Dr. Benjamin S. Carson is himself a patient.
He opens his hands-the hands that have performed so many thousands of lifesaving operations-as he begins to explain. Though he's meant to be recuperating quietly from prostate surgery, the phone rings repeatedly, and a procession of delivery vans arrive with baskets of fruit and bouquets of flowers from friends, colleagues, and well-wishers.
"I wish they would make a contribution to the Scholars Fund instead," he says with a smile. "I could never eat all this! But people are just so kind."
The massive outpouring of affection and concern still leaves Carson bemused. "I shared the situation with my Sabbath school class at Spencerville [Maryland] church, and by the next day we were receiving calls from all over the country! Even high-level government officials were calling to find out what was happening. One radio station reported I had a glioblastoma-a malignant brain tumor with a one-year life expectancy. Another rumor was that I had bone cancer. The whole thing just mushroomed, with messages coming in from everywhere. So we arranged with the Public Affairs Office of the hospital to issue a contingency statement, and sent it to the Baltimore Sun. The statement wound up on the obituary page, which just fueled the fire-some people just read headlines.
"The following Monday we were inundated. People were asking about funeral arrangements and where to send flowers. Because of all the rumors, we accepted the Washington Post's invitation to do an interview. One of the Post editors had heard the news in his church, so he called me. He said that they had been planning to do a profile for some time and wondered if this could be speeded up. We saw this as an opportunity to set the record straight and squash the rumors."
On the Examining Table
Carson had been having some symptoms usually caused by an enlarged prostate, which prompted him to visit his friend and colleague Dr. Pat Walsh, a top urologist at Hopkins. After trying antibiotics and other treatments, Carson had a biopsy, which initially indicated an 18 percent chance of prostate cancer.
However, the next day, while he was performing surgery, a nurse held the phone to his ear while he listened to the final report. It was cancer, high-grade. "That kind of threw me for a loop," Carson admitted. "I said, 'Thank you,' and tried not to think about it during the operation."
"On my way home the thought weighed heavily on me. The cancer could possibly have already metastasized-after all, I was almost two decades younger than those usually diagnosed with prostate cancer. The cancer was also high-grade. I had something that could kill me. It wasn't the thought of dying, but of leaving family, patients, and staff-the myriad people that were depending on me. I felt like I was betraying them, and this weighed heavily on me. My wife, Candy, and I talked about it-we were not 100 percent sure what this all meant. While it was kind of frightening, Candy reminded me that the Lord would take care of it, because He always does."
The next day Carson was back to consult with Walsh. He asked for a worst-case scenario. Walsh explained that if the cancer had already metastasized, it would probably take 10 years to kill him. "This sounded pretty good at that moment-you can do a lot in 10 years," Carson said with a grin.
"But some symptoms were not explained by the cancer-there was the possibility of neurological involvement. The MRI looked suspicious, and the concerns started all over again. If it was showing metastatic disease to the spine, that was a whole different kettle of fish-considerably less than 10 years.
A Family Affair
"I contemplated hiding this from the family, but then concluded it would be selfish of me, for they all had a stake in this. We prayed that the Lord's glory would be manifested, and we were confident that He would do something."
Further consultations followed. Since the MRI was so inconclusive, a bone scan was ordered. But before it could be performed, a spinal surgeon who had joined the Hopkins staff saw the MRI and was convinced that it did not show cancer.
"I asked him if he was sure, and he told me he was 100 percent sure," said Carson. "Boy, it felt like three tons of weight had just lifted off me. I gleefully canceled the bone scan. Bone scans sometimes give false positives, and I didn't want to go through all that again."
I ask if the up-and-down roller-coaster ride took a heavy toll on him and the family. Carson shakes his head. Though admitting concerns at times, he holds on to his faith in God. "I'm convinced that all things happen for a reason. This situation made me reexamine my own life and health, I reread Ellen White's book The Ministry of Healing, and it strengthened my belief that cancer is perhaps a curable disease. I changed my diet and started eating more organic foods, especially salads. I cut out preprocessed foods and eliminated sodas and potato chips. The symptoms I had been experiencing disappeared with this change in my internal environment."
The doorbell rings-yet another delivery of flowers and a fruit basket. The deliveryman is apologetic: "When my daughter saw your name on the ticket, she said she just had to come. You don't mind, do you?"
Carson smiles and signs the sheet, wishing her well. It seems as if all the world knows the surgeon with the "gifted hands."
Carson's wife, Candy, comes in to make sure he's getting enough liquids, on her way to running some errands. Rhoeyce, one of three sons, is busy answering the phones. A medical board teleconference is scheduled for later in the afternoon. Beside Carson on the couch is a bunch of medical papers. Just how much rest is he getting? I ask, looking around at so much activity.
"Oh, I'm doing fine. Especially with all this fruit!"
The Results Are In
Yes, but what were the results of his surgery? I inquire, pressing the point.
"The surgery was very successful. The cancer was contained, but within one millimeter of breaking through. The nodes were all negative, and the nerves were spared. I'm going to continue.
