Yesterday I was revolted by this story: Palestinians Fire Celebration Shots at News of Sharon in Hospital. I got a similar, but obviously much smaller, feeling when I received information about conflicting news reports of Sharon's medical condition (whether or not he lost consciousness, for example). It is understandable that optimism over his condition would translate into public wishful thinking. Those familiar with Israel's political traditions know that the public's "right to know" about its leaders is generally low.
Upon reflection, I realized that this is the key to the current election. Ariel Sharon is nearly 78, very much overweight and not likely to change. A stroke, which impairs mental functioning, is a likely effect of those two factors. Support for his new party, Kadima, is primarily based on reliance on his post-election judgement. One veteran journalist even expressed confidence that he would weather the storm over his aide's announcement of major concessions, including on Jerusalem, because everyone believes he's a liar. Essentially, according to Yaron Dekel, his is a Rorshach party: those on the right won't believe the report about Jerusalem, and those on the left won't believe the denial.
The medical team that treated the prime minister when he was first brought to the hospital, however, told the Maariv newspaper that Sharon had been quite confused for most of an hour.
"What was said at the press conference was, to understate, not exact," they said. "The prime minister did not know what day it was, what time is was or where he was. For 45 minutes he could not count or perform basic movements. They [the hospital officials ?ed.] are not obligated to disclose everything, but to give inaccurate information is already taking a position [on the matter of the PM's health] and is very problematic. Throughout the first night of his hospitalization the confusion continued, to a lesser extent, and Sharon has not returned to himself completely."
I heard Sharon speaking today and he did not sound like himself. This is not the first time Sharon's mental capacities have been questioned, although the matter has clearly left the level of speculation. Even those who have the greatest respect for his lifetime of public service could not have failed to be shocked by the facts of the asleep-at-the-wheel nature of his recent Rafah concessions, for example.
It's time for Netanyahu to borrow from the playbook of his rival Ehud Olmert. The popular Jerusalem Mayor Teddy Kollek was defeated on a brilliant out-of-the-box campaign slogan that swung the votes of many of his staunchest supporters. "Teddy we love you, but it's time to retire."
Update: An anonymous neurologist (whose identity I confirmed) just wrote me:
As a neurologist, let me add some context. The report of loss of consciousness does not seem reasonable as a result of a stroke since loss of consciousness caused by strokes is seen in massive strokes and clearly he did not have a massive stroke. If indeed there was loss of consciousness it would suggest something else causing the stroke, such as a minor myocardial infarction causing both stroke and loss of consciousness. However, the most likely cause of the odd responses is aphasia, a selective problem with speech. Not enough detail was given to distinguish between expressive or receptive aphasia, but either can give trouble answering questions and complying with requests. Most doctors in general medicine are not good at dealing with these subtleties and I'd put most stock in what the neurologists say.
Depending on the causes these can recur as similar or bigger strokes, or they can be a one time phenomenon, as was the case for Ed Koch; not enough detail was released to assess this. They did describe a clot but did not say whether they visualized it, inferred it, or found a cardiac cause for it, so I can not say with confidence whether this is an actual stroke or a transient ischemic attack. Presumably he will be put on daily aspirin and counseled on dietary changes.
Update 2 (Dec. 21):
WorldNetDaily presents additional contradictions from medical experts and put his finger on what I heard that sounded wrong with Sharon's speech ("One Israeli reporter who spoke with Sharon told WND, 'The conversation sounded scripted, like he was reading from a paper.'")
multiple renowned stroke experts told WorldNetDaily a minimum of several weeks of rehabilitation are necessary for the vast majority of minor-stroke sufferers, an immediate return to work is not recommended, and the prime minister may be at risk for recurring strokes...."almost unheard of to send even the most minor of stroke patients back to work within days. At least a week, usually two or three are needed"...."It is important for Sharon to lay off serious stressful situations for at least a short period of time. He needs to avoid making big decisions right now. He also needs to be monitored closely for the next few weeks."
....All information released regarding Sharon's health status has been filtered through senior aides and advisers.
The prime minister's office refuses to make public Sharon's medical records or the results of radiation and imaging tests conducted this week.
Update 3: My neurologist correspondent takes issue somewhat with the stroke experts cited above, although obviously nothing conclusive can be stated given that medical records have been withheld:
Although stress-released steroids can increase death of neurons I think it would be a stretch to argue that returning to work would result in a large increase in steroid release and it would be a stretch to argue that Sharon's neurons were so damaged as to not have recovered from the damage already. A recommendation that someone return to normal activities but get enough sleep is probably the most reasonable one.
