|Year : 2016 | Volume
| Issue : 2 | Page : 73-80
A unique, intuitive, creative, innovative, bold scientist in endless quest of the truth and a giant in high-altitude medicine: Prof. Dr. Gustavo Zubieta-Castillo, "The Parvatha Guru" (May 20, 1926-September 17, 2015)
Gustavo Zubieta-Calleja, Natalia Zubieta-De Urioste
High Altitude Pulmonary and Pathology Institute (IPPA), La Paz, Bolivia
|Date of Submission||04-Nov-2016|
|Date of Acceptance||04-Nov-2016|
|Date of Web Publication||19-Dec-2016|
Dr. Gustavo Zubieta-Calleja
High Altitude Pulmonary and Pathology Institute (IPPA), La Paz
Source of Support: None, Conflict of Interest: None
Professor Gustavo Zubieta-Castillo - The Mountain Guru, Bolivian visionary, loved art and science. He was a word class pioneer and defender of life and medicine at high altitude. In 1964, after his observations of the perfused heart in dogs, he affirmed that the hearts of high-altitude residents are much more resistant to hypoxia than those at sea level. He clarified misconceptions about lung diseases at high altitude, which were improperly termed "loss of adaptation." His original and unique views on what was called chronic mountain sickness (CMS), a term he proposed be discarded and be rather expressed as polyerythrocythemia (as a more precise symptomatic description of multiple pathologies in the hypoxic environment of high altitude). He created the "triple hypoxia syndrome," an essential description to explain the momentary decrease of PaO 2 in polyerythrocythemic patients. His concepts of hypoxia gave rise to the formulation of the high-altitude adaptation formula. On his obituary, legendary respiratory physiologist Prof. John B. West stated, "He was a remarkable man and our discipline has lost a giant." Renowned Environmental scientist Prof. Thuppil Venkatesh, a long-time friend of Prof. Gustavo Sr., stated, "We lost one of the most valuable and precious personalities… a great loss to the world scientific community." Prof. Gustavo's son Prof. Dr. Gustavo Zubieta Calleja is also a renowned pulmonologist like his legendary father and keeping his illustrious father's legacy with pride and honor at his "High Altitude Pulmonary and Pathology Institute," La Paz, Bolivia.
Keywords: Gustavo Zubieta-Castillo, high altitude, hypoxia, polyerythrocythemia
|How to cite this article:|
Zubieta-Calleja G, Urioste NZ. A unique, intuitive, creative, innovative, bold scientist in endless quest of the truth and a giant in high-altitude medicine: Prof. Dr. Gustavo Zubieta-Castillo, "The Parvatha Guru" (May 20, 1926-September 17, 2015). BLDE Univ J Health Sci 2016;1:73-80
|How to cite this URL:|
Zubieta-Calleja G, Urioste NZ. A unique, intuitive, creative, innovative, bold scientist in endless quest of the truth and a giant in high-altitude medicine: Prof. Dr. Gustavo Zubieta-Castillo, "The Parvatha Guru" (May 20, 1926-September 17, 2015). BLDE Univ J Health Sci [serial online] 2016 [cited 2020 Oct 23];1:73-80. Available from: https://www.bldeujournalhs.in/text.asp?2016/1/2/73/196081
This man, born in a poor family in the mining town of Oruro (3800 m), Bolivia, in the center of South America (latitude - 17.9 and longitude - 67.1), boldly proposed that human can adapt to live on the summit of the Mount Everest, when all world expert physiologists had set 5000 m as the highest possible altitude for human permanent residence. His mother Rosa del Castillo (Rose of the Castle), a widow who previously had four children, was a teacher in the Uncia School within the premises of the "Patiño mines" in Potosi. His father, Manuel Zubieta, a self-made man of unquestionable intelligence and writing talent who learned to read and write as an assistant in a newspaper, was the head in the company's "Pulperia," a supply store.
Gustavo, shown in [Figure 1] as the Parvatha Guru, was a relaxed student who learned to read when very young as he sat and played in her mother's classroom. He made little effort throughout the school but started to study the last year of high school in order to graduate. With hardly any resource, he traveled to the city of La Paz (4100-3100 m) and audaciously entered the Universidad Mayor de San Andres (UMSA) state's medical school, where he became a top student from the beginning.
|Figure 1: Prof. Dr. Gustavo Zubieta-Castillo being felicitated at St. John's Medical College and receiving the distinguished honor of being named, "Parvatha Guru" by the National Referral Center for Lead Poisoning in India|
Click here to view
He was such an excellent and skeptical student that his professors were often disturbed by his presence and tried to make him trip over mistakes, yet they never succeeded. In the anatomy class, he prepared a dissection of the "transverse facial artery," a small branch of the external carotid artery that according to Testut (Classical French Anatomy book) was meant to reach the oral region without previous bifurcation. When he was done, he realized that the branch bifurcated before reaching the oral region and presented it as such to his teacher who rejected it. Due to this, he repeated the dissection six times and insisted that the branch never followed the course described, but he was repeatedly told he did a bad preparation. In the end, he was forced, much to his displeasure, to sew a fake branch, and finally approved.
