The Making of a World Renowned Neurosurgeon

 

On February 7, 2013, at the National Prayer Breakfast at the Washington Hilton in the U.S. capital, Dr. Ben Carson stood a few feet from the President of the United States, gave the keynote speech, [1]   and stepped into the national spotlight. A little less than two years and three months later,  on  May 4, 2015, at Detroit’s Music Hall Center for the Performing Arts, Dr.  Carson announced his bid to become the Republican Party’s nominee for the President of the United States. [2].

Since his announcement, Dr. Carson, who has never held political office, has consistently ranked at or near the top in the myriad of political polls, second only to the outspoken billionaire real-estate tycoon, Donald Trump, and way ahead of experienced elected officials like former Florida governor, Jeb Bush, Senator Marco Rubio, and current Ohio governor, John Kasich. What has propelled this unlikely freshman candidate to the top of the polls in the race to become the next President of the United States? Nothing less than a real-life Horatio Alger story of a poor inner-city kid from Detroit and Boston who would one day become one of the most renowned brain surgeons in the world.

As Dr. Ben Carson campaigns to become the Republican nominee for President, his backstory has become increasingly well known. Much has been written and broadcasted about him since his ascendancy to the top of the polls. In this article—which will examine his medical career, and the subsequent article—which will examine his social views—I will attempt to examine the portrait of the man that has emerged from his own pen, from his speeches, and interviews that he has granted. I’m primarily interested in understanding Dr. Carson from his point of view, not from the perspective of a journalist or pundit who may or may not have a built-in bias, or a personal, professional or political agenda.

Abandoned

Sonya Carson gave birth to her second son, Ben, on September 18, 1951, in Detroit, Michigan. Ben’s father was Robert Carson, a minister, whom Sonya had married when she was only thirteen years old and he, twenty-eight.  Their first child, Curtis, was born two years before Ben [3].

Years into her marriage Sonya Carson was devastated after learning her husband had another family—that he in fact was a bigamist. The marriage deteriorated and Mr. Carson eventually left Sonya and their sons to fend for themselves. Mrs. Carson had only a third-grade education, could barely read, and had no work experience. She suffered physical as well as mental problems in the aftermath of discovering her husband’s secret, and him leaving. [4]. She would check herself into a mental institution for days at a time, leaving her sons in the care of one of her sisters and her sister’s husband.

One day life itself became too much to endure and Sonya Carson downed a bottle of prescriptions sleeping pills.  While recovering from the suicide attempt she was visited by a woman who would repeatedly speak to her about God. She also left a Bible for Mrs. Carson to read.  Slowly Mrs. Carson began to listen to the lady, and take what he said to heart.  Then one day she decided to learn to read the Bible. This determination triggered another significant attitude shift—a belief that if she could learn to read the Bible, she could do anything she set her mind to. This would be a mantra she would repeatedly instill in her sons.

Deciding to pursue her newfound Christian faith, she followed her sister and brother-in-law to the Seventh Day Adventist church, carrying her sons along with her.

Forced by lack of finances Sonya Carson packed up and took her sons to Boston, where they lived in a tenement.  In Gifted Hands Dr. Carson recalled living with roaches and rats so large they seemed to be larger than cats [5].  Poverty also caused the tiny family to rely on food stamps, a reality which, Dr. Carson would later recall,  caused him a great deal of  embarrassment, [6].

At eight years old, Ben received a chemistry set as a gift, and he spent hours playing with it, losing himself in the experiments. Also at this time he encountered his first religious experience.  The minister at his church delivered a sermon about missionaries which resonated with Ben, and he decided to become a missionary doctor [7].

The family’s financial situation improved somewhat and they moved back to Detroit.  Ben enrolled in a racially integrated school and found himself at the bottom of his class, which caused a great deal of embarrassment and shame [8]. His mother insisted that he could do better, and demanded that he and his brother read two books per week, and write a book report on each. After initial protest Ben actually began to enjoy reading, particularly science books.  Books on rocks held a   special interest and he soon began to identify rocks in his neighborhood, which was a proud accomplishment for him.

