This is rather fun.

He's not a morbidly obese whale, no. But he's plenty overweight enough that he's at increased risk for colon cancer. Add to that his Y chromosome, his age, his tobacco history, the pork-heavy Cuban diet . . .

Indeed, Cuba has better health care than some places, but then again so does Mexico. It's quite relative. Routine colonoscopies and cancer screenings aren't a part of Cuba's standard age-related care, although I do expect Fidelito has had better care overall than most average Cubanos.

The thing that persuades most of the medical people I've talked to is the last three words in his letter. Castro said extreme stress "had provoked in me a sharp intestinal crisis with sustained bleeding that obligated me to undergo a complicated surgical procedure." Non-serious matters generally don't require complicated surgical procedures.