Journal of the American Medical Association

New Yorker Report on Medical Problems of U.S. Diplomats in Cuba

The November 19, 2018, issue of The New Yorker has a lengthy article about the medical problems experienced by some U.S. diplomats in Cuba starting in late 2016 (and after the U.S. presidential election). [1]

The conclusion, however, is the same as previously reported: some U.S. personnel did suffer injury and the U.S. Government has publicly stated it does not know the cause or perpetrator of these injuries.[2]

But the article does provide greater details about many of the victims having been CIA agents and about the U.S.-Cuba interactions over these incidents.

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[1] Entous & Anderson, Havana Syndrome, New Yorker at 34 (Nov. 19, 2018).

[2] See posts listed in the “U.S. Diplomats Medical Problems in Cuba, 2017-18” section of List of Posts to dwkcommentaries—Topical: CUBA.

Continuing Controversy Over Medical Problems of U.S. Diplomats in Cuba (and China)

Since late 2016 some U.S. diplomats (now 26 in number) have complained about various medical problems that surfaced while they were serving in Cuba.[1]

The U.S., however, continues to assert publicly that despite subsequent investigations the U.S. does not know what or who caused the problems. Most recently, on September 6, 2018, at a House hearing, Kenneth H. Merten, Acting Principal Deputy Assistant Secretary, Bureau of Western Hemisphere Affairs, stated that the “Department does not currently know the mechanism for the cause of the injuries, the motive behind these attacks in Cuba, when they actually commenced, or who is responsible.” At the same hearing, Charles Rosenfarb, the State Department’s Medical Director, testified, “We’re seeing a unique syndrome. I can’t even call it a syndrome. It’s a unique constellation of symptoms and findings, but with no obvious cause.”[2] (Emphases added.)

Cuba, on the other hand, continues to assert that it did not cause the problems and indeed that there is no scientific basis for any contention that the diplomats suffered any kind of medical issues. For example, in June 2018, a Cuban diplomatic official said that Cuba had “challenged the U.S. on the use of the word ‘attack.’ “There is no evidence of a weapon, there is no evidence of a source, nobody can point to motivation and yet they continue to use the word ‘attack.’ We see it as politically motivated.’” He also noted that neither American nor Cuban experts had been able to determine what caused the symptoms. He renewed concerns that the Trump administration is using the incidents as an excuse to roll back U.S.-Cuba rapprochement started under the Obama administration.[3]

In the meantime, at least the following four theories about causation of the medical problems have emerged.

University of Pennsylvania Theory[4]

Physicians at the University of Pennsylvania examined the affected diplomats and in an article in the Journal of the American Medical Association (JAMA) asserted the following key findings:

The patients “appeared to have sustained injury to widespread brain networks.”
The patients have experienced “persisting disability of a significant nature” involving “hearing, vision, balance and brain symptoms similar to the brain dysfunction seen with concussions, but without histories of head trauma.”
In most cases, the affected diplomats reported hearing a loud, painful noise that they later associated with their symptoms, but the physicians concluded, “There is no known mechanism for audible sound to injure the brain” and “it is currently unclear if or how the noise is related to the reported symptoms.”
“Viruses or chemical exposures are unlikely,” but could not be “systematically excluded.”
“Advanced MRI scans spotted a few changes in some patients in what are called white matter tracts,” but these might be attributed to previous events.
“Several of the objective manifestations consistently found in this cohort,” including vision and balance abnormalities, “could not have been consciously or unconsciously manipulated.”

In August 2018 JAMA published letters from 10 neurologists and doctors from the United States, the United Kingdom and Germany that questioned the conclusions of the University of Pennsylvania report. They said it could have misinterpreted the result of medical tests or ignored disorders that cause symptoms among a large group of people, as psychological factors.

Smith and two colleagues published a response that said they are performing “advanced neuroimaging studies” of the patients and are “hoping to identify structural brain changes that may underlie the neurological manifestations.”

University of Michigan Theory[5]

A team of computer scientists from the University of Michigan’s Security and Privacy Research Group in March 2018 concluded that “if ultrasound played a role in harming diplomats in Cuba, then a plausible cause is intermodulation distortion between ultrasonic signals that unintentionally synthesize audible tones. In other words, acoustic interference without malicious intent to cause harm could have led to the audible sensations in Cuba.” The conclusion of the research paper itself also states, “our experiments do not eliminate the possibility of malicious intent to harm diplomats.” (Emphasis added.)

