VZCZCXRO0057
PP RUEHAG RUEHDF RUEHIK RUEHLZ RUEHROV
DE RUEHMD #0087/01 0171209
ZNR UUUUU ZZH
P 171209Z JAN 07
FM AMEMBASSY MADRID
TO RUEHC/SECSTATE WASHDC PRIORITY 1652
INFO RUCNMEM/EU MEMBER STATES COLLECTIVE PRIORITY
RUEHBO/AMEMBASSY BOGOTA PRIORITY 5082
RUEHBR/AMEMBASSY BRASILIA PRIORITY 0468
RUEHBU/AMEMBASSY BUENOS AIRES PRIORITY 0306
RUEHCV/AMEMBASSY CARACAS PRIORITY 1069
RUEHME/AMEMBASSY MEXICO PRIORITY 0573
RUEHSG/AMEMBASSY SANTIAGO PRIORITY 0464
RUEHLA/AMCONSUL BARCELONA PRIORITY 2370
RUEHUB/USINT HAVANA PRIORITY 0176
RUEAIIA/CIA WASHDC PRIORITY
RHEHNSC/NSC WASHDC PRIORITY
RUMIAAA/USCINCSO MIAMI FL PRIORITY

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