Rising inflation, a falling approval rating and a sharply divided country had put Brazil¡¯s Luiz Inacio Lula da Silva on the cusp of the most difficult chapter of his long years in office even before he underwent emergency brain surgery.

Now, the operation raises difficult questions about whether the 79-year-old leftist leader is fit to meet the challenges that are piling up in front of him.

Much as with Joe Biden in the U.S., the episode is bound to bring discussions about Lula¡¯s age and fitness to the forefront of Brazil¡¯s political conversation, especially as attention turns to whether he intends to seek a fourth term in 2026. The question is whether he draws the same conclusion and passes on the baton or waits for the storm to pass.

¡°He is a veteran politician, but at the end of the day, he is a human being,¡± said Mauricio Santoro, a fellow at the Center for Political and Strategic Studies of the Brazilian Navy, a think tank in Rio de Janeiro. ¡°It¡¯s normal that he will show the consequences of his old age and declining health.¡±

Doctors for the president known universally as Lula said Tuesday that he¡¯s awake and stable hours after undergoing a standard procedure to drain a hematoma, adding that he had not suffered any damage to his brain and should be back to work next week.

But speculation about the president¡¯s health has swirled in Brasilia and beyond since an October fall sent him to the hospital, causing him to cancel a trip to Russia and decide against traveling to the Amazon for a possible meeting with Biden.

Throughout his dramatic return to Brazil¡¯s top job, which he previously held from 2003 to 2010, Lula has been conscious of questions about his age and health.

The president, who was diagnosed with cancer in 2011 then spent 580 days in prison on a corruption conviction that was ultimately annulled, regularly posts videos of himself running, exercising and lifting weights on social media. He has routinely cited his remarriage ahead of the 2022 election as a source of rejuvenation that proved he had the energy to be president again.

For most of the past two years, it¡¯s helped push talk about his health to the backburner. But that changed on Oct. 19, when Lula fell while finalizing plans to travel to the BRICS summit in Kazan, Russia.

After trimming and filing his toenails, the president moved to place a toiletries case back into a bathroom cabinet. The stool he was sitting on, he later recounted to a local TV station, didn¡¯t move with him.

¡°My butt didn¡¯t lift, so I fell and hit my head,¡± he...