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Smerconish

Ebola Quarantine to Protect Public Health or Quell Public Fear?; Narrow Midterm Elections Nearing; Interview with Fmr. Sen. Alan Simpson; Making the Choice to Die Your Own Way; Interview with Aerosmith's Joe Perry

Aired November 01, 2014 - 09:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

MICHAEL SMERCONISH, CNN HOST: Hello. Welcome to the program. I'm Michael Smerconish. We have a great show for you today, digging down on key questions.

These Ebola quarantines, do we need them to protect the public health or need them to quell the public's fear? We'll get into it.

And the tightest elections we've seen in years. One man about to go out on a limb, throwing out the conventional wisdom.

Then the obesity epidemic and the question nobody wants to talk about: What happens when America gets too fat for sex?

And one of the greatest rock and roll guitarists ever pours his heart out about life with Aerosmith. Joe Perry is here and lots more. So stick around.

(MUSIC)

SMERCONISH: This week we've all been riveted by the saga of Kaci Hickox, the nurse who was forced into quarantine after treating Ebola patients in West Africa. Her week began in a tent outside of a hospital in Newark, New Jersey, with no heat, no shower and a makeshift toilet. She said that she was being held prisoner. Governor Chris Christie said she should stop complaining.

So she hired attorneys and, after a few days in the tent, she was allowed to go to her home in Maine. Enter a new governor of Maine, Paul LePage of Maine. He decided she should be quarantined again, not allowed out of her home. So her lawyers went back to court and she went out on her bike. As of now, after another court ruling, she is allowed to leave her house but is subject to daily monitoring by health officials.

Polls show that 80 percent of Americans are in favor of quarantines for those who've had close contact with Ebola patients. Many who live in Kaci Hickox's hometown of Fort Kent, Maine, feel that way also. But the nurse is free to go out in her town, so how are local authorities handling this?

Joining me now is the police chief of Fort Kent, Thomas Pelletier. Chief, welcome. Thank you for being here. There's been a great deal of concern about the safety of your community. I've got a different question. How concerned are you about her safety from people who want her confined?

THOMAS PELLETIER, FORT KENT POLICE CHIEF: I'm very concerned, especially in light of the -- some recent activity where up until late this afternoon, the state police have been assisting us with basically being placed at her residence. She -- their initial assignment was there to monitor her movements, when and if she left. Since then, the court order has changed and has allowed her to not necessarily be monitored, so the state police have left.

So it's -- we're dealing with making sure that the threats, some of the hate websites that are up; we're kind of monitoring those things. And I'm in direct contact with Ted Wilbur, her boyfriend, and Kaci at the house trying to keep an open line of communication so they can let us know at any time they may feel threatened, and kind of monitoring keeping our finger on the pulse of what the community is thinking, and making sure she does get some protection if need.

SMERCONISH: In other words, is it fair to say, Chief, that up until the time there was a new order entered by the court on Friday, there was a law enforcement role essentially to keep eyes on her and make sure that she remained somewhat confined? And now that's shifted to a local responsibility, not necessarily of keeping an eye on her, but keeping an eye on folks who might pose a threat to her?

PELLETIER: Yes. That is my responsibility as chief of police here. Our department is surely tasked with making sure that she is safe, she and Ted are safe. Certainly, there have been some concerns that have popped up. I've voiced those concerns to Ted and Kaci and let them know that -- what we're dealing with out here as well. And they have been understanding of that, exactly. We're going to keep those lines open, so we can still share what our concerns are on both sides.

SMERCONISH: Chief Pelletier, thank you for being here.

PELLETIER: Thank you.

SMERCONISH: Kaci Hickox has said repeatedly that she poses no threat because she's not ill and has no symptoms. Yet people are still afraid of her, perhaps for this reason. Many of those who have fallen ill, like Dr. Craig Spencer who is still in critical condition at Bellevue in New York, say they have no idea how they were exposed to Ebola.

Now, if that's true, how does anybody knows exactly how they could get Ebola? What makes Kaci Hickox so sure she won't pass it on?

Joining me to talk about this, Dr. Gavin Macgregor-Skinner who recently treated Ebola patients. Dr. Macgregor-Skinner, all the conversation as to how we should treat physicians, health care workers who've cared for those with Ebola, is this more about the stopping the spread of Ebola or more about stopping the spread of fear?

