conversation changed to, well, what is going to be the future of appalachia, the ? of eastern kentucky >> nawaz: born and raid in pikeville, dr. chase reynolds didn't think he had a future here. my mind i was going to g to a big city someplace and practice medicine. i was very surprised as i started looking at job owhpportunities to se had grown up and in pikeville you know since had left. >> nawaz: so, this will all be yours? reynolds says the hospital's continued growth and investments-- like this $30 million dollar cardiac lab-- have cvinced him to stay. they've expanded to 340 patient beds and there are now 100 open jobs. one of those jobs went to former coal miner kevin little. he started working in the mines at the age of 19. >> not everybody can crawl back inside of a mountain and, you know, go in and take out the middle of the mountain. it takes a special kind of people to do that. >> nawaz: kevin worked in the mines for 12 years. when he was laid off, he and his wife misty say times got tough for their family of four. >> it wasn fact of not being able to bu

i think there's a real sense, particularly in parted of, say, appalachia and things, of being judged by other americans, and there's a particularly by people from the east coast, i have to say, the idea that what they regard as -- they feel so badly let down by politicians and institutions, but also how they regard they're talked about by people they regard as elites in this country so i go from the outside and i'm not any part of that so that helps and also true to be montz in dealing with law enforcement as well. think people think you don't have an agenda and i didn't have an agenda other than to write this book and fine out what was going on. i think you don't come politically loaded, let's say. so, that definitely makes it easier. but, yes, hey have been struck by the institutionalized corruption in america over the years. i didn't really understand until i worked in washington, just how the money affects the policy in congress, and you see this here. one reason that congress really didn't act on this for so long was because where does the money -- so much money comes from drug

have read dreamland and other books about the crisis, it is a great book largely about opioids in appalachia. but they are everywhere. give us the smart remedy. azar was, secretary i right. this came out of the medicine cabinet and white coats. it is different than other drug crises we have had. that is the tragedy of it. the book is probably more about mom's than anything. that angle into the story, what mothers will do for their kids, is incredibly touching. vivid. is, this is a disease that is no respecter of persons. if you look at the stats in our states, overdoses, and 1-50, you will see a list unlike any other. in the best 10 and therich and poor, worst 10 states, rich and poor, mostly if you are looking, poor states are always hit the hardest. this is no respecter. the challenge right now, the arc of the problem, secretary a's are is right. -- the secretary is right. amount ofucing the prescription-based opioids prescribed. starting to come down. coming in ands swamping all of that. dyingou have more people of overdoses, last year, then in the vietnam war, we are losing a encyto desp

becomes a very widespread operation to deliver opioids on behalf of the drug companies across all appalachia. >> there are so many questions that come out of that which is why is it we only hear about it now? what questions do you address that you see a lot that this is a group of people dismissed as have been one - - hillbillies? they have not been stigmatized but they are written off it is a population whose health or condition is presumed to be wretched. and they don't have advocates is it because they are written off as disposable or how does it get to be a single place could be that kind of epicenter though whole describing in this country that didn't happen anywhere else a lot of soldiers are very badly wounded to be, more and more common name to with the name it comes with a hypodermic needle so it's much easier to use. so doctors start using it for all kinds of pain it is extremely common in this country and it gives rise to the first morphine epidemic alongside the life of opium and for the first time i have a president roosevelt who appoints a drug czar and as a commissioner of opi

it was pure appalachia when i was growing up. my grandparents had no money, they never had a car, never went on a vacation. my grandfather was a farmer but he never missed a church on sunday after he came back from the spanish-american war. my grandparents were both staunch republicans. my mother came from iowa. she came from a staunchly republican family in iowa. i got it from both sides. steve: did your dad talk to you about serving in congress? how did this come about? rep. duncan: when i was in school, high school and college, ashful, and ib don't think i ever would have ended up in politics. but i drove my dad around all over the district, i admired him so much. slowly, the politics got into my blood. i ended up -- when i got elected to congress it was like a dream come true. i saw it through my father that you could help thousands of people in a lot of different ways. i think since i have been here, which is 30 years now, it boggles my mind to say that. it has passed so fast. but i think the best thing about it is you get t

