Somewhere during that period of time I became acutely aware of an unusual ability—a divine gift, I believe—of extraordinary eye and hand coordination. It’s 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. This 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.
Some people have the gift of physical coordination. These are the people who become Olympic stars. Others can sing beautifully. Some people have a natural ear for languages or a special aptitude for math. I know individuals who seem to draw friends, who have a unique ability to make people feel welcome and part of the family.
For some reason, I am able to “see” in three dimensions. In fact, it seems incredibly simple. It’s just something I happen to be able to do. However, many doctors don’t have this natural ability, and some, including surgeons, never learn this skill. Those who don’t pick this up just don’t develop into outstanding surgeons, frequently encountering problems, constantly fighting complications.
I first became aware of this ability when a classmate pointed it out at Yale. He and I used to play table soccer (sometimes called foosball), and, although I had never played before, almost from the first lesson I did it with speed and ease. I didn’t realize it then, but it was because of this ability. When I visited Yale in early 1988, I chatted with a former classmate who is on staff there. He laughingly told me that I had been so good at the game that afterward they named several plays “Carson shots.”
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.
After my first year in med school, I had a summer job as a radiology technician taking X-rays—it was the only free summer I had from then on. I enjoyed it because I learned a lot about X-rays, how they worked, and how to use the equipment. I didn’t realize it at the time but subsequently this would be useful to me in research.
The medical school administration offered selected seniors opportunities as instructors, and by my senior year I was doing extremely well, receiving academic honors as well as recommendations in my clinical rotations. At one point I taught physical diagnosis to first-and second-year students. In the evenings they came over, and we practiced on each other. We learned how to listen to the sounds of our hearts and lungs, for example, and how to test reflexes. It was an incredibly good experience, and the job forced me to work hard to be ready for my students.
I didn’t begin in the top of my class, however. In my first year of med school my work was only average. That’s when I learned the importance of truly in-depth learning. I used to go to lectures without getting much from them, particularly when the speaker was boring. But I didn’t learn much either.
For me, it paid to thoroughly study the textbooks for each course. During my second year I went to few lectures. Normally, I got out of bed around 6:00 a.m. and would go over and over the textbooks until I knew every concept and detail in them. Enterprising individuals took extremely good notes for the lectures and then, for a little cash, sold their notes. I was one of the purchasers, and I studied the notes as thoroughly as the texts.
All during my second year, I did little else but study from the time I awakened until 11:00 at night. By the time my third year rolled around, when I could work on the wards, I knew my material cold.
* It came as no surprise to me that during her senior year with the Yale Symphony Orchestra, Candy performed in the European premier of the modern opera Mass by the gifted Leonard Bernstein. She actually had a chance to meet him in Vienna.
CHAPTER 11
Another Step Forward
There ought to he an easier way, I thought as I watched my instructor. A skilled neurosurgeon, he knew what he was doing, but he had difficulty locating the foramen ovale (the hole at the base of the skull). The woman on whom he was operating had a condition called trigeminal neuralgia, a painful condition of the face. “This is the hardest part,” the man said as he probed with a long, thin needle. “Just locating the foramen ovale.”
Then I started to argue with myself. You’re new at neurosurgery, but already you think you know everything, huh? Remember, Ben, these guys have been doing this kind of surgery for years.
Yeah, answered another inner voice, but that doesn’t mean they know everything.
Just leave it alone. One day you’ll get your chance to change the world.
I would have stopped arguing with myself except I couldn’t get away from thinking that there must be an easier way. Having to probe for the foramen ovale wasted precious surgery time and didn’t help the patient either.
OK, smart man. Find it then.
And that’s just what I decided to do.
I was doing my clinical year at the University of Michigan’s School of Medicine and was in my neurosurgery rotation. Each of the rotations lasted a month, and it was during this period that the surgeon commented on the difficulty of finding the little hole at the base of the skull.
After arguing with myself for some time, I took advantage of the friends I had made the previous summer when I worked as a radiology technician. I went to them and explained what was worrying me. They were interested and gave me permission to come into their department and practice with the equipment.
After several days of thinking and trying different things, I hit upon a simple technique of placing two tiny metal rings on the back and front of the skull, and then aligning the rings so that the foramen ovale fell exactly between them. Using this technique, doctors could save a lot of time and energy instead of poking around inside the skull.
I had reasoned it this way: Since two points determine a line, I could put one ring on the outside surface of the skull behind the area where the foramen ovale should be. I then would put the other one on the front of the skull. By passing an X-ray beam through the skull, I could turn the head until the rings lined up. At that point, the foramen falls in between.
