By Joan Tupponce 

The worldwide medical community lost an internationally renowned rock star in trauma and acute care surgery on February 27, 2024. 

But unlike many rock stars in the spotlight, Rao R. Ivatury, M.D., former surgeon and chief of the VCU Medical Center’s Trauma, Critical Care and Emergency Surgery Division, never let the prestige or accolades define him.  

As shared by close colleagues and those he mentored over the years, Ivatury lived his life embracing the humanity in human beings. He embodied humility and kindness. He loved his family, his coworkers, his staff, his students, and his work.  

His legacy goes far beyond the world of medicine. 

“He was down to earth. I don’t know another person like him,” reflected James “Jay” Gould Jr., R.N., director of the Center for Trauma and Critical Care Education (CTCCE) and AHA training coordinator. “He was always available for me. He looked at me like our conversation was the most important thing going on. He valued what I brought to the table.” 

Nancy New, former nursing director of VCU Health (left), with Rao R. Ivatury, M.D. (middle), and his wife, Leela Kriplani, M.D. (right), at the Shining Knight Gala. The event is held annually to honor VCU Medical Center’s trauma center and patients.

Setting the stage for greatness 

Born and educated in India, Ivatury completed surgical residencies at the prestigious All India Institute of Medical Sciences in New Delhi and Misericordia-Lincoln Affiliation in the Bronx, New York.  

Before joining VCU Medical Center and Virginia Commonwealth University in 1998, he served as director of trauma and co-director of the surgical intensive care unit for a decade at Lincoln Hospital in the South Bronx where he treated countless victims of severe trauma. That experience laid the foundation for many of the concepts he practiced, from damage-control surgery and the need for open abdomen management to the relevance of intra-abdominal hypertension and tissue-specific endpoints of resuscitation. 

Under his leadership at VCU Medical Center, the trauma unit was designated and verified as a comprehensive Level I trauma center through the American College of Surgeons and Virginia Office of Emergency Medical Services (OEMS). Treating more than 4,000 patients a year, it’s the only trauma center in the region verified in adult, pediatric and burn trauma care.  

Ivatury was part of VCU School of Medicine’s faculty when Vigneshwar Kasirajan, M.D., now chair of the medical school and health system's Department of Surgery, joined the university and academic medical center 23 years ago.  

“He’s one of the iconic figures in the world of acute care and emergency services. I knew him as a colleague, and then I became his department chair,” Kasirajan said. “He was an extremely skilled and intelligent surgeon. What was impressive about him is there was no pretension. He was a gentle giant, a decent human being.” 

Ivatury was the founder, past president and executive director of the Panamerican Trauma Society, a network of countries and hospitals. Kasirajan remembers being with him in Latin America during some of association’s meetings and noticed the rock-star-like reception his close colleague received.  

“Other countries felt the same about him as we did,” Kasirajan said.  

Caught up in the frenzy 

Ivatury’s expertise in acute care drew worldwide attention in 2002. As the eyes across the nation were glued to their televisions for updates on the D.C. Sniper, one of his victims from Central Virginia was transported to VCU Medical Center. Pam Lepley, who at the time was director of communications and public relations for VCU and VCU Medical Center, coordinated press coverage.  

“Dr. Ivatury understood the media’s needs. He considered all of our needs,” she said. “He was a first-class gentleman and so brilliant. It was a blessing to get to know him.” 

Gould was teaching a class with Ivatury when the surgeon started receiving multiple emails. 

“He said ‘I think I need to go to the ER.’ He took care of that patient. He slept here for four or five days. He never left,” Gould said. 

When Ivatury spoke to the national press about the patient, “he started off by saying this is not about me,” Gould recalled. “He said the EMS team made the right decision in the field, the OR staff, the surgeons, it took all of us; it took a team.” 

When he finished the first media event, he shepherded junior faculty into the building. Gould remembers Ivatury emphasizing to them that the care they are providing is a “team effort,” so they should highlight the whole team every time they’re asked a question by journalists.   

[Dr. Ivatury] was an extremely skilled and intelligent surgeon. What was impressive about him is there was no pretension. He was a gentle giant, a decent human being.

Vigneshwar Kasirajan, M.D., chair of the Department of Surgery

“That is the last time I will speak to the media,” Gould heard him say. “I don’t want to hear ‘Dr. Ivatury said.’ This is a team. You are going to be up there talking to the people.” 

Over the years, Ivatury received numerous awards and recognitions, including being inducted into the 2019 ACS Academy of Master Surgeon Educators. He was a prolific author, penning more than 300 publications contributing extensively to the scientific literature on trauma management and surgical critical care. 

Martin Mangino, Ph.D., professor in the medical school’s Department of Surgery, saw Ivatury as an innovator in the field of trauma “who built the foundation for what we have now.”  

Soft-spoken and admired by all, Ivatury was “cut from a different cloth,” Mangino said. “He would make things happen. If you wanted something done in the trauma department, you could go to him and tell him what you needed and he gets it done.” 

Ivatury was never one to resist change, always willing to listen and embrace new concepts. He never felt like he knew it all. 

“That always struck me about him,” Mangino said. 

Leading with respect 

Ivatury had incredible respect for the VCU faculty that worked with him, forever promoting the team and their work.   

“He never regarded anyone he spoke to as anything but equal to him,” said Michel Aboutanos, M.D., who became the chief of the Division of Acute Care Surgical Services at VCU and medical director of VCU Medical Center’s Level I trauma center and Trauma System Network after Ivatury retired in 2012. “It’s rare to see a true leader like him. He celebrates your success. When he does that, you become more successful and you want him to know about it because it’s genuine.” 

Ivatury was a true servant leader, never asking for or promoting his own recognition. 

“He always said, ‘It’s your work. Let your work speak for you.’ Bottom line, he was a person who was about others and you felt it. People trusted him,” Aboutanos said. 

Ivatury also embraced the idea of collaboration and partnership among colleagues and departments.

“His philosophy was that everyone was valued in his eyes and because of that, he was able to get rid of friction. He was strong in his message, but it was his approach of how can we help each other be what we can be,” Aboutanos said. “He valued your opinion. He would say ‘we need you.’” 

Aboutanos feels privileged and humbled to carry on what Ivatury started.  

“We owe him a lot. I am personally incredibly indebted to his amazing mentorship. I try to impart that on my own faculty,” he said.  

Gould first met Ivatury when Ivatury was appointed medical director of the CTCCE. 

“He became one of our most ardent supporters in the importance of training our EMS colleagues,” Gould said, noting the CTCCE is the largest training program of its kind in Virginia. “EMS providers across the state knew him by name.” 

Gould was the first recipient of the Rao Ivatury Award that means the world to him. 

“The award recognizing folks that shared his character and service, humbleness and mentoring,” he said. “It’s the greatest honor I have ever had.” 

James “Jay” Gould Jr., R.N. (right), with Rao R. Ivatury, M.D., at the Rao R. Ivatury Trauma Symposium held at VCU Health. (Contributed photo)

A final thank you 

A few months before Ivatury died, he wrote Gould a farewell letter, saying that he wanted to “tell me how thankful he was that we had the opportunity to work together. He said ‘you always made me look good. People thought it was me because I was the medical director, but it was always you,’” Gould recalled.  The emotions came rushing back after reading the letter again. 

“It was just unbelievable. Even at that moment – when you know he’s not going to be there much longer – he wants to make sure to reach out and tell you how important you are,” he said. 

After receiving the letter, Gould says he will be forever sorry that he wasn’t able to see Ivatury one more time. 

“I will remember it for the rest of my life,” he said. “I always thought of him like a father figure.”