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Obama States U.S. Goal Is To Destroy ISIS; Small Plane Crashes In Sea Off Jamaica's Northeastern Coast; What Caused Joan Rivers' Death?; Remembering Joan Rivers; Joan Rivers And Plastic Surgery

Aired September 5, 2014 - 20:00   ET


JOHN BERMAN, CNN ANCHOR: Thanks for joining us. A lot happening tonight. We are following late developments out of southern Iran where an airliner carrying Americans from Afghanistan to Dubai was ordered to land early this evening.

We being though with breaking news out of the Caribbean. It concerns that small plane that took off from Rochester, New York today, NORAD scrambled U.S. fighter jets when the plane stopped responding, ultimately it flew past the destination in Florida crossing Cuba and sadly crashing in to the sea off north eastern coast of Jamaica.

On board, the high performance single engine aircraft, a prominent Rochester couple, Larry and Jane Glazer. He was a big real estate developer there and a big booster of this particular kind of French- made airplane.

Now, there had been reports that wreckage from the plane had been found but that does not, repeat does not appear to be the case. Just moments ago, we spoke by phone with a major Basil Jarrett of the Jamaican defense force.


BERMAN: Major, give us the latest in the search efforts.

MAJOR BASIL JARRETT, JAMAICA DEFENSE FORCE (via phone): Like you said, the latest information I have, is that we spotted an oil slick in the vicinity where we suspect the aircraft went down about 14 miles northeast of Port Antonio, Portland which is of the eastern side of the island.

BERMAN: An oil slick. Any debris of any kind?

JARRETT: The information I have, which was up to about 5:00 p.m., it is just an oil slick. We just came from press conference here. The situation may have changed but unfortunately, I don't have that update for you.

BERMAN: OK. An oil slick. Are you fairly confident this oil slick is connected to this plane?

JARRETT: We're fairly confident, yes, sir. We're fairly confident. In fact, we have a search and rescue dive team now trying to carry out the -- well, at this point we're not even sure if it's going to be a rescue operation anymore, more like a recovery operation based on the length of time that the aircraft would have gone down. But we do have aerial assets on location as we speak.

BERMAN: Will they work throughout the night, Major?

JARRETT: That's the problem. We have two -- we're going to have to suspend the operation as long as permissible given the conditions. But the plan is to resume at first light tomorrow morning. We're actually expecting a U.S. cutter to be providing some assistance, as well, expected to get here early tomorrow morning as well.

BERMAN: So tomorrow morning, in addition to the U.S. cutter, what resources will have you have available to you at this scene of this oil slick?

JARRETT: We have committed one offshore patrol vessel. We also have two aircraft in the air, (INAUDIBLE), as well as 412 helicopter that does the transportation work for our search and rescue technicians.

BERMAN: And as you said, there is no sign now of wreckage, but you have seen an oil slick. Do you have any sense what type of wreckage you might expect to see in an incident like this? Do you have any reason to believe the plane is still intact, perhaps under the water?

JARRETT: Well, given the depth of the water, it's really difficult to say. It's really difficult to say at this point. In addition to the depth of the water, there is also the search and rescue, the theory that we triangled where the aircraft most likely would have gone and that's also fairly unpredictable given the size of the area and given the conditions. It's very difficult to say what we will be able to recover.

BERMAN: OK. Major Basil Jarrett, you have an oil slick to look at in the morning at dawn with a whole lot of resources there. We appreciate you being with us. Thanks.

JARRETT: You're welcome. Thank you very much for having me.


BERMAN: So you just heard it right there, the search when it resumes tomorrow is proceeding in parallel as always with a search for answers. Now, there may already be much to learn from the timeline itself.

CNN's Rene Marsh reports.


RENE MARSH, CNN AVIATION AND GOVERNMENT REGULATION CORRESPONDENT (voice-over): A search mission underway for this small plane after it crashed 14 miles off the coast of Jamaica. It took off from Rochester, New York around 8:45 this morning bound for Naples, Florida. On board, Larry Glazer and his wife, Jane.

Over North Carolina the pilot told air traffic control there was a problem, but did not declare an emergency. He was cleared to descend to 25,000 feet but asked to go lower.

UNIDENTIFIED MALE: We need to descend to about 180. We have an indication that is not correct in the plane.


UNIDENTIFIED MALE: 900KN descend and maintain level 250.

UNIDENTIFIED MALE: 250. We need to get lower, 900KN.

