Doubts concerning the field of medicine I should specialize in vanished. With confidence born of a good mother, hard work, and trust in God, I knew I was a good doctor. What I didn’t know, I could learn. “I can learn to do anything that anybody else can do,” I said to Candy several times.
Maybe I was a little overconfident. But I don’t think I felt cocky, and certainly never superior. I recognized others’ abilities as well. But in any career, whether it’s that of a TV repairman, a musician, a secretary—or a surgeon—an individual must believe in himself and in his abilities. To do his best, one needs a confidence that says, “I can do anything, and if I can’t do it, I know how to get help.”
Life was moving beautifully for me during this time. I’d been awarded a variety of honors for my clinical work at the University of Michigan, and now I was entering the last, and perhaps most important, phase of my training.
My private life was even better. Candy graduated from Yale in the spring of 1975, and we married July 6, between my second and third years of med school. Until our marriage, I lived with Curtis. Still unmarried at that time, he had received his discharge after four years of Naval service and then enrolled at the U of M to finish college.
Candy and I rented our own apartment in Ann Arbor, and she easily found a job with the state unemployment office. For the next two years she processed unemployment claims and kept our home while I finished med school.
It was exciting to move to Baltimore from the relatively small town of Ann Arbor. During our time there, Candy worked for Connecticut General Insurance Company. Because of her temporary status she found a job doing standard clerical-type work. She also briefly had a job selling vacuum cleaners, and then she got a job at Johns Hopkins as an editorial assistant for one of the chemistry professors.
For two years Candy typed for several different Johns Hopkins publications and did some editing. During that two-year period, she also took advantage of the opportunity of our being at Johns Hopkins and went back to school.
Since she was an employee of the university and married to a resident, Candy could go to school free. She continued with her course work and earned her master’s degree in business. Then she went over to Mercantile Bank and Trust and started working in trust administration.
I worked hard as a resident at Johns Hopkins. One of my goals was to maintain a good rapport with everyone because I don’t believe in one-person productions. Everyone on the team is important and needs to know that he or she is vital. However, a few of the doctors tended to be snobbish, and that bothered me.
They wouldn’t bother to talk with the “common people” like ward clerks or aides. That attitude troubled me, and I hurt for those dedicated employees when I saw it happening. We doctors couldn’t be effective without the support of the clerks and aides. From the start I made a point to talk to the so-called lowly people and to get to know them. After all, where had I come from? I had a good teacher, my mother, who had taught me that people are just people. Their income or position in life doesn’t make them better or worse than anyone else.
When I had free minutes I’d chew the fat on the wards and get to know the names of the people who worked with us. Actually this turned out to be an advantage, although I didn’t plan it that way. During my residency I realized that some of the nurses and clerks had been on their jobs for 25 or 30 years. Because of their practical experience in observing and working with patients, they could teach me things. And they did.
I also realized that they recognized things that were going on with patients that I had no way of knowing. By working closely with specific patients, they sensed changes and needs before they became obvious. Once they accepted me, these often-unpraised workers quietly let me know, for instance, those I could trust or those I couldn’t. They’d inform me when things were going wrong on the ward. More than once a ward clerk, on her way out the door after her shift, would pause and say, “Oh, by the way …” and let me know of a problem with a patient. The staff had no obligation to tell anyone, but many of them had developed an uncanny ability to sense problems, especially relapses and complications. They trusted me to listen and to act on their perceptions.
Maybe I began developing a relationship with the staff because I wanted to compensate for the way some of the other doctors treated them. I’m not sure. I know I hated it when a resident disregarded a suggestion from a nurse. When one of them tongue-lashed a ward clerk for a simple mistake, I felt bad and a little protective toward the victim. At any rate, because of the help from the lower echelons, I was able to make an excellent showing and to do a good job.
Today I try to emphasize this point when I speak to young people. “There isn’t anybody in the world who isn’t worth something,” I say. “If you’re nice to them, they’ll be nice to you. The same people you meet on the way up are the same kind of people you meet on the way down. Besides that, every person you meet is one of God’s children.”
I truly believe that being a successful neurosurgeon doesn’t mean I’m better than anybody else. It means that I’m fortunate because God gave me the talent to do this job well. I also believe that what talents I have I need to be willing to share with others.
* I still use the principle of this procedure, but I’ve done so many of these surgeries and gotten so experienced at finding the hole, I don’t need to go through the steps. I know exactly where the foramen ovale is.
CHAPTER 12
Coming Into My Own
The nurse looked at me with disinterest as I walked toward her station. “Yes?” she asked, pausing with a pencil in her hand. “Who did you come to pick up?” From the tone of her voice I immediately knew that she thought I was an orderly. I was wearing my green scrubs, nothing to indicate I was a doctor.
“I didn’t come to pick up anyone.” I looked at her and smiled, realizing that the only Black people she had seen on the floor had been orderlies. Why should she think anything else? “I’m the new intern.”
“New intern? But you can’t—I mean—I didn’t mean to — “ the nurse stuttered, trying to apologize without sounding prejudiced.
