Turning Point: The Dugan Smith story

It's a judgment admittedly based on insufficient information, but just from the look of things -- from the way he horses around with relatives or remembers a scene from a Vin Diesel movie -- 13-year-old Dugan Smith has the best smile in Fostoria, Ohio.

Everyone around here can remember Dugan from years ago, when he was a kid, and what made him smile the most back then: baseball. As a toddler, Dugan hit the ball so hard that his mother, Amy Baker Miller, would pitch to him only from behind a tree.

"A lot of kids nowadays don't get excited," said Dugan's dad, Dustin Smith, a longtime coach in the town just south of Toledo. When young Dugan would hit the ball, though, "it was funny watching him just being a boy, and being excited and happy that he hit the ball hard. … He'd run all the way around those bases. Oh, he was ecstatic."

It was late summer 2008, the night before Amy's 31st birthday, when a 10-year-old Dugan gave his mother a bracelet he'd bought that day as a present. He asked her to put it on the following day -- when doctors at a Columbus hospital would be amputating his cancerous right thigh bone.

"He asked, 'Will you wear this tomorrow when I'm in surgery?'" Amy remembered. "And I'm crying and said, 'Of course.'"

It was far from a traditional amputation, though. After undergoing weeks of chemotherapy to treat his bone cancer, Dugan Smith would undergo rare, radical surgery -- surgery he chose, for one reason only: the chance to play baseball again. "Not being able to do it … and having to watch other people do it?" Dugan said. "It would kill me."

"That's kind of who he was," said Pamela Baker Berrier, Dugan's aunt. "That's where he shined."

Dr. Joel Mayerson understood that about Dugan. He was the first to propose to Dugan's parents an unorthodox surgical procedure known as a rotationplasty.

"You take out the middle part of the leg, the diseased cancer bone," he explained, "and then turn the ankle around 180 degrees backwards. What that does is it allows it to function as a knee."

To be sure, the result is not the sort of thing you see every day: a backward-facing foot at the same height as the other leg's knee. But Mayerson felt certain that a rotationplasty (and subsequent lower-leg prosthesis) would remove all the cancerous cells inside Dugan, while giving him more mobility and requiring less energy than a full amputation and leg prosthesis would. More importantly, he felt that a rotationplasty, and the new "knee" it provided, would let Dugan play baseball -- hitting, running, fielding, pitching -- at a much higher level than he could otherwise aspire to.

Upon first hearing about a rotationplasty, Mayerson said, patients and parents "think you're from Mars, because it sounds like such a crazy thing to do." It's estimated that fewer than 20 rotationplasty surgeries are performed each year in the United States. But Dugan's father was gung-ho; it was Dugan's mother who wasn't so sure at first.

"I didn't know how this 10-year-old was going to react to having half of his leg cut out, fusing it, flipping it, people staring …" Amy said. "I was worried about him. I was thinking long term and how this was going to affect his whole life."

His mother and father left the choice up to Dugan. His reaction was a swift one: "Did God just make this surgery for me?"

Beginning the morning of Aug. 29, 2008, Dugan spent some 20 hours in surgery at the James Cancer Hospital in Columbus. He was still sedated when his parents came in to check on him for the first time. His father watched in wonder as Dugan moved his right foot. "Pretty amazing memory that I will never ever forget," Dustin said.

Yet after Dugan left the hospital, there were those unwanted stares to contend with -- people who would wordlessly gawk at him. "Then they'd just walk away," he said, "which is really rude. It made me sad. I'd want to wear pants all the time."

Rehab was painful and arduous, Dugan's father challenging him time and again. "I had to be the tough one; I had to be the mean guy," Dustin said. "He probably didn't like me for a while -- I know he didn't -- pushing him to be the best that hopefully he's going to be able to be."

But Dugan's decision -- and his hard work -- paid off. The day Dugan returned to the baseball diamond "was like watching him walk for the first time," Amy said. "We were so proud. … We had everybody go to his game, and it was an amazing feeling."

Now 13 and cancer-free, Dugan plays first base and pitches for the Fostoria Eagles, striking out opponents with fastballs and the occasional breaking ball, lining singles to left, even running the bases. It's not always easy. Sometimes Dugan gets frustrated, and not everyone at the games knows about his medical condition. "He has to work three times harder than anyone else," his aunt Pam said. "You still want to run in there and fix it; you still want to stand up and scream, 'You guys don't understand what he went through!'"

But Dugan understands, and he's having the time of his life.

"I feel like Superman now, how strong I've gotten from going through cancer," he said. "I'm just so happy inside when I'm running to the base. Even to slide is amazing -- my first time sliding straight out was really cool."

"He keeps pushing, and he's just not giving up," said Sethe Daugherty, a friend and teammate. "He's going to push it and push it and do whatever he wants. He says we're gonna be beasts this year."

Not everyone would have made his choice, but for Dugan, it was the right one. Because the one thing everyone has always remembered about Dugan Smith can be seen whenever he takes the field.

"Watch him play," says Pam, "and when that smile comes on his face, you know."

Chris Connelly is a reporter for ESPN.