Sunday, October 02, 2011

How ill is Mrs Gandhi?

By M H Ahssan

The news is good. The operation was a success. She is back in India and has begun to defuse the life-threatening crisis within Congress and government at a time when what she really needs is some rest. India doesn't know what exactly ails its most powerful citizen.

The one unanswered question, which continues to fuel speculation ranging from the ignorant to the bizarre, is: why did the authorities keep details of Sonia Gandhi's medical condition such a tightly wrapped secret? Some word has begun to trickle down since Sonia has returned. She has confided to a select few Congress leaders that she had first stage cancer, for which she went through a seven-hour-long surgical procedure. "In June, when Congressmen claimed that she had gone abroad to tend to her ailing mother, she had gone for her own treatment," a Congress leader told India Today. "The good news is that the illness is not life-threatening. However, it will be at least six months before she will be able to handle the normal workload," the source said.

India has substituted news with plenty of conjecture. Since August 4, when bbc and Agence France-Presse broke the news of Sonia Gandhi's surgery, Delhi's politically connected physicians have been in demand. Some have been toeing the Congress line that it's a private matter, some reprimanding nosy reporters, some citing the Hippocratic Oath while most are denying any knowledge. Various theories have been doing the rounds in a season of enforced silence-that it could be gastrointestinal or gynaecological cancer.

At the centre of all this is the Memorial Sloan-Kettering Cancer Center in New York, US, where Sonia reportedly had her surgery. According to some doctors, speaking in strict confidentiality, the seven-hour-long surgery indicates a rare and difficult cancer. They said the 64-year-old Congress president was initially diagnosed with an "unspecified mass" in her pancreas. The tests indicated the probability of the rare neuroendocrine tumour of the pancreas (pNET). The more common pancreatic cancers, adenocarcinoma, are virulent and have a survival rate of about two per cent. But pNET is more slow-spreading and treatable. "The long ot time could be because pNET is so rare. It affects less than one person in 100,000 in the US," the doctors told Newsindia.

The operation could have taken long, says a doctor who refuses to be identified, because, post-operation, the biopsy revealed that it wasn't probably a cancer at all. "It was most likely an unusual disorder, pancreatic tuberculosis, which very often mimics pNET," he said. The symptoms for pancreatic tb and cancer can be surprisingly similar, making diagnosis virtually impossible: from fever and fatigue to weight loss to upper abdominal pain radiating to the back.

Radiological imaging techniques, ultrasonography, CT scan and other tests usually fail to make a clear distinction. "It's a very lucky and extremely rare misdiagnosis but not totally unheard of," says the doctor. At the world's top cancer facility, a patient with an unspecified mass can get a biopsy, an ultrasound for size and surgical procedure, all in a day. The doctors took time to detect it correctly and put Sonia on heavy-duty anti-tb therapy (reportedly for the next six months). "She should be fine after that," he says.

Beyond pNET and pancreatic tuberculosis is another theory. It stems from her physician of choice in the US. Internationally-known cancer specialist, Dr Dattatreyudu Nori, is professor and executive vice chair of radiation oncology at the New York-Presbyterian Hospital/Weill Cornell Medical College in New York City hospital. Nori is an acclaimed expert in women's cancer. He has been named as one of the top doctors in the US for the treatment of women by one of the most popular women's magazines, The Ladies Home Journal. Nori was on vacation in Iceland at that time, but was apparently called back urgently and returned to New York to coordinate the entire procedure for Sonia. Nori has neither confirmed nor denied that he was treating her.

There is no final official word on the Congress President's health but what can be confirmed is that the Congress party seems to have become suicidal. The most obvious manifestation of it is the sight of a hapless prime minister reduced to a bystander while the turf war between two of his senior Cabinet colleagues, Finance Minister Pranab Mukherjee and Home Minister P. Chidambaram, takes a heavy toll on governance.

Sonia remains the absolute authority where all arguments stop. The PM has fallen from grace, while Rahul has failed to rise to the occasion. According to a party official who met Sonia recently, "she is not happy with the handling of the 2G letter conflict by the prime minister." He was referring to a March 25, 2011, note written by the finance ministry to the PMO which stated that Chidambaram could have prevented the 2G scam by insisting on an auction.

