Stature of surgeon is not about height Dwarf: Dr. Michael Ain's genes put a stop to his growth but not to his determination to excel in medicine.

September 06, 1998|By Jonathan Bor | Jonathan Bor,SUN STAFF

Dr. Michael Ain stands 4 feet 3. It's the first thing you notice. There's no way around it. He rolls his green surgical pants around the ankles. He climbs a step-stool to reach the operating table. Even then, his colleagues stand a foot or so above him.

He's an orthopedic surgeon, a specialty usually reserved for the jocks of medicine. Ain doesn't exactly fit the stereotype, but he did wrestle in high school, and now he golfs on weekends and fixes bones with big power tools that could tear down walls.

Before long, his height is the last thing you think about.

Ain, who is 36, treats children of all sizes who come to him at Johns Hopkins Hospital with shattered bones, torn muscles, club feet and worse.

But he concentrates on dwarfs -- children who, like him, will remain short all their lives but would like to stand erect and stay out of wheelchairs.

He straightens their legs and spines, realigns their hips and feet, replaces hips and knees -- procedures that require an athlete's strength and a jeweler's precision.

To children who will always stand waist-high to the world, Ain is a guy to look up to.

Average-sized children think so too, describing him as funny and calm.

The word "awesome" comes up a lot.

"He was something different, something unexpected," said Genny Lowe, a 16-year-old of average height who first laid eyes on Ain after coming out of anesthesia.

"But after a while, you didn't notice at all. He's really comfortable, not like a complete stranger. He jokes around and makes you see the brighter side of things."

Said Lowe, a high school tennis star who nearly lost her leg in a boating accident, "Never in my life have I met anyone like him."

Michael Ain came to Hopkins three years ago after winning a coveted fellowship in pediatric orthopedic surgery.

Now, he is one of three full-time surgeons at Hopkins working in the field. Of the three, he focuses most on skeletal dysplasia -- the bone defects that make people abnormally short.

Only a handful of hospitals in the world do this work, and two are in Baltimore.

The other is St. Joseph's Medical Center in Towson, where Dr. Steven R. Kopits is perhaps the nation's recognized "guru" in skeletal dysplasia.

Ain, about 30 years younger, is starting to build a national reputation in the field, too.

He is thought to be the first dwarf in the United States to practice surgery of any kind. But Ain never set out to shatter myths, to be a role model or crusade for anything.

The whole notion, he says, gives him a headache.

Mainly, he wanted to be a doctor, even when others in the profession said to his face that he was a fool to try.

"I try not to think about it," he says of being "first."

"I just want to do a good job, and I don't want to be the first one to screw up, either. I'm not here to run for president."

During a routine day in surgery, Ain is sawing into a patient's thigh. The patient is 41-year-old Alyce Williams, one of many adult dwarfs who come to him, too. Ain replaced her worn left hip a few months earlier; now, he's replacing the right.

Violence in the OR

Ain stands on a plastic stool that's two steps high. Around him are four colleagues who create a pyramid of forms in goggles and gowns. Ain can reach everything, but he gains leverage by leaning into his tools -- a drill with a bit as long as his arm; a chisel with a vibrating, serrated edge; a grater with razor-sharp teeth that glistens in the light.

The air is filled with the sound of whirring power tools and a scent that is both antiseptic and acrid. The work is technically exacting -- a poorly placed hip joint can paralyze the leg -- but it's amazingly rough, almost violent.

Carpenters and car mechanics would feel at home.

Ain, who has built furniture since he was a child, is clearly thrilled with what he does.

"One day you can be doing this fine hand case, working with nerves finer than your hair," he says later. "The next day you might be putting in a total hip. You're banging on this prosthesis with a big mallet, and it's very physical."

With a satisfied smile, he says: "It's the best."

Ain grew up middle-class and Jewish in Roslyn Heights, Long Island. His father was a judge, his mother a travel agent. His sister would become a lawyer.

Michael, the first and only dwarf in his family, said he started thinking about medicine as a young boy because of some unsatisfactory experiences as a patient.

"Sometimes, they treated you not as a person but a thing," Ain said. "They were at times callous, very quick." Ain thought he could do better.

Results of a faulty gene

There are 300 types of dwarfism, each caused by a different genetic abnormality. Ain has the most common type, achondroplasia, triggered by a faulty gene that prevents the long bones in the arms and legs from growing fully. The gene doesn't affect the torso, so when he sits across from taller patients they see eye-to-eye.

He faced the predictable teasing as a child, but says nobody really got in his way.

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