OTTAWA—Canadian and American diplomats who suffered health problems during postings to Havana appear to have been exposed to some form of directed energy, says a U.S. doctor who has evaluated some of the workers.

In a career dedicated to the treatment and study of brain injuries, Dr. Douglas Smith says he’s never seen anything like the injuries suffered by the Canadians and Americans.

It has left them suffering persistent, concussion-like symptoms — dizziness, nausea, headaches and trouble concentrating — yet without a head trauma to explain the cause.

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“It’s kind of fascinating and terrifying,” said Smith, director of the University of Pennsylvania's Department of Neurosurgery and Center for Brain Injury and Repair.

With no plausible environmental explanation for the health woes, “the other possibilities are that this was something nefarious,” he said.

“It’s highly suspicious that U.S. government and Canadian government were the only ones we know of with this issue,” Smith told the Star in an interview.

The mystery has even taken on a name: the “Havana Syndrome.”

The working theory is whatever the cause, it originated in the housing, not the embassy, itself, because none of the Cuban staff who worked alongside Canadians have suffered health problems. But the houses are not in a single compound, but rather are spread out across the city.

Smith was among a team of specialists from the University of Pennsylvania asked by the U.S. State Department to evaluate 21 U.S. diplomats who, last year, began complaining of health problems experienced during postings to Havana.

Ten Canadians — diplomats and family members — also suffered similar health problems during their time in Cuba. Smith could not say whether he has examined the Canadians, but did say he’s been in touch with Canadian officials to discuss the findings.

Smith admits that he and his colleagues were initially skeptical, but became convinced that it was “something real.”

Smith said that mass psychogenic illness or mass hysteria was discounted as the cause, noting that some of the symptoms presented by the U.S. employees are impossible to fake. “We were convinced that this was a syndrome,” he said.

He said the government employees were “indistinguishable” from patients treated at the concussion clinic — except they had no history of a head impact.

“People started calling this immaculate concussion,” Smith said.

U.S. diplomats have reported that they felt targeted in attacks that had a “laser-like specificity,” seemingly able to pinpoint specific parts of a building, The Associated Press has reported.

Smith says there was a “directional aspect” to the exposure, with some saying they felt the sensation more on one side of the body than the other. They could move behind a concrete wall or into another room and it would disappear.

“Toxins and infections don’t do that. It supports the idea of a directed energy type of exposure,” he said.

When they felt these exposures, some Canadians and Americans also reported hearing noises at the same time that ranged in descriptions from high-pitched tones, grinding machinery to the sound of warping sheet metal. But Smith said the noise wasn’t the cause of the injuries.

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“Audible sound cannot hurt your brain,” Smith said. “It happened at the same time as another type of exposure that did injure the brain.”

He said there are energies used to deplete brain tissue, but those require direct contact. Ultrasound, microwave and infrasound have also been shown to cause some brain changes in animals in lab testing, but these, too, require close proximity, he said.

Environmental assessments of Canadian diplomatic quarters in Havana, including air and water quality tests, did not turn up anything that might suggest a cause.

“We do not think this is environmental exposure. At least, there’s nothing we know of in the environment without a head impact that could cause this,” Smith said.

One problem is officials don’t know how many were exposed. “We saw those with persistent symptoms. Maybe other people were exposed and were fine and didn’t report anything,” Smith said.

Smith and his colleagues wrote about the case earlier this year in the Journal of the American Medical Association. In a commentary on their findings, two other medical experts flagged several cautions, including the concern that those who developed symptoms may have been aware of what others had previously reported. Before reaching any conclusions, “additional evidence must be obtained and rigorously and objectively evaluated,” they concluded.

Officials appear no closer to solving the mystery, despite the involvement of medical teams in Canada and the U.S. and investigations by the Royal Canadian Mounted Police and the Federal Bureau of Investigation.

Still, as a precaution, Global Affairs Canada announced last Monday that it was removing family members of diplomats from Havana, seven months after the U.S. State Department made the same move.

Those dependants will leave the country within the coming weeks and Ottawa is also reviewing staffing levels in the embassy.

All Canadian diplomats assigned to Havana will undergo baseline medical testing before they leave Canada to track any health changes that may occur during their time there better, an official told the Star.

In March, the U.S. State Department said its embassy in Havana would continue to operate with minimal personnel. “We still do not have definitive answers on the source or cause of the attacks, and an investigation into the attacks is ongoing,” the department said in a statement.

Smith notes that the incidents have disrupted diplomatic operations by both Canada and the U.S. in Cuba.

“The end result is that both the Canadians and the U.S. has pulled out with only a skeleton crew left behind … if that were the desired goal, it’s really disappointing to know that was successful,” he said.