DR. GAVIN MACGREGOR-SKINNER, ELIZABETH R. GRIFFIN FOUNDATION: Oh no, this is really important, that when we deal with any highly infectious disease like Ebola, or even anthrax, we are always dealing with either the bacteria or the virus, that's what we're fighting, but there is that other side that we have to deal with, anxiety and fear in any of these highly infectious diseases.

So we are dealing with both in public health all the time. And it's really important to look at our training, the supervision, the other mechanisms we have in place to ensure as we do the job. And I know, having just come back from West Africa, it's scary. It is scary to deal with Ebola patients. But I know the mechanisms were in place for me to wear the personal protective equipment and the supervision in place. If I made a mistake, it was going to be corrected there and then, and that gave me the confidence to do the work that I need to do.

SMERCONISH: Doctor, I want to show you a portion of the order that was entered in Maine yesterday pertaining to the nurse that we're all talking about. If you could just put that up on the screen.

Here's what the court wrote. "The court is fully aware that people are acting out of fear and this fear is not entirely rational. However, whether that fear is rational or not, it is present and it is real."

Doctor, as a lawyer, I interpreted that as the judge saying, hey, the fear is irrational, we're going to keep this woman or keep eyes on this woman to some extent because we just want to keep a limit on that getting out of control. It's not so much that we really fear she's going to spread Ebola.

MACGREGOR-SKINNER: No, and she won't. Unless she has symptoms, Michael, she doesn't have the disease. She is no risk to anyone. Unless you have symptoms of Ebola and you're diagnosed with Ebola, you are no risk. There is no risk to anyone. And you can't spread Ebola without the symptoms.

I think the chief judge, though, really captured what the American people are thinking at the moment. And it's that need for where is the national Ebola communication plan that we can get everyone, all the governors from all of the states, plus the medical personnel, the doctors and nurses, on the same page to understand what are those key communication messages that need to go out every day about the risk of Ebola?

And everything we do is based on a risk assessment. And so we're now looking for where is that national communication plan?

SMERCONISH: Thank you, Gavin Macgregor-Skinner.

One of the most confounding things about quarantine is that the standards for imposing it are different everywhere. In California, the rules are less strict. Local officials will decide who will get quarantined on a case-by-case basis. Dr. Colin Bucks is a health care worker home from the hot zone. He's in quarantine in his home in Redwood City, California, and he joins me now via Skype.

Doctor, thank you for being here. Tell me about with your wife and your dogs. I understand that, as part of your self-imposed quarantine, you sent them away.

DR. COLIN BUCKS, MD, STANFORD MEDICAL SCHOOL (via Skype): Yes. They're very well, thank you. We have not had opportunities to see each other since the start of the quarantine, and they have not been in the house. My dog, Matteo, really values his privacy quite a lot.

SMERCONISH: But you've had the forethought to say god forbid there should be a complication for me. I don't want to cause further inconvenience either to my spouse or to my beloved pet.

BUCKS: The goal is to completely reduce the number of potential contacts heaven forbid I develop a fever or other symptoms.

SMERCONISH: Have you seen any evidence of a reluctance on the part of health care workers, because this is the big concern. I think we all agree that it needs to be eradicated at its source, meaning in West Africa, and we're worried about health care workers paying attention to the news and all the reports of quarantine saying, well, I'm not going over there. Do you have any reason to believe that that's now playing itself out?

BUCKS: Yes. I'm interviewing candidates from around the world who are interested in volunteering and acting responsibly and doing their patriotic duty in that regard, but I have not interviewed a single U.S. candidate and it concerns me. I would like U.S. physicians and nurses to be responding to this, to protect our country.

SMERCONISH: Do you think that the nurse in Maine paid a price for the physician in New York City after all of those reports of him having used the subway system and going bowling? You know that story, Dr. Craig Spencer. Do you think that that didn't sit well with Americans, and consequently when the nurse stepped off the plane a week ago at Newark International Airport, she went through the process with which we're now familiar?

BUCKS: I think it helps frame the conversation if we refer to Kaci Hickox as Maine's preeminent expert in the clinical management of Ebola and politicization of her return did damage the efforts to get volunteers abroad.