fifty seven percent of the votes not man enough percent that's the fact and that is how i live in appalachia years he. said he wanted senor collections and in the clear he's not going to run when you having elections when we have so i don't know if we have elections without because the only certain we're separating you think the kind of us little guys are calling for elections you probably still i need to win a fight of my people you personally probably not actually see what i did i'm doing it now and i'm getting there junctions the judges are doing a fantastic job not president abbas what was the prison system there's a go and he told them mr president you must specify the steps in accordance with the timelines and i'm willing to go along with that as long as we reach the ballots and not the bullets and you say you can't have elections until you unify whatever strategy you sort you were employing to make things better for your people it's not looking this i mean god so you've actually been helping to cause hardship you asked israel to cut electricity to cause us not to because of iraq with

of people became hooked on these drugs but it became a distribution center for a whole part of appalachia and beyond as you see the establishment of one of the biggest pill mills in the anntry, and that came out of individual named henry vincent who was appropriately and undertaker. he had just come out of prison, arving four years are running gay escort agency in washington, d.c. that was busted by the secret service. he was sent back to williamson by his parole officer and he sees a business opportunity in setting up a group of doctors in an industrial warehouse as technically a pain clinic, prescribing drugs to just about anybody who wanted them, provided they could slap down the cash. become ailliamson place to go to for a while for a decade. williamson wellness as it was called, they would just prescribe thousands of pills every day without really consulting the patients. you paid $150 and got a prescription. host: "american overdose" is the title of the book. you are a british reporter for the guardian newspaper. how is this a uniquely american crisis, as you described it? guest: a

the cbc has a map, and you see the beginnings of the epidemic in the mid-1990's in the area of appalachia that i talked about, is virginia, kentucky, and it is a red dot. it grows and gets deeper and deeper and it spreads across that park, that region of the country, and then the red dots pop up everywhere else. by the mid-2000's, partly because mass prescribing meds -- meant very large numbers of pills going to people, whether they needed them or not, it is not just the number of people that were getting these drugs, it was also that when they were prescribed perhaps for two or three days worth of treatment, they got 30 days' worth of pills. they were left in the medicine cabinet. a couple of things that happen. one, they simply got passed around within the family. these are good pain pills, why don't you take one? or you have other people in the family, perhaps younger people, who start to experiment with their parents' drug supply. but the scale of the prescribing, not only the number of people, but the number of pills given out with each prescription, meant that a lot of these pills w

. >> stephen: we wee grew up in appalachia purpose were appalachian turd minors.th lost many people close to us of turd lung. it's been a terrible thing. so working at "the daily show" i felt like i was toilg in the turd mines. and i finally quit, and a giant turd asteroid-- ( laughter ) heads toward the planet-- ( cheers and applause ) now, in that instance, if someone said, "you were a turd minor. this is the largest turd deposit ever seen. don't you wish you were in there?" and you're just like, "i'm out of the turd business. i'm out!" ( laughter ) >> stephen: come on in, jon. the turd's fine. ( laughter ) >> we have to go to a commercial. stick around. when we come back, more stephen colbert. got directions to the nightclub here. and if you get lost, just hit me on the old horn. man: tom's my best friend, but ever since he bought a new house... tom: it's a $10 cover? oh, okay. didn't see that on the website. he's been acting more and more like his dad. come on, guys! jump in! the water's fine! tom pritchard. how we doin'? hi, there. tom pritchard. can we get a

white women from appalachia, chiefs from the a paech nation and latino men and women from el as on.stand on the shoulders of the martis. there's power when you refuse to go back. there's power when you won't turn around. there's power when you focus love and truth and justice and the truth is even if one fall in one generation we can pick it up in another generation. so let us declare that we are soldiers in the holder in the blood stained battle and we've got to hold it up until we die. no matter what trump does, hold it up. no matter what races do, hold it up. no matter what injustice does, hold it up. we've got to hold it up until we die. we've got to hold it up until every vote is protected, until every person is respected, until every person has healthcare. >> we've got to hold it up until every child is lifted and loved and we've got hold it up, and every person in property guaranteed a aftness is and we have to hold to vr it up, by everyone and every wall is torn down and every imgrant is welcome and every creature prays for presidents, and while they are praying, p-r-a-y-i-n