If I correctly understand this theory, the audible sound similar to that heard in Cuba requires at least two ultrasound sources that interfere with each other and this suggests that the audible sound was accidental and not intended. This supports Cuba’s consistent assertion that it did not intend to do anything to harm the American diplomats, an assertion that makes obvious sense from Cuba’s own self-interest of avoiding antagonizing the U.S.

Microwave Theory[6]

The lead physician and author of the University of Pennsylvania report, Dr. Douglas H. Smith, recently told the New York Times that “microwaves were now considered a main suspect and that the team was increasingly sure the diplomats had suffered brain injury.” He added, ““Everybody was relatively skeptical at first [but] everyone now agrees there’s something there.”

According to the Times, “Strikes with microwaves, some experts now argue, more plausibly explain reports of painful sounds, ills and traumas than do other possible culprits — sonic attacks, viral infections and contagious anxiety. In particular, a growing number of analysts cite an eerie phenomenon known as the Frey effect, named after Allan H. Frey, an American scientist. Long ago, he found that microwaves can trick the brain into perceiving what seem to be ordinary sounds.” Moreover, “scientists have known for decades that the brain can perceive some microwaves as sound.” Indeed, “The false sensations, the experts say, may account for a defining symptom of the diplomatic incidents — the perception of loud noises, including ringing, buzzing and grinding. Initially, experts cited those symptoms as evidence of stealthy attacks with sonic weapons.”

Beatrice Golomb, a professor of medicine at the University of California at San Diego, is a leading proponent of the theory that pulsed microwaves could explain the symptoms. She has authored a paper that will be published in coming days in the journal Neural Computation. The symptoms experienced by the Cuba patients match symptoms in other people who are “electrosensitive,” according to her analysis, which relies on the JAMA study and news reports.

Asked about the microwave theory, the State Department said the investigation had yet to identify the cause or source of the attacks. And the F.B.I. declined to comment on the status of the investigation or any theories. In addition, In addition, members of Jason, a secretive group of elite scientists that helps the federal government assess new threats to national security, say it has been scrutinizing the diplomatic mystery this summer and weighing possible explanations, including microwaves.

James C. Lin of the University of Illinois, a leading investigator of the Frey effect, described the diplomatic ills as plausibly arising from microwave beams. Dr. Lin is the editor-in-chief of Bio Electro Magnetics, a peer-reviewed journal that explores the effects of radio waves and electromagnetic fields on living things. In his paper, Dr. Lin said high-intensity beams of microwaves could have caused the diplomats to experience not just loud noises but nausea, headaches and vertigo, as well as possible brain-tissue injury. The beams, he added, could be fired covertly, hitting “only the intended target.”

In February, ProPublica in a lengthy investigation mentioned that federal investigators were weighing the microwave theory. This article also mentioned that a wife of a member of the embassy staff had looked outside her home after hearing the disturbing sounds and had seen a van speeding away.

Kenneth R. Foster, a professor of bioengineering at the University of Pennsylvania, has studied microwave phenomena while working at the Naval Medical Research Center in Bethesda. Foster, who was not involved in examining the diplomatic personnel, said that the reported illnesses remain mysterious and that he doesn’t have an explanation.

Nevertheless, Foster said, “But it’s sure as heck not microwaves.” Such a theory is “wildly impossible.” According to Dr. Foster, “to actually damage the brain, the microwaves would have to be so intense they would actually burn the subject, which has never happened in any of these incidents.” Foster added that there is no technology capable of using microwaves to produce the kinds of symptoms that the U.S. diplomats have experienced — and not for lack of trying. “Actually the Navy was interested in seeing whether this could be used as a weapon, and we spent a lot of time thinking about it, but the phenomenon was simply too weak to be of any conceivable use.”

A rejection of this theory also was voiced by University of Cincinnati neurologist Alberto J. Espay, who said, “Microwave weapons is the closest equivalent in science to fake news.”

A Cuban diplomat, Fernández de Cossío, Director for United States at Cuba’s Foreign Ministry, insisted that the microwave theory cannot explain the symptoms suffered by the U.S. diplomats in Havana. Mr. Fernández de Cossío accused the U.S. of carrying a deliberate political manipulation. On Monday, CNN reported that Dr. Mitchell Valdés-Sosa, a neurologist investigating on behalf of the Cuban government, also dismissed this theory.

