No Bones About It:
words by Barbara Hurley / photographs by John Emerson
harles Gatt, Jr., MD, has always wanted to fix things that were broken. An engineering student as an undergrad, he turned his “mechanical mind” to the moving parts of the human body and put into motion the beginnings of a career in orthopaedic surgery.
He knew going into UMDNJ-Robert Wood Medical School (RWJMS) that he wanted orthopaedics and stayed there for a residency program that he, unlike many of his colleagues, “enjoyed tremendously.” Chalk it up to the fact that he was truly in love with the specialty as well as with a fellow resident who would become a plastic surgeon and his future wife, Sandra Gatt, MD. A former competitive runner, Gatt now finds himself running that very residency program as chair of the department of orthopaedic surgery at the medical school.
His enthusiasm for sports — he coaches his two sons’ Pop Warner football teams – is colored by his interest in sports medicine. While myriads of football fans spend the fall months analyzing play action passes and nickel defenses, Gatt is thinking in terms of how the body is reacting to the sometimes brutal demands of sports. In 1997, for example, he participated in a study to determine the impact force to the lumbar spine when football players hit a blocking sled. The published data suggest that the mechanics of repetitive blocking may be responsible for the increased incidence of lumbar spine injury incurred by football linemen. But he also remembers treating a girl who broke her wrist playing football with the boys and how good he felt when she sent a note thanking him.
Gatt believes that tissue engineering will change the future of orthopaedic surgery. When he returned to RWJMS in 1997 after a fellowship at the Cleveland Clinic and a staff position in a California hospital, he had the good fortune to work with Michael Dunn, PhD, who was pioneering tissue engineering techniques. The technology employs the use of biocompatible materials shaped as fibers and combined with a collagen sponge to serve as a scaffold that ultimately stimulates its own replacement by the body. Gatt and his research colleagues are engineering ways to replace a damaged meniscus — the rubbery shock absorber in the knee — with an implant.
He is in the second year of an NIH grant for a tissue engineered knee meniscus scaffold and has just finished laying out a plan to explore applications for tissue engineering in limb recovery in the case of war wounds. He already has some funding for this project. But he admits that research is “a slow and arduous process” with many more failures than successes. “It’s really challenging,” he notes, “and you have to have patience.”
Patience, according to Gatt, is also a requisite for the other demands of academic medicine, whether it is his clinical practice or his role as teacher to future physicians. “In academics, you have to want to be teacher, researcher and clinician,” he explains. “A surgeon can be out on his own doing his own thing, but in an academic environment you must really want to do it all and to cope with the sacrifice of time that this requires.” He has a medical student or orthopaedic resident with him most of the time and always has a resident alongside in surgery.
It also helps to have good mentors, he says. Orthopaedic surgery made the leap from division to department at RWJMS in 2003 under the leadership of Joseph Leddy, MD, whose guidance Gatt credits as an important influence on his career. When Leddy retired, Gatt was tapped to head the department at the relatively young age of 44. Now, added to everything else, he has the administrative responsibility for a growing department.
The considerable demands of academic medicine have this former engineering student operating in high gear. He views success as “a happy overall life” that strikes a balance between family and work. Fortunately, everything seems to be running like a well-oiled machine.