“That’s OK,” I said, letting her off the hook. It was a natural mistake. “I’m new, so why should you know who I am?”
The first time I went into the Intensive Care Unit, I was wearing my whites (our monkey suits, as we interns called them), and a nurse signaled me. “You’re here for Mr. Jordan?”
“No, ma’am, I’m not.”
“You sure?” she asked as a frown covered her forehead. “He’s the only one who’s scheduled for respiratory therapy today.”
By then I had come closer and she could read my name badge and the word intern under my name.
“Oh, I’m so very sorry,” she said, and I could tell she was.
Although I didn’t say it, I would like to have told her, “It’s all right because I realize most people do things based on their past experiences. You’ve never encountered a Black intern before, so you assumed I was the only kind of Black male you’d seen wearing whites, a respiratory therapist.” I smiled again and went on.
It was inevitable that a few White patients didn’t want a Black doctor, and they protested to Dr. Long. One woman said, “I’m sorry, but I do not want a Black physician in on my case.”
Dr. Long had a standard answer, given in a calm but firm voice. “There’s the door. You’re welcome to walk through it. But if you stay here, Dr. Carson will handle your case.”
At the time people were making these objections, I didn’t know about them. Only much later did Dr. Long tell me as he laughed about the prejudices of some patients. But there was no humor in his voice when he defined his position. He was adamant about his stance, allowing no prejudice because of color or ethnic background.
Of course, I knew how some individuals felt. I would have had to be pretty insensitive not to know. The way they behaved, their coldness, even without saying anything, made their feelings clear. Each time, however, I was able to remind my
self they were individuals speaking for themselves and not representative of all Whites. No matter how strongly a patient felt, as soon as he voiced his objection he learned that Dr. Long would dismiss him on the spot if he said anything more. So far as I know, none of the patients ever left!
I honestly felt no great pressures. When I did encounter prejudice, I could hear Mother’s voice in the back of my head saying things like, “Some people are ignorant and you have to educate them.”
The only pressure I felt during my internship, and in the years since, has been a self-imposed obligation to act as a role model for Black youngsters. These young folks need to know that the way to escape their often dismal situations is contained within themselves. They can’t expect other people to do it for them. Perhaps I can’t do much, but I can provide one living example of someone who made it and who came from what we now call a disadvantaged background. Basically I’m no different than many of them.
As I think of Black youth, I also want to say I believe that many of our pressing racial problems will be taken care of when we who are among the minorities will stand on our own feet and refuse to look to anybody else to save us from our situations. The culture in which we live stresses looking out for number one. Without adopting such a self-centered value system, we can demand the best of ourselves while we are extending our hands to help others.
I see glimmers of hope. For example, I noticed that when the Vietnamese came to the United States they often faced prejudice from everyone—White, Black, and Hispanics. But they didn’t beg for handouts and often took the lowest jobs offered. Even well-educated individuals didn’t mind sweeping floors if it was a paying job.
Today many of these same Vietnamese are property owners and entrepreneurs. That’s the message I try to get across to the young people. The same opportunities are there, but we can’t start out as vice president of the company. Even if we landed such a position, it wouldn’t do us any good anyway because we wouldn’t know how to do our work. It’s better to start where we can fit in and then work our way up.
My story would be incomplete if I didn’t add that during my year as an intern when I was in general surgery I had a conflict with one of the chief residents, a man from Georgia named Tommy. He couldn’t seem to accept having a Black intern at Johns Hopkins. He never said anything to that effect, but he continually threw caustic remarks my way, cutting me short, ignoring me, sometimes being just plain rude.
On one occasion the underlying conflict came into the open when I asked, “Why do we have to draw blood from this patient? We still have —”
“Because I said so,” he thundered.
I did what he told me.
Several times that day when I asked questions, especially if they began with “Why,” he snapped back the same reply.
Late that afternoon something happened that had nothing to do with me, but he was angry and, I knew from experience, would stay that way for a long time. He spun toward me, beginning, as he often did with, “I’m a nice guy, but — “ It hadn’t taken me long to learn that those words contradicted his nice-guy image.
This time he really laid into me. “You really do think you’re something because you’ve had an early acceptance into the neurosurgery department, don’t you? Everybody is always talking about how good you are, but I don’t think you’re worth salt on the earth. As a matter of fact, I think you’re lousy. And I want you to know, Carson, that I could get you kicked out of neurosurgery just like that.” He continued to rant for several minutes.
I just looked at him and didn’t say a word. When he finally paused, I asked in my calmest voice, “Are you finished?”
“Yeah!”
“Fine,” I answered calmly.
That’s all I said—all that was necessary—and he stopped ranting. He never did anything to me, and I wasn’t concerned about his influence anyway. Although he was the chief resident, I knew that the chiefs of the departments were the ones who made the decisions. I was determined that I wasn’t going to let him make me react because then he would be able to get to me. Instead I did my duties as I saw fit. Nobody else ever voiced any complaints about me, so I wasn’t overly concerned about what he had to say.
