Sharon's Political Career Over, Likely Caused by Poor Medical Judgement

Note: This post was first published approximately 15 minutes after the first news report that Sharon had suffered a brain hemmorrhage.

Our prayers are with Ariel Sharon, a lifelong public servant.

According to my neurologist correspondent, his reported cerebral hemorrhage is such that he potentially has a few hours to live. If he does survive, his political career is effectively over.

A cerebral hemmorrage in these circumstances is often the result of overly aggressive anticoagulation. From the first reports, my neurologist correspondent presciently insisted that he be treated with nothing more than aspirin in terms of a blood-thinning agent.

Sharon Suffers 'Significant Stroke,' Undergoing Surgery for Cerebral Hemorrhage

initial tests showed Sharon had suffered a cerebral hemorrhage, or bleeding inside his brain.

Addressing reporters in English, Mor-Yosef said Sharon had "massive bleeding and was being transferred to an operating theater."

Ehud Olmert Taking over Prime Ministerial Powers

Sharon Suffering from Paralysis in his Lower Body

Sharon's Physician Says he Expects PM to Emerge from Surgery 'Safely'
This is wishful thinking

Update: Sharon in Critical Condition

Radical Palestinian Calls Sharon Illness 'God's Gift'

The first wire story is now out repeating my neurologist's point, published hours ago, that blood thinners may be responsible for the bleeding:

The prime minister had been taking blood thinners since the first stroke to prevent another clot, but such drugs also raise the risk of cerebral hemorrhages, which account for only about 10 percent of strokes. Other possible causes of cerebral hemorrhages are ruptured blood vessels, an aneurysm, or bulge in a vessel wall that bursts, or even chronic high blood pressure.

Blood thinners may not have caused the latest stroke but could have made the bleeding worse and may account for its severity, Steig said.

The best breaking updates on this story can be found at the Mere Rhetoric blog. Mere Rhetoric, by the way, is focusing on another possible medical error: the fact that the seriousness of the problem was not immediately recognized and that there was confusion about which hospital to take him. My guess is that the significant efforts earlier to downplay the seriousness of his condition led to a lack of preparedness.

Mere Rhetoric is now reporting Channel 10's shocking news that Sharon was initially "shuttled from one hospital to another." Additionally, there is some scandal that no aircraft was used to bring him from his ranch in the Negev to Jerusalem, because of the lack of preparedness.

Clearly Sharon's team was much more focused on managing the political perceptions of his health than his actual medical condition. It is possible (but completely speculative), given what we discovered about the initial disinformation propagated by his doctors about of the seriousness of his medical condition, that his medical team may not have been chosen primarily for their technical skill.

Mere Rhetoric has now brought word of a full article in Maariv (Hebrew only for now) expressing strong criticism of the decision not to bring him to a closer hospital. A number of medical authorities are outraged that during the stroke, when time was critical, he was sitting in a car being transported from the Negev to Jerusalem's Hadassah Ein Kerem. The explanation given was that they were more familiar with Sharon's treatment. However, it is completely possible that these were politically preferable doctors, given the scandalous disinformation they provided for Sharon's political benefit in the initial news conference.

Approximately 6 hours after IRIS, the New York Times is now apparently the second MSM source to confirm IRIS's original medical claims:

The huge stroke suffered last night by Prime Minister Ariel Sharon of Israel, caused by uncontrolled bleeding into the brain, is likely to be devastating and nearly impossible to treat because Mr. Sharon, 77, is taking blood thinners, neurologists say.

Although Mr. Sharon was taken to surgery to try to remove the blood pouring into his skull, it was a desperate move, neurologists said....Statistically, the likelihood of death is greater than 80 percent, Dr. Fink said.

"They are trying to save his life with surgery, but this is an extremely hazardous procedure," Dr. Fink said. "The goal is to save his life, but there is not much evidence that it will preserve neurological function."

Mr. Sharon was placed on blood-thinning medicines in the last two weeks to treat a different type of stroke - one that was much smaller - which he suffered on Dec. 18. In many respects his stroke yesterday was a medical complication of his earlier treatment.

IRIS's neurologist has just reported that he knows Dr. Fink to be the doctor who treated the Lubavitcher Rebbe, Menachem Mendel Schneerson.

Consider my dismissiveness toward the earlier headline "Sharon's Physician Says he Expects PM to Emerge from Surgery 'Safely'" in the light of this article. It is more than excessive optimism to make such a claim; it is preposterous. The question is whether this is more public disinformation or medical incompetence. In the context of the entire bungled episode, it is potentially scandalous.

Mere Rhetoric is now posting another source confirming our original post 5.5 hours earlier:

Walla is now reporting information that IRIS Blog posted four or five hours ago - blood thinners given to Sharon after his last stroke were reponsible for this one: (crude tranlsation) Dr Shtreifler (sp?) the head of the neurological department in Rabin's Medical Center claims that the shots Sharon got 'definitely did not help' his present condition. Another (anonymous) doctor said that there is a good chance that there is a connection between the blood thinners and current stroke.

Yet again, the MSM is far behind the blogosphere--it took approximately 20 times longer to get the story out (15 minutes vs. 5.5 hours).

6:27 am (Israel time): IRIS's neurologist source has just relayed an important point: high blood pressure makes a bleed more likely and Sharon had ample cause for tension at the time. The bleeding occurred shortly after television reports showed a police document containing alleged evidence of a $3 million bribe to Sharon.