UNIDENTIFIED MALE: Working on that.

MARSH: About an hour and 15 minutes after takeoff, the pilot stopped responding to radio calls. U.S. military F-15s tracked it along the east coast of Florida. One fighter pilot looked through the window.

UNIDENTIFIED MALE: I can see his chest rising and falling. Right before I left was the first time we could see he was actively breathing.

MARSH: The pilot was slumped over and the plane's windows frosted, both are signs the pressure may have escaped leaving the pilot without enough oxygen to stay conscious. The aircraft flew over the Bahamas and south to Cuba where a Cuban fighter jet took over the pursuit.

MARIE HARF, STATE DEPARTMENT SPOKESWOMAN: We have been in touch with the two countries in whose flight space it went through, the Bahamas and Cuba. I don't have more details on those conversations but obviously, this is an issue of security and safety and so we're in touch, as well.

MARSH: Four and a half hours after takeoff, the plane crashed near Port Antonio, Jamaica.


BERMAN: And Rene Marsh joins us now from Washington. And Rene, incidents like this, they are rare but they are not unheard of. There was actually a similar incident last week, correct?

MARSH: That's absolutely right, John. You know, if this pilot did indeed suffered from hypoxia, was unconscious as the plane continue to fly, you are right. This type of incident is rare but it's not unheard of.

Similar situation just this past weekend. We know the FAA lost contact with a private plane. It flew into restricted air space over Washington D.C. and the pilot in this case, as well, unresponsive, did not respond to radio calls from air traffic control. We know that fighter jets were scrambled. They tracked that plane until unfortunately it eventually crashed into the Atlantic ocean. And then, John, there is also the Payne Stewart incident. That back in 1999. You remember, the famous golfer, five others were on board. They were killed when that plane crashed. The plane was actually flying for about 1500 miles, most of it, we believe, the pilot, co-pilot and passengers were apparently either unconscious of dead. So it flew for a very long time.

BERMAN: I remember.

All right, Rene Marsh in Washington, thanks so much.

Let's bring in a couple more experts to discuss this. Joining us is CNN analysts Miles O'Brien and David Soucie.

Miles, veteran private pilot, aviation correspondent. David is a former FAA inspector and author of "why planes crash, an accident investigator's fight for safe skies."

And Miles, based on the fact the f-15 pilots could see a pilot slumped over and breathing right by the plane's frosted windows, that does seems to make it highly likely that there was some sort of decompression event?

MILES O'BRIEN, CNN AVIATION ANALYST: Yes. All right, the evidence is put in that direction, John. You had a situation where he reported an indication that something was not correct, which is kind of a vague statement. And then he requested a drop in altitude to 18,000 feet. There was not a lot of urgency that was portrayed in that radio transmission and it was kind of a muddled message, if you will, which would tell you something about perhaps someone who was suffering from hypoxia which creates confusion in your decision making process and frankly, euphoria.

And so, frankly, he might have been suffering from this hypoxia when he made the first call. The air traffic controller did not pick up on the signs, however. He was busy and he did not get him down to a lower altitude, even 18,000 feet very quickly.

BERMAN: Hypoxia is what, Miles, lack of oxygen and again which does leads to confusion?

O'BRIEN: Yes, simple as that. Whenever you get above 10,000 feet, give or take, the human body without any assistance doesn't have enough air to survive. And when you're at 25,000 feet, 28,000 feet, you have about three minutes or so of what we call useful consciousness and after that you are going to pass out and what you saw unfold might happen.

BERMAN: All right. David, this type of aircraft, the TBM 900, you say it can go as high up as 40,000 feet so how advanced is the pressure system?

DAVID SOUCIE, CNN SAFETY ANALYST: Well, it's very advanced. In fact, it was just recently changed from 2013 to the now 900 from 2014 that did a lot of work with improving the pressurization so they can get an extra 1,000 feet. The service ceiling is actually only 31,000 feet. But the differential, the pressure differential from the outside to the inside of the aircraft is really what they worked on a lot.

There are some different components n the aircraft that were not in last year's model. So those are the areas that I would be looking at first with trying to determine what happened with this pressurization system, if indeed, that is what happened with the aircraft.

BERMAN: And you were just at a safety symposium a few months ago for this exact plane. So can you tell us anything about its safety record?

