Little upheavally of late so we thought we would start the week somewhere experiencing a bit of a downheaval. Hong kong. Where last weeks protests have been downgraded from massive, antigovernment rallies to listless teen hang session. laughter which is surprising after days like these. Hundreds of thousands packed the streets of downtown hong kong as police fired as many as 87 cans of tear gas. Determined demonstrators shielding themselves with umbrellas and spawning the socalled umbrella revolution. Jon thanks, china laughter im have to change the name of my new album. laughter you know, i spent a lot of time designing that cover. So the umbrella revolution protesting, anyway . Theyre fighting for what they call a full democracy. They want the right to be able to elect their own leaders. The Central Government in beijing says sure, they can have elections but they can only vote for candidates that have been preapproved by beijing. Jon well, that makes sense, i mean what good is an election if all the candidates are the same . Like choosing whatever you want for breakfast when youre at dennys. What, dow get all american slam, lumber jack slam, the grand slam its all egg, toast, meat soaked in human missery. Thats all it is. laughter laughter might even get a gift basket from arbys after that hong kongers were also protesting income inequality, housing aford ability and union issues. And i think we know from experience how rowdy that kind of thing can get. Hong kong protests now really put the civil back in the civil obedience. There is a very, very sort of atmosphere. They are sharing snacks. People who are scurrying around collecting bar gaj and recycling when they can. China china, you surpassed us once more. I cant believe this first the chinese beat us at business with alibaba. Now they are doing protests better than us. They are beating us at both the occupy and the wall street. Its not fair even the police have been minding their manners. Here they are offering helpful signage to alert passerbies they are about to be tear gasd. Very thoughtful, right. And here is an officer politely getting the attention of an older gentleman. I dont imagine that was silly string. Excowes me, pardon me. There has got to be something that we do better than china. Rich, entitled celebutant tweeting stupid out of touch opinions. They will never top us there. The 22yearold daughter of hong kongs chief executive was online bragging about her taxpayer funded purchases. Jon [bleep] go on. This is the beautiful necklace bought at lame crawford funded by all you hk taxpayers, hong kong. Actually, maybe i shouldnt say all of you since most of you here are probably unemployed. What kind of communists are these people . Paris hilton is like but the big question is how are these protests playing in the mainland of china. This is what chinese viewers of cnbc saw during its recent coverage of the hong kong protests. On bbc 2 the screen went to black. Chinese authorities are working to keep images of the protests in hong kong off tv on the mainland. Jon you just go to black. You just people watching and theyre just like oh. laughter i mean if its just a black screen, every show on Chinese Television is a potential last episode of the sopranos, it just goes to blajt i pet when the sopranos finale aired in china they were all like oh, i guess tony was sitting down with his family to to discuss antigovernment protest. Thats a weird ending. Of course, when it comes to official obfiscation china has nothing on the master. N to the orth, korea. It has been a little more than a month since kim jong un has been spotted in the public. It is that he is in poor health or having health issues. The state run media says he has quote discomfort. Jon oh, right. Discomfort. Heres my take, kim jong unwent to the hospital, with a canister of body spray stuck up his ass. Laugh of laugh the doctor was like whats this. Kim jong unwas i done know, i was freshening up and i fell. And i certainly wasnt trying to put a in my and the doctor is like what do i put on the form. Kim jong unis like dont put it out, just put it as discomfort can. I will pay cash. Fine. Any more specific diagnosis . Experts are suggesting he may have gout. Suffering from gout, diabetes and hypertension. A report now claiming the young ruler has been hospitalized recovering from surgery on two broken ankles. Jon wow. How bad is your medical system have to be when its up in the air whether you have gout, or two broken ankles. laughter yeah, hes got a i dont know, hes got [bleep] going on with his feet, i dont know. Laugh of laugh gout, broken ankles, maybe hes pregnant. I dont know what the hell. The Supreme Leader is laid up due to gouty, discomforting, broken ankles, that doesnt mean anything. The man who is considered to be second in command in north korea after the leader kim jong unpopped down to south korea for a last minute visit. This visit was both surprising and significant. The North Koreans agreed to another rank of high level talks for the end of the month and the start of the next