The strangest reaction to the microwave theory came in a Washington Post editorial. After reviewing the pros and cons of the theory, it concluded, “the microwave explanation has again raised a question about whether the United States has discovered more than is being said about the perpetrators. If there are known culprits, they should be identified and held to account.”

Neuro-Weapon Theory[7]

A team put together by the State Department to investigate this problem consisted of Dr. Michael Hoffer of the University of Miami and an expert in brain trauma and otolaryngology; Dr. Carey Balaban, professor of otolaryngology, bioengineering and neurobiology at the University of Pittsburgh; and Dr. James Giordano, professor in the departments of neurology and biochemistry at Georgetown University Medical Center, and an expert in “neurotechnology” and its use in the military.

This team independently studied the first tests taken of those affected. And this team believes that the patients likely were hit by a weapon that uses directed energy and is capable of causing a “cavitation” effect or air pockets, in fluids near the inner ear. The bubbles can travel quickly through two pathways that carry blood to the brain from the inner ear — the cochlear and the vestibular — and “function as a stroke,” Giordano said.

Such “neuro-weapons” can be biological, chemical, or in the case of the incidents in Havana, “directed energy weapons.” The team was unable to conclude exactly what method the perpetrators of the attacks used but reduced it to the following possibilities:

▪ Ultrasonic (acoustic) exposures were considered “very possible and probable.”

▪ Electromagnetic pulsing was also described as “very possible and probable.”

▪ The team reported that the use of microwave energy was possible, but “unlikely.”

Conclusion

I am not a scientist or medical doctor and am unable to evaluate the merits and demerits of the above theories. I, therefore, specifically invite comments with additional information or thoughts.

But I also confess that I am amazed that after nearly two years the official U.S. public position is an inability to identify the cause or perpetrator.

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[1] Previous posts about these issues are listed in the “U.S. Diplomats’ Medical Problems in Cuba, 2017-18” section of Lists of Posts to dwkcommentaries—Topical: CUBA.

[2] U.S. House Foreign Affairs Comm., Western Affairs Subcomm., U.S. Policy Toward Cuba (Sept. 6, 2018); Kaplan & Ashenbach, Scientists and doctors zap theory that microwave weapon injured Cuban diplomats, Wash. Post (Sept. 6, 2018).

[3] Recent U.S.-Cuba Developments, dwkcommentaries.com (June 15, 2018), Cuba Still Baffled by Illness of U.S. Diplomats, dwkcommentaries.com (June 11, 2018).

[4] Swanson, et al., Neurological Manifestations Among US Government Personnel Reporting Directional Audible and Sensory Phenomena in Havana, Cuba, JAMA (Mar. 20, 2018); Medical Report on U.S. Diplomats with Health Problems Occurring in Cuba, dwkcommentaries.com (Feb. 16, 2018); What affected the US diplomats in Cuba? Ten scientists question the ‘attacks,’ Diario de Cuba (Aug. 15, 2018); Gianoli, et al., Neurological Symptoms in US Government Personnel in Cuba, JAMA (Aug. 14, 2018); Mojena, The truth is that they do not want to listen, Granma (Aug. 17, 2018); Do ‘Sonic Weapons’ Adequately Explain ‘Health Attacks’ on Diplomats in Cuba? Snopes (updated Sept. 4, 2018); Rasenick, et al., Letter: Cuba ‘sonic attack’ conspiracy theories and flawed science, Guardian (June 1, 2018); Sample, Cuban ‘acoustic attack’ report on US diplomats flawed, say neurologists, Guardian (Aug. 14, 2018).

[5] Possible Solution to Mystery of “Sonic Attacks” on U.S. Diplomats in Cuba, dwkcommentaries.com (Mar. 4, 2018).

[6] Broad, Microwave Weapons Are Prime Suspect in Ills of U.S. Embassy Workers, N.Y. Times (Sept. 1, 2018); Kaplan & Achenbach, Scientists and doctors zap theory that microwave weapon injured Cuba diplomats, Wash. Post (Sept. 6, 2018); Could ‘Microwave Weapon Really Have Caused US Embassy Workers’ ‘Bizarre Symptoms? LiveScience (Sept/ 5, 2018); Foster, Cuba’s “Sonic Attack” on the U.S. Embassy Could Have Been Merely Sounds Emitted by a Listening Device, Scientific American (Sept. 7, 2018); Editorial, A literal secret weapon is hurting U.S. diplomats abroad. What is it? Wash. Post (Sept. 7, 2018).

