Military Faces of Neurosurgery – A Hero So Named

Carlos A. David, MD, FAANS
Associate Professor of Neurosurgery, Tufts University School of Medicine
Director of Cerebrovascular and Skull Base Surgery, Lahey Hospital & Medical Center
Burlington, MA 

It is shortly after midnight, April 17, 1961. The paratroopers of “A” company, 1st Battalion anxiously await the moment their C-46 plane will be airborne. One paratrooper asks, “What is the delay?” A few others exchange rumors that begin to circulate. “Things aren’t going well.” Another frets, “There are problems being reported.” Most, however, remain silent. Deep in their own thoughts, these men of action want only to do the job, to succeed at the mission for which they have trained. Finally, the plane gathers speed traveling down the Nicaraguan runway and gradually climbs into the night sky. The destination is Palpite, on the south-central coast of Cuba. It is D-Day for the Bay of Pigs invasion.

As the C-46, accompanied by a C-54 carrying heavy weapons and ammunition, approaches the West side of the bay near Playa Larga, they are met with ammunition fire. Quickly, the planes take evasive action and make plans to get the paratroopers on the ground. They turn back toward the drop zones but are now approaching from the wrong direction. With no evident landmarks, they fly over the Zapata Swamp and begin the drops when they spot Playa Larga-Central Australia road. They are off target, and the paratroopers are scattered widely. They are on the ground but far from their planned drop sites. The C-54 is also off target, and most of the supplies and weapons are lost in the swamp.

A few small groups of the paratroopers are able to join together. Fighting in small groups, or in some cases alone, they fight until they have no ammunition. Trapped without the expected air control over the beach, the brigade is pounded by the remnants of Castro’s small air force. U.S. forces do not intervene. The invasion plan fails, and the internal resistance is quickly crushed. The U.S. administration of President Kennedy is humiliated, and the brigade commandos who survive are captured and imprisoned. Among the many prisoners is a brave 18-year-old young man named Roberto Carlos de los Heros.

The failure of the Bay of Pigs invasion remains a wound that has never quite healed in both the Cuban exile community and the U.S. psyche. Much has been written regarding the ill-conceived plan, the poor invasion location, the information leaks and the lack of the Kennedy administration’s resolve. Growing up in Miami as the son of a Cuban immigrant, I had often heard the stories and witnessed the visceral reaction that the failed invasion aroused in the exile community. The bitterness toward Kennedy I have come to expect; hence, as I grew older, I avoided discussing the topic with many in the exile community — despite my strong interest in the history of this invasion.

In 1996, I met Roberto C. Heros, MD, FAANS, as he assumed the co-chair position at the University of Miami Department of Neurosurgery. Of course, I knew of him, his family and his famous neurosurgeon uncle, Jorge A. Picaza, MD. I was timid as I asked him about the Bay of Pigs invasion. Here was a true hero from that ill-fated invasion, someone who had suffered firsthand the pain of the failed invasion and the resulting internment. I had come to expect the often encountered bitterness toward the U.S., but to my surprise, here was someone incredibly appreciative of what this country had done — a man whose heart was full of gratitude. The next few paragraphs represent my feeble attempts to find words that can capture and relate his story. This is the story of a hero who became a world-class surgeon, role model, mentor and friend.

Background

On March 17, 1960, then President Eisenhower approved a covert action against Cuba and the Castro regime, the Bay of Pigs invasion. The plan was to be executed by a CIA-sponsored paramilitary group named “Brigade 2506.” At a secret base in the Guatemalan jungle, American CIA agents trained Cuban exiles to invade Cuba. Their goal was to establish a beachhead at Playa Girón (Girón beach) in the Bahia de Cochinos (Bay of Pigs) and hold it against the expected counterattack by the army and militia of the Cuban government led by Fidel Castro. The plan called for the eventual link up with anti-Castro rebels located in the Escambray Mountains some 80 miles away, as well as internal resistance from an anti-Castro underground. This was thought to be the impetus for the Cuban people to rise and overthrow Castro.