In the final practical examination, he was told to ligate the radial artery as was customary for emergencies at the time. He immediately started using the scalpel, but one of the testing professors interrupted him saying: "Wait, you did not make the appropriate measurements," then the other professor always mocking and challenging Gustavo, followed: "Let him do it!" hoping he would fail the test. Nevertheless, without hesitation, Gustavo made the incision, rapidly elevated the artery, and made the ligature, proudly presenting it. The other students came around doubting he had done it right. That was his personality: No hesitation, absolute self-certainty, wisdom, and pride.
Later as a student and in order to support his studies, he became chief of practical training in physiology. When a revolution broke out, all professors who opposed the starting new regime, massively resigned but he stood up and said, it is "useless to resign, we are scientists, and besides everything will change anyways." Only one colleague, the elder Anatomy Professor "Ciego" Florentino Mejia, agreed and stood by him. He had hit the jackpot, as he was immediately appointed as the interim professor of physiology. Many of the professors who had resigned had to admit they were wrong and later came back. After that, he made great changes and physiology began to be taught in an outstanding manner, as never before, and never to be repeated again. Unfortunately, he was ousted 25 years later, due to political changes, and particularly due to opposing groups that wanted the job. We, the authors, can firmly affirm: Fifty generations of medical students in La Paz lacked the appropriate physiology training after he was ousted. He always tried to return to teaching but they never allowed him, out of pure jealousy and fear for his capacity and talent. They all feared being overshadowed.
Fortunately and intuitively, he had formerly become a young army medical doctor with the rank of captain in the Bolivian armed forces. At the time, he had met Clotilde Calleja, who was acting as a secretary for her father, the Minister of Defense (a military war hero who became General of Division). They got married, and Gustavo daringly wore a black military gala suit borrowed from his soon to be brother-in-law. He did this because he had no other suit to wear. He also worked in the social security hospital as a tisiologist (now known as pneumology), evaluating incapacity in pulmonary function in miners. This is where he began to study what was termed "polycythemia" and made the first classification in three levels: mild, moderate, and severe at
Gustavo Sr., was also one of the founders of the first high-altitude research center in La Paz, the Bolivian Institute of High Altitude Biology, a French-Bolivian association, but although he was the physiology professor, he was not granted a salary and got tired of working ad honorem.
However, his inquisitiveness pushed him to create the first high-altitude clinic in the world in 1970: The High Altitude Pulmonary and Pathology Institute - IPPA Clinic. People laughed at him and one colleague ironically affirmed: "He will probably set up a pressure chamber!" Much to everyone's surprise, we eventually did by creating the hyperoxic/hypoxic adaptation chamber with an air lock, unique in the world. During the First World Congress on High Altitude Medicine and Physiology that we organized in La Paz jointly with John Triplett, the American Embassy medical attaché, one of our guest scientists Charly Houston walked in the laboratory at the clinic and exclaimed "Barcroft's glass chamber!!!" We had created it unaware of Barcroft's work in respiratory studies, many years before. Our chamber was used to study performance going higher reaching hypoxic levels of even the Mount Everest or going down to sea level by changing the PiO2 (inspired oxygen tension). Many around the world imitated our model.
We built the clinic, and the future building where the IPPA is located currently (46 years later, at the time of this manuscript), assisting by bringing the construction materials, ourselves in a 1952 Chevrolet truck that we still possess. Gustavo Sr., his wife Clotilde (nutritionist), and the four children: Rosayda (MD), Gustavo Jr., (MD), Nancy (biotechnologist), and Luis (MD), all went in the Chevrolet to pick up stones to build the walls. We also brought bricks and sand. The windows were carefully designed to be economical. Nowadays, the new building has evolved and has quite a bit of technology. Noteworthy is the fact that three other grandchildren followed the same path as Gustavo Ardaya-Zubieta also became a physician in Bolivia, Joyce Bersatti-Zubieta became a physician's assistant in the US, and Natalia Zubieta-DeUriosteis finishing her studies in Bolivia to become a physician as well.
