What Do We Know About Khamenei's Illnesses and Surgeries?

Ayatollah Ali Khamenei, at 85 years old, is one of the oldest leaders in the world. Born in July 1939, Khamenei has been in power since the 1979 revolution in Iran, but has held the position of Supreme Leader for 35 years since 1989. He is the fourth oldest political leader in the world and the sixth longest-serving leader currently alive. Despite this, he continues to speak passionately, sometimes appearing at military ceremonies and being filmed walking without difficulty. However, it has been a long time since images of him hiking have been released. His associates claim, 'Thank God, he is healthy.' Dr. Alireza Marandi, Khamenei's family doctor, stated on April 10 of this year, 'The age of leadership is not small, and he is nine months older than me, but thank God he is healthy... sometimes we recommend that he eat more fruit.' Is the Supreme Leader really healthy enough at 85 years old, despite various illnesses, to only have issues with vitamin deficiency and fruit consumption? Khamenei has undergone multiple surgeries over the past four decades. Severe shoulder injury, loss of function in his right arm and its nerve network, along with rib fractures and severed nerves and blood vessels in the armpit area due to an assassination attempt in 1981, and years later, gallbladder surgery, prostate surgery, and heart disease are just examples that can be definitively discussed. The government generally hides and censors the physical and mental health status of the Supreme Leader and has not allowed a serious and transparent discussion about the next successor, should the structure remain the same. 1- Khamenei's survival was a 'miracle'; 1981 Khamenei was targeted for assassination on June 27, 1981, while he was the Friday prayer leader of Tehran and a representative of Ayatollah Khomeini in the Supreme Defense Council. At that time, he was only 42 years old. The recording device on his lectern exploded, and according to Dr. Hadi Manafi, the then Minister of Health, Khamenei's survival was a medical miracle: 'The artery in his right hand and its nerve network were completely destroyed; we opened his right leg and took a vein, which took about four hours.' Khamenei survived, but physically he was no longer the same Khamenei. When he regained consciousness, he asked Dr. Manafi if his tongue and brain would work. 'As soon as he regained consciousness and was able to become aware of his surroundings, while a tube was in his lung and he was unable to speak, he gestured for a pen and paper. Naturally, his right hand was not functioning, but he wrote a few questions with his left hand. The first question was about the condition of the children around him, meaning he asked about his guards. The second question was whether his tongue and brain would work, to which we said yes. He replied that was enough for him.' Less than three and a half months after the assassination attempt, with the approval of the political incompetence plan of Abolhassan Banisadr and his removal from the presidency, Khamenei, while still in poor physical condition, became president in October 1981. During his presidency, no report on his ability and health status was published. It had to be shown that the loss of function in his hand and its resulting complications did not hinder his duties. 2- Gallbladder surgery; 1991 Khamenei became the Supreme Leader of the Islamic Republic at the age of 50 in 1989. This time, more effort was made to keep his serious illnesses from becoming public. Almost two years later, news of his need for another surgery emerged. Akbar Hashemi Rafsanjani, the then president, wrote in his memoirs on April 16, 1991: 'Last night, around midnight, we were awakened by a call from the Leader's office. Mr. Mohammadi Golpayegani informed us that Ayatollah Khamenei's stomach pain had intensified, and the doctors recommended surgery, but for now, he was resting with painkillers and could not attend the Eid prayers and ceremonies. He asked me to lead the Eid al-Fitr prayer (...) I visited the Leader. His pain had subsided, but he was unwell. The doctors said that a lot of stones had accumulated in his gallbladder and that surgery was necessary. It was decided to conduct further examinations before the surgery, and to prevent rumors, a short meeting with police commanders was arranged.' Khamenei went to Shahid Rajai Heart Hospital on May 10, 1991, for surgery on what was referred to as 'gallbladder.' Dr. Manafi had described Khamenei's injuries as 'very severe.' 'The injuries were mostly on the right side of his body; his shoulder and arm were completely damaged, and the nerves and blood vessels in that area under the armpit were completely destroyed, and his right hand was not functioning at all. Due to significant blood loss, his blood pressure was very low, and overall, his survival after losing so much blood was a real miracle. From a medical perspective, it is among miracles that a person with this level of injury and blood loss, with such low blood pressure and no pulse, could survive.' Khamenei survived, but physically he was no longer the same Khamenei; when he regained consciousness, he asked Dr. Manafi if his tongue and brain were functioning. 