From the streets of inner-city Detroit to the heights of the medical profession, Benjamin S. Carson has come a long way in his 49 years.

Propelled by his faith in God, unending optimism, and intense determination, Carson is now the director of pediatric neurosurgery at Johns Hopkins University and a world-renowned surgeon.

Famed for his skill at two notoriously difficult surgeries--the separation of Siamese twins joined at the head, and cerebral hemispherectomies, in which half of an epileptic brain is removed to end severe seizures--Carson gives several speeches a month, frequently drawing on his life story. A prolific author, he has written three autobiographical books, Think Big, The Big Picture, and Gifted Hands; authored a text on complex cranofacial problems and more than 90 journal articles on neurosurgery; and has inspired a Baltimore play, Dr. Ben, M.D.

Today, Carson, Class Day speaker at the Harvard Medical School (HMS), will bring his message of hope--and his wishes for the future of medicine--to the school's graduates.

His speech, entitled "Let the Healing Begin," will likely encourage graduates to address problems of bureaucracy and inadequacy in America's health care system.

From Poverty To Stardom

A native of inner-city Detroit, Carson was a less-than-astounding student in his elementary school days who once referred to his younger self as "a walking TV guide." He credits his mother with transforming his life by making him read books and write weekly book reports--even though she herself only had a third-grade education. Carson did well enough in high school to gain admittance to Yale University, which he reportedly chose over Harvard because he saw their team win in an academic bowl, followed by the University of Michigan for medical school.

Carson met some doubt in school from his teachers, according to Alvin F. Poussaint, HMS professor of psychiatry and faculty associate dean for student affairs, who invited Carson to speak on behalf of the dean of the Medical School.

"Early in his career, his teachers may not have thought he would be so extraordinary," Poussaint says.

Surpassing expectations, Carson went on to become the director of the pediatric neurosurgery division at Hopkins at the age of 33--an unusually early age to receive such an important position.

"That's very, very young--heading a department, that usually doesn't happen until your 40s or 50s," Poussaint says.

But Carson was truly catapulted to international fame in 1988, when he was an integral part of a team that separated German Siamese twins who were born joined at the head.

The Doctor's Advice

"He hasn't forgotten his roots, and yet he's in the highest position," Poussaint says. "We thought he would just be a wonderful person to exemplify for all the medical students what a doctor can do."

Carson's message for the graduating doctors will likely be about the duty well educated people have in advancing society.

"What are the opportunities that exist to do something with that education in terms of healing society as a whole?" is a question Carson says his speech will address.

One of the problems that Carson might take on in his speech-- which he says will not be "canned" or "jelled" until he gives it--is the increasingly common struggle between health maintenance organizations (HMOs) and doctors.

"Obviously physicians need to be in the forefront of that battle and have to stand up for patients--nobody else is going to," Carson says. "The HMO is not going to do it."

Carson also says he wants insurance premiums to become affordable, and advocates coverage that will encourage people to get preventive check-ups-- such as providing a 1 or 2 percent yearly rebate on healthcare costs.

His extraordinary life and ideas about healthcare are strengthened by a great speaking style, Poussaint says.

"We had him up earlier this year to give a lecture in which he packed the auditorium," Poussaint says. "That was the first time I'd ever heard him speak."

Poussaint was impressed at this first meeting, he says, and the speech likely played a key role in Carson's selection as Class Day speaker for the students who chose him.

"He was a wonderful speaker, he had a gentle sense of humor," Poussaint says.

Procuring the neurosurgery superstar was something of a boon for the medical school. Because he juggles his clinical work with administrative work, still teaches, and gives priority to his family, Carson's calendar is so full that he turns down many speaking engagements simply because his schedule has no opening.

"I love commencements," says Carson. "I used to do 12 a year, now I've cut back to six a year."

But his hectic schedule does not prevent the doctor from taking on what's important, he says, because he makes a point of prioritizing.

"I always say, if you need somebody to do something you have to get somebody who's busy," Carson says. "Because people who are not busy take all day to do nothing."

--Staff writer Lauren R. Dorgan can be reached at dorgan@fas.harvard.edu.