SMERCONISH: So with regard to the subject of quarantine then, is it about eradicating fear or eradicating the virus? I ask that because, if truly she is symptom-free, she doesn't pose a risk of transmission. And the only reason therefore to keep her quarantined would be to lessen the unfounded fear that her neighbors might have.

BUCKS: Correct. This is -- education can provide great illumination on this situation. Right now, the measures I'm taking in great part are to provide reassurance that all of my neighbors, my community, are completely safe. And it's not -- it's easy to incorporate isolation in that regard as an extension of my deployment. But we shouldn't overshoot these with unscientific recommendations.

SMERCONISH: Dr. Colin Bucks, we wish you well. Thank you for being here.

BUCKS: My pleasure. Thank you.

SMERCONISH: Coming up, we'll have the man who called the presidential race correctly in 49 of 50 states. Which party does he think will take the Senate? His prediction is next.

And I'll talk to the groundbreaking author of a new book, "XL Love." There has been much written about obesity, but not this. Stick with us.

(COMMERCIAL BREAK)

SMERCONISH: The midterm elections are just three days away now and we've got a real horse race going. The big question, of course, who will take control of the Senate? And there are ten, count them, ten races that are tied or close to it. Some of the tightest races that we've seen in years.

Whether Democrats hang on to the Senate or Republicans take it away rides on just a few key races. My three favorites: Kansas, Iowa, Colorado. Each has a great story. And I'm joined now by CNN's chief national correspondent and host of "INSIDE POLITICS", John King to run through them.

All right, let's talk Kansas. Republicans as you know of all types have gone all in for Pat Roberts. My question, is it more than just saving a seat? In other words, do they fear threats from others who might run as independents if Greg Orman is successful?

JOHN KING, CNN HOST, "INSIDE POLITICS": Goal number one here is the simple math of trying to get 51 or more in the United States Senate. So this is about not just survival for Pat Roberts but Mitch McConnell trying to get a majority in the United States Senate. That is goal number one without a doubt.

But, yes, you're right. Look, number one, they want to keep the seat in Republican hands. Number two, they don't want to encourage this idea that independents -- remember, the one thing the two parties agree on is to make it hard for a new third party to emerge. If Greg Orman wins that seat in Kansas -- and I'll tell you this, Michael, I talked to two Republicans today who think it's gone; they don't think it's close. They think it's gone. Now, other Republicans dispute that.

But the Democrats remember, there is a governor's race out there that's going to drive Democratic turnout. Most of those Democrats are going to vote for Greg Orman. If an independent wins in ruby red Republican Kansas, it's still hard, there's no Ross Perot out there with all that money, but will somebody think about running independent for president in 2016? If Orman wins, I think the answer to that's yes.

SMERCONISH: I agree with you. Hey, tell me which way these two races seem to be breaking. Iowa, Joni Ernst versus Bruce Braley. Colorado, Cory Gardner versus Mark Udall. How do you see them?

KING: Both right now trending Republican but narrowly. In Colorado, let me start there. Republicans say their tracking polls Cory Gardner, the Republican, pulling away. Still in single digits but they say it's not a 1 or 2 point race anymore; they say it's more a 4 or 5 point race.

Again, this is a test. In Colorado, it's Latinos. Can the Democrats get the Latinos in the Denver suburbs, particularly Adams County, to turn out somewhere near their 2012 numbers or at least in their 2010 numbers? If the Democrats can do that, Udall has a prayer. But Republicans say that's trending their way.

Iowa is just a classic. It's a -- yes, it's been a blue state in presidential politics, but it's a rock 'em sock 'em robot state if you look at registration. Pretty evenly divided between the parties. Bruce Braley, frankly, Michael, has been a bad candidate. He's been better at the end than he was in the beginning or the middle, but because of those missteps early, Ernst has run a really smart, provocative advertising campaign. That is a 2-point edge as you see right there going into the final weekend. Republicans think they have the wind at their back. Again, this is a place Democrats say they have the experience, the nuts and bolts on the ground. We'll see if they can prove that.

(CROSSTALK)

SMERCONISH: If Joni Ernst wins, I think she become as female Ted Cruz. And all I mean by that implication is that she takes on a national stature because she's colorful.

