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September 03, 2020

Brain surgery on a former president? We can do that

IU Health Methodist Hospital

Brain surgery on a former president? We can do that

From president to patient: Amos Sawyer led the country of Liberia for four years, but it was his connection to IU Bloomington that led him back to Indiana for lifesaving surgery.

By Maureen Gilmer, IU Health senior journalist, mgilmer1@iuhealth.org

It may not be surprising to hear that people come from all over the world to receive lifesaving care at IU Health hospitals.

But would you be surprised to learn that one of those patients is the former president of Liberia in West Africa?

Amos Sawyer, whose anglicized name can be traced back to Christian missionary roots in his father’s birthplace of Sierra Leone, is indeed a former president of the war-torn nation.

A scholar in the areas of social science, governance, conflict resolution and peace building, he led the country’s transitional government from 1990-1994. It was supposed to be a six-month gig.

“In finding somebody to head the transitional government, they needed someone who didn’t have ambitions to participate in elected government,” Sawyer explained from the kitchen table at his efficiency apartment in Bloomington, Indiana.

“I was selected to become president of the interim government. I was to serve for six months. We were naïve, that’s why I accepted,” he said with a chuckle. “Instead, the negotiations, ceasefire, disarming of various factions, etc. took years. My six months went on for four years.”

He’s been the target of death threats, was imprisoned by a military leader who rejected his attempts to promote democracy, and was placed under house arrest for a year in the 1980s.

With all of that, he has made it his mission in life to bring peace and understanding to people everywhere.

PROFESSOR AT IU

Sawyer, 75, has been traveling back and forth from Liberia to Indiana, for about 35 years now. He was on the faculty at Indiana University for two decades, specializing in political science and policy analysis. He holds a doctorate in political science from Northwestern University.

He treasures the community of researchers, academics and physicians he has found in Bloomington, which is why he has made it his part-time home on and off for years.

But when he returned to Bloomington with his wife last year for a medical checkup, he told his primary care physician he was experiencing pain in his left leg, which then moved into his back. Doctors first thought it might be related to his sciatic nerve and sent him to a pain management specialist, who recommended a series of injections.

Sawyer, eager to return to Liberia to continue his work there, opted to postpone the treatment for a few months and went back to his home country. This was in November 2019. He planned to return to Bloomington in late March, but then COVID struck and travel was restricted.

By then, the pain and weakness in his leg had spread to his left arm, which became so weak he could hardly lift it. Writing (he is left-handed) became increasingly difficult.

At the urging of his wife, Sawyer sought a consultation with a neurologist in Liberia’s capital city of Monrovia. A CT scan revealed a massive tumor on the right side of his brain.

The good news? It was benign. But still, “it was devastating,” Sawyer said. “I never expected it.”

MEDICAL EVACUATION

The challenge then was to get back to the United States for surgery in the midst of COVID. The couple was eventually evacuated by the U.S. Embassy on a charter flight, and Sawyer was put in the care of Dr. Mitesh Shah, chief of neurosurgery at IU Health Methodist Hospital.

“It was all so well-coordinated. We are so grateful,” Sawyer said in mid-August, several weeks after the June 30 surgery. “Dr. Shah and his team did a fantastic job.”

Did the surgeon realize he was treating a former president? Well, not at first, the humble Sawyer says with a hearty laugh. It was a visit by two other members of the medical team to his room before surgery that gave it away.

The gentlemen in question were natives of Ghana and Guyana, neighboring countries to Liberia, and the three men began talking about their backgrounds. When Sawyer mentioned his name, it resonated with one of the men, who said, “Where have I heard that name before?”

In an instant, he knew. “You are the Sawyer who was president of Liberia!”

Sawyer laughs while retelling this story, adding that he never mentioned his past to anyone on his medical team.

“It made me more an object of curiosity,” Sawyer said.

But the treatment he received didn’t change. He laughs again. “It was already good. I didn’t need it to get better.”

