was most needed and least expected. anderson, everyone i spoke to here who had worked with him said he was really just an amazing man and always fun and great to work with, professional but always lighthearted. and they're devastated. >> incredibly dedicated. and our thoughts are obviously with his family and his friends. susan, thanks very much that does it for this two-hour edition of "306." "cnn tonight" with don lemon starts now. this is cnn breaking news. >> good evening. this is "cnn tonight." i'm don lemon. >> great to be with you, don. i'm alisyn camerota. >> tonight chilling words from the apparent executioner of american journalist steven sotloff. >> just as you continue to strike our people, our match will continue to strike the necks of your people. >> experts fear that terrorist becoming a star who can recruit even more fighters. what will it take to stop him,

alisyn? >> tonight we have got a team of experts here to weigh in on the terror threat and the military response. also, this is going to be fascinating. a former jihadist who knows how the terrorists work, how dangerous they really are, and how to break their mind-set. plus, we'll have the very latest on joan rivers on life support in new york's mount sinai hospital. surgery more dangerous than we realize? we're going to begin with the fight on isis. president barack obama is sending additional u.s. military personnel into iraq. and that comes just after the release of that video that appears to show the beheading of american journalist steven sotlo sotloff. karl penhaul is in london. good evening to both of you. pamela, i'm going to start with you first. i want to get the breaking news in tonight. more u.s. military personnel headed to iraq. what do we know about that? >> yeah, don, we're learning today the u.s. is sending over approximately 350 additional military personnel on the ground in baghdad to provide additional

security for the embassy and other diplomatic facilities over there. and this brings a total numbers of troops who are providing diplomatic security in iraq to 820. don, a statement from the white house notes the troops will not be serving in a combat role on arriving around the white house is filling a request from the state department as the country continues to fight isis. >> and i want to turn now to that gruesome isis video, carl. you have seen the video in its entirely. describe what you saw. >> don, it's close to three minutes. it's a video with relatively high production values. at least two cameras appear to have been used in that video. steven sotloff, the 31-year-old american journalist appears once again in an orange jumpsuit, reminiscent of the prisoners in guantanamo bay. also alongside him a man who seems very similar to the man who appeared in the james foley execution video two weeks ago. he also speaks with the same distinctive british accent that experts say is a multicultural

london accent. that man once again talks to obama and says obama, i'm back. and then he concludes that video, warning obama to back off and stay away. we see at some point a knife being passed across steven sotloff's throat. and then later pictures of his severed head on top of his body. a very difficult video to watch. and apparently isis making good on its threat that steven sotloff would be next if the u.s. did not cease its air strikes on isis positions in iraq. don? >> and karl, it's alisyn here. that video is obviously sickening. cnn is only going to play a small portion of the message, in part because it is clearly propaganda from this terrorist group. but here is the small portion that we will play so the viewers get a taste of it. >> continuing your bombings,

despite our serious woman, you, obama, have yet again for your actions another american citizen just as your missiles continue to strike our people, our mash will continue to strike the noefx your people. >> karl, what do we know about this executioner? >> from what we have already gleaned, and that principally from the james foley execution video two weeks ago, that british intelligence experts in fact were saying ten days ago they were pretty close to identifying who he was. we haven't heard from them yet if they have in fact managed to identify who he is and where he is from. but he does speak with that pretty distinct accent that language experts is from a multicultural district of london. but beyond that, we really don't know publicly at least who he is. but clearly, isis has put him up there for propaganda purpose, possibly also some people say to draw other foreigners to the

jihadi cause, alisyn. >> karl, we want to hear now from steven sotloff himself. we're showing this limited portion of his message, because we think it is very important to hear him and see how incredibly brave he is in his last moments. steven sotloff's last words on the video were clearly coerced. and for all we know, we thought that his life would be spared possibly if he cooperated. so here is a brief portion of his remarks on video. take a look. >> obama, your foreign policy of intervention in iraq was supposed to be for the preservation of american lives and interests. so why is it that i'm having to pay the price of the interference with my life? >> karl, show that message being interpreted tonight? >> well, there is no indication that u.s. administration is going to pull back from its campaign of air strikes on isis positions, and also the indications that the u.s. may be considering air strikes in syria. also in terms of britain, one of the united states' major allies