From the beginning, his brain was structured to be very critical and always questioned what was thought to be a fact. I, Gustavo Jr., shared 50 years of life together with him and he has been the greatest teacher one could have. When I was 7 years old, he sat me down and taught me Ohm's law in Electronics. As anyone can imagine, I was confused and did not understand a thing. Fifty-three years later, I can strongly affirm, he was so, so right. What a visionary! I studied medicine, but my hobby has always been mechanics and electronics. This allowed us to build our own equipment from scratch. We never received a grant for research, but we had to compete internationally with laboratories that had millenary budgets. Unhesitant, he always said "we can build it ourselves." When I was 10 years old, as a birthday gift, instead of buying me a toy, he bought me tools for carpentry. From then on, I have always been looking for tools and using them to create equipment. Jointly, we developed all our exercise testing equipment, an oxygen dissociation curve analyzer using yeast cells, an electrophoresis equipment, different blood pressure testing equipment, ventilation studies equipment, our famous breath-holding pulse oximetry equipment, and much, much more. We studied isolated perfused hearts in dogs and cats and myocardial infarction. He was a great physiologist! He affirmed in 1964 that the heart was much more resistant at high altitude than at sea level [Figure 2]. Currently, the top research centers in the world work on this concept, many unaware that he had affirmed it so many years back.
|Figure 2: Working in the isolated perfused heart as a Professor of Physiology in Universidad Mayor de San Andres, in 1964|
Click here to view
As the head of evaluation of disability in the Bolivian miners in the National Social Security Insurance (Committee on National Security Systems), when the miners who had lung disease due to silicosis and silicotuberculosis wanted to retire, he was in charge of evaluating their condition and that is when he found the need of classifying polycythemia, as it was called then. These were the first observations he made regarding the increase of the hematocrit at high altitude.
Gustavo Sr., was fond of buying used Mercedes Benz cars. He never cared much for fashion, he only cared for functionality, quality, and durability. We repaired our cars personally and even made full-car overhauls.
We innovated and changed our engines to make them more efficient at high altitude. When our 1965 Mercedes Benz gasoline injection engine would not start, he once brought oxygen and we injected it in the air inlet. He was an extremely Intuitive and stubborn man, but surprisingly correct in his appreciation. As he was often right, many resented him, but he remained confident and relaxed. He did, however, have gastritis that as he well prognosticated would be his primary cause of death in the very end. By that time, his walking had become difficult, his hearing and vision reduced and deficient, so he decided it was time to leave. He specifically asked us not to be medically aggressive if he would present another gastrointestinal (GI) bleeding from his ulcer (he had suffered from it, on three occasions previously in his life [once while he was a visiting professor in Tulane]), and we treated the last 2 jointly very successfully with all our medically oriented family, at his home, located one floor above the IPPA (High Altitude Pulmonary and Pathology Institute). On his final GI hemorrhage, he said, "give me only pain medication." And, that is exactly how it went in the lapse of little over a day.
Some of his sayings in his last years of life are as follows:
- "Difficulties are the stairway to success"
- "Intuition is much more perfect than intelligent logic"
- "Mediocrity is a congenital disease that is very painful and has no treatment."
Some minds are unique, and his was very similar to the Indian intuitive scientist Swami Vivekananda that I learned about from a book given to me by Prof. N. Shashidhara on my last trip to fabulous India, invited by prof. Thuppil Venkatesh. While at Tulane he assisted the Hypoxia Symposium in Canada, and met Leon Cudcowicz who later came to work in La Paz, and a paper on ventilation in women at high altitude was coauthored with him.
We constructed the Chacaltaya Pyramid Glass Laboratory (a different model from our glass hyperoxic/hypoxic glass chamber) with our own resources and using our own hands. It is located at 5240 m of altitude, slightly higher than the Chacaltaya Particle UMSA Physics Laboratory [Figure 3]. Hence, in reality, it is the highest high-altitude laboratory in the world. What an extraordinary feat for someone without resources! There we studied exercise in the Bolivian Army Geographical Institute students.
|Figure 3: The Chacaltaya Glass Pyramid Laboratory, at 5250 m of altitude, shown here with the portable laboratory vehicle, and tent, where the treadmill was placed for exercise studies|
Click here to view
We took an oxygen concentrator that we had bought second hand in the US, brought down to La Paz with much difficulty. It did not work well in Chacaltaya as it continuously shut down. It had not been programed for such high altitude. We carried out our ventilation studies equipment up there, along with cardiac monitors, pulse oximeters, treadmill, all in our moving camping laboratory truck.
All our scientific work was innovative, creative, and never copied what others had done. We hardly had access to databases, so we had to run to libraries wherever we traveled. This was interesting because it gave us an unparalleled, unbiased, free thinking, liberty. While some Peruvian scientists would breakdown sophisticated equipment, in order to simplify it because it did not work, at IPPA thanks to our knowhow, we computerized everything. We were the first clinic to have analog digital converters with a cardiac monitor in a very basic Apple II plus computer that had only 48 Kb of memory in 1980. We were the first to present computer-designed graphics at medical meetings. We designed multiple channel polygraphs and made respiratory and cardiac observations. We used a Van Slyke apparatus to calibrate our gas mixtures that we prepared in the cylinders ourselves. This gave us unusual advantage over many researchers because we knew how intricately things worked, and we could always fix them. Equipment malfunction never stopped us from carrying out our observations.
