHING YOU ARE PERSONALLY PREPARING FOR, IT GIVES YOU A DIFFERENT KIND OF VOICE TO SPEAK ABOUT THESE ISSUES.

LOOK, WE DEFINITELY NEED THESE OLD REFORMS AND WE NEED PEOPLE WHO AREN'T AFRAID TO SPEAK WITH CONVICTION.S I THINK THE TRADITL LEFT-CENTER SPECTRUM FOR ASSESSING THE DEMOCRATIC PARTY HAS, IF ANYTHING, BECOME A LITTLE BIT LESS USEFUL THAN BEFORE.

I DO THINK THAT A LOT OF VOTERS, INCLUDING VOTERS HERE IN THE INDUSTRIAL MIDWEST WHO MIGHT BE CONSIDERED INDEPENDENT OR EVEN CONSERVATIVE-LEANING WILL PAY MORE ATTENTION TO VOICES FROM MY PARTY IF WE'RE TALKING ABOUT ADDRESSING THE FUNDAMENTAL PROBLEMS THAT MADE A PRESIDENCY LIKE THIS ONE AND AN ELECTION LIKE THE 2016 ELECTION EVEN I WOULD ARGUE THAT THIS IS A SYMPTOM OF -- AND THE CAUSES HAVE TO DO WITH STRUCTURAL PROBLEMS, DEEP PROBLEMS IN OUR ECONOMY AND IN OUR DEMOCRACY THAT HAVE LEFT FAR TOO MANY, ESPECIALLY IN COMMUNITIES LIKE MINE IN THE AMERICAN INTERIOR, FEELING LIKE THE SYSTEM WASN'T WORKING FOR THEM, WHICH IS WHY A GREAT MANY OF THEM, MOSTLY OR AT LEAST LARGELY WITH NO ILLUSIONS ABOUT THE CHARACTER OF THE CURRENT PRESIDENT, STILL DECIDING TO GO INTO THAT VOTING BOOTH AND VOTE EFFECTIVELY TO BURN THE HOUSE DOWN, WHICH UNFORTUNATELY IS WHAT WE GOT.

RIGHT.

HAVING -- HAVING VOTED FOR HIM AFTER PREVIOUSLY HAVING VOTED FOR BARACK OBAMA AS PRESIDENT.

SO, I MEAN, YOU'RE PRETTY MUCH SUMMING UP THE POLITICAL DYSFUNCTION THAT'S UNDER WAY IN TERMS OF WHAT PEOPLE FEEL THEY'RE MISSING AND LACKING.

BUT TO THAT POINT THEN, LET ME ASK YOU DO COMMENT ON WHAT TIM WU, A COLUMBIA LAW PROFESSOR AND A REAL SORT OF ANALYST OF THESE TIMES WROTE TODAY IN 'THE NEW HE'S TALKING ABOUT ON ISSUES OF HIGHER TAXES, PAID MATERNITY LEAVE AND MEDICARE, ALL THE THINGS THAT MANY ARE NOW TALKING ABOUT, THE DEFINING POLITICAL FACT OF OUR TIME IS NOT POLARIZATION, IT'S THE INABILITY OF EVEN LARGE BIPARTISAN MAJORITIES TO GET WHAT THEY WANT ON ISSUES LIKE THESE.

CALL IT THE OPPRESSION OF THE SUPERMAJORITY, IGNORING WHAT MOST OF THE COUNTRY WANTS SUCH AS DEMAGOGUERY AND POLITICAL DIVISIVENESS IS WHAT IS MAKING THE PUBLIC SO ANGRY.

IS HE RIGHT?

YES, I VERY MUCH AGREE WITH WHAT PROFESSOR WU WROTE THERE.

HE'S REALLY IDENTIFYING THE PROBLEM WITH OUR DEMOCRACY, BEFORE WE ATTEND TO ANY OF THE OTHER ISSUES THAT WE CARE ABOUT, FROM ECONOMIC ISSUES TO THINGS LIKE CLIMATE CHANGE, WE IN AMERICA HAVE TO ASK WHETHER OUR DEMOCRATIC REPUBLIC IS AS DEMOCRATIC AS WE THINK.

IT'S ONE OF THE REASONS I'VE CALLED FOR SOME STRAIGHTFORWARD BUT PERHAPS BOLD SOLUTIONS LIKE DOING AWAY WITH THE ELECTORAL COLLEGE THAT TWICE IN MY LIFETIME HAS OVERRULED THE AMERICAN PEOPLE.

I MEAN, WHEN YOU HAVE -- TAKE UNIVERSAL BACKGROUND CHECKS, A COMMON SENSE GUN POLICY, THAT SOMETHING LIKE 80% OR 90% OF AMERICANS AGREE ON, IF THE U.S.

CONGRESS CAN'T DELIVER SOMETHING THAT THAT MANY AMERICANS, BELIEVE IS THE RIGHT THING TO DO, IT'S EVIDENCE THAT MONEY AND THE DRAWING OF CONSTITUENCY LINES SO THAT POLITICIANS ARE CHOOSING THEIR VOTERS INSTEAD OS EVIDENCE OUR DEMOCRACY HASPED AD RECOGNITION AND NEEDS TO BE REFORMED IMMEDIATELY.REFORM.

FIXING THE ENGINE OF DEMOCRACY.

YOU'VE TALKED JUST NOW ABOUT THE ELECTORAL COLLEGE.

YOU'VE TALKED ALSO ABOUT THE SUPREME COURT, HUGE, BIG ISSUE IN THE UNITED STATES.

YOU TALKED ABOUT REFORMING IT.

EVEN ADDING MORE JUSTICES, MORE THAN NINE.

WHAT WOULD THAT SOLVE?WHAT DO Y?

WELL, THE PROBLEM THAT WE HAVE TO SOLVE IS THAT THE SUPREME COURT IS ON A TRAJECTORY TOWARD COMING TO BE VIEWED AS A NAKEDLY POLITICAL BODY BY MANY AMERICANS.

WE NEED TO STOP THAT BEFORE IT'S TOO LATE, AND SO I THINK WE NEED TO ENTERTAIN A RANGE OF REFORMS THAT WOULD MAKE THE SUPREME COURT LESS POLITICAL SO THAT EACH VACANCY WON'T BECOME ANOTHER APOCALYPTIC IDEOLOGICAL BATTLE.R EXAMPLE, IT MAY BE POSE WITHOUT EVEN AMENDING THE CONSTITUTION TO ADJUST THE STRUCTURE OF THE SUPREME COURT SO THAT IT HAD 15 MEMBERS BUT ONLY 10 OF THEM WERE APPOINTED POLITICALLY.

THE OTHER WERE ROTATED UP FROM THE APPELLATE BENCH AND COULDATS CONSENSUS AMONG THE OTHER TEN.

THAT'S JUST ONE OF A NUMBER OF REFORMS THAT HAVE BEEN PROPOSED AND I DON'T PRESUME TO KNOW WHAT THE EXACT RIGHT ANSWER IS.

I DO BELIEVE THAT SOMETHING MAYBE IN THE PAST WAS CONSIDERED OFF LIMITS BECAUSE IT'S TOO DEEP OR TOO STRUCTURAL, THESE KINDS OF THINGS NEED TO BE ENTERTAINED BECAUSE OUR DEMOCRACY IS VERY MUCH IN DANGER OF SLIPPING AWAY FROM US.

FREEDOM HOUSE DID ITS ASSESSMENT OF FREEDOM AND DEMOCRACY AROUND THE WORLD, AND THE UNITED STATES' RANKINGS ARE SLIPPING.

SOME SAY WE'RE IN A DEMOCRACY RECESSION GLOBALLY AND HERE AT HOME I'M VERY MUCH WORRIED THAT DEMOCRACY'S IN RETREAT UNLESS WE REPAIR OUR INSTITUTION.

SOMETHING THAT WE USED TO BE WILLING TO DO THROUGH STATUTE AND CONSTITUTIONAL CHANGE.

EVERY GENERATION WOULD SEE SOME RANGE OF REFORMS TAKE PLACE, AND FOR SOME REASON THAT'S JUST STOPPED SHORT.

IF ANYTHING, WE'RE GROWING LESS DEMOCRATIC IN MY LIFETIME WITH MEASURES TO MAKE IT MORE DIFFICULT FOR MANY AMERICANS TO VOTE AND INCREASING DISTORTION WITH THE ROLE OF MONEY IN OUR POLITICS, TOO. KNOW, TO THAT POE WOULD TRACE IT AT LEAST TO PRESIDENT TRUMP MAYBE BEFORE, MAYBE, YOU KNOW, MAYBE IT'S BEEN GOING ON FOR LONGER, THIS EROSION OF DEMOCRACY IN THE UNITED STATES, THIS EROSION IN THE BELIEF OF THE INSTITUTIONS, BUT YOU ALMOST NEVER MENTION THE PRESIDENT BY NAME.

