The Prognosis

Osmel Almaguer

Yesterday I visited my aunt Mamita; it was her birthday.  Before knocking on their door, I imagined she’d be in a festival mood, celebrating with friends and relatives.

But when opening the door, she had an expression of fatigue on her face. And in the house were only her husband Manolo and her.

After congratulating her, I asked her what was the problem, and she began recounting the history of what had happened to Manolo the week before.

Manolo is a 63-year-old man in poor health.  He suffers from kidney problems, is a diabetic and has circulatory problems, in addition to being susceptible to common illnesses like colds, which he always gets.  That’s why when he has any illness it’s almost always complicated by his other ailments, as happened to him recently.

Strong stomach pain, a 103 degree fever and urinary incontinence convinced my aunt to accompany him 12 miles to the Naval Hospital from Guanabo. Fortunately they have car.

Although Manolo is not in the military, in urgent cases people can be seen by the on-call staff.  The person who saw him was a resident doctor (a practicing student), because most of the specialists are performing service abroad.

This guy, it seemed, was not exactly the head of his class.  He kept second guessing himself when making any diagnosis.  My aunt could see on his desk a list of symptoms related to each illness, like something we call a “mata-burro” (donkey-killer).

After much thought -but without making any in-depth exam, and although Manolo’s symptoms were not 100 percent textbook consistent- the student mechanically diagnosed him as having the A (H1N1) fever and prescribed him the required treatment for that illness.

Manolo was lucky.  His case was much more serious than diagnosed, and had it not been for sheer chance who knows what would have happened.

While leaving the hospital they ran into Luis, a urologist who was a former client of Manolo at the notary office.  Hearing about the case, Luis suggested conducting another exam.

After a rectal exam, which was painful due to the inflammation, using an effective manual technique, Luis extracted a great amount of sepsis from Manolo, who immediately began to feel better.

The doctor later explained that had he not treated Manolo that same day, the situation would have become serious.  The prostatic infection and the urinary sepsis had increased his blood’s sugar to a level whose consequences would have soon been fatal.

In doing so, Manolo’s life was saved.  Likewise, my aunt -instead of spending her birthday at a wake- only had to attend to him so he’d get better.

The father of my oldest friend, Leslie, was not so lucky.  Due to a misdiagnosis, he died in his bed one night after the staff misdiagnosed his pulmonary emphysema.  They told him it was “only a little gas.”

Others like me have had better luck; I’ve now been operated on four times.  Thanks to these I continue leading a normal life, although the operations were performed before the 1990s “Special Period,” when the Cuban health care system functioned better.  To be frank, I don’t know what would have happened had they needed to operate on me since then.