Doctors to Revive Sharon and Assess His Condition

Doctors said early today that they planned to begin reviving Israeli Prime Minister Ariel Sharon, a procedure that could provide the best opportunity thus far to assess the extent of brain damage he suffered because of a massive stroke.

The 77-year-old prime minister, who has remained in a medically induced coma for four days, continued today in critical but stable condition, as doctors set out to begin easing his sedation and testing his responses.

“This is what we are all waiting for since Wednesday: to know how the prime minister’s brain is functioning,” Dr. Shlomo Mor-Yosef, director of the Hadassah University Medical Center, told reporters Sunday during a daily briefing outside the hospital.

Mor-Yosef said a brain scan Sunday showed that swelling in Sharon’s brain had continued to subside slightly. Other vital signs such as blood pressure and pulse rate were “within the norm,” he said, and there were no indications of fever or infection.

Sharon has hovered near death, connected to a respirator, since suffering a massive cerebral hemorrhage late Wednesday, and has undergone three delicate brain surgeries in the time since. Though he may survive, Sharon is not expected to return to his job as head of the Israeli government.

“The [medical] team has decided to begin reducing the prime minister’s sedation tomorrow morning, given of course that no significant changes occur” overnight, Mor-Yosef said Sunday. “The process will begin of decreasing the level of sedation and testing the prime minister’s neurological functions.”

Another hospital spokesman early today announced that Sharon’s condition remained unchanged, and the procedure would go ahead as planned.

Mor-Yosef previously said the right side of Sharon’s brain appeared to have been damaged, but the left side, which controls speech, was “intact.”

Acting Prime Minister Ehud Olmert on Sunday presided over the first regular Cabinet meeting without Sharon, whose tan leather chair was left empty at the table where the ministers gathered.

Attempting to project a business-as-usual image of calm and governmental stability, Olmert delivered a planned report on Israel’s economic performance for 2005. Olmert is finance minister as well as being one of Sharon’s closest allies, and officials are keen to reassure foreign investors and prevent a collapse of the Israeli stock market.

But the void left by Sharon -- in all fields, including domestic politics and efforts to make peace with the Palestinians -- has been enormous. In the government, he held 12 ministerial posts, and Olmert will eventually have to figure out how to divvy them up.

Olmert told the Cabinet that he hoped his tenure as substitute prime minister would be brief and called on Israelis to pray for Sharon, known to his friends as Arik.

“I imagine that if I could speak to Arik this morning and ask him, ‘Arik, what would you say? What would you want us to do?’ he would say, ‘I appreciate your concern for my health, thank you. But there is work to do.’

“And that is what we are doing,” Olmert added.

Israel also faces an election March 28, a poll that Sharon was expected to win handily with his newly created centrist party, Kadima. His stroke has thrown Israeli politics into disarray. One potential showdown was averted Sunday, however, when former Prime Minister Shimon Peres, the last of the nation’s founding generation still in politics, endorsed Olmert to replace Sharon as Kadima’s candidate for prime minister.

Speaking on CNN’s “Late Edition” program, Peres, 82, ended speculation that he might return to the Labor Party that he abandoned to support Sharon, or that he would challenge Olmert for Kadima’s leadership.

Doctors at Hadassah used heavy sedation to place Sharon in a coma, a common treatment for severe cerebral trauma because the comatose state reduces intracranial pressure, eases demands on the brain and reduces the brain’s need for blood and oxygen.

Awakening a patient in this condition is delicate and must be done gradually to avoid side effects including an abrupt rise in blood pressure, said Dr. Azriel Perel of Tel Hashomer Hospital near Tel Aviv. The process can take hours; as the patient rouses, doctors give simple commands, such as “raise your arm,” to determine whether he hears, comprehends and can move.

“It is not a nanosecond, defining moment, an on/off-switch situation, and I think curiosity should not be a factor in expediting the process,” Perel told Army Radio. The process can be stopped or reversed if doctors determine Sharon is not responding properly or experiencing new trauma. And there is no guarantee that Sharon will wake up, doctors said.