YOU DON'T SORT OF GO OUT THERE AND DEFINE YOUR STUMP SPEECH IN OPPOSITION TO HIM.

AND YOU EVEN JUST SORT OF ALLUDED TO HIM SLIGHTLY BY SAYING I DON'T THINK TALKING ABOUT, AGAIN, LIKE MAKING OF THING THAT WE NEED TO DO FOR THE FUTURE.

WHAT IS YOUR POLICY, WHAT IS CURRENT PRESIDENT?TAKING ON THE

ONE THING I'VE NOTICED IS THAT PRETTY MUCH ANY ATTENTION DIRECTED HIS WAY IS SOMETHING THAT HE ABSORBED AND USES TO GROW BIGGER.

EVEN IF IT'S CRITICAL ATTENTION.

AND I THINK FUNDAMENTALLY THIS ELECTION ISN'T ABOUT HIM.

LOOK, AN ELECTION AGAINST A CANDIDATE AS FLAWED AS HE WAS IN 2016, THAT SHOULD NEVER HAVE EVEN COME WITHIN CHEAT DISTANCE, SO TO SPEAK.

IT SHOULD NEVER HAVE BEEN CLOSE.

I BELIEVE THAT FOR AN ELECTION RESULT LIKE THAT, FOR A PRESIDENCY LIKE THIS EVEN TO BE POSSIBLE, THERE MUST BE MORE PROFOUND ISSUES IN OUR ECONOMY AND DEMOCRACY SUCH THAT THE PROBLEM IF IT WEREN'T HIM COULD VERY WELL BE SOMEBODY ELSE CAUSING SIMILAR DAMAGE.

OF COURSE HE NEEDS TO BE DEFEATED.WHEN HE SAYS SOMETHINGT NEEDS TO BE CORRECTED.

WHEN HE DOES SOMETHING WRONG, IT NEEDS TO BE CONFRONTED.

BUT FUNDAMENTALLY THIS ELECTION CAN'T BE SIMPLY ABOUT HIM.

IF THE MESSAGE IS ALL ABOUT HIM, I CAN TELL YOU THAT ONCE AGAIN, A LOT OF PEOPLE, ESPECIALLY IN THE INDUSTRIAL REGIONS WHERE I LIVE, WILL SAY THAT NOBODY'S TALKING ABOUT ME.

WE HAVE TO TALK ABOUT LIVED EVERYDAY EXPERIENCE OF PEOPLE IN THEIR LIVES ACROSS AMERICA AND HOW OUR VALUES AND THE POLICIES THAT FLOW FROM THOSE VALUES WILL MAKE EVERYDAY LIFE BETTER.

IT CAN'T BE ALL ABOUT HIM.

THAT'S THE SHOW.

HE'S VERY GOOD AT MAKING THAT SHOW ALL ABOUT HIM.

WHEN I TALK TO NEIGHBORS ABOUT WHAT'S REALLY IMPACTING OUR LIVES AND WILL ULTIMATELY DRIVE OUR POLITICAL CHOICES, IT'S NOT WHAT'S GOING ON IN WASHINGTON, IT'S WHAT'S GOING ON IN OUR NEIGHBORHOODS IN OUR COMMUNITIES.

PART OF THE PURPOSE OF COMING FROM LOCAL OFFICE TRYING TO ENTER A NATIONAL ELECTION IS TO REMIND EVERYONE WHAT'S AT STAKE SO WE CAN BUILD A MESSAGE THAT WILL MAKE SENSE EVEN WHEN THIS PRESIDENCY COMES AND GOES.

WE'LL HAVE AS MUCH TO SAY TO THO IN 2020.

YOU KNOW, OBVIOUSLY PRESIDENT TRUMP IS BANKING ON THE ECONOMY CONTINUING TO DO WELL AND BELIEVING THAT HE'S DELIVERED AS HIS CAMPAIGN HAS PROMISED.

LET ME ASK YOU, THOUGH, ABOUT YOU ARE OPENLY GAY, BUT YOU DID NOT COME OUT UNTIL YOUR 30s.

YOU WERE -- I BELIEVE YOU WERE MAYOR WHEN YOU ACTUALLY OFFICIALLY AND OPENLY CAME OUT.

WHAT TOOK YOU SO LONG AND WHAT WAS THE REASON FOR COMING OUT THEN?

HOW HAS IT ALL PLAYED OUT?

I GUESS DO YOU THINK AMERICA IS READY FOR, YOU KNOW, A MAJOR CANDIDATE, OPENLY GAY AND ANOPE?

WELL, WHAT I'LL SAY IS THAT, YOU KNOW, AT A PERSONAL LEVEL, I THINK EVERYBODY FINDS THEIR WAY TO COMING OUT WHEN THEY'RE YOU'RE JUST READY WHEN YOU ARE.

THE THING THAT MADE ME REALIZE I NEEDED TO COME OUT WAS AFTER MY DEPLOYMENT TO AFGHANISTAN.

I WAS FORCED TO CONFRONT THE FACT THAT I ONLY HAD ONE LIFE, THAT IT WAS LIMITED, THAT I WANTED TO GET ON WITH A PERSONAL LIFE AND BEGIN DATING.

SO I MADE THE DECISION I NEEDED TO COME OUT FOR PERSONAL REASONS GOVERNOR OF MY STATE AT THE TIME, BUT I KNEW THAT IT WAS SOMETHING THAT I HAD TO DO.

MY COMMUNITY IS SOCIALLY CONSERVATIVE, AND WE DIDN'T KNO.

BUT WHEN I EXPLAINED MYSELF AND CONTINUED GOING ABOUT DOING MY JOB, I WOUND UP GETTING RE-ELECTED WITH 80% OF THE VOTE.

SO I THINK WHAT WE'VE LEARNED IS THAT MORE THAN ANYTHING PEOPLE WANT TO KNOW WHAT YOU CARE ABOUT, WHAT YOUR VALUES ARE, WHAT YOUR IDEAS ARE AND WHAT KIND OF JOB YOU CAN DO FOR THEM.

THAT'S HOW I'M EVALUATED BY MY CONSTITUENTS HERE AT HOME IN SOUTH BEND.

OF COURSE I'M PROUD OF MY MARRIAGE.I MARRIED A TEACHER ANT MARRIAGE IS ONE OF THE MOST IMPORTANT THINGS IN MY LIFE.

IT'S ALSO, BY THE WAY, SOMETHING THAT EXISTS ONLY BY THE GRACE OF A SINGLE VOTE ON THE U.S.

SUPREME COURT, WHICH IS WHY PEOPLE LIKE ME CAN NEVER FORGET WHY POLITICS MATTERS AND HOW IT CAN AFFECT OUR EVERYDAY LIVES IN SO MANY WAYS.

AS TO THE QUESTION OF WHETHER AMERICA'S READY FOR THAT, THE BEST ANSWER I CAN GIVE IS THAT THERE'S ONLY ONE WAY TO FIND OUT

INTERESTING ALSO THAT YOU MENTION ABOUT, YOU KNOW, MIKE PENCE, THE VICE PRESIDENT, WHO WAS GOVERNOR AND HAVE SOME VERY, VERY EXTREME VIEWS ON HOME SEXUALITY AND HE BELIEVES THAT GAY MARRIAGE WILL LEAD TO SOCIAL COLLAPSE.

INTERESTING THAT YOUR OWN CONSTITUENTS WHO YOU SAY ARE SOCIALLY CONSERVATIVE ACTUALLY, YOU KNOW, DIDN'T USE THAT AS AL.

CAN I ASK YOU --

THAT'S RIGHT.

GO AHEAD.

GO AHEAD.

NO, GO AHEAD.

I'LL JUST SAY THAT PEOPLE HERE I THINK REALLY SEE THE HUMANITY IN ONE ANOTHER.

THAT'S BEEN A STRUGGLE FOR A LOT OF PEOPLE WHO HAVE SEEN ALMOST A DIZZYING PACE OF CHANGE IN THE WAY THIS ISSUE IS UNDERSTOOD.

BUT ONE THING I'VE OBSERVED ON EVERYTHING FROM LGBTQ EQUALITY TO THE TREATMENT OF IMMIGRANTS IS WE'RE ALWAYS A LOT BETTER TOWARDS PEOPLE WE ACTUALLY KNOW.