SOUCIE: Well, yes. They had a pretty troubled history, actually, when it comes to the ability of private pilot to maintain and fly this sophisticated aircraft. So there has been a lot of loss of control- type of accidents. But as far as the structure and the integrity of the aircraft itself, it is reliable and always has been. The French military uses aircraft extensively. So this aircraft has a great history as far as its structural and mechanical background. But as far as the pilot's ability to maintain and keep up with the aircraft, that's where they suffered a little bit.

So they started these safety seminars. They hired me to do a few of these safety seminars in which we talk about safety awareness and being aware of the oxygen deprivation problem and what can happen within the (INAUDIBLE) range of flight, so it's -- we do a lot of work on that and I know that Mr. Glazer has attended these seminars. He was not in my seminar in June this year, but he had been done down to simcom to the training at simcom. And so he was very aware of this. But what this does is highlights as Miles was pointing out just how quickly hypoxia can sneak up on somebody.

BERMAN: So Miles, you know, the pilot did indicate there was a problem to air traffic control. But as you point out, he not declare an emergency or ask for assistance, you know, maybe it was the hypoxia, maybe it was confusion. But what difference would it had made had he said emergency?

O'BRIEN: Well, all of a sudden he owns the air space around him and all the other traffic has to get moved out of the way. And for an air traffic controller, once you hear mayday, once you hear emergency, that plane owns that air space. And so, things would have happened dramatically differently if he used those words.

But of course, the catch 22 here is that because of the nature of the emergency, he may not have been able to recognize it and call for it.

BERMAN: All right, Miles O'Brien, David Soucie, thank you so much for joining us.

As we said, the search resumes tomorrow morning at dawn.

A quick reminder, make sure you set your DVR so you can watch "AC 360" whenever you'd like.

Next, the breaking news on the flight with Americans on board that was forced to land in Iran.

Also tonight, new developments in the death of Joan Rivers. We'll tell you about early word from the medical examiner's office here in New York and what investigators want to know about the clinic where she stopped breathing.


BERMAN: More breaking news as the scramble to locate any survivors from that small plane got underway off the coast in Jamaica, another aviation story hit. We got word that a charter airliner filled with American military contractors leaving Afghanistan have been forced to land in southern Iran. Now, at the time, we neither knew how things would unfold nor where they might lead, now we do.

And Tom Foreman joins us with the very latest. Tom, lay exactly what happened here?

TOM FOREMAN, CNN CORRESPONDENT: John, this was a strange story. The plane was taking off here from Bagram air base in Afghanistan to fly down here over the tip of Pakistan across Iran to land in Dubai. Chief problem, it took off three hours too late, and that became a problem when it hit the air space down here going into Iran because the Iranians at that point said this is too late. You're outside of your flight plan window. You must turn around and go back and the pilot of this chartered plane with these 100 American contractors on board said I don't have to fuel to do that. So Iran said your choice is you land here at Bandar Abbas or we will force you down, John.

BERMAN: So it's on the ground in Iran, not where it wants to be, Tom. What then?

FOREMAN: Then what happens is the officials from Dubai air, which operate this charter basically start having a meeting with the Iranians and explaining what's going on. The Iranians come on board. They look over the plane. They check out apparently, the people on board, I'm sure, the plane itself to make sure they are satisfied that there is nothing wrong with what they were dealing with there. And after they were satisfied with all of that, then they said this plane can go on, John.

BERMAN: All right. We know it took off a short time ago. Do we know if it's finally made it out of Iranian air space or back to Dubai?

FOREMAN: Yes. We know that it actually -- finally was able to take off. They had to get a new crew, because the new crew was involved so long they couldn't keep flying. So that took a little bit more of the delay. But once they get the people in, the plane took off at 6:45 p.m. eastern time. And yes, I think we can bring up right now the message that came out of the state department short while ago saying yes, in fact, it has landed in Dubai about 8:00 eastern time and no doubt, everybody on board is relieved and answering a lot of questions about precisely what happened with the Iranians. A pretty tense moment for awhile there, John, that ultimately seems to have ended out OK.

BERMAN: The end of an unexpected odyssey to be sure, Tom Foreman, thank you so much.

President Obama arrives home tonight after an especially high stakes moment on the global stage with Russia threatening Ukraine and ISIS on a bloody tear through Iraq and Syria. The president had a two-fold mission at the NATO meeting in wails. Rally his fellow leaders to meet those challenges and also clear up confusion in some corners and outright doubt in others about his policy confronting ISIS.

Joining us now from Wales, Jim Acosta who has been traveling with the president.

