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I do some consulting work on american in

the room was column that was saved or

that what about the shaolin semantically

laughing for a community trying to becca

bernie doing in autism his life is the

stuff of movies in fact one was made

about him gifted hands the ben carson

story tells how a hot tempered

inner-city kid from a broken home

overcomes all odds to become a renowned

pediatric neurosurgeon in 1987 he made

medical history when he separated

conjoined twins joined at the head now

the director of pediatric neurosurgery

at Johns Hopkins Children's Center and

2008 Presidential Medal of Freedom

winner he dedicates his spare time to

cultivating Future Leaders we talked

with Carson about his work and

philanthropy his thoughts on health care

reform and about what's still on his

to-do list here's our conversation with

dr. ben Carson dr. ben Carson welcome to

the conversation thank you

among other things you focus your

practice on traumatic brain injuries

brain and spinal cord tumors

neurological and congenital disorders

including separating conjoined twins and

trigeminal neuralgia which is sometimes

referred to as the suicide disease

because it's so painful wide neurology

and why specifically pediatric neurology

well you know I always was interested in

medicine it was the only thing that

interested me as a kid and you know when

I entered college I thought I was going

to be a psychiatrist when I entered

medical school I thought I was going to

be a psychiatrist so I I loved the brain

and as time went on I realized I loved

the tangible aspects of the brain even

more than I did the intangible aspects

and also that that was where my talents

were you know I had a great deal of I

hand coordination the ability to think

in three dimensions I was a very careful

person ever knock things over and said

oops

which is a great characteristic for a

brain surgeon by the way so all of those

things seem to be pointing me in that

direction and I started out as an adult

neurosurgeon but

I developed an affinity for the kits

because you know what kids what you see

is what you get when they feel good you

know they feel good when they feel bad

you know they feel bad and you can spend

enormous amounts of time operating on a

kid and if you're successful your reward

may be 40 50 60 years of life you don't

get that with adults oh I get a big

return on my investment

now not that long ago your caseload was

as many as 500 surgeries a year you've

cut back in recent years that was twice

the caseload of the typical neurosurgeon

why so many well for one thing it's

because I was pediatric neurosurgery at

Johns Hopkins and you were it I was it

and now you know there are four of us so

which is good because I was I was

working way too hard there's no question

about it but you know I still do plenty

and have an opportunity to be involved

and a lot more not only in our surgical

cases but other outside activities which

is wonderful

what's plenty by the way I just put a

number on it yeah I still do 300 350

cases a year now

this is coming from someone who

describes himself as a hot-tempered kid

growing up in a single-parent family and

inner city Detroit you became the the

chief of pediatric neurosurgery at John

Hopkins at the age of 33 which I think

would have been remarkable for anyone

but especially remarkable for someone

who came from your background how did

you do it well I had help but you know

one of the things that I think my mother

instilled in me and my brother was a

sense of responsibility

she had a incredibly difficult life

herself you know one of 24 children got

married when she was 13 found out her

husband was a bigamist had only a

third-grade education but she never

became a victim and she never felt sorry

for herself and she never felt sorry for

us and she never let us feel sorry

since she always said you know do you

have a brain if you have a brain then

you're fine

it doesn't really matter what's going on

out there and you can deal with it and

so were there obstacles along the way

absolutely were there people telling me

you can't do this of course they were

did I listen to them of course not you

described it as the no excuses household

which i think is absolutely remarkable

that your mother as you said with the

third grade education had the wisdom yes

to require the kinds of things that she

did from you and your brother right and

and that was it you know she was a good

observer and because she worked as a

domestic cleaning other people's houses

and she would work two or three jobs at

the time because she didn't want to be

on welfare because she noticed that she

never saw anybody go on welfare and come

off of it and she didn't want that life

for her or for her or for us but she

would observe in those homes of very

successful people what they did and then

she would bring that home what they did

was read right she was working in homes

where there were lots of books there are

lots of books they read they plan they

strategize

they had vast amounts of knowledge about

all kinds of things they didn't sit

around watching TV all day drinking and

playing games and she said that's what

people do in our neighborhood and then

she would take us to the places where

she worked and she would say now you

have a choice you can do what people do

in our neighborhood and you can stay

there or you can do it people doing this

neighborhood and you can go there you

said that growing up you hated your

neighborhood you hated the environment

you were angry but you knew at some

point this is temporary right well it's

once I started doing a lot of reading I

stopped hating poverty quite as much

because I knew by reading stories of

people like Booker T Washington who was

born a slave it was illegal to read but

he taught himself to read anyway read

everything in sight became an advisor

the president

and I began to realize that the person

who has the most to do with you is you

it's not the environment and it's not

somebody else

and as I begin to understand that I

realized that I didn't have to remain in

