Evolution in medicine

The hero behind the HiRO teaches students to dream big

A disaster medicine DO now instructs students on how to respond to emergencies, drone included.


Transitioning from one area of medicine to another, or away from practicing altogether, isn’t always easy. But with proper planning and an ability to self-assess, it is possible if that’s your goal. Just ask Italo Subbarao, DO.

On Sept. 11, 2001, Dr. Subbarao stood beside his fellow residents in a hospital lobby transfixed by the horrific images unfolding on the television. American Airlines flight 11 had crashed into the north tower of the World Trade Center in New York City. Dr. Subbarao’s heart raced. His brother was a student in Manhattan. Less than 20 minutes later, United Airlines flight 175 crashed into the south tower. In that moment, Dr. Subbarao knew that the world had forever changed.

Emergency medicine responds

“It was a life-altering event. I was struck by the images of people running, people terrified,” says Dr. Subbarao, then a first-year family medicine resident at Lehigh Valley Hospital in Bethlehem, Pennsylvania. “It was at that point that I decided to go into emergency medicine. I wanted to focus my training on trying to understand terrorism and the various ailments that would come from such incidents.

Dr. Subbarao’s commitment to emergency medicine would lead to a fellowship in disaster medicine at Johns Hopkins University. Then over the next two decades, he would put his experience to work. During
Hurricane Katrina and the Pakistan earthquake in 2005, the Mumbai attacks in 2008, and the 2010 Haiti earthquake, Dr. Subbarao would be actively involved in the treatment, recovery and well-being of those displaced by these events while also providing tactical assessments to better assist in the allocation of resources and responders for those areas.

“Every disaster is unique but the common thread is that people are suffering,” he says.

Lessons learned through disaster

Recognizing the commonality of need during disaster led Dr. Subbarao to empower the next generation of osteopathic physicians who would respond to those needs. He packed up and moved to Biloxi, Mississippi, to take the post of associate dean of pre-clinical sciences and associate professor at William Carey University College of Osteopathic Medicine (WCUCOM).

Not long after his transition into academia, a category 4 tornado struck the area, leaving a trail of destruction in its path, including downed power lines, demolished buildings and flooded areas, making them nearly impossible to access. “My students wanted to study the event,” Dr. Subbarao says. “And as we studied, we began to ask questions and I became very reflective. I began to ask, ‘How can we use today’s technology during this type of crisis?’ I asked, ‘How can we use today’s advanced telemedicine technology and drone technology to go around these barriers and get eyes on the scene?’ ”

From those conversations, an idea was born. 

A drone carrying life-saving supplies could be used to access otherwise inaccessible areas.

The name of the heroic device would be HiRO (Health Integrated Rescue Operations) ambulance drone and it would help to revolutionize the manner, speed and effectiveness of medical response during disaster. With the assistance of co-developer Guy Paul Cooper Jr., then a fourth-year medical student, and Dennis Lott, director of the unmanned aerial systems program at Hinds Community College in Raymond, Mississippi, where the drones were built, the vision became a reality.

“We can fly a drone into an area, provide guidance on the ground, and empower the responder to take certain actions to assist those in need.”

Here’s how it works. The HiRO drops a supply kit near an incident where a citizen responder is already on the scene, surrounded by those in need. Once the responder opens the kit, he or she is connected remotely to a physician who is able to see everything that the responder sees.

The ability to intervene in this type of situation, Dr. Subbaro says, “provides an understanding of the magnitude of the event so that we can learn how to develop our resources to respond appropriately.”

Making moves in medicine

Yes, Dr. Sabbarao successfully transitioned from emergency medicine to disaster medicine to academia, and produced a potentially life-saving drone in the process. Still, having that sort of connectedness between areas of interest is not required when considering additional career pathways.

For DOs considering a transition, Dr. Subbarao suggests:

  1. Self-reflection
  2. Identifying areas of passion or curiosity, and
  3. Assessing the risk
Dr. Subbarao poses with William Carey students, holding his award for Most Motivational Professor at WCUCOM

“What’s most important is to be reflective of what you’re passionate about. DOs have a natural openness to opportunities that can lead to greater satisfaction and better lifestyles,” he says. “But too often, we magnify the risk and that fear keeps us from taking that next step. But realize, you don’t have to take a major leap over a giant chasm. Over time, you will reach your destination.”

As more physicians explore opportunities, Dr. Subbarao advises maintaining a focus on the integration of technology. As is the case with drone technologies, he says, “Many technological advances, when they’re released, are not intended for a health care audience. But DOs should ask, ‘how can this be used or adapted to help patients?’ DOs should always be open to innovation in ways that augment our ability to provide care.”

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