By Tom Brown Tue Jan 16, 7:18 PM ET
MIAMI (Reuters) - Cuban leader
Fidel Castro has long prided himself on Cuba's doctors and free public
health care system, but that system seems to have let him down after he
fell ill in July , U.S.-based doctors said on Tuesday.
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Based on a report in Tuesday's edition of Spain's El Pais newspaper, the
doctors -- who have no first-hand knowledge of Castro's condition --
said Castro had received questionable or even botched care at the hands
of health experts on his communist-ruled island.
"It's not a good story. Too bad they didn't send him to Miami for
surgery," said Dr. Charles Gerson, a clinical professor of medicine in
the gastroenterology division of New York's Mt. Sinai School of Medicine.
According to two medical sources cited by El Pais, the veteran
revolutionary was in "very serious" condition after three failed
operations on his large intestine for diverticulitis, or pouch-like
bulges in the intestine, complicated by infection.
The sources in El Pais were from the same Madrid hospital where a
surgeon who visited the 80-year-old Castro in late December works.
The Spanish surgeon, Jose Luis Garcia Sabrido, had not changed his
opinion that Castro was slowly recovering after stomach surgery for an
undisclosed ailment, his secretary said.
But El Pais said Castro was being fed intravenously and his outlook was
bleak. If confirmed, the newspaper's account was the first with details
of Castro's clinical history since he first underwent surgery six months
ago. His condition is considered a state secret inside Cuba.
Gerson and Dr. Meyer Solny, a veteran gastrointestinal expert at New
York Presbyterian Hospital and the Weill Cornell College of Medicine,
said Castro's doctors erred by seeking to avoid a colostomy -- or
opening in the abdomen to get rid of stool -- after an initial operation
to remove part of his large intestine.
'VERY RISKY SITUATION'
"They took a chance, which was probably not the best judgment under the
circumstances," Gerson said.
"It sounds like they tried to spare him the colostomy, which would have
been the safer and more conservative approach, and what they did was to
try to establish continuity of the bowel by sewing the colon to the
rectum, and for one reason or another it sounds like that didn't work.
And now there are troubles," said Solny.
Gerson said the Cuban doctors appeared to have suffered one problem
after another.
"What you're into is multiple operations with complications and
infection in someone his age, you know, the wear and tear is going to
start wearing him down, and he's going to get weaker," he said.
U.S. medical experts were also puzzled by El Pais' report that Castro
had undergone a third operation to implant a Korean-made prosthesis,
possibly an artificial stretch of bowel, after a second failed operation
to clean and drain an infected area and perform a colostomy.
"I would say that that would likely be a very risky situation because of
the nature of the large intestine, which is a sewage line," said Dr.
Stephen Hanauer, chief of gastroenterology at the University of Chicago.
He said the use of a prosthesis in such cases was "experimental" at best
and unheard of in the United States.
"I think the prognosis is very grave at this point," said Dr. Roshini
Rajapaksa, a gastroenterologist at NYU Medical center and assistant
professor at the NYU School of Medicine.
"For an elderly person to undergo major abdominal surgery three times,
especially when they're unsuccessful, is a very serious situation."
http://news.yahoo.com/s/nm/20070117/wl_nm/cuba_castro_doctors_dc_1
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