Ariel Sharon is still alive, but only just.
The man whose inspired military leadership and controversial policies earned him the nickname "the Bulldozer" today lies silent and motionless in the Sheba Medical Center outside Tel Aviv.
"His predicament is like a Greek tragedy," said Dr. Raanan Gissen, his longtime spokesman and friend, in an interview with ABC News. "He is between life and death. He is neither here nor there."
On Jan. 4, 2006, the prime minister suffered a massive stroke. He has not been seen in public since.
On the night of Sharon's stroke, an Israeli television crew snatched fleeting pictures of him in the back of an ambulance, still conscious and still sitting upright. It is the last image of Sharon most have.
His condition was stabilized after several life-saving surgeries and in May 2006 Sharon was transferred to a unit for the long-term treatment of stroke patients. He has been there since. He turned 80 this year.
"People don't like to think about it, it's just too painful," Gissen said. "He was a real leader. People were prepared to follow him. He made mistakes but he always got back up and carried on. People appreciated that."
Bodyguards are still on duty outside of Sharon's hospital room 24 hours a day.
According to Gissen, Sharon's room is fully sterilized to avoid infection. Gissen says that he is not reliant on a ventilator, but that sometimes at night an oxygen mask is placed across his face to help him breathe. He is fed intravenously and only a handful of people are allowed to visit him.
"His two sons visit every day sometimes with their families," said Gissen. "They play music to him and talk to him, but there is no cognitive response. His body is strong however. His father lived well into his 90s."
According to Israeli media reports, however, Sharon's youngest son, Gilad, is convinced he can communicate with his father. Doctors treating Sharon admit there is slight movement in his hand and eyes apparently in response to a familiar voice or music.
In September, professor Zeev Rothstein, the hospital's director general, gave a rare interview to Israel's Army Radio.
"He can move his eyes or a finger or a few fingers, that sort of reaction. … He reacts to pain, to the voice of a family member. These reactions suggest he is not completely unconscious but conscious at a very basic level. It is hard to say what he understands or what he does not understand. He does react to stimuli but this is nothing new," Rothstein said.
Sharon's demise has left a huge hole in Israeli politics and in the lives of those who worked with him.
Gissen used to read the newspapers to Sharon every morning at 5 a.m. to brief him on the day's developments at home and abroad.
"It's a great void," he said. "I try to fill the time, but it's just not the same without him."
Gissen also believes Sharon's disappearance has left a regrettable void in Israel's political life.
"Sharon was a real leader. The real predicament of his absence is that he left no obvious heir. Right now it would be good to have someone of his stature to lead us, to guide us," he said.
As to Sharon's physical condition and the state of his body, Rothstein said, "A patient who has spent such a long time on a hospital bed will never look the same as he looked as he was up and running. So he looks different."
Rothstein hasn't lost hope that Sharon will make progress but admits there has been no real recovery of brain function since the stroke.
For some the idea of Sharon lying in his current listless state raises difficult questions about whether or not he should be kept alive.
"It's up to the family," said Gissen. "He is still alive. If you stop feeding him, he will starve to death. That's against every Jewish law. There is still the slightest chance he may improve, although it's very unlikely. It's up to the family."
Gissen clearly misses his old boss. He said Sharon was one of the last "founding fathers of Israel," part of the generation of soldiers and politicians who helped establish the Jewish state in the 1940s. Despite their decades-long relationship, Gissen has chosen not to visit Sharon's hospital room.
"I don't want to see him in this condition. It's very sad, it's tragic. I don't believe he himself would ever have wanted to end up like this."