Thursday, December 16, 2010

Confidential memo: Castro fired his doctor after brush with death

This March 2007 Interests Section cable says Fidel Castro fired his personal physician, Eugenio Selman, after an intestinal disorder nearly killed him.
Michael Parmly, then chief of the U.S. Interests Section wrote:
We are missing too many variables to be able to predict accurately how many more months Fidel Castro will live. Frankly, we don't believe anyone, including Castro
himself, can state that with certainty.
That's a curious statement. I mean, can anyone - short of those who are committing suicide or jumping in front of a train - know for certain when he is going to die? So why should Fidel Castro have any greater power to know precisely when he is going to die?

Reference ID Created Released Classification Origin
07HAVANA258 2007-03-16 18:06 2010-12-15 21:09 CONFIDENTIAL US Interests Section Havana

VZCZCXRO8161
PP RUEHAG RUEHROV
DE RUEHUB #0258/01 0751828
ZNY CCCCC ZZH
P 161828Z MAR 07
FM USINT HAVANA
TO RUEHC/SECSTATE WASHDC PRIORITY 1454
RHEHAAA/NATIONAL SECURITY COUNCIL WASHINGTON DC PRIORITY
INFO RUCNMEM/EU MEMBER STATES COLLECTIVE
RUEHWH/WESTERN HEMISPHERIC AFFAIRS DIPL POSTS
RUEHSW/AMEMBASSY BERN 0062
RUEHROV/AMEMBASSY VATICAN 0050
RUMIAAA/USCINCSO MIAMI FL
RUESDM/JTLO MIAMI FL
RUCOGCA/COMNAVBASE GUANTANAMO BAY CU

C O N F I D E N T I A L SECTION 01 OF 02 HAVANA 000258

SIPDIS

SIPDIS

E.O. 12958: DECL: 03/16/2017
TAGS: PGOV PINR CU
SUBJECT: CUBA: HOW BELIEVABLE IS A FIDEL CASTRO COMEBACK?


HAVANA 00000258 001.3 OF 002


Classified By: COM Michael E. Parmly; Reasons 1.4 (b/d)

¶1. (C) Summary: XXXXXXXXXXX
passed us a document March 14 that describes Fidel Castro's
declining health, as analyzed by a respected, retired Cuban
doctor. The document concludes by saying that Castro has a
terminal condition, and will suffer an inevitable
deterioration of his faculties until he dies. But he is not
about to die "immediately." This contrasts with a flurry of
news and public statements by key regime figures about Castro
making a comeback, including his having spoken to Hugo Chavez
on the phone while the latter was in Haiti. We believe that
a full comeback is unlikely, but that Fidel Castro is more of
a presence behind the scenes -- and even "on stage" as a
presence -- than he was a few months ago. End Summary.

¶2. (U) Media have reported increased activity on the part of
Fidel Castro this past week: Speaking on the phone to Hugo
Chavez during the Venezuelan's visit to Haiti; and receiving
Colombian author and long-time sympathizer Gabriel Garcia
Marquez. Both Foreign Minister Felipe Perez Roque (in
Europe) and Parliamentary Speaker Ricardo Alarcon stated
publicly that Fidel Castro was making a comeback and would
return to the GOC's helm. Alarcon's statement included
Castro's "winning reelection for president" in 2008. Interim
dictator Raul Castro has kept a low profile during the past
few weeks.

¶3. (C) XXXXXXXXXXX, on Wednesday evening March 14, passed COM and
Pol-Econ Counselor a document XXXXXXXXXXX. The
document traces Fidel Castro's critical condition from its
onset last July, through the various ups and downs with his
local medical staff and with the visiting Spanish doctor,
Garcia Sabrido. Most of this repeats what has previously
been reported, with one new development: Castro has fired
his long-time personal physician, Dr. Selman. Informal
translation of this document follows in Para 4.

¶4. (C) Doctor's Statement:

"The illness began in the plane from Holguin to Havana (Note:
after a full day of July 26, 2006 activities. End note). As
this was a short flight there was no doctor aboard and they
had to land urgently once they knew of his bleeding. He was
diagnosed with diverticulitis of the colon.

This illness is characterized by diverticulae in the large
intestine, generally. A diverticula is a protuberant sack in
a segment of the intestine, not in itself necessarily
dangerous. Waste gets trapped in them, for example.
Nevertheless, they can cause hemorrhaging, inflammation and
infection, resulting in diverticulitis. (Health Unit
Comment: Simple diverticulitis, without perforation,
hemorrhaging or infection, is treatable. End Comment.)

The condition requires surgery when the diverticulae are
gigantic, because they are more likely to become infected and
burst.

He had a perforation in the large intestine and needed to
have a colostomy done; which he opposed, saying that they
should splice out the infected part and reattach the
intestine to his colon. Dr. Selman, who was chief of the
medical team, was in agreement, but the rest of the team
opposed. But Fidel Castro, capriciously, did not permit the
colostomy.

With the passage of time, as the colon was infected, the
operation collapsed and the reattached part separated. They
had to operate again, but found a fistula. It wasn't known
at that time what he had, but normally a fistula in the
abdomen has the effect of blocking the digestion of
food--resulting in the loss of 40 pounds. They began to feed
him by IV serum, and they used a Korean-made device to treat
the fistula, which didn't have much success. That was when
they called in the Spanish doctor, the one who said that they
Cuban team had done what they could, but the correct
treatment should have been a colostomy.

At that point they removed Selman from the team, who is now
working as a low-level doctor someplace else.

XXXXXXXXXXX

HAVANA 00000258 002.3 OF 002


this illness is not curable, and will not, in her opinion,
allow him to return to leading Cuba. He won't die
immediately, but he will progressively lose his faculties and
become ever more debilitated until he dies."

¶5. (C) This report is consistent with our reporting that
Fidel Castro probably came close to death in July, 2006, and
then again around October. Since then, as we have seen in
video and audio broadcasts, Castro has been able to engage
with Hugo Chavez and others for limited periods of
conversation and other forms of carefully controlled
activity. He has not appeared live on TV or in any other
public context during the entire period of his critical
illness, which caused him to miss the September, 2006
Non-Aligned summit and a large-scale celebration of his
birthday and armed forces day in December, 2006.

¶6. (C) Cubans react to news about Fidel Castro with
resignation and wild speculation. XXXXXXXXXXX
told us March 15 that he thought last month's taped call-in
by Castro to Hugo Chavez's radio show was fake and that he
would die by May. XXXXXXXXXXX, described the Castro illness as having a similar
effect on the public as the Pope's 1998 visit: Greatly
raised expectation for change, followed by disappointment and
reversion to the totalitarian norm.

¶7. (C) Comment: We are missing too many variables to be able
to predict accurately how many more months Fidel Castro will
live. Frankly, we don't believe anyone, including Castro
himself, can state that with certainty. However, while he is
still alive, even in a reduced capacity, his presence has a
chilling and retardant effect on Cuban society. The high
expectations for change are still out there, but are mostly
associated with the idea that the dictator has to die first
before anything substantial will happen.
PARMLY

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