that neighborhood I didn't have to

remain in that state that I could change

it to whatever I wanted it to be and at

that point it didn't bother me anymore

because I knew it was temporary but here

you were a kid you weren't on welfare

but your family did use medical

assistance and and you recall times when

you would sit in the waiting room in the

hall waiting for your turn but you loved

that environment you did you despite the

fact that you didn't weren't necessarily

showing that you had what it took to

become a neurosurgeon as a young kid you

loved that environment well I loved the

hospital environment and you know

sitting in the hallways and listening to

the PA system it was just exciting to me

it was thrilling seeing doctors walking

by with charts with their stethoscopes

around their neck and hearing them being

paged all that just excited me and I

just said yeah this is this is where I

belong so you had to imagine yourself

there even when as a young child you say

you were considered the class dummy you

even used to say to your mother I'm not

smart right well you know I was I was

like a lot of kids are you know you ask

him what do you want to do what do you

want to be and they'll say oh I've been

astronaut I want to be you know this or

that or the other but you look at their

list of achievements and they're not

very impressive but somehow they think

magically it's going to happen well I

was the same way but in my case

magically it did happen but it wasn't

really magic it was a lot of work behind

that's right in fact preparation you you

underscore the importance of preparation

and it's absolutely critical in what you

do I'm thinking of especially in your

early days separating conjoined twins

conjoined twins who were who were joined

at the head in a first time ever surgery

that required a team of 77

personnel and 22 hours on your feet what

kind of preparation goes into that well

first of all these were occipital

cranial pay Gaston at the back of the

head and none of those had ever been

successfully separated before because

they share all the major blood drainage

systems of the brain and so they tend to

exsanguinate or bleed to death and so

obviously I did a lot of studying about

not only those kinds of twins but other

kinds of twins because there have been

some other types of twins that had been

successfully separated and then thinking

about some of the techniques that we

used in craniofacial surgery talking to

some of the cardiovascular surgeons

about ways to stop blood flow and this

putting all that together into a plan so

and it was very much like what I had

done for a number of other complex types

of cases I was at that point in my

career doing all kinds of pretty amazing

things that most people wouldn't do and

it wasn't because I would do anything it

was because I had a lot of people around

me who were brilliant and I was taking

advantage of I would pick their brains

I'd say well what do you think about

this and find out you know you can you

can make a lot of progress if you you

know walk on the back of people who've

already made some progress and you just

keep putting all those little stones

together and pretty soon you make a

bridge it is interesting though that

many of your most pioneering

accomplishments happened very early in

your career yes

is that typical or or I mean is that is

that youth and boldness well well

actually if you stop and you think about

it you look at people for instance who

went nobel prizes in science and

mathematics they usually don't get them

until they're in their fifties or

sixties but it's for work they did when

they were in their 20s and 30s you know

this this that the most productive part

of your life because you get lots

energy and you know like boundless

enthusiasm now you know if I were

starting out today at age 58 there's no

way I would do it faster I mean I don't

have the energy to do that anymore or

the desire quite frankly but you know

then it is very very exciting and and

that's why I tell young people all the

time I said now is the time I said don't

be sitting around thinking oil in ten

years I'll do this and then 15 you don't

do that now is the time prepare yourself

use that enthusiasm use that energy

focus on stuff make it happen you know

look at Bill Gates

you know stuff that he did did that ends

20s and a lot of other people Steve Jobs

all of those people even though that you

know they're sitting pretty right now

they did that stuff when they were in

their 20s so that's a good time to to

use that energy effectively well what

does that say to a physician I hope they

won't mind if I say I think you're 58

years old 18 percent of the of the

practicing physicians in this country 18

or 19 percent are 65 or older and they

do have a different view in fact many of

them are retiring and in something like

neurosurgery which requires stamina and

and an unbelievable I hand coordination

what does that mean well they tend to

retire earlier it used to be that

neurosurgeon is retired generally around

65 now it's about ten years earlier than

that not so much that there's been a

decrement and their abilities as it is

it's very difficult particularly in

private practice now to be able to pay

the malpractice premiums so you're the

second most sued specialty it's that

right you're a surgeon see the first or

second it's neurosurgery and OB and

people used to start slowing down when

they hit about 50 and then I kind of

take it easy over the next 10 to 15

years before they fully retire and now

you can't do that because if you've got

to pay these enormous malpractice

premiums you just can't slow

so it there comes a point when you're

you know fifty-five or so you say you

know I can keep working like a madman or

I can retire a lot of people are

choosing to retire there are some

studies that suggest that that slowing

down actually may be worse for an aging

surgeon or physician well there are some

studies that indicate everything but but

the fact of the matter is we are losing

some some tremendous talent earlier than

we should be losing it there's no