Jim, this seemed to be tougher talk than we've heard from the president lately on the issue of ISIS. This wasn't about making ISIS a manageable problem.

JIM ACOSTA, CNN SENIOR WHITE HOUSE CORRESPONDENT: That's right, John. This was a different President Obama on this final day of the NATO summit. You recall last week the President got in a lot of hot water, not only with Republicans but with Democrats when he said he didn't have a plan for dealing with ISIS and Syria. And as you mentioned earlier this week, he said he wanted to reduce the ISIS threat to a quote "manageable problem." He was much tougher on the ISIS threat earlier today. Here is what he had to say.


BARACK OBAMA, PRESIDENT OF THE UNITED STATES: We are going to degrade and ultimately defeat ISIL the same way we have gone after al-Qaeda, in the same way that we have gone after the al-Qaeda affiliate in Somalia. You can't contain an organization that is running roughshod to that much territory causing that much havoc displacing that many people, killing that many innocents and slaving that many women. The goal has to be to dismantle them.


ACOSTA: And the president cautioned that this effort will take some time and even secretary of state John Kerry added at a session earlier today that the effort could take years, John.

BERMAN: And he said that this effort will take a coalition and accordingly, Jim, he announced a coalition, a core coalition of allies to fight ISIS. What more can you tell us about that?

ACOSTA: That's right. It's a coalition of ten countries at this point, ten including the United States. These countries will be doing different things based on their varying capabilities and appetite for direct military action in Iraq and potentially Syria. But secretary of state John Kerry and top administration officials like defense secretary Chuck Hagel and the counterterrorism advisor, Lisa Monaco, they will be going to the Middle East in the coming days to start lining up some air partners for this coalition and say an effort and endeavor that the president thinks will be successful and ultimately help this mission have credibility on the world stage.

BERMAN: This administration, Jim, does still seem to be conscious or aware or under the belief that many people in the United States are war weary. So how did administration today address that feeling?

ACOSTA: That's right. Well, we heard the president say during his press conference which by the way only lasted 24 minutes, he was out of here quickly, that there will be no boots on the ground. There will not be a ground combat role for forces, U.S. forces, in Iraq or potentially Syria.

And then secretary of state John Kerry had interesting comments at a NATO session earlier today during which he said that would be a red line for the United States in terms of having combat troops on the ground in Iraq and potentially Syria. Of course, that term red line is not one that the White House would use because President Obama's red lines have been crossed in the past, but it does under line just how serious the president is taking this pledge of having to combat troops on the ground.

BERMAN: Jim Acosta in Wales for us. Thanks so much, Jim.

ACOSTA: You bet.

BERMAN: We will have much more on this story and others at Just ahead, the exact cause of Joan Rivers' death still a mystery. Tonight, the latest on the investigations that her passing has triggered.


UNIDENTIFIED FEMALE: This is the egg arrival. The arrival. She was incubating is what she told us.

UNIDENTIFIED MALE: What do you say about this?

JOAN RIVERS, COMEDIAN: I'm not going to say anything nasty. She came in an egg and some people will do anything to not have to speak to Ryan Seacrest. I have to do a full disclosure here because I was supposed to be one of the people, seriously, they asked me to walk around in the entourage and hold the thing but I got fired when I raised my hand after the first meeting. I said is it just me or am I the only one that thinks this is (bleep)?



BERMAN: In her hometown New York and in Hollywood, Joan Rivers' fans are paying tribute leaving flowers outside her Manhattan apartment and on her star on Hollywood's walk of fame. Her funeral will be Sunday here on New York.

Now tonight, the exact cause of her death is still unknown. Today the medical examiner said an autopsy was inconclusive and more tests will be needed. What we do know is that for whatever reason, Rivers stopped breathing and went into cardiac arrest at the outpatient clinic where she went last week for what is being described as an elective throat procedure.

Here's Miguel Marquez.


RIVERS: Do you understand you would have something to talk about for the rest of your life? MIGUEL MARQUEZ, CNN CORRESPONDENT (voice-over): Joan Rivers joking

about her own death during her last show.

RIVERS: I am now 81 years old. I could die any second.

MARQUEZ: Now multiple investigations into that very issue. An intense spotlight on what transpired at Yorkville endoscopy.

JAY REDACK, JOAN RIVERS' LONG TIME FRIEND: A procedure on her vocal chords or her throat in the morning.

MARQUEZ: Didn't seem concerned.

REDACK: No. Not at all.