‘Obsidian’

At around this time, in the fifth grade, his school conducted a compulsory eye exam, and he discovered he required glasses. His vision significantly improved, and his love of books and learning increased.

One day in class, a teacher held up a rock and asked if anyone could identify it.  Ben identified it as ‘obsidian’ and was able to relate how it was created. The stunned expression on his classmates’ faces sealed the desire to excel in all of his studies and he was on his way to the top of the class, surpassing students who only a couple of years earlier regularly laughed at him for his customary spot at the bottom.

A few years later, after giving in to peer pressure, his grades began to slip. His mother played a pivotal role in getting him back on track, using subtle techniques to motivate him. One method was to memorize a poem entitled ‘You Have Yourself to Blame’.  Dr. Carson writes it was ‘a poem about people offering excuses for failing to do their best. ‘The bottom line was that we have only ourselves to blame. We create our own destiny by the way we do things. We have to take advantage of opportunities and be responsible for our choices’ [9].

He joined the Reserve Officers’ Training Corps (ROTC), where he excelled. His superiors recognized his intelligence and leadership skills and promoted him rapidly. His success at ROTC enabled him to receive a full scholarship to the United States Military Academy at West Point. He did not accept the scholarship. ‘I didn’t refuse the scholarship outright, but I let them know that a military career wasn’t where I saw myself going. As overjoyed as I felt to be offered such a scholarship, I wasn’t really tempted. The scholarship would have obligated me to spend four years in military service after I finished college, precluding my chances to go on to medical school. I knew my direction—I wanted to be a doctor, and nothing would divert me or stand in the way’ [10].

A Divine Gift

Ben was recruited by the top schools in the country, including Harvard and Yale.  However he applied only to Yale.  The reason being, incredibly, he had only ten dollars for a non-refundable entrance fee, which each of the top schools required with an application.  Why didn’t he simply borrow the money to apply to other schools, or ask for a waiver?  ‘[M]y mother had pushed the concept of self-reliance for so long I didn’t want to start out owing a school just to get accepted’ [11].

Ben was accepted to attend Yale University in the fall of 1969 with a 90% academic scholarship. There he met the woman who would become his wife, Lucena ‘Candy’ Rustin. He graduated from Yale in 1973 and was accepted at the University of Michigan Medical School.  He had applied to the U of M at Ann Arbor for two reasons:

‘First, the University of Michigan was in my home state, which meant much lower school expenses for the next four years. Second, U of M had the reputation of being one of the top schools in the nation’ [12].

The summer between graduation from Yale and medical school at U of M, Carson discovered he possessed a unique skill.  His mother was caring for the children of a family who owned a steel business. She was able to get her employer to offer Ben a summer job at his company. Ben learned to be a crane operator and soon discovered he possessed ‘an unusual ability‘, a ‘divine gift…of extraordinary eye and hand coordination’. He adds:

‘It is my belief that God gives us all gifts, special abilities that we have the privilege of developing to help us serve Him and humanity. And the gift of eye and hand coordination has been an invaluable asset in surgery. The gift goes beyond eye-hand coordination, encompassing the ability to understand physical relationships, to think in three dimensions. Good surgeons must understand the consequences of each action, for they’re often not able to see what’s happening on the other side of the area in which they’re actually working.’

‘[M]any doctors don’t have this natural ability, and some, including surgeons, never learn this skill…During my studies at medical school and the years afterward I realized the value of this skill. For me it is the most significant talent God has given me and the reason people sometimes say I have gifted hands’ [13].

During his clinical [third] year at the University of Michigan Medical School, doing his neurosurgery rotation, Ben found his calling.

‘[T]he first few times I looked down upon a human brain, or saw human hands working upon that center of intelligence and emotion and motion, working to help heal, I was hooked. Then realizing that my hands were steady and that I could intuitively see the effect my hands had on the brain, I knew I had found my calling. And so I made my choice that would become my career and my life’ [14].