month. Jon [bleep] north corian, so let me get this straight. Kim jong undisappears with discomfort, and north korea goes to south korea to Start Talking . Im beginning to think his discomfort is less my tummy hurts and more of a quietly toppled in a coupache. laughter somewhere kim jong unis yelling through a barred doorway at armed guards, come on. I brought you rob what more can you ask from a child king . As mentioned before, north korea wrote the book on nonreporting the news. How is their media handling it . Supreme leader Kim Jong Unhas been sent to a farm upstate where the clouds are made of webs and spent all day shooting missiles at things and making love to dallas cowboy cheerleaders, all hail the immortal kim jong un. Jon so i guess hes okay. Well be right back. cheers and applause ted what are you doing . I was trying to get these skittles, but i got stuck. [ crickets chirping ] maybe i should try. [ spider ] i say go for it. [ crickets chirping ] trap the rainbow taste the rainbow so did you hear the new iphone is out . Im getting one sprint is offering this exclusive new plan with unlimited data. The plan is only 50 a month 50 . Unlimited iphone [glass shattering] so should we eat . The new sprint simply unlimited plan, exclusively for iphone 6. Unlimited data, talk and text for just 50 a month. Switch to sprint and well buy out your contract. Its the best value in wireless. The time has come to put down the dark roast youve been putting up with and reach for the one you deserve. Dunkin donuts dark roast is here. Bold start, smooth finish, never bitter. The double and triple fishermans knot ok google, whats a double fishermans knot . Are used in arboriculture. She got it right, man. Yeah, see . Ok google, how do i get to silver falls . Getting directions to silver falls. Ok google, what times sunset . The sun will set at 8 08 p. M. [laughs] wow. Wooo. Hoo jon just briefly talking about the United Nations. The United Nations, the United Nations was founded in 1945 to save generations from the scourge of war. I think we all know ever since everythings been pretty great. More or less. We sent jordan chreper to the u. N. s recent General Assembly to report on how they are doing. Right now the world is racked with problems like ebola, syria, climate change, sudan, palestine, the ukraine, and that is just one branch. If only there was an organization whose seoul purpose was to solve these kinds of issues. Oh, right, the u. N. With 117 World Leaders in town last week for the General Assembly, i headed over to see what the hell they were doing fix these messes. I have been attending the United Nations meetings for quite a couple of years now. And sometimes i think it becomes just the u. N. Needs to be a lot more effective in their actions that they are taking to combat things like ebola. We have this organization that was established after world war ii in order to guarantee that war will not be the destiny of humanity. So is it working . It should be working but in our case it is not working. With so many diplomatic minds in the same place, surely they were all working together towards the common good as one. I would blame primarily russia. What state specificallies are getting in the way . Being such a good diplomat as i am, i should perhaps not name and shame all the states. India . India. China. China is. Is china the one you werent going say. China, United States is. Israel is refusing to negotiate in good faith for us. Pointing fingers gets us nowhere. But who is in the way of progress . Is it that guy . As i said, pointing fingers will get us nowhere. But him . It is not enough to just when we point a finger, you go to that person, and tell him that look, you are the one stalling the progress. Yeah, him . Okay. Yeah. But perhaps the biggest obstacle of all is the u. N. Security council. Aka, the world [bleep] it decide who get sanction, who gets resolutions and most often who gets ignored. Equally handi cap kd, briefly divided on ukraine. Not majority rules because five permanent members have a veto. The United States, you have china, you have france and you have the united kingdom. They all together. Three of those were major. Finally i found a representative of the u. N. Spokesperson for the secretarygeneral himself to ask him what the point of this whole place was. We represent the collective willpower of government, the states and the people. So the collective willpower is to pass resolutions. You know, we all need to have good resolution, right. We all need to keep resolutions. I break my resolutions like a week after i make them. I think you do really well if you win this then. The only bull net their gun is the hallow pointed suggestion. So your strongest move is to urge. Strongest move is to encourage. Urge is encourage. Theyre the same thing. No, urge is encourage kd. Its more. It felt like every one i spoke with was just talking in circles. A little dizzy. What the world needs is a fresh start without nonbinding resolutions or infighting or those Security Council ass hole. I had a Truly Original idea and i even had a name. What do you think of this . World buddies. A place where everyone has everyones back. With varying membership levels. The best buddy level can text me any time. Ill text you right back. Even if im out at a restaurant with a friend. I will send youo sign your resolution if you sign mine. Kind of like scratch your back. Scratch my back. Silver buddy comes with 53 air strikes. 