a dozen plus federal prosecutors will go into nine states and five judicial districts in appalachia, partner with our attorney general's offices around the country, to bring experienced prosecutors to bear to work side-by-side with u.s. attorneys offices in those affected districts to target doctors. to target pharmacies. to target healthcare professionals that are spreading this disease and this addiction and this poison in those communities. the way it will work is the way it has always worked. we bring a strikeforce model to bear in these states. we send in, at the request of the united states attorneys and with respect to the strikeforce that was announced today, i had an opportunity, i and my deputy, to speak to all nine u.s. attorneys before we did this and we had enthusiastic support from all nine u.s. attorneys for us to come into the districts and work to prosecute cases in one of the most deeply and artist hit parts of the country. the way we do it is, through, in addition to the typical hard work that prosecutors do working with our federal law enforcement partners to make

this brings it more home to us because we have folks in our movement from appalachia who right now areaking over mitch mcconnell's office this week because of the conditions happening with black long and the serious health impacts of the coal workers and communities whose water and land have been polluted. it is s not a question of w wkes versrsus communityty, but togetr we have a solution. we are bringing a real vision of just transition that can transform the whole economy while also dealing with this urgent climate crisis. >> this is the place, one of the where it is not very nice air-quality. not a very nice air-quality. it is not a good example for step we are some places in this place where air-quality is the worst in europe. this is the reason people have to use masks. this is the symbol for the cop24 . that if we want to talk about changes, first we have to think about people. >> i am from friends of the earth indonesia. ourre here professing government because our government plans to build more coal power plants. we need to leave coal immediately. there is a typhoon. people ha

. >> macgillis: sensingpo unity, people were pouring into dayton-- ites from appalachia and blacks fromsouth. >> dayton is crammed, jammed, every living facility packed. this is dayton on a monday night, or a wednesday night. the retail stores aropen. the markets are open. the department stores are open. the banks are open. >> mcgillis: by 1960, the cities populaon reached 262,000. >> and then, sadly, things get ugly fast. in part it's because a lot of people were terrified of what this racial integration would mean. >> macgillis: a lot of t new workers that came to dayton were black, coming up as part of the great migration from the south. and people were not comfortae with their new neighbors. >> and so, we get the firstof round hite flight. and that means a bunch of things happen, right?e, onou're no longer invested in what goes on in the city. so you're consumed, quite rationally, with making sure that all your tax dollars help youruburban school district. (dog barking) when you hollow a counity out of its lawyers, its doctors, its nurses, its teachers, those who hold communities be

be power our money and time into organizations that fed and mentor people, teach in uganda and appalachia, show up in refugee camps with water and art supplies, people team teach children, teach girls auto repair and electrical installation, teach boys to care for babies. witnessing this fills me to bursting with hopement never witnessed both more global and national brutality and such goodness in the world's response to our own. and then there were our families of origin, we call those our foos in recovery. some grew up in the alternative universe of unhappy marriage accept as normal, desperate, parental need. i'm sure your family was just fine. and the temp plat of love you grew up with was kindness and mutual respect, delight in each other, patience with the spouse or a child's foibles, but other families, just a few, hardly worth mentioning, were stressful, home foamic, racist, alcoholic, psychiatrist trendic and/or repressed. brothers and sisters didn't always survive. we became jumpy perfecticses. ts elliott wrote, teach to us care and not care, teach to us sit still. we long for th

i meant an infantryman from appalachia and she said where i came from, in the little town i came from in an old mining community, in the late 1950s and 60s he said what all all the men got drunk and pete up their wives including my mother and that's what they did and this is well outside my read, and you talk to a black u.s. air navigator a missioned officer who is serve ing on a b-52 when you took his wife off the base no hotel would have them. this is also weird and so -- but you get absolutely gripped by the stories that people tell you. the vietnamese, and i interviewed a lot of other books, a lot of chinese, and i once asked a chinese a question, which he treated with a contempt i said was there any happiness in your school in me and looked at me with absolute contempt and said how could there be happiness? all we were doing all the time, from the moment of our birth, was struggling for survival, to exist. things in vietnam, on the mekong delta was better because there was real prosperity but a you see windows into packets of other people's lives that i still find absolutely rive