Quickly, his notoriety spread, eventually reaching Dr. Shah.

“It was the craziest thing,” the surgeon said, remembering how Sawyer was one of the last people he saw in clinic one day after colleagues at IU Health Bloomington asked him to take a look at the man’s case. Dr. Shah recalled how Sawyer arrived with his brother, a urologist from Michigan.

“It was late in the day, the poor guy couldn’t walk. He was in a wheelchair,” Dr. Shah said of Sawyer. “We had so much to talk about with his disease he never even mentioned any of his history.”

It wasn’t until later that an anesthesiology resident recognized his name, Dr. Shah said. He was as stunned as his medical team.

It was a complex operation, the surgeon said, but it wasn’t until afterward that he really began to sweat.

“He woke up after the surgery not able to move his leg or arm at all. I was distraught,” Dr. Shah said.

But within a few days, the movement gradually returned to Sawyer’s limbs.

“These are the moments of highs and lows,” the physician said. “You take the tumor out and feel like you did a good job, and he wakes up temporarily paralyzed. We had to be patient.”

PATIENCE FOR THE PATIENT

Two months post-surgery, the scholar, author, peacemaker, father of four and grandfather of eight is rehabbing with outpatient physical and occupational therapy in Bloomington. But he is eager to get back to his writing, research and collaboration on a host of policy issues. He retired from the faculty of IU in 2010, but he continues to meet with colleagues there to discuss his work.

While he says he couldn’t ask for a better home away from home, he is impatient to get back to Liberia, where he believes he can offer advice based on life experience and research that can benefit people throughout the West African region, specifically on conflict resolution. He is writing a book on the subject and is creating a series of citizenship education books for elementary schools in Liberia.

“Liberia is where I can transfer knowledge, from what I learn here though interaction with colleagues,” he said. “I can bring back some ideas as to how … you bring groups together and create a win-win situation so nobody is sufficiently unhappy that you take your marbles and leave the table.”

In any negotiation, whether for peace or a property settlement, it’s important that both sides come away with something, he said.

“If this were used more in areas of conflict resolution, you would get a lot done … so people don’t feel marginalized.”

Despite his passion for democracy, he laughs when asked if he might consider running for president of his home country again. The answer is a resounding no.

Then a memory hits him. The date of our conversation was Aug. 19.

“It was Aug. 19, 1984, when a military dictator threw me in jail.”

Despite the threats he faced then, he knew he couldn’t sit idly by while his country was destroyed by war and corruption.

“I knew there were risks in speaking out, but it was going to be difficult to live with myself if I didn’t say something.”

PROGNOSIS IS GOOD

Sawyer gets around with a walker now, but his surgeon believes that with continued therapy he will be walking independently within the next several months.

“I think his prognosis is good. We took out all of the tumor except that portion that was attached to a large blood vessel,” Dr. Shah said. “That will have to be followed over time, and he may need some form of radiation if it shows evidence of growth.”

For someone who had no idea that a meningioma (a tumor) was forming on his brain, his diagnosis elicited a feeling of panic at first, Sawyer said.

“But the first thing that I appreciated was the way in which the doctors calmed me down. ‘It was going to be OK. We will deal with this together,’ they said. That approach, that relationship with Dr. Shah and his team, was fantastic.”

While Dr. Shah, who serves on the IU Health Foundation Board, may have been surprised to find out he was operating on a former president, that kind of celebrity is not new.

“When we talk about the benefits of being part of a large group like IU Health, this is a great example,” he said. “People come here from all over because they trust the care they will get. That speaks volumes.”

Photos submitted and by Mike Dickbernd, IU Health visual journalist, mdickbernd@iuhealth.org

Related Services

Neurosurgery

Neurosurgery treats conditions that affect the brain, spine and nerves, including aneurysms, tumors and injuries.

Brain Tumors

Brain tumors can put you at risk for serious complications that interfere with normal functioning. Cancerous or noncancerous, they can cause disruptive symptoms.

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