there, britain has also said that it is considering arming the kurdish militias who we know are fighting isis, and also prime minister david cameron has said he will consider giving more intelligence to the u.s. to help it in its bombing campaign. and that brings a world of problems to the british prime minister because not only are we now faced with the fact that the executioner appears to be british, but also at the very end of this brutal video, a third man is brought forward, and that is at least according to the isis propaganda video, a third british hostage we didn't even know was being held hostage. the clear implication there, if this campaign against isis continues, that briton will be the next in line for execution. >> karl penhaul, pamela brown, thanks. great to see you both this evening. her organization first spotted this new isis video today. rita, thanks so much for being here. explain how you came upon this

video. >> well, we have tried for over a decade monitor, search, and study the jihadist online. as you had me speaking here before, talking about the threat of the online recruitment and jihad network and infrastructure, we have been studying and monitoring the jihadists online which also as they get more sophisticated, we follow their techniques and study them. based on that, we could predict where they will be uploading their video. after all, we have to remember that much of this propaganda is being posted online. their releases are released online. so they have to be able to use certain location to upload their releases before they are published. >> and rita, do you know about this report that they did not

intend to release this video today? somehow it was leaked? >> i mean, we released it because we found it on their sites that they prepare for a release. i believe -- i strongly believe that it was supposed to be released today. and, in fact, they even posted a message on their social media official site, isis, that they will be releasing the video soon, and that was about very shortly after we released their video. they were also going to release it in other additional languages, german and french and russian. but we first released the video. >> so rita, you study these guys. you have made your career out of following isis and similar groups. so how do you think the u.s. should be handling them?

>> i think that it's very important to understand the online infrastructure. we're all facing the problem of recruitment online. we're facing the problem of americans, brits, australians, you name it, all over the world, individuals are joining isis. the executer is british or at least has a british accent. last week we faced the problem of two americans killed while fighting for isis. and the list is long. and we are facing currently the problem of how are we going to stop the radicalization process. unfortunately, though, i don't remember any comprehensive study that was made by the united states or other governments in trying really to understand what makes -- what creates the radicalization, what is making individuals going to fight with these groups from the sense of what is happening on line. and the online component is so

important. and as long as we will not pay attention to it, unfortunately, their recruitment will continue. >> so you think we aren't paying attention to it? you think the u.s. is not paying attention to the online component or we're not as savvy as they are? >> i believe that not enough is being done on the online network. i believe that the bottom line is that we have been in this war for almost 14 years, and at this stage al qaeda is very strong and isis is very strong in almost every single country in the world is facing the problem. what we can say for sure is that the drone attacks were not enough, because we are having a serious problem that we need to study, and studying the internet is extremely important. i've testified before congress years before, but 2007, 2008, and i said the problem of the internet is going to be

extremely important for every, because the internet breaks the borders the problem over there suddenly becomes a problem over here. >> yes. >> the video is released there. the inspiration that is happening in iraq is affecting every single individual. and among the problems we're having right now, not only that individuals from the united states and other western countries are going to fight in syria and iraq, emotionally and idealogically supporting the group. and for various reasons, they can't leave, they can't go. and they are among us. and as long as the internet will not be faced very seriously, i think that the radicalization process will be becoming even more an important threat. >> we'll be talking all about that for the next couple hours. rita katz, thank you so much for your incite. she says we have to beat them at their own game and become as savvy as they are online, why we're not yet. i want to talk to a woman

who has known steven sotloff. danielle, thank you for joining us. tonight. i need to tell our viewers that you group and went to school with steven back in miami. and when you first realized that the man in the video was your childhood friend, when did you realize that? >> it was a couple of weeks ago when i saw the video in which james foley was beheaded, and i was instantly horrified. steven was my hero. he was traveling to the most dangerous, troubled places on the planet so that he could report back stories of human suffering. he was someone who could not ignore pain and a injustice. he felt responsible. and he had to respond. >> so, you know, you shared your first great class photo from your temple. and i want to show it here. you tell us that steven sotloff, there he is in the top second row from the right, and you're on the lower right. you hadn't seen him in 15 years. but he actually reached out to

