The hardships he overcame in Cuba made him the compassionate doctor he is today

When Israel Penate was 17, he began his medical studies in Santa Clara, Cuba. By the time he was 23, he was a doctor and had begun his residency in cardiology. By the age of 27, he was a cardiologist.

Three years after that he was a rafter, fleeing Cuba in a small fishing boat with several other people. He wound up in the Florida Keys knowing little English and with the daunting prospect of having to rebuild his life and medical career.

Penate said he wanted to be a doctor almost “since I was born.’’ His aunt was a doctor and his father had aspired to be a doctor too, but those plans were derailed when the University of Havana, a hotbed of anti-government protests, was closed from 1956 until 1959 and in the turmoil after the Cuban Revolution.

“Medicine was always my passion,” said Penate, 52, now a board-certified internal medicine physician at Broward Health Coral Springs and the hospital’s chief of staff.

He started his medical studies at the Instituto Superior de Ciencias Medicas de Villa Clara just after he graduated from high school. It meant leaving his home in the small provincial village of Calabazar de Sagua, but he excelled despite many difficulties and graduated in 1994.

During part of his time at med school and later during his cardiology residency in the early 1990s, Cuba was in a deep economic decline after the collapse of the Soviet Union and the end of its generous subsidies to the island. Known as the Special Period, it was marked by shortages of just about everything, including food.

“Studying being hungry was very difficult,” said Penate. There were shortages of books and the equipment needed to practice medicine. “Sometimes our tool was just the stethoscope. Sometimes there weren’t X-rays available,” he said.

That meant young doctors like Penate got very good at giving physical exams and really listening to patients.

There were also constant power outages.

“We lost power almost every night. Sometimes I had to wait until 1 a.m. when the lights came back on to study or I had to go to the hospital to study because there was power there,” he said.

Walking home after a 24-hour shift in Cuba

During his residency, he lived about 19 miles from the hospital and fuel shortages meant it was often difficult to find public transportation to get home after a 24-hour shift. “Sometimes I would just start walking and hitching a ride if someone came along. It could take me four or five hours to get home.”

Then, instead of resting, he often found townspeople who needed medical attention waiting for him at his home.

“You do what you have to do,” said Penate. “I just really wanted to study and be a doctor.”

Although he loved practicing medicine and seeing his patients, something was missing from his life.

“Mainly it was freedom, freedom of speech,” said Penate. “You couldn’t say what you thought.” He remembers during the Florida Marlins’ 1997 run-up to the World Series championship that Cubans would have to shut their doors if they wanted to listen to games.

Shortly after he finished his residency in cardiology, Penate decided to leave the island, joining generations of rafters before him. His group arrived in the Keys on Dec. 18, 1997, three days after they left from Cuba’s north coast.

Red tape with his residency application meant he couldn’t work for nearly two years, but once that was cleared up, he went to work at a dialysis company.

He never lost his dream of being a doctor again. First, however, he had to learn English.

“Living in Hialeah Gardens, learning English was a challenge,” Penate said.

He turned on the captions on his television and watched English-language programs. ‘“Law & Order’ and ‘Columbo’ helped me a lot,” he said. His girlfriend, now his wife, Midalys, who had come to the United States as a 13-year-old and had become fluent, also helped him.

As he learned English, he also prepared to take the U.S. Medical Licensing Exam, a series of tests required to get a license to practice medicine in the United States. “I was working in dialysis 40 hours a week and studying for the exam,” said Penate.

For the practical part of the USMLE, he went to Georgia to do a simulated physical examination. Although he had years under his belt as a licensed doctor in Cuba, “I was very nervous because of the language,” said Penate.

He got his certification in 2003, but Penate feared a delay in getting the paperwork documenting his medical studies in Cuba would mean he would have to wait a year to apply for a residency.

By the time his papers came through he had missed the traditional residency match period, but he was still invited to an interview for an internal medicine resident position at Bronx-Lebanon Hospital in New York on June 24, 2003.

