UMN surgeon known as his native Philippines’ father of orthopedics dies

Dr. Ramon Gustilo, a renowned orthopedic surgeon who revolutionized the treatment of open fractures and mentored doctors from around the world, died after a battle with kidney disease late last year at his home in Eden Prairie. He was 94 years old.

Known as the “father of orthopedics” in his native Philippines, Gustilo’s studies brought him to America in the 1950s. After completing a medical residency at the University of Minnesota in 1964, Gustilo became a leading surgeon in his adopted home.

“He was very grateful for what the state and the university had provided him — the opportunity for a poor kid from the Philippines to become one of the most recognized individuals in orthopedic surgery in the last 100 years,” said Marc Swiontkowski, a professor and former chair of the U’s Department of Orthopedic Surgery.

Gustilo is best known for developing a classification system that has helped generations of surgeons assess open fractures — serious wounds where broken bones protrude from the skin.

The Gustilo-Anderson classification, which he and fellow doctor John Anderson published in 1976, provided a standardized way of assessing open fractures and figuring out how to promote healing and prevent infection. The pair came up with the classification after studying hundreds of wounds and tracking what treatments worked and what didn’t.

“It is still the most widely used classification of the severity of open injuries,” Swiontkowski said. “The number of times that article has been cited is in the thousands. There have been efforts to refine it, but his was the pioneering effort.”

Born in 1930 in Manapla, a small city on one of the central Philippines islands, Gustilo survived the Japanese occupation during World War II, an experience that fueled his ambition. During the war, when he was unable to attend school, he tended water buffalo.

While his parents were not poor by Filipino standards — his father had a job as an overseer at a sugar plantation and their family had a house and servants — Gustilo spent his time with the water buffalo dreaming of bigger things.

“Ever since I was a kid, I wanted to be a famous, rich doctor,” Gustilo wrote in his 2007 autobiography, “I Will Not Be Poor.”

After graduating from medical school at the University of the Philippines, Gustilo arrived in Minnesota in 1957 for a post-graduate residency. In his book, he wrote that he chose the state after a group of touring missionary basketball players told him Minnesota was a land of 10,000 lakes, a good medical community and beautiful women.

Gustilo met his future wife, Gloria, during his second week in Minneapolis. When they married, Gloria, who was a Lutheran, had to convert to Catholicism. Over the decades, the two would have five children: Melissa, Nick, Lillian, Christopher and Tara.

He spent years sleeping four hours a night, his daughter Melissa Hanson said in a phone call. The family never ate until before 7 p.m. each night, because he was always working, Hanson said. “His mantra was always, ‘focus, focus, focus,’” she said. “He was busy doing his doctoring thing and we knew that was good, and mom handled everything else.”

As a surgeon, Gustilo was known for taking on difficult hip, knee and joint replacement surgeries. He often did revision surgeries, which involve fixing hip and knee implants placed by another doctor, the U’s Swiontkowski said.

“A lot of surgeons don’t take that on, frankly because they take a lot of time and don’t make much money,” Swiontkowski said. “Ray loved that stuff, to solve a problem that seemed unsolvable, particularly for failed joint replacements.”

And his patients liked his work. When Gustilo needed money to establish an orthopedic learning center for teaching surgeons, he sent letters to the 5,000 to 6,000 patients he had performed joint replacements on. His former patients sent him some $350,000.

Gustilo was a man with a mind in “constant motion,” several people who knew him said. He served for more than two decades as the chair of Orthopedic Surgery at HCMC. He wrote books and founded medical societies, and was always telling people about his ideas for business ventures and inventions.

Many of these ideas did not pan out, and there were other stumbling blocks: A patient sued the doctor in 1973 and was awarded $20,000 after his right leg was shortened by 2 inches. His medical office caught on fire in 1979, and his house burned in 1988. But Gustilo did not dwell on setbacks, people who knew him said.

Gustilo also made his mark overseas. In 1987 he started a fellowship program for orthopedic surgeons in Asia and Scandinavia, which over the years led to him mentoring more than 120 students and doctors.

Yoshi Ishii, a former fellow from Japan, recalled how Gustilo’s mentorship helped form his guiding principles. Ishii said he learned from Gustilo the importance of dressing neatly, making eye contact with patients, greeting them with a handshake, and placing a hand on their shoulder. “I am who I am today thanks entirely to Dr. Gustilo,” said Ishii, who built a hospital near Tokyo.

After retiring from HCMC, Gustilo continued to work in the Philippines. He founded a company providing low-cost orthopedic implants to Asia, and he returned to Manapla, where he grew up.

In his hometown, he rebuilt the local church and founded a hospital. “He wanted to go back to the land of his birth, and address the situation from that level, from a grassroots perspective,” said Angel Gomez, an anesthesiologist at the hospital Gustilo founded in Manapla.

“He didn’t lose touch with his hometown,” Gomez said.

Gustilo liked being the rich, well-known doctor he had dreamed of being as a child, according to friends who knew him. He took up skiing and golf and was poor at both.

“He worked hard, and he lived well, and he enjoyed that,” said Joan Bechtold, who worked with Gustilo as the director of the HCMC’s Orthopaedic Biomechanics Research Lab.

“But he did feel an obligation to help other people back home,” Bechtold said.

Toward the end of his life, Gustilo met with those he had taught over the years. Bechtold recalled a gathering of former fellows in August.

She said the bedridden Gustilo told them, “You have to be good to others. You have to take care of others.”