In 1976, Ben applied for an internship at the neurosurgery program at Johns Hopkins and was accepted. He entered the internship program at Hopkins in 1977 and was a resident from 1978 to 1982. With the prodding of a colleague from Australia, Carson, together with his pregnant wife, Candy, moved to that country’s western city of Perth in June of 1983, for a year-long residency, as a ‘senior registrar’.  The reason for the move to the country ‘down under’ was to gain as much neurosurgery experience there in one year as he would obtain in five years anywhere else. And this hope was quickly fulfilled.

‘In my one year there I got so much surgical experience that my skills were honed tremendously, and I felt remarkably capable and comfortable working on the brain. Before long, the wisdom of spending a year in Australia became increasingly clear to me. Where else would I have gotten such a unique opportunity for volume surgery immediately after my residency?’ [15]

After a year he, his wife, and their baby son returned to the United States, and he continued his career at Johns Hopkins.

Surgeries

Hemispherectomy

A four year old girl, Maranda Francisco, was brought to Johns Hopkins in the hope of receiving treatment for seizures. They started when she was just eighteen months old, and by the time she arrived at Hopkins, she was suffering up to a hundred per day, on one part of her brain. She was diagnosed with a disease that caused a slow but steady inflammation of brain tissue, resulting in paralysis of one side of the body, retardation, and ultimately, death.  Dr. Carson was asked to perform a hemispherectomy—the removal of   the half of the brain that was responsible for the seizures.  According to Dr. Carson, hemispherectomies had been attempted before, in the late 1930s and ‘40s, and again in the late ‘50s, with poor results. ‘Many patients hemorrhaged to death in the operating room. Others developed hydrocephalus or were left with severe neurological damage, and either died or were rendered physically nonfunctional’ [16].

With the knowledge that without the surgery the little girl would die Dr. Carson and his team elected to operate on her. The surgery was a success.  The seizures stopped, and even though the left half of her brain—the half responsible for speech– had been removed, the little girl started to speak again.  The breakthrough operation garnered national media attention in the United States, including articles in the Washington Post [17] and the Los Angeles Times [18].

At the time of the writing of Gifted Hands, Dr. Carson recalls that, as far as he was aware, he had performed more hemispherectomies than any other practicing physician [19].

The West German Twins

Dr. Carson is perhaps best known for being the first physician to successfully separate Siamese twins joined at the back of the head. The twin boys were delivered by caesarian section in February of 1987 in West Germany. The West German doctors contacted the pediatric surgical team at Johns Hopkins and asked if they could devise a plan to separate the babies [20].

Dr. Carson likens the preparation of the surgery to that of a military operation.  The surgery would require seventy professionals altogether. Dr. Carson would do the actual separation. The very senior members of the Hopkins medical staff would play key roles in the operation, including the Director of Cardiac Surgery, an Assistant Professor of Plastic Surgery, a Pediatric Anesthesiologist, and the chairman of Neurosurgery. Altogether the team would include ‘seven pediatric anesthesiologists, five neurosurgeons, two cardiac surgeons, five plastic surgeons…and dozens of nurses and technicians’ [21]. Five months of planning went into the surgery, including five ‘three hour dress rehearsals’ using life-sized dolls attached at the head by Velcro.

Dr. Carson brings the reader into the operating room and guides him/ her, step by step, through the surgery:  cutting into the scalp to remove the bony tissue that held the two skulls together, opening the covering of the brain, untangling the venous sinuses, dealing with the bleeding, cooling their bodies down to 68 degrees Fahrenheit. (This induced-hypothermia caused metabolic activity to a near halt, and enabled the surgeons to stop the heart and blood flow for an hour.) During this time the surgeons would construct separate veins for the twins. Dr. Carson describes the point of separation:

‘…20 minutes after lowering their body temperatures…came the critical moment. With their skulls already open, I prepared to sever the thin blue main vein in the back of the twins’ heads that carried blood out of the brain. It was the last link remaining between the little boys…For the first time in their young lives, Patrick and Benjamin were living apart from each other’ [22].

