Israeli Prime Minister Ariel Sharon suffered a massive and life-threatening cerebral hemorrhage Wednesday evening and was rushed into all-night emergency surgery in a desperate attempt to halt extensive bleeding. The reins of national leadership were handed over to Deputy Prime Minister Ehud Olmert.
The 77-year-old prime minister's medical team painted a picture of a life-and-death struggle, saying he was in intensive care after nearly eight hours of surgery. Doctors managed to stem bleeding in several areas of his brain, and Sharon's vital signs had stabilized, but prospects for a full recovery were seen as virtually nil.
The medical crisis surrounding the prime minister threatened to trigger political turmoil as well. Israel is less than three months away from general elections, and Sharon is the linchpin of a new centrist party that holds a commanding lead in the polls.
Without him, the new party, called Kadima, or Forward, could falter, clouding hopes for a far-reaching accord with the Palestinians. Following up on Israel's withdrawal this summer from the Gaza Strip, Sharon has said his party's next order of business will be determining the shape of a Palestinian state.
The prime minister suffered the severe hemorrhagic stroke on the eve of a scheduled medical procedure to repair a congenital heart defect, a small hole that was thought to have contributed to a minor stroke Sharon suffered Dec. 18. Since then, he had been treated with blood thinners to inhibit the formation of clots such as the one that blocked a vessel in his brain and caused his first stroke.
Although significantly overweight, Sharon had until now been considered in generally good health. He returned to a full working schedule within days of his previous hospitalization and seemed lively and vigorous in government meetings and public appearances, joking often about doctors' demands that he go on a diet.
Even after his recent health scare, he was imbued, in the minds of many Israelis, with an aura of indestructibility -- one in keeping with his longtime nickname, "the Bulldozer."
Sharon himself seemed to think he could handle the demands and pressures of his office indefinitely. In a speech hours before his collapse, he hailed Israel's improving economy, none too modestly crediting his own policies for it.
"I don't intend to hand this job over to anyone else!" he said with a laugh.
Sharon began feeling ill while spending Wednesday evening at his Negev desert ranch with his sons and several associates, with symptoms variously reported as weakness and chest pain. His personal physician, Shlomo Segev, who was visiting to discuss the following day's scheduled procedure, urged that the Israeli leader be taken to the hospital.
Sharon and a small entourage that included his sons Omri and Gilad made the 90-minute trip via an armored ambulance that is on permanent standby at the prime minister's Sycamore Ranch, arriving at Jerusalem's Hadassah Ein Kerem hospital shortly before 11 p.m.
Israeli television stations carried live footage of the motorcade speeding through the darkness toward Jerusalem. Sharon was carried into the trauma unit on a stretcher.
It was not immediately clear why it was decided to transport the prime minister to Jerusalem instead of to Soroka hospital in the southern town of Beersheba, only a few miles from his ranch, or why a helicopter was not used.
Israeli media reports said that a helicopter had initially been summoned but that Segev had decided the situation was not urgent. Initial reports even said the prime minister had been able to sit up during the ride to the hospital.
A short time after Sharon arrived at the Jerusalem medical facility, a somber-faced Dr. Shlomo Mor-Yosef, the director-general of Hadassah hospital, appeared before the cameras to announce that Sharon had suffered a major stroke, had been sedated and was receiving breathing assistance. After undergoing a brain scan, the Israeli leader was swiftly rolled into surgery, where a team that included two neurologists attempted to stem the bleeding from the hemorrhage.
Although it was nearly midnight when the news of Sharon's hospitalization broke, word spread almost instantaneously throughout the country. In the streets of Jerusalem and Tel Aviv, the blue lights of television screens could be seen in countless apartments and houses, flickering into the predawn hours.
Israel's chief rabbis urged citizens to recite psalms and ask God to guard Sharon's health.
In Washington, President Bush praised Sharon as "a man of courage and peace" and said in a written statement that he and First Lady Laura Bush were praying for the prime minister's recovery.
"On behalf of all Americans, we send our best wishes and hopes to the prime minister and his family," the statement read.
Bush was briefed about Sharon's condition in the late afternoon by his national security advisor, Stephen Hadley, a White House spokesman said.
U.S. officials involved in Middle East issues have closely followed news bulletins on Sharon's health and agreed that on a political level, the premier's latest stroke added one more question mark to a situation already laden with uncertainty.
"It's become a cliche to say that this is such a sensitive time in the region and for the peace process, but the reality is that it's true," said a senior official, who declined to be identified by name because he was not authorized to speak on the issue. "Things were already uncertain there, but this adds to the uncertainty."
As they customarily do in times of crisis, Israelis overloaded the regional cellular-phone network and local Internet servers with calls and e-mails to exchange the latest snippet of news.
Adding to the air of tumult and drama, paramilitary border police and soldiers fanned out, forming a tight security perimeter around the hospital -- and around Olmert's residence in Jerusalem.
Cabinet Secretary Yisrael Maimon told journalists at the hospital that the prime minister's leadership authorities had been transferred to Olmert, a longtime Sharon confidant and former Jerusalem mayor whose position as deputy prime minister places him first in the line of succession.
Israel's Cabinet was to meet in special session today, a gathering to be convened by Olmert, at which the 60-year-old official is expected to formally assume Sharon's duties.
Without Sharon as leader, the new Kadima party's prospects would be much more uncertain in the upcoming election.