6:33 am (Israel): Merely Rhetoric is reporting on the Channel 10 news conference, essentially confirming IRIS's headline of 6.5 hours ago: "the question is not whether Sharon will suffer permanent and irreversible damage, but how extensive that permanent and irreversible damage will be."

6:55 am (Israel): I just watched the televised surgical press announcement of Professor Mor-Yosef. Here are the significant points:

1. Sharon's blood pressure was significantly elevated when he arrived at the hospital, confirming my 6:27 am post.

2. A CT scan was done after the initial surgery showing more blood accumulation.

3. He is back in the operating room and expected to be undergoing surgery for several more hours.

4. His condition is "grave."

7:07 am (Israel) Mere Rhetoric has just posted the following:

CNN's Dr. Gupta just described the PM's situation as "dire", invoking the phrase "uncontrollable bleeding". He didn't directly blame the condition on the anti-clotting blood thinners that Sharon has been taking, but it seems like another example of what we've been hearing all day - that prescribing that medication to the PM was nothing short of criminally stupid (and by hearing, we mean reading - since IRIS blog was saying that five and a half hours before Hebrew outlets got it).

Note: I very much appreciate the credit for being ahead of this story, but my neurologist source never stated his objections in these strong terms. The issue was one of judgement, not negligence, at least given the limited medical information made public. Clearly the doctors took a calculated risk to be aggressive that proved disastrous, but the opposite could have been the case.

3:58 pm (Israel) Sharon is still struggling for life. Israel is entering into a period of national grief for the loss of their leader. Palestinians are, of course, celebrating with the traditional shooting in the air that frequently results in injuries and deaths as the bullets fall. The mainstream media will, of course, cover up this phenomenon.

The key moment while I slept, occurred at 10:47 am (Israel), when Mere Rhetoric reported the first truly honest report of Sharon's medical condition which was inserted, in passing, during a political discussion: "at the hospital, people told me that if a civilian had shown up to the hospital in Sharon's medical condition, he would have not have been treated. His condition was that bad. Mere Rhetoric was the acknowledged "blogger of record" on the Sharon medical tragedy. He did a fabulous job of immersing himself in the local and world media coverage and posted continuous updates. There was basically no candid revelation of the true medical situation by the news media until almost 11 hours into the crisis. IRIS revealed the medical truth after 15 minutes. The first definitive statement in the mainstream media that Sharon's political career had ended was apparently posted 3 hours and 10 minutes into the story. IRIS, on the other hand, published this after 15 minutes. I am speaking only of the first mainstream media (MSM) reports to get the story right. There was, of course, much misinformation and even disinformation such as "Sharon's Physician Says he Expects PM to Emerge from Surgery 'Safely.'"

4:50 pm (Israel): Yet again the blogosphere has run circles around the mainstream media (MSM) in terms of publishing accurate news information. On the three key elements of the Ariel Sharon medical story, the MSM took 13, 22, 43 and 80 times as long as IRIS. See this post for details: IRIS Scoops the MSM on Sharon Medical Crisis

6:55 pm (Israel): How Sharon's Medical Tragedy Happened

8:46 pm (Israel): Debunking the Sharon Brain Death Story

11:32 (Israel): YNet News is now confirming our neurologists post shown above: "Hadassah Ein Kerem director qualifies remarks, says Sharon's condition cannot be determined as long as he's anesthetized." This was published at 10:56, so again IRIS sccoped the MSM by two hours.

4 am (Israel-Jan. 6) The Jerusalem Post, echoing IRIS's commentary of 16 hours earlier, appears to be the first MSM source to suggest the possibility that the "recent reports of developments in the police investigations severely harmed his health."

7:20 am (Israel): The New York Times just published another problem with agressive anticoagulation:

When doctors examined him on Wednesday night, Mr. Sharon had complained of chest pain that could have resulted if part of a clot traveled to his lungs and another piece went through the hole to his brain. Or, if he had suffered a heart attack, a clot within the heart might have broken off to lodge in a brain artery. In either case, the anticoagulant therapy could have converted the clot into a hemorrhagic stroke.

14:20 am (Israel) Sharon's Condition Deteriorates
Rushed to Operating Room after CAT Scan.

5:36 pm (Israel): Hospital Director: "Indescribable Negligence" in Sharon Treatment

7:04 pm (Israel): Perspective Regarding the Sharon Treatment

See the IRIS Blog for the latest scoops regarding the Sharon tragedy

See these previous IRIS posts for context:

Sharon's Medical Team Disputes Clean Bill of Health

Sharon's Health Reporting Still a Farce

Welcome new readers. Here are some of my best previous entries:

Abbas Approves Reward Payments for the Family of Today's Suicide Bomber

John Bolton is Further Confirmation of Bush as the Best Appointer in History

Evidence the "Paris Riots" Are Actually the "French Intifada"

Prediction Confirmed: Israel Admits Rafah Security Deal was "Worthless"

Princeton Censors Ex-PLO Speakers; Likely to Hire PLO Professor

IRIS Exposes Reporters Stealing Others' Errors

Other bloggers covering the story heavily: Boker tov, Boulder, All Things Beautiful and The Political Pit Bull.

Click here for complete IRIS Sharon coverage.