MARQUEZ: Jay Redack had dinner with Rivers the night before she went for an early morning in what should have been routine procedure.

If a patient was going to Yorkville endoscopy which you are familiar with, would it be for really anything other than a digestive issue.

DOCTOR JONATHAN AVIV, CLINICAL DIRECTOR, VOICE AND SWALLOWING CENTER: What they're advertise and they're very, very well-known for and I sent many patients to them very very happily is for upper and lower endoscopy.

MARQUEZ: So anything from acid reflux to ulcers?

AVIV: Correct.

MARQUEZ: A patient would typically have been sedated likely with propofol, says Aviv.

One of propofol, you call this a twilight. It's not fully under.

AVIV: Twilight anesthesia, you're not so deep that you need to have your breathing controlled for you. You're actually breathing on your own.

MARQUEZ: A camera connected into a tube then inserted into the esophagus.

Tommy Wright had an endoscopy for acid reflex done at Yorkville last year.

TOMMY WRIGHT, HAD ENDOSCOPY PROCEDURE AT YORKVILLE ENDOSCOPY: This place looks like you're in a hospital in a professional setting. And I think that that reassured me at the time there wouldn't be any issues. And if there were, they would be an addressed right there.

MARQUEZ: Aviv says 10 million offer endoscopies are done in the U.S. each year. Still anytime sedation is involved, there is risk. In this procedure considered minor, but still a risk.

AVIV: You can have issues with the heart. You can have a heart attack. You can have the heart rhythm not working well which can lead to other problems or you can have problems breathing

MARQUEZ: The New York state department of health and accrediting agencies have opened investigations into Yorkville endoscopy and Ms. Rivers death. An autopsy now complete, cause of death still unknown.

Yorkville open in 2013. The state department of health only saying there have been no complaints or violations regarding this facility. The clinic has not responded from calls from CNN for comment.


MARQUEZ: And now, you are looking at a live picture of the space just outside her upper east side apartment here in New York. There are stunning orchids, beautiful, beautiful roses out there, sunflowers. I have seen a lot of these sorts of memorials over the year. I have never seen such beautiful flowers left for anyone, certainly fitting for the queen of comedy -- John.

BERMAN: I'm sure she would appreciate that. Miguel, you said, as of now, no known cause of death. Any word when we may get that official statement from the medical examiner?

MARQUEZ: Yes, we know the examination of the body has been done and that will now be turned over to the family. It's the toxicology at that point. This is a very high profile case, obviously. They want to understand what happened.

There are several investigations that hinge on what those toxicology reports come back with. It could be days before they get them back, depending how complicated, though, it could be some weeks -- John.

BERMAN: All right, thank you so much, Miguel Marquez in the Upper East Side outside Joan Rivers' apartment. Appreciate it.

And as you just heard there, the procedure that Joan Rivers apparently had, it's not uncommon, neither are outpatient surgery clinics. There are almost as many of them as there are hospitals in the United States.

I want to bring in chief medical correspondent, Dr. Sanjay Gupta. Sanjay, in these types of outpatient clinics, is it always an anesthesiologist who is administering the anesthesia?

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Not necessarily. First of all, when you talk about anesthesia, there are all sorts of different things that can be done. If someone is having surgery, for example, the throat which is what we presume she was having, it could be a numbing spray in the back of the throat.

It could be medications that are more of anti-anxiety medications. It could be medications like propofol or even using a type of general anesthesia. But that's typically reserved for hospitals.

But there are people who are not anesthesiologists that take courses in sedation. They learn how to sedate someone. They are not an anesthesiologists, but they could use that sedation training to try and perform these types of procedures in an outpatient setting.

We don't know if there was an anesthesiologist present. There are no anesthesiologist on the roster, if you will, at this particular endoscopy clinic that we could find.

BERMAN: Sanjay, you just brought up the drug, propofol. Now it hasn't been confirmed what type of anesthesia was used on Joan Rivers, but propofol is commonly used in clinics like this. Obviously a lot of us know the name of this drug because of Michael Jackson's death. What do we know about it in its safety record?

GUPTA: Well, you know, it's a medication that's been used for a long time. It's medication that I use even in my own practice and part of the attractiveness of a medication like this that obviously got people to know about it because of Michael Jackson.

But it's gotten a lot of use in terms of its very quick actions. It's able to come on very quick and go off very quick so a patient can go to sleep quickly and they can wake up quickly and that's exactly what you want, especially in settings where it's more of an outpatient- typesetting.

