Time to get a candidate for SD-Sen

(Cross-posted at dailykos with a different title)

I've been waiting to hear something about how Tim Johnson was doing, and finally this story (http://www.nytimes.com/2006/12/29/us/29j ohnson.html?_r=1&ref=politics&or ef=slogin)    came out in the NY Times yesterday. As a neurologist, I am able to do some reading between the lines that others might be unable to do. Here's what it says medically for him -- and, since this is an analytical group blog, politically for us.

First, they are weaning down his sedation, which obviously means he is getting better rather than worse. The tone of the doctor's comments supports that too. While one can obviously never be too certain about anything when it comes to serious illness, at this point I would have no reason to believe that Senator Johnson is going to die. As many on this site (and others) have discussed, Senate precedent appears to indicate that he will continue to hold his seat as long as he is alive, so barring an unforseen catastrophe I think we will hold the Senate 50-49.

More on the flip.

Second, however, is that fact that he's been in the ICU for over 2 weeks. That's quite a long time. Anybody who gets any neurosurgical procedure spends a day or two in the ICU, and one might commonly be in the hospital for a week or so -- but in a regular floor bed, not the ICU. That tells me that his condition remained quite serious for quite some time. Another thing that tells me that is simply the fact that he has remained on sedation so long. I don't think they would do that unless there was significant cerebral swelling -- otherwise sedation would have been weaned far sooner.

Third is an offhand detail from the article that is pretty ominous -- if you know something about neurology:

"They have said that he is expected to undergo physical therapy to address weakness in his right side."

I can deduce 2 things from that statement, in combination with the rest of the clinical history as it has been reported:

3a. Because the right side of the body is controlled by the left side of the brain, Sen Johnson's arteriovenous malformation (AVM) was in his left cerebral hemisphere.

3b. In virtually all right-handed people, and even in the substantial majority of left-handers, the left hemisphere is responsible for language. And some of the areas important for language are in the back part of the frontal lobe -- close to the areas that would be responsible for the movement of his right side. So there is a good chance that Sen. Johnson has suffered damage to his language functions. This is referred to as aphasia.

Aphasia relates not only to your ability to produce language, but also to your ability to comprehend language. It can be hard for laypeople to even come to grips with what this means. In its most severe form one is basically left in the state of a pre-verbal (or nearly pre-verbal) child. Imagine the closest 18 month-old in your life to grasp this. That child can look around, see plenty about what's going on, who is there, she knows who her mommy & daddy are and that they love her, etc. But she can't understand the vast majority of what you say -- maybe a word or a phrase or two here and there. In its milder forms a person with aphasia might be able to communicate pretty well, but have trouble finding words sometimes -- and also trouble grasping the exact meaning of things that are said from time to time. Some people have limited forms of aphasia -- where just expressive language is affected, and comprehension is intact, or vice versa. But this is actually very uncommon; the vast majority of people with aphasia have some degree of difficulty with both expression and comprehension.

Now I cannot say for sure that Johnson is going to be aphasic, nor do I want to appear to be engaging in Fristian diagnosis from a distance (from my perspective as a neurologist, his actions vis-a-vis Terry Schiavo make him an utter disgrace to the medical profession). But there is another important historical clue in this regard: the fact that he had some impairment of speech abilities -- i.e. aphasia -- during the initial conference call with reporters. That tells me that the bleeding -- and therefore the AVM itself -- was right near his language areas.

For someone like a sitting U.S. Senator, even mild aphasia is not a good thing to have -- especially if you're up for re-election next cycle. If he has trouble finding words, then it will be very tough for him to make a good impression on the campaign trail -- doubly so, since voters in SD will be looking for evidence that he is healthy -- or damaged -- in making their voting decisions. And if has trouble with comprehension, there is simply no way he is going to be able to deal with complex legislation, negotiations, committeework, etc. One may conceive of language as the most fundamental of our cognitive abilities; it serves as the foundation for almost all our other cognitions, and it is truly what makes us human.