We organized the "First World Congress on High Altitude Medicine and Physiology" here in La Paz, in 1996, in a bold move. He insisted that we go ahead in spite of all the difficulties. It was so successful that it has gone around the world and still exists. We generously let it flow through Cusco, Peru; Matsumoto, Japan; Arica, Chile; Barcelona, Spain; Xining, China and Lhasa, and Tibet, but then after the 6th lost track, partly because it changed completely in the original focus we had of having everyone attend and present their work. Our scientific work was published in several languages around the world and dealt with arterial oxygen content regulation in CMS, low oxygen oxyhemoglobin saturation in CMS during exercise at 3510 m, and opposing bloodletting, all the three in China. In Japan, we published on high-altitude residents in Bolivia. We questioned the use of the term of chronic acid-base disorders in high-altitude normal residents and were fortunate to publish in India. In England, we published on the adequate interpretation of acid-base at the summit of Mount Everest. We observed hypoventilation in some newcomers to high altitude and published in Austria and the response to hyperoxia facts. Interestingly, he made very few publications in Spanish in Bolivia like the one in the Bolivian Academy of Sciences of which he was a member.
We were very honored with Dr. Emilio Marticorena's invitations to attend the High Altitude Conferences in La Oroya, Peru, which we attended on several occasions. There, in the First Conference of Medicine and Surgery at High Altitude, we discussed on coronary circulation and myocardial oxygen consumption of dogs at high altitude.,
In the V Congress of High Altitude Medicine in La Oroya, Peru, we presented work on the triple hypoxia syndrome, an essential description he created, to explain the momentary drops in blood oxygen partial pressure in patients with polyerythrocythemia., This differentiation between different types of hypoxia (hypobaric hypoxia, polyerythrocythemia hypoxia, and acute disease hypoxia) is truly a transcendental observation., We also presented observations during 12-year follow-up in a patient with what was called then CMS. In Bengaluru, India, on November 11, 2009 [Figure 1], he was awarded the title Parvatha Guru "Mountain Guru" under the auspices of Dr. Thuppil Venkatesh, at the prestigious medical college, St. John's Medical college, and the National Referral Center for Lead Poisoning in India, a unique distinction of the type honoris causa in this rare case applied to a high-altitude researcher.,
Several studies of exercise at different altitudes were performed. Gustavo Sr., was the leader who crystallized the highest football match in the history of humanity as shown in [Figure 4], on the top of Mount Sajama (6542 m) proving that sports at very high altitude were feasible (highlighting the extraordinary ability of the Bolivians), thereby defending the fact that Bolivia can carry out World Cup preliminaries, on their home court (3600 m).,
|Figure 4: The historic football game on the summit of Mount Sajama at 6542 m of altitude|
Click here to view
He was always conscious of the environment and one of the first in the 1980s (maybe the first) to oppose the bonfires of San Juan, a traditional night festivity in Bolivia, for being highly polluting in a large population such as the city of La Paz and El Alto. He was initially questioned and ignored, but such practices are nowadays forbidden by the Mayor's office.
Noting the low arterial partial pressure of oxygen (PaO2 ) in patients with polyerythrocythemia at high altitude, the football game on the top of Mount Sajama, the low level of PaO2 in fetuses, and the triple hypoxia syndrome,, extreme hypoxia in cases of high-altitude pulmonary edema, and other observations, he formulated the theory that human can adapt to living on the top of Mount Everest.,
His last lecture at the age of 89 was given in February 2015 at the International Congress of Medicine High Altitude in Puno, Peru, close to the Titicaca Lake at 3800 m (shared both by Bolivia and Peru), in a joint and very successful effort between the medical colleges of the two countries. He was the subject of many distinctions by Peruvian colleagues.
We jointly created the First Course of High Altitude Pathology (1992) in La Paz, Bolivia; subsequently, the Symposium on the Effect of Chronic Hypoxia on Diseases at High Altitude then evolved to be held every 2 years until the VI Symposium of Chronic Hypoxia 2016 (at the time of these writings). The first three were held in La Paz. The VI International Conference on Chronic Hypoxia jointly with the Global Hypoxia Summit in New Delhi at DIPAS is shown in [Figure 5].
|Figure 5: The Global Hypoxia Summit and the 4th International Conference on Chronic Hypoxia held at the Defense Institute for Physiology and Allied Sciences in New Delhi, India, 2012. From left: Col. G. Himashree, Dr. ShashiBala Singh, Prof. Dr. Gustavo Zubieta-Castillo, Dr. W. Selvamurthy, Minister of State for Defense, M. M. PallamRaju, Air Marshal, DP Joshi, and Dr. Peter Bartsch|
Click here to view
During the second symposium of chronic hypoxia, we created the International Society of Chronic Hypoxia with those present at the meeting. The Wilderness and Environmental Medicine magazine published the abstracts.
After a long transatlantic journey, arriving in the city of La Paz, despite the fatigue, he insisted that we practice various examinations on ourselves to study the adaptation to high altitude. This gave course to the scientific article entitled, "altitude adaptation through hematocrit changes."