The procedure seemed simple and obvious—once I’d reasoned it out—but apparently no one had thought of it before. Fact is, I didn’t tell anyone either. I was thinking of how to do a better job and wasn’t concerned with impressing anybody or showing my instructors a new technique.
For a short time I tormented myself by asking, Am I getting into a new realm of things that others haven’t yet discovered? Or am I just thinking I’ve figured out a technique no one else has considered before? Finally I decided that I had developed a method that worked for me and that was the important thing.
I started doing this procedure and, from actual surgery, saw how much easier it was. After two such surgeries, I told my neurosurgeon professors how I was doing it and then demonstrated for them. The head professor watched, shook his head slowly, and smiled. “That’s fabulous, Carson.”
Fortunately, the neurosurgery professors didn’t resent my idea.*
From just having an interest in neurosurgery, the field soon intrigued me so much it became a compulsion. You may have noticed that I’d had that happen before. I have to know more, I’d find myself thinking. Everything available in print on the subject became an article I had to read. Because of my intense concentration and my driving desire to know more, without intending to I began to outshine the interns.
It was during my second rotation—my fourth year of med school—that I became aware that I knew more about neurosurgery than the interns and junior residents. While we were making our rounds, as part of the teaching procedure the professors questioned us as we examined patients. If none of the residents knew the answer, the professor would invariably turn to me. “Carson, suppose you
tell them.”
Fortunately, I always could, although I was still a medical student. And, quite naturally, knowing I excelled in this area produced a real emotional high. I had worked hard and pursued an in-depth knowledge, and it was paying off. And why not? If I was going to be a doctor, I was going to be the best, most-informed doctor I could possibly be!
About this time several of the interns and residents started turning over a few of their responsibilities to me. I don’t think I’ll ever forget the first time a resident said, “Carson, you know so much, why don’t you carry the beeper and answer the calls? If you get into something you can’t handle, just holler. I’ll be in the lounge catching a little sleep.”
He wasn’t supposed to do that, of course, but he was exhausted, and I was so delighted to have the opportunity to practice and learn that I enthusiastically agreed. Before long the other residents were handing me their beepers or turning cases over to me.
Perhaps they were taking advantage of me—and in a sense they were—because the added responsibility meant longer hours and more work for me. But I loved neurosurgery and the excitement of being involved in actually performing the operations so much that I would have taken on even more if they had asked.
I’m sure the professors knew what was going on but they never mentioned it, and I certainly wasn’t going to tell. I loved being a medical student. I was the first man on the line taking care of problems, and I was having the most fun I’d ever had in my life. No problems ever arose over my workload, and I maintained a good relationship with the interns and residents. Through all of these extra opportunities, I became convinced that I enjoyed this specialty more than anything else I tried.
Often as I walked through the wards I’d think, If this is so great now while I’m still a student, it’s going to be even better when I finish my residency. Each day I went on rounds or to the lectures or operating theater. An attitude of excitement and adventure filled my thoughts because I knew I was gaining experience and information while sharpening my skills—all the things that would enable me to be a first-rate neurosurgeon.
By then I found myself in my fourth year of medical school, ready for my one year of internship and then my residency.
Professionally, I was heading in the right direction, without any question. As a kid, I had wanted to be a missionary doctor and then got caught up in psychiatry. Now and then, as part of our training, the medical students watched presentations in clinical medicine made by various specialists who talked about their particular field. The neurosurgeons impressed me the most. When they talked and showed us before-and-after pictures, they held my attention like none of the others. “They’re amazing,” I’d say to myself. “Those guys can do anything.”
But the 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 the choice that would become my career and my life.
All the facets of my career came together then. First, my interest in neurosurgery; second, my growing interest in the study of the brain; and third, acceptance of my God-given talent of eye-and-hand coordination—my gifted hands—that fitted me for this field. When I made my choice for neurosurgery, it seemed the most natural thing in the world.
In medical school during our clinical (or third) year we did rotation work for a month at a time, giving us an opportunity to experience each of the fields. I signed up for and received permission to do two neurosurgery rotations. Both times I received honors in my work.
Michigan had an outstanding neurosurgery program and except for a casual incident, I would have stayed at Michigan for my internship and residency. I believe residency works much better if you’re in the same place you took your previous work.
One day I overheard a conversation that changed the shape of my plans. An instructor, unaware that I was nearby, commented to another about the chairman of our neurosurgery department. “He’s on his way out,” he said.
