It's almost 8 a.m. and Dr. Alfredo Quiñones-Hinojosa—universally known as Dr. Q—is racing through the tunnels beneath The Johns Hopkins Hospital.
"I usually walk this way, because if I walk upstairs, through the hallways, it takes too long," he says, adding his signature high-pitch laugh. "Everybody wants to stop and talk."
He was in the operating room until 2 a.m. the night before on an emergency brain surgery, but you would never know it from his brisk pace and bright eyes. He stops by the operating room where, in about an hour, he will tunnel through Kimberly Norbet's* nose, drill into her skull, and remove a marble-sized tumor from her pituitary gland, where it is precariously resting on her carotid artery. It's an incredibly dangerous procedure, but it's typical of those that Dr. Q performs daily.
The surgeon greets Norbet with a big, warm smile, explains one last time what he'll do during the operation, and reassures her that she is in good hands. "The last thing they see is that light in the operating room," he says. "Then they turn themselves over to me."
Dr. Q has a unique connection to that experience. Back in 1989, when he was an illegal Mexican immigrant working on railroad tankers in California, he fell backwards into an empty tanker and clearly remembers seeing the light at the top before he lost consciousness, knowing that he would have to depend on others to save him.
Luckily for him—and for Norbet—Q's brother-in-law, who was also working on the railroad, risked his life to save the future doctor. "I surrendered myself to someone else," he says. "It's no different than what my patients do every day."
Q writes about the near-death experience in his memoir, Becoming Dr. Q: My Journey from Migrant Farm Worker to Brain Surgeon, which came out in October. If Dr. Q only wrote about his medical cases, the memoir would be compelling enough. His story of growing up poor in rural Mexico, crossing the border at age 14 to earn money for his family, then going from community college to Berkeley to Harvard Medical School to Hopkins, and earning U.S. citizenship along the way, is truly one of a kind.
"I hope it can tell the world that the American dream is still alive," he says. "This is the most beautiful country in the world."
While Norbet is being sedated, Dr. Q tunnels back to the neurology suites on the other end of the hospital to consult with three new patients.
In one small room, Jill Anderson, Dr. Q's physician's assistant, has set up the CAT scans and MRIs of each patient, while the patients are each in an adjacent exam room. When the doctor arrives, Anderson quickly briefs him on Barbara Brooke*, who had a non-cancerous tumor removed from her brain several years ago and is now having trouble with her peripheral vision. He stares at the scans for a minute, then goes into the first exam room.
"Ms. Brooke, tell me about yourself," he starts. The woman, in her 60s, is sitting next to her son, and clearly apprehensive. Suddenly Dr. Q, who, 10 minutes ago was practically sprinting down the hall, seems to have all the time in the world.
After they chat for a while, he explains that he sees a tumor and that it's pushing against her optic nerve, causing the vision problems. He says he needs to operate or the vision problems will get worse, and then explains the risks involved, including a 2 to 3 percent chance of serious impairment or death. She agrees.
Before Dr. Q goes on to the next patient, he asks Brooke to tell him a story, something about herself, something that he can remember when he's doing surgery on her brain. She talks about her family, how close they are, how they've discussed her conditions together and are ready to deal with it. The doctor thanks her and says goodbye.
He's back on fast-forward as he preps for the next patient, who also has a tumor and will also need surgery. (Her story is about being a college cheerleader.) Lastly, he sees a man from New York he operated on last year, when he removed a tumor. The patient makes the drive down I-95 every six months to go over his scans with Dr. Q. After warmly chatting for several minutes, the doctor reassures him that nothing looks abnormal and sees him off.
Dr. Q stands out from most neurologists, not only because he's one of the most widely respected surgeons in the field, because of his innovative cancer research, and because of his humble beginning as a poor illegal immigrant from Mexico, but also because he's an incredibly nice guy.
"I don't think I've worked with anyone who is as brilliant a surgeon and also has such a rapport with patients," says Dr. Clifford Solomon, director of neurosciences at Baltimore-Washington Medical Center, who frequently operates at Hopkins and has done hundreds of surgeries with Dr. Q. "No other surgeon I know gets as emotionally invested in his or her patients."
Surgeons in general, and brain surgeons in particular, have such a high skill level and are required to act so decisively and confidently, that some say the profession practically requires arrogance.