As mentioned, it possible that I am in error (I haven't examined the man, after all), and it is also possible that Johnson recovers with some mild aphasia, but that his language improves to 100%, or very close, over the course of months or a year. But given the details we have been privy to thus far, suggesting a fairly serious neurologic injury, I think there is a good chance that he will be left with a permanent and significant language deficit. With such a deficit he may still be able to enjoy his life, and appreciate the attention of his family and friends. And if he's lucky, and it's mild, he might even be able to function halfway decently -- but not at the level of a U.S. Senator.

So while we wish Sen. Johnson a full recovery, and send our prayers to him and his family, from the strategic standpoint I think it is highly likely that Johnson will not be running for re-election in '08 -- and that SD is thererfore going to be a major Republican takeover target. Any Dakotans care to comment on the Democratic bench?

Tags: Senate 2008, South Dakota, Tim Johnson (all tags)

Comments

30 Comments

Re: Time to get a candidate for SD-Sen

By the way, no matter where I looked I could not find instructions on how to do proper links, blockquotes, bold, italics, etc. on this site (for dKos it is all self-explanatory). If anyone could provide a link to the proper documentation I would be grateful.

by scottso 2006-12-30 09:33AM | 0 recs
Re: Time to get a candidate for SD-Sen

I think you have to do the links manually.  Type them in the message using html code. Kind of a pain (more medium than message) but pretty easy.

Keep a typical link text in a Notepad TXT file and then just copy/paste the new url and the new link text in, then copy paste that into the message composition box.

Old school but it works.

by BrionLutz 2006-12-30 09:44AM | 0 recs
Re: Time to get a candidate for SD-Sen

TPM Cafe helps with codes here.

by jrb1968 2006-12-30 02:03PM | 0 recs
Re: Time to get a candidate for SD-Sen

Thanks!

I gotta say, it's a hell of a lot easier on dKos, though . . .

by scottso 2006-12-31 03:47PM | 0 recs
RE: Posting Links and formatting

When I want to format and include links in my comments here, I start a comment post in an open thread at dailykos.  When I'm happy with the preview, I copy and paste the html here and cancel the comment at dailykos.

by ThosJoseph 2006-12-31 04:32PM | 0 recs
Re: Time to get a candidate for SD-Sen

Idea is probably that, should Johnson not be able to run, Daschle steps in at last minue, which gives Dems a very good chance of holding the seat.

by BrionLutz 2006-12-30 09:37AM | 0 recs
Re: Time to get a candidate for SD-Sen

I initially thought Daschle could run for the seat as well and think he would be a giant, but what about Steph Herseth?  It might mean giving up a House seat but she's young and the Senate needs more women and she's a good fit for the state.

by Vox Populi 2006-12-30 10:38AM | 0 recs
recruitment begins and ends...

with Stephanie Herseth. she's a stronger candidate than Daschle, who I believe is a DC lobbyist now anyway.

by johnny longtorso 2006-12-30 11:08AM | 0 recs
Re: recruitment begins and ends...

Yep, it's been over 64 years since SD elected a new senator who wasn't a representative.

by bschak 2006-12-30 08:17PM | 0 recs
Re: recruitment begins and ends...

Heaven forbid - but if we have to get a new candidate, definitely go with Stephanie Herseth.

Seems to me that almost everything was going wrong when Daschle was the Senate Democratic Leader - and everything started going right when Reid became the leader.

Bless Daschle's heart, but honestly, I think the Republicans did us a favor by beating him in 2004.

by bushsucks 2006-12-31 12:55PM | 0 recs
Re: Time to get a candidate for SD-Sen

It's either Herseth or Tim Johnson's son.

Daschle is out considering the chances of him being majority leader are nil.

My question to the South Dakotans is who is there to fill Herseth's shoes? We've got a pretty good system going in the Dakota's right now with Democratic senators (Thune excluded) and two Democratic representatives (herseth and pomeroy) that could step up if a senator retires. So how do we keep this system going in these very republican (at least at the statehouse level) states? Who could take over for Herseth?

by adamterando 2006-12-30 11:18AM | 0 recs
Re: Time to get a candidate for SD-Sen

"Daschle is out considering the chances of him being majority leader are nil."

Not sure that is relevant or accurate.

Relevant - Daschle would like another six years in the Senate.

Accurate - Reid is pushing 70 and has had a couple small strokes.  Lot can happen between now and the eight years that would mark the end of Daschle's senate term.