[7] Gámez, Doctors reveal possible ‘neuro-weapon’ used in alleged attacks in Cuba, Miami Herald (Sept. 7, 2018).

Cuba’s Latest Commentary on “Alleged” Health Incidents Affecting U.S. Diplomats in Cuba

On April 26 Granma, the official newspaper of the Communist Party of Cuba, published what it called “the 10 most common lies about alleged health incidents affecting U.S. diplomats in Cuba.”[1] Here is an analysis of the truth of those assertions without attempting to assess whether there have been lies about these assertions.[2]

U.S. DIPLOMATS WERE VICTIMS OF “ATTACKS” IN CUBA

GRANMA: “The use of the word “’attack”’implies a certain position with regard to the incidents. Neither Cuban or U.S. authorities have been able to identify the origin or cause of the alleged incidents, which are by their very nature profoundly sensationalist. “

GRANMA: “An FBI report leaked by Associated Press noted that there is no evidence of a ‘sonic attack’ against U.S. diplomatic personnel in Cuba. Nor have those working the case been able to identify possible authors or persons with the motive, intent or means, to carry out such actions.
If this were a court trial, the case would be missing a perpetrator, the device, and victims. Despite this, the international press and White House, continue to use the word “’attack..’”

RESPONSE: It is true that neither the U.S. nor Cuba publicly has identified the origin or cause of the health problems some U.S. diplomats have experienced in Cuba, but there is enough public information to support the contention that there have been some adverse health problems. Thus, it is inappropriate for Granma to suggest that there have been no adverse effects. It also is true that some U.S. officials use the word “attack” to refer to these incidents, and the public record to date does not support such a contention.

CUBA POSESES A STATE-OF-THE-ART “SONIC DEVICE

GRANMA: “Since the story hit the headlines the theory has circulated that a state-of-the-art sonic weapon could be responsible for the incidents. However, this has been overwhelmingly refuted by national and international scientists.”

GRANMA: “Although sonic weapons do exist, above all in the arsenals of developed countries, for audible sound to cause damage, it would need to be as loud as plane engine and would be impossible to go undetected.”

GRANMA: “Cuba meanwhile, has categorically denied that it owns, has any knowledge of, or is familiar with such technologies.”

RESPONSE: It is true that some of the public articles have mentioned the possibility that some state-of-the-art sonic device could be responsible for the adverse medical issues of some U.S. diplomats, that there has been no public identification of such a device and that Cuba has denied that it owns, has any knowledge of or is familiar with such a device. It, therefore, would be unjustified (based on the current public record) to assert that Cuba has such a device.

TARGETED ATTACKS
GRANMA: “It seems unlikely that the alleged incidents would have occurred where they reported to have taken place: including sites guarded by the U.S. itself and without direct access from outside. The attacks would have had to have laser-like precision to affect a specific individual without also causing damage to others.”

RESPONSE: This assertion is difficult to evaluate from the outside. At most, whether or not there have been targeted attacks is at most a contention or allegation without any public evidence to prove or disprove the contention.

VICTIMS SUFFERED BRAIN DAMAGE

GRANMA: “The symptoms cited by U.S. diplomats include ear pain, loss of hearing, dizziness, headaches, fatigue, cognitive problems, difficulty sleeping, and the most mysterious of all, brain damage.”

GRANMA: “Experts have noted that there is no documented medical case of sound leading to concussions or cognitive problems. According to “Joseph Pompei, a former MIT researcher and psychoacoustics expert, “Brain damage and concussions, are not possible… Someone would have to submerge their head into a pool lined with very powerful ultrasound transducers.”

RESPONSE: It is true that public information indicates that some U.S. diplomats who had served in Cuba have reported the mentioned symptoms and that there have been public articles about possible causes. Joseph Pompei, a former MIT student, was quoted in a public article that it was impossible for some secret sonic weapon to cause concussions, brain swelling and other symptoms, but that same article quotes Vince Houghton, the curator of the International Spy Museum, as speculating that “the most likely scenario is . . . a beta test of new Russian technology that went bad.” (Birnbaum, A secret sonic weapon in Havana? Scientists say ‘no way,’ PRI’s the World (Oct. 3, 2017).) For this outsider, there has been no definitive medical or scientific conclusion on this issue.

