Baltimore Grill: Dr. Alfredo Quiñones-Hinojosa

The Hopkins neurosurgeon—and local hero—on Rocky, mastering his fear, and the 3-pound enigma.

His story has been well told: Dr. Alfredo Quiñones-Hinojosa ("Dr. Q" to friends) was an illegal immigrant from Mexico who put himself through medical school—at Harvard, no less—and now is a top neurosurgeon at Johns Hopkins. Below, he tackles a slightly lesser challenge: The Baltimore Grill.  

Where did you go to school?
I started my education in a small rural school in a quiet, peaceful little farming community surrounded by the dessert of Baja California on the outskirts of Mexicali, Mexico. Mexicali was looked upon as a "big town" by the people I grew up with and I eventually went there to study to become an elementary school teacher. I continued my schooling in the United States, learning English at San Joaquin Delta College in northern California and finishing my bachelors at UC Berkley. I went on to medical school at Harvard and returned to California to do my residency in neurosurgery at the University of California, San Francisco.

What book or films most changed your life?
I remember reading the book by Gabriel Garcia Marquez Love in the Time of Cholera—what an amazing story. This great work by the gifted Colombian-born Nobel Prize winner taught me two very important lessons—keep your dreams alive and no matter what happens, if you give the world your best, the best will come back to you.

One of the films that had a great impact on my life was the 1976 movie Rocky. Interestingly I didn't get a chance to see this movie until I came to the United States in the mid 80's. As you can imagine, I could really relate a lot to the story—the idea of realizing the "American Dream" and the idea of giving your best in any given situation were important messages that I also felt deep in my heart. Both Rocky and I had to "go the distance" to realize our dreams. I have always believed that it is not only what we have in our brains but it is also what we carry in our hearts that allows us to achieve great things.

Who is your favorite Baltimorean?  
Wow this is a tough question!  How can one have one favorite?  I have several favorites to be honest with you. A group that is extremely important to me and also part of my life are my patients—many of whom are from Baltimore. I often form close relationships with my patients—what can be closer than operating on someone's brain? Through my relationships with my patients, I learn a lot about them, their families and myself. Finally, I am inspired by the students and post-doctoral fellows working in my laboratory. They work very hard helping find better ways to cure brain cancer. My team reminds me of what Santiago Ramon Y Cajal (Nobel Prize Winner in 1906) said once: "Science like an army needs generals and needs soldiers; the former may do the thinking but it is the latter who do the conquering!"

What is the best advice you ever got?
The best advice I ever got was to bet on myself, be humble, be a good human being and never forget where I came from—my roots! My parents taught me early in my life to treat others the way I would like my loved ones to be treated.

What is the biggest mistake you have ever made?
I have made a lot of mistakes in my life. But it is not the errors and mistakes that matter most, it's how we respond to those errors and mistakes that makes the difference.

What is the bravest thing that you have ever done?
I was told as a little boy that familiarity with danger makes a brave person braver. I think that without  question  dealing with my patients with brain cancer in and out of the operating room is the bravest thing I do every day.

What is the greatest problem facing Baltimore today?
I think the greatest problem we face in Baltimore is education. We need to educate our people; we need to educate our future generations of students that are going to carry us forward. Our future scientists, artists, and writers could be among those kids that are struggling on the streets of our wonderful city. We need to go back to what made this country a beautiful nation, hard work and education. We need to try to help this nation's young people get ahead in life.

When were you most tempted to leave Baltimore?
I can say that I have never been tempted to leave Baltimore. I am very happy where I am today. Baltimore is a wonderful city with a wonderful multicultural and diverse society. I feel at home here everyday.

Who would play you in the movie for your life?
Honestly, it is hard to imagine someone would want to make a movie about me, so I haven't much thought of  who I would choose to play me if such a movie was made. But I do think very highly of Javier Bardem after his performance in the movie No Country for Old Men. Javier I think would do a phenomenal job not so much because of me or my story but because of my respect for him as an artist.

What is your guilty pleasure?
I love sweets, I can not deny it. I think that it runs in my blood.

If you could write Baltimore's motto what would it be?
Strive for Perfection and Never Give Up!

There are so many illegal immigrants working below their true abilities what advice would you give them?
Never work below your true abilities. Always keep moving forward. No matter what you do, whether you sweep the floors, whether you shovel fish deposits in a tank, whether you are a scientist or a carpenter, always give it your best the best will come back to you. Even if you are doing the most menial job, do it to the best of your ability and this country and its citizens will recognize your talent.