question about that and it's something

that you know as a society we really do

need to deal with it that brings us to

to healthcare I know when when Hillary

Clinton devised health care reform you

weren't a fan I'd like to know why and

what you would describe as critical

ingredients to real health care reform

yeah well you know the key thing is I

don't know anybody who doesn't think

health care reform shouldn't be done it

is absolutely crucial and it should be

available to everybody and the costs

should be reasonable now having said

that the question is how do we get there

we certainly don't get there by throwing

more money at the problem

we already spend more than twice as much

per capita on health care as the next

closest nation in the world so what that

tells me is that we're plenty plenty of

money into the system we're just not

using it very efficiently as I like to

say there are too many hogs feeding at

the trough of the healthcare dollar so

what I would suggest you know rather

than spending a lot of time criticizing

what other people have suggested is I

would suggest some real measures to get

cost under control such as you know

billing and collections you know we

spent enormous amounts that most

practices spent somewhere between 20 and

30 percent on billing and collections

and it's not necessary because every

single diagnosis has something known as

the icd-9 code every procedure has

something known as a CPT code and we

have computers which means all billing

and collection can be done

instantaneously electronically without

generating all those mountains of papers

and armies of people to push them around

completely unnecessary at a fraction of

the cost now you know some insurance

companies and others would say well if

it were that easy then a healthcare

practitioner could simply say well I did

two appendectomy

let me just enter that when they only

did one and get paid twice and who would

know the difference well first of all

there are very few people that I've ever

met who would even and consider such a

thing I mean that's ridiculous but there

are some the solution to that is not to

build a gigantic bureaucracy that's very

costly the solution is what I call the

Saudi Arabians solution why don't people

still in Saudi Arabia you cut their hair

no you're not serious

well I wouldn't cut their hand okay but

there would be some real teeth and the

punishment you know you'd lose your

license to practice forever that's not

what happens now yeah you go to jail for

no less than ten years and you would

lose all your personal assets not only

with no one cheat but everybody would

check every bill seven ways to Sunday to

make sure it was correct it would not be

an issue it's sort of like you know why

don't people drive drunk and Sweden they

like alcohol just as much as we do

but the penalties for drunk driving are

so severe that it's part of the culture

you wouldn't even think about and that's

the same thing that would happen they're

so not big bureaucracy just real teeth

and the rules that would reduce the cost

dramatically the other thing that would

reduce it dramatically is making the

government responsible for catastrophic

health care now you know a lot of people

say oh the government should amuse both

way they can't do anything right but

that's not exactly true government has

done a number of things that have helped

all of us for instance the reason we can

on our home homes is because we have

homeowners insurance now we wouldn't be

able to get homeowners insurance if

there were no government agency known as

FEMA but because your insurance company

would say well there may be a hurricane

it may be earthquake there may be this

that the other so we have to be prepared

for all those things and their premiums

would just skyrocket and you'd have to

have that through your employer - well

it's the same kind of analogy with

health care if government is responsible

for catastrophic health care and

insurance companies are owned

responsible for routine health care now

it's going to be pretty easy to predict

what they're going to have to put out

and what they need to take in and they

can be regulated just like the utilities

are regulated if we didn't regulate

utilities I guarantee you they'd be fine

all kind of reasons why the cost of your

watering electricity should be a lot

more than it is this deregulation a lot

of states exactly what will happen but

that that would again dramatically

reduce the cost and the ideal would be

to get the cost down to the point where

people could afford their own insurance

they wouldn't have to have it to their

employer and that's going to do wonders

for job creation by the way but but also

if you own your own health insurance I

can say to you if you get an annual

physical exam you get a two to three

percent discount so you're incentivized

to get that annual exam we catch stuff

early a whole nother level of savings we

need to start talking about wellness and

preventive care this is where we're

really going to save enormous amounts of

money and then what about the 47 million

people who don't have health insurance

or the forty or the 30 of the 15 or 12

or whatever number that's you know first

of all they don't exist because they can

go to the emergency room where they have

to be taken care of it calls five times

more to take care of them there than it

would in the clinic so what we should be

saying is what we're paying for them

anyway but we're paying premium dollars

so let's figure out a way to pay for

them with economical dollars let's find

a way to encourage them to go to the

clinic rather than to the emergency room

and well I would

use again another government program as

an example the food stamp program why

don't people starve to death in this

country because we have a food stamp

program they get a monthly allocation

and they learn very quickly not to go

out the first five days and buy

porterhouse steak they learn to you know

proportion things out over the course of

the month people would do the same thing

if we had an electronic health account

that was replaced each month now a mr.

