Ariel Sharon started breathing on his own Monday and moved his right arm and leg in response to pain stimulation in what his surgeon called an important development. But it will be days before doctors can determine whether he is lucid or will be able to return to the job.
"The prime minister is breathing spontaneously," said Dr. Shlomo Mor-Yosef, the director of Hadassah Hospital, adding that the movements of Sharon's arm and leg marked "a slight but significant improvement."
Sharon's response is a "very important" sign and indicated his brain stem is working, said his chief surgeon, Dr. Felix Umansky, briefing reporters for the first time.
It is still too early, however, to assess what impact the massive bleeding he suffered in his right brain would have on his abilities to think and reason or on the left side of his body, Umansky said.
"We are just at the beginning of a very long way," the surgeon said. "It's too early to talk about the cognitive issue."
A final medical analysis on Sharon's long-term prognosis would end days of uncertainty over the fate of the 77-year-old prime minister, heralded by many as the best hope for Mideast peace. Doctors said his chances of survival are better, but he is far from out of danger.
He remains hooked up to a respirator and unconscious in a guarded room where classical music is being played.
More clarity as to Sharon's condition might enable his new, centrist Kadima Party to select a successor and start campaigning for March 28 elections. Acting Prime Minister Ehud Olmert — Sharon's ally and a proponent of unilateral withdrawals from more Palestinian-claimed lands — is seen as the most likely heir.
The Palestinians' political future, which was to be decided in Jan. 25 parliament elections, also appeared in limbo.
Palestinian leader Mahmoud Abbas reiterated Monday that the vote would take place on time, but Palestinian Interior Minister Nasser Yousef that warned his security forces would not be able to protect polling stations against gunmen. Some have worried that gangs from Abbas' Fatah Party may attack polling stations if Fatah appears to be losing to the Islamic militant Hamas party.
Sharon has been in a medically induced coma since his massive stroke Jan. 4. Doctors plan to continue lowering the level of sedatives in his body over the next several days, Mor-Yosef said.
Sharon has not yet opened his eyes. His doctors hope he will when the sedative levels are lowered further, though outside experts cautioned there was no assurance he would wake up at all.
"His chances of survival are better than if the respiratory center had been damaged, but that still doesn't mean he's going to survive," said Dr. John Martin, a professor of cardiovascular medicine at University College in London. He said Sharon's weight and age worked against him.
Israel TV's Channel 2 quoted Sharon's advisers, who are keeping watch by his side, as saying he also responded to words in some fashion, though they weren't specific.
Doctors had kept Sharon in an induced coma to help him recover from the stroke and brain surgeries, and Umansky said the doctors could put Sharon under again if his condition worsens.
The doctors' final assessment on Sharon's brain damage, whenever it comes, will be presented to Attorney General Meni Mazuz, who will decide whether to declare the prime minister permanently incapacitated.
In the event of such a ruling, the Cabinet would have to elect a prime minister within 24 hours, from among the five sitting Kadima Cabinet ministers who are also lawmakers, said Justice Ministry spokesman Yaakov Galanti.
Olmert, who is among the five, was named acting prime minister after Sharon's stroke, and can serve in the role for 100 days, which would carry him through the elections.
The uncertainty over Sharon's condition has unsettled Israelis, who have been anxiously following news updates. At the entrance to the hospital Monday, three Jerusalemites hung up a white sheet with blue lettering in English and Hebrew that read, "Ariel Sharon, there is more to do, please wake up."
In the Gaza Strip, where Sharon is reviled for his tough policies on Palestinians, 40 masked gunmen from the Al Aqsa Martyrs' Brigades militant group held a demonstration against the Israeli prime minister. One held a gun to a photo of Sharon that was labeled "the killer of children" and then burned the picture.
Before Sharon's stroke, he had been expected to handily win re-election in March, then use his third term to try to draw Israel's final borders by pulling out of large parts of the West Bank and completing a separation barrier with the Palestinians.
Former US President Clinton said Sharon's stroke is a blow to peace efforts. "All of us who believe in peace in the Middle East are in his debt, and so more than anything else, I pray for his health," he said.
Iran's supreme leader, Ayatollah Ali Khamenei, said Monday that Sharon's death would be a serious defeat for United States policy in the Middle East, state-run radio reported.
"The Americans have been defeated in Palestine since the butcher of the Palestinians, who intended to destroy the Palestinian Intifada, has come to his end," the radio quoted Khamenei as saying to a group of visitors.
On Thursday Iran's hard-line president Mahmoud Ahmadinejad said he hoped for the death of Sharon.
Amid uncertainty over Sharon, US Secretary of State Condoleezza Rice was sending two envoys to the Middle East to try to resolve an Israeli-Palestinian dispute over the participation of Arab residents of Jerusalem in the Palestinian parliament election.
Abbas has said such participation is a requisite for holding the election, and he said Monday he had received US assurances Palestinians would be able to vote in the city, despite Israeli opposition.
Earlier Monday, Israel allowed campaigning in Jerusalem, a conciliatory step, but said it has not yet decided whether to permit voting.
(Chinadaily.com via agencies January 10, 2006)