WHEN WE BEGIN -- WE'RE NOT TALKING ABOUT SOME GROUP OUT THERE BUT REAL HUMAN BEINGS, MANY OF WHOM YOU MIGHT BE RELATED TO OR CROSS PATHS WITH IN YOUR COMMUNITY.

IT'S HARDER TO HATE FROM UP CLOSE AND IT'S ONE OF THE ANTIDOTES THAT I THINK A LOCALLY ORIENTED POLITICAL STYLE CAN BRING TO A NATIONAL CONVERSATION THAT IS LEAVING FAR TOO MANY

I JUST WANT TO MENTION OR ASK YOU TO JUST COMMENT BECAUSE YOU SORT OF GLOSSED OVER IT.

BUT IT'S A BIG DEAL.

MAYOR., YOU TOOK UNPAID LEAVE AS YOU DID A SEVEN-MONTH TOUR IN AFGHANISTAN.

IT'S A REALLY DANGEROUS PLACE.

IT'S REALLY WHERE, YOU KNOW, I MEAN, SEPARATES THE MEN FROM THE BOYS GOING OUT THERE.

WHAT DID YOU LEARN ABOUT YOURSELF?

WHAT WAS GOING ON ABOUT THE CURRENT, YOU KNOW, FOREIGN POLICY WHEN IT COMES TO THREATENING TO WITHDRAW TROOPS FROM EITHER SYRIA OR AFGHANISTAN?

WELL, YOU KNOW, IT WAS ONE THING TO LEARN ABOUT FOREIGN POLICY WHEN I WAS A STUDENT AT OXFORD.IT'S ANOTHER THING TO LEN ABOUT FOREIGN POLICY WHEN SENT TO A WAR ZONE ON THE ORDERS OF A YOU UNDERSTAND IN A VERY DEEP AND PERSONAL WAY WHAT'S AT STAKE.

MAYBE THE MOST IMPORTANT THING I TOOK FROM IT WAS A BETTER SENSE OF WHAT IT WAS TO BE AN AMERICAN.

BECAUSE THE PEOPLE THAT I SERVED WITH, ESPECIALLY WHEN I WAS RESPONSIBLE FOR DRIVING OR GUARDING VEHICLES ON CONVOY MOVEMENTS, WHICH IS A BIG PART OF MY JOB WHEN I WAS POSTED IN KABUL, WAS THAT, YOU KNOW, WE LEARNED TO TRUST EACH OTHER WITH OUR LIVES REGARDLESS OF OUR PEOPLE GETTING INTO MY VEHICLE DIDN'T CARE IF I WAS GOING HOME TO A GIRLFRIEND OR A BOYFRIEND OR WHAT COUNTRY MY FATHER HADM.

OR WHETHER I WAS A DEMOCRAT OR A WE SIMPLY LEARNED TO TRUST EACH OTHER WITH OUR LIVES.

IN A BROADER SENSE, I THINK THAT'S WHAT HAS TO HAPPEN IN AMERICA, BUT YOU SHOULDN'T HAVE TO GO TO WAR IN ORDER TO HAVE I BELIEVE THAT NATIONAL SERVICE IS SOMETHING WE NEED TO CREATE MORE OPPORTUNITIES FOR HERE AT HOME AND WE REALLY NEED TO LEARN FROM ALL OF THE WAYS IN WHICH FOR PRIOR GENERATIONS, MILITARY SERVICE WAS OFTEN A LEVELLER, AN EQUALIZER.METHING THAT MADE IT E FOR PEOPLE LIKE A YOUNG JOHN F.

KENNEDY OR GEORGE H.W. BUSH TO LEARN HOW TO RELATE ON MORE OR LESS EQUAL TERMS WITH THE SONS OF FACTORY WORKERS AND FARMERS IN PLACES LIKE INDIANA.

AND IT'S UNFORTUNATE THAT WE'VE LOST THAT TO SOME DEGREE, BUT I THINK THERE'S A CHANCE, CERTAINLY NOT NOW LED BY A PRESIDENT WHO IS CREDIBLY ACCUSED OF FAKING A DISABILITY IN ORDER TO AVOID SERVICE WHEN IT WAS HIS TURN, BUT I DO THINK THERE IS AN OPPORTUNITY TO RESTORE A CULTURE OF SERVICE TO WHAT IT MEANS TO THE HEART OF THIS COUNTRY.

NATIONAL SERVICE IS SOMETHING MANY PEOPLE HAVE TALKED ABOUT.

IT WOULD BE REALLY INTERESTING TO SEE IT IN SOME WAY BROUGHT BACK.

MAYOR BUTTIGIEG, THANK YOU SOND.

IT'S A PLEASURE.

THANKS FOR HAVING ME.

SO IT DOES SEEM LIKE AWHILE AGO SINCE PRESIDENT TRUMP ANNOUNCED THE COLLAPSE OF THE ISLAMIC STATE CALIPHATE IN SYRIA.

ALTHOUGH THE BATTLE TO EXTRICATE THE EXTREMIST GROUP FROM ITS FINAL ENCLAVE IN EASTERN SYRIA ISN'T YET FINISHED.

CORRESPONDENT BEN WEDEMAN HAS BEEN FOLLOWING THOSE WHO ARE FLEEING THE VIOLENCE AND THE IMPACT ON SOME OF ITS YOUNGEST VICTIMS.

HERE IS A LITTLE PIECE OF HIS

Reporter: NO ONE IS MORE TRAUMATIZED BY THIS CATASTROPHE WHO GREW UP IN THE MADHOUSE OF THE STATE THAT CALLED ITSELF ISLAMIC.

BRAINWASHED AND CAUGHT IN A WAR NOT OF THEIR CHOOSING.

THE LUCKY ONES MAY RETURN TO THEIR COUNTRIES FAR, FAR AWAY.

THE REST DOOMED TO A GRIM LIFE IN OVERCROWDED INTERNMENT CAMPS.

JUST A SMALL SNIPPET, BUT A POWERFUL, POWERFUL SENSE OF WHAT PEOPLE ARE GOING THROUGH IN THAT PART OF THE WORLD.

THE ISLAMIC STATE ONCE HELD HUGE SWATHS OF LAND IN BOTH SYRIA AND IRAQ, AND MY NEXT GUEST EMMA SKY ONCE SERVED AS A POLITICAL ADVISER TO THE TOP U.S. GENERAL IN IRAQ.

HER NEW BOOK IS CALLED 'IN A TIME OF MONSTERS: TRAVELS THROUGH A MIDDLE EAST REVOLT' AND IS JOINING ME FROM YALE UNIVERSITY WHERE SHE'S A SENIOR FELLOW AT THE JACKSON INSTITUTE FOR GLOBAL AFFAIRS.

WELCOME TO THE PROGRAM.

THANKS FOR HAVING ME ON.

BEFORE I GET TO THE MEAT AND POTATOES OF YOUR BOOK AND YOUR WORK AND IRAQ AND YOUR TRAVELS, I JUST WONDER WHETHER YOU CAN PICK UP ON ANYTHING THAT MAYOR PETE BUTTIGIEG SAID, PARTICULARLY ABOUT WHAT HE LEARNED BEING DEPLOYED ON THE FRONT LINES AND THE STATE OF, YOU KNOW, AMERICAN POLICY IN

I THINK FOR MANY PEOPLE WHO HAVE SERVED OUT IN IRAQ AND SYRIA, IN AFGHANISTAN, THEY FIND IN THEIR SERVICE THAT THEY SEE IN A WAY THE BEST OF THEMSELVES, THE COMRADERY THAT THEY HAVE WITH THEIR FELLOW SOLDIERS, MARINES, AND THAT REALLY FORMS A VERY, VERY STRONG BOND.

WHEN YOU LOOK AT THE TRUST, THE WILLINGNESS TO DIE FOR EACH OTHER, TO GIVE LIFE OR LIMB FORY STRONG -- IT'S A VERY STRONG BOND AND IT'S A REAL SENSE OF SERVICE, AND I THINK MANY FIND WHEN THEY COME BACK HOME THEY MISS THAT SENSE OF DEDICATION.

I THOUGHT IT WAS INTERESTING THAT HE TRANSLATED THAT INTO THE DESIRE AND ARTICULATED A NEED FOR SORT OF A NATIONAL SERVICE BACK IN THE UNITED STATES.

SOMETHING THAT WAS SORT OF MOOTED RIGHT AFTER 9/11 BUT NEVER HAPPENED.