It was also the first time ever that such an operation had been performed successfully.

The South African Twins

Seven years after successfully separating the West German twins, Dr. Carson was contacted by Dr. Samuel Mogkokong, professor of neurosurgery at the Medical University of Southern Africa (Medunsa). Growing up under the apartheid regime in South Africa, Dr. Mogkokong had overcome insurmountable odds. In so doing, Dr. Carson soon realized, the South African doctor had developed a kinship with him after reading about his own rise from poverty in Detroit and Boston. Moreover, Dr. Carson writes, the South African had an additional motive for separating the twins.

‘Sam also was hopeful that a successful separation of the twins would put Medunsa on the medical map. He explained that as the “black medical school” in South Africa, Medunsa had long been the stepchild of the country’s university system. Compared to the world renowned university in Capetown, where Dr. Christiaan Barnard pioneered heart-transplant surgery, Medunsa was unfairly perceived by many as a second class medical institution where black South Africans trained but had achieved little, if anything, of note.’ [23].

The two neurosurgeons soon developed a close friendship and Dr. Carson agreed to perform the operation. The surgery was scheduled for June of 1994, after an initial delay due to the girls’ illness. However, their condition deteriorated so much that the medical team felt that separation was the only hope of the babies’ survival. New equipment was purchased specifically for the surgery—ventilators, surgical tools, and monitors for the anesthesiologists and cardiovascular surgeons. The surgical team consisted of surgeons from Medunsa as well as a neurosurgeon from the hospital in Soweto. Unfortunately the smaller of the twins died on the operating table, and the second died a few days later. Dr. Carson describes the autopsies in this way:

‘It turns out these twins had been completely symbiotic and were only able to survive as long as they had because they had been joined together. As they had grown, the one with the cardiac function did not have the ability to provide adequate circulation for both. That is why their condition had deteriorated so much in the weeks prior to surgery’ [24].

The Zambian Twins

Two and a half years later, Dr. Mogkokong called again and asked him to consider undertaking another operation. Joseph and Luka Banda, from the central African country of Zambia, were Siamese twins joined the entire width and length of the tops of their heads [25]. Dr. Carson now had the benefit of a 3-D imaging machine, which allowed him to ‘see’ into the twins’ heads, and practice the operation in virtual space. The net benefit of this resource was knowledge. ‘This time I at least had a detailed road map to study before I got there. In fact, I felt almost as if I had successfully performed the operation already’ [26]. Together with a team that included Dr. Mogkokong, and a neurosurgeon from Zambia who was also the twins’ primary physician, the surgery took place in December of 1997. The twenty-eight hour surgery was a success. The twins not only survived but began to crawl a mere two weeks after the operation [27].

The Iranian Twins

In 2003 Dr. Carson was faced with another groundbreaking surgery—separating adult twins joined at the head, a surgery that had never been attempted before. Ladan and Laleh Bijani were Iranian young women who vowed that they would rather die than ‘spend another day together’.  According to Biography.com, Dr. Carson and a team of over 100 surgeons, specialists and assistants traveled to Singapore.  On July 6^th of 2003 Dr. Carson and his team began the surgery, which would eventually span almost 52 hours. The surgery revealed that the brains had fused together and shared a major blood vessel.  The surgery was completed at 1:30 pm on July 8^th. Unfortunately an hour after the surgery was completed Ladan died from complications, and three hours later her sister died as well [28].

Intrauterine Surgery

A woman was pregnant with twins, one of whom had ‘severe’ hydrocephalus –a condition in which fluid accumulates in the brain, enlarging the head. The condition would eventually put the mother into premature labour and kill both twins.  Inducing the babies was not an option–doing so would have killed them since their lungs were not sufficiently developed. At the time this type of intrauterine surgery was only in an experimental phase, being practiced on sheep. Dr. Carson and his team nonetheless went ahead with the surgery, inserting a shunt into the twin’s brain to drain the cerebrospinal fluid out.  The surgery was a success, with both twins surviving without any ill effects [29].

