South Dakota Senator Critical After Brain Surgery

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Johnson's Condition May Impact Balance of Power in Senate
By MARY CLARE JALONICK, AP

WASHINGTON (Dec. 14) -- Democratic Sen. Tim Johnson was in critical condition Thursday after late-night brain surgery, creating political drama about which party will control the Senate next month if he is unable to continue in office.

Meanwhile, U.S. Capitol physician said Johnson underwent successful brain surgery for an arteriovenous malformation, a condition which causes arteries and veins to grow abnormally large.

The Democratic Party holds a fragile 51-49 margin in the new Senate that convenes Jan. 4. If Johnson leaves the Senate, the Republican governor of South Dakota could appoint a Republican -- keeping the Senate in GOP hands with Vice President Dick Cheney's tie-breaking power.

A person familiar with Johnson's condition said the 59-year-old senator has an underlying condition that caused stroke-like symptoms and doctors will be watching him closely for the next 24 to 48 hours. The person spoke on condition of anonymity out of respect for the senator's family.

A person in George Washington University Hospital's media relations office early Thursday said the hospital was preparing to announce that Johnson's condition was critical. The employee, who declined to be identified because a formal statement was pending, would not describe the surgery.

The emergency surgery lasted past midnight Wednesday, and was disclosed by another official who spoke on condition of anonymity, citing the sensitive nature of the subject.

Apart from the risk to his health, Johnson's illness carried political ramifications, coming so soon after the Democrats won control of the Senate. If he were forced to relinquish his seat, a replacement would be named by South Dakota's GOP Gov. Mike Rounds.

A Republican appointee would create a 50-50 tie, and allow the GOP to retain Senate control.

Rounds' press secretary, Mark Johnston, said Thursday the governor was watching events and had nothing new to say.

"We're watching as much as everyone else," he said. "The most important thing is making sure Sen. Johnson is OK."

President Bush awoke Thursday to news of Johnson's condition, said first lady Laura Bush. "We're praying like I know all the people of South Dakota are for his very, very speedy recovery," Mrs. Bush told CBS's "Early Show."

Johnson, who turns 60 later this month, was admitted to George Washington University hospital at midday after experiencing what his office initially said was a possible stroke.

His spokeswoman, Julianne Fisher, later told reporters that it had been determined that the senator had suffered neither a stroke nor a heart attack.

But several hours after she spoke, Dr. John Eisold, the Capitol physician, called that into question with a statement of his own.

"Senator Tim Johnson was admitted to the George Washington University Hospital today with the symptoms of a stroke. He is currently under the care of physicians at the George Washington University Hospital."

Fisher and Eisold both said they did not intend to issue further updates on Johnson's condition until Thursday.

Johnson became disoriented during a conference call with reporters, stuttering in response to a question.

Before he ended the call, Johnson appeared to recover and asked whether there were any additional questions.

Fisher said he then walked back to his Capitol 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.

He was taken to the hospital by ambulance around noon, Fisher said.

"It was caught very early," she said.

In its earlier statement, Johnson's office had said he had suffered a possible stroke and was "undergoing a comprehensive evaluation by the stroke team."

Senate Democratic leader Harry Reid of Nevada went to the hospital to check on Johnson. He called Johnson a "dear friend to me and to all of us here in the Senate."

Johnson is up for re-election in 2008.

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 the Senate Republican Conference in 1972.

Johnson, who was elected in 1996, holds the same seat previously held by Mundt.

South Dakota Secretary of State Chris Nelson said there were no special restrictions on an appointment by the governor and a replacement would not have to be from the same political party.

Johnson, a centrist Democrat, was first elected to the Senate in 1996 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.

Johnson 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.

Associated Press writers Laurie Kellman and Natasha Metzler in Washington and Dirk Lammers in Sioux Falls contributed to this report.

[BettorsChat]

Doctor Calls Senator's Progress 'Encouraging'
By MARY CLARE JALONICK
AP
WASHINGTON (Dec. 15) - Sen. Tim Johnson was experiencing post-surgery swelling in his brain Friday, but his doctors said his recovery was still encouraging. They said he would remain hospitalized until the swelling went down.

The South Dakota Democrat , who suffered a brain hemorrhage Wednesday, remained in critical but stable condition Friday, just short of three weeks before the new Senate is to convene with his party holding control by a single vote.

The timing of his return is uncertain, but Democrats would still be in control of the Senate if his recovery period extends into the new session.

