Mexico City, Sunday, 16 October 2011
Translated into English from the original Spanish
Hugo Chávez. Life Expectancy: Two Years
The president went from having problems with triglycerides and cholesterol 20 years ago to receiving treatment for bipolarity during the last ten years and now has an aggressive tumor in his pelvis that requires chemotherapy and offers a very bad prognosis.
The cancer President Hugo Chávez is suffering from has shaken Venezuela and the President’s allies. The physician who had brought in a team of Venezuelan physicians to Miraflores Palace to look after the President’s health, before the President would subsequently entrust his life only to Cuban physicians, agreed to talk to M Semanal about the subject. In this interview, surgeon Salvador Navarrete Aulestia traces the profile of patient Hugo Rafael Chávez Frías, and his diagnosis is not good: the President suffers from an aggressive malignant tumor of muscular origin lodged in his pelvis. The life expectancy in those cases can be up to two years.
During recent years, steeped in secrecy, several Latin American presidents have seen their health deteriorate while wielding power: Fidel Castro bequeathed the presidential chair to his brother Raúl in Cuba as he was on the brink of death in 2006; Néstor Kirchner become ill while he was President and died last year, and his widow Cristina is showing signs of depression as she leads Argentina; Paraguayan President Fernando Lugo has cancer; Uruguayan President Pepe Mujica, age 76, has mentioned that he suffers from stress; Salvadoran President Mauricio Funes does not hide his extreme attachment to tobacco, while Brazilian President Dilma Rousseff is recovering from lymphatic cancer; Vicente Fox had spinal surgery amidst his term of office and Peru’s former President Alejandro Toledo suffers from alcoholism.
Having taken care of the President’s health is not the only merit earned by Salvador Navarrete, a specialist in laparoscopy trained in Venezuela, France, the United States and Cuba. He has published some thirty writings and scientific videos, and received a series of awards; among them the Venezuelan Society of Surgery prize, the Cipriano Jiménez Macías Prize and the Ricardo Baquero González Prize, at several sessions of the Venezuelan Congress of Surgery. This is his testimony.
VFG: What is the profile of Hugo Chávez Frías as the patient of a physician to the Office of the President?
SN: President Chávez is a man who, in the past, has been treated for an illness of the manic-depressive kind, something known to his biographers and to those of us who have seen him as physicians. This illness had been previously managed by a group of psychiatrists led by physician Edmundo Chirinos, who in 2010 was sentenced to 20 years in prison for murdering a female patient in 2008. This medical treatment serves to counteract the President’s manifestations of unstable mental states that swing from euphoria to sadness, states in which the personality becomes dissociated and reaches episodes of losing contact with reality. It is a very frequent illness in today’s world, categorized as bipolar disorder. President Chávez oscillates between these two poles, with more of a tendency toward euphoria, to hyperactivity and to mania.
VFG: When was your first meeting with President Chávez as a patient?
SN: I saw him as a patient at Miraflores Palace in March of 2002, on the eve of the coup d’état against him, because he was feeling very distraught. The Minister to the Secretariat of the Presidency, Rafael Vargas, who was living at the presidential residence, asked us to create an inner circle of politically trustworthy Venezuelan physicians in order to treat the ailments of a President who was under immense pressure and physical debilitation.
VFG: What was the work like for that medical team having the mission of caring for a President during Venezuela’s greatest political crisis of the last decade?
SN: It was a very intense experience. He had us become members of the personnel of highest political trust assigned to Miraflores Palace. The three of us were Venezuelan physicians: a cardiologist, a gastroenterologist and yours truly as the team’s surgeon. Of the three I was the only one having political militancy, being a member of the Expanded National Office of the Fifth Republic Movement (MVR), founded by President Chávez, as part of the Office of Ideological Training, which was a great political party until its conversion in 2007 into the core of the Unified Socialist Party of Venezuela (PSUV).
VFG: What was the experience like for this group of Venezuelan physicians who were faced with a powerful patient who was being hounded permanently?
SN: The three of us went to evaluate the President several times. On that occasion, less than 10 years ago, we found it necessary to perform an upper and lower endoscopy (inserting a camera through the mouth and through the anus). The reason we went there was to protect him, so that that ailment would not evolve, but he did not allow us to examine him. Today, now that the cancer he suffers from has been discovered, the President states publicly that he regrets his haughtiness toward the medical recommendations.
VFG: Does this then have to do with an unwilling and skeptical patient?
SN: The President is very distrustful. Very, very distrustful. He thought he was never going to take ill. On one of those occasions he and I had an important discussion, when I called to his attention the lack of political responsibility that resulted from his not allowing his ailments to be tended to and from his not allowing us to perform our medical work, which was to preserve his health.
VFG: Were there any consequences?