Gradually, we developed the concepts of adaptation to high altitude based on hematocrit, and that evolved into the creation of the high altitude adaptation formula. When we discussed it, he stated that this formula was analogous to Ohm's law, used in Electronics.
His vision was original and unique,,, against what was called CMS or polycythemia terms that he suggested be forgotten and in his later years introduced the exact name for it "polyerythrocythemia" (poly = many, erythro = red, cyt = cells, hemia = blood, i.e., many red blood cells in the blood), as a precise sign description of multiple pathologies in the high-altitude hypoxic environment. It was a subject of controversy, but he, as an irreproachable scientist in his absolute certainty, based on more than 50 years of medical practice at high altitude, never flinched. He opposed the obsolete concept of reducing red blood cells by archaic treatments such as phlebotomy or use of toxic drugs such as phenylhydrazine, a drug prohibited by the WHO., He stopped hundreds of patients from using it to avoid lethal consequences. Often he considered this (saving many lives), the greatest achievement of his life. He claimed that the bleeding of the patients was due to the misconception that the increase of erythrocytes was harmful to the individual, and quite the contrary, he considered it a mechanism of adaptation to the various diseases in the hypoxic environment at high altitude. We have several studies in relation to the oxygen content of blood in polyerythrocythemia patients which in these criteria was a favorable response of the organism. Interestingly, many affirmed that there was no CMS in Tibetans. When we arrived Lhasa, during the VI World Congress on Mountain Medicine, as we got off the plane, upon arrival, he spotted a drummer with cyanosis and evident CMS and he immediately said, "take a photo of me with him," and we presented it often in our talks.
One of his most interesting achievements was his opposition to the use of the "loss of adaptation or maladjustment" terms in the polyerythrocythemia (polycythemia). He emphatically said, "there is no loss of adaptation!!",,,, So, we had a different point of view in the International Consensus Definition of Disease at High Altitude that eventually stopped using the "loss of adaptation" term. It is interesting to note that at one point we were even called "schizophrenic." Gustavo Sr., laughed out loud about it. We hereby confirm the great Gandhi's affirmation "First they ignore you, then they laugh at you, then they fight you, then you win!" As a consequence of all this, he wrote:
"The organic systems of human beings and all other species tend to adapt to any environmental change and circumstance within an optimal period of time, and never tend towards regression which would inevitably lead to death." These words with translation into English represent a timeless concept that lingers into eternity next to the urn with his ashes in the center of the memorial located at the High Altitude Museum at the IPPA building in La Paz, Bolivia.
We developed special equipment to observe changes in oxygen saturation (SpO2) by pulse oximetry during the voluntary apnea. Great variations in SpO2 with each change of breathing can be observed.,, We studied the SpO2 in CMS (as we called it at the time). One of the most essential observations was the extraordinary tolerance to apnea in patients with increased hematocrits as shown in [Figure 6], where the patient could hold his breath for 3 min. Note that on acute exposure to high altitude, initially the heart rate increases along the ventilation to facilitate the transport of oxygen to tissues, which later on are downregulated with the increased oxygen content due to compensatory polyerythrocythemia, efficiently sustaining life in the chronic hypoxic environment at high altitude.
|Figure 6: Extraordinary breath-holding time in a patient with polyerythrocythemia (Ht = 81%) with oscillation of the oxygen saturation at 50%. Left axis: Oxygen saturation; right axis: Pulse|
Click here to view
Hypoventilation in polyerythrocythemia is interpreted as a mechanism for saving energy by increasing red blood cells that replace initial high-altitude exposure hyperventilation and tachycardia, both highly costly in energy expenditure., It is interesting to note that many authors have interpreted this hypoventilation as the cause (rather than the consequence) of CMS. The circulation time in patients with polyerythrocythemia Ht >58% was not different from normal residents measured at high altitude by our technique of pulse oximetry during voluntary apnea., This can be explained due to other adaptation mechanisms well described in the physiology of high altitudes such as angiogenesis that allows an adequate transport of the increasing red blood cells.
Exercise testing at high altitude in patients with polyerythrocythemia was performed regularly in men and women. By invitation of Andrew Pollard, we participated in the International Consensus Children at high altitude, where we affirmed that frequently high acute pulmonary edema was due to intercurrent viral processes.
The Chipayas, a population that lived for more than 2000 years in the plains of Salar de Coipasa (3657 m), were also subject of our studies. We visited this ethnic group with Michael Moretti, an American anthropologist, and Alberto Guerra, a Bolivian anthropologist, and could appreciate that polyerythrocythemia existed equally in this population, regardless of their long adaptation to high altitude. We also measured the p-50 dissociation curve of hemoglobin in the Chipayas finding a left-shifted curve.
We created the distinction "Science, Honor, and Truth" with a medal carrying an inscription "defeating hypoxia." The most distinguished scientists who actually follow these transcendental concepts receive this award every 2 years.