you in 2010 to reconnect, right? >> yeah, he did. i think we had a kinship because he knew i was writing and he was writing. and we were both journalists, although i certainty would not put myself in the same category as him. but he did reach out to me. and he would send me lovely notes. and he would send me articles that he was writing and send them from wherever in the world he was. he would always let me know when he was going into the middle east. i know that was a passion of his. he really felt a responsibility to go there and tell stories of human degradation and pain. >> and danielle, we're playing only a small portion of the hideous video that was released, in part to show steven's stoicism at the hands of this barbaric act. you say it was a trademark of his personality to not cower from danger. >> no. i mean, what i remember of him, and for some reason he was one

of those -- he was one of those kids who just made an impression on you. have i such a powerful memory of him even from such a young age. he was goofy and playful and fun, and just so full of light and joy. and he was an incredible, beautiful soul and spirit. >> have you spoken to the family tonight? and if so, or lately, how are they doing, do you know? >> i have not spoken to the family. they have asked that people respect their privacy. i can only imagine the horrific amount of grief that they're feeling at this moment. but have i been in touch with friends from home and certainly people from the synagogue that steven and i both belonged to. and it's just the whole community is grieving. it's a terrible tragedy. and i think anyone, you know, who cares about freedom of expression and human life should be appalled and saddened by this really horrific act.

>> yeah, barbaric. thank you very much, danielle berrin, a childhood friend of steven sotloff. as we have been talking about the family, the mom last week made a plea for the release of her son, and all of the sudden this today. >> she made a personal appeal to the head of isis, baghdadi, hoping that speaking as a mother that it would change the course of fate. but of course it did not. >> when we come right back, from isis to al shabaab, is the white house doing too much or not enough to battle terrorism? we'll ask a man who has reported from hot spots around the world. that's nick kristof. also, how isis recruits young people from around this story. and then joan rivers on life support in a new york hospital. the surgical procedures we take for granted more dangerous than we realize? ♪

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we want to update you on our breaking news tonight. president obama is sending 350 additional u.s. military personnel back to protect the country's diplomatic facilities in baghdad. a statement from the white house says the forces will not be serving in a combat role. and meanwhile today, a state department official says, quote, stay tuned for how the white house plans to battle isis. but are we running out of time to take action there? joining us now, a journalist who calls the apparent beheading of steven sotloff evil and heartbreaking. that's nicholas kristof. we were hoping last week that

the mother's plea might save his life. >> it's heartbreaking for anybody who has reported out in the field like that, that it sends a shiver down your spine. and i hope we remember steven sotloff not for that beheading video, not him in those orange cover-alls, but for the extraordinary work he did from yemen, from syria, from libya, from egypt. >> isis was very specific in their video message today to president obama. they say they were doing this in response to the air strikes that allowed the locals to be able to take control of their town from isis. does that mean that the air strikes are working? that they are upsetting isis? >> i mean, the irony, the great irony here is that isis are the only people who seem to think that obama has been particularly aggressive or effective in striking them. and, i mean, clearly those air strikes have had some impact. i think it's also clear that

they've been kind of marginal overall. >> but today is the second beheading. does that put more pressure? you heard the president say we don't have a clear strategy. does that put more pressure on him to come up with a strategy that everyone understands what page we're on? >> i think it creates more political pressure for him to be tough, to show some kind of action. and there is always a danger if you don't have a substantial strategy and you're under that pressure, one way of solving that politically is you go drop some bombs on somebody. >> james foley and steven sotloff both journalists. but steven haynes is a contractor. it's not just journalists under fire. >> there are aid a workers under fire. there are an awful lot of people who are, you know, who are trying to help others and go out there and who are now in grave danger themselves. my heart goes out to sotloff in particular, because frankly, we in journalism so often have dropped the ball. and you look at the kind of stories we in the media have been covering this year.

it's an awful lot of celebrity news, and now it's jennifer lawrence and this kind of thing. it's people like sotloff who are out there taking the risks, trying to keep the world focused on 200,000 people dying in syria. and he dies for it. >> but we haven't brought up sotloff before now because frankly we were told not to because -- i mean, his family and the government we thought were working back channels. and they didn't want us talking about sotloff. do we know if there are other americans that are being held by isis? >> we believe there are other americans being held by isis. my understanding is that there are. >> we're hearing tough words. let's talk about tough words from david cameron. he talking about possibly confiscating passports, banning fighters from coming back to the uk. does the obama administration need to be bolder in its fight against extremists? does he need to be more like david cameron and his response? >> the most crucial thing we need to be doing is gather intelligence on those american passport holders who are out