On April 15, 1961, as a prelude to the invasion, six American bombers disguised in the colors of the Cuban Air Force took off from Nicaragua for a crucial attack on Cuban airfields. The goal was to destroy much of Castro’s air force. Unfortunately, only three Cuban planes were destroyed, and seven civilians were killed. The resulting international condemnation led then-President Kennedy to cancel the critically needed air support that was to protect the invasion as the battalions hit the beach. When the invasion began two days later, approximately 1,400 commandos landed at Playa Girón. Despite fierce resistance, the brigade initially was successful against the local Cuban militias. Castro, fearing that this was a full-scale U.S. invasion, mobilized all of Cuba’s forces. Without American air support or resupply, the invasion force was outnumbered and outgunned. The invasion was over in 72 hours; all of the invaders were either captured or dead.

Growing Up in Cuba

Roberto Carlos de los Heros, the eldest son of Elsa and Angelberto de los Heros, was born in Havana, Cuba on Sept. 27, 1942. His father was a prominent pediatrician and director of the Children’s Hospital in Havana; his uncle, Jorge A. Picaza, MD, was a highly respected Mayo Clinic-trained neurosurgeon. Both men would have a significant impact on Dr. Heros’ decision to become a physician. He describes his childhood as uneventful and happy. “Cuba was a paradise until Castro took over.” He was an excellent student, highly competitive in the classroom and on the athletic field. He played American football passionately and led his team to a championship in his final year of high school.

He was only 16 years old when Castro came to power, but life in Cuba changed quickly. In an interview for the Sou’wester, the collegiate newspaper of Southwestern at Memphis (now Rhodes College), he describes the confiscation of lands, the indoctrination of schools and the rapid downfall of the Cuban economy. In a 2011 video interview of Bay of Pigs veterans, Dr. Heros described the effect of the Castro regime: “The totalitarian regime changed the very fabric of daily life attempting to control the individual.” He graduated from high school in June 1959. His plans for medical school were thwarted because the university had been closed. He obtained employment in life insurance and became increasingly angry. Very quickly, he became involved in disorganized anti-Castro activities and student groups. He had several altercations with Castro militiamen, reaching a point where he challenged “anyone with a beard.” His friends and family became increasingly alarmed and urged his father to “get Roberto out of here because he’s going to get killed.” After one particular altercation related by his brother Fernando (Fred) in a University of Tennessee alumnus interview: “He beat the [blank] out of Castro’s man and the next day my father had him out of Cuba.”

The Bay of Pigs

Roberto’s parents realized that he was in imminent danger and sent him to England in the fall of 1959, hoping that being far away in Europe would make it less likely he would return and again become involved in anti-Castro activities. He spent ten months in London working as a clerk for a life insurance company. Around this time, he received word from friends in the U.S. that the CIA was recruiting Cuban exiles for an invasion of Cuba. Here was a chance to do something and he jumped at the opportunity. He traveled to New York to volunteer. Dr. Heros had no intention of telling his parents, who by this time had escaped from Cuba and were living in Virginia. By some strange coincidence, he ran into his uncle while walking the New York streets. His uncle, quite surprised to see him, inquired as to why he was in the U.S. His uncle was aware of the invasion plans and actually was helping coordinate the medical support. After hearing of Roberto’s intentions, he strongly suggested that he tell his parents of his involvement in the invasion. Dr. Heros describes the ensuing discussion with his parents as “the most miserable three days of my life.” His mother objected fiercely at the thought of her 17-year-old son risking his life in an invasion. His father objected but did not stop his son, now a grown man capable of making his own decisions. Lying about his age, he volunteered and was sent to Guatemala for training. He arrived in the training camps in September 1960. Shortly thereafter, he volunteered for paratrooper duty. He was transferred to a new training base for the airborne troops and spent the next ten months training in the mountains.

On April 17, 1961, Roberto C. Heros was part of the ill-fated “A” company. Because of anti-aircraft fire, his plane was forced to drop the paratroopers off target. The supplies were dropped hastily and were lost in the swamps. Despite these setbacks, some of his unit was able to regroup and confront a Cuban militia. The militia was quickly defeated, and the town objective was secured. Their mission was to control access via the road leading to Playa Larga. They held on until ammunition ran out. With no resupply and lacking the heavy guns needed to engage the oncoming column of Castro’s tank battalion, they were ordered to retreat through the swamps to Playa Larga. Without radio communication, the unit became lost in the swamps. The commander asked for volunteers to seek out a path to Playa Larga. Dr. Heros volunteered and set out with the highly decorated WWII veteran, Manuel Perez Garcia.

