The president just wouldn't listen. Kosovo leader and chain smoker Ibrahim Rugova, reports physician and Democratic League of Kosovo (LDK) party heavyweight Alush Gashi, refused to heed any warnings or allow anyone to examine him. "We weren't even permitted to measure his blood pressure," says Gashi.

Nobody, in other words, was surprised to hear the bad news from the American military hospital in Landstuhl, Germany. Ibrahim Rugova, President of Kosovo, has lung cancer. Even if the cancer has yet to metastasize beyond the one lung it's currently attacking, it does not look good.

But it's not just Rugova's own future that is looking bleak. The life-threatening illness of Kosovo's most well-known politician has plunged the entire political leadership of the province into a deep crisis. While Kosovo newspapers have published page after page of get well wishes from all over the world, the political struggle to succeed Rugova is well underway.

Officially, Rugova's successor has already been picked. Nexhat Daci, the current president of the semi-autonomous region's parliament, has been picked to soon take over Rugova's day-to-day duties. But the more important question is whether Rugova's weakened LDK party can survive his departure. Currently, the party forms a governing coalition with the Alliance for the Future party. However, many fear that without Rugova's leadership the bitterly divided LDK could finally break apart completely. The result would be a dangerous political crisis in a dangerously volatile region.

The United Nations, which has controlled Kosovo since 1999, is worried. Already, the region was tense in the face of final status talks for the region -- still officially part of Serbia -- which were scheduled to begin this autumn. Now though, those talks may have to be put on ice. The Kosovo Albanians, says United Nations Mission in Kosovo (UNMIK) spokesman Remi Dourlot, are not at all ready to negotiate.

Even with Rugova, the Kosovo Albanians had been struggling to unite before the final status negotiations. A group called the "Forum of all Party Leaders" has been trying for months to agree on a collective, Kosovan negotiating strategy -- so far without success. The insurmountable differences between Serbs and Albanians will ultimately have to be settled by an international conference, at which, Kosovo's ethnic Albanians hope, Washington will help push through independence for Kosovo.

In return, of course, the Albanians would be forced to accept strict conditions imposed by the international community. The NATO-led protection force would likely remain and UN would probably still have a major roll to play in the region's administration.

But a transition to Albanian leadership could be risky, says UNMIK spokesman Dourlot. He thinks there's a real danger that radical groups in the region could take advantage of a new government and increase their power. An organization called "Vetevendosje" (Self-determination), led by former student leader Albin Kurti, is currently gaining support in the province, especially among young ethnic Albanians. Vetevendosje, whose motto is "Self-determination, no negotiation!" has provoked what it calls the region's occupiers with its demand that UNMIK be pulled out as quickly as possible.

The movement has also found support among many veterans of the former rebel army, Kosovo Liberation Army (KLA). They are now hinting they may revive their struggle for liberation if independence continues to be delayed. Only a few months ago, Rugova himself had even threatened to declare independence unless there was finally some progress in efforts to gain sovereignty for the region. Indeed, Kosovans are already celebrating their ailing president as a hero of the independence movement.

In an official appearance last week, Rugova also made it clear that he believes he is coming closer to his great political goal. The visibly weakened leader announced that he will soon be performing his official duties again -- with God's and America's help -- in an independent state of Kosovo. It's a goal, however, that is by no means assured.