9/11 WAS PART OF WHAT CAUSED YOU AND CIRCUITOUSLY TO LEAVE THE COMFORT OF YOUR HOME AND JOB IN GREAT BRITAIN AND GO OUT TO EVENTUALLY BECOME A BRITISH WOMAN SERVING OF AN AMERICAN GENERAL COMMANDER IN THE MOST DIFFICULT AREAS OF IRAQ AFTER THE INVASION THERE.

HOW DID IT EVEN HAPPEN THAT YOU WENT OUT?

WELL, IN 2003, THE BRITISH GOVERNMENT SENT OUT AN E-MAIL ASKING FOR VOLUNTEERS TO GO OUT TO IRAQ TO ADMINISTER THE COUNTRY FOR WHAT THEY THOUGHT IT WAS GOING TO BE FOR THREE MONTHS BEFORE WE HANDED IT BACK TO THE IRAQIS.

AND I WAS SOMEBODY WHO HAD SPENT THE PREVIOUS TEN YEARS WORKING IN ISRAEL/PALESTINE.

FELT I HAD SOME USEFUL SKILLS IN TERMS OF CONFLICT MEDIATION AND CAPACITY BUILDING, AND SO I WAS ONE OF THOSE PEOPLE WHO VOLUNTEERED.

BUT WHEN I LEFT THE UK, I HAD NO IDEA WHAT MY JOB WAS GOING TO BE OR WHERE I WAS GOING TO BE BASED IN IRAQ.

THEY JUST SAID FIND YOUR WAY TO BASRA, YOU'LL BE MET ON ARRIVAL AND EVERYTHING WILL BE MADE CLEAR.

AND WAS IT?

NO, I WAS TOLD TO LOOK OUT FOR THE PERSON CARRYING A SIGN WITH MY NAME ON IT, AND, YOU KNOW, I LANDED AND I WAS LOOKING AROUND FOR THAT PERSON, BUT THERE WAS NOBODY THERE TO MEET ME, NOBODY WAS EXPECTING ME, SO I, YOU KNOW, SPENT ONE NIGHT IN BASRA, THEN I MADE MY WAY TO BAGHDAD, FOUND MY WAY TO THE ROYAL REPUBLICAN PALACE THAT HAE TAKEN OVER BY THE COALITION, AND AFTER A WEEK THERE THEY SAID, OH, WE'VE GOT ENOUGH PEOPLE HERE.

TRY THE NORTH.

SO I THEN FLEW UP TO MOSUL AND THEY HAD PEOPLE THERE.

SO I KEPT GOING UNTIL I GOT TO KIRKUK.

WHEN I ARRIVED IN KIRKUK, I WAS THEN TOLD I WAS THE SENIOR CIVILIAN REPORTING DIRECTLY TO AMBASSADOR BREMER AND THAT I WAS RESPONSIBLE FOR, YOU KNOW, THE ADMINISTRATION OF THE PROVINCE OF KIRKUK.

I MEAN, YOU CAN'T MAKE THAT STUFF UP.

IT REALLY DOES TELL US IN BRILLIANT TICHNICOLOR, THE AD HOC NATURE OF THESE MASSIVE, MASSIVE ENDEAVORS.

YOU'RE IN CHARGE OF THE PROVINCE OF KIRKUK, ONE OF THE MOST SENSITIVE PROVINCES IN A COUNTRY THAT HAS JUST BEEN THROUGH AN INVASION AND IS ABOUT TO LAUNCH INTO AN INSURGENCY AND YOU'RE THERE SERVING THE HEAD OF THE U.S. EFFORT THERE, THE HEAD OF THE COALITION PROVISIONAL AUTHORITY PAUL BREMER.

WHAT IS YOUR TAKEAWAY, GIVEN THEN THE, YOU KNOW, THE RISE OF ISIS AND NOW THE DEFEAT OF ISIS, CERTAINLY IN THAT PART.

WHAT IS YOUR TAKEAWAY ABOUT WHAT HAPPENED AND WHAT'S GOING ON RIGHT NOW?

WELL, WE SHOULD NEVER HAVE INVADED IRAQ IN 2003.

IT WAS BASED ON FAULTY INTELLIGENCE.

THAT SADDAM HAD WEAPONS OF MASS INTELLIGENCE THAT PROVED TO BE BUT NOTHING THAT HAPPENED IN IRAQ AFTER 2003 WAS INEVITABLE.

THERE REALLY WERE HOPES OF CREATING A BETTER WORLD, HOPES OF A WORLD WITHOUT SADDAM HUSSEIN.

AND UNFORTUNATELY DECISIONS TAKEN BY THE COALITION VERY EARLY ON COLLAPSED THE STATE OF IRAQ, SO THAT WAS THE DISMISSAL OF THE CIVIL SERVANTS, THE DISMISSAL OF THE MILITARY, AND IN THE COLLAPSED STATE, IRAQ DESCENDED INTO CIVIL WAR.

BUT BETWEEN 2007 AND 2009, THAT PERIOD THAT WE CALL THE SURGE, FOR THE FIRST TIME WE HAD THE RIGHT LEADERSHIP, THE RIGHT STRATEGY AND THE RIGHT RESOURCES, AND THE VIOLENCE CAME DOWN AND THE CIVIL WAR CAME TO AND WE HOPED, AND THE IRAQIS HOPED THAT THE VIOLENCE WAS BEHIND THEM AND THAT THEY WERE HEAD IN THE RIGHT DIRECTION.

IN 2010, THEY WENT INTO A VERY, VERY CLOSELY CONTESTED ELECTION.

AND EVERYBODY TURNED OUT.

PEOPLE WHO HAD FORMALLY BOYCOTTED THE ELECTION TURNED OUT.

AND A NEW COALITION CAME TOGETHER THAT WAS LED BY A MEAN NAME ALLOWY IT WON 91 SEATS.

AHEAD OF MALAKI WHO WAS THE INCUMBENT, 89 SEATS.

NOW, MALAKI REFUSED TO BELIEVE THE ELECTION RESULTS.

IT'S THE MIDDLE EAST.

SO NO ONE EVER LOSES AN ELECTION IN THE MIDDLE EAST.

HE JUST SAT IN HIS SEAT.

HE DEMANDED A RECOUNT.

HE TRIED TO DISQUALIFY THE CANDIDATES OF IRAQIA, BUT HE JUST WOULDN'T ACCEPT THE RESULTS.

AND THERE WAS DISAGREEMENT IN THE AMERICAN SYSTEM OVER WHAT TO DO.

RIGHT.

AND THEY LEFT HIM THERE.

SOME SAID THE U.S. SHOULD HOLD --

YES.

THEY LEFT HIM THERE.

WANTED TO UPHOLD THE ELECTION RESULTS.

AND THE REASON WHY IT'S IMPORTANT IS BECAUSE IT LAID THE GROUNDWORK FOR THE RESECTARIANIZATION OF IRAQ.

AND THEN YOU SAY IN, YOU KNOW, I MEAN, YOU'VE SAID RECENTLY THAT THE MISTAKES MADE IN IRAQ POISONED WHAT WAS POSSIBLE IN SYRIA.

I THINK WE LEARNED THE WRONG LESSONS.

I MEAN, THE UNITED STATES HAS BEEN JUSTLY CRITICIZED FOR ITS INABILITY TO GET IT RIGHT AT ALL IN SYRIA.

WHAT WERE THE WRONG LESSONS THAT YOU THINK IT LEARNED?

WELL, WHEN PEOPLE THINK ABOUT SYRIA, THEY THINK ABOUT IRAQ.

AND, YOU KNOW, IRAQ WAS -- HAD RETURNED TO SOME LEVEL OF STABILITY BY 2010.

BUT IT WAS MALAKI'S SECTARIAN POLICIES BY ACCUSING THE SUNNIS OF TERRORISM, BY RENEGING ON HIS PROMISES TO THE TRIBAL LEADERS WHO HAD FOUGHT AGAINST AL QAEDA IRAQ, IT WAS THIS THAT CREATED THE CONDITIONS FOR ISIS TO RISE UP OUT OF THE ASHES OF AL QAEDA IN IRAQ AND PRESENT ITSELF AS THE DEFENDER OF THE SUNNIS AGAINST THE IRANIAN-BACKED SECTARIAN REGIME FROM NOURI AL MALAKI.

SO WHEN YOU LOOK AT SYRIA, SYRIA WAS DEEPLY AFFECTED BY WHAT HAPPENED IN IRAQ.

ISIS, WHICH SPRUNG UP BECAUSE OF MALAKI'S POLICIES, THEN FOUND A FOOT INSIDE SYRIA IN THE CIVIL WAR THERE.

AND THE IRAQ WAR CHANGED THE BALANCE OF POWER IN THE REGION IN IRAN'S FAVOR.