KING: Without a doubt. And she's from a presidential big state like Iowa. Every 2016-er is going to fall -- take this as I mean it -- in love with Joni Ernst and try to get that endorsement and support from her. She will instantly be a national figure, without a doubt you're right about htat.

SMERCONISH: All right. It's going to be fun. Get some rest. We'll see you on Tuesday. John King.

KING: Sleep is overrated.

SMERCONISH: Dr. Sam Wang runs the Princeton Election Consortium. Now, back in 2012, he beat all the election prognosticators, even Nate Silver, the famed 538 blog guru. Dr. Wang called the presidential race correctly in 49 of 50 states. And perhaps more important for today's dicussion, he went 10 for 10 in the closest Senate races. Last month on this program, here's what he predicted about control of the Senate after Tuesday's midterm.

(BEGIN VIDEO CLIP)

SAM WANG, FOUNDER, PRINCETON ELECTION CONSORTIUM: Based on what those polls have been doing all summer of that number landing on Democrats and Independents having 50 seats or more on Election Day, and so based on what we've been seeing all summer, the polls pointing toward a very close contest, everybody should vote, but in indicating that Democrats and Independents are favored.

(END VIDEO CLIP)

SMERCONISH: All right, fast forward to today. Dr. Wang is still an outlier among those who aggregate polling data. Take a look at this graphic. It was prepared by "The New York Times", which shows his outlook as paired to his brethren. Where "The Washington Post" says there is a 93 percent chance of Republicans taking control of the Senate, "The New York Times" says it's 68 percent likelihood, there's the Princeton Election Consortium at 52 percent.

Dr. Wang, why do you see this so differently than the others?

WANG: Well, Michael, the way I look at it is this. All of the calculations are on the same side of 50 percent. Everyone is saying that the Republicans are favored. I'm saying they're very slightly favored. These other guys are saying more favored.

I think what we're doing at election.princeton.edu is we're taking into account the historical uncertainty. And I think we're doing it in different ways, which results in different numbers. Midterm polling is often inaccurate and can be inaccurate across the board by as much as 2 to 3 points in either direction, and there is no telling which way. So I would say we're all starting with the same polling data, and we all see a slight Republican advantage, but that advantage is quite narrow.

I mean, just the fact that Joni Ernst in Iowa is only ahead by, in my calculation, half a percentage point, that is razor thin and that is a race that can go either direction. And when you take the six closest races, all within two percentage points, they could all go one direction for the Democrats; they could also go all one direction for the Republicans. And anything in between. So I would say that I think I feel good about our calculation.

SMERCONISH: Can we put that back up on the screen? Because this is how you drill down on the three key races. You're saying Joni Ernst right now by 0.5 percent in Iowa, Cory Gardner by a percent in Colorado, and Greg Orman, the independent, by a point and a half in Kansas. Indicative of what I think you've regarded a photo finish is what you expect on Tuesday.

WANG: That's right. If you look at Iowa and Colorado, those margins were a little bit wider for the Republican candidates; they've gotten closer. That could be the effect of early voting; it could be voter opinion shifting. Could be noise. But in any case what we're seeing here is that these margins are razor thin and not outside the bounds of surprises. And I would say surprises for either side. So --

SMERCONISH: Dr. Wang --

WANG: Also as you say in Kansas.

SMERCONISH: There is something else you have been speaking of at Princeton Election Consortium, and that is the close nature of so many gubernatorial and Senate races, as compared to, say, where we were 10 years ago. Why is that the case? And explain what I'm referring to. WANG: Right. So what's going on right now is that if you define

races as being close, within say 2 or maybe 3 points, there is currently six races close in the Senate as we just saw, a dozen races close among governorships.

What we're seeing here is probably the effects of previous wave elections. So, 2010 was a great year for Republicans; they took over governorships. Those governors are now up for re-election. 2008 was a great year for Democrats, and those Democrats are now running for re-election in states that Mitt Romney won in 2012.

And so in some sense 2014 is not a wave election at all; it's more like corrections from previous waves, from four or six years ago. And this is a perfect storm now, in which now these close races, there are more of them than there were in the last two midterm elections put together. It's a really tremendously suspenseful election that we have coming up next Tuesday.