"I began to entertain the thought of not going through with the surgery-that the changes I had made could reverse the cancer. But I realized that as a role model to many people, this would be an incredibly irresponsible thing to do. People needing traditional medical therapy might not go through with it, and many lives might be lost needlessly. The Lord could cure me spontaneously if He wished, but He had put me in an environment where I would have the best care available."
Carson spreads his hands, and takes a sip of a dark-brown liquid. He changes the topic, and begins speaking about his work. In typical fashion, Carson is more concerned about his patients than his role as a patient. Does he feel bad that he's not there for them?
"In the past couple of weeks [my patients] have been more concerned about me than about themselves. They tell me that they and their churches are praying for me." He nods gratefully.
Reducing the Risks
The prescription for beating prostate cancer: catch it early and take precautions.
The American Cancer Society estimates that about 180,000 men in the United States will be diagnosed with prostate cancer each year. Of those, approximately 37,000 will die of the disease.
Studies show the incidence of prostate cancer is between 15 to 30 percent in men over the age of 50. By the age of 80, some 60 to 70 percent of men show microscopic evidence of prostate cancer at autopsy, leading some to conclude all men would get prostate cancer if they lived long enough.
The prostate specific antigen (PSA) test measures an enzyme found in seminal fluid. In prostate cancer, but also in the case of an enlarged prostate gland, PSA levels in the blood are often, but not always, raised. Levels between 0-4 nanograms/milliliter are in the normal range. Black males appear to be at increased risk for prostate cancer and by age 40 should have an annual screening, which includes a digital rectal exam and a PSA test. White males should start the same surveillance program at age 50.
Diet may offer the most promising clues to reducing the risks of prostate cancer.
Low fat. High fat intake, particularly saturated fat, as found in red meats, may play a role in prostate cancer. Reduction in animal fat intake is recommended, as well as total fat intake to around 25 percent of calories from fat per day.
Fiber. In animal studies, fiber seems to prevent the development of prostate cancer. Vegetarians who eat legumes, beans, lentils, and peas are apparently more protected.
Lycopene. This plant pigment accumulates in the prostate, and in laboratory culture inhibits prostate cancer cell growth, acting as an antioxidant. Cooked tomatoes and tomato juice release higher quantities than raw tomatoes.
Phytoestrogens. Foods such as soy products (containing genistein and daidzein) are associated with reduced rates of prostate cancer. Japanese men, whose diet includes a high percentage of soy products, have one quarter of the risk of prostate cancer as Americans. Eating a diet rich in lignans from grains and legumes may reduce the risk of prostate cancer.
Selenium. Excellent sources of this mineral include Brazil nuts, pasta, and sunflower seeds.
Vitamin D. Some studies suggest its antioxidant properties may offer protection against prostate cancer.
Ultimately, genetics play a major role in prostate cancer vulnerability. While a low-fat, vegetarian diet may offer significant benefits, it will not prevent all prostate cancers. Those who live the healthiest of lifestyles may still succumb to disease, but at a later stage than they would have with less-healthy lifestyles.
(Data taken from Simon Margolis, M.D., Ph.D. and H. Ballentine Carter, M.D., Johns Hopkins White Papers, Prostate Disorders 2000.)
By Allan Handysides, M.D., director of health ministries for the General Conference.
I ask the obvious: what's happening while he recuperates? "Because I knew almost two months ahead about the surgery date, I was able to make sure that few things were left undone. The Lord has blessed me with incredible colleagues. They have been unbelievable, telling me that they would take care of anything I needed."
Then the surgeon folds his hands and rests back against the sofa's cushions. He closes his eyes and speaks even more softly. "The last operation I performed before I left to prepare for [my own] surgery was for a 13-year-old girl from Ohio. She had intractable seizures. We placed sensors under the skull and, with sophisticated electronics, mapped out where these seizures were coming from in her brain. We resected-removed-the area. There were five epileptologists present, as well as the surgery team. We were delighted with the procedure, and I was on cloud nine. I talked with the family and told them how well it had gone."
"Before I left I found she wasn't moving or talking, not even waking up that much. It just didn't compute. I thought there may have been some swelling, and that she would be OK in a couple of days. But in two days she was no better; she was doing really poorly. For the first two days of my vacation all I could think about was this little girl. On the second night I earnestly prayed. We had done everything humanly possible; nothing could have been better. But she still wasn't improving, and this bothered me greatly.
"I prayed, 'Lord, if it's not too much trouble, can You cure her tonight?' I was somehow in a sunlit room, full of golden light, clean and crisp. I called the next morning and asked how she was doing.
"'Yesterday she was doing terribly,' I was told, 'but something dramatic happened last night, and now she's moving-walking and talking. In a few days she'll be going home.'"
He sits up and smiles his wide smile, eyes twinkling. "Then I had a truly joyful vacation! It just proves again that the Lord is in control of everything. Proverbs 21:1 says that 'the king's heart is in the hand of the Lord, as the rivers of water: he turneth it whithersoever he will.' It doesn't matter what the problem or obstacle is, God can take it and change it, reorient it, or go around it-all we need to do is spend our energy in keeping close to God."