Brown gets that diabetic foot ulcer

instead of going to the emergency room

he's going to go to the clinic because

you don't want to blow half of his

budget that one night and you know he

gets the same treatment in both places

but the difference is in the emergency

room they patch him up and send them out

and that's it that's until the next

until he comes back and in the clinic

they patch them up and they say now let

mr. brown let's get your diabetes under

control so you're not back here in three

weeks with another problem a whole

nother level of savings these are

intelligent and logical ways to get the

cost down and to to create the kind of

environment that will allow everybody to

have you know excellent healthcare and

in a system that by the way is second to

none what we have to do is just apply a

little logic to the system and the

reason a lot of these things aren't

being done the very things that I'm

talking about they're very logical

anybody can understand it they would

make sense anything that's done that

comes out of Washington that doesn't

make sense it's because of the fourth

branch of government which is special

interest groups which has really become

the most powerful and when you really

want to stop and think about it how did

they become so powerful it's because

believe it or not we distorted what was

a extraordinarily good system that was

set up by our founding fathers a

representative government they planned

it so that teachers janitors dog

catchers pharmacists nurses would go to

Congress as representatives of their

communities

for a couple of years making sure that

their constituency was heard and then go

back and somebody else would come and

then somebody else would come but now

now we've created a situation where you

give these lifetime politicians and of

course they're worried about getting

reelected every couple of years which

makes the special interest groups

incredibly important so we're we've kind

of distorted the plan and that's why

we're suffering the consequences now you

have obviously a can-do attitude but I'm

wondering how optimistic you are that

the kind of health care that you've

described or something even comparable

could pass oh I know I know it could

pass the problem is getting it out there

and you know the establishment it isn't

all that interested to be honest with

you in alternatives and I have found

that out they're just not that

interested in them and you know I guess

so it status quo yeah I guess what you'd

have to do is almost declare yourself a

candidate and run and which I'm not

particularly interested in doing but one

of the things that that I've noticed and

studying our government and our

government structure is that they are

deathly afraid of real change I know for

instance the current president ran on

change and people actually do want

change but as you can see nothing has

changed and nothing will because do you

know whether it's Democrat or whether

it's Republican you know there's a

certain order of things and a certain

way that things are done that serves

their purposes and not necessarily the

purposes of the people I had a little

glimmer of you you thought about

politics well many people have told me

that I really should do it but you know

the thing that really is most

important to me right now is is working

with the next generation and getting

them prepared and and maybe creating the

right kind of leadership out of them and

one of the things I know is that if I go

into the political arena I automatically

will eliminate half of my audience from

one side or the other side so and you

know that won't work well for the kids

and the kids are an enormous focus of

your energies these days there's the

Carson scholars the angels of the o.r

tell us first about Carson scholars

which is now in what 32 states 34 34

states yes well you know some years ago

I was reading a statistic looking at the

ability of our eighth grade equivalence

to solve math and science problems there

were 22 countries involved and we ranked

number 21 out of 22 did they did they

calculate it the same way we do though

yes yes it was standardized and my wife

and I became very alarmed and we said

what what does this mean for the future

of our nation and we said we have to do

something about this so we started

giving up $1000 scholarships to students

starting in the fourth grade initially

we just paid out of our own pocket who

demonstrated tremendous academic prowess

and also humanitarian qualities they had

to show they cared about other people

because we don't want people who are

just smart but selfish because that's

how we got in the mess we are and now

and you know we try to put them on the

same kind of pedestal as we did all

state basketball players and they all

state wrestlers because those are the

people who get all the attention in our

schools the the smart kids are you know

they're nerds and Geeks and nobody gives

two hoots and a holler about them so not

only there's a school get a big trophy

that goes out with all the other sports

trophies but the kid gets to wear a

medal

they go to a banquet they get local

press attention and

and it makes a huge difference and we

started at giving out scholarships 14

years ago we get about 25 scholarships

in Baltimore and of course it's grown

very rapidly and now as you mentioned

we're in 34 states with almost 4,000

scholars and continuing to rapidly

expand now these kids can can earn $1000

scholarship they can they can earn one

from fourth grade through 12th grade

so by the time they're ready for college

there's some money there it's

interesting that you are focusing on 4th

graders because so many other

scholarship programs they focus in on

juniors and seniors right and the reason

for that is because you know it's like a

road and it begins to diverge and we

find that fourth fifth grade that's

about where the divergence starts so you

know if you're trying to reach them at a

time they've got in high school you've

already missed the boat and in half the

cases and you know this is so incredibly

important because we have got to vastly

increase the pool of academically

competent people you know we produce

60,000 engineers a year

40% of whom are foreigners China