SMERCONISH: Dr. Wang, as always, thank you, sir. We appreciate your being here.

WANG: Thank you.

SMERCONISH: One of President Obama's top aides, his former press secretary Jay Carney, made this prediction about next week's midterms.

(BEGIN VIDEO CLIP)

JAY CARNEY, CNN POLITICAL COMMENTATOR: Democrats are, as we talked about before, going to have a bad Election Day. No matter how you slice itM Republicans are going to pick up seats in the Senate and the House, and they may win control of the Senate.

(END VIDEO CLIP)

SMERCONISH: Now, if that's true, what exactly did the Republican Party do to resuscitate itself? You remember all those dire predictions about Republicans over the last few years, their problems with women, the Tea Party wing, you name it. Is this a new day for the Grand Old Party?

After a short break, I will ask these questions of one of the wisest men anywhere, a real American treasure. Stick around because I'll be right back.

(COMMERCIAL BREAK)

SMERCONISH: Whether Democrats keep the Senate or Republicans take it away, the morning after, we're still left with a painful reality: Washington has never been more paralyzed. Nothing gets done.

How do we change it? Is there any reason to hope a new batch of senators and congresspeople will bring in a new day? I can't think of anybody better to really help answer these questions than one of the wisest men ever to serve in the Senate; that would be Republican Alan Simpson of Wyoming. And he joins us now from his ranch up there in the town of Cody.

Welcome, Senator. Here is my first question. So if Republicans take control --

ALAN SIMPSON (R), FORMER WYOMING SENATOR: Well, when you said wise, a lot of people fall apart. Yes, go ahead. Excuse me, I was mumbling there.

(LAUGHTER)

SMERCONISH: If Republicans take control of the Senate and it's a more conservative Senate by the new blood that comes in, is there any reason to believe that things will get done? I ask the question because I heard Governor Romney say, well, if Republicans control the House and Republicans control the Senate, they'll pass things and force the president's hand.

SIMPSON: Well, I think that's his view. My view is that if they do that, they're going to have to govern. If they're going to pour it on and say if we can get back into power and we have the House and the Senate, I would think that the object of the game is not to see how much they can punish Obama and twist him in a knot; the object of the game is to make Republicans look like they can govern instead of just saying no and bitching and giving each other the purity test or the saliva test of purity.

That's my take on that. It's a wonderful opportunity for a complete rebirth of the Republican Party. Conservative then would keep the word within fiscal and monetary issues, and not out in the social issues, where we get eaten alive.

SMERCONISH: Might a resurrection of Simpson-Bowles be a means of doing exactly what you've just described?

SIMPSON: Rise from the dead like a Halloween monster. And it's the day after.

No. Simpson-Bowles or Bowles -- we don't use Bowles-Simpson because of the acronym there. We don't like that. So we use Simpson-Bowles, which means some -- well, anyway, we leave it at that. But I'll tell you, one thing about it, it ain't going away. It's the only thing that was voted on by five Democrats, five Republicans, after eight months of work, and one independent, that deals with everything. Gores every sacred cow. Talks about reform of the tax code, solvency of the Social Security. If you can't even deal with the Social Security solvency for 75 years because the AARP is tearing off your shorts, I mean, our grandchildren have had it.

So these groups, they laugh at Simpson-Bowles; they've had a fun (INAUDIBLE), you name them. Grover Norquist, the club for growth, the ACLU, the AFL-CIO, all of them, chuckling. But let me tell you, gang, when the election is over and we're headed for a $20 trillion debt, which interest will be about $600 billion a year going out, useless to us, and going to other countries so they can do their infrastructure and educate their kids, I mean, somebody will wake up along the line and hopefully it will be the Republicans. SMERCONISH: Senator, on Wednesday morning, the starting gun will be

fired for the 2016 cycle. Do you think that there's a possibility that Republicans, victorious on Tuesday night, will have beer muscles and will say, well, see that? All we need to do is stick to our conservative roots and then nominate a candidate that is incapable of winning in 2016?

