By Patricia Sellers

Ted Turner has been defying death his entire life. His sister, Mary Jane, who was his only sibling, died at 17. His father, a philandering alcoholic, killed himself at 53. Young Ted loaded up on debt to save his father’s billboard company and later took big financial risks to create CNN , build a media and sports empire, and win the America’s Cup. “If you can get yourself where you’re not afraid of dying, then you can move forward a lot faster,” Turner told Time  in 1991 when named Man of the Year.

One more feat: Turner turned 75 on Nov. 19. When Fortune last visited him, for a 2003 cover story, “Gone With the Wind,” he had lost $8 billion from Time Warner’s plummeting stock; his job; and the love of his life, Jane Fonda. Today Turner is worse for wear physically — he is frail as well as forgetful — but he still has $2.1 billion in wealth, including 2 million acres, 55,000 bison, and a restaurant chain (but no longer any Time Warner shares). He has paid $973 million of the $1 billion he pledged to the UN in 1997. Calmer than he once was, he is also more self-aware — as he revealed in an exclusive interview with Fortune’s Pattie Sellers. An edited transcript:

How are you feeling about life at 75?

It’s better than being dead.

How’s your health?

It’s okay, but it’s not great. I have both sleep apnea and atrial fibrillation, which are both debilitating conditions.

You have a pacemaker?

I do. I had it put in a few months ago. I have two. I feel a little better. But I still get exhausted real easily.

How would you describe yourself today at 75 compared to Ted Turner at 50?

I had more energy at 50. On the other hand, at 75, I’ve probably got a little more wisdom and good judgment than I had at 50 because I’ve got more experience. But I haven’t really changed. I’m still driven by the same philosophy.

And what is that?

Well, we need to make a lot of changes in order to survive another 50 years. We’re in a lot of trouble. For one thing, we’ve got thousands of nuclear weapons on hair-trigger alert. An accident or an earthquake could cross wires and off we go. And that would be the destruction of the world. If the Russian nuclear arsenal was fired at the United States and other targets and we fired back at them with thousands of nuclear weapons, it would be the end of life on earth.

Ted, I interviewed you for a Fortune cover profile called “Gone With the Wind” 10 years ago. In 2003 you said to me, “I think the chances are fifty- fifty that humanity will be extinct in 50 years.” Do you still believe that?

Fifty years aren’t up yet. I’d say that’s generally the case. The nuclear threat is the most imminent threat. But global climate change and environmental destruction of the earth and our resource base, that’s the other great threat. It works a little bit slower, but it would still work at a 50-year time frame very possibly.

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