20 off. Im especially about the one that has to do with speaking of wealth, and around the world. Yes,. Yes, i have a vision of a world where countries come together and listen to one anothers problems. As long as theyre not too complicated. Call world buddies. Pless dont join, please dont join. Its an opportunity to get every country together, doesnt have to be every one but most countries together. If youre interested you dont have to be, i would love to you take a look at that or just hand it back to me. I will read it. I will give it, i will give it yeah. Well leave it at that. Jordan klepper, well be right back. cheers and applause vo you are a business pro. Maestro of project management. Baron of the buildout. You need a permit. To be this awesome. And you. Rent from national. 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He can hear you. He didnt mean that, kevin. Kevin yes, he did keeping our competitors up at night. Now, thats progressive. Applebees let the fans put thefamous 2 for 20 menu. The i put the wonton tacos on applebees 2 for 20 menu because i love them. And, i am old enough to know what love is were still talking about tacos. Right . Applebees. Where fans know best. Anncr now you can merge the physical freedom of the car, with the virtual freedom of wifi. Chevrolet, the first and only car company to bring builtin 4g lte wifi to cars, trucks and crossovers. Hi mom. You made it anncr its the new independence. Jon welcome back, my guest best selling author and surgeon and professor at harvard medical school, his new book is call kd, being mortal, medicine and what matters in the end. Please welcome back to the program, atul gawande. applause applause thank you so much for being here. This is, being mortal, it is a really, you know, its the kind of discussion that we do not have in this country, it is a reasoned discussion about the end of life. And what matters to people. In this country, all the panic of death panels and all these things. How should we start this conversation . So, i started asking that, 17 of our country at the end of the 90s died at home. And the rest were in institutions. And thats not the way most people want to go. So what i was wondering about were the people who had it go better, at the centre were conversation about simple things. We dont ask what the priorities people have in their life, besides just living longer. What are the tradeoffs youre willing to make, and not willing to make. What are fears and goals you might have. What worries do you have for the future. And if we ask that, as doctors, you start getting some real guideposts to what people can achieve in their lives. Jon because theres a sense in america, no matter what, i dont care what happens, i done care what position im in, dow what you can, cut off my head, future in a jar, hook it up to a battery, whatever you need to do, you must do this. And thats not as you start to see, you know, going through this with your parents that are getting older, you start to realize, maybe this isnt about just do whatever you can. I mean i wrote the book in part because im a cancer surgeon. And i didnt feel like i handled things very well. And then my dad got a actual never his brain stem, his spinal chord. And we didnt want that pass pathway to the end. We wanted him to get all the surgery, all the radiation, all the chemotherapy, but not at the cost of what he thought a life was worth living for. He wanted to still be who he was. And we had these hard conversations that i learned from watching how people handle things better than i did it an those conversations were just a few basic questions. I would ask my dad. So what is your understanding of your condition now . How is it going . And he would say not going that well. Im concerned. Im losing my ability to walk now. We would say, what are your fears and goals . And he would say well, as long as i can actually interact with other people, as long as i can still contribute, you know, still wanting to do charity work and work for rotary foundation was important to him in his last few months of life. He still did it. Jon right. And we can make that choice along the way. We did surgery because it let him do things more. We did radiation, but when the chemotherapy took it away, thats when we stopped it. Jon right. And some of these aggressive treatments, people maybe dont realize the effect that it might have on their simple quality of life. And the amazing thing to me is, these more palliative or hospice type remedies, people tended to live longer. Yeah, theres an amazing series of studies now, one example, at the mass General Hospital in boston, they randomize half of the patients