SN: The President never made enemies with me. That episode stayed where it was, suspended in midair, and faded away even more so as a result of the tribulations of the coup d’état that followed. From that moment onward I became aware of many things surrounding power and I abandoned my political militancy and moved on to “winter quarters” as an advisor to the government in the field of Health; but I did not withdraw completely. Two years later the then Minister of Health, Francisco Armada, appointed me as his ministerial representative to the administration of the University Hospital of Caracas, an office I held until July of this year when, happily, after having resigned twice, the current Minister of Health, who had been a student of mine, Eugenia Sader, accepted my resignation from an office I held from 2005 until July of 2011, with a very nice letter of appreciation. It was a very interesting honorary public office which kept me active in hospital administration, despite the fact that three less-than-transparent, formerly military, Ministers of Health came and went. Now I dedicate myself to medical and academic activity.
THE PRESIDENT’S CLINICAL HISTORY
VFG: What kind of person did the President turn out to be during the medical auscultations that he allowed to be performed on him at that time?
SN: He is a very, very clean person. It is noteworthy that he sees to it that someone grooms his fingernails and toenails, and that is something that draws much attention toward him, a military man. The President presents himself very well and has a very particular magnetism. He is a man who is very careful about his personal appearance, who is always well groomed, who does not smell bad, who is meticulous, who is concerned about being in good physical shape. He is an interesting man of power, not inclined toward reading in a systematic way, but reads fragments he tries to tie together in his own ideological imagination, which can swing from one faction to the other.
VFG: What was the most noticeable addiction entered in his medical record?
SN: He is a man who drinks a lot of coffee, lots of it. He drinks countless cups of coffee daily. He smokes under stressful situations or for pleasure, in private, never in public. On a daily basis he works until late hours of the night, is a night owl and makes his ministers work at the same pace as he does. He gets up at six-thirty or seven in the morning, with an average of three or four hours of sleep nightly, no more than that, and he sleeps very little. He is a strong man, even though he may now appear deformed from the effect of the chemotherapy.
VFG: What records appear in the history prior to the President’s current clinical record?
SN: There are no operations or records of previous surgeries. He has a record of a metabolic disorder known as dyslipidemia, in other words, high cholesterol and triglycerides. At that time he was not receiving treatment for it and he was showing a tendency toward high arterial tension, but he was not hypertense. At about 180 pounds he was barely ten to thirteen pounds overweight, not like he is now. He is a tall strong man whose height is about 5 feet 10 inches.
VFG: How did this patient, a decade later, suddenly display a clinical profile with cancer?
SN: The President decided to go in a radically different direction after the coup d’état against him. He walked away from all the Venezuelan physicians and placed himself absolutely in the hands of Cuban physicians. A month ago we met with people very close to the President and I told them the same thing I told him at Miraflores when he was my patient: that there is a lack of awareness of the national political impact stemming from the President’s health. The answer from these people around him was the same: that he cannot be told anything about his health, that he does not pay attention to anyone, much less to Venezuelans.
VFG: There is much speculation about the type of cancer that afflicts the President. Neither he nor anyone else has said what it is.
SN: I am going to offer the information I have concerning that premise you propose to me. President Chávez has a tumor in his pelvis that is called a sarcoma. Those are retroperitoneal tumors of the pelvic floor. From the embryological point of view they can be of three types: mesodermal, ectodermal and endodermal. The information I have from the family is that he has a sarcoma, a very aggressive tumor having a very bad prognosis and I am almost certain that is the reality. That is why they are giving him such an aggressive chemotherapy, because if it were prostate cancer, then hormonal treatment would be given and that would be it, and you wouldn’t even notice he was receiving any treatment.
VFG: Are you then discarding a prostate tumor?
SN: It is not a prostate tumor. It is a tumor that is very near to the prostate and is probably invading his bladder. Or it is a tumor that originates in the bladder and is invading the pelvis. In any case, it is a tumor that originates in the lower part of the pelvis, which is considered to be the anatomical region that is within the hips. Behind that region are the iliopsoas muscles, which are muscles that, [originate] at the lumbar region of the spine, [and insert at] the femur, lifting it upwards. It is the muscle that makes it possible to raise the knee while seated. That is why we think the tumor is of a muscular nature, that it is lodged and originates there; I say so because, before undergoing surgical intervention for removal of the malignant tumor the size of a baseball, the President was oversensitive to a problem in his knee: referred pain. That is why we are almost certain that this has to do with that kind of cancer. That is a some information that, through the public’s natural interest, we have been integrating and constructing little by little. I am the family’s surgeon and I met with one of their (the family’s) other physicians, we shared the available information and fully coincided in this diagnosis I am making.
VFG: The inevitable question everyone is asking is: what is the range of life expectancy for a profile similar to that of President Chávez?
SN: We believe that the prognosis for President Chávez is not good. And when I say the prognosis is not good that means that the life expectancy can be for as many as two years. This explains the decision to hold elections sooner.
ILLNESSES OF POWER
VFG: Is an ill president the result of two decades of stress, starting with his attempted coup d’état in 1992 and which includes the 12 years he has been in power?
