By PABLO ALFONSO El Nuevo Herald

SAN JOSE, Costa Rica -- Cuban President Fidel Castro was treated in October for a potentially fatal illness affecting the brain, according to Elizabeth Trujillo Izquierdo, a Cuban surgeon who said she was part of the medical team at Havana's CIMEQ Hospital.

Trujillo defected in April and is now living in Costa Rica, where she was interviewed at length last week at the place where she has been hiding since she said she was the object of a kidnap attempt by presumed Castro agents last month.

Her identity has been confirmed through documents and multiple sources. But no other sources in or outside Cuba have confirmed her report of Castro's illness. News of the 71-year-old Cuban leader's health is guarded like a state secret, although rumors of various illnesses have circulated on the island and abroad for years.

The Cuban Foreign Ministry in Havana did not return calls requesting comment.

Trujillo said Castro arrived at the hospital in October with symptoms of hypertensive encephalopathy, a traumatic rise in blood presure that often leads to stroke and usually implies at least partial paralysis. The condition paralyzes brain functions and it can lead to death in severe cases.

When Trujillo was ordered to remain at her post at CIMEQ -- the Center for Medical and Surgical Research -- in October, she thought it was just another emergency exercise, she said. She never imagined she would spend two weeks in the exclusive hospital because the gravely ill patient on the fifth floor was Castro.

Trujillo also said that last August -- she can't remember the exact date -- Castro had a ``central paralysis'' that affected ``the left side of his face.'' When Pope John Paul II visited Cuba in January, ``Castro was recovering from another relapse,'' she said.

Trujillo said Castro was rushed to CIMEQ on Oct. 22 and was released Oct. 28. She said he was brought back two days later, for a two-day stay.

``The medical diagnosis that appears on his medical records for that admission is hypertensive encephalopathy,'' she said.

Silent killer

According to Dr. Enrique Carrazana, chief of neurology at Baptist Hospital in Miami and head of the Neurological Center of South Florida, hypertensive encephalopathy is caused by the silent killer known as hypertension.

``Hypertensive encephalopathy has a high index of mortality,'' Carrazana said.

According to Trujillo, the treatment given to Castro basically consisted of ``sedating him as much as possible, almost to a state of coma, during the first three days, to prevent the formation of a blood clot that might affect the brain.''

``That's what is usually done in those cases. I was there as a surgeon and don't know the specific medication that was given to him,'' she said. ``Castro's personal physician, Carlos Valdes, was in charge of that.''

During those days, the atmosphere at the hospital was tense, Trujillo said, but the doctors did not discuss Castro's condition among themselves.

``It's standard procedure. We don't talk about it,'' she said.

``His appearance was good, as the result of makeup and the treatment he received in the hyperbaric chamber,'' she said.

Patients are placed in hyperbaric chambers where oxygen is pumped in under pressure to restore oxygen to the blood.

``He has [a chamber] at his home, at his office, and in his plane,'' Trujillo said. ``I'm surprised he doesn't have one in his Mercedes. When he travels abroad, one of the planes is practically a hospital. They can even do surgery in it.''

`Cardiac problems'

Trujillo said she has heard from other doctors that Castro suffers from ``cardiac problems'' that she cannot describe because she had no access to the specific information.

However, rumors that Castro suffers from lung cancer are false, she said. Rumors of lung cancer circulated after Castro quit smoking cigars several years ago.

``That report has been dismissed,'' she said. She said she had learned from a good source that Castro had traveled to Geneva for a series of tests that ruled out lung cancer. She did not say when that happened.

Trujillo, 34, is a relative of important people who move discreetly in Cuba's corridors of power. She escaped to Costa Rica in April and had no intention of making any statements to the press. But, she said, the attempt to kidnap her on a San Jose street June 20 prompted her to go into hiding and tell her story.

Her husband, Dr. Felix Ochoa Cabrera also defected in April, during an official trip to Brazil, she said, and she believes he is still there. He is a half-brother of Gen. Arnaldo Ochoa, who was executed by a Cuban firing squad in 1989 after a controversial trial on charges of drug trafficking.

