Is it real, or is it ADAM René Gonzalez 79 creates life-like robot for medical
training
By Rob MacKay 89
Rene Gonzalez 79 with one of the
early prototypes of his human patient simulator.
René Gonzalez 79 was leaving
his summer job at a lab one evening in 1976, when an EMT crew rushed
by, frantically tending to an asphyxiating man. The patient died,
but an idea was born.
I was positive that guys life could have been saved,
he says. It made me wonder if there was a better way to do
things.
Fast-forward to 2002, and René Gonzalez, an anesthesiologist
in Pennsylvania, is busy promoting his AirMan and SimMan inventions,
super-realistic humanoid robots that trainees use to learn and hone
their emergency medical skills.
With patient simulators, we can keep doing it until we get
it right. Its the best way to prepare, says Gonzalez.
A clinical situation is often wild and wooly, and you can
never replay that scenario.
A biology major who minored in the history and philosophy of science,
Gonzalez was long bothered by what he termed serious teaching
limitations in medical education.
When I finished my residency program, I was not qualified,
says Gonzalez, who earned his medical degree from the University
of Pennsylvania. I had studied, and I could spit back answers,
but I had no hands-on experience in critical situations. Manual
skills and rapid decision-making are keys to working in an emergency,
not test-taking.
Cadavers were too static to use for training, he thought, and practicing
on animals was unethical and often irrelevant for humans. There
were a few robot models before Gonzalez got started, but they were
incredibly expensive (about $250,000 each) and didnt offer
sufficiently realistic reactions.
They werent user-friendly. The obstructed airway, breathing
and circulation systems didnt have all the functions that
we needed, he says. And they werent practical
in terms of teaching the masses.
Then, while chief of anesthesiology at the University of Pittsburgh
Medical Center in the 1980s, Gonzalez hooked up with John J. Schaeffer,
who holds an undergraduate degree in engineering and a medical degree.
By using simple switching mechanisms, implanting mechanical and
pneumatic devices, and even employing a tire compressor pump from
Sears, the two doctors, in 1995, created ADAM, who is also known
by his more technical name: Advanced Difficult Airway Management.
Life-size, anatomically correct and around 70 pounds, ADAM breathed,
talked, coughed, vomited, moaned, and cried. He also had a pulse
and measurable blood pressure. Thanks to artificial intelligence
programs, he reacted to IV drugs and other treatments.
Easily nourished by AC electricity or a car battery, ADAM could
be directed with a laptop or a handheld remote control. He could
also be turned off so a professor could explain what was
going on and then turned back on in the same exact condition
as before. And should he die, well, ADAM could be brought back to
simulated life. And at the end of the day, he could be disassembled
and thrown into a suitcase.
Since his creation, ADAM has begotten the more evolutionized SimMan
and AirMan, who feature realistic skin and the most modern hi-fidelity.
The Laerdal Medical Corporation now holds the patents for these
two robots and sells them for between $10,000-$25,000 each.
Commercially released in January 2001, medical and nursing schools,
EMTs and firehouses have bought about 250 of these human simulators
so far.
Laerdal has a lot of tech skill and computer power, so the
price should go down further while quality will rise, says
Gonzalez, who has a royalty agreement.
With Laerdal, a medical products company that also markets such
mannequins as Choking Charlie, Crash Kelly, and Mr. Hurt Head, handling
the business aspects of his robots, Gonzalez is free to toil as
chief of the anesthesiology department at St. Lukes Quakerstown
Hospital outside Bethlehem, Pennsylvania. He lives in nearby Coopersburg
with wife Susan and daughters Marianna, Christina, and Angela.
Gonzalez also finds time to plug his inventions at about a dozen
conferences a year. (SimMan was declared the best new product at
the 2002 National Emergency Medical Conference.) And he continues
to work with Dr. Schaeffer at UPMCs Human Simulation Center.
Up next for Team Schaeffer-Gonzalez are infant and female robots.
They have already created working prototypes for these two humanoids
and could produce final products by the end of the year.
Then I feel that we really can train on a large scale,
says Gonzalez. When I watched the response to the September
11 terrorist attack on the World Trade Center, I was thinking that
as a country we arent that well-prepared for disaster. One
of the aspects of my vision is that [the robots] will become routine
for training the masses.
Rob Mackay edits the Times Newsweekly,
a newspaper in Queens.