AND THIS EXACERBATED A GEOPOLITICAL STRUGGLE BETWEEN IRAN ON THE ONE HAND AND SAUDI AND THE GULF COUNTRIES ON THE OTHER, WHICH LED THEM TO SUPPORT SECTARIAN ACTORS IN DIFFERENT COUNTRIES, AND WE SEE THIS IN PARTICULAR ABOUT WHAT HAPPENED INSIDE SYRIA.

RIGHT.

WHEN DIFFERENT OUTSIDE PLAYERS WERE SUPPORTING DIFFERENT LOCAL PLAYERS ON THE GROUND.

SO I WONDER HOW YOU REACT --

AND THE WEST SAID AT THE BEGINNING --

YEAH.

SORRY, I JUST WONDER HOW YOU REACT BECAUSE IRAN HAS OBVIOUSLY -- AND YOU RIGHTLY SAY THAT IRAN WAS THE BIG WINNER AFTER THE INVASION OF IRAQ, AND IT HAS TRANSFERRED THAT POWER TO BACKING ASSAD IN SYRIA, MUCH TO THE CONSTERNATION OF MANY IN THE REGION AND THE UNITED STATES.

SO DO YOU BELIEVE THAT THE EFFORT TO PERSUADE PRESIDENT TRUMP TO KEEP AT LEAST A CONTINGENT OF AMERICAN FORCES INSIDE SYRIA NOW RATHER THAN, YOU KNOW, PULL THEM ALL OUT AS HE HAD THREATENED TO DO, IS THAT THE RIGHT THING TO DO?

WILL 200 OR SO AMERICAN TROOPS, BASED ON YOUR EXPERIENCE, BE ENOUGH TO WARD OFF IRAN'S INTENTS -- INTENTIONS IN SYRIA?

YOU KNOW, THERE'S A MUCH BIGGER GAME GOING ON INSIDE SYRIA.

I MEAN, THE ASSAD REGIME HAS SUCCEEDED IN STAYING IN POWER.

AND, YOU KNOW, THAT HAS HAPPENED.

RUSSIA AND IRAN ARE HIS SUPPORTERS AND THEY'VE COME OUT.

THE WAY IN WHICH ISIS WAS FOUGHT, WHICH WAS BY THE USE OF COALITION AIR POWER AND LOCAL MILITIAS ON THE GROUND, BASICALLY ENABLED IRAN TO INCREASE ITS INFLUENCE ACROSS IRAQ AND SYRIA, AND IT NOW HAS LAND CORRIDORS ACROSS BOTH COUNTRIES, PUSHING UP AGAINST ISRAEL'S BORDERS.

I THINK THE MAIN CONCERN WHEN PRESIDENT TRUMP ANNOUNCED JUST, YOU KNOW, VIA TWEET THAT HE WAS PULLING ALL U.S. TROOPS OUT WAS WHAT WAS GOING TO HAPPEN TO THE KURDISH FIGHTERS WHO HAD BEEN VERY, YOU KNOW, INSTRUMENTAL IN PUSHING ISIS BACK FURTHER ANDR.

AND HIS ANNOUNCEMENT THAT ALL U.S. SOLDIERS WERE GOING TO BE WITHDRAWN SOUNDED LIKE AN ABANDONMENT OF THE KURDS.

EMMA SKY, YOU HAVE WRITTEN -- SORRY.

YEAH, I MEAN, IT DID DEFINITELY SOUND LIKE AN ABANDONMENT.

THERE WAS A LOT OF ANGER ABOUT THAT.

I WANT TO GET TO YOUR BOOK.

YOU KNOW, 'IN A TIME OF MONSTERS.'SAID ABOUT YOUR GAP YI FELL IN LOVE WITH THE REGION THE FIRST TIME I SET IN FOOT IN IT, AGE 18.

I FOUND SOMETHING LACKING THERE.

THE WARMTH, THE INTERCONNECTEDNESS, THE HISTORY.

I THINK PEOPLE WHO HAVE SEEN THESE COUNTRIES FRAGMENTED AND AT WAR AND IN THE WORST WORST THROES OF THE WORST THAT HUMANKIND FACES, MIGHT MISS THAT ELEMENT OF WHAT YOU WRITE ABOUT.

I THINK THAT'S ABSOLUTELY TRUE.

WHEN YOU LOOK AT PEOPLE'S INTEREST IN THE MIDDLE EAST, AND I SEE IT WITH PEOPLE WHO TAKE MY CLASS ON MIDDLE EAST POLITICS, THEIR INTEREST NOW IS JUST IN TERRORISM AND IN REFUGEES.

THE MIDDLE EAST THAN THAT.ORE TO IT IS A REGION THAT HAS AN AMAZING ARRAY OF DIFFERENT PEOPLES, DIFFERENT LANGUAGES, DIFFERENT CULTURES.

IT HAS AN INCREDIBLE HISTORY, AND THERE IS SO MUCH RICHNESS TO THE REGION, AND I TRY IN MY BOOK TO REALLY INTRODUCE PEOPLE TO THE MANY DIFFERENT CHARACTERS THAT I MET ON MY TRAVEL.

PEOPLE WHO ARE DOING THEIR BEST TO LIVE THEIR LIVES, WHO ARE LOOKING FOR OPPORTUNITIES, WHO SEE HOW WE LIVE IN THE WEST AND WOULD LIKE TO HAVE THEIR CHANCES TO HAVE JOBS, TO BRING UP CHILDREN, TO SEND THEIR KIDS TO SCHOOL, ALL THE SAME THINGS THAT WE WANT.

EMMA, YOU CALL YOUR BOOK, AS I SAID, 'IN THE TIME OF MONSTERS' AND YOU'RE QUOTING FOR THAT TITLE AN ITALIAN PHILOSOPHER WHO SAID 'THE OLD WORLD IS DYING AND A NEW WORLD STRUGGLES TO BE BORN.

NOW IS THE TIME FOR MONSTERS.'

HOW DOES YOUR MIND'S EYE SEE TODAY'S NOW IN THE TIME OFNSTER?

YOU KNOW, THE SOCIAL CONTRACT BETWEEN GOVERNMENTS AND PEOPLE HAS FRAYED IN THE MIDDLE EAST.

THE OLD SOCIAL CONTRACT WAS THAT GOVERNMENT WOULD PROVIDE JOBS, WOULD PROVIDE SECURITY AND PEOPLE WOULD JUST KEEP THEIR MOUTHS QUIET, BUT THERE'S BEEN SUCH A GROWTH IN POPULATION, A DROP IN THE PRICE OF OIL, GOVERNMENTS CAN'T PROVIDE, AND YOUNG PEOPLE CAME OUT TO PROTEST THIS IN THE ARAB SPRING.

BUT THE SAME CONDITIONS ALSO LED TO THE RISING UP OF DIFFERENT INSURGENT GROUPS, AND SO YOU LOOK AT THIS TIME OF MONSTERS WHERE THAT OLD SOCIAL CONTRACT HAS ENDED, BUT WE'RE NOT YET CONTRACT IS GOING TO BE.

SO THE REGIMES HAVE COUNTERED.

THE REGIMES HAVE REGAINED CONTROL.

BUT UNLESS THEY REFORM, UNLESS THEY PROVIDE OPPORTUNITIES FOR THE YOUNG PEOPLE, THEN THERE WILL BE ANOTHER ITERATION OF PROTESTS AND AMONG THOSE PROTESTS THOSE GRIEVANCES WILL FUEL YET ANOTHER CYCLE OF INSURGENCY.

YOU WENT TO SOME OF THESE COUNTRIES AT THE TIME OF THE ARAB SPRING IN 2011.

YOU EVEN WENT TO SYRIA AROUND THAT TIME.

WHEN YOU WERE IN SYRIA AT THAT TIME, DID YOU GET A SENSE THAT WHAT THEY HAD ACHIEVED IN TUNISIAN OR EVEN IN TAHRIR SQUARE, HOWEVER BRIEFLY THAT WAS, COULD ALSO BE ACHIEVED IN DAMASCUS AND AROUND SYRIA?

SO I WENT TO SYRIA IN THE SUMMER OF 2011.

AND BY THAT STAGE 2,000 YOUNG SYRIANS HAD BEEN KILLED.

AND IT WAS CLEAR THAT ASSAD WASN'T GOING TO MOVE ANY TIME HE WAS INTENT IN STAYING IN POWER.

AND IN MY CONVERSATIONS WITH PEOPLE, THEY KEPT QUOTING WESTERN LEADERS, IN PARTICULAR PRESIDENT OBAMA, WHO SAID 'ASSAD MUST GO.'

