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Editorial—In Memoriam: JAAOS Remembers Freddie H. Fu, FAAOS

Levine, William N. MD; Beim, Gloria MD; Lin, Albert MD; Navarro, Ronald A. MD; West, Robin V. MD; Wright, Vonda MD, FAAOS

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Journal of the American Academy of Orthopaedic Surgeons: January 15, 2022 - Volume 30 - Issue 2 - p 45-49
doi: 10.5435/JAAOS-D-21-01043
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As most of the world knows by now, Dr. Freddie H. Fu, MD, FAAOS, passed away peacefully on September 24, 2021, surrounded by his family. On behalf of the AAOS and the editorial staff of the JAAOS, we present our readers with a tribute to one of the true legends in orthopaedics. Rather than presenting a more traditional obituary and review of his accomplishments, we sought to create an enduring testimonial of his life and legacy through the eyes of five of his protegees—Drs. Gloria Beim, MD, FAAOS, Albert Lin, MD, FAAOS, Ronald (Ron) Navarro, MD, FAAOS, Robin West, MD, FAAOS, and Vonda Wright, MD, MS, FAAOS. They each provide a heartfelt personal perspective highlighting advocacy/support of his mentees, love and commitment of Pittsburgh, family, sports medicine/career development, and diversity.

Advocacy/Support of Mentees—Gloria Beim, MD, FAAOS

It is no secret that on September 24, 2021, the medical community lost one of the greatest sports medicine pioneers of all time. His accomplishments and contributions have been praised on websites far and wide. For me and his other fellows though, Dr. Freddie Fu made history in another way.

I first began hearing stories about Dr. Fu when I was a resident at Columbia in the early 1990s. Already a legend, Dr. Fu was known for his superhuman energy and a presence that was larger than life. Almost every resident I knew wanted to get a sports medicine fellowship at UPMC Center for Sports Medicine—it was considered one of the best programs in the United States, and it was also home to Dr. Freddie Fu. I wanted to be in that fellowship program too, but no women had ever been accepted. Dr. Fu ended up granting me an interview, and soon thereafter, I became Dr. Fu's first female fellow.

John L'Insalata, Freddie Fu, Gloria Beim, Ron Navarro. © 1995 Gloria Beim, with permission
Freddie Fu, and Albert Lin. © 2018 Albert Lin, with permission.
Ron Navarro and Freddie Fu at the Pitt Alumni function at the AAOS in 2017, overlooking the San Diego bay and Padres stadium. © 2017 Ronald A. Navarro.
Robin West and Freddie Fu. © 2021 Robin West, with permission.
Vonda Wright and Freddie Fu. © 2017 Vonda Wright, with permission.

What Dr. Fu was to his students, residents, and fellows is not something that can easily be put into words. He could see what we were capable of far before we could see it for ourselves. He would ask us to do the impossible knowing that he was not asking too much. No matter how daunting the task, we would rise to the occasion because that is what Freddie inspired in us. His instruction was tough and demanding, while also being full of love—and we felt it. I can say with certainty that Freddie Fu made us better doctors than we would have been otherwise.

Although any doctor would have been filled with pride to say that he was a fellow under Dr. Fu, to be his first female fellow felt like something else altogether. Freddie gave me a shot when no one else did. He then went on to give many other women a shot, as well as students from backgrounds and countries near and far. He ended up building one of the most diverse orthopaedic residency training programs in the world.

Caring beyond compare, Freddie's love and support extended well beyond classrooms and ORs. For 25 years, he sent me emails, photographs, and medical articles almost daily. When the Pittsburgh Synagogue shooting occurred (October 27, 2018), he immediately called to see how my parents were doing, knowing that they were Holocaust survivors. He responded to my texts or calls within five minutes and would always be the first to congratulate me on any achievement. He often ended these conversations telling me that he missed me.

I had the honor and privilege of sitting with Freddie one last time several days before his passing. I told him that he changed my life and that I owe so much to him. In turn, he told me that he loved me and that he was proud of me—a teacher like no other.