We wrote the first medical book published in English in Bolivia called "High Altitude Pathology at 12000 ft." It is dedicated "to all those who suffer shortness of breath at high altitude."
The people of the city of El Alto, residing at 4100 m, descend daily to work in the lower part of the city of La Paz at 3100 m. This implies a daily change in altitude of around 1000 m (which also occurs in the opposite direction), with changes in ventilation and acid-base balance as reported in 15 residents of the city of El Alto.
However, Prof. Dr. Gustavo Zubieta-Castillo was devoted not only to science but also to literature and art. Throughout his life, he achieved notable positions such as academician of the National Academy of Sciences of Bolivia and the Bolivian Academy of Literature, corresponding with the Royal Spanish Literature Academy. Today, his name is printed in the official Dictionary of the Real Academia Española. Surprisingly, he painted dozens of oil paintings showing his love for life and beauty he found in simple things of everyday life. The various subjects of his paintings include floral and fruit arrangements, landscapes, indigenous life (selling, dancing, etc.), the houses where he lived, and some interpretations of works known as "La Fragua" by Velazquez or "Le Moulin de la Galette" of Renoir.
In the literature field, he wrote in Spanish, multiple newspaper essays and four literary books entitled, "Stories, dreams, and realities," "Pleasant and unpleasant memories of medical practice," "An interview with Mr. Sherlock Holmes," and "Free Thoughts." Several of his writings are short stories and a delight for the imagination. He also created and wrote the newspaper, "The Zodiac" in which as he was the author of most of the contents, he adopted an anonymous Chief Editor name "Gus Little Bridge" (it should be noted that the name "Zubieta" is vasque and means "little bridge").
A very singular article entitled, "Mathematics in the structure of Literature" published in "The Rinconete" Cervantes Virtual Center discusses how Miguel de Cervantes described Don Quixote and Sancho Panza, both situated in the extremes of a Gauss bell distribution curve.
His publications are cited in many papers around the world and recently have become very popular. These can be appreciated at ResearchGate.net. Some more of his lifetime achievements can be appreciated at: http://altitudeclinic.com/blog.
Natalia Zubieta-DeUrioste, his granddaughter, and Gustavo Zubieta-Calleja (Jr.,) are the creators of the first high-altitude museum in the world in October 20, 2010. He strongly supported it and was very proud that Natalia was its Director. He enjoyed visiting the premises in his later days. It is still under development as Natalia is very busy in medical school. There, in the center of it all, lies the "Parvatha Guru's Doma" (the first two words stand for "Mountain Guru" from India and "Doma" stands for house in Russian, the two countries he loved the most). In this memorial, his ashes (containing the sodium, potassium, calcium, iron, magnesium, carbon, chlorine, sulfur, boron, cadmium, chromium, cobalt, copper, fluorine, manganese, molybdenum, selenium, silicon, tin, vanadium, and zinc molecules that he last used, oxygen, hydrogen, and nitrogen gone) remain in a wooden urn, surrounded by his medals, his titles, his books, some of his paintings, and a wooden elephant, that reminded him of India, the country he loved very much. He learned Russian when he was 60 years and went to Moscow once and we ended up attending meetings, together on three occasions later on in Russia and Ukraine. The Fiziol Journal of the Bogomoletz Institute in Kiev, Ukraine, published his first paper on "Adaptation to the summit of Mount Everest." A more advanced version was published after the meeting we attended in Moscow on adaptation.
It was, indeed, an honor to share the invaluable time in life with him, his intuition, his wisdom, his kindness, his creative and inquisitive mind, his observations, his criticism, his tenacity, his firmness, his surprisingly visionary certainty, his love and caring support, for which we are most, most, most grateful and will forever remember carrying proudly his genes and his teachings into eternity!
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Zubieta-Castillo G, Zubieta-Calleja R, Zubieta-Calleja G. Classification of erythrocytosis at high altitude according to the number of erythrocytes (Abstract in Spanish). In Primer Congreso Boliviano de Biología. UMSS Cochabamba; 1979.
Zubieta-Calleja G, Zubieta-Castillo G, Zubieta-Calleja R. The production of carbon dioxide during myocardial oxygen consumption in dogs at 3600 m (Abstract in Spanish). In Primer Congreso Boliviano de Biología. UMSS Cochabamba; 1979.
Zubieta-Castillo G, Zubieta-Calleja R, Zubieta-Calleja G. Studies on myocardial coronary circulation at high altitude. (in Spanish). Acta of the First High Altitude Medicine and Surgery Meeting. La Oroya, Peru; 1978.
Zubieta-Castillo G, Zubieta-Calleja GR. Chronic Mountain Sickness and Miners (in Spanish). Cuad Acad Nac Cienc Boliv 1985;62:109-16.
Cudkowicz L, Spielvogel H, Zubieta G. Respiratory studies in women at high altitude (3600m or 12,200ft and 5,200m or 17,200ft). Respiration 1972;29:393-426.