SIMPSON: I really don't see that. I think that they will be juiced up, but there isn't any way that they're going to go out and drift off to, say, well, now we've proven that we got rid of all of these moderate Republicans. That isn't going to happen in this election. You're going to find things -- you're going to find people who are willing to say that the word compromise is not a four letter word.

Without compromise we would have no Declaration of Independence, no Bill of Rights, no Constitution, nothing. So you clean out those guys. They have mush for brains. And then you move on with people who care, who know damn well you have to do something with Social Security. When the thing started, the age of death of 63 and you retired at 65. Now it's 78 headed for 80. You don't have to -- you got to have more than rock for brains to figure out you got to do something. Who is telling us that? The trustees of the system.

Disability insurance will be gone in two years. Who is telling us that? The trustees.

You know, Medicare will go broke in 2026 or 30. Who is telling us? The people who run the money.

I mean, wake up out there. If you can't, if the Republicans can't do the job, get confidence, let people know they came to government, instead of just bitch. It will be great for the party.

SMERCONISH: Senator Simpson, when you come back tell us what you really think. I don't want you to feel you have to hold back your opinions, OK? Thank you, sir.

SIMPSON: I'll try.

SMERCONISH: I appreciate you being here.

SIMPSON: Yes, indeed.

SMERCONISH: But up next, the tragic case of Brittany Maynard, a woman with terminal brain cancer who says she will soon take her own life. I'll talk about it with the long time lawyer for Dr. Jack Kevorkian, the man who forced America to face the uncomfortable issue of the right to die.

(COMMERCIAL BREAK)

SMERCONISH: Brittany Maynard was diagnosed with terminal brain cancer in April and told she had no more than six months left to live. The newly wed said she wanted to choose when to die. She moved to Oregon where physician-assisted suicide was legal.

She appeared to pick a date, November 1st, today. But this week, she said not yet.

(BEGIN VIDEO CLIP)

BRITTANY MAYNARD: I still feel good enough and I still have enough joy and I still laugh and smile with my family and friends enough that it doesn't seem like the right time, right now. But it will come because I feel myself getting sicker. It's happening each week.

(END VIDEO CLIP)

SMERCONISH: Her story reminds us all I think of the late Jack Kevorkian, the champion of the right to die. Back in 1999 he was convicted of second degree murder after helping a man with Lou Gehrig's disease end his life. His longtime friend and lawyer was Geoffrey Fieger, who joins me now from Detroit.

Jeffrey, do you see this case, she's got the right to do this in Oregon, as a vindication of Dr. Kevorkian?

GEOFFREY FIEGER, FORMER ATTORNEY FOR DR. KEVORKIAN: Well, but for Jack's work, she wouldn't have that right. Ron Atkins was instrumental in pushing that in Oregon and Washington, to the -- two of the states that allow it. And for sure, without Jack Kevorkian, having done what he did, she would not have that right.

SMERCONISH: And yet, for all of its progressive tendencies, she was a resident of the Bay Area in California. Couldn't do it in California. Had to pick up roots, go to Oregon, where there are only five states -- Oregon being one of them. I guess what I'm saying is, there are 45 where you couldn't do this if you chose to.

FIEGER: That's right. And it's very sad. And not only could she not do it but a doctor couldn't help her. That's the real frightful thing.

Even in Oregon, the physicians prescribe the medication which provides a solace for her. She only wants control.

What's going on right now, Michael, is that she feels well enough, and Jack would have encouraged her to go to the very end. And even then you'll find that the patients very often don't do it. But want the control, want the ability to control. They are smart people. They want to control their lives and their deaths and suffering. They don't want to suffer.

So, very often they don't carry it out. She may never do that. And if she doesn't, it's up to her. It's nice if a doctor could be with her, though.

SMERCONISH: Respond to those who watch this unfold and say it's legalized suicide.

FIEGER: Well, it is legalized suicide and it's the same beneficence we provide to our animals. Nobody would make their animals suffer in horrible pain with brain cancer and say that it was all right to make the animal suffer and die naturally without helping the animal die. Why would we subject our own kind to that kind of suffering? What

type of person would do that?

I know what kind of person does it. The people who believe that it's God's will. And they believe that they should be able to control other people's lives. But in America, if we have any freedoms at all, it's the right not to suffer when we die. And not to have somebody else or government control that right.