AND THEY BELIEVED THAT THE WEST WAS COMING TO HELP THEM.

THEY POINTED TO THE SITUATION IN THIS WAS CAUSING MORE -- WHERE THE NO-FLY ZONE HAD BEEN PUT IN THIS WAS CAUSING MORE AND MORE YOUNG SYRIANS TO BELIEVE THE WEST IS COMING, HELP IS COMING, AND TO MOBILIZE AGAINST THE REGIME, BUT I COULD ALREADY SEE AMONG THE PEOPLE THAT I WAS TALKING TO THERE WERE THOSE WHO SUPPORTED THE REGIME WHO SET BASHAR, YOU KNOW, HE'S OKAY, HE'S GOT SOME BAD ADVISERS BUT WHAT'S THE ALTERNATIVE?

THEN I HEARD OTHER PEOPLE WHO SAID THIS IS OUR CHANCE, THIS IS OUR OPPORTUNITY, THIS IS A VERY, VERY EVIL REGIME AND WE NEED TO

WHAT CAMP DO YOU PUT YOURSELF IN, THOSE WHO BELIEVE LIKE PRESIDENT OBAMA AND OTHERS HAVE SAID, THAT THERE WAS NEVER ANY WAY THAT THE WEST COULD HELP IN THIS SITUATION, THAT THE DYE WAS CAST OR THOSE THAT BELIEVED HAD THE UNITED STATES REALLY TAKEN, I DON'T WANT TO USE THE WORD ADVANTAGE, BUT ACTUALLY HELPED AT THE VERY BEGINNING OF THE SO-CALLED DEMOCRATIC UPRISING, THAT IT MIGHT HAVE LED

YOU KNOW, THE COUNTERFACTUAL, IT'S ALWAYS DIFFICULT TO ARGUE, BUT I REALLY BELIEVE THAT IF THINGS HAD HAPPENED DIFFERENTLY IN IRAQ IN 2010, IF THERE HAD -- IF THE RESULTS OF THE ELECTION HAD BEEN UPHELD THERE IN IRAQ, ISIS WOULDN'T HAVE COME UP OUT OF THE ASHES.

AND WITHOUT ISIS IN IRAQ, IT WOULDN'T HAVE BEEN THE SAME PROBLEMS INSIDE SYRIA.

IF IRAQ HAD BEEN MORE BALANCED, I THINK THERE WOULD HAVE BEEN A BETTER OPPORTUNITY INSIDE SYRIA FOR SOME MEDIATION BETWEEN THE DIFFERENT GROUPS.

WHAT WE HAVE SEEN ACROSS THE REGION IS WHENEVER A REGIME IS OVERTHROWN, WHAT COMES AFTERWARDS SOMETIMES ISN'T BETTER THAN WHAT WENT BEFORE.

SO I THINK THERE WERE DIFFERENT OPPORTUNITIES TO TRY AND MEDIATE REFORMS WITH ASSAD RATHER THAN TAKING A VIEW RIGHT FROM THE BEGINNING THAT HE MUST GO AND THEN NOT DOING ANYTHING TO PUSH HIM OUT.

AND SO THE LACK OF A STRONG WESTERN RESPONSE MEANT THAT THERE WAS AN ARRAY OF DIFFERENT DONORS SUPPORTING DIFFERENT GROUPS.

THERE WAS NOT ONE FUNNEL THAT COULD COALESCE ALL THE DIFFERENT AND SO IRAN AND RUSSIA, THEY TOOK A STRONGER STANCE.

THEY SUPPORTED ASSAD, AND BASICALLY THEIR SIDE HAS WON.

YEP.

IT'S A PRETTY DEPRESSING NOTE TO END ON AND A CAUTIONARY TALE.

EMMA SKY, THANK YOU SO MUCH FOR JOINING ME.

AND HER NEW BOOK, 'IN A TIME OF MONSTERS,' IS AVAILABLE NOW.

> FOR MOST DOCTORS, THE MAIN GOAL IS TO PRESERVE LIFE, TO GET PEOPLE BACK ON THEIR FEET AND TO DO NO HARM, BUT HOW DOES THIS APPROACH IMPACT PATIENTS' PERSONAL DIGNITY OR HOW WE THINK ABOUT DEATH?

DR. SUNITA PURI RUNS THE PALLIATIVE MEDICINE AND SUPPORTIVE CARE SERVICES AT THE UNIVERSITY OF SOUTHERN HER LIFE'S WORK IS IN HELPING PATIENTS COME TO TERMS WITH DYING, PROVIDING MEDICAL AND SPIRITUAL SUPPORT AS THEY FACE THEIR FINAL JOURNEY.

AND SHE SAT DOWN WITH OUR ELYSIA MENENDEZ TO TALK ABOUT HER NEW BOOK, 'THAT GOOD NIGHT,' AND HOW HER PERSONAL EXPERIENCES HAVEK.

DR. PURI, THANK YOU SO MUCH FOR BEING HERE WITH US.

THANK YOU SO MUCH FOR HAVING ME.

WHY WAS IT IMPORTANT TO YOU TO WRITE THIS BOOK?

I THINK THIS BOOK WAS ALWAYS IN ME.

MMM-HMM.

AND I TWO MAIN STRANDS OF THE BOOK ARE WHAT IT WAS LIKE TO GROW UP WITH MY PARENTS, WHO ARE BOTH IMMIGRANTS FROM INDIA, AND WHO GREW UP IN POVERTY, AND THAT POVERTY REALLY INSTILLED IN THEM A VERY DEEP REVERENCE FOR THE DIVINE AND FOR ALL THINGS SPIRITUAL.

THAT WAS SOMETHING THEY PASSED ON TO MY BROTHER AND I.

SO I GREW UP WITH THIS OUTLOOK ON LIFE AND ON MORTALITY AS LIFE IS TEMPORARY AND WE ARE ALL IMPERMANENT AND THEREFORE SO IS OUR SUFFERING.

AND I FOLLOWED MY MOTHER INTO MEDICINE BECAUSE I WANTED TO BE EXACTLY LIKE HER, BUT I CAME INTO A PROFESSION THAT HAD A VERY DIFFERENT LOOK AT MORTALITY AND A VERY DIFFERENT LOOK AT ITS OWN PURPOSE IN KEEPING PEOPLEIV.

AND I WROTE THIS BOOK TO RECONCILE WHERE I CAME FROM, HOW IT LED ME TO THIS PROFESSION AND HOW I MADE THE PROFESSION MY OWN, BUT I ALSO VERY MUCH WROTE THIS BOOK KIND OF IN HONOR -- TO HONOR THE PATIENTS AND THE FAMILIES THAT I'VE HAD THE PRIVILEGE OF TAKING CARE OF BECAUSE THEIR STORIES I BELIEVE CAN HELP SO MANY OTHERS WHO ARE IN A SIMILAR POSITION OF FACING MORTALITY AND DYING AND NOT KNOWING HOW TO NAVIGATE THAT, AND IT'S ONE OF THE LONELIEST THINGS I THINK PATIENTS AND FAMILIES FACE.

YOUR FIELD IS A RELATIVELY NEW FIELD, RIGHT?

YES.

SO WHEN YOU GO INTO A ROOM AND YOU DESCRIBE TO A PATIENT WHAT PALLIATIVE CARE IS, HOW DO YOU EXPLAIN IT?

SO THE VERY FIRST THING I DO WHEN I TELL SOMEONE I'M FROM THE PALLIATIVE CARE TEAM IS TO SAY, IT'S TOTALLY OKAY IF YOU HAVE NOT HEARD OF THIS FIELD.

SOMETIMES I'LL EVEN JOKE AND SAY MY PARENTS DON'T EVEN REALLY TOTALLY UNDERSTAND WHAT I DO.

JUST TO KIND OF PUT THAT OUT THERE.

YEAH.

BECAUSE IT'S A WORD THAT TONGUE. ROLL EASILY OFF THE

MMM-HMM.

MANY PEOPLE HAVE NOT HEARD OF IT.

AND SO IT INSPIRES FEAR.

AND WHAT I TRY TO TELL PEOPLE, REALLY MY JOB IS TO HELP YOU ADDRESS THE MANY WAYS THAT YOU MIGHT BE UNCOMFORTABLE.

SOMETIMES THAT'S PHYSICAL SUFFERING FROM YOUR DISEASE OR FROM THE TREATMENTS THAT WE'RE PROVIDING THAT CAN MAKE YOU FEEL REALLY BAD.