Mukherjee is blaming the PMO for giving such a detailed response to an otherwise general RTI inquiry, as well as for demanding such a note in the first place. In a four-page letter written to the Prime Minister, he has said that it was at the behest of the then Cabinet Secretary K.M. Chandrasekhar that such a note was prepared. According to finance ministry sources, the letter states "the finance ministry sent a 12-paragraph note apprising the cabinet secretary of the facts but this was sent back with paragraphs added." Whether he wanted it or not, the Prime Minster has become party to the deepening crisis.
Though Mukherjee rushed to New York on September 25 to meet Manmohan, who was attending the UN General Assembly, and Chidambaram had been in touch with the Prime Minister on the phone, Sonia still had to step in for damage control. On her return home on September 8 from the medical treatment in the US, there was hardly any political news to cheer her up. She has questioned her colleagues about the fallout of the Anna Hazare fiasco. Saddled with a Prime Minister who lacks political authority and a son whose disinterest is only matched by his diffidence, an ailing Sonia does not have the luxury of a quiet recuperation.

There has been speculation ever since she left for treatment that she would appoint Rahul as Congress working president. That has not happened. The main reason for this is Rahul himself. He is not sure of himself, and now it looks like even the party is coming to terms with the reality of a reluctant prince. Soon after the 2G letter crisis broke, Rahul flew to Srinagar where, for two days, he dabbled in Youth Congress matters and breakfasted with his pal, Chief Minister Omar Abdullah. Just as he refused to play an active role during the Anna Hazare agitation he has gone out of his way to distance himself from this crisis too.

The four-member core group that Sonia had appointed to run the party when she left for her treatment on August 4 has already been disbanded. It held no structured meetings during the 36 days she was away. This was again an indication of Rahul's reluctance to take charge. When the Hazare agitation was at its peak in August, Rahul led a delegation of MPs to the Prime Minister to talk about the land acquisition bill. Impatient with his disconnect, the MPs surrounded him at 7 Race Course Road after the meeting with Manmohan and pleaded with him to step in. They complained about the Government's mishandling of the Hazare campaign. Though Rahul spoke in Parliament the next day, he did not offer any resolution or display leadership.

What aggravates Sonia's agony is the fact that, set against an heir apparent who is a permanent work in progress is a prime minister who has lost his elan. When Manmohan complained that the Opposition was trying to destabilise his government, Janata Party leader Subramanian Swamy asked, "Does he mean opposition within or outside the Congress?"

The dominant feeling within the Cabinet is that there is a growing need for a political Prime Minister. "All the crises have been political, not economic. We don't need an economist, we need a politician," says a Congress Cabinet minister. There are also few takers for Manmohan's economic policies. "The two arms of the Prime Minister are the pmo and the Planning Commission. Both are out of sync with the party," says the Cabinet minister.

He rattles off a list of Congress Cabinet ministers-Kamal Nath, Jairam Ramesh and M. Veerappa Moily-who are upset with Planning Commission chief Montek Singh Ahluwalia. "To solve the problems of the rural poor, the Planning Commission has hired a team of the urban rich," adds a party general secretary. "Once Pulok Chatterji joins the PMO, then the party will have its man in place there. Right now, there is no connect between the party and the Prime Minister's Office," he said. Added to this leadership vacuum is the mystery about Sonia's illness.

Since the party has not yet been officially briefed about it, the field has been left open to conspiracy theorists. "Even public personalities are entitled to privacy in so far as their personal life is concerned," says Congress spokesperson Manish Tewari. Sonia has never functioned as a 'visible' leader; yet never was the need for her party to get a glimpse of its president greater.

Her spin doctors organised a well-choreographed meeting of the Central Election Committee on September 15, ostensibly to discuss candidates for the Uttar Pradesh Assembly polls. It provided an ideal showcase of a leader in control. When the Prime Minister drove up to 10 Janpath, she was at the door to receive him and see him off. "She looked at the candidate list and her immediate reaction was why there were so few Congressmen on it," said a senior Congress leader, pointing out that most of the candidates were former bsp and sp politicians. "Rahul then said he would talk to the Youth Congress to suggest some names," added the Congress leader. What he didn't voice was the relief that his party president seemed 'okay'. Later, Congress General Secretary Janardhan Dwivedi told the media that "she looked normal... but it will take her a little time to fully recover".

Until the Pranab vs Chidambaram letter bomb landed in her in-tray, Sonia was content with routine party work such as nominating pcc teams for Goa and Maharashtra and taking a decision on whether the Congress should go it alone in the Tamil Nadu local elections. She has also begun meeting Cabinet ministers and party officials, managing four-five meetings daily.

"She is watching a lot more television than she does normally and is worried about party turf wars," says a Congress leader. Considering the malady afflicting the Government, it could be a long while before the Congress president sees something she likes on TV.

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