produces 392,000 engineers a year and

this is the technological age the

Information Age we're going to fall so

far behind we were going to be totally

incapable of competing in the future and

I think we have maybe one more

generation to fix this problem one of

the things that your scholarship focuses

on is also creating Reading Room's

reading was was really your lifeline it

broadened your horizons it allowed you

to escape and we should mention that

your mother required that you turn off

the TV and that you read two books a

week and actually submit a report to her

at a time one when she couldn't read

your report that's correct

um so tell us about these reading rooms

and why that's so important well first

of all most people would be shocked to

learn that a large number if not most

elementary and middle schools don't even

have a library and I was shocked when I

found that out so we started putting in

these reading rooms and they're

incredible places almost no little kid

would pass it by decorated very fancy

with whimsical characters on the wall

and beanbags

seats and incredible books very

interesting books and the kids get

points for the amount of time they spent

in the reading room and for the number

of books that they read they save them

like S&H Green Stamps and they can trade

them in for prizes and things in the

beginning they do it for the prizes but

I got to tell you it doesn't take very

long before they really began to

understand how enjoyable reading is and

that translates into much better

academic performance and also bear in

mind that seventy to eighty percent of

high school dropouts are functionally

illiterate so if we can truncate that

problem early on then we're going to

have a lot more people graduating from

high school and a lot more people going

into college and that's what we need to

do we need to backfill that that great

void in order to be able to compete into

the future you know I had dinner my wife

and I with Craig Barrett some years ago

who is the chairman of Intel and he said

they have to import almost all of their

technological help from outside of this

country because we don't produce enough

people to do it

that was a very alarming statement and

so you know we're working in several

different venues right now trying to

work with the YMCA's and Boys and Girls

Clubs to to figure out ways that we can

create programs there for those 13 and a

half million students who frequent those

places after school instead of just arts

and crafts and sports maybe some real

interesting science and math project

you're the poster child for not enough

hours in the day how do you maintain

your practice your family you have a

wife and three children with the

philanthropy well you know I always say

if you need to have something done you

have

somebody who's busy to do it because

people who are not busy never have time

to do anything because it takes them all

day to do nothing but also you know I've

been extraordinarily fortunate to have

wonderful people around me and that

helps enormous ly to have someone

trustworthy

who's effective you know I have a

wonderful wife of 34 years who helps me

enormous Lee my senior physician

assistant Carol James has been with me

my entire career Wow

she started when I was chief resident

and joined me when I became a faculty

member has been with me from day one you

know my office manager Audrey Jones many

many years with me other secretarial

staff have been with me for even longer

so and my colleagues I have some of the

most wonderful colleagues imaginable you

know when I say I need to go on Tuesday

to Penn State no problem

come free no matter where no matter what

time no matter how many times you no

problem we're happy to take care of it

and you know they're just excellent so I

don't have to worry about any decreased

you know capability in terms of taking

care of complex problems so all of those

things make it possible for me to do

some of the other things I did know you

mentioned your wife kandi you met her

when you were at Yale she's an

accomplished musician and and music

classical music is an important really

important part of your life yes um you

were turned on to classical music as a

teenager which i think is pretty

incredible for a kid growing up an inner

city Detroit but tell us about classical

music and your well the reason I became

interested in it is because I wanted to

be a contestant on GE college ball and

you know not only did they ask questions

about science and math and history and

geography but they also ask questions

about classical art and classical music

and there I was in inner-city high

school in Detroit and

I knew the answers about the other stuff

but it no idea who you know peter paul

rubens ergo again or Telamon or all

these people and so I just said I gotta

learn this stuff myself so I was always

listening to classical music because I

had to get to the point where I could

identify a piece in just a few seconds

because I wanted to be a contestant on

the program I only play a couple of bars

so that's that's really how I got

interested in it and it even had a huge

impact on on the college that I intended

because I had enough money to apply to

one college and I said I'm going to

apply to the college that wins a Grand

Championship in college ball and that

year the Grand Championship was between

Harvard and Yale and and yelled

demolished Harvard so I applied to Yale

and fortunately they accepted me with

the scholarship I you know I was kind

young and naive I had no idea how

foolish it was just to apply to one

college in Tibet to be yeah but you know

it all worked out and of course even

even you know Matt getting together with

my wife turned out to hinge on you know

the music the music connection and there

was a music connection even in your

acceptance into a highly prestigious

residency program that's right that was

you were one of a hundred and fifty

three candidates 125 candidates and they

took two a year and at Hopkins and I

want to go to Hopkins because that was a

place that was best known for

neurosurgery but the odds of getting in

obviously were slim but when I went for

my interview a guy dr. Hoover High who

was in charge of the residency program