AND SOMETIMES THAT MEANS THAT YOU AND I JUST GET TO HAVE A CONVERSATION ABOUT WHAT'S GOING ON FOR YOU MEDICALLY, WHAT'S MEANINGFUL TO YOU IN YOUR LIFE AS A HUMAN BEING AND HOW WE CAN CRAFT THE BEST PLAN MEDICALLY TO SERVE WHAT'S MOST IMPORTANT TO YOU.

I WAS STRUCK BY HOW ALMOST UNIVERSALLY EACH OF THESE CONVERSATIONS BEGINS WITH THE FAMILY OR THE PATIENT WANTING TO REJECT THE PREMISE OF THE -- WANTING TO MAKE, RETURN TO SURVIVAL AS THE PREMISE.

WHAT DO I HAVE TO DO IN ORDER TO SURVIVE?

WHAT DOES THAT TELL YOU ABOUT THE STATE OF MEDICINE?

SO WE ARE ACCULTURATED AS DOCTORS TO MAINTAIN LIFE AT ALL COSTS, SOMETIMES AT THE COST OF DIGNITY.

AND I THINK WESTERN MEDICINE HAS BEEN VERY FOCUSED ON EXTENDING SURVIVAL.

IF YOU LOOK AT OUTCOMES THAT WE LOOK AT IN MEDICAL JOURNALS, WE LOOK AT THINGS LIKE SURVIVAL BENEFIT.

THAT IS DISTINCT FROM QUALITY OF

RIGHT.FIT.

WHICH WE'RE STARTING TO STUDY MORE, BUT IT IS ENGRAINED IN US TO PROLONG SURVIVAL AND WE DON'T KNOW WHAT TO DO WITH THE FACT THAT WE WILL NOT HELP PATIENTSV.

AND ACKNOWLEDGING THAT IN A REAL MEANINGFUL WAY IS VERY DIFFICULT BECAUSE IT'S NOT PART OF OUR TRAINING, AND I WOULD SAY IT'S NOT WHAT MANY PATIENTS AND FAMILIES EXPECT FROM US.

NO, I MEAN, I EVEN AS A NON DOCTOR THINK ABOUT THE PORTRAYALS OF DOCTORS ON 'E.R.'

OR 'GREY'S ANATOMY' THE PERSON WHO SAVES THE LIFE IS A HERO AND NOT A FAILURE.

YEP.

IT'S FUNNY, I DO A LOT OF TEACHING FOR THE MEDICAL STUDENTS AND I'LL SOMETIMES REFERENCE THOSE SHOWS AND SAYLYO MEDICINE MAYBE WANTING TO EMULATE WHAT YOU SEE ON TV.

WE'RE HAMMERED WITH THAT MESSAGE OF THIS IS WHAT A REAL DOCTOR IS, BUT I WANT TO SHIFT THAT PERSPECTIVE A BIT AND HELP YOU UNDERSTAND THAT A REAL DOCTOR IS SOMEONE WHO WILL WALK WITH THEIR PATIENT THROUGH EVERYTHING, INCLUDING THE FINAL STAGES OF LIFE, BECAUSE THERE IS SO MUCH IN MEDICINE THAT WE CANNOT CURE.

MOST ORGAN FAILURE LIKE HEART FAILURE, LIVER FAILURE, THE FAILURE OF LUNGS, THOSE ARE NOT THINGS THAT WE CAN REALLY TAKE AWAY FROM PEOPLE.

WE CAN MANAGE THEM SYMPTOM ATICALLY AND HELP THEM TO FEEL WELL AND ENJOY THEIR LIVES, BUT PART OF YOUR RESPONSIBILITY IS GOING TO BE OWNING THE RESPONSIBILITY TO TALK TO THEM ABOUT WHAT IT MEANS AS ORGAN FAILURE PROGRESSES.

WHAT IS -- WHAT IS MOST IMPORTANT TO THEM IF THEIR LIFE IS NOT AS LONG AS WE -- AS THEY WOULD LIKE IT TO BE?

AND HOW DO YOU LEARN TO TELL WHEN A LIFESPAN IS SHORTENING?

WHICH IS ALSO SOMETHING WE DON'T REALLY LEARN MUCH ABOUT IN MEDICAL SCHOOL.

AND THEN YOU GO INTO YOUR RESIDENCY TRAINING AND MORTALITY SLAPS YOU IN THE FACE.

AND YOU DON'T HAVE THE LANGUAGE OR THE TOOLS TO NAVIGATE THAT.

AND I HAVE A LOT OF COMPASSION FOR MY COLLEAGUES AND FOR MY EARLIER SELF IN MY TRAINING WHEN I MADE A LOT OF MISTAKES AROUND AND DID PROCEDURES AND GAVE MEDICATIONS TO PATIENTS BECAUSE I COULD BUT NOT NECESSARILY BECAUSE THAT'S WHAT I SHOULD HAVE DONE.

AND I KNOW THAT I PROLONGED SUFFERING FOR PATIENTS IN THE PAST.

AND IT WAS THE GRAVITY OF THOSE EXPERIENCES AND MY OWN REFLECTION ON THEM THAT REALLY LED ME TO RECONSIDER HOW I COULD DOCTOR BETTER, HOW I COULD DOCTOR DIFFERENTLY.

SOME OF THAT CAME DOWN TO THE SIMPLEST TOOL WE ALL HAVE, LANGUAGE.

THERE IS A PASSAGE FROM THE BOOK I WOULD LIKE YOU TO READ, AND IT'S ABOUT A PATIENT NAMED DAVE.

DAVE, UNFORTUNATELY YOUR EMP SEEMA IS GOING TO CONTINUE TO GET WORSE UNTIL IT TAKES YOUR LIFE AT SOME POINT.

I KNOW THAT IS DIFFICULT TO HEAR.

IT'S DIFFICULT FOR ME TO SAY.

BUT I HAVE TO TELL YOU THIS BECAUSE IT'S IMPORTANT THAT WE TALK ABOUT WHAT YOU WANT FOR YOURSELF AS YOU GET SICKER.

I HELD MY BREATH HOPING THAT HE WOULDN'T SHUT ME OUT.

HE NODDED.

YEAH, DOC, I KNOW.

I KNOW YOU'RE RIGHT.

TIME YET, YOU KNOW? SEEM LIKE MY BEFORE RESIDENCY AND FELLOWSHIP, WHEN I PICTURED A DYING PATIENT, I'D IMAGINE SOMEONE COMATOSE LYING IN A BED FULLY DEPENDENT ON OTHERS FOR CARE.

BUT DYING CAN BE A SLOW UNFOLDING RATHER THAN A SUDDEN A DYING PERSON MIGHT STILL BE ABLE TO WALK, TALK AND GO ABOUT THEIR LIVES, EVEN WHEN LIVING WITH A TERMINAL ILLNESS.

THIS WAS WHY IT HAD BEEN HARD FOR ME TO ACCEPT THAT MYDYING.

SHE WAS STILL IN HER RIGHT MIND.

STILL MOVING AROUND MY UNCLE'S FLAT.

STILL ABLE TO EAT AND INTERACTW.

DAVE PROBABLY AND UNDERSTANDABLY SAW HIMSELF THE SAME WAY.

MANAGING TO LIVE, NOT INCREMENTALLY DYING.

HOW UNIVERSAL IS THAT UNDERSTANDING AND HOW MUCH DOES IT AFFECT THE WAY WE THEN HAVE SUBSEQUENT CONVERSATIONS ABOUT THE DECISIONS THAT WE MAKE?

SO, THIS PICTURE THAT WE HAVE OF DEATH AND DYING IN OUR COUNTRY IS VERY MUCH THE PICTURE I HAD WHEN I WAS A YOUNG PERSON, WHEN I WAS A RESIDENT BEFORE MY GRANDMOTHER DIED.

WE THINK THAT DYING LOOKS LIKE BEING IN A HOSPITAL BED UNABLE TO INTERACT, UNABLE TO SPEAK.

AND SO WE DELAY A LOT OF CONVERSATIONS ABOUT WHAT PATIENTS WANT FOR THEMSELVES AS THE END OF THEIR LIVES APPROACH BECAUSE THEY'RE STILL WALKING AND TALKING AND THEY'RE IN THEIR RIGHT MIND AND THEY'RE MOVING ABOUT MAYBE A LITTLE MORE SLOWLY BUT MUCH AS THEY DID BEFORE.

AND SO IN THE MIND OF THE PATIENT AND THE FAMILY AND THE PHYSICIANS, THEY MAY NOT LOOK LIKE THEY'RE DYING.

AND THAT -- THAT PICTURE THAT WE HAVE IS INACCURATE.

