Web Exclusives: Alumni Spotlight

September 11, 2002

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 guy’s 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. It’s 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 didn’t offer sufficiently realistic reactions.

“They weren’t user-friendly. The obstructed airway, breathing and circulation systems didn’t have all the functions that we needed,” he says. “And they weren’t 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. Luke’s 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 UPMC’s 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 aren’t 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.