there working with isis. and the widespread belief is they released 100 of those and maybe more than 300 of those. maybe not all working with isis particularly, but with other jihadi groups in syria. and it's a little bit reassuring that some of those have been killed on the battlefield, because that indicates that isis is willing to use them as cannon fodder rather than to wage attacks on u.s. soil. but there is the fear that somebody with a u.s. passport can be dispatched. >> can't we assume they're on a watch list? david cameron spoke about revoking those british passports when they have intel that they have gone over to work for isis. aren't they on a watch list of ours? >> to the extent we can track them. but these are people who flew to istanbul, and there are an awful lot of americans who fly to istanbul, and then from istanbul they migrate south in turkey and you go to the border, and you cross. and it's a chaotic border. nobody is keeping track of passport there's. i'm sure we know a lot of those people and we're able to track

some of their communications. i doubt if we know all. >> you wrote that the president missed an opportunity to arm moderates in syria, correct? is this part of what we're saying no? is this directly connected to that? and is it time to revisit that possibility? >> you know, i'm a fan overall of president obama's foreign policy, but i think he did to an extent blow it on syria when he was urged by david petraeus, by hillary clinton to arm the syrian moderates. at that point there were moderates to arm. and president assad of syria very cleverly fought them and left isis alone. and these days there isn't so much of a center there. >> but as has been reported in other places that the president -- was the president briefed on this a year ago and then sort of looked the other way, didn't take it seriously enough? >> i don't think that he -- i don't think it's quite right to say he didn't take it seriously enough. i think the problem there is there aren't good options.

there are commanders in syria, moderate commanders. you can send them money, and you can send them weapons. you don't know where that money is going toned up, where the weapons are going to end up. and therer were risks. in retrospect, the failure to do that meant there were an awful lot of fighters who simply moved on to the most jihadi commanders. they did have money. they did have weapons. and if you wanted to fight the assad government, then you moved to some commander who had that weaponry. and so you grew a beard and joined those. i don't think it's too late for president obama to still do more to support that, but it's going to be, you know, right now the glamorous thing to do is to drop bombs on isis. and that might be a part of the strategy. but you need to have a force on the ground. and that means working with regional partners in that area to create a viable military force to tackle isis on the ground. >> nicholas kristof, thank you

so much. >> thank you. when we come back, how radicals are recruiting in america, and what will it take to stop them? we'll talk to the experts, including a former jihadist himself. when folks think about what they get from alaska, they think salmon and energy. but the energy bp produces up here creates something else as well: jobs all over america. engineering and innovation jobs. advanced safety systems & technology. shipping and manufacturing. across the united states, bp supports more than a quarter million jobs. when we set up operation in one part of the country, people in other parts go to work. that's not a coincidence. it's one more part of our commitment to america.

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a new front in the war on terror is the radical recruitment right here in the united states. joining us to discuss how to combat this at home is a former jihadist, mubin shaikh. also mia bloom, author of bombshell. and paul cruickshank, cnn analyst and co-author of the just published "agent storm." it's great to have all of you for this assistant topic. mubin, i want to start with you because you have such a fascinating story. at 19 years old, you became radicalized. you became a jihadist. later you rejected extremism and now you speak out against it. how can you explain to us how a revolting video like the one released today serves to recruit other people to join isis?

>> i think the video does two things. one, it does help with recruitment? for those who want to see some kind of harm, suffering come to the enemy as they perceive it, the u.s. in this case, or the west in general, any image of that or any manifestation of that they're happy with. the other side, however, is that it's raising challenges to isis that how do you justify kill agnone combatant journalist that has nothing to do with foreign policy and doesn't act as a combatant. on one hand, it does recruit, but on the other hand it's dissuading people from this approach. >> mubin, do you think he thought his life was going to be spared? why would he say those things? obviously he is coerced. why would he say those things? did he think his life was going to be spared? do you think he saw the other videos? did hoe know what was happening? >> i think they probably didn't tell him that he was going to get killed. probably that it was going to be a recording in the hopes that he would -- they could get some