BECAUSE SO MANY PEOPLE ARE STILL ACTUALLY LIVING QUITE FULLY AS THEY'RE DYING.

AND UNTIL WE CAN HAVE A BETTER, CLEARER UNDERSTANDING THAT DYING MAY NOT LOOK ALWAYS LIKE SOMEONE IN A HOSPITAL BED DEPENDENT ON OTHERS AND ON MACHINES, THEN WE'RE NOT GOING TO BE ABLE TO ADVANCE OUR CONVERSATIONS TO AN EARLIER POINT IN ILLNESS.

AND THAT'S REALLY WHEN WE SHOULD BE HAVING THEM, BEFORE THE PATIENT, THE PERSON IS IN A BAD COMATOSE, UNABLE TO TALK.

IT TOOK YOU AS A MEDICAL PRACTITIONER A VERY LONG TIME TO LEARN HOW TO HAVE THESE CONVERSATIONS.

YEAH.

HOW DO WE AS LAYPEOPLE LEARN HOW TO HAVE THEM PRE-EMPTIVELY.

YEAH.

BEFORE THEY'RE A CONVERSATION THAT IS FORCED.

YEAH.

WELL, ONE OF THE HARDEST BUT NOT MEANINGFUL SECTIONS I WROTE IN THE BOOK WAS ABOUT MY OWN ATTEMPT TO TALK TO MY PARENTS.

AND TO SAY THAT THAT WAS DIFFICULT IS A HUGE UNDERSTATEMENT.

BECAUSE -- AND I REALLY -- I WONDERED WHY I HAD SO MUCH DIFFICULTY WITH IT, GIVEN THEIR OWN VIEWS ON MORTALITY AND IMPERMANENCE AND GIVEN THAT I HAVE THESE CONVERSATIONS EVERY SINGLE DAY.

ONE THING THAT I FIND REALLY HELPED ME WAS TO KNOW THAT IF I DIDN'T ASK THEM I WOULDN'T KNOW WHAT THEY WOULD WANT, AND I NEEDING TO GUESS.OSITION OF WHICH I THINK IS ONE OF THE MOST STRESSFUL THINGS THAT PATIENTS AND FAMILIES EXPERIENCE, IS JUST THE NOT KNOWING.

RIGHT.

AND THERE HAVE BEEN SO MANY MEETINGS I'VE BEEN IN WHERE SOMEBODY HAS BECOME CRITICALLY ILL.

SOMETIMES WE COULD SEE IT COMING AND SOMETIMES WE COULDN'T.

BUT THEIR LOVED ONES ALWAYS TELL ME, I WISH THAT I HAD TALKED TO MY MOTHER OR MY FATHER OR MY PARTNER BEFOREHAND SO I WOULD KNOW WHAT TO DO FOR THEM.

AND I THINK IF WE THINK ABOUT IT JUST AS ALMOST LIKE CRISIS PLANNING, JUST LIKE WE PLAN FOR UNEXPECTED THINGS ALL THE TIME, WE HAVE CAR INSURANCE, FOR EXAMPLE.

WE HAVE HOME INSURANCE.

AND HAVING THIS CONVERSATION I THINK IS THE BEST INSURANCE AGAINST HAVING THINGS HAPPEN THAT WILL CAUSE YOU TREMENDOUS SUFFERING.

I ALSO THINK THAT PART OF LIVING A GOOD LIFE IS DYING A GOOD DEATH.

AND SO IT'S A GIFT WE GIVE OUR LOVED ONES TO FIND THAT COURAGE TO SAY, THIS IS REALLY HARD, AND I WISH THAT WE DIDN'T HAVE TO TALK ABOUT THIS, BUT I WANT TO BE SURE I'M THE BEST SPOKESPERSON FOR YOU THAT I CAN BE.

IF YOU CAN'T TALK TO ME OR YOUR DOCTORS YOURSELF.

HOW DO THE CONTOURS OF THIS CONVERSATION CHANGE WHEN IT IS A PARENT MAKING THESE DECISIONS

I'M SO GLAD YOU ASKED THAT QUESTION BECAUSE I THINK THE IMAGE OF PALLIATIVE CARE IN OUR COUNTRY IS VERY MUCH JUST FOR ADULTS.

THERE IS PEDIATRIC PALLIATIVE CARE AND THERE IS -- I SEE A TREMENDOUS NUMBER OF PATIENTS WHO ARE ACTUALLY IN THEIR 20s AND 30s AND 40s AND THEY'RE DECISION MAKERS OR SOME OF THEIR DECISION MAKERS ARE THEIR PARENTS.

AND I THINK THAT FOR PARENTS THE CHALLENGE IS -- THE DEEP EMOTIONAL CHALLENGE IS I SHOULDN'T NEED TO BURY MY CHILD BEFORE ME.

MY CHILD SHOULD BE BURYING ME.

AND I THINK WHAT I HAVE TO DO IN THOSE CONVERSATIONS IS HELP THEM TO COME TO AN UNDERSTANDING THAT THEIR CHILD IS MAYBE 35 YEARS OLD BUT THEIR CHILD'S BODY AND THEIR CHILD'S ORGANS ARE ACTING LIKE THEY'RE 85 AND THAT THE BODY IS REALLY AT THE VERY END OF ITS EXISTENCE.

AS HARD AS THAT IS TO RECONCILE.

AND I THINK GETTING A PARENT TO ACCEPT THAT IS A PROCESS THAT WILL TAKE PLACE LONG AFTER THE CHILD PASSES AWAY.

I CAN'T IMAGINE BEING IN THAT POSITION, BUT I DO SEE THE RESILIENCE OF PARENTS WHOSE CHILDREN I HAVE TAKEN CARE OF, AND IT IS SOMETHING TO SIT IN AWE AND ADMIRE.

DR. PURI, THANK YOU SO MUCH.

THANK YOU SO MUCH FOR HAVING ME.

IT'S AN HONOR.

AND PERHAPS THERE'S NO GREATER ANGUISH THAN A PARENT HAVING TO BURY A CHILD.

IT SEEMS TO GO AGAINST THE LAW JOIN ME TOMORROW FOR MY INTERVIEW WITH HOLLYWOOD STARS JULIAN MOORE.

THE ENGLISH REMAKE OF THE CHILEAN ROMANCE DRAMA.

GLORIA IS DIVORCED MORE THAN TEN YEARS.

SHE APPEARS TO BE AT EASE.

YOU'RE BUSY BELTING OUT HITS FROM THE '80s AS YOU'RE DRIVING.

I WONDER HOW KIND OF REVEALING THAT WAS FOR YOU TO BE SINGING IN FRONT OF THE WHOLE WORLD.

WAS THAT KIND OF MORTIFYING?

YOU WERE GREAT.

OH, THANK YOU.

NO, I MEAN, I THINK -- I THINK THE DANCING WAS THE HARDEST PART FOR ME.

JOHN REALLY IS A DANCER, YOU KNOW?

HE LOVES TO DANCE AND HE TAKES SALSA LESSONS REGULARLY.

I AM NOT A DANCER.

SO FOR ME THAT WAS -- THAT WAS THE PART WHERE I REALLY HAD TO TRY TO FREE MYSELF.

THAT WAS FUN, THOUGH.

WE REALLY HAD A GOOD TIME.

BUT ACTUALLY I WAS -- TO HAVE A PARTNER LIKE JOHN EVERY DAY, TO GO TO WORK, TO LOOK FORWARD TO BEING WITH AN ACTOR OF HIS CALIBER AND ALSO SOMEONE WHO IS INTERESTING AND FUN TO BE WITH, OH, MY GOD, THAT MAKES SUCH A TREMENDOUS DIFFERENCE.

SO TO BE ABLE TO DANCE WITH HIM AND REALLY TRY TO COMMUNICATE PHYSICALLY, YOU KNOW, THAT WAS -- THAT WAS SOMETHING NEW AND REALLY I WAS EXCITE -- IT WAS EXCITING, RIGHT?

SHE WAS A GREAT PERSON TO WORK WITH BECAUSE SHE PUTS HER ATTENTION ON THE OTHER -- ON HER PARTNER.

THAT'S JUST A WONDERFUL THING.

BECAUSE ONCE YOU DO THAT, YOU'RE NO LONGER THINKING ABOUT YOURSELF.THINK ABOUT THE OTHER PERSON.

RIGHT.

AND INTERESTING THINGS OCCUR.

INTERESTING INDEED.

THAT'S IT FOR OUR PROGRAM TONIGHT.

THANK YOU FOR WATCHING 'AMANPOUR & COMPANY' ON PBS AND JOIN US FOR THAT TOMORROW NIGHT.