kind of a denser area that goes up the mississippi valley, over into the ohio river valley and the appalachia area. this is where the id doctors are. there are massive areas in this country where there are no infectious disease physicians at all. endo cologic deaths. so this is diabetes and all the complications of diabetes. this is where the endocrinologists are. neurologic deaths. this is strokes, so forth. where the neurologists are. now, you could say, well, maybe this is just the way doctors distribute themselves. so let's take a look at that. here are the ophthalmologists and the otter orthopedic surgeo. and so you see them all together. there is a difference. so what are the ratios? so this is the number of each specialty per hundred thousands medicare beneficiaries. so we have 6.65 orthopedic surgeons for every medicare beneficiary. endocrinologists 1.68, infectious disease specialists. this is a consequence of the system that has gone awry. there are just too many incentives for procedurallists to make a ton of money. and it affects the work force. the distribution of the talent, the

the problem will be ice and snow in the carolinas and appalachia.n north carolina where parts of the state are bracing for as much as four to 18 inches of snow. >>> a cab driver in new orleans put his driving talents to a different use after lending his cell to a customer in need. the cab driver wound up going in hot pursuit of him when the customer made off with the phone. >> wow. >> video of the chase shows the driver catching up with the man. the cabbie bumped into him with his car and got his phone back. he also decided not to file charges against the man. >> very generous. >> remember when someone stole serena williams' phone and she ran after him? >> it's your phone, it's your life. >>> a u.p.s. delivery man got quite a surprise the other day. while waiting for the door to open during a house call this week, a squirrel jumped on oscar lucy's head. it caught the delivery man laughing it off. he said he felt like snow white with all of her animals. there he is. >> talking to the animal. >> i love how he ends up on top of the head. >>> it's about

they are one of many families affected by crumbling water infrastructure across central appalachia whereg outages often leave customers without running water for days or weeks at a time. outages like this -- like this left the tailors feeling neglected. like his who live every day not knowing if they will have water for bathing and cooking, not -- much less, drinking. what are your infrastructure needs? what are the priorities if congress and the trump administration were to come to a deal on infrastructure, where do you think the money should go where you live? the tailors say the martin county water district has been the subject of heavy scrutiny from state regulators for years because of its leaky water lines which lose nearly three of every four gallons of water the district treats before it can reach customers. poor water quality and reliability and shoddy management, local officials have warned the district was weeks away from financial collapse. with more than $1 million in debt and barely enough money to meet payroll at times. in november, the kentucky public service commission,

of people became hooked on these drugs but it became a distribution center for a whole part of appalachiaeyond as you see the establishment of one of the biggest pill mills in the anntry, and that came out of individual named henry vincent who was appropriately and undertaker. he had just come out of prison, arving four years are running gay escort agency in washington, d.c. that was busted by the secret service. he was sent back to williamson by his parole officer and he sees a business opportunity in setting up a group of doctors in an industrial warehouse as technically a pain clinic, prescribing drugs to just about anybody who wanted them, provided they could slap down the cash. become ailliamson place to go to for a while for a decade. williamson wellness as it was called, they would just prescribe thousands of pills every day without really consulting the patients. you paid $150 and got a prescription. host: "american overdose" is the title of the book. you are a british reporter for the guardian newspaper. how is this a uniquely american crisis, as you described it? guest: a couple

, i heard different candidates mentioned the need for government subsidies for people living in appalachiaher areas where jobs have declined to pay for people to move or to pay them living costs while they are training -- the 40-year-old you mentioned, the 50-year-old who needs to train and cannot go to a plot or your college or stop every few years and go back to college. host: elizabeth, thank you for the call. we will let our guests bounce off that. or vouchers tos help people move are a good idea. one challenge we have is a country is that a lot of people are trapped in places where work is declining. since the great recession, they are doubly trapped because maybe they own a house that is not regained its value. without that, they might pick up and move to where the jobs are. mobility as at a historic low. i think that is an excellent idea. i think we cannot assume that is not going to solve all the problems. , we have toid dramatically increase investment in those communities. we cannot have entire swaths of .he heartland collapsing it came out after our report, unfortunately. towe h