Never in a million years did I think I would be accepted into the fellowship program of this sports medicine legend. Never in a billion years did I think I would one day find myself sitting at his bedside during his final days. Perhaps Freddie appreciated that he had made history in the orthopaedic world, but I wanted him to know about the histories he made for those he taught too—about the history that he had created for me.

In gratitude for your wisdom, foresight, and caring, Dr. Freddie Fu… You will be forever missed. Thank you for giving me a shot.

Pittsburgh—Albert Lin, MD, FAAOS

Dr. Fu was so many things to so many people. I grew up in Pittsburgh in the 80s and 90s and went to school with his children. I was an elementary school tour guide the first time I met him, and as he would remind me years later, I held his hand to shuttle him around at a Parents' Day event with excitement. In the years to follow, my family and I frequently ran into him at our favorite restaurants, sporting events, and Chinese cultural celebrations. He was always kind and energetic. I have in many ways grown up with him—he was a larger-than-life father figure. I am deeply grateful for crossing paths with this truly great man who, perhaps short of my parents, made more of an impact on my life than any other person.

The contributions that Hilda and Freddie Fu have had on the city of Pittsburgh, and in turn, the world, are remarkable. They remain inextricably tied to the social, cultural, and economic fabric of this city. You cannot travel far in Pittsburgh without encountering something that they positively touched—health care, sports, the arts, the ballet, the symphony and opera, museums, the Pittsburgh marathon, restaurants, and the Chinese community. I was young enough to remember when the UPMC did not exist, and now you cannot go anywhere without seeing the UPMC and the UPMC Sports Medicine emblems. Mark A. Nordenberg, JD, chancellor emeritus of the University Pittsburgh, said this best during his tribute to Dr. Fu, which echoes my own experiences growing up here and watching with awe, the influence the Fus have had in transforming the city. “It is hard to imagine you without Hilda. As a pair, you have been tireless and generous supporters of everything that was good in our community… Freddie, there are few people who might rival you in terms of contributions to either the enhancement of the quality of life in this community or the transformation of its economy.” The Fus loved this city and Pittsburgh loved them back—the beautiful pictures of nature and the views around the city in Dr. Fu's frequent 5 am emails were a reflection of this love.

Growing up in Pittsburgh at a time when diversity and inclusivity were less valued than today, I was keenly aware that I looked different. I looked up to Dr. Fu as a hero and inspiration. Here was someone who looked like me, did not speak good English, but was doing amazing things. He was paving a road for others, showing me not only how to succeed but how to do good for the community. He was the American dream.

Yes, Dr. Fu was so many things to so many people—mentor, friend, role model, hero, pioneer, and leader. His energy, memory, high expectations, love of fashion, cars, good food and wine, and love for his family were the stuff of legends. He was a once-in-a-lifetime inspiration and a force of nature. Through the years that followed, I remained close with him and wanted to follow in his footsteps. I am lucky to call him a lifelong friend and mentor, and like many others, I am so grateful for the opportunities he gave me to succeed. He made everyone and everything around him better. More than all of this though, I will always remember him for his love and his generosity. For me, my family, and for everyone, he cared for. I simply loved him like my father. When my brother and father both passed away right before I joined practice, he became a second father to me and cared for me at a time when I felt like my life was truly falling apart. My wife was never able to meet my father, but was able to tell Dr. Fu in his remaining days that she was grateful for knowing him because it was the closest thing. I loved this man so much. He gave so much of himself to others, and I am but one person when so many others have similar stories to share.

Dr. Fu, you have left such an impact on this earth that it is impossible that your light will ever fade. Although the world will never be the same without you, know that your legacy lives on in the countless lives that you have touched and in all individuals who have the privilege of calling you their friend and their family. To me, you will always be family. Thank you, thank you, thank you. We love you forever.

Family and Freddie Fu, MD, FAAOS—Ronald A. Navarro, MD, FAAOS

My daughters kept peering through the glass surrounding our front door. I answered the “When is Dr. Fu going to get here?” question multiple times. Freddie Fu was going to visit our home!! We had gone out and obtained the best local Chinese food after many tastings to ensure that we had picked the best in our area of Los Angeles. We had purchased Chinese dinnerware (which I think is kind of silly now) and authentic chopsticks. I could not have Freddie eat with cheap wooden throw-aways. We were ready to sit at our table and open our home to him. When Freddie finally burst through the door, the first thing he said after the salutations was that he wanted to see the view. He loved the view we have of the LA basin and gave me a nod of approval. Still my wife was ready to serve him and worried about the food getting cold. Freddie tossed us a curve ball. He wanted to swim. My daughters (who at the time were younger than 10 years) were more than happy to accommodate him. He said, “Call me Uncle Freddie,” and then proceeded to have a grand time with them in the pool.