"When I first said I wanted to be a neurosurgeon, people said, 'Are you crazy? Brain surgeons are arrogant SOBs,'" Dr. Q recalls. "It took me a while to come around to the idea that I could be relatively nice and still be a brain surgeon."
Alfredo Quiñones-Hinojosa grew up in the tiny village of Palaco, Mexico, the oldest of six children. He was 3 years old when a sister, Maricela, died at six months from diarrhea—which is still common in poor, rural areas—forming some of his earliest memories. The book is dedicated to her.
The family ran a rural gas station and were economically stable until the mid-'70s, when the Mexican economy nose-dived and the family struggled.
"I remember seeing my father crying," says Dr. Q. "I'm sure he was dealing with depression as a young man, not being able to put food on the table. Then he started to self-medicate, which is a classic thing that depressed people do."
When Dr. Q's father started drinking heavily and getting into trouble, his mother emerged as a pillar of strength. "She would say, 'Let's not look back, let's just keep moving,'" he remembers. "'Let's leave all this negative thinking behind.' That's really the foundation of my life."
At age 14, Dr. Q convinced his mother to let him go to Fresno, CA, where an uncle was a foreman for a farm, to look for work. He took a 10-hour bus ride there, with no trouble entering the U.S., and convinced the uncle to let him work. "I had tears in my eyes and I said, 'I need this,'" Dr. Q recalls.
Pretty soon, the teenager was pulling weeds with two hands, working in fields that grew cantaloupe, corn, cotton, and tomatoes. In the mid-'80s, President Reagan signed an immigration reform act that allowed migrant farm workers to get work authorization, which Q got in 1987, leading to permanent residency and, in 1997, when he was a student at Harvard, U.S. citizenship.
"When I first came to the United States and I was working in those fields, it's not like there were people lining up to take those jobs," he says. "And I can assure you right now, there's not a lot of people lining up to do those jobs. There's always a place for hard-working people and that's what made this country."
In 1988, Dr. Q enrolled in community college, where he excelled, and, in 1991, transferred to the University of California at Berkeley. He initially thought he wanted to be a lawyer but found that he had a gift for scientific thinking.
"I was taking psychology classes so I could learn to write better English, but to keep up my GPA, I was taking science classes," he says. "That stuff came easily to me. An organic chemistry or calculus or physics exam was much easier than writing an essay in psychology."
Soon he realized he had taken all of his pre-med classes and had a near-perfect GPA while holding down two or three jobs. Looking at medical schools, he debated between staying in California and venturing east to go to Harvard. Berkeley professor Dr. Joe Martinez, Dr. Q's mentor, convinced him to go east.
"He said, 'If you don't go, I'm gonna break your legs,'" Dr. Q recalls. Martinez is from a Mexican-American family that has lived in California since the 1700s. "'A lot of us have wanted to have those opportunities, and we've never been able to get to those Ivy League schools,' he told me. "'You have an opportunity, you gotta take it.'"
Dr. Q followed his mentor's advice and, after observing an "awake" craniotomy—in which the patient is conscious during surgery on his or her brain—decided to specialize in neurosurgery.
"For one thing, I've always liked working with my hands," he says. "Also, I love the brain because when you open it, the first thing you see is the rhythm, the way that it dances with the heart. You also can't tell whether a person is black, white, Jewish, or Christian."
In his practice and research, Dr. Q has specialized in brain cancer, something few neurosurgeons choose to do, largely because the disease is so deadly: Even with surgery, radiation, and chemotherapy, the life expectancy for someone with brain cancer is generally 14 to 16 months.
Dr. Q runs his own lab at Hopkins, which is producing some of the most promising research into finding a cure for brain cancer. "Other doctors don't want to fight the disease because they consider it to be an insurmountable challenge," he says. "I refuse to believe that. Everything revolves around finding a cure for brain cancer."
Part of the reason for the success of Dr. Q's lab is his access to tissue from a broad group of people—his patients. "No one has access to the brain the way I do," he says. "My patients are part of history because I collect their tissue from the operating room."
Dr. Q's research asks, "Are there certain cells within brain cancer that, no matter what we do, they survive?" His research says there likely are. They're called brain-cancer stem cells. He and his team manipulate those cells, working with bio-medical engineers, among others, to understand the way they move and how they can be treated.