We sit without speaking for a few moments. The sun shines brightly through the high arched windows. The high trees at the far side of the Carsons' home in the country sway in the slight breeze. God is close.
He answers my unasked question: "Even in the bleakest moments-thinking that I perhaps had metastatic disease to the spine-my faith was strong. As I've said before, I believe God never makes mistakes. This gives me great confidence. Even if I die, it will be for a reason, and God will make the best of it. Even though I had nothing like Job's experience, I can identify with his statement about God: 'Though he slay me, yet will I trust in him.' To my dying breath I will have confidence in God, and be sure that He will take care of everything. By the same token, I didn't think God would let me die, even if I did have metastatic disease to the spine-He could solve the problem and cure me. Dying-it wasn't going to happen.
"This has deepened my experience with God. Even though I have always started and ended the day with prayer and Bible study, I do so now with even greater vigor. I have been thinking and appreciating what God has done: the flowers and the trees, the incredible beauty of birdsong in the morning, the foxes and the cornfields . . . I am so thankful for a healthy family, for God's gift of freedom-to come and go as you please, to choose to do what you want. It's an incredible blessing.
"I now recognize to an even greater extent how much God loves us. I have been thinking about my own life, remembering the time I was 8 years old, sitting on the dilapidated wooden steps of our home in Boston, surrounded by weeds and dirt and broken glass, with the winos and the gangs . . . I remember the sense of hopelessness I had. Boy, it has been a long way from there to now.
"And the person who brought you here was God, I reminded myself. How God brought that little boy from that old tenement to here. I thought of the people of the Bible, and how God was just as active here today-He's willing to listen to us and to work in our lives. As it says in Proverbs 3:5, 6: 'Trust in the Lord with all thine heart; and lean not unto thine own understanding. In all thy ways acknowledge him, and he shall direct thy paths.' So often people fall short in acknowledging God, especially when they have what man thinks is success."
Gifts of the New Day
So for the future? I suggest.
"I will certainly spend more time appreciating God and what He has done. In trying to be all things to all people you can shortchange yourself and your family."
In my research before the interview I'd read that, on average, neurosurgeons die 10 years earlier than other surgeons. I'm wondering how to bring this point up delicately. Then, as if reading my thoughts, he said, "Neurosurgeons die 10 years earlier-so that's another aspect to change. I have to remind myself that all the problems at the hospital not resolved by 6:00 p.m. also won't be resolved by 6:00 a.m. So I'll take more time out.
"Additionally, I will trust other people more. The world was here before I was and will be here after I'm gone. My being there is simply not required. So I need to think of increasing my own longevity.
"Candy tells me I'm too nice to a fault, that I'm willing to shortchange myself for others. If, for whatever reason, I'm not here prematurely, then I will shortchange a lot of other people. Christ told His disciples, 'Let's go away.' People are who we should be concerned about, but at times we all need to be able to rest. I'm planning to cut back on the procedures to about 350 a year [still a huge workload, at least double normal].
"I'd also like to extend the opportunities for public speaking, which I enjoy-but never to do it exclusively.
"Then there's the scholarship program that's on the verge of exploding. I am committed to this concept of helping young scholars progress, not just from an academic perspective but also for human quality.
"Added to that is the professional area. Some years ago I considered leaving the medical profession. It can be incredibly frustrating, with all the bureaucracy and managed care that cause financial constraints. I told myself it wasn't worth all this hassle.
"The Benevolent Endowment Network Fund makes it possible to practice medicine in a reasonable way. For those who are underinsured or who have no insurance and who have complex diseases, this fund means the physician can treat without worrying about the patient's financial status. When I was encouraged to become a physician, I studied the life of Christ and His healing ministry, and He didn't check insurance status first! I would love to be able to realize that dream."
The Unbroken Circle
What about the family? I asked. They certainly seem to be highly supportive.
"The family tends to take their cues from me and my attitude, for the most part. I'm not worried; I know I'm going to be fine, one way or another. God does so many miraculous things for my patients; I can't believe He doesn't have one left for me! The family has been incredible; they all chip in to make life easier for Dad, and we are even closer together.
"Before the surgery we had prayer in the pre-op room-the family, my mom, and friends. We held hands. I was not concerned at all, I turned it all over to God. I believed it was all going to be OK. I had a top-notch anesthetist, the number one surgeon, and I knew the nurses. Most of all I was in God's hands.
"What does God have in store for the future? Something quite different from what I think it will be, I'm sure! I just hope I'm ready. He has a tendency to set things up. I don't know why I'm on corporation boards and learning all about finances, but God does He knows how all the pieces fit together. It's in God's hands."
* The title of Dr. Carson's first book. His other two books are Think Big and The Big Picture.
For more details on the Carson Scholars Fund and how to contribute, go to www.carsonscholars.org.
Jonathan Gallagher is the United Nations liaison for the Seventh-day Adventist Church, with headquarters in Silver Spring, Maryland.