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Meet Dr. Arnold

Pediatric resident at Children's wins high praise for her skills and determination

Tuesday, August 07, 2001

By Anita Srikameswaran, Post-Gazette Staff Writer

At a height of 3 feet, 2 inches, Dr. Jennifer Arnold is hard to miss.

She recently finished her first year of pediatric residency training at Children's Hospital of Pittsburgh, where most patients older than 4 are taller than she is.

Dr. Jennifer Arnold and Dr. Raymond Karasic review X-rays of a possible fracture during a consultation at Children's Hospital. (Annie O'Neill/Post-Gazette photos)

But the 27-year-old knows her stuff and exudes confidence. One young patient was so impressed with her that she announced: When I grow up, I want to be a little doctor like you!

You can't! You can be a tall doctor, a laughing Arnold replied.

According to the Little People of America, there are an estimated 200 types of dwarfism. Arnold was born with spondyloepiphyseal dysplasia, or SED, in which a random genetic mutation causes abnormal collagen formation. That led to her dwarfed growth and orthopedic problems.

Dr. Dena Hofkosh, pediatric residency program director, has nothing but praise for Arnold.

"She's really got this very lovely ability to connect with the kids and with parents. They trust her," Hofkosh said. "If she were just a Little Person, it would be a novelty. The fact is, she's a fabulous doctor."

Hofkosh, who supervises the resident in an outpatient clinic, often hears youngsters ask with natural frankness why Arnold looks different.

"Jen is able to come back with an equally honest and open response" and deftly turn the conversation back to what ails the child, Hofkosh said.

Arnold's standard explanation is that some people are made tall and some short and she happens to be "really little." Children usually accept that and move on, she said. A few want her to play with them.

"I'd rather people ask than just point or stare and wonder," she said. "I prefer that people ignore me in some ways. I like the people who treat me like anybody else."

Sometimes the attention can be intrusive and disconcerting. Once she was in her car waiting to pick up some food when two kids sitting in the bed of a nearby pickup truck spotted her.

"And they wanted me to say 'hi' and they're waving at me," Arnold recalled.

She added wryly, "I'm thinking, 'You shouldn't be riding in the back of that truck!' "

Arnold is almost a celebrity in children's clothing shops and grocery stores in her Squirrel Hill neighborhood. Especially when buying junk food, the doctor can't help but wish sometimes that she weren't so recognizable.

But mostly she doesn't let height -- hers or yours -- stop her from getting things done.

She is cheerful, friendly and kind, which makes families quickly warm to her. She is also self-assured, thorough and smart, earning their respect for her medical skills.

No one seems to mind lending a hand if she can't reach something. Most marvel that she doesn't need assistance very often. She's good at modifying her surroundings to meet her needs.

To wash her hands in an examination room, for example, she stood on a chair she dragged to the sink. She then pushed the chair over to an out-of-reach dispenser to get paper towels, placing extras on the counter to minimize future chair moving. She stood on the chair to examine her patient on the hospital bed.

In the halls of the emergency department, there are portable stools for Arnold's use. At the nurse's station, a plastic file holder hangs on the wall below counter level, so she can drop papers into it easily while standing.

If there's no place to sit, co-workers crouch or kneel when talking with Arnold so she doesn't have to crane her neck.

Hofkosh said some sinks and soap dispensers were moved, gloves were special-ordered and size-appropriate chairs and tables were placed in the nurses' stations when Arnold arrived. She also was given a cellular phone because some hospital phones are out of her reach.

Charles Cusick, 4, of Clairton, was so intrigued by Dr. Arnold's size that he asked her as she left the room if she wanted to stay and play. Charles' brother was being treated by the doctor.

"She has been wonderful at letting us know when things need to be done, although she probably waits a bit too long to do that. She's too willing to make do," Hofkosh said.

Toward the end of the training program, another senior resident likely will be on call with Arnold as a precaution in those rare emergencies that demand quickly covering a lot of ground.

"Getting to a place in a split second is something that's going to be difficult for her," Hofkosh said. "She gets more physically tired with the walking and the step climbing that has to be done. And she obviously can't get to places quite as quickly as others do."

Arnold's height translates into a shorter stride. But more significant, her medical condition has affected her hip, knee and ankle joints. Her hips have been getting more sore during the past several years.

"I'm tired of the pain now," she said. "My hips are already pretty much breaking down. It's just a matter of how long I want to deal with it."

Arnold has had more than 20 orthopedic surgeries, which she calls "tune-ups," to prevent her bones from bending and deforming as she grew and gained weight. When she was 14, rods were implanted on each side of her spinal column to keep her back straight.

Her right hip called it a day July 8. She could not get out of her car without pain shooting through her groin. After a fitful sleep that night, she could barely move.

So this morning, the joint is being replaced at St. Joseph's Medical Center near Baltimore.

Arnold graduated from Johns Hopkins University's medical school and has been treated at Baltimore hospitals since childhood.

She was staying at her parents' home in Celebration, Fla., near Orlando, before the operation and will be there afterward to recuperate. She plans to resume her medical training here in October.

Arnold's surgeon said that if all goes well, she will be able to start physical therapy days after the surgery.

But if the surrounding tissues are too lax, she must wear a girdle-like brace and rest in bed for six weeks while bone grows into and stabilizes the prosthetic joint. Then she can begin physical therapy.

That time-consuming possibility is horrifying to the energetic Arnold, who said, "If I wake up and hear that news, I'm not going to be happy."

Her bosses at the hospital are keeping a place for her even if her recovery time is longer than she anticipates.

"We're very supportive," Hofkosh said. "If we need to adjust her schedule to accommodate some difficulties, we can certainly do that."


Post-Gazette staff writer Anita Srikameswaran will follow Dr. Jennifer Arnold's progress in a story when she returns to Children's this fall.



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