After graduating with high honors from the medical school at the University of Santo Tomas in the Philippines, he would complete a residency and fellowship in general surgery at Bronx-Lebanon Hospital in the Bronx, NY and a fellowship in surgical critical care, burns and trauma at Cook County Hospital in Chicago. Both hospitals deal with a huge volume of patients who are crime victims, often arriving in critical condition from shootings or stabbings.
“It was unbelievable what we saw there,” said Fildes, who has been a Fellow of the American College of Surgeons since 1990. “I found that I was good under pressure, that I was making a difference in people’s lives.”
He became so respected for his trauma work in Chicago in the ‘90s that he became president of the Chicago Metropolitan Trauma Society and earned leadership positions with the Metropolitan Chicago Chapter of the American College of Surgeons. His research on shock and treatment of hypothermia included publications in the highly respected Journal of Trauma and the American Journal of Surgery.
Fildes' stellar work in Chicago led in 1996 to his move to Las Vegas as director of the UMC Trauma Center. UMC is Nevada’s only Level 1 Trauma Center, only Pediatric Trauma Center and only Burn Center. Under his guidance, UMC, the main training hospital for the UNLV School of Medicine, has become one of the national leaders in trauma care. Of those who arrive alive at the trauma center -- many have less than a 1 percent chance to live -- an incredible 96 percent survive and are discharged.
According to the federal Centers for Disease Control and Prevention, if you are severely injured, getting care at a Level I trauma center can lower your risk of death by 25 percent.
“I look for surgeons who exhibit grace under pressure, who are able to operate under uncertain conditions,” said Fildes, who has served as a consultant to American surgeons working on soldiers wounded in the War in Afghanistan. “They need to go from zero to one-hundred miles an hour in five minutes, who can lead teams of doctors, nurses and technicians well.”
Given his success in Chicago and Nevada -- when Fildes came to the Silver State, he was teaching advanced trauma life support at the University of Nevada Reno, School of Medicine’s Las Vegas campus as well as collecting trauma data -- the American College of Surgeons placed him on its evolving National Trauma Data Bank committee.
It was in the wake of the 9/11 attacks on the U.S. by terrorists that Fildes' work with the trauma data bank became nationally recognized. After he and other members of data bank committee were called to testify before the U.S. Senate, he was instrumental in gathering information on the nation’s trauma centers, finding out just what they were capable of, what they were actually doing throughout the United States.
“It informs policy makers in real time what’s occurring in the United States,” said Fildes, who became national chair of the American College of Surgeons Committee on Trauma in 2006. “Without information, you can’t plan...we need to build systems of care based on data...even the wearing of motorcycle helmets is based on data sets.”
In July 2008, Fildes -- surgical centers around the globe ask him to speak -- found the time to establish the nation’s first acute care surgery fellowship program at UMC.
Over the past several years, National Trauma Data Bank information has been increasingly used in trauma research, with more than 400 peer reviewed articles published. Clinicians have applied derivations from the data to improve the standard of care delivered to trauma patients, while administrators and policy makers have used data to make informed decisions about injury prevention and control as well as workforce and financial resource allocation.
Given the fact that he coordinated the medical response to the Oct. 1, 2017 mass shootings on the Strip, it isn’t surprising that Fildes was often sought out by the media and even President Trump. On camera he reminds older TV viewers of Sgt. Friday on the classic television show Dragnet, sharing “just the facts."
At a recent meeting of the American College of Surgeons in San Diego, UNLV trauma surgeon Dr. Deborah Kuhls spoke about Fildes' leadership. She said he found ways for staff to utilize every possible area of the hospital to quickly treat patients, such as turning the ambulatory surgery unit into another emergency room
“I just try to find ways to get the best job done,” he frequently says when others praise him.
As Fildes looks to the future, he sees much more to do in Las Vegas.
“I would like to grow UNLV surgery,” he said. “I want to see liver and heart transplant centers, comprehensive surgical oncology treatment for cancer, expanded pediatric surgery, the kind of things people now have to leave Las Vegas for.”