I wanted to show you, John, if I could for a second, what it looks like. We'll go inside the operating room to give you an idea of how it works and what's necessary for it to work. Take a look.


GUPTA: We're here inside the operating room of a chief of Anesthesiology here. Propofol is the medication he uses all the time. It looks like Milk of Amnesia.

UNIDENTIFIED MALE: Milk of Amnesia. Are you OK? We have to monitor his EKG and make sure that he's breathing and make sure he's ventilating.

GUPTA: That's all typical stuff.

UNIDENTIFIED MALE: Standard of care, yes.

GUPTA: OK, so the Propofol.

UNIDENTIFIED MALE: You'll get sleepy. Give me some good, deep breaths.

GUPTA: Take a look at his eyes, how quickly --

UNIDENTIFIED MALE: Deep breath, Vincent, doing great. You may feel a little burning, OK?

GUPTA: Ten, nine, eight, seven, six, five, four, three, two, one.


GUPTA: You saw, John, what I mean how quickly a medication like that works, but you also saw everything ahead of time. They were given oxygen and want to make sure one is pre-oxygenated. They are monitoring all these various things, blood pressure.

They are monitoring how much carbon dioxide someone is making. The point is, John, that you know, even though it's a medication that's used quite a bit, there is a lot that goes into using a medication like that and that's why you want people trained doing it.

BERMAN: Lastly, Sanjay, what type of resuscitation equipment is required to be on the premises at a clinic like this?

GUPTA: The basics sort of really apply here and we talk about ABC, literally, airway, breathing and cardiovascular circulation. You want to be able to make sure if someone has problems with airway, we literally call it losing the airway because the throat swells.

There is bleeding, something happens, you got to be able to secure the airways and there are certain things that you need to have if someone has problems with blood pressure or heart problem to be able to give them medicines or perform procedures to get the heart started again.

Everything from defibrillator to certain medications that increase blood pressure. I will tell you, John, you know, there are tens of thousands of these procedures done in outpatient centers every year in the United States.

Most of them go without an absolute hitch, but you're zeroing in on a couple important points in terms of what exactly is required, what the accreditation really means, do anesthesiologists need to be on standby. Some of those are more fuzzy in terms of the answers than I think we have realized.

BERMAN: These are some questions that no doubt will be asked during these investigations. Dr. Sanjay Gupta, thanks so much for being with us. Appreciate it.

GUPTA: You got it, John, thank you.

BERMAN: Up next, the red carpet Joan Rivers that the world saw was one facet of a remarkable woman, that's according to her head writer at "Fashion Police," head writer and close friend. Rivers gave him his big break in the business and he joins me ahead.


BERMAN: Joan Rivers was famously industrious always working, I mean always. As reported hours before having outpatient surgery and suffering cardiac arrest, she performed at a comedy club in Manhattan, something she did frequently.

And even well after she became famous, she continue to break new ground, her show "Fashion Police" on the E! Network. With that, she kind of created a whole new comedy genre.


JOAN RIVERS: She wanted to be noticed. This is as subtle as a Tabasco enema. That dress has more creases than my face before Botox. This dress is like the invasion of Iraq of Kirsty Ally trying to grab second.

Her body is like the dark meat special at KFC, all thighs and no breast. That dress was so hot, she was sweating more than Dean watching Tory going through his phone. It's like hip-hop music, you know what I mean? It started all black and sexy and now there's a bunch of white trailing behind it.


BERMAN: "Fashion Police" announced a two-week hiatus shortly after Rivers was hospitalized. Tony Tripoli is the show's head writer. He worked closely with Rivers on her material. They were more than colleagues. They had a close, close friendship and Tony Tripoli joins me tonight.

So Tony, you first met Joan Rivers a little more than four years ago when she picked you to be the head writer of "Fashion Police." That had to be an incredible moment.

TONY TRIPOLI, HEAD WRITER, E! FASHION POLICE: She changed my entire life in that moment. I was sort of asked to go and spend a day writing with Joan Rivers, of course, who will say no to that? After 10 minutes, she goes, I need to talk to you in the kitchen.

I thought, my gosh, this is my childhood hero is going to take me in the kitchen tell me I'm too dirty or too pushy or too obnoxious and to get out and we got in the kitchen and her little finger spun around.

And she said you're the new head writer of "Fashion Police." I said come on, no network is going to let me be, you know, the head writer of a television show. I have no credits. I'm some struggling standup comic. She said it's done.

