By Jake Miller • Wausau Daily Herald • March 7, 2011
Dr. Fernando "Fritz" Riveron stepped off the plane in Havana in the
middle of a February night, eager to begin his journey into Cuban medicine.
The 54-year-old Wausau heart surgeon was scheduled during his weeklong
trip to work alongside some of Cuba's best doctors, share ideas and
immerse himself in the nation's first-world cardiovascular program. He
was going to be the first American surgeon to work in Cuba since the
revolution in the 1950s.
What actually happened inside the communist country was far different.
When he landed with his brother, Dr. Ricardo Riveron, an emergency room
doctor practicing in Toledo, Ohio, the two Cuban exiles were greeted by
government officials.
Fritz Riveron, returning for the second time in four years, now had a
Cuban passport -- Cuba does not recognize the U.S. and therefore
considers him a Cuban national -- and received little resistance.
As for Ricardo Riveron, he had finally touched down on Cuban soil for
the first time since his father took his family to the United States to
escape the newly formed government 60 years ago. His joy over returning
to his homeland wouldn't last.
Cuban officials refused to allow Ricardo Riveron to stay because he did
not have a Cuban passport, and they said he needed a visa. He was put on
the next flight back to Toronto.
His brother's abrupt departure left Fritz Riveron in Cuba alone, where
he would soon get more bad news.
The government had caught wind that an American was coming to Cuba and
would participate in surgery. Though Fritz had planned the trip for
months with his friend, the head of Cuba's world-class heart-care team,
he was informed upon arrival that he would not be allowed to participate
in surgeries or to give medical presentations.
"I ended up in Havana all of a sudden by myself, and then I essentially
got censored," he said.
That was the beginning of a trip that took a handful of unexpected
twists and turns.
Making a difference
Riveron wasn't kept from every component of Cuba's health system.
His friend, whom Riveron declined to name to protect the man's identity
in Cuba, was devastated. He found out only a day before Riveron arrived
that the government would not allow Riveron to participate in operations.
Riveron planned to demonstrate techniques not often used in Cuba and to
work alongside the 43-year-old Cuban doctor, whom he considers a better
surgeon than himself.
Riveron concluded that the Cuban government didn't want an American
coming in and "showing off" -- a misconception his Cuban friend fought
but couldn't defeat.
"I think the concept that somebody who was an exiled Cuban American did
well was probably not something they wanted to showcase," Riveron said.
That didn't stop Riveron or his friend. They snuck him into the Hermanos
Ameijeiras Hospital wearing a white coat and allowed him into three
surgeries during a three-day period.
Still, there were restrictions. He could stand at the head of the
operating table and give suggestions or ideas, but as much as it killed
him, he couldn't actually participate in a surgery -- or take photos.
"I was nervous about it, frankly, but I was really looking forward to
operating," Riveron said. "It was very disappointing. It was very
embarrassing."
His nights were filled with long conversations at Cuban restaurants,
where live music banged in the background and rum was plentiful. He and
Cuban surgeons talked late into the night about cases they've seen
during the years, sharing ideas, tips and techniques.
"It was sort of like 'stump the other guy,'" he said. "Like, 'OK, I had
a case a few years back with this kind of valve; what would you do?'"
And during the entire trip, Riveron had no idea whether a government
official was keeping tabs on him, although he never ran into any trouble.
"There may have been (someone watching), but I got into everything," he
said. "I got into places where people aren't supposed to be getting into."
Top-tier care
Riveron's goal, along with touring more of his native country, was to
learn more about Cuba's health care system.
Throughout the country, many people have access to decent primary care
and other services, but it's the cardiovascular program that shines.
Cuba has invested heavily in the heart program and its surgeons because
it's excellent propaganda to be able to go toe-to-toe with the U.S. in a
high-profile specialty, Riveron said.
And what Riveron saw gave him no reason to doubt the heart surgeons in
Cuba. They do about 15 heart transplants a year and have begun to
develop a mechanical heart.
"I was impressed. They are a first-world medical team," he said.
"They're as good as many heart teams here in this country."
Of course, the U.S. and Cuba's health care systems do have dramatic
differences. While Cuban operating rooms are sterile, it's not unusual
to see a rusty IV cart rolled in, or a high-tech imaging machine shoved
in a rundown room no bigger than a small cubicle.
The doctors, too, are treated very differently. Cuban physicians make
about $35 a month, and many are exported to foreign countries, where
their services are exchanged for goods. For example, a heart surgeon
might be sent to Venezuela in return for oil.
But watching the surgeries and speaking with the doctors only increased
Riveron's hunger to collaborate more in Cuba. He's planning to return,
this time with a scientific license and perhaps more U.S. doctors. And
his brother has begun the process to get a Cuban passport.
"If they don't make the obstacles too insurmountable, we should be able
to do this," Fritz Riveron said.
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