Because it's going to be unseemly for Democrats to openly compete for Johnson's seat, the replacement candidate will likely be picked on short noice by the Democratic committee vs. an election.

That would be an ideal situation for Daschle who would offer the Democrats the best chance of retaining the seat.

by BrionLutz 2006-12-30 11:31AM | 0 recs
Re: Time to get a candidate for SD-Sen

My assumption (and I think the diarist's assumption) is that Johnson will finish out his term and if health problems warrant it, he will retire in 2008.

Thus, the next Democratic nominee will not be a replacement candidate, it will be the nominee for an open senate seat in 2008, just like Ben Cardin was the nominee for an open senate seat in Maryland. I don't think that would be unseemly. We're talking voluntary retirement (if need be), not replacement.

Given that, I don't see how Daschle could win the nomination considering he lost in 2004 and the whole premise of his reelection campaign that year was that his seniority was a huge asset for South Dakota. He won't have that this time. I'm not saying it's impossible, just that I think Democrats will be looking hard at someone younger that can hold the seat for a long time.

I also HIGHLY doubt that Daschle would move up again to majority leader given that other senators have moved up the ranks and would like their chance if and when Harry calls it quits. Dick Durbin sure as hell ain't going anywhere.

by adamterando 2006-12-30 01:40PM | 0 recs
Re: Time to get a candidate for SD-Sen

"My assumption (and I think the diarist's assumption) is that Johnson will finish out his term and if health problems warrant it, he will retire in 2008."

That's everybody's assumption and that decision by Johnson is likely to be late (election is 18 months away) so the normal primary process would not be applicable.

Democrats would have to basically appoint someone to run.

Be interesting to see the polling in SD on who offers Dems the best shot.

by BrionLutz 2006-12-30 07:38PM | 0 recs
Re: Time to get a candidate for SD-Sen

Huh?

The election is actually closer to 22 months away. Johnson has plenty of time to recover and to decide whether he wants to run again or not.

by adamterando 2006-12-30 07:57PM | 0 recs
Re: Time to get a candidate for SD-Sen

Although, Daschle can certainly run again, I wouldn't recommend it against Rounds, Hearseth wants to run, although she was waiting in the wings to run against Thune in 2010, she may have to go early this time around.

by olawakandi 2006-12-30 12:56PM | 0 recs
Re: Time to get a candidate for SD-Sen

I'm 90% sure Stephanie is waiting for an open senate seat (and by open I actually mean, one where she doesn't have to run again Rounds or Thune).  This could happen if Thune gets tapped for VP spot as some have said he will, or god-forbid, if a new republican prez puts him in the cabinet, as he has also angled for.  

This means Daschle is our best bet, since Rounds is 90% going to run in '08 anyway, which was true even before Johnson had this major health problem.  

I think Daschle can win, his negatives were never that high, and still aren't.  Thune was and still is relativley beloved.  I think against Rounds, Daschle could compete.  

SD is going to be competitive either way.  

This info may not be foolproof though...

I worked on the herseth special for the Dtrip for a while, and I'm in Nebraska, and I also know a lot of SD party folks from here there and everywhere.  But I'm no SD political expert...

/my 4 cents.  

by johnowens2 2006-12-30 09:04PM | 0 recs
Re: Time to get a candidate for SD-Sen

Rounds keeps saying he doesn't want to be a senator. From what you're writing, this is BS?...

by PsiFighter37 2006-12-30 09:46PM | 0 recs
Re: Time to get a candidate for SD-Sen

Stephanie Herseth would be the ideal candidate.

by robliberal 2006-12-30 12:58PM | 0 recs
Jeers: Herseth. Cheers: Tim Johnson's Son

by jrb1968 2006-12-30 02:05PM | 0 recs
Re: Time to get a candidate for SD-Sen

People have been mentioning Tim Johnson's son. Is he even involved in politics?

