The prominent Spanish surgeon José Luis García Sabrido was asked to travel to Cuba and assess Castro’s condition some weeks ago. He has said only three things of note since his return: (1) Castro does not have cancer; (2) his condition has been improving; and (3) all other assessments are speculative unless they come directly from Castro’s medical team. The latter comment, made to CNN in recent days, was in response to a detailed report in the Spanish daily El Pais, quoting anonymous sources at Madrid’s Gregorio Marañón Hospital, where the surgeon works.
If these sources are correct, what happened is that Castro was diagnosed last summer with a severe inflammation of the large intestine (see a good graphical presentation of the problem and subsequent surgeries here) which had ruptured, releasing matter into the the abdominal cavity, which resulted in a severe internal infection. Faced with a choice between attachment of a colostomy bag, and a more risky surgery to short-circuit the problem, Castro prevailed upon his surgeons to attempt the latter. The fix failed, leading to a new rupture, which required a new surgery, which was also botched, leading to further surgery — the last being performed as late as late December, just before the visit of Dr. Garcia Sabrido. Reportedly, the surgeons were eventually forced to remove the large intestine entirely, connecting the end of the small intestine directly to a colostomy bag.
If this is true, it belies Garcia Sabrido’s upbeat characterization. The large intestine is crucial to absorbing liquids and minerals, as well as some nutrients, from digested food. In the absence of a large intestine, Castro must receive these intravenously. But no intravenous supply can regulate what the body needs nearly as precisely the digestive system, so Castro needs to be watched constantly for a variety of complications — among the most visible of which is confusion resulting from dehydration and other causes. This may explain why he is not permitted to speak publicly. Further, at Castro’s age, there are likely to be other medical problems exacerbating, and exacerbated by, his severe intestinal problems. On the other hand, I have also been told that it is conceivable – if the details emerging from Gregorio Marañón Hospital are accurate — that he could linger like this for years.
That good news at least is that Cubans don’t have to listen to him anymore.