Sunday, October 18, 2009

A Gentle Revolutionary

Famed UI Physician Dr. Ponseti Has Died

By Steve Gravell/The Gazette

IOWA CITY - Parents from around the world put their children in Dr. Ignacio Ponseti’s hands.

“He was very gentle, very, very bright with tremendous insight,” said Dr. Jose Morcuende. “Not just in medicine, but in life. He had tremendous humanity, and tremendous care for everybody, especially for children.”

Ponseti, 95, who developed a non-surgical method to correct the birth defect clubfoot, died suddenly Sunday afternoon at the University of Iowa Hospitals and Clinics. Morcuende said Ponseti suffered a stroke last week in his office at the Ponseti International Association at UI.

Born in 1914 on the Spanish island of Minorca, Ponseti developed dexterity while working for his father, a watchmaker. He graduated from medical school in Barcelona and worked as a medic during the Spanish Civil War.

A Loyalist, Ponseti escaped to France when Gen. Francisco Franco won the war. He moved to Mexico, where he met Dr. Juan Farill, who had studied under Dr. Arthur Steindler at the UI. Farill recommended Ponseti to Steindler.

Ponseti came to the UI in 1941, finished his residency, and joined the faculty of orthopedic medicine. Steindler asked Ponseti to review clubfoot surgery results.

At the time and for decades after, it was accepted in the medical community that surgery was the only treatment for clubfoot. The condition affects one in every 1,000 births, leaving feet twisted down and inward.

Ponseti found surgery often left patients arthritic and needing further surgery. Studying the anatomy of the foot, he realized club feet develop normally in the embryo. Muscles pull the foot out of shape for reasons that aren’t fully known.

Ponseti learned to align a child’s club foot by manipulating ligaments and tendons and applying plaster casts to the full leg. The casts must be changed often as the leg develops.

“Because I’m that way,” Ponseti told The Gazette last December. “If I can get by without surgery, then I do.”

Ponseti largely perfected his method, which has a success rate of 95 to 98 percent, by the 1950s. But skepticism prevented its widespread acceptance until relatively recently, Morcuende said.

“People didn’t believe him, they didn’t believe all the principles he was explaining,” said Morcuende. “He was the only man in the whole world to say this is the way to go.”

Ponseti’s technique gained acceptance only with the spread of the Internet, and the publication of his book in 1996.

“It’s perseverance and keep working, and keep teaching people little by little,” said Morcuende, who came to the UI from his native Spain in 1991 to cofound the Ponseti International Association.

“He was my mentor,” Morcuende said of Ponseti. “Actually, he was my father here in the United states.”

As his work gained attention, more parents brought their children to Ponseti and the UI clinic that bears his name. Morcuende said tens of thousands around the world have been treated with Ponseti’s methods.

“The kids and the parents would see him and immediately trust him, just because they saw his heart,” he said.

Ponseti was forced to retire at 70 but returned to work the following year when mandatory retirement was lifted. He continued to practice through late 2008.

“I kind of enjoy the job,” he said last December. “I like children, and I can do this very well.”

Ponseti’s pace was slowed when he broke his hip last January, Morcuende said. But he soon returned to his namesake clinic, consulting with doctors and meeting former patients.

Ponseti’s work continues. He trained 250 to 300 doctors at the UI. Another 1,800 practice his technique in foreign countries. His death came two days after the annual Ponseti Races kicking off the International Clubfoot Symposium. Race proceeds help fund treatment for babies with clubfoot.

1 comment:

Dolores said...

This is a great story of a big hearted doctor. I was so happy to read that he'd trained other doctor's to perform his technique, so his good works can continue.