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Putin Updates Russia's Nuclear Doctrine After U.S. Green Lights Ukraine's Use of Longer-Range Missiles; Face Transplant Recipient: "I Look Like A Person Again"; Trump To Attend SpaceX Test Flight Launch With CEO Elon Musk. Aired 1:30-2p ET

Aired November 19, 2024 - 13:30   ET

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

[13:30:00]

BORIS SANCHEZ, CNN HOST: Ukraine hitting Russian territory with U.S.- made missiles as Vladimir Putin broadens Russia's nuclear doctrine, hinting at a potentially devastating response.

Stay with us.

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BRIANNA KEILAR, CNN HOST: U.S. officials now confirming that Ukraine has fired U.S.-provided long-range missiles on targets inside of Russia just days after President Biden gave Ukraine the green light to do so.

It's a major escalation in a war that has now raged for a thousand days. The Kremlin says six missiles were launched at one of its weapons arsenals in the Bryansk region. And it claims that five of those six were shot down.

Russia's foreign minister says the attack marks a new phase of war by the West.

And the timing here is quite notable. Today, President Putin lowered Russia's threshold for using nuclear weapons.

[13:35:03]

Let's talk about this now with former NATO supreme allied commander, retired General Wesley Clark.

General, thanks for being with us.

As we said, Russia is saying that only one of the six ATACMs made it through here and that one was damaged before fragments of it hit a military facility in Bryansk.

Is this weapon a game changer or just another weapon in the arsenal?

GEN. WESLEY CLARK, FORMER NATO SUPREME ALLIED COMMANDER: Well, first of all, we don't know how many missiles really made it through, despite what Russia might say. But it's not a game changer. It's another weapon in the arsenal. There's not enough of them. They don't have enough range. They're

being used in a fragmentary basis. They add some -- every weapon helps. It -- and it adds some leverage if you're going to go into negotiations.

It's something where Ukraine can say, OK, we won't shoot anymore missiles into Russia, if you won't do X. But, no, it's not decisive. And Russia knows this very well.

KEILAR: So we're -- and a very good point, obviously, not to take Russia at its word on that.

We did hear from Ukrainian officials that they hit an ammo depot there inside Russia.

A State Department spokesman, Matthew Miller, said that Russia bringing in North Korean troops, I think the U.S. estimate right now is it's over 11,000 that are operating there in the Kursk region, along with Russian troops.

That it's, quote, "a major escalation by Russia." Then you have the U.S. OK'ing Ukraine, using U.S.-made longer-range missiles.

Is the Biden administration's calculus here that this is OK to do because it may actually be time limited by Trump taking over the White House. How do you see this, as Trump certainly wants to end the war quickly?

CLARK: I see it more as a continuation of existing administration policy. It's a tit-for-tat policy in which the Biden administration has tried

to manage the escalation.

So if Ukraine is -- is winning, then we don't do as much. If Russia is going to win, we don't want Ukraine to lose. So we're going to do more. And we've managed to continue this policy with slow motion on artillery, HIMARs, tanks, F-16s, ATACMs, and now ATACMs into Russia.

It's always the same decision process. And we're probably at some level even talking to the Russians. Anow we're considering this because the Russians have already begun fortifying their airfields and so forth that are in ATACM's range to reduce their vulnerability to it.

So this is a political gesture. From the beginning, the administration has not wanted Ukraine to win this war. I don't know how they thought it was going to end.

At one point, Jake Sullivan was saying, well, time is on our side, time is on our side. But actually, if you look at Ukraine's manpower, if you look at the fragility of Western democracies, if you look at Putin's resolve and now bringing in the North Koreans, we don't know if time is on our side or not.

It really depends on American leadership. And Ukraine's manpower is about a fourth of what's available for Russia. So that was never a good recipe for success.

Really there's -- this is going to continue until Putin decides he can't win or until we give him most of what he wants and he's willing to take a pause and wait to get the rest of it.

KEILAR: When you look at Russia lowering its threshold for using nuclear weapons today, and it's doing so, it says that "it now considers an aggression by any non-nuclear state but with participation of a nuclear country," -- obviously, that would be Ukraine with the U.S. - "to be a joint attack on Russia."

How do you read that?

CLARK: I read it as typical Russian propaganda. Here's the truth, Brianna. Putin could use a nuclear weapon anytime he wants, as many as he wants, regardless of what any Russian doctrine says.

That Russian doctrine is for public consumption in the West. And it's adding to the pressure.

You know, from the beginning, the president said he didn't want a confrontation with Russia. He said at one fundraiser he didn't want to start World War III.

Donald Trump is on -- out there. And his son, Don Jr, saying it's going to be world war. It's just all of that process of trying to influence public opinion in the West to not help Ukraine, to not offset Russia's escalation, to do less and eventually let Ukraine crumble.

So, yes, there's always a chance that this could escalate into something that is dangerous. That's why the U.S. has nuclear forces. That's why we have a deterrent.

And that's why, you know, we have missiles, we have submarines, we have aircraft. We deploy them around the world. And Russia knows this.

But we don't want to engage in that sort of what we term reckless talk, whereas Putin has found it very, very useful to do so because it does inhibit the Western response.

[13:40:09]

KEILAR: General Wesley Clark, it's always great to talk to you, especially at a pivotal time like now. Thank you.

CLARK: Thank you, Brianna.