After the swim, Freddie insisted on a shower. I never say no to my Fellowship boss, and so we outfitted the guest bathroom. Afterward, he came out as comfortable as I hoped he would be. He was family to us, and we were enjoying the events, although they were not in the sequence we had originally planned! What followed were lots of storytelling and laughing. My older daughter described how I had accidently flooded an area of the house a few years prior. He got such a kick out of that. In fact, he then reminded me of the story repeatedly for years afterward, cackling as he recounted her honest recollection of the events, as only she would do with a trusted family member. After we had (finally) eaten and he was ready to leave, he asked to use our home phone. He called a mutual friend of ours who lived in Hawaii. He reminded the friend on the call that he loved his home, but he told him that his fellow, Ron Navarro, had a home with a view that rivaled it.

That was Freddie. Needling, joking, praising, and cajoling all of us were uniquely his endearing way, and he would titrate just the right amounts of fun and motivational stimulus to keep us climbing. He cared like only family would. It is family who knows our best and can show us the mirror to help humble us in the most honest ways. We all know that Freddie adored his own family and his ability to connect with so many of us and ours as well is a phenomenal feat that reveals a capacity for enduring sincere care and concern that still makes me marvel.

I had the great pleasure to meet and get to know Lanny Johnson, MD, in recent years. Some know that Freddie and Lanny shared time together after Albert Ferguson, MD (then the Pitt Orthopaedic Chair) suggested Freddie, after his formal residency, go learn arthroscopy from Lanny. At that time, Dr. Johnson was perhaps one of the earliest American orthopaedic surgeons who had become adept at the then new skill. Families are known for their interesting lineages. I feel that I am a part of a family lineage that will honor Freddie and becoming close to Lanny seems to have closed a family loop and brought a part of this family full circle. I look forward to seeing Freddie again in heaven and hope he reminds me of that flood.

Robin West, MD, FAAOS—Sports Medicine/Professional Development

With his larger-than-life aura, keen imagination, and profound regard and generosity for others, Freddie's professional, community, and personal priorities have had a dramatic influence on countless people. In 1986, Dr. Fu founded western Pennsylvania's first sports medicine program on a small site near the University of Pittsburgh. After outgrowing that original site, Freddie helped to design, develop, and open the UPMC Center for Sports Medicine in 2000. The Center was built in a 37,000-square-foot building on Pittsburgh's South Side, within the 60 acres now known as the UPMC Rooney Sports Complex. The complex was built on an old steel mill site and was a novel innovation, combining the resources of a major academic health system with professional and collegiate sports programs. The facility encompasses large indoor and outdoor football training facilities for the University of Pittsburgh Panthers and the Pittsburgh Steelers and has helped to economically and socially revitalize the surrounding area.

Dr. Fu continued to expand and advance UPMC Sports Medicine to become one of the premier programs in the world. As a result of Dr. Fu's vision and charm, thousands of elite, professional, Olympic, and amateur athletes have traveled to UPMC to seek care. He developed an exceptional comprehensive medical team and built the center to provide top-notch care for everyone, whether you were a world-class athlete, a youth athlete, or a weekend warrior. In 2018, the center was renamed the UPMC Freddie Fu Sports Medicine Center, following a multimillion dollar renovation and expansion.

