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Israel's Prime Minister Undergoes Emergency Surgery; Sole Survivor of Mine Disaster Battles for Life

Aired January 06, 2006 - 13:21   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

KYRA PHILLIPS, CNN ANCHOR: President of the United States with his economic speech there at the Economic Club in Chicago, Illinois.
Hello, everyone. I'm Kyra Phillips at the CNN center. And you've been watching the president's speech there at the Economic Club. His remarks are part of a team effort today by the administration to talk up the economy. Members of the Bush cabinet are making the case at stops all around the country.

CNN's Ali Velshi watched the president speak along with the rest of us. He's standing by now in Washington. Obviously focusing on the importance of tax cuts. We heard a lot about that, Ali Velshi. And of course, that leads us to want to know: more jobs, healthier economy?

ALI VELSHI, CNN CORRESPONDENT: And you know, I've got to tell you after the way that 2005 ended for this administration, this sounded confident. This sounded like what you're going to see a lot of this year in terms of campaign speeches.

Kyra, you and I have listened to the president talk about the economy many times together. And one of the things that often comes out of it is that he touches on a lot of topics. They seem very broad and sometimes missing focus. There was a lot of focus today, and while he touched on a lot of things, including the fact that the unemployment numbers are now down to 4.9 percent as a national average. And we created two million jobs in the United States in 2005.

He talked about tax cuts. Back in 2001 and 2003, this administration put forward a massive package of tax cuts: income tax reductions, lowering of taxes on capital gains and on dividends, repealing of the death tax. All of these things some say, the White House says, and some economists say have contributed to the strength of this economy that the president is touting.

Well, a lot of those things expire. Some expire in 2008. Some expire in 2010. And what a lot of members of Congress have been telling the president is get out there and tout this economy. Talk about how well this economy is doing so that we can get reelected. If they get reelected, the president gets to extend those tax cuts. He wants them made permanent.

He says anybody who refuses to extend those tax cuts is, quote, "Saying the equivalent of 'We're going to raise taxes on you'." That's a theme you are going to hear a lot about, Kyra. PHILLIPS: All right. We'll talk more about it the next couple of hours.

VELSHI: Yes.

PHILLIPS: Ali Velshi, thank you so much. We're going to take a quick break. More LIVE FROM right after this.

(COMMERCIAL BREAK)

PHILLIPS: Well, another crisis, another operation, same grim but uncertain prognosis for Ariel Sharon.

The Israeli prime minister has undergone a third round of emergency surgery aimed at stopping bleeding and decreasing pressure on his brain. Today's procedure lasted more than four hours, after which hospital officials reported significant improvement in all the relevant tests.

Now aside from draining blood and other fluids, surgeons also removed clots that resulted from nine hours of surgery earlier yesterday. But improvement is a relative term. Sharon remains in critical condition. And barring further setbacks, will stay in a drug-induced coma at least until Sunday.

My colleague, Wolf Blitzer, following Sharon's condition from a city that he knows very well. That was his beat.

Wolf, has his condition changed at all since we last talked?

WOLF BLITZER, CNN ANCHOR: Well, when we got up this morning it seemed like it had deteriorated. They really had hoped that he would emerge from this induced coma Saturday or Sunday. And then they would do a CAT scan and see how he was doing and begin to try to wake him up a little bit.

When they did a CAT scan this morning they saw there was considerable pressure on the brain, considerable breeding -- bleeding. The hemorrhaging was continuing. They didn't want to have to do surgery again. But they went in for another four or five hours of surgery.

The doctor emerged later and said it's stabilized somewhat. And maybe it's improved a little bit. But it's not good, Kyra. It's a very, very bad situation. And everyone here in Jerusalem recognizes that.

PHILLIPS: We're going to talk more about his condition with a neurosurgeon in just a minute, Wolf. But I just want to take a second to talk about your interview with Ariel Sharon. You had a chance to sit down with him and go one on one. And I remember specifically a question you asked about his concern about a civil war breaking out in Israel. And this is what he told you.

(BEGIN VIDEO CLIP) ARIEL SHARON, PRIME MINISTER OF ISRAEL: I mentioned the atmosphere in Israel. I would say the atmosphere is an atmosphere that looks like an eve of civil war. But I can tell you that I'm going to take every step in order that things like that will not happen.