Security alert

According to Trujillo's account, she and the rest of her medical colleagues and nurses had finished their shift at 4 p.m. Oct. 22, when they were told they could not leave the hospital. The reason: a security alert.

``As usual, nobody asked anything. We knew that we couldn't ask. We just waited,'' she said. ``At one moment, someone said softly: `I bet the man upstairs is . . . ' and he touched his chin as if he were stroking a beard,'' a standard gesture used by Cubans when alluding to Castro.

They didn't have to wait long. A group of doctors and nurses was sent to the fifth floor. The others were sent home. Trujillo was one of the people selected to stay.

``They formed something like a support group, two per specialty, to assist and consult with Fidel's personal physicians,'' she said.

Among the doctors selected were Margarita Alonso Castro, an angiologist, and Carmen Garcia Beltran, a general practitioner. Others included cardiologist Noel Gonzalez and Dr. Hernandez Cañero, director of the Center for Cardiovascular Research, both of whom are on Castro's personal team, she said.

``In addition, Castro has two German doctors in his personal team, from the former German Democratic Republic, very good physicians,'' Trujillo said. ``They are the ones who practically made all decisions.''

At the CIMEQ, a hospital in the exclusive Siboney neighborhood that functions under strict military regulations, the fifth floor is reserved for high-ranking military and government figures. Whenever one of them is hospitalized, access to the building is restricted.

Access barred

``This time, things were different. Access to the fifth floor was barred to all, except to the handpicked doctors and nurses, plus a few service people. The rest were security agents,'' Trujillo said.

The fifth floor has three suites, each like an apartment, with all amenities, she said. Castro was placed in Suite A, the largest, and his bodyguards occupied Suites B and C, across the hall and next door, respectively, she said. Doctors have a small lunchroom, next to a terrace, and two bedrooms with cots and separate bathrooms, one for men, the other for women.

``I saw him, physically, all seven days,'' Trujillo said. ``I didn't give him medicine but went in to check him during my shifts. Valdes, or one of the Germans, would tell us about his vital signs and how he responded to treatment.''

Trujillo said that during Castro's hospitalization she didn't see any members of his family come to visit him -- nor any government officials.

``Nobody went there,'' she stressed.

``Fidel is hyperactive and he had to be sedated fully. They had to make his mind a blank, as in a coma, because if they hadn't he would have kept on ordering people around and asking questions,'' Trujillo said. ``He bosses even the doctors. That's the way he is. He is the boss.''

Out of danger

After three days, when Castro became more relaxed and was practically out of danger, Trujillo spoke with him twice, she said.

``We talked about my personal affairs. He knows me since I was a child. Normal topics. He asked me about my son. I asked him how he felt. That was all,'' Trujillo said. ``But we didn't discuss medicine or his health problems.''

The team that treated Castro remained confined to the hospital until Nov. 11, she said. Trujillo said she had no idea why they remained in the building long after Castro was discharged.

``I have no explanation for that, but I can't forget the date because my birthday falls on Nov. 14 and I was afraid I would spend my birthday there,'' she said.

Cuban newspapers reported Castro carrying on routine activities during part of the period Trujillo mentioned. On Oct. 31 Castro was reported to have signed an order promoting Gen. Alvaro Lopez Miera to armed forces chief of staff, replacing Gen. Ulises Rosales, who was appointed minister of the sugar industry.

Phoned home

On Nov. 2, Castro appeared at the inauguration of the 15th International Fair of Havana. It was not clear whether this was after the two-day final stay at CIMEQ that Trujillo mentioned.

During the time that she was confined to the CIMEQ, Trujillo said she phoned her home a couple of times to say that she was well but gave her family no further explanation.

Security personnel left the floor to bring in clean uniforms for the doctors and brought the food in daily, she said. She said Castro's meals were sealed, and carried on an aluminum tray.

``Knowing how his security system works, I can imagine that plate was changed 10 times en route,'' Trujillo said, smiling. ``I'm sure that the first tray that leaves the kitchen is not the one that is placed before him.''