As an internationally renowned orthopaedic surgeon and scientist, Dr. Fu also led the revolution of ACL reconstruction. In 2019, the Orthopaedic Journal of Sports Medicine identified Dr. Fu as the most-cited ACL author and the University of Pittsburgh as the most prolific institution for ACL research.1 His academic accolades and contributions to sports medicine are immense. “Overall, he delivered more than 1,200 national and international presentations, co-authored 173 book chapters, wrote more than 675 peer-reviewed articles and edited 30 major orthopaedic textbooks. He was also the recipient of 260 prestigious awards and honors.”2

“Dr. Fu was the cherished head team physician for the University of Pittsburgh Department of Athletics for 32 years. Dr. Fu established the first-ever high school athletic training program in western Pennsylvania. Legend has it that Dr. Fu had to hold manual traction on a player who suffered a fractured femur until the ambulance arrived! This athletic training program now supports 44 high schools, making it one of the largest such programs in the country. The National Athletic Trainers' Association awarded Dr. Fu the Presidential Challenge Award for his significant contributions and support in advancing athletic training.”2

The sadness that we feel by Dr. Fu's passing is a price we have to pay for having to get to know such an incredible man. He has had a tremendous impact on so many of us and was not only a mentor but also a father figure.

Dr. Fu. You have rocked our world, and we are all better people for it. So, I ask all of you to carry on his torch and his mission of excellence, equality, and opportunity. Love your family and live life to the fullest.

Vonda Wright, MD, MS, FAAOS—Opportunity

I spent nearly 20 years at Pitt, and everywhere I go, people always want me to tell them new Freddie stories or confirm the stories that they have heard. It is not surprising because that is what we do with legends—we tell their stories—it somehow makes us feel closer to the legend themselves.

We even did this on the Friday of his memorial as I gathered for lunch with a group of fellow Pitt alumni to commune and remember him, and we told stories. We were laughing and crying all in one sentence, and as we remembered, it was clear that Freddie changed lives by intentionally offering opportunities.

Dr Fu loved to be surrounded by the best of the best—the best food, the best cars, the best research, but most importantly, the best people. His view of where to find the best people was broad as he was a man of the world and it allowed him to see past the typical homogeny of orthopaedics to fill his department with the best people from multiple backgrounds, many countries, races, religions, and genders.

But for Dr. Fu bringing diverse people together, or more specifically accepting female residents was more than checking boxes, it was his intentional philosophy of offering opportunities to the best people he could find. If you looked around the lunch table on memorial Friday you saw that, but frankly would see it at every grand rounds, every department dinner, a cornucopia of diversity.

Freddie was proud of his leadership in diversity. Recently, he tallied the number of women who were trained at Pitt, and at the time, I was a resident, when the national average for women was 3%, and Pitt boasted 9%. Three of the eight residents in my class were women. Today, 29% of the Pitt residency are women, and over Dr. Fu's tenure as Chair, the average was 12%, which is double the national average of 6%.

Although as a resident I realized that there were few women in orthopaedics, I never felt it in the environment that Dr. Fu created. Sometimes, the stories that female surgeons share about their experiences are surprising to me because for me, it was easy to be simply an ortho resident not a female resident. I now realize that that is not the case for many women in surgery and I am forever grateful to Dr. Fu for cultivating that environment.

But I know it was not always easy for Dr. Fu. In one particular rushed grand rounds morning, he looked particularly weary and I asked him whether he was OK. He confided in me that it was not always easy. In a homogenous world of orthopaedics, he represented diversity as an immigrant and an Asian man, and despite his vast success, it was not always easy. He used his personal experiences, however, to provide opportunities to every talented person no matter their gender, skin color, or geographic origin.

In medicine, we have preprescribed pathways and measures of what success looks like. Dr. Fu was successful by any measure—but in the 20 years I spent learning about success from Dr Fu, the most important lessons I learned were to live an authentic and indefinable life, being courageous in all things including who you surround yourself with and offering equal opportunities to every talented person.

We love and miss you Freddie….

References

References printed in bold type are those published within the past 5 years.

1. From:. Tang N, Zhang W, George DM, Su Y, Huang T: “The top 100 most cited articles on anterior cruciate ligament reconstruction: A bibliometric analysis”. Orthop J Sports Med 2021;9:1-16.
2. “UPMC and the University of Pittsburgh Mourn the Passing of Dr. Freddie Fu”. Available at: https://www.upmc.com/media/news/092421-fu-obit. Accessed online on 10/11/2021.
Copyright 2021 by the American Academy of Orthopaedic Surgeons.