With an arduous series of radiation treatments looming, Mayor Bob O'Connor probably won't be able to return to his City-County Building office until October or November, and that's under the best of circumstances.
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And with more surgery set for today and the first of 20 radiation treatments tentatively scheduled for Monday, doctors do not want Mr. O'Connor to resume any of his duties for at least two to three weeks, perhaps longer.
"We much prefer that he focus his energies on getting better," said Dr. Stanley Marks, director of clinical services at UPMC Hillman Cancer Center.
He did not want to predict when Mr. O'Connor could retake command, even though he has been regaining strength in his left side and becoming more alert and cognitive since Aug. 6 surgery to remove fluid buildup in his brain, a complication from his cancer.
"I think we'll play that by ear, honestly. If he has a dramatic response in the next couple of weeks with the radiation, then we'll leave that decision up to him. But right now we are definitely discouraging it," Dr. Marks said.
As a result, Deputy Mayor Yarone Zober, appointed to fill in for Mr. O'Connor when he underwent surgery for the fluid buildup, could end up holding the job for much longer than anyone anticipated.
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| Associated Press Deputy Mayor Yarone Zober |
It all amounts to uncharted waters for the city, which is accustomed to seeing deputy mayors appointed for short periods, typically when the mayor is traveling out of state or out of the country.
The city's Home Rule Charter does not put any specific time limit on how long the appointed deputy can remain in power, and the decision appears to rest with the mayor.
The charter states the mayor can appoint a deputy when he is "necessarily absent from the city or temporarily disabled." While the charter goes on to outline what the deputy can and cannot do, it is silent on the question of how long he can serve.
George Jacoby, who was executive secretary to Mayor Richard Caliguiri in the 1980s, said he believes the deputy can remain on the job as long as the mayor wants, assuming the mayor isn't incapacitated.
"In my opinion, the call is really the mayor's," he said.
The charter does allow a mayor or any other elected official to be impeached for "mental incapacity," but Mr. Jacoby said that would be "pretty crass," and there has been no indication of anyone pursuing that action in Mr. O'Connor's case.
Mr. Jacoby said he does not believe the mayor's extended absence will have much impact on the city's daily operations or even initiatives that already have been set into motion, like Mr. O'Connor's Redd Up campaign.
"Ninety percent of the city runs by itself, even if all the directors stay home," he said.
Where a long absence could have some effect is in new policy or legislative initiatives launched by the administration, particularly without the mayor available to lead the charge, he said.
"It's very difficult to take on new initiatives without the mayor there," Mr. Jacoby said.
City Councilman William Peduto said mayors now are not permitted to keep acting directors in place indefinitely, but he added he does not believe that applies to a deputy mayor.
He said that is an issue council may want to address at some point in the future, but not now.
"I don't think it's really time to have a debate. Everybody's best interest is to have the mayor return to work," he said.
One of the key challenges the administration could face in Mr. O'Connor's absence is the budget, a responsibility that has assumed even more significance with the city's financial problems and subsequent state oversight.
"It's not clear to me whether that can be done or should be done by the deputy," said Aldo Colautti, executive secretary under Mayor Joseph Barr. "That seems like the first major responsibility of the mayor that's going to have to be dealt with."
Mayoral spokesman Dick Skrinjar said he did not foresee any problems with the budget. He said Scott Kunka, the city's budget and acting finance director, is "one of the better number guys" in the city and has been involved with both the state Act 47 team and the state-appointed Intergovernmental Cooperation Authority.
"If you had people who were less professional and experienced than what you have there, it would be a problem. But it's not," Mr. Skrinjar said, adding that Mr. O'Connor, with his business background, was "very careful" selecting those who worked on the city's finances.
While doctors aren't predicting an early return for the mayor, Mr. Skrinjar said Mr. O'Connor was "very engaged" in issues of the city Monday when he visited.
At the time, he asked about a crackdown on squalid housing conditions in Oakland and even suggested that the city turn it into a "back to school special" with students arriving for the fall.
But the mayor, he said, also agrees "in the interim that having Yarone handling some of the administrative and executive duties is a good idea for as long as it is needed."
Doctors revised their timetable in announcing a change in Mr. O'Connor's course of treatment. Chemotherapy did not shrink the tumors in the mayor's brain, and doctors now plan to switch to radiation starting next week, assuming there are no complications to today's surgery to place a shunt into his abdomen.
The shunt is being used to drain fluid from Mr. O'Connor's brain. With the surgery the shunt will drain back into the body rather than outside it and should give Mr. O'Connor more mobility and allow him to begin physical therapy. It also should allow him to be moved from intensive care to a regular room.
Dr. Marks said it is possible that Mr. O'Connor could be out of the hospital in two weeks after starting radiation, although he cautioned that he also could end up staying at UPMC for the entire four weeks, depending on how he responds.
He noted that one of the cumulative effects of the radiation is that Mr. O'Connor is going to be "pretty tired, even if he's getting better." Once the treatments end, it may take a couple more weeks to regain his strength, he said.
"So we've made it clear there's no way we want him to even consider going back even if he is responding and getting better in that four-week period," Dr. Marks said.
Doctors also said there's a chance of some loss of cognitive ability in the long term from the radiation, although Dr. Marks estimated the risk in Mr. O'Connor's case at about 10 percent.
While the chemotherapy hasn't reduced the tumors in Mr. O'Connor's brain, it has helped to eliminate his headaches and back and neck pain. Yet, although Mr. O'Connor has improved cognitively, he still "goes in and out in terms of lethargy," Dr. Marks said.
"There are periods of the day when I can go see him and we'll have a great conversation about the Steelers or Pitt football or just events. We talked about the Israeli war the other day."
But there are other times, he added, that Mr. O'Connor is so lethargic that he "just wants to nod off." Part of that could be due to the tumors, and could be reversed with the radiation, he said.