Castro has Parkinson's disease, CIA has concluded
Two officials said the CIA is convinced that Cuban leader Fidel Castro suffers from Parkinson's disease. The agency has made a point of alerting U.S. policymakers.
BY PABLO BACHELET AND FRANCES ROBLES
WASHINGTON - The CIA has alerted policymakers over the potential eroding of Fidel Castro's health.
The CIA recently concluded that Cuban leader Fidel Castro suffers from Parkinson's disease and has warned U.S. policymakers to be ready for trouble if the 79-year-old ruler's health erodes over the next few years.
If true, the CIA's assessment of the nonfatal but debilitating condition would mean Castro may be entering a period where doctors say the symptoms grow more evident, medicines are less effective and mental functions start to deteriorate.
Although Castro's brother Raúl, head of the armed forces, has been anointed as his successor, Cuba analysts fear the possibility of a tumultuous period during which an incapacitated Castro refuses to give up power but can no longer project his overpowering personality to Cuba's 11 million people.
''For Fidel to start shaking in a real and substantial way -- in public -- sends quite a powerful message to people around the world,'' said Frank O. Mora, a professor of national security strategy at The National War College.
Rumors that Castro suffers from Parkinson's have been around since the mid-1990s. In 1998, he even jokingly challenged journalists to a pistol duel at 25 paces to show the steadiness of his hands.
But the Central Intelligence Agency began briefing senior members of the State Department and lawmakers about one year ago that its doctors had become convinced that Castro was diagnosed with the disease around 1998, said two longtime government officials familiar with the briefings. Both asked for anonymity because leaking the contents of the classified briefing could violate U.S. laws.
''About one year ago, we started seeing some pretty definitive stuff that he had Parkinson's,'' said one of them.
There has been no independent confirmation of Castro's illness, or any indication of how the CIA came to its conclusion. The State Department and the CIA declined to comment for this story.
But one State Department official said there is already evidence that Castro's abilities are fading noticeably. He is increasingly slurring his words and going off on tangents in public speeches, although he seems to have good days and bad days. Clearly, ''he is not the same person he was five years ago,'' added the official.
Others insist that Castro is fine, however. ''He enjoys excellent health,'' Ricardo Alarcón, president of Cuba's National Assembly, said last month after he was asked about Castro's failure to attend the Ibero-American summit in Spain.
Parkinson's symptoms include tremors, stiffness, difficulty with balance and muffled speech, although its exact manifestations vary according to the victim. High-profile individuals stricken with the disease include the late Pope John Paul II, former U.S. Attorney General Janet Reno, actor Michael J. Fox and boxer Muhammad Ali.
Dr. Carlos Singer, a Parkinson's expert at the University of Miami, said the disease on average cuts short the lifespan of a patient only by one or two years. ''The issue is not as much how long they can live, it is how much do they suffer in the process,'' he said.
The first five to eight years usually are ''manageable with relatively small doses of medication,'' Singer said. After that, symptoms such as stooped postures and difficulties with balance become more evident. And in the advanced stages, about 40 percent of patients develop what one specialist on the disease called ``basically an overall decline in cognitive functions.''
DRUG EASES SYMPTOMS
The main drug to ease the symptoms of the disease is levodopa, which replenishes the brain with the dopamine chemical that is deficient in Parkinson's. Patients can program their activities around the periods when the drug is taking effect, known to doctors as ''on periods.'' But over time, the drug loses its effectiveness.
''As the disease slowly progresses, the medications have to be taken more frequently, at higher doses,'' said Paul Larson, a neurosurgeon and Parkinson's specialist at the University of California, San Francisco. 'But you eventually reach a point where the patient is fluctuating between an `on period' and an 'off period' so frequently that you can't, in essence, keep up with just medications.''
Possible side effects of levodopa are involuntary movements and facial grimaces, as well as visual hallucinations. As both Parkinson's and the drug can cause blood pressure to drop, patients can sometimes faint, Singer said.
FAINTED, NODDED OFF
Castro has displayed some signs of ill health in recent years, though perhaps no worse than other 79-year-olds.
Castro fainted during a speech in a Havana suburb in 2001 and was seen almost collapsing during the inauguration of Argentine President Néstor Kirchner in 2003. A public tumble last year left him with a fractured knee and arm, and former Ecuador President Lucio Gutiérrez wrote in his recent book that he had to prop up a nodding-off Castro several times while sitting next to him at an international event.
Cuba watchers also noted Castro was not shown touring the areas of Havana hit by Hurricane Wilma, something out of character for a man who has personally managed every crisis in Cuba since taking power in early 1959, from the 1961 Bay of Pigs invasion to the Elián González affair in 2000.
For U.S. policymakers, the report that Castro may suffer from Parkinson's has sparked concerns about Cuba's political stability down the road.
''It's going to be harder for Fidel to go out and perform, and he's been performing the guerrilla theater for 50 years,'' said Brian Latell, a retired CIA analyst on Cuba. Latell is the author of After Fidel, a new book about Castro and his brother Raúl, the world's longest-serving defense minister and the sole designated successor of Castro.
Damián Fernández, director of Florida International University's Cuban Research Institute, said the larger questions are how Castro's subordinates would react to his mental or physical erosion, and how that could affect Raúl's role as Cuba's No. 2.
''I envision Raúl trying to forge key alliances with subordinates in the military and among civilians to rule very tightly,'' he said. ''But I don't know how this could sustain itself without delivering benefits'' to the Cuban people.
That's assuming that Raúl, 74, does not die before his brother. That would leave Fidel without a clear successor and the powerful military, now controlled by the younger brother, without a widely recognized or respected leader.
The result might be political turmoil as senior government officials jockey for power with a Fidel Castro too infirm to make vital decisions.
''The revolution could be hanging by a thread,'' Latell said.
But that may be some time away. During his recent TV interview with Argentine soccer star Diego Maradona, Castro said that rumors of his health were so frequent that "the day that I die, nobody is going to believe it.''