The Miami Herald
Wed, Jan. 17, 2007

Experts: Prognosis is grim for Castro

Experts say Fidel Castro's chances for survival are slim if reports on his health are accurate.


A Spanish newspaper's report that Fidel Castro is wasting away from life-threatening complications following multiple intestine-related surgeries means he has little chance of recovering, four South Florida medical experts said Tuesday.

If the anonymous sources that El País quoted are accurate, Castro is experiencing problems with his intestines and gall bladder, significantly decreasing his chances for survival, Dr. Miguel J. Rodríguez, a gastroenterologist at Homestead Hospital, told The Miami Herald.

''The chances are he won't survive this illness,'' Rodríguez said, adding that the Cuban leader would have an ''80 to 95 percent chance of dying'' from his ailments.

Three other South Florida medical experts agreed that the El País article portrays a very ill Castro.

The El País report Monday said its information came from two people who work at the same Madrid hospital as Dr. José Luis García Sabrido, who acknowledged examining Castro in December. He denied that Castro has cancer and said he was recovering well but declined to give details.


Havana remained silent Tuesday on the latest media reports on Castro's health. But a Cuban diplomat in Madrid called the El País report ''an invented story,'' according to The Associated Press.

Venezuelan President Hugo Chávez said he had talked to Castro a few days ago and denied that his condition was grave, according to the AP.

''I received recent reports that Fidel continues a slow process of recovery that is not easy, but I'm far from sure of all these catastrophic versions that have already killed him several times,'' Chávez said.

The Bush administration Tuesday stood by its assessment that Castro is terminally ill. ''Nothing from this end has changed,'' said Ross Feinstein, a spokesman for the Office of the Director of National Intelligence,

García Sabrido stopped short of denying the El País report. But he told CNN on Tuesday that any statement on Castro's health that doesn't come directly from his medical team was ''without foundation.'' If the report is true, it becomes the most detailed to date on the ailments that have kept Castro out of power for 5 ½ months.


Castro, 80, has undergone at least three failed operations and several infections resulting from diverticulitis -- perforations of small pouches in the intestinal wall that weaken with age -- according to the Spanish newspaper. The report called his prognosis ``very grave.''

''My impression is he's in deep trouble,'' said Floriano Marchetti, a surgeon specializing in colon and rectal cancer at the University of Miami. ``This sounds like a problem that could kill anybody. Particularly in an older man, this could be deadly.''


Since Castro ceded power to his brother Raúl on July 31, saying only that he had undergone surgery for intestinal bleeding, Havana has released only a handful of photos and videos of the Cuban leader. The last was on Oct. 28 -- more than 11 weeks ago -- in a video that showed him looking thin and tired but walking and ridiculing rumors that he had died.

Oriol Guell, one of the El País reporters who wrote the article, told The Miami Herald that García Sabrido had ``shared the information with other people in the hospital. . . . We got confirmation from two of those people.''

Marchetti and other medical experts said the story has some confusing and contradictory parts. The article says Castro has suffered from diverticulitis, but while such perforations can leak bacteria into the abdominal cavity and cause problems, they don't generally bleed.

Diverticulosis, a word El País doesn't mention, can cause these pouches to bleed, but that bleeding stays in the intestines and exits through the rectum. Miami's experts said they believe the journalists may have mixed up the terminology.

Whatever the type of diverticular disease Castro may have, El País' sources said Cuban surgeons had one of two choices: remove the infected part of the intestine and reconnect the good parts; or create an artificial anus by connecting the intestines to a bag outside the body, and reconnect the good parts later.

In a follow-up story late Tuesday, El País reported that ''Castro and his people'' opted for the first procedure because it would avert the need for the external bag and a second operation. But there was apparently a problem with the connection, feces leaked into the abdominal cavity and a serious infection developed.

''For a person over 65, that's a 90 percent mortality rate. That's a killer,'' Rodriguez said.

The problems led to a second surgery during which an external bag was attached, according to El País. But then Castro's gall bladder became seriously infected.

A device that El País described as a ''prosthesis made in Korea'' was attached to the biliary duct, which connects the gall bladder and intestines. This probably was a small tube designed to drain the infection, said the South Florida experts.


The first drain failed, said El País, and a second drain, made in Spain, had to be installed. The failure of the first drain could have led to more complications and infections, the South Florida experts said.

The story also said that Castro is suffering ''a severe loss of nutrients'' and ''regression in his muscular mass,'' requiring intravenous feeding.

Castro has suffered from diverticular disease since the 1970s and had several relatively sharp attacks that required more than one nonsurgical procedure, a former Cuban official who was close to the Castro brothers but defected in the 1990s told The Miami Herald on Tuesday.

The official, who asked for anonymity, said he obtained his information from Raúl Castro -- who would comment freely whenever his brother underwent one of the procedures.

Miami Herald correspondent Pablo Bachelet, Chief of Correspondents Juan O. Tamayo, translator Renato Pérez and Madrid special correspondent Lisa Abend contributed to this report.