ROSS WAS BORN with a genetic condition called achondroplasia, a common form of dwarfism. Corrective surgery has been a defining part of his life, and right now two different things are going on. The operation coming up is a one–shot aimed at fixing his spine, which is curved badly enough that he walks with a painful–looking sway. His spinal canal is also narrowed, causing compression in the lumbar region because there's not quite enough room inside for his spinal cord. This isn't life–threatening, but his spine has to be repaired—opened up, fused, and braced with metal rods—or he could have problems with organ function as an adult.

In addition, Ross has been undergoing a series of elective surgeries for several years—he'll have had four in all between the ages of seven and 17—that are designed to make him nearly a foot taller. This is called limb lengthening, and it's controversial. Though the procedure has some mundane applications on non–dwarf patients—such as repairing old fractures that didn't heal properly—it's also used to increase stature, through a process that is expensive, painful, and protracted. For these and other reasons, advocacy groups like the National Organization of Short Statured Adults oppose the use of limb lengthening for what NOSSA calls the "cosmetic" goal of gaining inches. "You will get more out of life if you strive to accept yourself as you are," reads the group's Web site, "short height and all."

Ross's parents don't agree. They see limb lengthening as a way for modern technology to make Ross's body function a little better. Without it, he would have topped out at four feet or so, and he wouldn't be able to do simple things like drive without special equipment. With it, he now stands around four–ten, so he'll be able to drive, use an ATM by himself, and do much more.

However you look at it, limb lengthening is a tough road. The procedure was developed in the Soviet Union after World War II and brought to the U.S. in the eighties. Its targets are the femur, tibia, and fibula in the leg, and the humerus in the upper arm. During the most serious operation, surgeons drill long, sharp–tipped rods into the leg bones, then crack them with a mallet and sharp chisel. The rods protrude outside the flesh, serving as mounts for a spreader device that can be adjusted to slowly pull the bone halves in opposite directions. As the junction starts to heal, an at–home caregiver—Tracey, in Ross's case—carefully turns screws four times a day to separate the ends by a total of a millimeter. Length builds up as new bone cells form to bridge the tiny gaps.

This goes on for months, and, yes, it hurts. During two procedures on Ross's legs—which happened when he was seven and 13—he went through nine months of painful recovery each time, growing a total of nine and a half inches. The total cost will be several hundred thousand dollars—most of it covered by insurance—and Ross will have spent more than two years of his childhood recuperating.

Some of the world's best surgeons in both specialties—limb and spine—are based in Baltimore, and there's a divide among them about whether limb lengthening is a good idea. Tracey and Ross were there a few days before our fishing trip for a pre–op consultation with Ross's spine doctor, a Johns Hopkins orthopedist who's against using it for height gain. According to Tracey, he scared the hell out of Ross, stressing the small but real chance that the spinal surgery could leave him paralyzed or dead. She thinks he rubbed that in because he was angry about the limb lengthening.

Whatever happened must have been traumatic, because Tracey and Ross are both pretty tough, and I admire the way they band together stoutly in the face of an often cruel world. Several years ago in Baltimore, with Ross in a wheelchair after his first round of leg surgery, they were approached at a train station by a woman who said she was the parent of a dwarf child herself. She knew what Ross's leg hardware meant and she didn't like it. She tore into Tracey, telling her that no mother who really loved her child would put him through such an ordeal.

Tracey returned serve and the woman left. She asked Ross what he thought about what he'd just heard. He replied, "How many times have I told you not to talk to strangers?"