I knew Rehnquist was sick with the thyroid cancer, but to me he just looked really, really frail this AM. That trach tube worries me too; it shows that in the recent past he's been on a ventilator, and for some amount of time; if someone needs to be on a vent for just a few days, they just use the tube that goes down the throat. They don't do the surgical opening in the neck unless it will need to be in for awhile. And seeing the plastic tube there means they anticipate he'll need it again; otherwise they'd remove it completely. Normally, there's no need for a surgical trach after surgery or radiation or chemo unless there were complications.
He did look very alert today, and happy that he could administer the oath. I know from some experience that people can "hold on" for important events, and today I just got the feeling that this was it for Renquist.
The tracheostomy tube stays in place in order to keep an open airway. The radiation treatment in the head and neck area can severly damage the air passageways making it difficult to breath without the tube. My father had a tracheostomy done since he had a lot of swelling in his airways due to the radiation and subsequent damage to the healthy tissue (radiation fibrosis which eventually led to radiation necrosis. Radiation is a horrible thing. It can kill the cancer BUT it also destroys the healthy tissue. This damaged tissue gets prgressively worse over time.)