ransom from it. and probably told him on the second time you're going to do another video and then then they just killed him. >> oh, wow. >> mia, you have seen this video. besides its barbaric nature, what stands out to you? >> well, there is a few things. i think that the initial reaction was that maybe they -- that foley was killed at the same time. but i think now that we have looked at the video, we can see that the beard stubble is different, the hair growth is different. but similar to what aqi under abu musab al zarqawi did, what they did in 2006 was release a video approximately every ten days. and i'm wondering if they're going to keep doing that because it keeps it in the story. it keeps the attention focused. and it keeps terrorizing the american people to see their journalists or aid workers or any other americans or british citizens killed in that way. >> paul, the executioner says that he is doing this in

response to president obama's foreign policy of air strikes, including those that were just in the past 48 hours against amerli. so how is the administration supposed to respond to that? >> clearly this is going to increase the pressure on the obama administration to do a lot more in iraq, but also a lot more in syria. you cannot defeat isis without going after this group in syria. syria is the stronghold of this group. the majority of its fighters are there. its stronghold is there in racca, a city in the north of syria. and much of the leadership is also in syria. so you need to do something more in syria many people argue to confront this group and to roll it back. >> you know, bob, you have compared al qaeda to a cult, but you say isis is much closer to a larger uprising. is it more dangerous than al qaeda do you believe? i'm sorry, paul? >> isis is potentially more

dangerous than al qaeda. it has really frightening capabilities. it has up to a thousand european recruits that it could train and send back to the west. it has training camps on a scale last seen in taliban run afghanistan. it has tens of millions of dollars of cash reserves. so all of this is quite scary capability. what the group's leadership have not yet done have actually plot attacks back in the u.s. they didn't even do that back in the iraqi insurgency days when the united states were involved with major operations against them in iraq. but obviously there is a real concern that they move in that direction now, that they have the capability to do that. and many people think that if the united states acts in syria, that this group may see that as an existential threat and really escalate their response, don. >> mubin, you suggest that there be immediate blackout on isis. how is is that supposed to happen? >> i'm referring to what has been happening on twitter for some time.

you have accounts that are being blocked, especially those that share these videos, these decapitation videos, images and such. and that we, we ourselveses who are online all the time, we not do it ourselves. there is no reason for us to do it. like your previous guests have done, celebrate his life. show people how good of a person he was. he has more integrity in what he was doing in his own self than all of isis combined. and that's something that needs to be reminded. >> hey, paul, i want to talk to you about something that is in tomorrow's "new york times." and that's thomas friedman's column. he writes about president obama being excoriated for saying we don't have a strategy yet. and some people mike roger, ask told fox news sunday that this don't do stupid stuff policy isn't working. and thomas friedman said that sound odd to my ear. like we should just bomb somebody, even if it is stupid. if obama did that, what would he be ignoring?

>> yeah, well, you know, that no real good option now for the obama administration, because if you do now get involved militarily in syria, you're essentially becoming assad's air force. you're helping assad confront isis. really in syria right now, it's just assad against isis. the rebels don't really exist in the same way they existed several years ago, don 10. no good options now in syria, unfortunately. >> when we come right back, it's not just young men being recruited. you may be shocked at just how young the youngest recruits are. that story is next. >> we're going the talk to our panel more about how to break it. so factors like diet can negatively impact good bacteria? even if you're healthy and active. phillips digestive health support is a duo-probiotic that helps supplement good bacteria found in two parts of your digestive tract. i'm doubly impressed! phillips' digestive health. a daily probiotic.

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welcome back, everyone. stopping the breeding of terrorists at home is one thing. but preventing it around the world much more complicated. so we're going to bring back now our formest jihadist mubin shaikh and mia. mia, this appears to be happening every ten days. of course this there is concern

for david haines. every ten to 11 days they turn up something. what do you think is next for isis? >> well, i think they have indicated that they have additional hostages, not just british hostages, but american hostages. so the question is going to be how many beheadings we're going to see in the future. so this is very, very disconcerting. >> mubin, i want to get back to your personal story, because after you were a jihadist, you then somehow, your eyes were opened and you rejected that extremist lifestyle. how did you break out of that mind-set? >> for a lot of people, it's a process to get into this mind-set. there are a number of factors that played. it could be family life. it could be political issues, social issues. and for me, though, it was the 9/11 attacks really made me rethink whether or not this is really what i basically signed up for. but it was only after i had spent two years in syria studying arabic and islamic studies, actually learning islam