If there are doubts about a patient's medical abilities these should be evaluated before someone is allowed important executive responsibility. It sounds like that has been done. I haven't heard anything about Sharon's condition that can't be explained by a transient language problem, with some accounts sounding worrisome only because they were described by non-neurologists. I wonder whether the reports of unconsciousness were broken-telephone confabulations based on someone saying something like Sharon sounding out of it and someone else interpreting this as a problem of consciousness instead of language.
The one piece of information I feel is least well described is what sense of uncomfortableness Sharon felt when he called his son from his car. One might imagine that it was not a language problem because he held a conversation on the phone with his son, but it could have been a language problem and the son could have decided that he sounded terrible and recommended medical attention. If the doctors were taking a good history they would have obtained the answer to this question. I have not heard an answer to this question in the reports I've seen.
The most important issues for recurrence are crud in blood vessels and coagulation of blood. Assuming that the doctors have evidence of a clot and assuming that Sharon was not anti-coagulated before the stroke the most important thing would be to initiate anti-coagulation, probably using low doses of aspirin. If other factors were involved such as heart problems there may be a need for more powerful anticoagulation. Dietary changes can help reduce crud on blood vessel walls but such interventions are slower, though diet can also have rapid effects through effects on coagulation status.
Depending on these interventions and on the details of the underlying problem there may indeed be a high risk of recurrence. However, if he had a coagulation problem and little blood vessel crud and no heart problem he should do very well on anticoagulation.
What's the situation regarding Sharon's health?
The IRIS Blog presents some interesting facts surrounding press coverage of the now "recovered" Ariel Sharon's health, which has remained shrouded in the usual media fog. However, there has been some interesting news that the medical team has been di...
Weblog: Tel-Chai Nation Tracked: Dec 21, 17:45
Sharon's Health Reporting Still a Farce
Sharon Was Incapacitated on Night of Stroke
Prime Minister Sharon was not qualified to make decisions the night he was hospitalized for a stroke on Dec. 18, his physicians said Monday at a press conference in Jerusalem. The physicians said Sharon recover
Weblog: IRIS Blog Tracked: Dec 27, 17:03
Sharon Rushed to Hospital
From the Jerusalem Post:
Prime Minister Ariel Sharon was rushed to Hadassah Ein Kerem hospital in Jerusalem again late Wednesday night. Sharon, according to Channel 10, reportedly was conscious, and able to speak, but was suffering from some weakness.
Haveil Havalim #52
For those of you who still don't know what HH is all about, here is Ezzie's official HH definition:
Haveil Havalim is the carnival of Jewish blogs -- a weekly collection of Jewish & Israeli blog highlights, tidbits and points of interest collected...
Weblog: Israel Perspectives: Feeling 'Right' at Home Tracked: Jan 09, 13:16
More Sharon Misinformation
After the explosive leak earlier today that the diagnosis of CAA had been missed in the treatment for Prime Minister Sharon's first stroke, the medical team's spokesman appears to be peddling misinformation, saying that the CAA diagnosis is nothing new. T
Weblog: IRIS Blog Tracked: Jan 10, 23:05
Experts Join IRIS Condemnation of Sharon Treatment
Two days ago, I paraphrased my neurologist's assessment of Sharon's apparent treatment following his first stroke as "hopelessly contradicted by medical norms." A neurologist is as likely to prescribe Heparin for a stroke victim diagnosed with CAA as he i
The cover up about Sharon's illness and possible incapacity reminds me of the miasma of lies surrounding arafat's last days, as well as his life after death. Yasser A. actually died on 4 November 2004, but the death was not announced until 11-11-04. Meanwhile, the doctors kept pumping the corpse with breathing devices for another week because Suha had her reasons to pretend that he was alive. She went so far as to accuse Israel of spreading lies that he was dead when he just "in a deep coma," according to her and her flunkies, whereas Radio Monte Carlo --a French govt station-- had reported on 4 Nov 2004 that he was in a state of "brain death" [mort cerebrale]. She used the French govt too as her flunkies, while the chief physicians at the hospital lied for her. The French-language Metulla News Agency reported that, according to physicians inside, during the week of life after death, the brain was no longer controlling bodily functions and liquids were freely flowing out.
Of course, the Arabs go a lot farther with lies like this than our people do, but there is still an effort at deceiving the public.