World-renowned neurosurgeon Juha Hernesniemi was in Helsinki at about 2 p.m. on August 27 when he received an urgent phone call from Central Asia.
Uzbekistan's President Islam Karimov was hospitalized in Tashkent after suffering a brain hemorrhage.
According to the Uzbek government's official medical report, an unconscious Karimov had been taken to the Central Clinical Hospital in Tashkent about two hours earlier, at 9 a.m. Tashkent time.
A cranial CT scan revealed that Karimov suffered a "massive subarachnoid hemorrhage" -- a stroke caused by a ruptured blood vessel in the fluid-filled space between his brain and the thin tissues that cover the brain.
Karimov's heart had stopped, but the official medical report said medical teams managed to get his heart beating again after 20 minutes of resuscitation attempts.
Karimov was left in an "atonic coma," however. The function of his brain stem were inhibited and he was put on life support to keep him breathing.
Authorities in Uzbekistan wanted Hernesniemi to travel to Tashkent as quickly as possible to assess the president's condition and recommend any possible treatment -- including brain surgery, if necessary.
Finnish neurosurgeon Juha Hernesniemi (credit: Finnish Broadcasting Company)
Soon after he agreed to make the journey, a private plane met Hernesniemi in Helsinki and whisked him away to Uzbekistan, stopping first in Germany.
It was August 28 by the time Hernesniemen arrived at the Central Clinical Hospital in Tashkent and found himself standing beside Karimov's bed.
Hernesniemi told the Finnish Broadcasting Company (Yle) that it was clear that the "game was over" for Karimov because, "in practical terms," he was already "brain dead."
He said he gave his professional opinion that "surgery did not make any sense at that point" and that it was pointless to continue treatment.
Hernesniemi said he was at the hospital when German and Russian medical experts gave their opinions.
According to the Uzbek government's official report, the German and Russian experts included Hugo Katus from University Hospital Heidelberg, Amir Samii from the International Neuroscience Institute in Hannover, and Leo Bokeria, the head of the Department of Cardiovascular Surgery at Moscow State Medical University.
The official medical report said Gilles Dreyfus, the medical director at the Cardiothoracic Center of Monaco, was also consulted about Karimov's condition.
Hernesniemi told Yle that once the experts had given their assessments, the "power game" began.
Asked to elaborate, Hernesniemi said he was referring to situations like the deaths of Spanish dictator Francisco Franco and Israeli Prime Minister Ariel Sharon -- where a politically important person falls into a coma with severe brain damage, but is kept clinically alive on a life-support machine while others take steps to establish a political successor.
Karimov remained on life support through Uzbekistan's celebrations marking the 25th anniversary of the country's independence from the Soviet Union on September 1.
On August 31, amid rumors of Karimov's death and conjecture over who might succeed him, a broadcaster for Uzbek state TV read out the text of an Independence Day speech traditionally delivered by Karimov.
In the absence of any official government statement about Karimov's condition or the reason for his hospitalization, his daughter Lola Karimova-Tillyaeva posted messages on social media announcing that he had suffered a brain hemorrhage and was in "stable" condition.
She also implied that Karimov was still alive and there was a chance of "recovery."
But on the morning of September 2, after Uzbekistan's Independence Day celebrations had concluded, it was announced that Karimov was in "critical condition."
He was officially pronounced dead at 8:55 p.m. on September 2.