Nevertheless, should Johnson's prognosis be pessimistic, it's probably a safe bet to assume he'll be retiring in 2008. Rounds doesn't want the job, and given the whipping Herseth delivered to her GOP opponent in 2006 (she got about 70% of the vote, IIRC), she's got to be the clear favorite to run for the seat. With her, I think we have a good shot at holding it. The trick, then, is to find a good person to run for the House seat, and it seems like our bench is pretty thin after Herseth.

by PsiFighter37 2006-12-30 03:34PM | 0 recs
Re: Time to get a candidate for SD-Sen

Thanks for this analysis of his condition.  I personally have always liked Daschle so much that I would want him back in the Senate.

by Bob H 2006-12-31 03:41AM | 0 recs
Re: Time to get a candidate for SD-Sen

i think you should cross post this elsewhere (kos?). excellent analysis.

by b1oody8romance7 2006-12-31 11:18AM | 0 recs
Re: Time to get a candidate for SD-Sen

just kidding. you already did. duh.

by b1oody8romance7 2006-12-31 11:48AM | 0 recs
Well.....

.....word within the SD Democratic party workers' circles is that Stephanie is ready and willing to run for Johnson's seat if needed.  

As far as who will replace her?  I don't know.

The recent gubernatorial candidate, Jack Billion, is going to be state party chairman so rule him out (if he keeps his promises that got him to that position in the first place).

I wouldn't be surprised to see his running mate, Eric Abrahamson, (who is known to be enjoying the taste of publicity) reject a chance to be in the limelight once more.  

Other than those gentlemen, I'm not sure who'd run for Stephanie's spot.

by ira13ping 2006-12-31 12:08PM | 0 recs
Re: Well.....

Are there any popular Democrats in Rapid City?

by adamterando 2006-12-31 01:28PM | 0 recs
Re: Well.....

No, not particularly.  Eric Abrahamson is prominent as his name recongnition is getting better (obviously) but is still somewhat reviled by everyday south dakotans.  He comes off as an east-coaster and thus rubs a lot of folks the wrong way.   "He's just not one of us."   In other words, he's culturally unacceptable.

by ira13ping 2007-01-02 07:51PM | 0 recs
Re: Time to get a candidate for SD-Sen

Having spent some time in South Dakota, I can say Stephanie would be a great candidate for the state.  However, a lot of the progressives in the state have grown very wary of her foray to the right over the years (pro-torture, pro-Iraq, etc.) and might want a more progressive candidate.  Eric Abrahamson would be an excellent candidate to replace Stephanie should she decide to run but may suffer from the fact that the Governor's race was not closer.  He is a true progressive from the western part of the state, and may have some trouble with the political make up of SD - that being why Stephanie has been moving to the right.

In terms of Sen. Johnson's son, he would be a great candidate for either position although I am not sure the interest is there.  He has a ton of experience working with his father and is a well respected attorney in Sioux Falls.  He has a wonderful reputation in the state, is exceptionally bright, hard working and young.

The other thing to consider is that if Rounds does not run, the Republican bench is really not that impressive.  Many of the state senators are far too extreme for the general election. The LG does absolutely nothing and was a non-factor on the campaign.  I don't think there is another big name besides Rounds (although I can see one of the anti-abortion wingnuts getting into an ugly primary battle).  If i am wrong about this please let me know.

But again, i do think it is premature to have these talks about Senator Johnson's replacement.  We will see over the next few months where he stands.

by SoDak Dem 2007-01-02 04:12PM | 0 recs
Re: Time to get a candidate for SD-Sen

Since I know Eric personally, I can't see him winning in our state for the house seat.  The last campaign has changed him and he comes off as elitist and snobby.   Many Democratic volunters have even admitted to this character change in him.  His personality was so polarizing within the party, in fact, that he was actually pissing off party officials within the state.'

PS: I heard a rumor that Howard Dean was not too happy with Jack Billion winning the chairmanship.  In fact, the whole whole SD State Dem Party actually resigned once he won.  These two guys (billion and Abrahamson) are just bad for the party.

by ira13ping 2007-01-02 07:54PM | 0 recs
Re: Time to get a candidate for SD-Sen

That is ridiculous - it is a tradition that all party officials resign when a new chairman takes over so that they can choose how they want the party to go.    I think Billion will end up being a consensus builder, as he spent more time West River then any Democratic candidate in very long time.

by SoDak Dem 2007-01-03 07:43AM | 0 recs

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