SMERCONISH: Geoffrey Fieger, thank you for being here.

FIEGER: Thanks, Michael.

SMERCONISH: Up ahead, I'll talk to legend Joe Perry of Aerosmith. His great stories about his relationship with Aerosmith superstar Steven Tyler. You'll want to hear that.

(COMMERCIAL BREAK)

SMERCONISH: Diabetes, stroke, heart attack, they are all a typical part of a conversation about the impact of America's obesity crisis. So too the cost to the health care system.

But what about the impact of obesity on relationships and sex?

That previously unexplored subject is the focus of a new book by Sarah Varney, a senior reporter with "Kaiser Health News", whose work appears on NPR and PBS. The book is called "XL Love: How the Obesity Crisis is Complicating America's Love Life".

And she joins us now from San Francisco.

Sarah, let's get right to it. Why are American girls stepping into their sexual selves sooner?

SARAH VARNEY, AUTHOR, "XL LOVE": Well, we know that there is this massive increase in children who are overweight and we know that weight plays a significant role in when girls begin puberty. This is something that's been well-established for a long time.

So, now, we see that among girls who are 7 years old, among African- American girls one in four, are budding their breasts by the age of seven, about 15 percent of Latino girls have their breasts bud by the age of 7 and 10 percent of white girls. So, we know that weight plays a significant role in when the body kicks off the puberty process.

SMERCONISH: Your book opens with a vignette from the NICU, at the University of Mississippi Medical Center. If we were there, what would we see?

VARNEY: Sure. I wanted to start the book really at the beginning, right, because we know that human relationships are cumulative. And our experience of ourselves and our human relationships start from when we are first born.

So, in Jackson, Mississippi, there is this neonatal intensive care unit. Jackson is a fairly small city but one of the largest NICU's in the country. And this is in part because so many of the moms there are overweight and obese. They have uncontrolled diabetes or hypertensions. So, they give birth to children very prematurely.

And when you're standing there, you know, you look out it's almost a football field long and you see these little isolates. Inside these isolates are these little wisps of bone and tissue and, you know, these children are born so, so little. It's incredibly sad.

And then, right next to them you see these babies that are 12 or 14 pounds, and I remember when I was reporting the book I turned to one of the nurses and said, why is a child who is 12 or 14 pounds here as well? They said, oh, that's an infant of a diabetic mom.

So what happens is the fetus grows rapidly in the womb but a lot of the organs, like the lungs, can't keep up. So, when the child is born, they have to be kept alive.

SMERCONISH: So, consequently, these diabetic moms are giving birth to big babies, the big babies are reaching puberty far sooner than they would have historically. Consequently, they are thought to be or viewed as attractive by guys, and let's just say things happen sooner than they would have otherwise, and it becomes almost a self fulfilling prophecy.

VARNEY: Well, this is a real concern among adolescent psychologists, particularly in places like Jackson, Mississippi where you have these girls who are 7 or 8 or 9 years old. I met with many of the girls themselves, who have very adult female bodies and they don't understand, you know, why is it that my uncle or the kids on my block or the boys at school, why are they treating me differently. I'm still somebody who likes Dora the Explorer and I can't understand why the world is treating me differently?

So, we that know for girls who had early puberty they have -- at a higher risk for sexual abuse. And we also know that these girls, one thing (INAUDIBLE) though is that girls who are obese, who are overweight and obese, actually do have a later sexual debut than girls who are not obese. They are less likely to have sex.

The problem, however, is when they do have sex, it's much riskier. So overweight girls who do engage in sexual activity are more likely to have had sex by the age of 13, they are more likely to have had multiple sex partners by the time they graduate high school, and they are less likely to use contraception.

SMERCONISH: For all that is said and written about obesity, and relationships for that matter, why do you think it comes to your book "XL Love" before this conversation begins? Because I never heard an open conversation about this before. And my specific question, do you think political correctness plays a role?

VARNEY: Well, I think that we have a very sort of schizophrenic view about weight in this country. Like we either want to say you should just sort of pick yourself up and brush off all of the discrimination and bias that we have as a culture about people who are overweight. Or you should cower in self pity. You know, we don't want to have to see you.