“They asked me: ‘When can you start? How about tomorrow?’” said Penate. He didn’t even return to South Florida; he just went to work. Penate was on rotation for two years and in his third year became chief resident.

“I worked very hard,” he said simply, explaining his success. “It’s a very big hospital with 17 floors. It was a great place to learn.”

The contrast to what he was used to in Cuba was staggering.

“It was a shock. It was day and night from the hospitals where I worked,” Penate said. “It was like going to Disney. I have no words to tell you.”

Cuban training has stayed with him

But he still drew on his training in Cuba to serve his patients.

“In Cuba, we didn’t have anything. We had to use the physical exam, getting information from patients,” said Penate. “I incorporate everything I learned. I do the same things, the same way I examined my patients 25 years ago.”

He said he always starts his exams from the right side and goes through a head-to-toe checklist. “I like to follow my steps always. You are less likely to miss something. The times where a disease can be detected and treated early are often the most rewarding.”

Even if a patient comes in complaining of a migraine, he said he is still going to check the patient’s feet. “You don’t know what is under that sock,” especially with elderly patients, said Penate.

When Penate left Cuba there was very little diagnostic screening being done, so he had to learn those techniques when he began practicing medicine in the United States, he said.

Wasn’t easy adjusting to U.S. medical system

Dr. Kutty Chandran, the chief medical officer for Broward Health Coral Springs, said he believes Penate’s experience in Cuba has helped shape the type of doctor he is today. “Absolutely. He’s a compassionate physician. That’s No. 1. He always gives very personal care to his patients,” said Chandran, who has known Penate for about 15 years.

“When people come from a foreign country, they often struggle to adapt to the U.S. medical system. It takes a lot of work and initiative,” said Chandran. Penate has told him about his early challenges with English.

“He struggled through all these things, but he’s overcome obstacles with courage and enthusiasm, and built up his practice — a very good practice.”

Penate’s advice for physicians starting their practices today is to listen to their patients and to show compassion. “Take the time, listen, examine them. You can get a lot of information from patients.”

The emphasis on patient communication and thorough examinations that he developed in Cuba coupled with the resources of a U.S. hospital is “the perfect combination,” he said.

After finishing his residency in New York, Penate wanted to return to South Florida and joined a private practice in Coral Springs. He’s still with that practice, although it’s now owned by Optum, which is part of UnitedHealth Group.

Penate has been affiliated with Broward Health Coral Springs since 2006, seeing patients at the hospital and in his practice.

Elected as chief of staff

About four years after he joined Broward Health Coral Springs, he became more active with the medical staff, he said, and he is now serving his second term as the hospital’s chief of staff, an elected position.

“Being elected is an honor,” said Chandran. “He’s shown a lot of leadership and he’s a team worker with other physicians and the medical staff.”

Penate also played a key role in the launch of the hospital’s new cardiac catheterization lab in 2020.

“It was a new program for us, and he had to get everyone on board,” said Chandran. “He worked very hard with the cardiologists and the medical staff to get buy-in. It’s really a pleasure to work with him and it really helps me do my job.”

Through the years, Penate said, it’s been satisfying for him to see Broward Health Coral Springs grow from a small hospital to one that can now do complicated surgeries.

Sometimes he still marvels how far he’s come from being a young Cuban doctor who had to walk/hitchhike home for four or five hours to where he is today.

Penate, the father of two daughters, says his home in West Boca Raton is about the same distance from the hospital as his home in Cuba was from the hospital where he worked so many years ago. “Now the drive only takes me around 15 minutes,” he said.

“Without having English as my first language and then learning English from TV, I would never have believed I would have this opportunity [in U.S. medicine],” Penate said.

“Even after 25 years, my passion for medicine is unchanged — to be able to help someone, to give them a recommendation that will help them means so much,” said Penate. “If you love what you do, it’s not a job.”

Mimi Whitefield can be reached at mimiwhitefield@gmail.com Follow her on Twitter @HeraldMimi

This story was originally published March 17, 2022 at 6:00 AM.