CUBA: SPANISH PAPER SAYS CASTRO OPTED FOR RISKIER

UNCLAS SECTION 01 OF 02 MADRID 000087 SIPDIS SIPDIS SENSITIVE EUR FOR A/S FRIED AND PDAS VOLKER WHA FOR A/S SHANNON AND PDAS SHAPIRO EUR/WE FOR ALLEGRONE, CLEMENTS, AND CERVETTI E.O. 12958: N/A TAGS: PREL CU SP SUBJECT: CUBA: SPANISH PAPER SAYS CASTRO OPTED FOR RISKIER SURGERY REF: A. 2006 MADRID 3095 ¶B. HAVANA 005 MADRID 00000087 001.2 OF 002 ¶1. (U) Summary. Spanish daily "El Pais" reported today that Fidel Castro and his inner circle opted for a riskier surgery during his initial medical crisis in hopes that he could avoid a second surgery and the need to wear a colostomy bag during his recovery. Citing sources in the hospital where Spanish doctor Garcia Sabrido (REF A) is chief surgeon, El Pais reported on January 16 that this riskier option had failed and that a series of medical missteps had severely aggravated Castro's condition and that he was now in very poor health. Doctor Garcia Sabrido said the El Pais report was "absolutely false," stuck by his contention that Castro was not suffering from cancer, denied that Castro's condition was as dire as that described by news reports or that medical errors had contributed to Castro's condition, and declined to issue any further statements regarding Castro's health. The January 16 El Pais report indicated that Castro's long-term case of diverticulitis had worsened in the summer of 2006 and led to intestinal bleeding, that during the initial surgery Cuban doctors removed a segment of Castro's large intestine and reconnected the remaining section of his large intestine to the rectum instead of performing a colostomy, and that infections and other complications had triggered a gall bladder infection that required the insertion of prosthesis in his bile duct. As a result, Castro has failed to recover and is in very poor condition. End Summary //MEDICAL SOURCES DETAIL CASTRO ILLNESS// ¶2. (U) The El Pais report cited sources at Madrid's Gregorio Maranon Hospital, where Doctor Jose Luis Garcia Sabrido is Chief of Surgery, in reporting that a series of medical errors, compounded by lingering infections, had left Castro in a "grave" medical state. The El Pais story (e-mailed to EUR/WE, WHA/CCA, and USINT Havana) indicated that: -- Fidel Castro had suffered from diverticulitis for many years and that this diverticulitis had worsened during the summer of 2006, causing intestinal bleeding and an abdominal infection described in the news report as peritonitis. -- Castro's doctors determined that he required immediate surgery to halt the bleeding and deal with the peritonitis. Doctors removed a portion of Castro's sigmoid colon and his rectum, the areas most severly affected by the diverticulitis. The surgeons had the option of attempting to reconnect the transverse colon directly to the rectum or performing a colostomy to allow the damaged segments of the large intestine to heal. -- According to a January 17 El Pais report, Castro and his inner circle of advisers knew of these options before the surgery and opted to reconnect the transverse colon to the rectum in order to avoid the need for Castro to wear a colostomy bag and to avoid a second operation to reconnect his intestines. This was understood to be the riskier of the two options. -- Following the connection of the transverse colon to the rectum, the two segments failed to heal properly and led to the introduction of feces into Castro's abdominal cavity and to a second severe peritoneal infection. -- Doctors then performed a second operation (no date was given for this event),during which they removed another portion of Castro's large intestine, cleaned out the infection, and fitted him with a colostomy bag. However, the scar in this second operation also failed to heal properly, and his recovery was further complicated by a gall bladder infection, described in the press report as a case of cholecystitis. -- In order to deal with the gall bladder infection, doctors MADRID 00000087 002.2 OF 002 reportedly inserted a biliary prosthesis. The first prosthesis failed and was replaced by a Spanish-manufactured model, which functioned properly. -- By the time Doctor Garcia Sabrido saw Castro in December, doctors were reportedly draining one-half liter of fluid daily from Castro's abdomen, a factor that contributed to a loss of muscle mass and to nutritional deficiencies. //SPANISH DOCTOR DENIES "EL PAIS" REPORT// ¶3. (U) Doctor Garcia Sabrido immediately denied being the source of the "El Pais" report and said that the report was "absolutely false." He said that only Castro's doctors in Havana could speak authoritatively regarding Castro's condition and repeated his assertion from December that, "to the best of his knowledge," Castro was not suffering from cancer and was recovering slowly. Asked whether he knew of any changes in Castro's medical team, Garcia Sabrido said that he was not aware of any developments in Castro's case in addition to what he had observed during his visit in December. //COMMENT// ¶4. (SBU) While it appears that Garcia Sabrido, as a friend and sympathizer of the Cuban leadership, does not wish to fuel speculation regarding Castro's condition, his medical colleagues are obviously less reluctant to come forward and do not feel bound by any promises made to the Cuban Government regarding the secrecy of this medical information. The details described in El Pais appear to support Garcia Sabrido's contention that Castro does not have cancer and is suffering from another ailment. However, this information also decidely undermines Garcia Sabrido's suggestion to the media that Castro is on the road to recovery. Aguirre