BLITZER: When you say a civil war, you mean Israeli Jews fighting Israeli Jews? That would be almost unheard of in Israel.

SHARON: I would say during the last revolt against the Romans.

BLITZER: That was, you know...

SHARON: That was some years ago.

(END VIDEO CLIP)

PHILLIPS: And Wolf, considering that Ariel Sharon may no longer be prime minister. I wonder what -- how he would respond or how others would respond to that question that you asked him about civil war?

BLITZER: Well, you know, it's interesting, Kyra, that he was referring to the last revolt against the Romans. That was, what, 2,000 years ago here in Jerusalem.

He was the one even before we had sat down at Blair House, across the street from the White House, when he was there in April of last year to meet with President Bush. He had been the one who spoke about the atmosphere of a civil war. And I pressed him to try to understand what he was talking about.

He was really concerned that his decision to uproot Jewish settlers, 8,000 or 9,000 from Gaza as a result of Israel's withdrawal from Gaza, that that would spark the kind of animosity, the hatred, the fighting even among Israeli Jews. And he was very worried about that.

Now he went forward with his commitment. The withdrawal took place, and it was a lot more organized. Peaceful, less violent than a lot of people had feared, which was all positive. But he was very worried about that.

And especially given the fact that he was one of the architects, Kyra, over the years of Israel's settlement policies, Israel's housing minister, later as defense minister.

It was a very painful moment for him. But he became more pragmatic as is Israel's prime minister than he had earlier showed a capability of being another cabinet minister or as an opposition leader.

PHILLIPS: And wolf, as I mentioned, of course, we all know this was your beat for a number of years, and I asked you what other interviews you've done with other prime ministers. I was expecting maybe one or two. But you gave me the list, Yitzhak Rabin, Golda Meir, Menachem Begin, Ehud Barak. I'm curious, you met all those other prime ministers, you interviewed them. What do you think the biggest difference is between or among those and Ariel Sharon, with regard to being a progressive prime minister?

BLITZER: All of them emerged as leaders in Israel, and took steps that they really did not think they would be able to take before they became prime minister. But once you're sitting there in the prime minister's office, and you have the responsibility, the awesome responsibility, of leading this country. It's a small country surrounded potentially by lot of hostile adversaries, you have to be pragmatic. Menachem Begin, for example, was willing to give up the Cyanide Peninsula and establish a peace treaty with Egypt, making concessions which few thought he would have been able to make, and that was an impressive gesture that he made in the Camp David Accords that he signed with Anwar Sadat and Jimmy Carter back in 1978 and the peace treaty in '79.

And even Ehud Barak, Sharon's immediate predecessor. At the Camp David Accords, negotiations that he tried to work out under Bill Clinton, in the final months of Bill Clinton's administration in 2000. They were very close, but not close enough. It went pretty far ahead in trying to make concessions to Yasser Arafat that eventually did not pan out. And the second intifada basically erupted.

But all of them basically indicated a readiness to make concessions given the political environment here in Israel that few had thought they would be willing to make going into office. Sharon was no different.

PHILLIPS: Wolf Blitzer live from Jerusalem. Wolf, we'll check in with you throughout the next couple of hours and throughout the day. Thanks, Wolf.

Well, it's understood that Sharon's true condition and prognosis can't be known until doctors wean him off the sedation. But it's also known that the man nicknamed "The Bulldozer" for his dominant personality and sheer force of will may be in a fight that he just can't win.

We are going to talk now with Dr. Dan Barrows. He heads the neurosurgery department at Emory School of Medicine here in Atlanta, and you and I were talking about the one thing that caught all of our attention, and that's when the doctor mentioned significant improvement. I just want to listen to that for a minute, and then get your response, OK?

DR. DANIEL BARROW, EMORY SCHOOL OF MEDICINE: Well, significant improvement, Kyra, is a relative term usually in a situations like this. Little things can mean a lot as the doctors have said in their press conferences. We are not going to know Mr. Sharon's condition until the anesthesia he's under, which is helping control the increased brain pressure, has worn off. And when a brain suffers an injury, it's kind of like when you sprain your ankle. It doesn't look so bad when you do it. But two or three days later, it swells like a grapefruit, and the brain can do the same thing. So you're really not out of the woods until those days have passed, and it's going to be very hard to prognosticate I think at this point.