"I truly believe that Q and his team will find a cure for brain cancer," says Dr. Solomon. "There's no one around doing better work than them."
Part of Dr. Q's relentless pursuit of a cure undoubtedly grows out of the deep personal connections he makes with his patients. He describes the intense devastation he feels when his patients die from the disease—which they frequently do—sometimes leading him to seek counsel in his family or other physicians, and even to question what he does. But he always comes back to the fight.
"Everybody says, 'How do you do brain cancer? Everybody dies,' he says. "I say, 'Yes, but I don't focus on the death. I focus on their happiness when they are here.'"
In September 2008, John Petrovick, then 24, was training to run the Baltimore Marathon when he collapsed on the sidewalk in Canton with a seizure—the first of his life—and was rushed to Hopkins-Bayview Medical Center.
Doctors ran seemingly endless tests, including a spinal tap, but couldn't determine the cause. A lab technician was looking over Petrovick's brain scan when Dr. Q happened to walk by and noticed a mass in the right frontal lobe. The doctor personally went to Petrovick's room at 11:30 p.m. to explain what he had found and agreed to take him on as a patient.
"Just in meeting him, in about 15 minutes, I felt really comfortable putting my life in his hands," says Petrovick, whose trust was only reinforced when he met Dr. Benjamin Carson at a symposium and the famous neurologist raved about Dr. Q.
Days later, Dr. Q operated on Petrovick, removing the quarter-sized tumor, which turned out to be cancerous. Despite undergoing chemotherapy and radiation and suffering often debilitating effects, Petrovick vowed to run the Baltimore marathon in 2009 for Dr. Q's research fund. He completed the race, raising more than $10,000. He ran again in 2010, raising another $5,000.
In June of this year, Petrovick suffered another seizure. Another tumor was found, not far from the first one, but this time, it was intertwined with blood vessels and in the part of the brain involved with motor function. "I'd be lying if I said I wasn't scared," he wrote on a blog he kept to keep in touch with friends and family.
A week later, Dr. Q operated again and, somewhat miraculously, removed the tumor without removing any of the blood vessels or brain tissue. As a result, Petrovick's recovery was quick and his prognosis is excellent. Although he again would undergo chemotherapy and radiation, he vowed to complete half of the Baltimore marathon in October, just four months after his surgery.
And, this time, Dr. Q agreed to run it with him.
"I haven't run in 10 years," says Dr. Q, who ran four mornings a week to prepare. "But if John is willing to do this, I have to do it with him." On October 15, Dr. Q and Petrovick both completed the half marathon in about two hours, raising more than $185,000 in sponsorships.
Petrovick is not the only one of Dr. Q's patients who has been moved to support his research. Mary Lamb, 54, was diagnosed with a brain tumor in 2008 and was sent to Dr. Q for surgery. "I didn't think I was going to make it," says Lamb, who is a street light coordinator in Anne Arundel County. "I made arrangements for my death."
Dr. Q removed a tumor and, after her recovery, invited Lamb to his lab. "I saw all these college students and medical students spending their weekends in the lab," she says. "They were clearly very connected to him." She has since become a tireless advocate, hosting two events to raise money for Dr. Q's research, including a Bull and Shrimp Feast in 2010 and a Crab Feast this past September. Combined, the events have raised $20,000.
"I've just never met anyone like him," says Lamb, explaining why she feels so committed to Dr. Q. "He has the best bedside manner ever."
That bedside manner is in evidence when Dr. Q visits Kimberly Norbet just as she's waking up from anesthesia. During the surgery, Dr. Q deftly removed the tumor and had it tested: no cancer. As she wakes up, Dr. Q is there, holding her hand and telling her what to expect. She'll be able to go home later today.
Then he goes to greet Kimberly's parents who are waiting outside the operating room doors. When they hear the good news, they both break down in tears, and the mom squeezes Dr. Q, sobbing in relief. "I told her, 'If you see the light, run away,'" she says, letting go of her tension with a hearty laugh.
Walking away, Dr. Q is understandably gratified. "That is the payoff for everything I do," he says. But there isn't much time to revel in the success. Rodney Hawkins, who has two tumors, one pressing behind each eye, is waiting in another operating room down the hall.