Zubieta-Castillo G, Zubieta-Calleja G, Zubieta-Calleja L, Zubieta N. Arterial Oxygen Content Regulation in CMS. In VI World Congress on Mountain Medicine and High Altitude Physiology - V Annual Meeting for Chinese High Altitude Medicine. Xining, Qinghai, and Lhasa, Tibet P.R China; 2004.
Zubieta-Calleja GR, Zubieta-Castillo G, Zubieta-Calleja L, Zubieta N. Low Oxyhemoglobin Saturation in Chronic Mountain Sickness (CMS) Patients During Exercise at 3510m. In VI World Congress on Mountain Medicine and High Altitude Physiology - V Annual Meeting for Chinese High Altitude Medicine. Xining, Qinghai, and Lhasa, Tibet P.R. China; 2004.
Zubieta-Calleja G. Bloodletting: A medical resource since the stone age. J Qinghai Med Coll 2004;25:73-275.
Zubieta-Calleja G, De Urioste L, Zubieta-Calleja L. High altitude residents in bolivia. In: Ohno TK, Masuyama S, Nakashima M, editor. Progress in Mountain Medicine and High Altitude Physiology. Matsumoto, Japan: Press Committee of the 3 rd
World Congress on Mountain Medicine and Physiology; 1998. p. 185-9.
Zubieta-Calleja G. Do over 200 million healthy altitude residents really suffer from chronic acid-base disorders? Indian J Clin Biochem 2009;26:62-5.
Zubieta-Calleja GJ, Paulev PE, Mehrishi JN, Zubieta-Castillo G Sr. Extremely high altitude hypoxic conditions during mount everest expeditions, residence at South Pole stations, in tibet and among the Andes: Van Slyke equation modification is crucially important for acid-base measurements.
J Biol Phys Chem 2012;12:103-12.
Zubieta-Castillo G, Zubieta-Calleja G. Acute Hypoventilation on Ascent to High Altitude. In European Respiratory Society Congress. Vienna, Austria; 1992.
Zubieta-Castillo G, Zubieta-Calleja GR. Progressive high altitude hypoventilation reversed by hyperoxia.
Am Rev Respir Dis 1990;141:a924.
Zubieta-Castillo G, Zubieta-Calleja GR. Pulmonary Diseases and chronic mountain sickness. (in Spanish). Cuad Acad Nac Cienc Boliv 1986;68:3-12.
Zubieta-Castillo G, Zubieta-Calleja G, Zubieta-Calleja R.Myocardial oxygen consumption in dogas at 3600m and at different oxygen tensions (in Spanish). La Oroya, Peru; 1978.
Zubieta-Castillo G, Zubieta-Calleja G. Ace erythrocytosis, COPD and Triple Hypoxia Syndrome (in Spanish). La Oroya, Peru; 1992.
Zubieta-Castillo G, Zubieta-Calleja G. Triple hypoxia syndrome.
Acta Andina 1996;5:15-8.
Zubieta-Castillo G, Zubieta-Calleja GR. The triple hypoxia syndrome at altitude. Am Rev Respir Dis 1988;137:509.
Zubieta-Castillo G, Zubieta-Calleja GR. The Triple Hypoxia Syndrome at high altitude (in Spanish). La Oroya, Peru; 1992.
Zubieta-Castillo G, Zubieta-Calleja G. Hematocrit, PaO2 and PaCO2 changes in a high altitude increased polycythemic during a 12 year follow up.
Am Rev Respir Dis 1990;141:a921.
Zubieta-Calleja G, Zubieta-Castillo G, Zubieta-Calleja L, Zubieta N. Exercise performance of bolivian aymara in 3 conditions: At la paz 3510 m, breathing a hypoxic mixture simulating chacaltaya and at chacaltaya 5200 m.
High Alt Med Biol 2002;3:114-5.
Zubieta-Calleja G, Zubieta-Castillo GR. International soccer vetoed in stadiums above 3000 m of altitude. Int Soc Mt Med 1996;6:23-7.
Zubieta-Castillo G Sr. How chronic mountain sickness (cms) contributed to the theory of life at the hypoxic levels of the summit of mount Everest. High Alt Med Biol 2004;5:291-2.
Zubieta-Castillo G. Life and Oxygen Content at Extreme Altitudes. In Astroeco-2002. Terskol, Russia; 2002.
Zubieta-Castillo G. Adaptation to life at the altitude of the summit of Everest. Fiziol Zh 2003;49:110-7.
Zubieta-Castillo G, Zubieta-Calleja GR. Facts that prove that adaptation to life at extreme altitude (8848m) is possible. In Adaptation Biology and Medicine: Health Potentials. New Dehli, India: Narossa Publishing House; 2007.
Zubieta-Calleja G. 1 st
Symposium on the Effect of Chronic Hypoxia on Diseases at High Altitude; 2005. Available from: http://www.zuniv.net/symposium/
. [Last accessed on 2016 Sep 22].