PHILLIPS: So when they come out and say significant improvement, it may just mean they just stopped the bleeding.

BARROW: It may mean they've stopped the bleeding. It may that the pressure in the intracranial cavity, within the skull, is actually under better control. Obviously doctors don't have control over the injury that occurs at the time of a massive hemorrhage, like Mr. Sharon experienced. And so the efforts of neurosurgeons are really directed towards keeping the pressure in the brain within normal range, so that the part of the brain that hasn't been injured can continue to get an adequate supply of blood and oxygen.

PHILLIPS: You know, you and I were talking about the number of surgeries on the brain. And I was talking to you about a personal experience where I was surprised just to hear that they were doing so many surgeries. Is that normal to do two, three, four surgeries on the brain when you are dealing with hemorrhaging like this?

BARROW: Right. Well, it's certainly something that has to be done on occasion, but it's highly, highly unusual. And obviously I would be speculating to try to guess why the surgeons have done the operations they've done.

But based upon the information that we're getting through the news media, it sounds as though there've been a couple of problems. One is they've had difficulty controlling the bleeding. Mr. Sharon, as I understand, was on a blood thinner, because of a defect in his heart that led to a small stroke recently. And that's an appropriate treatment for that. Those blood thinners do put patients at higher risk of having brain hemorrhages. And if you have to take them to surgery, you need to reverse the effects of those blood thinners or anti-coagulants, in order to safely do surgery. I suspect they may have had some difficult getting the blood to clot properly. That may be one of the problems.

And the other is that the pressure within the head from the swelling and the edema that occurs after the initial insult, I think, has been a problem they've been combating with repeat operations, as well as with the drug-induced coma that he's in.

PHILLIPS: Now, is that normal, for you as a neurosurgeon, somebody who's in their late '70s, early '80s, to do up to three or four surgeries?

BARROW: Well, those decisions are highly, highly individualized. And they're made oftentimes in concert with the family. Knowing and understanding what the patient's wishes were if they let them be known before hand, or what the family thinks they might have been. I do suspect, quite honestly, that the very aggressive nature of Mr. Sharon's treatment may have something to do with the fact that he's the prime minister of Israel.

And I think they're probably being very heroic in trying to do everything he can to sustain his life at this critical moment. PHILLIPS: And we were talking about another part of that surgery, too, wondering for part of the bone was kept out. Explain the difference to our viewers. I'm not going to attempt to get technical. But it was interesting point that you wanted to know.

BARROW: Well, the operations that we do as neurosurgeons to get to the brain is called a craniotomy. That means we make an opening in the scalp, and a or window, if you will, in the skull. And at the end of the operation, routinely that bone is put back in place.

In critical situations like Mr. Sharon's, as I understand that it is, it is not uncommon for us to not only leave the bone out, but to very aggressively remove part of the skull to make room for the swelling of the brain that we anticipate, and that's called a craniectomy.

And I was wondering and speculating whether this third and most recent operation, whether the surgeons might have left the bone out, so that that closed box I referred to earlier is now an open box and provides more room for brain swelling that we anticipate in the days to come.

PHILLIPS: Well, now I know my next question will be to Fionnuala Sweeney when I talk to her live from Jerusalem.

Dr. Dan Barrow, thank you so much for your insight. I know you've been with us a number of days now. We sure appreciate it.

BARROW: It's my pleasure.

PHILLIPS: Thank you.

Well, you continue to monitor the health of Israeli Prime Ariel Sharon on CNN.com/pipeline. We are also going to go back To Jerusalem live in the next hour. And Dr. Barrow, we're going to have him stay with us to talk about another story that we're working on, another medical situation we want to discuss. And that of course is of the only survivor from the Sago mine tragedy. We're going to get an update on the condition of Randal McCloy Jr. straight ahead.

The news keeps coming. We're going to keep bringing it to you. More LIVE FROM right after this.

(COMMERCIAL BREAK)

PHILLIPS: The sole survivor of the Sago Mine disaster is now battling for his life in recovery. Randy McCloy is in a Pittsburgh hospital, still in critical condition and receiving specialized treatment to try and prevent severe brain damage after his long ordeal underground.

CNN's Jonathan Freed is outside the hospital there in Pittsburgh.