was also in charge of Cultural Affairs

at the hospital and after we talked for

a while somehow we started talking about

class come is it can we talk for over an

hour about different composers

conductors their styles orchestras

orchestral halls he was on cloud nine

and there was no way he wasn't broken in

the program could be had there somebody

discussed this with it and I'd love to

tell young people that there's no such

thing as useless knowledge because you

you don't know when it's going to open

up doors for

and you know when I was learning all

that stuff you know black kid and Motown

listening to Mozart kids thought I was

nuts but you know I always say the more

you know the more valuable you become

and the more doors it can open up for

you and some people said but you

overload your brain you keep what I can

tell you as a brain surgeon you cannot

overload your brain it is impossible the

average human brain could contain all

the knowledge and every volume that was

ever written in the history of the world

and have plenty of room left over so you

just can't do it so really just drop

that one off the table in terms of worry

do you listen to classical music in the

Ennio are I do all the residents know

when they come to pediatric neurosurgery

that they're going to get asked about

classical music as well as about the

function of the medial longitudinal

fasciculus tell us about the brain

because you are still obviously in awe

of the brain this this thing that is is

considered to be more complex than any

natural or artificial thing on earth

well you know the human brain

you know billions and billions of

neurons I mean if you start it from as

soon as you learn how to count until you

die counting the neurons you wouldn't

even get close to the number of neurons

that we have hundreds of billions of

interconnections it can calculate and

process more than two million bits of

information in one second it remembers

everything you've ever seen and

everything you've ever heard it is the

source of creation of all the things

that we marvel at the computers the

television cameras the Space Shuttle all

that comes from the human brain so you

know when when people start talking

about what they can't do they really are

not thinking about what they really have

between their ears and every time I look

at that thing

I'm so impressed you know I was asked by

an NPR correspondent not too long ago

she's at dr. Carson I know this that you

don't talk much about race why is that

and I said it's because I'm a

neurosurgeon and she gave me a quizzical

look and I said you see when I go into

the operating room and I peel back that

scalp and I take off that skull I'm

actually working on a thing that makes

that person who they are I say the

covering really isn't that important the

brain is what makes us who we are and

yet people always refer to you as the

first black neurosurgeon to do this or

do that and in many cases you were the

first neurosurgeon period to do things

and most of the cases where dictum Brown

breaking things yeah has nothing to do

it race and you know I don't know why

people get so fixated on things that

don't make a difference you know what I

always say is I believe that we had a

wonderful creator who gave us variety I

said can you imagine how horrible and

how boring it would be if everybody

looked exactly like you

so you know that's a good thing but

certainly not a thing to spend so much

time and energy on and one of the great

examples I like to give its ants I say

who always comes to a party uninvited

ants you got a group of black ants group

of red ants and it's good they're there

because they need to clean up all those

those crumbs but they see each other and

what do they do they fight why because

one's red and ones black now have you

ever done a craniotomy on an ant

take an INT put his head under a

dissecting microscope you've done will

open it up and look for his brain you're

gonna be looking for a long time that's

their excuse what's your Excuse

you I want to get back for a moment to

to the fact that you specialize you you

are a pediatric neurosurgeon we're

talking about very small brains and part

of I think aside from the fact that that

the results of your success can be 40 or

50 years there's a plasticity you talk

about too young brain so you can even

remove half of a brain literally exactly

and this person becomes a functioning

human being and and and that's because

the immature brain has many neurons that

haven't quite differentiated or decided

what they want to do when they grow up

yet and they can be recruited to do

other things so you can recruit many of

the cells on the opposite side of the

brain to take over the function of the

removed side or the severely damaged

side but that only happens up to a

certain age so that doesn't work in the

mature brain and in the adult brain

that's one of the things that attracted

me to Pediatrics you could do some

rather unique and radical things to

solve some unique and radical problems

that you would not be able to do with

adults but as as we learn more and we

study more about plasticity and

particularly as we begin to understand

how to use stem cells in an appropriate

way there will be ways in the future

that we can bring plasticity to adult so

an adult who's had a stroke who's had a

severe traumatic brain injury or spinal

cord injury I have no doubt that in the

future we will be able to restore that

function some say that we are

approaching the study of the brain the

way we have approached learning about

the universe and I'm wondering are there

things on the horizon in terms of some

of the diseases and and tumors and

problems that you work on that you see

light at the end of the tunnel you see

an answer a real answer absolutely you

know I've I've been in neurosurgery now

for 32 years a long time and it's a very

different specialty now than it was when

I started
and thirty years from now it will be

completely different than it is now you

know you you look at some of the imaging

capabilities that we have now which

allow us to pinpoint precise areas of

the brain and look at the metabolic

activity that is going on in that area

of the brain and use an external source