Zubieta-Calleja GR, Paulev PE, Zubieta-Calleja L, Zubieta-Castillo G. Altitude adaptation through hematocrit changes. J Physiol Pharmacol 2007;58 Suppl 5:811-8.
Zubieta-Calleja GR. The increase in hematocrit during the high altitude adaptation process. Wilderness Environ Med 2010;17:202.
Zubieta-Calleja G. Human adaptation to high altitude and to sea level: Acid-base equilibrium, ventilation and circulation in chronic hypoxia. Copenhagen: VDM Publisher; 2007. p. 60.
Zubieta-Castillo G, Zubieta-Calleja G, Zubieta-Calleja L. New concepts on chronic mountain sickness.
Acta Andina 1995;4:123-6.
Zubieta-Castillo G. Respiratory disease, chronic mountain sickness and gender differences at high altitude. In: Ohno TK, Masuyama S, Nakashima M, editor. Progress in Mountain Medicine and High Altitude Physiology.
Press Committee of the 3 rd
World Congress on Mountain Medicine and Physiology; 1998. p. 132-7.
Zubieta-Castillo G Sr., Zubieta-Calleja GR Jr., Zubieta-Calleja L. Chronic mountain sickness: The reaction of physical disorders to chronic hypoxia.
J Physiol Pharmacol 2006;57 Suppl 4:431-42.
Zubieta-Calleja GR, Zubieta-Castillo G, Zubieta-Calleja L. Inadequate treatment of excessive erythrocytosis. Acta Andina 1995;4:123-6.
Zubieta-Castillo G, Zubieta-Calleja GR. Iatrogenic disease in a polycythemic patient at altitude. Am Rev Respir Dis 1988;137:509.
Zubieta-Castillo G. Loss of Adaptation and Maladaptation: Two Terms Inadequately Used-Conversely - "Adaptation: A Fundamental Law of Biology that at High Altitude, Even Permittes Life at the Hypoxic Levels of Mt. Everest". In Global Hypoxia Summit and 4 th
International Conference on Chronic Hypoxia. New Delhi, India; 2012.
Zubieta-Castillo G, Zubieta-Calleja G. New concepts on chronic mountain sickness.
Acta Andina 1996;5:3-8.
Leon-Velarde F. Consensus statement on chronic and subacute high altitude diseases. High Alt Med Biol 2005;6:147-57.
Zubieta-Castillo G, Zubieta-Calleja GR. Pulse oximetry in chronic mountain sickness-long breath holding time and oscillation at lowest saturation. In: Ohno TK, Masuyama S, Nakashima M, editor. Progress in Mountain Medicine and High Altitude Physiology. Press Committee of the 3 rd
World Congress on Mountain Medicine and Physiology; 1998. p. 349-54.
Zubieta-Calleja G, Zubieta-Calleja L, Kingston J. Does Breath Holding Time Increase with Adaptation to High Altitude? In Wilderness & Environmental Medicine - Wilderness Medicine Conference and Annual Meeting. Snowmass, Colorado: Wilderness & Environmental Medicine-Official Publication of the Wilderness Medical Society; 2009.
Zubieta-Calleja G. Pulse Oximetry at High Altitude (3510 m) in Normal Residents and Patients with High Hematocrit (Chronic Mountain Sickness, CMS). In Astroeco-2002. Terskol, Russia; 2002.
Zubieta-Calleja GR. Hypoventilation in chronic mountain sickness: A mechanism to preserve energy.
J Physiol Pharmacol 2006;57 Suppl 4:425-30.
Zubieta-Calleja GR. Non-invasive measurement of circulation time using pulse oximetry during breath holding in chronic hypoxia. J Physiol Pharmacol 2005;56:251-6.
Pollard AJ. Children at high altitude: An international consensus statement by an ad hoc committee of the International Society for Mountain Medicine, March 12, 2001. High Alt Med Biol 2001;2:389-403.
Zubieta-Calleja GR Jr. Chronic mountain sickness among the Chipaya after 2500 years of high altitude exposure. High Alt Med Biol 2004;5:291-2.
Zubieta-Castillo G. The P-50 of the hemoglobin oxygen dissociation curve of the Chipayas: A 2000 year high altitude dweller bolivian ethnic group. Wilderness Environ Med 2008.
Zubieta-Calleja GR, Zubieta-Castillo G. High Altitude Pathology at 12000 ft. La Paz: Papiro; 1989.
Triplett J. Physiological changes related to rapid altitude shifts in La Paz, Bolivia. Acta Andina 1996;5:19-21.
Zubieta-Castillo G, Zubieta-Calleja G, Zubieta-Calleja L, Zubieta-Calleja N. Facts that prove that adaptation to life at extreme altitude (8848 m. is possible). In: Takeda N, Singal PK, Lukyanova L, editor. Adaptation Biology and Medicine. New Delhi, India: Narosa Publishing House Pvt. Ltd.; 2008. p. 347-55.
[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]