And Jonathan, you've been following him since Morgantown. And anything change, anything different? Are you getting any briefings from the doctors? JONATHAN FREED, CNN CORRESPONDENT: Good afternoon, Kyra, we are. A few hours ago, we did have a news conference with a medical team here that's been looking after him. I can tell you that they are, of course, still listing him as critically ill.

It's a mixed review, though. And I'll take a second to walk you through it. They're saying that his lungs are doing well and improving. You'll remember when he was originally brought to the hospital in West Virginia, he had a collapsed lung. That's been dealt with. His kidneys, they say, have stabilized. His cardiac function, they say, is improving.

The big problem, though, is his brain. That is the reason that he was brought here to where they have a hyperbaric chamber. And we can show you what one of those looks like. We have some pictures of one that looks similar to what they have here. This is a case into which they slide the patient. It becomes a sealed environment and they fill it with pure oxyge.

And then they increase the atmospheric pressure, Kyra, to higher than normal. And the idea is, they're trying to push and purge the body of carbon monoxide, which may have built up inside the body in this case and in Mr. McCloy's case, down in that mine.

Now, what the doctors are saying is that they are keeping him in a medically-induced coma at this point to try to allow his brain to rest and heal. They feel quite sure that he has experienced a degree of brain damage, but they say that it's too early to assess exactly how bad it is.

And let's listen to more of what the doctors had to say earlier today at that news conference now.

(BEGIN VIDEO CLIP)

DR. JAMES VALERIANO, VICE CHAIRMAN, NEUROLOGY: Neurologically, I think there's a very wide gamut of what can happen. Again, given his age, there's a chance that he could make a very good recovery. Given what we've seen on the scans, there's a chance that the recovery will be much more limited.

It -- again, it helps you -- I mean, as you would expect, it helps you a lot if you can examine someone and try to interact. But we just don't have that available to us right now.

(END VIDEO CLIP)

FREED: So, Kyra, he is in what they are calling in a drug- induced or medically-induced coma right now. They're keeping him that way on purpose so that he'll be more relaxed and they hope heal faster. They say that if they were to remove the sedation -- and that has happened for moments at a time -- that they see him begin to move and respond to a certain degree.

He's obviously still not speaking. But they are confident that he is no longer in a coma of his own. It's a medically-induced state right now -- Kyra.

PHILLIPS: Jonathan, what about the family? I know I saw Anna. She was there at the hospital when he arrived. What about the kids? Has she made any statements to anybody?

FREED: Well, she was. She was here earlier today. And just yesterday, they had issued a statement on her behalf at the hospital in West Virginia, Kyra, where she said, look, she's just -- she needs some private time and private space and she didn't want to come before the cameras. But she quite courageously did that today, earlier today. And one of the things that she wanted to get across is she is absolutely convinced that she will eventually be back with her husband and see him well again.

PHILLIPS: Jonathan Freed. That's what everybody's praying for. Thank you so much.

Well, you may have never heard about the treatment that miner Randy McCloy is now receiving, but hyperbaric oxygen therapy has actually been around for a pretty long time. Here's the details.

(BEGIN VIDEOTAPE)

PHILLIPS (voice-over): Hyperbaric oxygen therapy is a fancy name for a fairly simple procedure. It works by putting a patient in a pressurized chamber with pure oxygen -- about five times more oxygen than we breathe normally. The increased oxygen spreads through the body and speeds up healing for many injuries. The increased pressure helps the body absorb and use the increased levels of oxygen.

Some people say hyperbaric oxygen therapy dates back more than a century. But it really didn't become mainstream until it was tested and developed by the U.S. military after World War I. It's mainly been used since then to treat deep sea divers suffering from decompression sickness.

It's also used today to treat several other conditions, including carbon monoxide poisoning. Some people believe it can also be effective in treating dozens of other conditions. You can even buy your own hyperbaric oxygen chamber. You may recall pop star Michael Jackson bought himself one in 1986.

Medical experts warned then and still do today hyperbaric oxygen therapy can be dangerous unless administered by trained medical personnel.

(END VIDEOTAPE)

PHILLIPS: And as you know, brain specialists attending to Randy McCloy are most concerned about the long oxygen deprivation that he endured in that mine.