And I think it's really important that we have a very open conversation. You know, we know that obesity is playing a huge role in hypertension and stroke and life expectancy even, right? We're having -- it's having a huge impact. Why would we not think it has an impact on our sexual development and our relationships?

SMERCONISH: Sarah Varney, thank you. The book is excellent.

VARNEY: Thank you so much. I really appreciate it.

SMERCONISH: Up next, rock 'n roll royalty in the house. My conversation with legendary Aerosmith guitarist Joe Perry. What is his relationship with Steven Tyler really about? We'll find out, next.

(COMMERCIAL BREAK)

SMERCONISH: Aerosmith, the iconic Boston rock band. I love to listen to them growing, still do, I've seen them many, many times.

I've always wondered, what's the real relationship between lead singer and superstar Steven Tyler and Joe Perry, one of the greatest lead guitarists ever? Are they a band of brothers or feuding prima donnas?

(VIDEO CLIP PLAYS)

SMERCONISH: Joe's just written a book, "Rocks: My Live In and Out of Aerosmith." It is terrific. The big question and we'll get right to it. What does he say about Steven? Joe writes that in a deep and abiding way, Steven Tyler is his brother.

So, what's the real story?

(BEGIN VIDEOTAPE)

JOE PERRY, AEROSMITH LEAD GUITARIST: They say you can love your brother you don't have to like them. I wanted people to know how tough it is to keep a band together. I mean, we are a family of choice, as opposed to a family by blood. And I had a brother for about five days. And sadly, he passed away before he was brought home.

And I have to think that in some way, in some deep level there was -- I've always felt like I need a brother. I had a beautiful sister, a couple of years younger than me. But there was -- maybe there is some kind of subconscious need for a brother.

And when I met Steven, there was definitely, aside from the musical connection, we found a lot of common ground.

SMERCONISH: It is rare that we see Joe Perry without a guitar attached at the hip. But the first guitar came from Sears. Tell me about that.

PERRY: They had a brand of musical instruments that you could buy. And I'd finally convinced my parents that I wasn't going to give them any rest until I got a guitar. So, they bought me a student guitar.

And it was -- I remember it was $12.95 and it came with a little string for a strap and instruction 45. And I picked it up and I put the guitar. I'm left handed so I put the guitar the way a left hander would play it naturally. And then I put the 45 on. And it said the put the neck in my lift hand and pick in my rand. And that's how I learned to play, backwards so to speak.

SMERCONISH: And one of the coolest things in the book. And we need to know more about this. But you explained that the band in the early era was the subject of a Harvard study on motivation. But you have never seen the file.

Like, what's up with that?

PERRY: We never saw that. A professor at Harvard who's doing a study on motivation and said, would you guys like to come in? I pay you $10 a day a piece to let me study your motivation, so to speak.

And we ran through a whole battery of psychological testing. I mean, we ate well for two weeks. It was great.

SMERCONISH: Aerosmith went to Harvard.

PERRY: Yes, we did. And we often think about it because we never saw the results. And I have to think that somewhere in the archives at Harvard, wherever they store their stuff, there are a couple of boxes --

SMERCONISH: That would be great.

PERRY: That would have that stuff.

I mean, to this day we have no idea what -- I would love to see it.

SMERCONISH: This is a bit unusual. But I have this extraordinary producer who shows up onset every day wearing an Aerosmith t-shirt. I'm bringing him in right now. His name is Jay Conroy (ph). And I want him to have the shot at asking the final question.

So, here you go, my man.

UNIDENTIFIED MALE: What's up, Joe?

PERRY: How are you?

UNIDENTIFIED MALE: I'm good man. Joe is the only guy I know that can get away with smoking in a bookstore. Funniest part is you didn't know where to put it out because you're in a bookstore.

PERRY: Actually I smoke pipe to tobacco. I take a few puffs and throw it away. I know it's bad for me and all that. And -- but I love the taste.

I've inhaled other things but I don't inhale that.

SMERCONISH: And he writes about all oaf it in the book.

Hey, Joe, it's great to have you here. Thank you so much.

PERRY: Thank you.

(END VIDEOTAPE)

SMERCONISH: All right. Thank you for joining me. And don't forget, you can follow me on Twitter if you can spell Smerconish. See you next week.