Brain Stem Tumors

Injuring the brain stem will result in paralysis. Surgeons do not operate in this area, simply because the risks are too great.  A video from U.S. News and World Report and Johns Hopkins University showcases one of Dr. Carson’s cases. It is the story of a young family with a daughter who had a slow growing tumor located next to the brain stem, an area where other doctors refused to operate. With a gentle smile the mother says that there was no other institution, or doctor, that she would have operate on her child [30].

Legal Action

Before his retirement in 2013 Dr. Carson had been practicing neurosurgery for over thirty years, and by some accounts had performed over 15,000 operations.   Since announcing his plans to seek the Republican nomination for the U.S. Presidency reports have surfaced that he has been involved in six lawsuits, some of which are still pending [31].

Wrap Up

Reading through the various books by Dr. Carson, several images come to mind.  The first, for me at least, is fearlessness. Time and again Dr. Carson has performed surgeries, utilizing innovation, knowledge and wisdom to perform medical miracles that had never been done before:

• Developing a brain surgery technique while still only a medical student [32]
• Making hemispherectomies more commonplace—hemispherectomies being a procedure that had never been put into popular practice
• Separating twins joined at the back of the head, where the extensive mass of blood vessels had fostered the belief that that type of surgery was practically impossible
• Utilizing a brand new 3-D imaging device to practice operating on twins joined the length and width of the top of their heads, prior to performing the actual surgery

Dr. Carson has demonstrated extraordinary courage and confidence in utilizing procedures that were not only innovative but ground-breaking. Where does this come from? Several answers come to mind.

Wisdom. Dr. Carson’s often refers to the book of Proverbs in the Old Testament, which is filled with nuggets of wisdom.  He suggests that God must have been smiling when he was born. His parents chose Solomon as his middle name–and ‘Solomon’ happens to be the author of the book of Proverbs. It’s ironic that the Biblical Solomon is famous for threatening to cut a baby in the middle and give each half to one of two women, each of whom claimed that the child was theirs. Centuries later, Dr. Benjamin Solomon Carson would become famous for separating babies joined at the head.

Intelligence.  As a child, as a student, as a physician, his keen intellect was and is clearly apparent. He was consistently at the top of his class in high school, was accepted to an Ivy League university, and accepted to practice medicine at one of the most prestigious hospitals in the United States.

Prayer.  Dr. Carson relates instance when, faced with a hopeless situation, he resorts to the only thing that he can do: pray.  From locking himself in the bathroom and praying, after almost killing a young man when a teenager, to the most difficult surgeries where he asks his patients’ families to pray [33], it is clear from his writings that prayer is a fundamental part of who he is.

Independent thinking. It is clear that Dr. Carson does not feel bound to follow the crowd.  He assesses a situation from his own perspective, and arrives at a solution that is his own. He is not bound by convention, by history, or by what was done before.  This is evident from his medical practice, and is becoming clearer in his political aspirations.

This incredible package of assets has enabled the doctor to be recognized as one of the best in his field. He has garnered numerous honours including sixty-seven honorary doctorates, the Spingarn Medal–the highest honour bestowed by the NAACP, The Congressional Medal of Freedom–the U.S. highest civilian honour.  [34]. And he has been twice invited to deliver the keynote speech at the National Prayer Breakfast.

Next month, Dr. Ben Carson, Presidential Candidate. Ideas on society, politics, a vision for his country’s future, and controversial comments.

Notes

[1] Youtube.com, accessed October 29, 2015 https://www.youtube.com/watch?v=83IiLN_EaF4

[2] Youtube.com, accessed October 29, 2015 https://www.youtube.com/watch?v=ulsA8aFOkRs

[3] Ben Carson, M.D., Cecil Murphy, Think Big, (Zondervan Publishing House, 1996) p34

[4] Carson, M.D., Cecil Murphy, Think Big, p37.