Once again, Dr. Dan Barrow with us to talk about this case. It's great to have you here.

BARROW: Thank you. It's great to be here. PHILLIPS: All these different cases you can lend your expertise. You were saying what was important -- because a lot of people don't know this. A little carbon monoxide 101, and why it's so damaging to the brain. Let's start there.

BARROW: Well, there's a molecule within our red blood cells called hemoglobin that carries oxygen to our body, our brain and every other tissue. And carbon monoxide binds to hemoglobin much more strongly than oxygen. So when patients are exposed to carbon monoxide, it becomes bound to the hemoglobin and so the blood can't carry oxygen anymore or does it inadequately.

And the brain -- of course all tissues in our body need oxygen and need blood flow. But our brain is vitally dependent upon a constant supply of well-oxygenated blood, because the brain has no energy stores. And so if it goes without blood and oxygen for more than a few moments, it begins to dysfunction, and within minutes, with critically low levels, it can die. That's what a stroke is, essentially, is a lack of oxygen and blood to the brain.

PHILLIPS: So the hyperbaric therapy, can that actually reverse what has happened? Or is it sort of a prevention of anything getting worse?

BARROW: Well, I'm not an expert in all the other organs of the body. And there may be some therapeutic benefit. But certainly with regard to the brain, you aren't going to revive dead brain cells, neurons, if you will, that have died because of lack of oxygen.

There is a phenomenon, however, in the brain that there are thresholds. There is a threshold below which blood flow or oxygen supply can drop. And the brain will not function, but it will continue to be alive. The neurons, the brain cells, don't die. And there is another threshold below which the brain can't survive.

And so I think what the hope is and what we all pray is that this gentleman's below the threshold where the brain is not working properly, but perhaps above the threshold where there is injury. And I think the idea of giving him hyperbaric oxygen at this point is to make sure that no stone is left unturned and to give him the benefit of any doubt and try to provide oxygen to all of his body, including his brain.

PHILLIPS: You brought up an interesting point, the difference between a working brain and a brain that is alive. I think a lot of people would think that's the same thing.

BARROW: Well, there are subtle differences. Again, neurons or brain cells can survive and can be alive with critically low levels of oxygen in blood, but yet, not function properly. However, not be below that other threshold where they actually die. And those are things that oftentimes in situations like this, we only know in retrospect.

PHILLIPS: Another -- the doctor -- we heard a little bit there from Jonathan Freed what the doctor said early on. But the doctor also came forward and talked about something else I wanted to ask you about. Let's take a listen.

BARROW: OK.

(BEGIN VIDEO CLIP)

VALERIANO: What's different in carbon monoxide than just in like cardiac arrest is that the lesions can progress. The scans can worsen over time. And -- or they can improve over time. So that's what makes it difficult this early. What we may -- what we're seeing is brain injury. But it may be transient injury. In other words, some of this may resolve. Some of it may progress and worsen. It's just hard to know right now.

(END VIDEO CLIP)

PHILLIPS: So explain -- did he say transient injury?

BARROW: Right. I think the most important point is that in a patient like this, he's in a drug-induced coma. They are giving medications to put his brain essentially into a state of animated suspension.

PHILLIPS: So they can't talk and they can't do motor tests, right?

BARROW: He is -- for all intensive purposes, he's under general anesthesia. And that lowers the metabolic demands of the brain. It makes the brain survive with less blood flow and keeps him sedated so he's not uncomfortable and not fighting the respirator and the other things he needs.

And so they really can't examine him. What they have to depend upon, primarily, are imaging tests -- cat scans, MRI scans. And those scans don't make a diagnosis. They draw a picture and it's a picture that we have to interpret. And there are abnormalities on scans that we can look at and say that's abnormal, but we might not know what that is.

PHILLIPS: So what is it you're looking for on this scan, as a doctor, where you can say, OK, I see that, now I know I can start to bring him out of this drug-induced coma and see how he reacts and hopefully see if we can have conversation, maybe even test his motor skills?

BARROW: Right. Well, what I heard earlier in the press conference is that they were concerned because the scan showed some signs of some increased pressure within the brain, and that is one of the consequences.

The physician's referring to the fact that things may progressively get better, then they progressively get worse. Much as in the former segment when we were talking about Prime Minister Sharon, when you injure the brain, immediately it may not look so bad. But it will swell like a sprained ankle over the next two or three days.