of energy to ablate or to destroy an

area that needs to be removed without

actually cutting into a person you know

these kinds of things are in their

infancy you know it reminds me of the

Star Trek episode with the whales I

think it was Star Trek 3 and they found

a human skull you know from the 1990s

and it had evidence of a craniotomy and

they were saying can you believe those

barbarians back in those days what they

used to do well you know we are

approaching those kinds of things you

look at the the various things that can

be done with an endoscope with something

you know no no bigger than a pencil or

less that can be placed into cavities in

the brain to look around inside to

remove tissue to coagulate abnormal

vessels to do a whole host of things to

divert flew it to another area these

these are just amazing things and that's

not to say that there aren't still

primitive tools in your toolkit drills

and saws and things that absolutely

would make most people shudder well it

is kind of funny I remember once there

was a Reader's Digest reporter who

wanted to come to the operating room and

I said are you sure you're going to be

ok I was in Vietnam and you know took a

drill and started drilling into the head

and next thing we know but he was awful

but it's really not that bad think it is

to some some neuroscientists described

themselves really as as you know

scientists on one hand but mechanics on

the other absolutely but well I

frequently say you know being a

neurosurgeon in many cases like being a

plumber because for instance

people who have hydrocephalus or fluid

on the brain we have to put in a shunt

to divert the fluid from the brain to

the abdomen or to the laundry to the

heart or to some other part of the body

that can absorb the fluid so that's

that's very similar to a plumber and you

know we might not make as much money as

plumbers but now it's very similar to

what thank you how do you get over

you've talked in your book gifted hands

the story of Ben Carson you talk about

surgeries that were incredibly complex

and that we're successful and yet your

patients died I'm thinking of of twins

from Germany who after the successful

surgery one child aspirated on food and

I think suffered brain damage another

died how do you get over that well you

know anytime something doesn't work out

the way you can get by it is knowing

that you did the best that you can do

and recognizing that you're not

ultimately in charge of everything in my

case I believe in a higher power than

myself and I believe that that my duty

is to do the very best that I can do

with the abilities that have been given

to me now does that mean that I don't

feel it when somebody dies or somebody

has a bad result of course I feel it and

of course it hurts but you're able to

move on because you know you've done

your best and that you can't sit there

and and become you know ineffective

because you're worried about that you've

taken on some cases that other

neurosurgeons has have said I'm not

touching this it's too risky there's

sort of a four prong question that you

ask yourself and and you really are very

serious about weighing risks and

benefits what is that four point

well I asked myself what's the best

thing that happens if I do this and

what's the worst thing that happens if I

do it what's the best thing that happens

if I don't do it

and what's the worst thing that happens

if I die

do it and by analyzing the answers to

those four questions I can frequently

very quickly decide whether this is

something that's worthwhile if I then

decide that it's worthwhile I frequently

will ask another series of questions who

what when where how why who is it

affecting all those kinds of things but

you need to have a good mechanism for

sorting things out and and in some of

the cases where you know people have

thought maybe I was a bit of a maverick

it's not that I was a maverick in awe

it's because I asked those questions one

well-known pediatric ear surgeon once

said Carson will operate on anybody who

will lay down which is not true because

I operate on people in the sitting

position too but but now the fact of the

matter is I would I would ask those

questions and if this person had

absolutely no chance if we didn't do

something but maybe a small chance if we

did you know I'd sit down with the

parents I talked about that I said you

know the chances really are not good if

we do something but the changes are

virtually zero if we do nothing and

fortunately and in many of those cases

things worked out well there was one

case that I'm curious about it was 29

year old Iranian twins joined at the

back of the head they wanted desperately

to be separated their uh surgeons in

Germany said no and you took on the case

well I didn't actually when they

actually you were part of a team I said

when they when they first came to me I I

told them about chengying bunker and how

they live to be 63 years old without

being separated and they were having no

parts of that they want to be separated

so they found the team in Singapore

right a team with whom I was familiar

and had worked with before and and then

that team subsequently you know

convinced me to come and help them even

though I wasn't particularly game to do

so that's how that works okay and and of

course that that ended tragically but

you were but but that team was

fulfilling their wish to try right they

you know they said something to me that

it really struck me they said doctor we

would rather die than spend another day

stuck together and that seemed

incredibly harsh to me but then I put

myself in their shoes and I said you

know yeah what if you were stuck to

somebody 24/7 you could never get away

from them for one second and the two of

you had very different aspirations that

probably would be worse than that so I

at that point fully understood where

they were coming from and then I was I

was more at ease with it what percentage

of the patients that you see require a

medical assistance and what I'm

wondering you and your wife started

angels of the o.r and I'm wondering how

many patients you have to turn away

because they don't have the means or you

have to come up with with another

