As the practitioner in charge at Pacific Medical Prosthetics & Orthotics, Will Cox has been known to burn the midnight oil in his lab at 4626 Willow Road. He might be at the sewing machine stitching part of a custom brace to stabilize a patient's bone fracture. Or perhaps he is assembling a microprocessor-controlled prosthetic foot for an amputee who wants to play golf again.
No matter what Cox is doing, there is always one person and one goal in tight focus: the patient and what he wants to accomplish. "It's important when you see a patient to really listen to their story to identify what their needs are," Cox explains. "Everyone has a different background and different goals. As a practitioner, the first thing I need to do is hear them out and get a good understanding of what they want."
Once he has that understanding, he can then start to fashion the appropriate device. An athlete amputee who wants to return to track and field will need a different prosthesis than one designed for a patient who simply wants to take walks with a grandchild. "It is really important to know the patient's needs and what he wants to do," Cox stresses.
Cox has been with the Tracy-headquartered Pacific Medical Prosthetics & Orthotics, which opened its Hacienda site last October, less than six months, but he comes to his position with more than a decade of experience in his field. The Dublin native was already drawn toward a career in physical therapy when he went off to San Diego State for his undergraduate degree.
A few class projects led to research in foot orthotics. In one study, he worked on developing a more ergonomic walker; in another he tried to create an adjustable heel wedge foot orthotic with pressure activating adhesives from 3M Inc. "My professor suggested I try my hand in prosthetics and orthotics, or P&O, and he helped arrange an internship at Bionics in San Diego," Cox relates. He graduated with a B.S. in kinesiology with an emphasis on physical therapy.
His next step in becoming a P&O specialist was enrolling in Northwestern University's year-long, post-Bachelors program, based in downtown Chicago. The school's close ties with the Rehabilitation Institute of Chicago, rated the preeminent rehabilitation hospital in the country, exposed him to a wide spectrum of conditions and cutting-edge technology. It also implanted the conviction that every patient is "an individual with unique circumstances, needs, and desires," entitled to lead a rewarding life to the best of his current capabilities.
When Cox finished at Northwestern he came back to the Bay Area and went to work for a prosthetics and orthotics provider in San Jose. After a few years he was ready for more specialized training, this time through the Newington Certificate Program, offered in partnership with the University of Connecticut and Hanger Orthopedic Group. Most of the coursework was done via distance learning while Cox was still holding his day job, although he remembers flying back and forth several times for mid-terms and finals. He completed the program in 2008, joining Pacific Medical in February 2010.
While the Willow Road facility has a retail ambiance, Cox tends to view his workplace more like a clinic, "a place where people go for care." He and medical assistant Jessica Jones have worked hard to create a welcoming environment for patients seeking to recover functionality and mobility after disease or disability.
As a good listener, Cox has heard countless accounts of illness and injury, but his sights are always trained on what is ahead, not what happened in the past. Guided by the familiar aphorism, "You're either part of the solution or part of the problem," his outlook is decidedly pragmatic: "When you're in grievance with the patient, you are not doing him any good. You always want to take the productive approach. The reward is using your knowledge of technology, fitting techniques, and materials, and matching them to the patient's capabilities, activity level, and lifestyle preferences."
The primary tools to regain functionality are orthotic and prosthetic devices. Cox explains that although orthotics is often thought of in reference to feet, the field actually encompasses bracing for all parts of the body, literally from head to toe.
"The brace could be for post-operative support, for a patient after back surgery, for example, or perhaps for someone with polio, where it could stabilize and protect a leg. It really runs the gamut," he says. Pacific Medical also carries a line of off-the-shelf orthopedic braces, but when it comes to accommodating a specific injury, a custom device is typically necessary.
Prosthetics entails the fabrication of a new limb, either upper or lower extremity. When a patient comes in with a prescription from the doctor for a new arm, for example, it is up to Cox to determine what is necessary. After assessment and evaluation, he formulates a design to return the person to his level of function before the accident or illness.
Then he retreats to the lab to apply his skills, often after hours. "When you see patients all day, there is no mystery about where you find the time to fabricate the device, another part of my role here," he explains. The work is complex and can get quite challenging. Cox's end product could be a microprocessor-operated knee joint, or a biomechanically sound prosthetic foot that reduces friction within the socket to provide good energy return for the patient.
Almost all fabrication takes place in the lab. Some components, like microprocessors, are purchased, but most are made entirely on site. "We only outsource things we can't make ourselves, like shoes," Cox comments. "This gives us good quality control over the final product. We see it all the way through from evaluation to mold-making to delivery, with the personal touch that everything fits to the patient."
Cox enjoys working with cutting-edge materials, like the woven carbon fiber laminated to the socket of the prosthetic for patient comfort. A strong background in material science is essential, he points out. "You can't start assembling a device without knowing the way the materials will react to various forces and how the body will work. You need a good understanding of biomechanics to be in tune with all facets of the prosthesis."
Cox and his younger brother grew up in Dublin, in a sports-oriented family. A baseball legacy began with his grandfather, who was a pitcher for the minor league Oakland Oaks. Cox's father, a pipefitter for PG&E, spent several years as assistant coach for Dublin High School's baseball team. Cox himself played Little League, but in high school he carved out his own niche as a wrestler.
He is also a surfer, and in his downtime he is off to the beach as often as possible. Although he managed to schedule a surfing excursion to Costa Rica in 2006, his usual destination these days is Santa Cruz, just as it was before college. He has also managed to combine his passion with his desire to give back through involvement with Ampsurf, the nonprofit that helps people with disabilities, especially veterans, participate in "fun safe outdoor activities." "I can help people out with their prostheses, and then teach them how to surf," Cox remarks. "This is something I really enjoy."
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