What's lost in the war against illegal immigrants

Meet Dr. Alfredo Quiñones-Hinojosa (above).

This Johns Hopkins neurosurgeon got his start in 1987 when as a 19-year old he realized that selling hot dogs on the corner in Mexicali, Mexico was not a promising career path.

He climbed a border fence, made his way north and now, 21 years later, finds himself removing brain tumors for a living.

Here's Claudia Dreifus's Q.&A. with him, from today's New York Times.

A Surgeon’s Path From Migrant Fields to Operating Room

At the Johns Hopkins School of Medicine, Alfredo Quiñones-Hinojosa has four positions. He is a neurosurgeon who teaches oncology and neurosurgery, directs a neurosurgery clinic and heads a laboratory studying brain tumors. He also performs nearly 250 brain operations a year. Twenty years ago, Dr. Quiñones-Hinojosa, now 40, was an illegal immigrant working in the vegetable fields of the Central Valley in California. He became a citizen in 1997 while at Harvard.

Q. Where did you grow up?

A. Mexicali. My father had a small gas station. The family’s stability vanished when there was a devaluation of the Mexican peso in the 1980s. My father lost the gas station, and we had no money for food. For a while, I sold hot dogs on the corner to help.

As the economic crisis deepened, there seemed no possibility for any future in Mexico. I had big dreams and I wanted more education. So in 1987, when I was 19, I went up to the border between Mexicali and the United States and hopped the fence.

Some years later, I was sitting at a lunch table with colleagues at Harvard Medical School. Someone asked how I’d come to Harvard. “I hopped the fence,” I said. Everyone laughed. They thought I was joking.

Q. After you crossed the border, what kind of work did you find?

A. I was a farm laborer in the San Joaquin Valley, seven days a week, sunup to sundown. I lived in this little trailer I paid $300 a month for. It didn’t take long to see that farm work was a dead end.

After a year of it, I moved to Stockton, where I found a job loading sulfur and fish lard onto railroad freight cars. My eyes burned from the sulfur, and my clothes smelled from fish lard, but it paid me enough so that I was able to go to night classes at San Joaquin Delta Community College. There, I met this wonderful human being, Norm Nichols, the speech and debate coach. He took me into his family and mentored me. Norm helped me apply for and get accepted to the University of California, Berkeley.

Once at Berkeley, I took a lot of math and science classes to up my G.P.A. Science and math are their own language. You didn’t need to write in perfect English to do well in them. I pulled straight A’s in science. In my senior year, someone told me to go see this guy, Hugo Mora, who helped Hispanics with science talent. I brought him my transcript and he said: “Wow! With grades like these, you should be at Harvard Medical School.” That’s how I got to Harvard. All along, I had much luck with mentors.

Q. Did you find Harvard tough?

A. Not really. Compared to working in the fields, it was easy. The question was what kind of doctor should I become? For a while, I thought I’d be a pediatric oncologist, because I wanted to help children. But then I thought, I’m good with my hands. Maybe I should do surgery.

One day, I was walking through Brigham and Women’s Hospital and I saw Dr. Peter Black, the chairman of neurosurgery. I introduced myself, and he invited me that day to come to watch him do an operation. As it happened, he was doing an “awake” surgery, where the patient’s brain is exposed and the patient is awake so that the surgeon can ask questions. As I watched that, I fell in love with brain surgery.

Q. What about it spoke to you?

A. Imagine, the most beautiful organ of our body, the one that we know least about, the one that makes us who we are, and it was in Dr. Black’s hand. It was in front of me. It was pulsating! I realized I could work with my hands and touch this incredible organ, which is what I do now. I cannot conceive of a much more intimate relationship than that. A patient grants you the gift of trusting you with their lives, and there is no room for mistakes.

Dr. Peter Black, he was a very humble person. And he took me under his wing. So here again, I was very fortunate with mentorship.

Q. I'm told that you do something that not all surgeons do: you spend a lot of time with patients before an operation. Why?

A. I meet them several times, and their families. They don’t know if they are going to wake up after the operation. Not all the time am I successful. I do about 230 to 240 brain tumor operations a year. The majority make it. Some have complications. And some — 2 to 3 percent — it takes awhile for the patients to wake up. I need to meet everyone so that they know the risks. But getting to know these patients, it’s the most painful part.

I was at a funeral yesterday. This was a 21-year-old man with a young wife, pregnant. Three surgeries, and the tumor kept growing and growing. And he told me, “There’s no possible way I’ll give up.” He fought so hard. He trusted me with his life. Not once, several times. I owed him my presence.

Q. How do you handle such losses?

A. One of the ways I work it out is through research, the laboratory. I’m trying to learn about the causes of these recurring tumors. The patients, they can donate tissue, which we will examine.

My hypothesis is — and there are quite a few scientists who believe this — there are within these brain tumors a small subset of cells that can keep growing, even when you think you’ve taken them all out. We call them brain stem cells. They can keep making themselves, and they can make “daughter cells” that can become anything else in the brain. They have the ability to go to sleep for a little bit and then wake up and do it again. So we’re trying to identify this small subset of cells we may be leaving behind when we make these beautiful surgeries.

Q. Have you actually found them?

A. Yes, but only in the laboratory. When we’ve found them, they may be a product of the experimental conditions of the laboratory. We haven’t found them yet in live patients. The next challenge is to see if they truly exist in the human brain while the patient is alive.

Q. When you hear anti-immigrant expressions on talk radio and cable television, how do you feel?

A. It bothers me. Because I know what it was that drove me to jump the fence. It was poverty and frustration with a system that would have never allowed me to be who I am today.

As long as there is poverty in the rest of the world and we export our culture through movies and television, people who are hungry are going to come here. There’s no way to stop it.