The mystery in Cuba continues. Yesterday the Cuban authorities released photographs and a statement from Cuban leader Fidel Castro on the eve of his eightieth birthday. Our continuing conjecture about what is really going on…
From the photographs (assuming they are real and not doctored fakes)
As we suspected, he is not dead.
He is also not intubated or on a breathing machine at the time of the photos. It also appears that he does not have or has not had a tracheostomy, which is a hole fashioned into the trachea or windpipe for long-term ventilator use. At the time of the photos he was not using any supplemental oxygen, although as it takes 60 seconds for most patients to desaturate, any supplemental oxygen delivered through nose prongs could have easily been removed for the photos. It does not look as if he is in danger of dying in the next several days.
He appears to be awake but looks very drawn and tired and thin. It could qualify for cachexia, which is the wasting syndrome that patients get with cancer. It could also be associated with the normal weight loss (tissue catabolism) that patients undergo with any major surgery for any cause.
He is either sitting or reclining in the four photos and not standing. the fact that he is not walking or ambulating continues to be very curious to me. It would seem to me that if they could have somehow gotten him out of bed to stand, even for a few moments to take a photo or to have him wave from a balcony, they would have. One must consider whether he is too incapacitated to stand or if he has a functional problem with his legs.
He is not smiling. This is what makes me really think he is really sick. On his eighieth birthday when he opens his statement to his countrymen that “I feel very happy…” he is not able to manage even a glimmer of a smile??
Musings:b> he fails what physicians call the “foot of the bed test”. I have unfortunately seen it all too often when patients are dying and have lost their spark of vitality, their sense of optimism and connectedness with life. Patients particularly with end-stage cancer have (for lack of a better term) a way of turning inward as they contemplate their mortality and their approaching death. Understandably, most people are very subdued.
From the statement
“For all those who care about my health, I promise to fight for it.”
If he had a curable condition, why would it not be something like, “I am regaining my health after my surgery and will be back at work soon.” When a person says they are fighting a disease or for their health it is usually a euphemism for an expected bad outcome.
“To say that the objective stability has considerably improved is not making up a lie.”
This seems to indicate that he made it through his surgery and is stable from a surgical point, which is confirmed from the photo’s – that is he is awake and not on a breathing machine, etc.
“To affirm that the recovery time will take a short time and that there is no risk would be absolutely incorrect.”
Okay, if it is not metastatic cancer, why would the recovery time not be short and what would the risk be? He is awake and sitting up and again, not on a breathing machine. In many American hospitals (cancer or no cancer) he would be a day or two away from being discharged. He is clearly communicating that he will not be appearing soon (or probably ever).
“I ask you all to be optimistic, and at the same time to be ready to face any adverse news.”
In the US when a patient is about to die, we tell the family to “get ready for the sad news.”
Conclusion: I still believe that Castro’s diagnosis is some type of metastatic intraabdominal cancer. It just seems to me that if it was at all possible they would have wheeled him onto a balcony for at least a few seconds of a live appearance. When Pope John Paul II was really just hours from death he appeared at the window of his room. The photos from Havanna were intended, of course, to portray that Castro is not as sick as he probably is. Or maybe Castro just doesn’t care anymore if he makes a live appearance or not. I will bet my house that we never see him alive again.
Copyright 2006 Insidesurgery.com