“You think it’s that serious?” the other man asked.
“Without question. He told me so himself. Too much political strife.”
That chance conversation forced me to rethink my future at the U of M. The change of personnel would severely damage the residency program. When an interim chairman comes on the scene, he’s new, uncertain, and has no idea how long he’ll stay. Along with that, chaos and uncertainty reign among the residents, loyalties often divide, and personnel changes occur. I didn’t want to get caught up in that because I believed it could adversely affect my work and my future.
The combination of that piece of information and the fact that I’d long admired the Johns Hopkins complex made me decide to apply at Hopkins.
I had no trepidation at sending in my application for internship at Hopkins the fall of 1976 because I felt that I was as good as anybody else at that point in my training. I had made excellent grades and achieved high scores on the national board examinations. Only one problem faced me: Johns Hopkins accepted only two students a year for neurosurgery residency although they averaged 125 applications.
I sent in my application and within weeks received the marvelous news that I would be interviewed at Johns Hopkins. That didn’t put me in the program, but it got me inside the door. I knew that with the competition as stiff as it was, they interviewed but few of the applicants.
The manner of Dr. George Udvarhelyi, head of the neurosurgery training program, put me at ease immediately. His office was large, tastefully decorated with antiques. He spoke with a soft Hungarian accent. The smoke from his pipe lent a sweet fragrance to the room. He began by asking questions, and I felt he honestly wanted to know my answers. I also sensed that he would be fair in his evaluation and recommendation.
“Tell me a little about yourself,” Dr. Udvarhelyi began, looking across his desk at me.
His manner was straightforward, interested, and I relaxed. I took a deep breath and looked him in the eyes. Did I dare to be myself? Help me, Lord, I prayed. If this is Your will for me, if this is the place You know I should be, help me to give the answers that will open the doors to this school.
“Johns Hopkins is certainly my first choice,” I began. “It’s also my only choice. This is the place where I want to be this fall.”
Had I said that too strongly? I wondered. Had I been too open about that I wanted? I didn’t know, but I had decided before going to Baltimore for the interview that, above all, I wanted to be myself and to be accepted or rejected by who I was and not because I successfully projected some kind of image through a super-sales job.
After he gained a few bits of information about me, Dr. Udvarhelyi’s questions revolved around medicine. “Why did you choose to become a doctor?” he asked. His hands rested on his large desk.
“What aspirations do you have? What are your primary fields of interest?”
I tried to answer clearly and concisely each time. However, at some point in the conversation, Dr. Udvarhelyi made an oblique reference to a concert he had attended the night before.
“Yes, sir,” I said. “I was there.”
“You were?” he asked, and I saw the startled expression on his face. “Did you enjoy it?”
“Very much,” I said, adding that the violin soloist had not been quite as good as I had expected.
He leaned forward, his face animated. “I thought the same thing. He was fine, technically fine, but —”
I don’t remember the rest of the interview except that Dr. Udvarhelyi honed in on classical music and we talked for a long time, maybe an hour, about various composers and their different styles of music. I think he was taken aback by the fact that this Black kid from Detroit knew so much about classical music.
When the interview concluded and I left his office, I wondered if I had gotten Dr. Udvarhelyi off track and the digression would
count against me. I consoled myself with the thought that he had brought up the topic and he had kept the subject foremost in our conversation.
Years later Dr. Udvarhelyi told me that he had made a strong case for my being accepted to Dr. Long, the chairman. “Ben,” he said to me, “I was impressed with your grades, your honors and recommendations, and the splendid way you handled yourself in the interview.” Although he didn’t say it, I’m convinced that my interest in classical music was a decisive factor.
And I pleasantly remembered the hours of study during high school I had put into being able to compete on College Bowl. Ironically, the year I entered college, College Bowl went off the air. More than once I had scolded myself for wasting a lot of time learning about the arts when it would never be used or needed.
I learned something from that experience. No knowledge is ever wasted. To quote the apostle Paul: “And we know that all things work together for good to them that love God” (Romans 8:28). The love I learned for classical music helped draw Candy and me together and also helped me get into one of the best neurosurgery programs in the United States. When we work hard to acquire expertise or understanding in any field, it pays off. In this case, at least, I saw how it certainly had yielded results. I also believe that God has an overall plan for people’s lives and the details get worked out along the way, even though we usually have no idea what’s going on.
I was elated when I received word that I’d been accepted into the neurosurgery program at Johns Hopkins. Now I was going to get the chance for training at what I considered the greatest training hospital in the world.
Gifted Hands Page 10