philanthropic fund to be able to treat

them well it's my hope that now that

we're engaged in this health care debate

that pretty soon angels the Oh our will

be irrelevant that we won't have to be

worried about that but you know there

there are a number of patients who may

have insurance but they're underinsured

it won't take care of a certain

procedure or a certain test or they may

have some travel issues and you know we

just felt that it would be horrible if

they couldn't get done what needed to be

done you know because of a matter of

five or ten fifteen thousand dollars

here or there and that was that was the

purpose of creating this organization so

that we could fill in the gap to allow

these families both adult and children

one of the adult neurosurgeon said that

is a close friend of mine dr. cliff

Solomon and myself we've both been

agonizing over this and we combined

forces to create angels of the or

and but we are we're both hoping that we

really will get some meaningful health

reform and that it will become

irrelevant but it's still there people

from all over the world have have sought

out your services and and there have

been instances where you've said yes I

will take on this case I'm thinking of a

young African boy who needed brain

surgery but you can't speak for your

four year old for your alar yeah well in

the in the early part of my career it

was actually pretty easy to do those

kinds of cases to do charity cases and

we all did a ton of charity cases

but what happened about ten years ago is

that hospitals no longer had this bit

cushion that they used to have because

reimbursements you know keep going down

down down down so you know most places

are sort of working on the edge now so

you know the answer I would get when I

wanted to do a charity cases yeah you

can give your time away but can you give

away anesthesia is time and the ICU and

the physical therapist and nursing it

and of course the answer is no so you

know that's something that has changed

pretty dramatically and one thing that a

lot of people don't know or don't

understand is that you know the indigent

always used to be taken care of

virtually every physician devoted a

portion of their practice to taking care

of indigent people so they always got

taken care of but now a lot of

physicians don't take care of them

because they're too busy struggling with

the system and so we've actually taken

something that used to take care of

itself and made it into something that

doesn't having said that I do think

there should be a formal way of taking

care of it but it needs to be done in a

logical way like we discussed before

it's perfectly easy for us as a society

to take care of these things paying much

less money than we pay now if we will

just exercise a little more logic and a

little less politics

your biological father must know about

you know about your successes um he was

a much older man than your mother who

was 13 when she married him she was he

was a Baptist minister from from

Tennessee and as you said he was a

bigamist and had a family of his own

have you reconnected with him well you

know he died many years ago but yeah I

have never been bitter toward him and

you like he was at my wedding and you

know but you know he did not play a

substantial role in my life and even

though as a kid I was very I was I was

devastated when my parents got divorced

it's like somebody pulled the rug out

from underneath it I prayed every night

that they would get back together but

you know later in life I realized that

had he been there with the influence

that he provided I probably would not

have become the person that I did

because you know he was into carousing

womanizing all these kinds of influences

that I'm sure would have been

deleterious so you know sometimes you

know you know we can't really see the

big picture and we say offices won't but

if we could see down the road we would

see that maybe this is for the better

speaking of the big picture that's the

title of one of your four books and in

it you pose a question that you think we

all need to ask ourselves so that we're

focusing on the right things and one of

the questions that you say aside from

where do you want to be 5 10 20 years

from now is how do you want to be

remembered yes how would you answer that

well I would like to be remembered as a

person who helped people to understand

the incredible potential that they had

and to help people realize that they

really don't have to depend on a lot of

other people what they have to do is

take advantage of their god-given

talents and to develop those and that

the person who has the most to do with

them and what happens to them is the

based on the choices that they make and

if you can get people to understand that

and you can abolish that victim

mentality you're going to have an army

of very capable people and I look at all

the things that were invented in this

country and you know the more I read

about the history of our nation the more

impressed I am about who we are what

kind of people we are as the world's

only superpower how benign we are

compared to other superpowers that have

been here the tremendous good that has

been done you know throughout the world

and you know I don't have a whole lot of

patience for those people who sit around

and bash the United States I would be

perfect no but we're a heck of a lot

better than anybody else has ever

occupied this position and we have the

potential to get even better and we need

not to be bashing ourselves but to be

looking at that the kind of innovation

the kind of can-do attitude that made us

into a great nation that allowed us to

reach the pinnacle faster than any other

nation in the history of the world we

don't need to be trying to become like

everybody else we need to be who we are

we need to lead and a reasonable in the

responsible fashion dr. ben Carson thank

you so much for talking with us thank

you for having me

we hope you enjoyed our conversation

with dr. ben Carson Comcast subscribers

can watch this program anytime on Penn

State on demand find out how through our

website conversations.psu.edu i'm patty

satalia we hope you'll join us for our

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