who had lung cancer, stage 4, lived only 11 months on average, getting unusual oncology care versus usual oncology care plus seeing a Palliative Care specialist who had conversations with them about who their goals might february their health was there so ones had the conversations ended up having, they had chose fewer days in the hospital, they stopped chemotherapy sooner. They went on hoss fis earlier. They had less suffering at the end of life and they lived 25 longer. That just means were making bad decisions along the way, out of our anxiety about having these conversations. Is there anything more nefarious other than anxiety . Is there sort of a pharmaceutical or industrial medical complex that is so steeped in procedures, and the finance that goes along with it that its going to be hard to break through that as well . Every push in our system is towards do something more. You know, i get paid more to do the operations by far than i will ever get paid to not do the operation. In fact, you know, we dont make it easy for people to have, to take the time for these conversations. You know, on the other side, the families can find it hard to acknowledge that we should be thinking about the worstcase scenario as well as the bestcase scenario. Lets go for the Lottery Ticket but also plan for what happens if the Lottery Ticket doesnt come through. And i think the good news for some of this is because of ebola, were all going to die soon anyway. laughter jon so in many ways, while this is an incredibly heartfelt and well reasoned book, two weeks from now, laughter are we all by the way, because you are a surgeon. You understand, you have written articles about ebola. About how we handle things. Are we all going to die immediately or do we have like a month. We are not in danger of this being an epidemic spreading through our population here. Dow watch the news . Slightly different take on it. Youre coming from a reasoned medical profession, theyre to the going with that. Are we well set up to handle these types of things . So on one level, look, we have some basic control practise that were to the good enough at in this country. We have 2 Million People who pick up infections in our hospitals. And my last manifesto was about the idea we arent even following the checklist about what we can do. The real concern is that by making well, so the red light has turned on, and suddenly hospitals are learning oh my god, we better be washing our hands. And we better put on the gowns properly and take them off properly. And thats probably a really good thing. Its amazing. Before ebola turns us into there were grass stains and rib juice. What the hell is going on. But heres i love your approach about it checklist manifesto was the same way. It just, it is dispassionate but compassionate f that makes sense. Its very reasoned but with compassionate its core. And it strikes me as the way forward for all of this. Well, i like being here with you too. Jon well, there then, you are. Thats how it goes. This is incredible. And i hope as it was it begins a conversation that is so necessary. I mean were all, our population is getting so much older now. An its so much better for them to have access to this type of care. Well. Jon for all of us it is great. Become mortal is on the book shelves now. Its really terrific. Atul gawande, thanks for coming by. applause whos going to do it . Whos going to make it happen . Discover a new energy source. Turn ocean waves into power. Design cars that capture their emissions. Build bridges that fix themselves. Get more clean water to everyone. Whos going to take the leap . Whos going to write the code . Whos going to do it . Engineers. Thats who. Thats what i want to do. Be an engineer. [ male announcer ] join the scientists and engineers of exxonmobil in inspiring americas future engineers. Energy lives here. Its part of a hersheys bar. We break it. We bite it. We sneak it. We smoosh it. We savor it. We love it. Hersheys is mine, yours, our chocolate. So im one of manyant wanurses at cignag. With answers, anytime, day or night. Im lauren, and ive got your back. With unlimited talk, textes for just a hundred bucks and now up to ten gigabytes of 4g lte data. Want phones with that . Hook up everyone in the family with the Samsung Galaxy s5 for zero down get four lines for 100 dollars and the Samsung Galaxy s5 for zero down so make the switch to tmobile today well even buy you out of your Service Contracts break the ice, with breath freshening cooling crystals. Ice breakers. Jon thats our show, join us tomorrow night at 11 00. Here it is your moment of zen. Captioning sponsored by Comedy Central captioned by Media Access Group at wgbh access. Wgbh. Org im going down to south park, gonna have myself a time Friendly Faces everywhere humble folks without temptation going down to south park, gonna leave my woes behind ample parking day or night people spouting, howdy, neighbor heading on up to south park, gonna see if i cant unwind mrph rmhmhm rm mrph rmhmhm rm come on down to south park and meet some friends of mine