BERMAN: You said you grew up and she was your hero. When you finally got to meet her and work with her, was she like you thought she would be?

TRIPOLI: No. No, because you see her on stage and she's this demon. She's, you know, prowling the stage like a tiger and she's just got that laser focus and she's, you know, she's vicious in the best possible way and you think this is hilarious.

But this person wouldn't probably be super fun to spend time with, right? Off stage, she's -- she was the most stereotypical Jewish grandma you could ever meet. She was forever holding your hand and telling you she loved you and she was always, you know, saying did she need a mint.

Because she was always worried that, you know, she was going to have not perfect breath. Like she was just always telling you to eat something and wanting to know why you haven't met a nice doctor.

BERMAN: What's it like to write jokes with someone who's been at it, you know, for 50 plus years? By the way, at the top of the game.

TRIPOLI: Yes, and she was never satisfied. She was grateful and would say these are great jokes, thank you so much, and then she would sit there in the makeup chair and go over them over and she would say Tony, how can we remove a word?

This joke needs to have one less word and she would figure out, which word to take out and suddenly the joke was ten times funnier. To her, comedy was mathematical.

BERMAN: I've also heard you say that the dirtier the joke, the harder she would laugh but still, there was stuff you had to explain to her?

TRIPOLI: I mean, we can't discuss on this show some of the names for sexual positions that I had to explain to this, you know, sweet, 81- year-old woman, right? I had to -- she just, you know, there were certain rap lyrics that we might reference in a joke.

And she -- you know, this is not a woman who has gotten jiggy with it very recently. So she was -- what are you talking about? But if, you know, if I said trust me, you saying that this lady's outfit is really ratchet will get a huge laugh because nobody expects you to say the word ratchet.

Then she would go OK, we'll try it and after the show she would take your hand and say thanks for making me do that. You were right.

BERMAN: What will you personally miss most about her?

TRIPOLI: She had the greatest laugh on earth, and most comedians always need to be the funniest person in the room and most comedians have this weird competitive thing around other people that might be funny, right?

They also need to be the alpha and Joan loved nothing more than when someone would say something that laid her out. That was her greatest pleasure. It was -- and so when I would get to, you know, pitch her an idea for a joke.

And she would throw her hands up and just go you're killing me and she would laugh -- I just -- it breaks my heart that I'm not going to hear that laugh again.

BERMAN: Well, it's a wonderful thing you got to experience it all and I think you're one of millions that will miss her so much. Tony Tripoli, thanks so much for being with us.

TRIPOLI: Thank you.

BERMAN: Joan Rivers was also famously frank about her cosmetic surgeries. It became part of her stick, someone on Twitter posted a photo of a sign at a London train station this morning saying, as a tribute to the late Joan Rivers, parts of this station will be gradually replaced over the next 40 years.

OK, maybe harsh, but you know what? It's a good bet this would have made her laugh. As with everything else she did, what she wanted when she wanted it when it came to plastic surgery, even though in her own words, it terrified her. Here is Gary Tuchman. (BEGIN VIDEOTAPE)

GARY TUCHMAN, CNN NATIONAL CORRESPONDENT (voice-over): Joan Rivers' comedy stood the test of time.

RIVERS: You're 30 years old, you're not married. You're an old maid is. A man, he is 90 years old. He is not married, he's a catch.

TUCHMAN: It didn't matter which decade it was.

RIVERS: I'm wearing the same underwear, which everyone back stage remembers.

TUCHMAN: Her unique style was consistent. Less consistent, her appearance.

RIVERS: My body is my temple and my temple needs redecorating.

UNIDENTIFIED FEMALE: This is such a stupid elective surgery.

RIVERS: No, no, no, it's elective, but I bet each one of you would do something if I paid for it.

TUCHMAN: Joan Rivers never hesitated to talk about her plastic surgeries. Back in 2007, she had a humorous heart to heart with Joy Behar who was filling in on CNN's "Larry King Live."

JOY BEHAR: When you first did it, Joan, the plastic surgery --

RIVERS: I did it, yes.

BEHAR: How old were you?

RIVERS: I was 41. Natural bags from my father and I was starting to get that tired 41-year-old look, you know, and I just thought let me do it now. Somebody told me I look -- Johnny's wives said do it before you need to do it.

BEHAR: Really, but did you do it because you wanted to be prettier or because you felt you were looking older?

RIVERS: I wanted to look better and of course, you want to be pretty. Everyone in society -- as I always said, nobody ever asked Eleanor Roosevelt to dance.

