- The Washington Times - Saturday, September 18, 2004

Discussions about the U.S. trade embargo with Cuba often center on economics and political differences. Biology has a way of transcending such discussions, not because it is a higher form, but because physiological mechanisms have little to do with governmental disputes.

“Trading with Fidel Castro can help entrench him. Trading with Mr. Castro will enrich him personally. Trading with Mr. Castro is a blow against freedom. Trading with Mr. Castro is an attack upon people who died trying to escape Cuba.” All these statements should be legitimately scrutinized.

However, there are apolitical science and medicine features that argue against blockades of academic commerce, i.e. discourse dedicated to advancing human health.

In March, the U.S. State Department prevented some 100 U.S. neuroscientists and physicians, including me, from attending the “Fourth International Conference on Coma and Death” in Havana. The reason given had something to do with aiding and abetting a communist regime.

However, in terms of money, the American contingent would have spent little. The weeklong conference attracted hundreds of scientists, philosophers, theologians and health-care providers from around the globe.

According to my Cuban counterparts, Americans were sorely missed. I certainly believe, though I was prepared to deliver two lectures, I lost out in not learning what the world could present on this very pervasive problem of the catastrophically ill.

For some reason, the cerebral cortex and brain stem do not distinguish whether the patient originates from a theocracy, a democracy, a feudalistic society or even a communist regime. I am aware of no tiny signpost visible on electron microscopy over spiny neurons in the basal ganglia that read “communist brain.” The corpus callosum, which connects the left and right hemispheres also is not a bridge “for capitalistic voters only.”

Our State Department doesn’t quite appreciate these points. It also likes to cast wide nets in international policy. This is part of the arrogance of regulators.

I was still seething from the travel rebuke when I learned on Sunday Aug. 29, that a family friend, an 18-year-old college student, Michi Padron, ironically of Cuban descent, had suddenly lapsed into a coma here in Miami.

As a researcher, I was not on “the front lines” of neurology care although I had practiced neurology in the 1980s and 1990s. I immediately opened a dialogue with her treating and consulting physicians on what could be offered this bright and beautiful young lady. I also launched detailed Internet searches and reviewed abstracts from the Coma and Death conference I was prevented from attending.

Disappointingly, I learned that although there have been steps toward more aggressive and successful treatment of coma in the last several years, we still have no truly effective strategy for brain salvage and protection. Thus, for the most apart, except for very special circumstances not applicable to Michi, only experimental unproven therapies can be offered.

One reason for this lack of success is international coma conferences are rare; the prior Havana conference was in 2000 and there is no such comparable gathering in the United States of which I am aware. In addition, because medical therapies are developed only when there is a particular economic incentive, certain multi-center research for difficult-to-treat problems such as coma is not often in evidence. Put another way, even though there are promising drugs for coma, there is no worldwide campaign to address it because some of the potentially effective drugs are not expensive blockbusters and might not yield massive profits for pharmaceutical companies, even if some applicability against coma could be determined.

The Miami Herald recently covered the story, however, of the State Department allowing trade with Cuba in a lucrative cancer vaccine. Somehow, earlier pro-emargo arguments were put on the back burner with a certain moneymaking deal in prospect. Was it “Viva the Special Interest Almighty Dollar” in that case?

Perhaps if I had attended the Coma Conference and brought back some cancer vaccines in my suitcase, government officials would have made an exception for me, maybe even slipped me a few “C-notes” or something.

The larger issue is governments can manipulate funding certain scientific and medical research. However, core basic science and clinical exchanges at international conferences should operate outside of political agendas. They are assembled to advance the human race: not the capitalistic or socialistic race, our human race.

I may have got no further insights into Michi’s coma by attending the March Cuba conference on Coma and Brain Death, but I do not know that for sure.

There is no magical solution for tragic medical conditions such as coma, brain death, Terry Schiavo-like vegetative states and cerebral anoxia. But one step in the right direction is to encourage more worldwide medical and scientific symposia.

We can start by abandoning the idiotic trade shutdown involving academic, medical and scientific dialogue with Cuba. Instead of the discourse embargo, let’s create Michi’s Bridge.

Michi Padron passed away on Sept. 6. Heartfelt condolences are extended to her family and friends.

KENNETH GROSS, M.D.

Assistant Professor of Neurological Surgery

University of Miami School of Medicine

Research Health Scientist

Miami VA Medical Center

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