The Salvadoran fisherman who survived 13 months in the Pacific is now terrified of his once-beloved sea and too mentally drained to leave his hospital for now, a psychiatrist says.
Doctors who have seen Jose Salvador Alvarenga since he returned to El Salvador on Tuesday say he is in remarkable physical shape but that he needs psychological attention following his ordeal.
Alvarenga, 37, returned to El Salvador on Tuesday, two weeks after emerging in the Marshall Islands following a 12,500 kilometre journey in a seven-metre fibreglass boat.
He told Salvadoran officials that several passing ships ignored his pleas for help, with one vessel coming close to hitting his boat and another's crew waving back at him.
Doctors at the San Rafael National Hospital near San Salvador say they are satisfied with the fisherman's progress, and that he is chattier than he was the previous day.
But psychiatrist Angel Fredi Sermeno says Alvarenga is suffering from post-traumatic stress disorder and mental exhaustion.
He will need psychological treatment for a few more days before he can return to his family's Pacific coast village of Garita Palmera, Sermeno told a news conference.
"It wouldn't be advisable for now" for him to see the ocean, Sermeno said, noting that Alvarenga is suffering from thalassophobia - the fear of the sea.
"He doesn't want to have anything to do with the ocean. He wants to avoid being in front of the sea as much as possible," he said.
The survivor has yet to talk about his 24-year-old crewmate, who died four months after they set off on an ill-fated shark fishing excursion off Mexico's southern coast in late 2012, Sermeno said.
"Reliving this experience could cause a lot of damage," he said, adding that doctors were avoiding questions and letting Alvarenga choose what to talk about for now.
Alvarenga says his companion, Ezequiel Cordoba, starved to death because he could not stomach the diet of urine, turtle blood, raw fish and bird flesh.
In a hand-written letter shown by doctors, Alvarenga briefly described his feelings during his ordeal: "On the first day I was afraid but I prayed to God and God listened to me."
The fisherman drew in a blue pen a stick figure with long hair, a nod to the shaggy-haired look he was sporting when he appeared in the Marshall Islands on January 30.
In the letter, Alvarenga renewed his plea for journalists to leave him in peace.
"To the media, I ask you for time for me to get better to be able to talk to you because I still cannot express myself very well," he wrote, signing with the initial "J."
He has also asked reporters to leave his family alone after an emotional reunion with his parents and 14-year-old daughter Fatima, who last saw him eight years ago.
Despite his psychological fragility, doctors remain impressed by Alvarenga's physical shape and slowing readapting to a normal diet.
The patient has eaten beans, drunk coffee and fulfilled his wish of wolfing down pupusas - a local specialty of thick corn tortillas stuffed with cheese.
"He's eating very well," said Doctor Manuel Bello.
Alvarenga's seemingly miraculous story was met with some doubt when images first emerged of him with shaggy hair and a bushy beard, yet looking plump.
But officials have said his story checks out and fishermen in the Mexican village of Chocohuital backed it up, saying they went looking for him when he disappeared in 2012.
They say pictures of his boat in the Marshall Islands confirm it is his.
