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Special envoy Richard Holbrooke has surgery for tear in aorta

By Karen DeYoung
Washington Post Staff Writer
Sunday, December 12, 2010; 12:39 AM

Richard C. Holbrooke, the Obama administration's diplomatic point man for Afghanistan and Pakistan, remained in critical condition Saturday night after surgery to repair a life-threatening tear in his aorta.

Holbrooke, 69, is a key member of the administration's war strategy team. He was taken to George Washington University Hospital on Friday morning after he became flushed and had chest pains during a meeting with Secretary of State Hillary Rodham Clinton. He was almost immediately taken into surgery that extended for 21 hours into Saturday.

With Holbrooke in intensive care only blocks away, President Obama's senior national security advisers met at the White House on Saturday to discuss a major internal assessment of the war in Afghanistan. Obama will review the assessment Monday, with release to the public scheduled for later in the week.

Holbrooke's family and members of his State Department staff remained at the hospital awaiting word on his condition. In a statement, Obama said he had spoken with Holbrooke's wife, author and journalist Kati Marton, and told her that he was praying for him.

Obama called Holbrooke "a towering figure in American foreign policy, a critical member of my Afghanistan and Pakistan team, and a tireless public servant who has won the admiration of the American people and people around the world."

Clinton and Adm. Mike Mullen, chairman of the Joint Chiefs of Staff, visited the hospital Friday night and again on Saturday, along with Thomas E. Donilon, Obama's national security adviser.

Hospital spokesmen referred questions to the State Department, which released a terse statement Saturday on his condition and the completion of surgery.

The aorta is the major artery carrying blood from the heart to other parts of the body. From the heart, it moves up through the chest toward the head, then bends and moves down through the chest and abdomen. Surgical repair of a tear in the internal wall is possible, although serious complications in the brain and extremities can arise from interruptions in blood flow.

Administration officials said that Holbrooke's condition would not affect the war review, compiled over the past month by the National Security Council staff from assessments made by Holbrooke and his staff and by the military coalition led by Gen. David H. Petraeus. In statements in recent weeks, Obama, Defense Secretary Robert M. Gates and others have called the strategy a success and indicated that they expect few, if any, changes.

But some members of the administration, including some intelligence and military officials, are less optimistic that offensive operations in southern Afghanistan will lead to long-term stability and the Taliban's defeat in that region. They have also noted an expansion in insurgent activity in the northern and eastern parts of the country and the ongoing failure of Afghan President Hamid Karzai to stem corruption and establish effective governance.

Despite billions of dollars in U.S. military and economic assistance, Pakistan has continued to resist U.S. urging to move aggressively against insurgent sanctuaries in tribal regions along the Afghanistan border, an effort considered crucial to coalition success. Obama has pledged to begin withdrawing by July an unspecified number of the 100,000 U.S. troops now in Afghanistan, and the 49-nation coalition there has projected a complete turnover to local military forces by the end of 2014. Although Obama's Democratic base has pressed for a faster withdrawal, to decrease the human toll of the war and its $100 billion annual cost, many Republicans have criticized the president for setting a deadline that they think favors the Taliban.

More than any other individual, Holbrooke has been the spokesman for the overall effort, testifying before Congress, cajoling other governments to contribute and making countless trips to the region.

His long diplomatic experience has given him a unique perspective within the administration and has positioned him perhaps better than anyone to navigate the often messy intersection of diplomacy, counterinsurgency and politics. During the three-month policy review last year that led to the current strategy in Afghanistan and Pakistan, he often referred to his experiences in Vietnam, where he began his career as a State Department official and had a front-row seat on what came to be seen as an unwise escalation of U.S. military forces based on deceptive assessments.

In the Clinton administration, Holbrooke served as ambassador to Germany and assistant secretary of state for Europe, and he was the chief architect of the Dayton peace accords that resolved the Balkans crisis.

He served as a senior foreign policy adviser to Hillary Clinton during her 2008 campaign for the Democratic presidential nomination, and he was one of the first members of her team announced after Obama chose Clinton as his secretary of state after the election.

Holbrooke's sometimes abrasive style has raised hackles in the administration and partner governments, including with Karzai. Obama's former national security adviser, James L. Jones, tried to persuade the president to fire Holbrooke as SRAP (the abbreviation for special representative for Afghanistan and Pakistan), according to officials who spoke on condition of anonymity about sensitive internal deliberations, but Clinton intervened to protect his job.

Holbrooke has had his own frustrations with internal sniping, congressional reluctance to fund the diplomatic and economic sides of the war effort, and the increasing power of the military to influence policy. His stock has risen and fallen numerous times in the past two years as his intense yet open way of doing business - including extensive contacts in the media - made him a particular target of the military and some in the White House.

His office on the State Department's ground floor has a diverse mix of policy experts and academics, some of whom were hired precisely because they disagreed with the George W. Bush administration's Iraq war strategy and had little better to say about Obama's efforts in Afghanistan and Pakistan.

He has been a strong advocate of a negotiated settlement of the war and of massive increases in development and governance aid. Under his direction, the number of U.S. civilian officials in Afghanistan has more than tripled, to exceed 1,000. One of his first initiatives was to end the U.S. focus on poppy eradication in Afghanistan, on the grounds that removing the livelihood from opium production that sustained many Afghan farmers was counterproductive.

Holbrooke crossed swords with another part of the administration in Pakistan, where he ordered an end to the automatic renewal of aid contracts with U.S. and other foreign nongovernmental organizations with long histories there.

He experienced health problems in August, when he underwent treatment for heart problems and canceled one of his frequent trips to Afghanistan and Pakistan.

During a meeting Friday morning in Clinton's seventh-floor State Department office, Holbrooke became flushed and uncomfortable, officials said. Clinton insisted that he go to the hospital immediately and sent him, with aides, in her private elevator to the medical unit in the department basement.

He collapsed in the elevator and was taken by ambulance to the hospital, where the aortic tear was quickly diagnosed and surgery began.

Staff writers Rob Stein and Rajiv Chandrasekaran contributed to this report.

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