SN: Men in power are individuals who believe themselves to be possessed by a supernatural force. In order to aspire to be President of a country you need to have an emotional condition different from the majority of the people, because you need to have a lot of ambition and perseverance to be able to move so many people out of your way and be able to take power and keep it. That constitutes a very particular psychic and emotional state. To have the cojones to aspire to lead a country of 50 million inhabitants, or 30 or 20 million, requires more than just will.
VFG: You know the President’s family because you as a surgeon have operated on them. Is there a common tendency toward certain illnesses?
SN: On the Chavez side of the family, the paternal branch, they tend to have vascular diseases. [His father] suffered a stroke. And on the Frías branch, his mother’s side, they have a tendency to have tumors. I operated on his mother for a benign tumor of the neck in 1999, together with another colleague who is their family physician and whom I still see frequently. And now she is a very healthy and very strong woman. But President Chávez was a healthy man when I examined him in the context that led to the coup d’état of 2002. He only suffered from a problem with elevated cholesterol and elevated triglycerides and a mental problem consisting of bipolar behavior under treatment. Someone in the family must have that illness, an ancestor, because President Chávez definitely has it, but we do not know who he inherited it from.
VFG: Are the President’s family’s physicians also Cubans?
SN: No, we are the family’s physicians.
VFG: And why is it that Cubans and not Venezuelans are occupying that space? Has the President become distrustful?
SN: Absolutely, right now President Chávez does not trust anyone.
SN: Nobody. In Venezuela President Chávez does not trust anybody: only Cubans. In fact, at the Military Hospital there is now a floor prepared just in case something happens to the President and all the personnel are strictly Cuban. Not even the stretcher-bearers are Venezuelan.
VFG: Does that explain the imprecise report published by the Miami Herald about President Chavez’s hospitalization a couple of weeks ago?
SN: I can say with certainty that between Sunday September 25th and Monday the 26th he was given dialysis because the kidney was not filtering the medications well and he was suffering. On Monday medical colleagues had to remove a dialysis machine from the Caracas Military Hospital and take it to Miraflores Palace.
VFG: It was in his bedroom at Miraflores Palace where you performed an auscultation at some moment. What’s it like within that intimate realm of the President of Venezuela?
SN: It is a very plain and orderly bedroom, just like he is. With a very small bookcase, with the readings he chooses for the moment, everything is very tidy, and I must insist that he his a very meticulous, clean, orderly and austere person. That is how he is.
VFG: What is the scenario with Chávez being ill in 2012?
SN: This scenario has two options: one with Chávez as candidate and the other without him. The President could die and the military would have to take power for a while; or, if his illness prevents him from running as candidate, then the incumbent party would lose the elections. If he comes forth under conditions of health acceptable for en electoral campaign, according to recent information he has more than 55 percent acceptance in popularity, but as a candidate Chávez scores 35 points, a yet unnamed independent candidate would receive the same 35 percent, and the opposition candidate only 22 points. These are the consequences of the President’s illness.
Salvador Navarrete, surgeon
A surgeon with specialty in bariatric and metabolic surgery, graduated from the Faculty of Medicine, Luis Razetti School, Central University of Venezuela, in 1981. Postgraduate work completed at University Hospital in Caracas, where he received the title of Specialist in General Surgery.
He completed his training in France, the United States and Cuba, specializing in laparoscopic surgery. Likewise, he was a visiting assistant at the Laparoscopic Unit led by the prestigious Dr. Moses Jacobs at Baptist Hospital in Miami.
As a specialist in surgery for obesity, he has participated widely as a panelist and presenter at medical conferences and gatherings in Venezuela, as well as in Japan, Brazil, Spain, the United States and Peru, among other countries.
Dr. Navarrete has more than thirty scientific publications and videos, which have earned him wide recognition, among them the following: the Venezuelan Society of Surgery Prize, the Cipriano Jiménez Macías Prize and the Ricardo Baquero González Prize, bestowed upon him at different events of the Venezuelan Congress of Surgery.
He has been Chief of the Surgical Team at University Hospital in Caracas, Chief of Residents of Surgery Service II and currently is Chief of the Endoscopic Unit of University Hospital in Caracas.
His teaching activity at the Luis Razetti School of the Faculty of Medicine of the Central University of Venezuela has been extensive, including General Coordinator of Postgraduate Studies of General Surgery and Coordinator of the Internship of the Undergraduate Program in General Surgery of the Department of Clinical and Surgical Therapy B of University Hospital in Caracas.
Currently he is Coordinator of Postgraduate Studies of General Surgery at University Hospital in Caracas and Head of the Department of Clinical and Surgical Therapy B.
Doctor Navarrete shares his professional activities among University Hospital in Caracas, El Ávila Clinic and Santa Sofía Clinic. He belongs to numerous scientific societies: founder of the Endoscopic Surgery Section and of the Bariatric Surgery Section that are part of the Venezuelan Society of Surgery, as well as founder of the Venezuelan Society of Bariatric and Metabolic Surgery.
He’s a member of the Latin American Endoscopic Surgery Association, The Society of Laparoendoscopic Surgeons and of the Laparoscopic Surgery Society of Spain, among others.
Víctor Flores García
Translation by: Indysurfer