Max Alexander
1 The hot sun burned his skin as Alfredo Quiñones-Hinojosa bent in the field to pick tomatoes. It was work few Americans would do for just $155 a week, and most of his co-workers on this 10,000-acre farm in central California were, like Quiñones, illegal Mexican immigrants.
2 It had been a year since Quiñones jumped the fence in the border city of Calexico, California, with the help of his cousin on January 2, 1987, Quiñones's 19th birthday.
3 The oldest of five children, Alfredo began work at age five, pumping gas at his father's filling station. When he grew older, he helped bring in extra money by working at a taco stand.
4 Still, he kept up with school. "My father kept telling me, 'You want to be like me? Just never go to school.' And I was not going to follow the same path." At age 14, Quiñones qualified for an accelerated program in Mexicali that prepared students for jobs as elementary school teachers.
5 He graduated near the top of his class. But because his family had no political connections, he was assigned a teaching job at a remote school. "I wasn't willing to put up with that injustice," he says.
6 Shortly after, he decided to leave Mexico in search of better options. He had been to America twice before, doing summer labor. So on his arrival, Quiñones headed with his cousin for the San Joaquin Valley to work in the fields. "I picked tomatoes, cauliflower, broccoli, corn, grapes."
7 When Quiñones looked up from the dirt, the best job he could see was driving the big tractors. The drivers were skilled, and they supervised crews. He was told it took ten years of fieldwork to land such a promotion, but Quiñones was soon behind the wheel of sophisticated plows and ditchdiggers. He learned how to service the engines and qualified for a temporary work permit.
8 A few months later, Quiñones told his cousin he was going to leave the farm. His response was, "What are you talking about? If you keep working here, one day you'll be the foreman!"
9 "Sometimes you have to be willing to risk," Quiñones said.
10 He moved to Stockton and took a job in a rail yard so he could attend night school at San Joaquin Delta College, learning English. His first job, shoveling sulfur, was the worst of his life—smelly and filthy. Once again, he scrambled to acquire new skills, this time as a welder repairing valves on tank cars. Within a year, he'd become a foreman.
11 With his English improving, Quiñones switched to the night shift and began full-time studies in science and math. To make ends meet, he also tutored other students.
12 After graduating with an associate's degree in 1991, Quiñones was accepted to the University of California, Berkeley. He moved to a low-rent district in Oakland, getting by on a combination of scholarships, loans, a small grant and, as always, work.
13 Quiñones excelled in the competitive environment of Berkeley, getting straight A's in advanced classes, writing his honors thesis on the role of drug receptors in the brain and teaching calculus on the side. In the spring of 1993, his mentor looked over his transcripts and told him he stood a good chance of getting into Harvard Medical School. Quiñones decided to give it a try.
14 Harvard accepted him, and Quiñones moved East in the fall of 1994. Three years later, Quiñones became a U.S. citizen. "I'm sitting there, ten years after hopping the fence, and it hits me how fast I came up."
15 Quiñones gave the commencement address when he graduated from Harvard Medical School and continued his training, in neurosurgery, at the University of California, San Francisco. It was an exciting but daunting prospect. Could an illegal Mexican fieldworker become a brain surgeon? It didn't seem possible.
16 Residency turned out to be a low point in Quiñones' American journey. "Neurosurgery has been reserved for people who come from a long pedigree of medicine," he says carefully. "It's rare that you have someone like me go into this highly demanding field, where lots of patients die." He'd experienced prejudice before—the farm owner's son who looked right through him, a former girlfriend whose mother disdained him for his nationality. "They just ignited my fire even more," he says.
17 He admits there were times, working 130 hours a week for $30,000 a year, when he considered quitting. "I felt what my father felt, not being able to put food on the table for my family," he says. "But I had a dream."
18 Dr. Quiñones, the noted brain surgeon, now 40, sits on the edge of a patient's bed. It's a Friday morning at Johns Hopkins Bayview Medical Center in Baltimore, and this will be his second brain surgery patient of the day. The woman, who's in her 60s, has two tumors; one is in the highly sensitive part of the cortex that controls motor movements. Quiñones holds her hand and looks into her eyes. "I walk a fine line every day between good and bad outcomes, and bad outcomes can mean life or death." he tells her frankly. She nods. Dr. Q, as everyone calls him, believes patients deserve both compassion and honesty. "That is the risk," he concludes. "So we're set. You and I have a date."
19 The four-and-a-half-hour procedure goes well—the patient comes to with no loss of motor function—and Dr. Q is ecstatic.
20 Although Dr. Quiñones is a relatively young doctor, his colleagues are already impressed. "Not only is he a talented and conscientious surgeon, but he's very sensitive to the needs of patients," says Dr. Henry Brem, director of neurosurgery at Johns Hopkins. "And he's a joyous person—full of enthusiasm and the mission to do good for the world."
21 It's now after seven, and Dr. Q has been working for 12 hours. Other surgeons are going home for the weekend, but he is headed for his research laboratory in downtown Baltimore. The lab is an extension of his operating room: Cancerous tissue that he removes in surgery is studied with the goal of finding new therapies. "One hope is that we can make brain cancer a bit more chronic, like diabetes, instead of a devastating lethal disease," he explains.
22 The following afternoon, many of the med students show up at Dr. Q's home for a Tex-Mex cookout. While flipping tortillas on the grill on the back porch, Dr. Q says, "I think my background allows me to interact with my patients in a more humanistic way. When they're scared, I'm one of them. I'm just lucky that patients allow me to touch their brains, their lives. When I go in, I see these incredible blood vessels. And it always brings me back to the time I used to pick those huge, beautiful tomatoes with my own hands. Now I am here, looking at the same color—that bright red that just fills the brain with nutrition and wonder. I'm right there in the field, and I'm just doing it."