properly that i realized the interpretations that i was give given were completely unfounded, taken out of context, and just destruct alternative islam overall. >> so mubin, who do you recommend for how the u.s. can tackle radicalization at home or abroad? >> i think there are two ways this can be done. one at home. i would suggest trusted intermediaries and trusted experts. trusted intermediaries are proven organizations that have stepped up and proven themselves that have stepped up and shown they're willing to work with law enforcement or put out a positive message, and that the government not touch those communities in the sense that if they though there are a number of youth that they might be counseling, they might be talking to, don't give that information to the government. let the government respect the space. and if -- once they're done with them, the government will continue to do its job. then, of course, subject matter experts, people who know the

mind-set. people who know how these things work or ideally how have some practitioner background so they can come with a policy that's not removed from the reality on the ground. >> paul, let's talk about social media. rita katz said we shouldn't underestimate the power of social media and how much influence it has when it's coming to isis. what happened on social media today after this video was released? >> well, isis supporters were ecstatic on social media. they're really energized by these kind of videos. it's almost like there is a pornographic attraction to violence, to the extreme brutality that they have. so there was a very positive unfortunately response from these kind of people. and isis knew this was going to be the case when they put this out. that's why they put these kind of things out, to recruit more people into their ranks, to satisfy these people's blood lust, frankly. >> mia, i saw you nodding while mubin was talking about how to tackle this. what do you think should be

done? i mean, we only can control mostly what goes on here in the united states. how do you think the rest of the world, particularly places like britain is struggling with this, all of europe, how can they start to tackle extremism? >> mubin makes a very good point that we have to approach this with a multipronged approach that involves the government, involves the community, involves and empowers the families. the fbi report that came out in april trying to ascertain why the somali community was so much at risk identified a series of risk factors, but also identified different things that we can do. and things like the interfaith dialogues that mubin does is very helpful, as well as being able to have after school programs so that there aren't, you know, three, four, five hours of time where the kids come home, there is nothing to do except be on the internet and be exposed to this radicalizing

social immediate yankees, i'm glad you brought up the kids. before the break we talked about how young kids are being radical ides. i want to play a video of young kids being recruited by isis. [ kids chanting ] >> so why children? is this just propaganda, or are children this young fighting? i'll ask mia first. >> so don, as you know, this is the research that i'm doing now, trying to figure out ways not just why children are being recruited, but how to prevent it. according to the isis spokesman, children under 16 are not being recruited. but we have seen children as young as 7 holding up severed heads. we have seen children in some of the vice videos, the vice news videos about the islamic caliphate showing children 9, 10, 11 years old being trained

on automatic weaponry. so i don't think it's just about the propaganda. it's certainly about preparing the next generation and making and insuring that these children hold some of the same values and ideology. it's a kind of brainwashing, but we are also seeing children as front line fighters. and my worry is going into the future very young children as suicide bombers. >> quickly, mubin, she correct with that? >> absolutely mia is correct. and i also want to add a thing in "the new york times," a piece today about using children as informants for the so-called islamic state. and it's more than just theater. it is as mia said, it's to prepare the next generation. >> mubin, mia, paul, thank you very much. >> thank you so much. we'll be talking to you again next hour because we have so much more to come on the fight against isis. when we come back, something completely different. this routine surgery supposedly for joan rivers that goes horribly wrong. and now she is in a new york

hospital. she is on life support. how rare is this? what do we need to know about minor procedures and surgery? we'll ask our experts. >> we get them all the time. >> absolutely.

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i say i hate, hate old people. the bodies, the bodies. enjoy your bodies now. add a brassiere, this is how i go to the bathroom. i use my left boob now as a stopper in the tub. >> that's the fearless and funny. >> clearly hope that voice is not silenced. >> she is fearless and funny. that's about as much as we can get away with showing there that act on our show. tonight her family and her friends are anxiously awaiting word on the legendary comedienne. according to her daughter melissa, joan rivers remains in a medically induced coma. this is five days after suffering respiratory and cardiac arrest during some medical procedure. joining us to discuss this is art caplan, head of the division for medical ethics at nyu's langone medical center.

