Sen. Paula Hawkins (R-Fla.) has made a dramatic change during the last two months in how she handles her hospital visits.

When Hawkins, suffering from chronic pains in the neck and right shoulder, checked into the Duke Medical Center for tests in February, she created a major campaign controversy by cloaking the visit in secrecy. She signed in under an assumed name, and her staff insisted for days that she had gone "on vacation" to an unknown hideaway.

Hawkins, locked in a tough reelection race, later blamed the controversy on "my goofy staff."

But when she checked into the same Durham, N.C., hospital for further tests 10 days ago, she brought along her new press secretary, Bill Hart, and a new strategy.

Instead of trying to hide from the press, Hawkins, injured four years ago when a television backdrop fell on her, has used her hospital bed almost as a campaign podium, issuing a series of blistering attacks on her Democratic opponent, Gov. Robert Graham.

She has appeared live via satellite on a Tampa television news show, allowed herself to be photographed almost daily, and on Thursday gave a 90-minute interview to a pool reporter representing the half-dozen newspapers staking out the hospital.

Wearing a Duke University sweatshirt and tennis shoes, Hawkins described herself as "a tough cookie" and said she wanted people to know that she "looks great, she has a good attitude" and she is "not depressed."

Hart, a former White House press aide, has kept reporters in Durham, Florida and Washington abreast of medical developments. "We want to make sure whatever story got out was the correct one," he said.

Hawkins on Friday underwent a myelogram, a sometimes painful test in which dye is injected into the spinal column to aid X-rays, and on Saturday had a CAT-scan study of brain waves, to try to determine if major spinal surgery would be necessary.

Hart announced last night that surgery will be performed Tuesday.

Hawkins, 59, had said she would like to avoid surgery, which will keep her from Senate and campaign duties for about a month. Hart said she will remain in the hospital one to three weeks.

"Everyone concedes the last visit could have been handled better than it was," said her chief political consultant, Charles Black. "There was never any planning for it and it turned out to be a bigger deal than anyone thought."