I want tell you what I think success is all about. It’s not about zillions of dollars and some dot-com organization. I’ll illustrate what I think it’s about by telling you a story.
In 1997, I was asked if I would come to South Africa to head up a team in an attempt to separate Type 2 Vertical Craniopagus twins. These are Siamese twins joined at the top of the head, facing in opposite directions. There’d been 13 attempts in the history of the world to separate twins like that, none of which had resulted in two living or intact individuals. So, I knew it was going to be a great medical challenge. But, also, this operation was being done at the Medical University of South Africa at Medunsa, the only major Black teaching hospital in South Africa—always the stepchild throughout apartheid and the post-apartheid period to Cape Town and Johannesburg. Big inferiority complex! This was their opportunity to stand shoulder-to-shoulder with the big boys, and all that pressure was on me, all that social pressure. I was prepared for the medical pressure, not the social pressure. I said, “Lord, you’re going to have to show me something that no one else has seen before, because smarter, more capable people than me have tried and failed.”
Interestingly enough, as I was looking at the various studies, I noticed that the common draining system between the two twins was a little narrower right in the center than it was on either end. Now, the traditional neurosurgical literature advocated that you would give one twin the major drainage system and separate the other one over the course of three or four operations, with the hope that they would each develop adequate circulation. I felt compelled to divide it right in the middle and that they would adequately reverse their circulation and be able to drain immediately. When I explained that to the team, they said, “You're the boss.”
When I went to the operating room, it was two days before New Year’s of 1998. There was a big sign over the O.R. that said, “God Bless Joseph and Luka Banda.” They were having song service and prayer service, and I felt good and I asked them to bring a stereo system into the operating room to play inspirational music, and 19 hours into the surgery, we were only three-quarters of the way finished. The part that remained was so complex; the blood vessels were engorged; they were adhesed; it was like spaghetti. And it looked impossible. I thought about the first set of Siamese twins we’d separated: 60 units of blood. The second set, 80 units. And, I looked at that and said, “There's not enough blood in South Africa.”
We stopped the operation and went into conference. I said, “Maybe we should just cover over what's been done here, come back in several months and they will have developed enough collateral circulation that we can cut through these vessels and they would still live.” The doctors from Zambia, which is where the twins were from, and from South Africa said, “I know you could do that at Johns Hopkins, but we don’t have the ability to keep partially separated twins alive. They’ll die.”
I really felt the weight of the world on my shoulders as I walked back into that operating room. I didn’t have my $350,000 Zeiss operating microscope that I have at Hopkins or my $400,000 3-D wand or my lasers or my ultrasounds or any of that fancy equipment. I just had my loupes and a scalpel and faith in God, and I went in there and said, “Lord, it’s up to you.”
To make a long story short, when I made the final cut between those blood vessels, up on the stereo system came the “Hallelujah Chorus.” Everybody had goose bumps. When we finished after 28 hours, one of those twins opened his eyes, reached up for the tube. The other one did the same thing by the time we got to the intensive care unit. Within two days, they were extubated; within three days, they were eating; within two weeks, they were crawling around, perfectly normal—which is how they remain today.
But, you know something? That’s not the success. The success you had to be there to witness. The people were literally dancing in the streets, their level of self-esteem was so high. We could not walk down the hallways. That is what success is. It is taking the talent that God has given you and using that to elevate other people. It’s not about accumulating things unto yourself. And that is what I mean when I say, “THINK BIG.”
Benjamin S. Carson, M.D., is the director of Pediatric Neurosurgery at The Johns Hopkins Medical Institutions and the author of three books, Gifted Hands, Think Big and The Big Picture. The above is an excerpt from his address at the University of Delaware’s 151st Commencement exercises on May 27, 2000.
By Benjamin S. Carson, M.D.