Forty years ago, long before the recent afternoon when Dr. Joseph Dutkowsky knelt at the warped feet of his 4-year-old patient, he was a small-town teenager approaching his Catholic confirmation and needing to select a patron saint. He made an unlikely choice, a newly canonized figure, St. Martin de Porres, the illegitimate child of a former black slave in 16th-century Peru.

Decades later, something — call it coincidence, call it providence — has bent the vectors of faith and science together in the career of Dr. Dutkowsky. The confluence of these often-clashing ideals has taken him to the top of his profession as an orthopedic surgeon specializing in the care of children disabled from cerebral palsy, spina bifida, Down syndrome and other afflictions. It has also taken him to the healing shrine of Lourdes and to the Lima barrio where his patron saint tended to the poor and broken and cast out.

Dr. Dutkowsky’s appointment with Christian, his young patient at NewYork-Presbyterian/Columbia hospital in New York, was as emblematic as any other on his calendar: cerebral palsy at birth, canted legs that could not be corrected by braces, muscle tissue softened by Botox injections, and each foot placed in a cast for several weeks to try to reshape it for stable walking.

“This is my ministry,” said Dr. Dutkowsky, 56. “Some people stand next to the ocean to feel the presence of God. I get to see the likeness of God every day. I see children with some amazing deformities. But God doesn’t make mistakes. So they are the image.”

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