Newswise — This summer, medical student Amber Hamilton was excited to begin an eight-week research fellowship program at Hospital for Special Surgery (HSS). She would be working on a project that aligned perfectly with her own background and experience: the psychosocial needs of adolescents undergoing limb lengthening and reconstructive surgery.
A generous grant to HSS from the “I’m Not Done Yet Foundation” had provided the impetus for a five-year research project to determine the changing needs of young patients as they become teenagers and young adults in the health care system.
Hamilton was thrilled to be accepted in the highly competitive research program. She would gain valuable experience and knew she could be of service. Her primary focus would be the psychosocial needs of adolescents having orthopedic surgery, a subject she understood firsthand. Starting at age 12, she had a number of surgeries at HSS to correct a condition that affected her legs. In the fellowship program, she would be working with Dr. S. Robert Rozbruch, chief of the Limb Lengthening and Complex Reconstruction Service. In addition to performing her surgeries, he had served as a role model and mentor to her for more than a decade.
Hamilton, who is 25 and just completed her first year at Weill Cornell Medical College, was born with a rare bone disorder called X-linked hypophosphatemia, which leads to low levels of phosphate in the blood. Phosphate is a mineral that’s essential for normal bone formation. The condition also makes it difficult for the body to absorb calcium and vitamin D. When she was diagnosed at age 2, she was prescribed vitamins to control the condition. Still, as time went on, she became severely bow legged.
At age 11, Hamilton’s pediatric endocrinologist referred her to Dr. Rozbruch, an expert in the highly specialized surgery that could straighten her legs. He performed Hamilton’s first surgery when she was 12. It entailed the placement of an external fixator on both of her legs. A fixator is a stabilizing metal frame attached to the outside of the leg following surgery to correct a problem with a bone. It is attached with metal pins and screws that are inserted into the bone through small incisions in the skin and muscle. Little by little, day after day, Hamilton turned struts on the fixators that straightened and lengthened her thigh and shin bones a tiny bit at a time. She wore the frames on her legs for several months.
“I remember seeing my first X-ray after surgery. It showed an empty space where Dr. Rozbruch had made a cut in my bone, which would fill in as new bone regenerated,” Hamilton recalls. “I would go in for follow-up appointments every couple of weeks and see that new bone was gradually forming. This fascinated me and is what sparked my interest in medicine. I wanted to gain a better understanding of how the body works.”
Over the years, Hamilton saw Dr. Rozbruch for follow-up and had several additional surgeries to straighten her legs. She had her final procedure when she was in college. It entailed lengthening her right leg so it would be equal to her other leg.
Ten years had passed since Hamilton’s first surgery, and this time Dr. Rozbruch used a newer technique. He implanted a lengthening rod with a small magnet into her thigh bone, with no need for an external fixator. “As opposed to turning struts on a fixator, as I was accustomed to, this time I used a magnetic machine that communicated with the magnet in the rod to lengthen my femur each day,” she recalls. Today her legs are perfectly straight and of equal length.
Hamilton never let her condition slow her down. “I decided I wanted to be an orthopedic surgeon very early in life,” she says. “Having surgery as an adolescent was scary, but it also motivated me. After enduring so much as a patient, I know that orthopedic surgery is exactly what I want to do.”
“Amber had an intense experience as a patient, but had a positive attitude and was always upbeat,” Dr. Rozbruch says. “In my experience, I’ve found that most patients and families deal with health challenges in a positive way, but for Amber to be interested in medicine and aspire to be an orthopedic surgeon, that takes it to another level. She is extremely intelligent, engaged and highly motivated. I expect that she will achieve her goals.”
To date, they have followed similar paths to obtain career goals. They both graduated from the University of Pennsylvania for their undergraduate degrees. Hamilton is about to enter her second year at Weill Cornell Medical College, where Dr. Rozbruch attended medical school.
“Our relationship has evolved beyond the patient-physician dynamic,” she explains. “We’ve been able to keep in contact and maintain a relationship that has nothing to do with my surgery. Any time I have ever needed anything or asked for advice, he was always super-receptive. He has motivated me in so many ways.”
After her surgeries, Hamilton says she gravitated toward HSS. “My experience as a patient at HSS was amazing,” she says. “My ultimate goal is to train there as an orthopedic surgeon.” She began to volunteer in 2013 in the patient care unit, where she helped out in the Nursing Department and checked on patients. For the next few years, she also accompanied Dr. Rozbruch on his rounds. Most recently, he was her mentor in the HSS Summer Research Fellowship program.
Dr. Rozbruch values the important role Hamilton has played in his project. She helped develop the patient needs survey based on her own experience, has contacted and enrolled patients in the study, and is helping to analyze the data.
She has also been able to shadow Dr. Rozbruch this summer. She accompanies him when he sees patients and has gone into the operating room with him to witness the very surgery she had years earlier.
Hamilton continues to follow in Dr. Rozbruch’s footsteps, mentoring and advising young people considering a career in medicine. She says she knows from experience that “if your heart is in it, it can be achieved.”
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HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the tenth consecutive year), No. 3 in rheumatology by U.S. News & World Report (2019-2020), and named a leader in pediatric orthopedics by U.S. News & World Report “Best Children’s Hospitals” list (2019-2020). Founded in 1863, the Hospital has one of the lowest infection rates in the country and was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center four consecutive times. The global standard total knee replacement was developed at HSS in 1969. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State. In addition, HSS will be opening a new facility in Florida in early 2020. In 2018, HSS provided care to 139,000 patients and performed more than 32,000 surgical procedures, and people from all 50 U.S. states and 80 countries travelled to receive care at HSS. There were more than 37,000 pediatric visits to the HSS Lerner Children’s Pavilion for treatment by a team of interdisciplinary experts. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. The HSS Global Innovation Institute was formed in 2016 to realize the potential of new drugs, therapeutics and devices. The HSS Education Institute is the world’s leading provider of education on musculoskeletal health, with its online learning platform offering more than 600 courses to more than 21,000 medical professional members worldwide. Through HSS Global Ventures, the institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally. www.hss.edu.