HARRISBURG, Pa. -- Looking extremely thin, his bushy black eyebrows accentuating the paleness of his skin, Gov. Robert P. Casey returned to work yesterday for the first time since a heart and liver transplant brought him back from the brink of death 190 days ago.
Mr. Casey's emotional return ended speculation that the 61-year-old Democrat would not come back to his Harrisburg office, but questions linger as to how effective he can be in his term's final 12 months. Twice since the operation, Mr. Casey was hospitalized for infections.
Yesterday, in a brief speech in the Capitol, Mr. Casey told 200 officials and family members that he never doubted he would return.
"The only question was when," he said. "I came back because it was my duty to come back. I was re-elected in 1990 by the people of this state to serve a four-year term, and that, with the help of God and our people, is what I intend to do."
Mr. Casey choked up once and was at a loss for words on occasion.
"This is all too much, I don't know how to begin," he said softly, standing at a lectern flanked by his wife, Ellen, and their eight grown children. Behind them a banner read: "Welcome back, Governor. Your return is our best Christmas present."
Clearly moved, Lt. Gov. Mark S. Singel, who has been acting governor, said, "Any time you can reduce a Mark Singel, a Bob Jubelirer and a Bill Lincoln to tears, you have accomplished something phenomenal."
Robert C. Jubelirer, the Republican minority leader of the state Senate, has been Mr. Casey's most outspoken opponent over the years; William J. Lincoln is the state Senate's Democratic majority leader.
Mr. Casey's doctors are concerned about the stamina of the governor, who suffers from familial amyloidosis, a rare liver disease that severely damaged his liver and heart and weakened his intestines.
The 6-foot-2-inch Mr. Casey weighs about 160 pounds, down from the 210 pounds he weighed before he began having heart trouble in 1987, his doctors say. To increase his weight and strength, doctors are giving him intravenous feedings at night and anti-viral medication.
The governor is the first American with amyloidosis to try to cure the disease with a heart-liver transplant and only the third person the world to do so.
Doctors say they have no evidence yet that transplants are a cure, but they are optimistic.
"We've encouraged him to go back to work gradually, and certainly not to take on a travel schedule. But even in terms of his daily schedule, we want him to step into it gradually and see how his stamina is, then build from there. With the viral illnesses he has had, we would be concerned if he tried to get into too heavy a schedule," said Dr. William P. Follansbee, his cardiologist.