'As soon as he regained consciousness and was able to become aware of his surroundings, while a tube was in his lung and he was unable to speak, he gestured for a pen and paper. Naturally, his right hand was not functioning, but he wrote a few questions with his left hand. The first question was about the condition of the children around him, meaning he asked about his guards. The second question was whether his tongue and brain would work, to which we said yes. He replied that was enough for him.' Less than three and a half months after the assassination attempt, with the approval of the political incompetence plan of Abolhassan Banisadr and his removal from the presidency, Khamenei, while still in poor physical condition, became president in October 1981. During his presidency, no report on his ability and health status was published. It had to be shown that the loss of function in his hand and its resulting complications did not hinder his duties. Khamenei became the Supreme Leader of the Islamic Republic at the age of 50 in 1989. This time, more effort was made to keep his serious illnesses from becoming public. Almost two years later, news of his need for another surgery emerged. Akbar Hashemi Rafsanjani, the then president, wrote in his memoirs on April 16, 1991: 'Last night, around midnight, we were awakened by a call from the Leader's office. Mr. Mohammadi Golpayegani informed us that Ayatollah Khamenei's stomach pain had intensified, and the doctors recommended surgery, but for now, he was resting with painkillers and could not attend the Eid prayers and ceremonies. He asked me to lead the Eid al-Fitr prayer (...) I visited the Leader. His pain had subsided, but he was unwell. The doctors said that a lot of stones had accumulated in his gallbladder and that surgery was necessary. It was decided to conduct further examinations before the surgery, and to prevent rumors, a short meeting with police commanders was arranged.' Khamenei went to Shahid Rajai Heart Hospital on May 10, 1991, for surgery on what was referred to as 'gallbladder.' Akbar Hashemi Rafsanjani noted in his memoirs that he witnessed Khamenei's surgery: 'To be present during Mr. Khamenei's surgery, I went to the heart hospital. I discussed state affairs with him for an hour. He was in good spirits. He was completely normal. We prayed Maghrib and Isha with him leading, and then we went to the operating room. I observed the anesthesia and the cutting and performing of the surgery and stitching, and then the contents of the gallbladder. Dr. Iraj Fazel and the surgical team performed the operation well; quickly, calmly, and confidently. Due to the use of an electric scalpel, there was no bleeding. The contents of the gallbladder were black and contained large stones (...) Ahmad and Mohammadi Golpayegani came. After the operation, I waited a bit and comforted his family and then went home. He had not regained consciousness yet. I told the doctors to quickly issue a statement about the operation.' The government was concerned about leaks of the news and its subsequent consequences. Therefore, Ayatollah Khamenei himself explained his illness in a radio-television interview before the surgery: 'I had an old stomach ache that had manifested itself as severe pain since 1974. When I visited doctors, they sometimes attributed it to ulcers in the duodenum and sometimes to stomach ulcers. The first time I was taken to a doctor for treatment, I was in prison, and this illness accompanied me, and I took care of this gastrointestinal ulcer until the last month of Ramadan, when I had several severe pains that last appeared on the last day of Ramadan, and this pain intensified on the night of Eid al-Fitr to the point that the doctors were calming it with strong painkillers. When thorough examinations were conducted, it became clear that these pains were related to gallstones. However, this does not negate the previous diagnoses of the doctors regarding the existence of ailments in the digestive system. But what put me under a lot of pressure at the end of Ramadan and prevented me from attending the Eid al-Fitr prayer, which Mr. Hashemi Rafsanjani announced, was this gallbladder issue. The doctors said that to treat this severe pain that brings a lot of weakness and lethargy with it, there was no choice but to perform surgery, and it had to be done. I wanted to have the surgery done sooner, but I was waiting for Mr. Hashemi Rafsanjani to complete his trip abroad, and now it has been decided that this operation will be performed in the coming hours. I have been told that I may stay in the hospital for two days.' The day after the surgery, Hashemi Rafsanjani also visited Ali Khamenei in the heart hospital. He wrote: 'He was conscious, but usually asleep. He woke up for a moment, and I inquired about his condition. He said that sometimes severe pain occurs, which the doctors say is natural.' 3- Heart disease; 1998 The media and the public did not learn about Ali Khamenei's 'heart disease' in 1998. This issue remained hidden for more than 23 years until Akbar Hashemi Rafsanjani, the then president, wrote about the type of illness of the leader that year in his memoirs published in 2021; an illness that officials at the time were working hard to keep from the public. In June 1998, only news of the Supreme Leader's 'illness' was published. From Rafsanjani's memoirs, we learn that initially, even he was not aware of Khamenei's 'heart disease' at that time. On June 9, he learned about the leader's heart disease from Ali Akbar Nategh Nouri, the then Speaker of the Islamic Consultative Assembly, who said, 'The doctors have advised him to rest due to his heart condition, and they have also canceled today's meeting with representatives to prevent rumors.'