MEDICAL REPORT SUPPORTS WASHINGTON’S THEORY

GRANMA: “On February 14, a controversial article was published in the Journal of the American Medical Association (JAMA) entitled: Neurological Symptoms Among U.S. Diplomats in Cuba. The text has been used to lend scientific credibility to Washington’s theory. However, authors Christopher C. Muth and Steven L. Lewis noted that ‘a unifying explanation for the symptoms experienced by the U.S. government officials (…) remains elusive and the effect of possible exposure to audible phenomena is unclear.’’”

GRANMA: “The study concludes in very general terms stating that diplomats seem to ‘have sustained injury to widespread brain networks.’”

GRANMA: “According to an article in The Guardian, Robert Bartholomew, an expert in mass psychogenic illness (MPI) who teaches at Botany Downs Secondary College in Auckland, New Zealand, said he was “’lured by the study’ and claims that it reads like U.S. government propaganda. ‘It’s like the authors are trying to get us to believe an attack has occurred,’ he noted. Meanwhile, the committee of Cuban experts assigned to the case explained that the information provided has mainly been subjective, based on the statements of those affected, and the opinion of investigators, while objective data (medical exams) are insufficient and incomplete.”

RESPONSE:The JAMA article reported on examinations of 21 of the 24 individuals with symptoms by University of Pennsylvania physicians that found that the patients “appeared to have sustained injury to widespread brain networks” and “persistering disability of a significant nature.” Drs. Muth and Lewis, who were not involved in the study, urged “caution in interpreting the findings.” (Medical Report on U.S. Diplomats with Health Problems Occurring in Cuba, dwkcommentaries.com (Feb. 16, 2018).)

RESPONSE: Granma sets forth an accurate quotation by Robert Bartholomew. (Sample, Fresh row over mysterious sickness affecting US diplomats in Cuba, Guardian (Feb. 24, 2018).) In an earlier Guardian article, however, Bartholomew was quoted as saying, ““None of this makes sense until you consider the psychogenic explanation.” (Borger & Jaekl, Mass hysteria may explain ‘sonic attacks’ in Cuba, say top neurologists, Guardian (Oct. 12, 2017).

RESPONSE: This Granma assertion does not prove a lie. It merely points out that there are disagreements by various experts about what happened without resolving those disagreements.

AN “ATTACK,” THE ONLY EXPLANATION

GRANMA: “Psycho-social factors have also been put forward as a possible cause for the alleged incidents, which would explain the variety of symptoms cited by Washington. In an online forum about the case, Cuban experts noted that an in-depth study of all possible causes must be carried out before forming an opinion.”

GRANMA: “Meanwhile international experts agree that: “From an objective point of view it’s more like mass hysteria than anything else,” according to Mark Hallett, the head of the human motor control section of the U.S. National Institute of Neurological Disorders and Stroke, who noted, “Psychosomatic disease is a disease like anything else. It should not be stigmatized.”

RESPONSE: Granma’s assertions do not prove the alleged lie of an “attack” being the only explanation. It merely points out some of the explanations that have been offered.

CUBAN AUTHORITIES REFUSE TO COOPERATE

GRANMA: “Ever since the alleged health incidents were first reported in February 2017, Cuban authorities have dealt with the issue in a timely, serious and professional manner. Cuba even allowed FBI experts to conduct investigations on the ground on several occasions, all of which failed to find any evidence of the supposed attacks.”

GRANMA: Meanwhile, the committee of Cuban experts working the case encountered difficulties due to a lack of cooperation from U.S. authorities, who failed to share all available information, and denied Cuban authorities access to patients and their medical records.

RESPONSE: The public information confirms the assertions that Cuba has cooperated with the U.S. investigation, including having the FBI come to Cuba as part of its investigations and that Cuban authorities have not had access to the U.S. patients and their medical records. But this does not prove that the U.S. has asserted that Cuban authorities have refused to cooperate.

DIPLOMATS ARE AT RISK IN CUBA

GRANMA: “Cuba is renowned for its adherence to the Vienna Convention and has never perpetrated attacks of any kind against diplomatic personnel from any country, or allowed its territory to be used to do so.”

GRANMA: “Meanwhile, Cuban diplomats have been the victims of acts of violence in the U.S. orchestrated by members of well-known terrorist groups with links to Washington.”