TUCHMAN: Joan Rivers talking about plastic surgery never failed to make audiences laugh. But Jones' daughter, Melissa, was clearly worried about her mother and her plastic surgeries.

MELISSA RIVERS, JOAN RIVERS' DAUGHTER: I have tried in every way possible to explain to you how frightened I am and how I feel like this is an unnecessary risk. It turns out I'm not the only person with concerns.

RIVERS: I don't understand this.

MELISSA RIVERS: Everyone feels the same way --

RIVERS: Feels the same way what?

UNIDENTIFIED FEMALE: We just don't want to lose you.

RIVERS: For God's sakes, you're all in the will.

TUCHMAN: But it wasn't just material for her act, Joan Rivers herself acknowledged having anxiety around her procedures.

UNIDENTIFIED FEMALE: Aren't you scared --

RIVERS: Terrified.


RIVERS: Very serious. My dad was a doctor. The anesthesiologist is as much a part of that group as the plastic surgeon, very serious. But you also want to be in a society that wants people to look good.

TUCHMAN: But she did not let anxiety stop her.

RIVERS: Look good, look good, look good. I spit on education. Did you go to college? Tell us how it helped you now.

TUCHMAN: And we laughed with her about it for decades. Gary Tuchman, CNN, Atlanta.


BERMAN: A quick program note, coming up at 10:00 p.m. Eastern, don't miss CNN spotlight "Joan Rivers," her life and legacy remembered.

Up next, California desperately dry. We have incredible photos of the drought in the fears that it may cause an even bigger disaster.


BERMAN: In tonight's "American Journey," we take you to California, a very, very dry California. That entire state facing one of the worst droughts on record. The before and after photos of lakes and other sites, they tell the story. Here is Dan Simon.


DAN SIMON, CNN CORRESPONDENT (voice-over): A healthy and full lake in Northern California. There is only one problem, this picture is three years old.

(on camera): And now I'm walking on top of that same bridge. Take a look. It is a virtual desert. This is what drought looks like in the state of California.

(voice-over): Here is another before and after side by side and just when this drought couldn't seem any worse, new research indicates that the depletion of ground water in the state may actually trigger earthquakes, more on that in a moment.

First, this is Lake Orville. A boater's paradise, at least when it's full. More importantly, it's a reservoir storing water ultimately piped into homes and for agriculture helping to grow much of the nation's fruits and vegetables.

John Predo took us on a boat to see the shoreline and it's even more astounding up close. The lake seems more like a narrow river. The drought has created a canyon, a hillside of rock that's normally covered by water. The water level is down by more than 200 feet.

It's a common site throughout the state, most of California's major reservoirs are less than half full.

(on camera): What would we be seeing?

UNIDENTIFIED MALE: The water up probably half way up the hillside at this time of the year.

SIMON: More than 80 percent of the state is either in the extreme or exceptional category, the highest levels. It's meant no showers or running water for several communities and increase in wildfires. Brown and neglected public parks and farmers losing crops.

UNIDENTIFIED MALE: It's like mourning. It's dead. Our product is dead. It's just -- we cannot sell it. We have to knock them down.

SIMON: Jesse Rodriguez grows table grapes and estimates he'll lose 40 percent of his crop this year due to the drought. With low reservoirs, farmers are having to pump water out of the ground.

And as if that weren't bad enough, there is new information from researchers who believed the depletion of ground water in California central valley could destabilize the infamous San Andreas Fault and trigger earthquakes.

The study published in the journal "Nature" concluded that removing so much weight in the form of ground water causes the earth to spring upward and the change in pressure can cause those quakes.

PEGGY HELLWEG, U.C. BERKELEY SEISMOLOGICAL LABORATORY: Earthquakes are these mysterious things that happen under our feet. So having a way for people to cause these earthquakes to happen is unsettling.

SIMON: Experts say the quakes would be small and unlikely to cause any damage, still, another example why this drought is causing so much stress to both the land and the mental well-being of nearly an entire state. Dan Simon, CNN, Oroville, California.


BERMAN: Those are stunning, stunning pictures. We'll be right back.


BERMAN: Before we go, we want to bring you up-to-date on the breaking news, the search for the wreckage of that small planes that have went down off the coast of Jamaica with a New York couple on board. Jamaican authorities saying they have located an oil slick, but so far that's all.

Thanks for watching. "CNN TONIGHT" starts now.