Olmert, while considered solid and capable, has nowhere near the personal following that Sharon enjoys, and other senior figures in the movement, such as Shimon Peres, are considered too closely associated with either the left or the right.
No transfer of power took place during Sharon's previous stroke, even though doctors later said he had probably been incapable of decision-making for about an hour. At the time, it set off anxious debate about the ambiguity of Israeli legal protocols on the transfer of power.
Mindful of that, Sharon's aides had announced in advance that Olmert would assume control during Sharon's scheduled heart procedure today, because Sharon would be under general anesthesia.
Olmert's assumption of duties, which came on the orders of Atty. Gen. Menachem Mazuz, marks the first time an Israeli prime minister has been legally declared incapacitated, even temporarily, due to illness or injury.
The transfer of prime ministerial powers is not without precedent in modern Israeli history, however. Prime Minister Levi Eshkol died in office in 1969 and his deputy served as acting prime minister for a month, until Golda Meir was elected. In 1995, Peres, then foreign minister, became acting prime minister after the assassination of Yitzhak Rabin.
Israeli law calls for elections within 100 days of the prime minister's death or incapacitation, but legal analyst Moshe Negby said that because balloting was already scheduled for March 28, no further action would be required.
Outside medical authorities said the aftermath of a cerebral hemorrhage such as the one suffered by Sharon was fraught with danger. Dr. Jonathan Halevy, the director of Jerusalem's Shaare Zedek hospital, said any stroke in which the patient required breathing assistance afterward suggested damage to a vital brain center.
Halevy said based on the information given by Sharon's doctors, he would assess the situation as "grave, to say the least."
"The prime minister is dealing with nothing less than a catastrophe, fighting for his life," Halevy told Israel's Channel One television.
Medical authorities said the blood thinners with which the prime minister was treated to prevent a clot could have increased the risk of bleeding in the brain.
The procedure Sharon was to have undergone today involves the use of a catheter to guide a tiny umbrella-like device into place. It would have been used to patch a hole measuring about one-eighth of an inch in the upper chamber of his heart. Doctors said a blood clot apparently slipped through that opening and lodged in Sharon's brain, causing his Dec. 18 stroke.
It was not known at what point Sharon suffered the cerebral hemorrhage -- while he was still at his ranch, while en route to Jerusalem, or after his arrival at the hospital.
An initial statement from the prime minister's office, though terse, was not particularly alarmist.
"Prime Minister Ariel Sharon this evening went to Hadassah Ein Kerem hospital in Jerusalem after feeling ill," it said. "He is fully conscious and is with his personal physician."
But as the night wore on, the notion seemed to sink in that even if Sharon survived the hemorrhage, he could be impaired to the point that he ceased to be a force in Israeli politics. News anchors adopted somber and stately tones usually associated with the gravest of national crises.
Few politicians could have weathered the political storms Sharon has encountered over the last two years. The patron of the movement to settle the West Bank and Gaza Strip with Jews, he was reviled by his onetime allies on the political right when he conceived a plan to unilaterally relinquish Gaza after a 38-year Israeli military occupation.
Despite death threats from the far right, and the furious opposition from many in his conservative Likud Party, Sharon pushed ahead with the withdrawal of Israeli troops and nearly 9,000 Jewish settlers from Gaza and a small swath of the northern West Bank.
Through it all, Sharon expressed sympathy for the settlers but was implacable in his determination to remove them.
In the aftermath, however, the rift between Sharon and his onetime allies was too great, and in November the prime minister acknowledged the reality of that divide.
He abandoned the Likud Party he helped found nearly three decades ago and spearheaded the formation of Kadima, which immediately drew supporters from across the political spectrum. In the latest polls, it was forecast to pick up at least 42 seats in the 120-member Knesset, or parliament, and when he was stricken, Sharon was working with aides on the party's slate of candidates.
Political analysts, while expressing shock and sadness at the turn of events, were already weighing the ramifications of a post-Sharon era.
"The race for prime minister, which until Wednesday looked like Sharon's one-man show, is now open," commentator Aluf Benn wrote in today's editions of the Haaretz newspaper.
Times staff writers Paul Richter and Tyler Marshall in Washington contributed to this report.
BEGIN TEXT OF INFOBOX
From commander to politician
* Born: Sharon was born Ariel Scheinerman on Feb. 27, 1928, at Kfar Malal, a cooperative farm in what was then British- administered Palestine.
* Education: He dropped out of university to join the Alexandroni Brigade in Israel's 1948 War of Independence.
* Career: Commanded Armored Reserve Division 138 in the 1967 Middle East War. Chief of the Southern Command in 1969. Retired from the army in 1973 and spearheaded formation of the Likud Party. Reentered the military and commanded an armored division in the 1973 Yom Kippur War. Elected to parliament in 1974. Resigned. Appointed security advisor to Prime Minister Yitzhak Rabin in 1975. In the late 1970s concentrated on establishing settlements across the occupied West Bank and Gaza Strip, raising Palestinian ire.
Served variously as minister of agriculture, defense, industry, housing and construction, infrastructure and foreign affairs.
Became prime minister in 2001. Left Likud and formed Kadima party last year.
* Personal: His first wife, Margalit, died in a car accident in 1962. A year later, he married her younger sister, Lily. Lily died of cancer in March 2000. In 1967, Sharon's only son by Margalit, Gur, died when a playmate accidentally shot him in the head. Has two sons, Omri and Gilad, by Lily.