GRANMA: “One of the most famous cases is that of Cuban diplomat Félix García Rodríguez, who was murdered in broad daylight by members of the Omega 7 terrorist group, on September 11, 1980, while serving at the country’s United Nations mission in New York.”

GRANMA: “Cuba, faced with the threat of war or in moments of great tension, has never opted for violence. Why would it do so after making the sovereign decision to reestablish diplomatic relations with Washington?”

RESPONSE: Yes, Cuba repeatedly has asserted that Cuba seeks to comply with the Vienna Convention on Diplomatic Relations, but that does not prove that Cuba did not put U.S. diplomats at risk. As previously noted, both countries have repeatedly stated that the matter is still unresolved. The earlier alleged incidents involving Cuban diplomats in the U.S. is irrelevant to the current controversy.

SOUTH FLORIDA POLITICIANS ONLY CONCERNED FOR THE WELFARE OF U.S. DIPLOMATS

GRANMA: “Sectors opposed to rapprochement between the two nations have been manipulating the issue of the alleged health incidents to justify a reversal in the process to improve U.S.-Cuba relations and advance their own agenda.”

GRANMA: “The politicization of the case, which recently led to unilateral measures by the U.S. government, only benefits a small group of right-wing anti-Cubans, led by Marco Rubio, which continues to promote a hostile policy toward the island – against the interests of the country and its citizens.”

RESPONSE: Agreed that Senator Rubio and certain other politicians from South Florida consistently have opposed normalization of relations with Cuba and have used the medical problems of U.S. diplomats as another excuse as purported justification for their position. This blogger, however, consistently has supported normalization and reconciliation of the two countries.

TOURISTS AT RISK

GRANMA: “As part of the political manipulation of the case, the White House alleged that in September of last year a dozen U.S. citizens who had traveled to Cuba, also experienced symptoms similar to those of the diplomats.”

GRANMA: “But bearing in mind that terms as general as dizziness and headaches are used, one can appreciate the absurdity of the accusations.”

GRANMA: “Over four million international visitors traveled to Cuba last year, including 620,000 U.S. citizens. Their experiences on the island and satisfaction, according to specialist surveys, is proof of Cuba’s tranquility, security, and stability, which has been recognized by international organizations such as the UN and other tourism agencies.”

RESPONSE: On September 29, 2017, the U.S. Secretary of State said,, “We have no reports that private U.S. citizens have been affected, but the attacks are known to have occurred in U.S. diplomatic residences and hotels frequented by U.S. citizens.”(Medical ‘Incidents’ Affecting U.S. Diplomats in Cuba Prompt U.S. To Reduce Staff at Havana Embassy and Urge Americans Not To Travel to Cuba, dwkcommentaries.com (Sept. 30, 2017).)

But on October 6, 2017, an unnamed State Department official said, “Since we issued the September 29 Travel Warning, we have received a handful of reports from U.S. citizens who report they experienced similar symptoms following stays in Cuba. We have no way of verifying whether they were harmed by the same attacks targeting official U.S. employees.” (U.S. Embassy in Cuba Issues “Hotel Restrictions in Havana” Security Message, dwkcommentaries.com (Oct. 7, 2017).)

Agreed that a large number of Americans have visited Cuba without experiencing any of the medical problems at issue.

CONCLUDING RESPONSE

While both countries’ frustration with the non-resolution of this situation is perfectly understandable, calling the other side liars is unfounded because neither side has grounds for saying that the other is saying something that it knows is untrue. Moreover, calling the other side liars does not aid in resolving the disputes.

As a prior post reports, but the Granma article fails to mention, research at the University of Michigan discovered that two inaudible ultrasonic devices can create interference (intermodulation distortion) that makes sounds similar to those recorded in Cuba that some of the affected diplomats heard.

There are competing theories of what caused the medical problems, and if that were the only dispute, the two sides could agree to submit that to a neutral fact-finder in an arbitration or some other dispute-resolution procedure. But that really is a side issue. The important issue is what can be done, if anything, to improve the health of the affected U.S. (and Canadian) personnel and to ensure that there will be no similar incidents in the future.

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[1] Gómez, The 10 most common lies about alleged health incidents affecting U.S. diplomats in Cuba, Granma (April 26, 2018).