[5] Ben Carson, M.D., Cecil Murphey, Gifted Hands (Zondervan Publishing House, 1991)   p23

[6] Carson, Gifted Hands, p47.

[7] Carson and Murphy, Gifted Hands, p27

[8] Carson and Murphy, Gifted Hands, p30

[9] Carson and Murphy, Gifted Hands, p65

[10] Carson and Murphy, Gifted Hands, p68

[11] Carson and Murphy, Gifted Hands, p78

[12] Carson and Murphy, Gifted Hands, p108

[13] Carson and Murphy, Gifted Hands, pp 109-110

[14] Carson and Murphy, Gifted Hands, p116

[15] Carson and Murphy, Gifted Hands, p141

[16] Carson and Murphy, Gifted Hands, p153

[17]WahingtonPost.com archives, accessed October 29, 2015 https://www.washingtonpost.com/archive/lifestyle/wellness/1985/09/25/maranda-story/9fd00018-2536-4a6c-b5f1-0b03e12e1a23/

[18] LATimes.com, accessed October 29, 2015 http://articles.latimes.com/1987-11-26/news/vw-24835_1_seizure-disorder/2

[19] Carson and Murphy, Gifted Hands, p162

[20] Carson and Murphy, Gifted Hands, p203.

[21] Carson and Murphy, Gifted Hands, p204

[22] Carson and Murphy, Gifted Hands, p208

[23] Ben Carson, M.D., and Gregg Lewis, The Big Picture (Zondervan Publishing House, 1999), p16

[24] Carson and Lewis, The Big Picture, p24

[25] Carson and Lewis, The Big Picture, p28

[26] Carson and Lewis, The Big Picture, p32

[27] Carson and Lewis, The Big Picture, p44

[28] Biography.com, accessed October 19, 2015 http://www.biography.com/people/ben-carson-475422#beginning-surgical-career ]

[29] BenCarson.com, accessed October 29, 2015, https://www.bencarson.com/news/video/ben-speaks-at-women-betrayed-rally-in-washington

[30]HopkinsMedicine.org, accessed October 29, 2015 http://www.hopkinsmedicine.org/neurology_neurosurgery/news/videos/ben-carson-brain-tumor-surgery-video.html

[31] TheGuardian.com, accessed October 29, 2015   http://www.theguardian.com/us-news/2015/may/04/ben-carson-malpractice-claims-doctor-for-president

[32] Carson and Murphy, Gifted Hands, p113

[33]Youtube.com, accessed October 29, 2015 https://www.youtube.com/watch?v=7QQBj2EucZk

[34] BenCarson.com, accessed October 29, 2015https://www.bencarson.com/meet-ben

Bibliography

Ben Carson, M.D., Cecil Murphy, Think Big, (Zondervan Publishing House, 1996)

Ben Carson, M.D., Cecil Murphey, Gifted Hands (Zondervan Publishing House, 1991)

Ben Carson, M.D, and Gregg Lewis, The Big Picture (Zondervan Publishing House, 1999)

Links

https://www.youtube.com/watch?v=83IiLN_EaF4

https://www.youtube.com/watch?v=ulsA8aFOkRs

https://www.washingtonpost.com/archive/lifestyle/wellness/1985/09/25/maranda-story/9fd00018-2536-4a6c-b5f1-0b03e12e1a23/

http://articles.latimes.com/1987-11-26/news/vw-24835_1_seizure-disorder/2

http://www.biography.com/people/ben-carson-475422#beginning-surgical-career ]

https://www.bencarson.com/news/video/ben-speaks-at-women-betrayed-rally-in-washington

http://www.hopkinsmedicine.org/neurology_neurosurgery/news/videos/ben-carson-brain-tumor-surgery-video.html

http://www.theguardian.com/us-news/2015/may/04/ben-carson-malpractice-claims-doctor-for-president

https://www.youtube.com/watch?v=7QQBj2EucZk

https://www.bencarson.com/meet-ben

Copyright © Weldon Turner, 2015. All Rights Reserved.