The surgery has been described as successful, relieving pressure on the 59-year-old senator's brain and stopping the bleeding.

"Considering his initial presentation, his progress is encouraging," Dr. Anthony Caputy, chairman of the George Washington University Hospital department of neurosurgery, said in a statement released by Johnson's office.

As a precaution, physicians placed a removable MRI-compatible filter in Johnson's vena cava, a large vein leading into his heart, to reduce the risk of a blood clot going to his lungs, said Dr. Anthony Venbrux, a cardiovascular specialist who participated in the surgery.

Johnson's doctors also disclosed that when he arrived at the hospital, he was feeling weakness on his right side. They said Friday that condition probably will require physical therapy as part of his recovery.

Johnson was rushed to the hospital at midday Wednesday after becoming disoriented and stammering during a conference call with reporters. He was diagnosed with arteriovenous malformation, or AVM, a condition that causes arteries and veins to grow abnormally large, become tangled and sometimes burst. The condition often is present from birth.

Caputy said postoperative swelling is routine after a brain hemorrhage.

"Much like a bruise, it takes time to heal," he said.

Johnson's office said the senator had had several CT scans since the surgery.

"His most recent CT scan shows that the pressure has been relieved from his brain and there is no further bleeding," said Dr. Vivek Deshmukh, who headed the surgical team.

Sen. Tom Carper, D-Del., visited Johnson Friday and told reporters outside the hospital that the senator was sedated.

Carper said he was not allowed into Johnson's room but talked to the family in a holding room. He speculated that Johnson would be sedated "probably into the weekend, maybe through the weekend."

Former Sen. Tom Daschle, D-S.D., also visited Johnson Friday and said his former colleague had had "another good day" and was doing better than on Thursday.

Johnson's office offered more details Friday about Johnson's responses to stimulation as small, but significant signs of his recovery. For example, he opened his eyes when his wife, Barbara requested him to a few hours after the surgery, and then reached out to hold her hand, said Julianne Fisher, a spokeswoman for the senator.

"That's very encouraging," Dr. Wouter Schievink, chief of neurovascular surgery at Cedars Sinai Medical Center in Los Angeles, said of the senator's responses and CT results.

Dr. Elliot Roth, medical director of the Rehabilitation Institute of Chicago, said the signs sound "like a reasonable course of recovery."

Among the next questions are whether Johnson has difficulty with speech or language or any other cognitive problems that doctors could detect only when he is able to verbally answer questions.

"We're used to seeing recovery take place over very long periods of time," Roth cautioned. "The more recovery there is during the early stages, the more likely it is that there will continue to be recovery, but the actual course and pattern and outcome really varies patient to patient."

The White House also offered hopes and prayers for Johnson. "This is a time to pray for Tim Johnson's health, and I'll leave it to others to start doing political calculations," said press secretary Tony Snow.

South Dakota Gov. Mike Rounds, a Republican , would be charged with appointing a replacement if Johnson were to leave office. 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.

There's ample precedent for senators to continue to hold office while incapacitated. Unless Johnson's seat is vacated by his death or resignation, Democrats would retain the majority. If Johnson is unable to attend Senate sessions, Democrats would have operating control of the chamber with 50 votes _ 48 Democrats and independents Bernie Sanders of Vermont and Joe Lieberman of Connecticut _ while Republicans would have 49 members.

Even if Johnson were to vacate his seat next year, control would not switch automatically unless Senate leaders addressed the issue in a usually obscure organizing resolution passed at the beginning of each two-year Senate term.

In 2001, when Republicans controlled a 50-50 Senate with Cheney's tie-breaking vote determining control, then-Minority Leader Daschle orchestrated passage of an organizing resolution that specified control of the Senate would automatically shift if Democrats obtained a majority.

At the time, speculation focused on the possibility that the elderly and frail Strom Thurmond, R-S.C., might die in office and be replaced by a Democrat. Instead, it was Vermont Republican Jim Jeffords' switch to an independent sitting on the Democratic side that gave Democrats control later that year.

Don Stewart, spokesman for GOP leader Mitch McConnell of Kentucky, said that Republicans were not seeking comparable language in the upcoming organizing resolution. McConnell and Reid had already started negotiating the pact and Johnson's situation had not affected those talks, Stewart said.

Associated Press writers Laurie Kellman, Natasha Metzler, Andrew Taylor and Lauran Neergaard in Washington, Dirk Lammers in Sioux Falls and Chet Brokaw in Pierre contributed to this report.