And this insult, this injury to his brain, depending on how severe it was, may result in increased swelling and edema. And that will show up on the scans. What we don't know and what the physicians were alluding to is the fact that they don't know whether they are seeing it at the peak now, the peak of these injuries, or whether he's in the process of actually getting progressively worse or better.

PHILLIPS: Because with Ariel Sharon we heard the director of the hospital come out and say we've stopped the bleeding. So that's a significant accomplishment there.

But with Randy McCloy we are still hearing that he's had small -- he's had a little bit of hemorrhaging, small doses of hemorrhaging. So you definitely have to stop the bleeding before you bring him out of that coma?

BARROW: I think it's an important point for your viewers to understand that the bleeding that Ariel Sharon had and the bleeding that Mr. McCloy has had, totally different.

PHILLIPS: Totally different.

BARROW: Totally different.

PHILLIPS: OK.

BARROW: Prime Minister Sharon had a massive hemorrhage into the brain. And that had to be removed because it was taking up space and potentially could cause injury to the part of the brain that wasn't initially damaged.

In Mr. McCloy's case, what he has are tiny, tiny little spots of hemorrhages, what are called punctate hemorrhages, which is just really is -- it's an epi-phenomenon. It is a sign that there has been an injury to the brain.

And the result of that injury is there's been a little bit of leakage of blood out of the blood vessels of the brain. But not the type of hemorrhage that would need consideration of surgical removal.

PHILLIPS: If you were with Randy McCloy right now, what would -- I'm just curious as a doctor, what would your next step be? What would you do?

BARROW: Well, I think what -- his doctors are doing everything they possibly can. I think in fact the transfer to an institution with hyperbaric oxygen was an heroic attempt to try to make sure that they did everything they possibly could. First and foremost, patients with injuries like he had, a pneumothorax or a collapse lung ...

PHILLIPS: Which is now getting better, a great sign.

BARROW: Which is now getting better.

PHILLIPS: His kidneys getting better. BARROW: Right, those things have to be managed first, and that's what was done in West Virginia. He had very high potassium levels which can cause arrhythmias of the heart. He couldn't be transferred, from what I understand, because of those conditions. Those need to be stabilized first. They have been, and really right now it's supportive care.

It's making sure you avoid the complications that patients can have when they are in that condition -- infections, pneumonias, deep vein thrombosis, pulmonary embotlite -- things that patients are prone to get. And with that supportive care, hoping that nature takes its course and heals the injuries that he's had.

PHILLIPS: Dr. Dan Barrow, thank you so much. Working double time for us today. We appreciate it.

BARROW: My pleasure. Nice to be here.

PHILLIPS: We'll be talking again. Thank you.

All right, much more, of course, of what happened at the Sago Mine. We are getting tapes now of the 911 calls that were made on the morning of the explosion. We're going to bring you those tapes at the top of the hour.

Also in the next hour of LIVE FROM, it's an important day in New Orleans, the kickoff of Carnivale. Out Susan Roesgen is there, and I know, Susan, this is a big day for you.

SUSAN ROESGEN, CNN GULF COAST CORRESPONDENT: Oh, it's a big day for all of us in New Orleans. Kyra, Hurricane Katrina could not knock out a New Orleans tradition. Celebrating the Carnivale season with king cakes, thousands of them. I'll show you the secret to making king cakes here at Gambino's, the biggest king cake factory in New Orleans, coming up.

(COMMERCIAL BREAK)

PHILLIPS: Well, Florida's highest court strikes down a small school voucher program. About 700 kids go to private or parochial schools through the Opportunity Scholarship Program. Opponents complained that the plan, which used tax payer money, violated the separation of church and state.

Under the law, students could get vouchers if they attended public schools earning failing grades from the state in two of four years. The court ruled that policy violated the state's constitution ban on using tax payer money for alternatives to public schools. Twenty-four thousand students in other state voucher programs aren't directly effected by that ruling.

It is possible that an act of nature was the cause of the Sago Mine explosion. Was it a possibility? We are going to take a look at the science behind a theory that could have major implications for everyone touched by this disaster. CNN's LIVE FROM continues in a moment. (COMMERCIAL BREAK)

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