In the general surgery department, I encountered several men who acted like the pompous, stereotyped surgeons. It bothered me and I wanted out of that whole thing. When I moved to neurosurgery it wasn’t like that. Dr. Donlin Long, who has chaired the neurosurgery department at Hopkins since 1973, is the nicest guy in the world. If anybody has earned the right to be pompous, it should be him because he knows everything and everybody, and technically he is one of the best (if not the best) in the world. Yet he always has time for people and treats everyone nicely. Since the beginning, even when I was a lowly intern, I’ve always found him ready to answer my questions.
He is about an inch under six feet and of average build. At the time I began my internship he had salt-and-pepper hair, heavy on the pepper. Now his hair is mostly salt. He speaks with a deep voice, and people here at Hopkins are always imitating him. He knows they do it and laughs about it himself because he’s got a great sense of humor. This is the man who became my mentor.
I’ve admired him since the first time we met. For one thing, when I came to Hopkins in 1977 there were few Blacks and none on the full-time faculty. One of the chief residents in cardiac surgery was Black, Levi Watkins, and I was one of two Black interns in general surgery, the other being Martin Goines, who had also gone to Yale.*
Many do their internship in general surgery but fewer in neurosurgery. Some years nobody from the Hopkins’ general surgery programs division goes into neurosurgery. At the end of my intern year, five out of our group of 30 showed interest in going into neurosurgery. Of course, there were also the 125 people from other places around the country who wanted one of those slots. That year Hopkins had only one open slot.
After my year of internship I faced six years of residency, one more year of general surgery, and five of neurosurgery. I was supposed to do two years of general surgery because I applied for neurosurgery, but I didn’t want to do it. I didn’t like general surgery and I wanted to get out. I disliked general surgery so much I was willing to sacrifice trying for a position in the neurosurgery department at Hopkins and go somewhere else if they would take me after only one year.
I had gotten an extremely good recommendation through all my rotations as an intern. I was finishing my month rotation as an intern on the neurosurgery service and was reaching the point of writing to other schools.
However, Dr. Long called me into his office. “Ben,” he said, “you’ve done an extremely fine job as an intern.”
“Thank you,” I answered, pleased to hear those words.
“Well, Ben, we’ve noted that you’ve done extremely well on your rotation on the service. All of the attendings [i.e., surgeons] have been quite impressed with your work.”
Despite the fact that I wanted my features to remain passive, I know I must have been grinning widely.
“It’s like this,” he said and leaned slightly forward. “We’d be interested in having you join our neurosurgery program next year rather than your doing an additional year’s work in general surgery.”
“Thank you,” I said, feeling my words were so inadequate.
His offer was a definite answer to my prayers.
I was a resident at Johns Hopkins from 1978 through 1982. In 1981 I was a senior resident at Baltimore City Hospital (now Francis Scott Key Medical Center), owned by Johns Hopkins.
In one memorable instance at Baltimore City, paramedics brought in a patient who had been severely beaten on the head with a baseball bat. This beating took place during the time of a meeting of the American Association of Neurological Surgeons in Boston. Most of the faculty was away at the meeting, including the faculty person who was covering at Baltimore City Hospital. The faculty member on duty at Johns Hopkins was supposed to be covering all the hospitals.
The patient, already coma
tose, was deteriorating rapidly. Naturally I was quite concerned, feeling we had to do something, but I was still relatively inexperienced. Despite making phone call after phone call, I couldn’t locate the faculty member. With each call, my anxiety increased. Finally, I realized that the man would die if I didn’t do something—and something meant a lobectomy* — which I had never done before.
What should I do? I started thinking of all kinds of roadblocks such as the medical/legal ramifications of taking a patient to the OR without having an attending surgeon covering. (It was illegal to perform such a surgery without an attending surgeon present.)
What happens if I get in there and run into bleeding I can’t control? I thought. Or if I come up against another problem I don’t know how to handle? If anything goes wrong I’ll have other people second-guessing my actions and asking, “Why did you do it?”
Then I thought, What is going to happen if I don’t operate now? I knew the obvious answer: the man would die.
The physician’s assistant, Ed Rosenquist, who was on duty knew what I was going through. He said just three words to me — “Go for it.”
“You’re right,” I answered. Once I made the decision to go ahead, a calmness came over me. I had to do the surgery, and I would do the best job I could.
Hoping I sounded confident and competent, I said to the head nurse, “Take the patient to the operating room.”
Ed and I prepared for surgery. By the time the operation actually began I was perfectly calm. I opened up the man’s head and removed the frontal and temporal lobes from his right side because they were swelling so greatly. It was serious surgery, and one may wonder how the man could live without that portion of his brain. The fact is that these portions of the brain are most expendable. We had no problems during surgery. The man woke up a few hours later and subsequently was perfectly normal neurologically, with no ongoing problems.
However, that episode evoked a great deal of anxiety in me. For a few days after I’d operated, I was haunted by the thought that there might be trouble. The patient could develop any number of complications and I could be censured for performing the operation. As it turned out, no one had anything negative to say. Everyone knew the man would have died if I hadn’t rushed him into surgery.
Gifted Hands Page 11