great to see you. >> thank you. >> she went in for what was supposed to be routine throat surgery, or maybe even a diagnostic test. maybe not even surgery. how can this have happened? >> well, she was at an outpatient clinic, and the short answer is nobody knows what happened. >> should she happen in an outpatient clinic? >> i don't even know why she was there. we haven't gotten clear like this. things like this are done outpatient, i'm sure. >> the problem is anesthesia, right? >> correct. >> you say there is always the chance. the fine print says there is always a chance. >> the risk is about 1 in 25,000. if you get that little mask put on you, people have reactions sometimes to the gas, or they have an underlying condition that we didn't know about. so there is a tiny risk. it's not as big as driving to the hospital, which is probably riskier for you. but there is a risk with any anesthetic. >> so is it your impression that this is something akin to what happened to michael jackson, where she had too much anesthesia and didn't wake up from it? >> not at all. michael jackson was getting

basically drug abuse from his doctor. he was addicted to something that was super dangerous. >> i mean, at the end. he had too much. he had too much of a dose of anesthesia. is that what snapped. >> we don't know. we don't know, whether she overdose order if she just had a frail heart. we saw her. she was joking the night before. >> she went to cardiac arrest they said. >> you can have a heart attack out of the blue. think about this. we see people playing sports. a kid on the basketball court, in great shape, wham, later attack. so they do occur. you don't necessarily have to be frail before you have a heart attack. >> but what role does age play in this? she is 81 years old. your chance is less if you're 20 or 30 or 40? >> age is definitely a risk factor for any medical procedure. and i have to point out something even simpler. age is a risk factor because it's age. if you're 81 years old, things happen to you. any day, some 81-year-old is going to have a heart attack and is going to die. >> she is in a medically induced coma. does that mean the doctors are keeping her sedated while they can stabilize her? >> when she had that heart

attack, her brain suffered as loss of oxygen. what you do now is you give kind of a barbiturate, a sedative. you put her into a near coma-like state, and then you make her cold. strange as that sounds, you're trying to drive oxygen to her brain to take care of the lack of oxygen as you have. some is as simple as shivering. some is getting energy up into her head. here is the danger. you go through that procedure. it hopefully does get enough oxygen up there to do something. but if your brain goes for several minutes, that's damage. >> that was my next question. the brain damage, that may be the next issue after this. >> the lawyers will sort out what happened. i think the lesson that joan rivers is going to teach success she could wind up very impaired. and her daughter has said if that happens, we know what she wants. that's the conversation that you got to have with your mom, with your dad when they're older. you got to say if you were brain damaged, 23 you couldn't think, if you were going to stay in a

coma, what should we do for you? she apparently had that conversation with her daughter, with her son. they seem pretty sure what she would want. they have tough decisions to make in terms. but at least they have more of a conversation. >> she doesn't make a secret that she has had lots of surgeries. >> right? >> that's correct. she may be the champion of surgery. >> no doubt she has read the fine print. >> yes. and she has also said in some of her recent routines, i know i could die. i understand this. i've talked about it. >> she is a reality show with her daughter on the e! network. and there is an episode where melissa said i don't want you having any more surgeries. you're getting up there in age. >> too risky for you. >> yes, yes. so that's a risk factor you want to watch for at the same time. when you're older, things are going to happen to you. you need to be prepared. i can't tell you how pleased i am to hear that they talked about this. it's a rough, rough time for her kids. it's a rough, rough time for her family. let's hope she pulls out. but if she doesn't, they know which way she wants to go. does she want a lot done or not

so much done? they know that. we all should know that. >> that's your message to everyone out here. >> absolutely have. that conversation. >> even though it's painful and difficult, it's important. >> can i ask you one thing before you -- can you have these surgeries and not do anesthesia? can you do it with maybe a painkiller? >> no. only in the civil war. >> i'm just saying you can do a painkiller. >> a local anesthetic and that sort of thing. but it's tough when you're trying to examine the throat, look at the vocal cords. >> where you're not all the way out. >> there can be more and less. that's true. >> that's a question where you don't go completely under. >> yes. >> art, thank you so much. >> my pleasure. >> we'll be right back. this is charlie. his long day of doing it himself starts with back pain... and a choice. take 4 advil in a day or just 2 aleve for all day relief.

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and find out more about our two-year price guarantee. comcast business. built for business. welcome back, everyone. arab-americans face a lot of challenges in this country, even when it comes to high school sports. a california high school has retired its controversial can mascot, a caricature of an arab man, which a lot of arab-americans found offensive. there you see it right there. the coachella valley school district is keeping its team nickname arab, and they have come up with a what some consider a more benign logo which is awaiting final approval. we're going have more on this in our next hour. this is cnn breaking news. >> welcome