[2] This blog has published many posts about the issues associated with the medical problems of some U.S. (and Canadian) diplomats who were stationed in Cuba. See posts listed in the “ U.S. Diplomats Medical Problems in Cuba, 2017-18” section of List of Posts to dwkcommentaries—Topical: CUBA.

Discovery of Brain Abnormalities in U.S. Diplomats in Havana with Medical Damage

A forthcoming article in the Journal of the American Medical Association describes brain abnormalities in U.S. diplomats who had been stationed at the U.S. Embassy in Havana Cuba and who have been suffering hearing, vision, balance and memory damage. The article is written by physicians at the University of Miami and the University of Pennsylvania who have treated the diplomats with input from the State Department’s medical unit and other government doctors.[1]

The abnormalities are in the brain’s white matter tracts that let different parts of the brain communicate with one another. But doctors still do not know how patients ended up with the white matter changes or how exactly those changes might relate to their symptoms.

U.S. officials also will not say whether the changes were found in all 24 patients. Most patients have fully recovered, some after rehabilitation and other treatment, officials said. Many are back at work. About one-quarter had symptoms that persisted for long periods or remain to this day.

U.S. officials have told the Associated Press that investigators have now determined:

The most frequently reported sound patients heard was a high-pitched chirp or grating metal. Fewer recalled a low-pitched noise, like a hum.
Some were asleep and awakened by the sound, even as others sleeping in the same bed or room heard nothing.
Vibrations sometimes accompanied the sound. Victims told investigators these felt similar to the rapid flutter of air when windows of a car are partially rolled down.
Those worst off knew right away something was affecting their bodies. Some developed visual symptoms within 24 hours, including trouble focusing on a computer screen.

Physicians are treating the symptoms like a new, never-seen-before illness. After extensive testing and trial therapies, they are developing the first protocols to screen cases and identify the best treatments.

Doctors still don’t know the long-term medical consequences and expect that epidemiologists, who track disease patterns in populations, will monitor the 24 Americans for life. Consultations with the Centers for Disease Control and Prevention are underway.

According to Elisa Konofagou, a biomedical engineering professor at Columbia University who is not involved in the government’s investigation, acoustic waves never have been shown to alter the brain’s white matter tracts.”I would be very surprised. We never see white matter tract problems” even though ultrasound in the brain is used frequently in modern medicine.

Apparently unconnected with this AP report, U.S. Secretary of State Rex Tillerson responded to a journalist’s question on this issue at a press conference at NATO headquarters in Brussels, Belgium on December 6.[2] The Secretary said the following:

“We are convinced these were targeted attacks. We have shared some information with the Cubans, and there are two restrictions I’ve placed on sharing information. One is respect for the privacy of individuals and their medical conditions, and the second is not to provide whoever was orchestrating these attacks with information that’s useful to how effective they were. What we’ve said to the Cubans is a small island, you got a sophisticated security apparatus, you probably know who’s doing it, you can stop it. It’s as simple as that. So that’s what we’ve asked the Cubans. We understand the Cubans don’t like the actions we’ve taken. We don’t like our diplomats being targeted.”

Conclusion

This medical report should at least eliminate Cuba’s recent assertion that the U.S. was lying about medical problems being experienced by some U.S. diplomats. The report also casts doubt on the notion that the cause was some kind of sonic attack. But the report leaves open the broader question of the cause and the perpetrator.

Secretary Tillerson’s comments are not very helpful. The reported U.S. physicians’ conclusion of observable brain abnormalities for at least some of the diplomats apparently was reached only recently and leaves other issues unresolved. Therefore, even if Cuba has a “sophisticated security apparatus,” it should not be surprising that Cuba has not uncovered a cause or a perpetrator.

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[1] Assoc. Press, Doctors Identify Brain Abnormalities in Cuba Attack Patients, N.Y. Times (Dec. 6, 2017) Many previous posts to this blog have discussed the issues raised by the medical problems of some U.S. diplomats; they are listed in the “U.S. Diplomats Medical Problems in Cuba, 2017” section of List of Posts to dwkcommentaries—Topical: Cuba.

[2] U.S. State Dep’t, Press Conference at NATO, (Dec. 6, 2017); Harris, Tillerson Suggests Cuba Could Have Stopped ‘Targeted Attacks’ on U.S. Diplomats, N.Y. Times (Dec. 6, 2017); Assoc. Press, The Latest: Tillerson says diplomatic people were ‘targeted,’ Wash. Post (Dec. 6, 2017).