Democratic senator in critical condition after emergency brain surgery

12/14/2006

WASHINGTON Democratic Sen. Tim Johnson lay in critical condition today after undergoing emergency overnight surgery to repair bleeding inside his brain, raising questions over whether his illness could cost Democrats their newly won control of the Senate.

The South Dakota lawmaker, 59, was recovering without complication, the U.S. Capitol physician said. Johnson suffered from a hemorrhage in his brain caused by a rare and sometimes fatal condition. Specialists said it could take days to wake up after such surgery.

Johnson was stricken as Democrats prepared to take fragile 51-49 control of the new Senate when it convenes in three weeks. Democrats seized control of both chambers of Congress from Republicans in November midterm elections.

If Johnson were to leave office, a replacement would be named by South Dakota s Republican governor, Mike Rounds. A Republican appointee would create a 50-50 tie and effectively allow the GOP to retain Senate control because of Vice President Dick Cheney s tie-breaking vote.

Johnson was rushed to the George Washington University Hospital at midday Wednesday after becoming disoriented and stammering during a conference call with reporters.

Adm. John Eisold, the Capitol physician, said doctors stopped bleeding in Johnson s brain and drained the blood that had accumulated there.

It is premature to determine whether further surgery will be required or to assess any long-term prognosis, Eisold said.

This afternoon, Johnson underwent an additional procedure to check for blood clots. The procedure is standard after surgery, said Julianne Fisher, Johnson s spokeswoman. Otherwise, she said, there were no new developments.

No news is good news, she said.

Johnson s condition, also known as AVM, or arteriovenous malformation, causes arteries and veins to grow abnormally large, become tangled and sometimes burst. The condition is often present from birth.

Johnson spokesman Noah Pinegar said the senator s diagnosis was a surprise. No one was aware of it, including Tim, he said.

Sen. Harry Reid, D-Nev., who is to become majority leader when the new Senate convenes on Jan. 4, said, We re all praying for a full recovery. We re confident that will be the case.

Reid, who visited Johnson at the hospital Wednesday night and again this morning, told reporters the senator really looks good. However, Reid declined to provide any details of Johnson s medical condition.

Politically, there isn t a thing that s changed, he said.

The Republicans selected their committees yesterday. We ve completed ours, Reid said. He said he was keeping incoming Senate Republican leader Mitch McConnell of Kentucky totally advised of developments.

Outgoing Senate Majority Leader Bill Frist, R-Tenn., visited the hospital this afternoon.

Senate historian Donald Ritchie said senators serve out their terms unless they resign or die. He said there was precedent for senators remaining in the Senate even though illness kept them away from the chamber for long periods.

Just this year, Sen. Jay Rockefeller, a West Virginia Democrat, missed three months of votes because of back surgery. Sen. Joseph R. Biden Jr., D-Del., was away for seven months in 1988 after undergoing surgery for brain aneurysms.

In 1969, another South Dakota senator, Karl Mundt, a Republican, suffered a stroke while in office. Mundt continued to serve until the end of his term in January 1973, although he was unable to attend Senate sessions and was stripped of his committee assignments by fellow Republicans in 1972.

The White House offered best wishes.

Our prayers are with Senator Johnson, said White House Press Secretary Tony Snow. Look, he s a great guy, and it s one of these things where everybody s concerned and our thoughts and prayers are with him, his family, his staff, his colleagues.

Johnson, who turns 60 in two weeks, was taken to the hospital by ambulance after experiencing what his office initially said was a possible stroke.

In a conference call with reporters, Johnson at first had answered questions normally but then had begun to stutter. He paused, then continued stammering before appearing to recover and ending the call.

Johnson spokeswoman Fisher said that after making the call from the recording studio in the basement of the Capitol, the senator walked back to his office but appeared to not be feeling well.

The Capitol physician came to his office and examined him, and it was decided he should go to the hospital.

Arteriovenous malformation is believed to affect about 300,000 Americans, according to the National Institute of Neurological Disorders and Stroke. The institute s Web site said only about 12 percent of those have any symptoms. The symptoms, which range in severity, can include severe headaches, memory loss and dizziness.

It s common to take several days for someone to wake up after AVM surgery, said Dr. Sean Grady, neurosurgery chairman at the Hospital of the University of Pennsylvania. Someone who is awake and alert and talking in the first day or two typically has a shorter recovery in the range of 4 to 8 weeks, he said. If it takes longer to wake up, it in turn takes more months to recover.

We wouldn t make any immediate long-term prognoses for at least one to two days, he cautioned. There can be a period of time where the brain is still swollen and the patient may have trouble responding.

The senator s wife, Barbara Johnson, said the family is encouraged and optimistic.

A person familiar with Johnson s situation said surgery began late Wednesday night and ended around 12:30 a.m. today and that the next 24 to 48 hours would be critical in determining Johnson s condition. The person spoke on condition of anonymity out of respect for the senator s family.

In South Dakota, gubernatorial press secretary Mark Johnston said today that Rounds had nothing new to say. We re watching as much as everyone else, he said.

The governor, elected to a second four-year term last month, has been widely seen as the Republican candidate with the best chance to challenge Johnson in two years.

Other than Rounds himself, top possibilities if a replacement senator were needed include Lt. Gov. Dennis Daugaard and state Public Utilities Commission Chairman Dusty Johnson, considered a rising star in the Republican Party. Retiring GOP legislative leaders, such as state House Speaker Matthew Michels and Senate Majority Leader Eric Bogue, also might be considered.

Johnson was first elected in 1996 and is up for re-election in 2008.

The last time the Senate convened with a perfect balance of 50 Republicans and 50 Democrats was in January 2001. Then, the two parties struck a power-sharing agreement that gave control of the Senate to Republicans but gave Democrats equal representation on committees.

That arrangement lasted only until June 2001, when Vermont Republican James Jeffords became an independent who chose to vote with Democrats on organizational matters, giving Democrats control until Republicans won back the Senate in the 2002 midterm elections.

Johnson, a centrist Democrat, was elected to the Senate after serving 10 years in the House. He narrowly defeated Republican John Thune in his 2002 re-election bid. Thune defeated Sen. Tom Daschle, the former Senate Democratic leader, two years later.

Daschle visited Johnson in the hospital today along with Reid.

Johnson is in line to become chairman of the Senate Ethics Committee.

He underwent prostate cancer treatment in 2004, and subsequent tests have shown him to be clear of the disease.

Johnson is the second senator to become ill after the Nov. 7 election. Wyoming Sen. Craig Thomas, a Republican, was diagnosed with leukemia on Election Day. He is back at work.

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