When the men reached Playa Larga, it was apparent that Castro controlled the area, and it would be impossible to make contact with the 2^nd Battalion of the invasion forces. The men retreated to their company, by which time it was evident that the invasion had failed. They attempted to retreat into the swamps with hopes of reaching Havana, but most were captured by Castro’s soldiers. Along with a fellow soldier, Dr. Heros managed to escape and avoided capture for another twelve days. He would spend the next 20 months in a Cuban prison.

Freedom and a New Life

Various unofficial attempts to procure the freedom of the prisoners were undertaken. The most notable was the failed effort of the Tractors for Freedom Committee, headed by former First Lady, Eleanor Roosevelt. After this failure, Berta Barreto de los Heros, mother of one of the prisoners and liaison for the Cuban Family Committee, began contacting other mothers and using her connections in Cuba to open dialogue with Castro. This groundwork eventually led to the assignment of James Donovan to directly negotiate with Castro. The conditions for the release wavered over the ensuing months; after painstaking negotiations, an agreement was reached. The prisoners were to be released in exchange for $53,000,000 worth of food and medicine.

Dr. Heros was released on Christmas Day 1962. He made his way to Miami and eventually Memphis, where his uncle, Dr. Picaza, had settled. He obtained employment as an insurance salesman. He worked saving money for college when, by chance, a university official overheard his story. He was offered a football scholarship to play at Rhodes College in Memphis. He was not successful on the athletic field, but he excelled in the classroom, earning all A’s. He was allowed to keep his scholarship, now an academic scholarship, and he completed his undergraduate work. The same college officer helped him procure admission to medical school. Dr. Heros was admitted to the University of Tennessee School of Medicine, where he graduated first in his class in 1968.

Upon graduation, Dr. Heros spent two years as a surgical resident at Massachusetts General Hospital. He next joined the U.S. Air Force, hoping to serve the country that had been so generous to him. After two years in the air force, he returned to Boston and completed his neurosurgery residency.

Surgeon, Teacher, Mentor

I am one of those fortunate enough to call Dr. Heros a teacher and mentor. His remarkable career has spanned over three decades. He has been academically prolific, a superb and dedicated teacher, and a master surgeon of impeccable technique and judgment. His commitment to patients is exemplified by both direct care and as an advocate for the general advancement of stroke care. Dr. Heros was an early leader in the U.S. promoting the phrase “Brain Attack” to help increase public awareness and highlight the urgency of getting immediate medical attention during stroke. To this end, he was the first chair of the Brain Attack Coalition, a multidisciplinary organization that continues to thrive today under the auspices of the National Institute of Neurological Disorders and Stroke (NINDS). He has published extensively in regards to stroke, aneurysms and vascular malformations.

These traits and his unquestionable honesty serve as a model for all neurosurgeons. Our neurosurgical societies have awarded him the highest honors, and there is no question that he is one of our greatest teachers. I am always amazed at his ability to patiently guide struggling residents through their first steps under the microscope with an uncanny understanding as to which surgical nuance must be shown and explained. Dr. Heros is a role model with unsurpassed moral character. Every complication is discussed openly and honestly. He teaches us to learn from our mistakes and publicly share them in the drive towards quality and excellence, always asking, “How could I have done this better?”

Perhaps most endearing are his human qualities. I recall my first case with Dr. Heros. He insisted on standing by the patient while holding her hand, comforting and providing reassurance as the anesthesiologist put the patient to sleep. I had never witnessed such a remarkable act, which I saw repeated countless times, and it has never left me. He exemplifies the humane qualities of a true healer: humility, honesty and complete devotion to his patients.

A Hero So Named…

Despite the hardships of his earlier life, Dr. Heros has always had a positive outlook. The loss of country, the failure of the invasion and his subsequent imprisonment never affected him as it did others in the exile community. He speaks of gratitude to the U.S. and what it has offered him. He garners no bitterness. In a recent phone interview with my son for a freshman English project, which Dr. Heros was kind enough to provide, he remarked: “I love this country, what it has done for me. I will give my life for it.”

It is fitting that he bears the name of “Hero.” As is said of Colonel Rowan in A Message to Garcia, can be equally said of him. The epitome of a hero: “To be loyal to a trust, to act promptly, concentrate their energies: do the thing.”

So on this 55^th anniversary of the Bay of Pigs invasion, I am proud to honor my role model, mentor and friend, Dr. Roberto C. Heros.

* Special acknowledgment to Drs. Paul Camarata and Jacques Morcos for early childhood photographs.