Fighting Poverty Isn’t Brain Surgery, but Ben Carson Can Do Both
At the end of our interview last week, I asked Housing and Urban Development Secretary Ben Carson for an example of the outside-the-box thinking that served him so well in his prior career as a pioneering neurosurgeon.
“Sure. I started advocating cervicomedullary decompression for achondroplasia,” said Dr. Carson, before shooting me a sly grin and switching to English. Achondroplasia, he explained, is the most common form of dwarfism, and 40 years ago about 7% of people born with the condition died in infancy. “It’s because they had tight, abnormal bone formation at the base of their skull, and that was squeezing the brain stem. And they would just stop breathing. Surgeons would try to go in sometimes and fix it, but it was so tight that they frequently made it worse or killed the patient.”
When he first talked about using a different surgical procedure on children with achondroplasia, at a medical conference in Rome in the mid-1980s, many objected: “The geneticists said, ‘You surgeons. If you would just leave these people alone, only 7% of them would die. But you guys think you can do anything.’ ”
Back home at Johns Hopkins in Baltimore, colleagues complained to the hospital president that “Carson’s a wild man. You’ve got to stop him.” But Dr. Carson didn’t stop. “Finally, I had done enough cases where I was able to reveal the data. None of [the patients] had died, and they were doing well. And even though I’d gotten all that pushback, now it’s a standard procedure.”
“I don’t get upset when people say horrible things,” the secretary told me. “I understand human nature. People don’t like change.” A disposition that serves him well these days, when taking cheap shots at Ben Carson is something of a sport among reporters and cable-news sages. Never mind that he grew up poor in inner-city Detroit, raised by a single mother with mental-health problems who worked as a housekeeper. Or that he blasted through racial barriers in his medical career. Or that he has used his fame and fortune to expand the educational opportunities of low-income minorities. After all, what could a person from that background possibly know about helping people in difficult circumstances?
In the press, however, the secretary is most often portrayed as a doctrinaire conservative who is out of his depth running an agency tasked with assisting the poor. After he told a town-hall audience in May that poverty is “in part a mindset” and “to a large extent also a state of mind,” commentators couldn’t stop snickering. But Mr. Carson stands by his words. “I don’t say that without evidence. I think of my own life. I think of the way I used to think when I was at the bottom of my class and going nowhere fast,” he told me. “A lot of it is . . . being told the system is against you or that you’re a victim.” Some individuals and organizations “want to convince people that somebody else is in charge of them, and that’s why they get angry at people like me who say it’s partly the way you think.”
Media portrayals notwithstanding, Secretary Carson told me he is not opposed to government assistance and safety nets. “We have an obligation to take care of people who can’t care for themselves—the elderly, the disabled, the mentally ill—and certainly at HUD we’re going to take care of those people.” A case in point, he added, is dealing more effectively with the homeless population. We’re doing a better job at sheltering them but not at diagnosing why they became homeless in the first place and then treating it. “If you don’t do two and three, then you’re wasting your time.”
Over and again, Dr. Carson reiterated his belief that the best way to help people is to help them do for themselves. He envisions an agency that’s much more focused on enhancing human capital. The objective isn’t to make people on government assistance as comfortable as possible. The objective is fewer people on government assistance. It’s an approach that may not be outside the box, but it’s certainly outside the Beltway.
Appeared in the June 21, 2017, print edition.