You have no doubt inspired others to strive for greatness. Has anyone told you a specific story of your influence?
So many great people have had an incredible impact on my life. I have almost lost count. And I too have had the privilege of passing down the advice that has been given to me over the years. Some of my students have thanked me profusely for having changed their lives and given them the opportunity to realize their potential. Once when I was a resident and it had been a very long night in the hospital, I had a medical student sitting with me and I asked him what he wanted to do with his career. For many years he had thought about becoming a brain surgeon but he told me that he didn't think he had what it takes. I had worked with the students already for a few months and I just knew that he could make it. I looked at him in the eyes and said that you have everything that it takes and more. The question is do you want to do it? Yes or no?  He eventually graduated from brains surgery residency at the University of California. When we spoke again a few years later, he told me how much of an impact that moment had in his life and how it really made him realize that he could fulfill his dreams as a brain surgeon. I was just happy that I had the opportunity to play a small part in helping him with his life.

You seem very humble about neurosurgery. You see it almost as a craft, right?
Neurosurgery is very complicated in the sense that we understand so little about this beautiful organ known as the brain. Remember this is the organ that allows us to be who we are, that allows me to do brain surgery. My biggest challenge is to try to simplify this very complex organ so we can better understand how it works, and what is happening when it doesn't work the way it was supposed to. I am humble about neurosurgery because I think and realize everyday that is spite of how much we know and continue to learn about the brain, we are still in the embryonic stages of understanding this wonderful organ. I am also humbled by the courage my patients have and the trust they have in me when they place themselves in my care.

One slip is the difference between life and death. How do you handle that pressure?  Do you allow yourself to think about it?
It is true that neurosurgery is a game of life and death and it is a profession that requires a great amount of concentration and dedication and focus. A fair amount of pressure comes when you are in the operating room. I think the way I deal with is by becoming part of the patient, by fully connecting with the patient in the operating room, by feeling I am part of their body. This puts me in a state of deep concentration and focus. Many people wonder whether or not surgeons are afraid and I always say that it is not fear that matters, it is how we gather that energy that fear brings. Fear is a product of the realization that you are faced with a big challenge. If this energy is properly channeled, it can help your senses become hyper acute, become fully aware of everything. It can also help you find peace in the operating room. Your hands, your pulse, your body are at peace and nothing can startle you, yet you have the ability to react in a fraction of a millisecond to a difficult situation that can mean the difference between life and death. It is that tension and the resulting concentration that allows you to do this wonderful job and allows you to be fully connected and fully aware and ready to respond to anything that might come.

How do you avoid getting that "God complex" that surgeons are often accused of having?
Brain surgery is what I was trained to do, my hands, my skill, my knowledge are part of a large system that includes neurologists, nurses, technicians, administrators and much more. In addition, I am humbled everyday by my own patients, by seeing them struggle through a difficult disease, through a difficult post operative care. When you really connect with your patients, if you can feel their pain and share their emotions and experiences, you realize we are all in this together and we are all equal in our own way.

You seem like a very happy guy, have you always been that way and does it help in your work?
I have always been this way, I love what I do, I have always loved every single thing that I have done, all the way from when I was just a little kid working at the gas station to growing up selling corn and hot dogs on the corner, to coming to the United States as an immigrant farm laborer. I love my life now as a brain surgeon. I enjoy every single moment, every breath I take I consider it a gift—a major privilege. I think that our attitudes and the way we see the world will have an effect on the way the world perceives us. I always try to focus on the positive, no matter how difficult the times may be and that helps me achieve a balance that allows me to be happy and to smile in the midst of chaos, in the midst of disaster, in the midst of difficult situations. To try to remain at peace with yourself, with both your strengths and your weaknesses, is really one of the greatest challenges that we face as human beings.

What is your greatest success as a brain surgeon?
I think my greatest success as a brain surgeon has been seeing my patients and their families experience joy and happiness after I have performed surgery on them or one of their loved ones. When I see them smile in my clinic or after surgery, and thank me and hug me, I know that what matters most is that my patients can have a good quality life after coming to see me. That for me is my greatest accomplishment. If, in addition, I can contribute to the group of people that are working to find a cure for brain cancer then I will also consider that a great success. Every single one of my patients and their loved ones deserve our commitment to curing brain cancer since they are the ones that struggle everyday fighting their disease.

What is the greatest disappointment?
The fact we are continuing to do a lot of work on the human brain and yet we still know so little about it. Every time one of my patients succumbs to a fatal neurological disease such as brain cancer, I feel pain and frustration for the patient and their family and for the fact that medical science has not progressed to the point where we can slow down diseases like brains cancer.

What's a Dr. Q operating room like? Quiet and intense? Relaxed? Is there music?
I like to think of my operating room as an extension of my laboratory. It is intense when it needs to be intense, it is relaxed when it can be relaxed. We have music when the situation allows for it.

What is one operating anecdote that your patients probably got that they didn't know?
I don't have anecdotes that I don't tell my patients. I believe in honesty and openness and in the operating room there is no room for mistakes. Every significant event happens in the operating room is shared with my patients and their families. There are no secrets.

If you weren't a brain surgeon what would you like to do?
I think that one of the noblest professions in our society is teaching. Teachers are and extension of the family, they are the backbone of society. Without teachers and education, we wouldn't have medicine, literature, science, industry, art, music . . . in essence, the world as we know it, would very likely not exist.

Issue date: September, 2008