KEILAR: And ahead, from tragedy to transformation. How one man survived a suicide attempt, then became the recipient of a groundbreaking surgery. We'll have his remarkable story next.

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[13:44:57] SANCHEZ: After receiving a life-altering face transplant, Derek Pfaff looked in the mirror and said he'd been given a second chance, that he finally looked like a person again.

Pfaff's face had been severely injured after he tried ending his life with a gun back in 2014. He lost his nose, lips, teeth and other parts of his face.

But now, thanks to an army of at least 80 people at the Mayo Clinic, the majority of his has been reconstructed and replaced with donor tissue.

CNN health reporter, Jacqueline Howard, spoke with him.

Jacqueline, walk us through this miraculous surgery and how this all came to be.

JACQUELINE HOWARD, CNN HEALTH REPORTER: Boris, after Derek sadly attempted suicide, he did have 58 reconstructive surgeries to really treat that severe wound to his face. They were helpful, but his doctors said he really was a good candidate for a full-face transplant.

Because he had some difficulty speaking, he had some difficulty chewing, he was still missing a nose, portions of his forehead. And that's when he was connected with the medical team at Mayo Clinic.

And they replaced and reconstructed 85 percent of his face with this transplant surgery. And like you said, Boris, this was more than a 50- hour long procedure involving at least 80 people. This was a huge, huge operation.

And here is Derek with his parents on what that moment was like when he first saw his new face.

(BEGIN VIDEO CLIP)

DEREK PFAFF, FACE TRANSPLANT RECIPIENT: Looked in the mirror, I had a face, no, lips, teeth. After all that work and it looked like a person again. It was incredible.

(END VIDEO CLIP)

HOWARD: Boris, he said he looked like a person again.

And as you said, he's doing well after his surgery. He is taking immunosuppressive medications so that his body does not reject the donor tissue on his face.

But overall, he says he's doing well. And he wants to use this moment to really raise awareness around suicide.

And he's encouraging any other young people out there, if you're struggling or feeling stressed like that's what he was feeling like when he was in college, to definitely reach out for help, call the crisis lifeline 988, and that's where you'll find some support. SANCHEZ: Such an important message to pass along.

Jacqueline, I do wonder, these surgeries are so innovative. They're so cutting edge. How many actual face transplants have there been?

HOWARD: Well, the very first face transplant was announced in 2005, and since then, there have been about 50 procedures performed around the world.

But like you said, each and every single surgery is innovative because every face is different. Every injury that the transplant is addressing is different. So any time we hear about a face transplant procedure like this, it is innovative. It is an advancement for the field of medicine.

And Derek says, again, that he's proud to be a part of this moment in medicine and science as well.

SANCHEZ: Yes. It's so incredible. And as he put it, he got a second chance at life.

Jacqueline Howard, thank you so much for the reporting.

And as Jacqueline mentioned, if you or someone you know needs help, you're not alone. You can reach the Suicide and Crisis Hotline by dialing 988. Help is out there.

[13:48:30]

Elon Musk has Donald Trump's ear and it's hosting -- he's hosting Trump today in Texas for the latest SpaceX launch. We're going to take you, live, to South Padre Island. In just moments

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[13:53:08]

KEILAR: SpaceX CEO Elon Musk, once again, has a prime spot in the Trump orbit. Later today, Musk and President-Elect Trump will attend the launch of the SpaceX Starship, the most powerful rocket ever built.

This is going to be its sixth test flight. SpaceX will also make another attempt at a spectacular feat that it made last month, steering the booster back into the mechanical arms, or chopsticks, of a launch tower.

CNN's Ed Lavandera is in South Padre Island, Texas, ahead of the launch.

Ed, tell us a little bit about what we should expect from the president-elect's visit.

ED LAVANDERA, CNN SENIOR NATIONAL CORRESPONDENT: Well, we do know that Donald Trump and Elon Musk are in route here to south Texas. They left West Palm Beach. They are expected to witness this sixth launch of the Starship

spacecraft later on this afternoon, scheduled to be about a 30-minute window that opens up around five central time, so about a little more than four hours from now.

And you can see the Starship there in the distance. We are about five miles away from the launch pad. And that is the Starbase area that SpaceX has essentially taken over in the last few years as they've developed this program.

And this relationship between Elon Musk and Donald Trump under intense scrutiny with now Donald Trump planning to return to the White House, in this relationship.

SpaceX has billions of dollars of contracts with NASA, and it is part of the space program. It's supporting the NASA Artemis mission and plans to return to the moon in 2026.

And there has been a great deal of concern about the environmental impact of the SpaceX program here in south Texas. And many activists, environmental activists concerned about that relationship and what it means for the future of these launches here.

One SpaceX executive saying recently that they expect to have some 400 launches over the next four years. So that's about 100 per year if you average it out. So the great deal of impact in all this.

[13:55:07]

But right now, you know, this SpaceX team preparing for this launch later this afternoon. We were here a little more than a year ago for the first launch. Brianna, A dramatic sight.

Hundreds of people showing up once again here to witness the sixth launch of the Starship spacecraft here in just under four hours-- Brianna?

KEILAR: All right. We'll be looking forward to that.

Ed Lavandera, thank you so much.

And coming up, a growing number of Republican Senators say they want to see the House ethics investigation on Trump's pick for attorney general, Matt Gaetz. We're following the latest on the Hill.

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