The Alfredo Story

From illegal migrant worker to Hopkins brain surgeon: It sounds like a movie plot, but the leading man now walks Hopkins' hallways. His story is also on the NPR.

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It’s early afternoon on a brilliant fall day, and the 38-year-old neurosurgeon—the director of the brain tumor program at Johns Hopkins Bayview—claims to be tired. The pressures of the operating room, he says, often leave him emotionally wrung out. But this exhaustion has manifested itself in a peculiarly Alfredo-like way, as a sort of giddy elation.“Look—look at this nice leather couch,” he crows. “There was a time when I was sleeping in a trailer. Now I’m sitting on this beautiful leather couch. People call me Dr. Q. They think I actually have something important to do.” He rubs the couch dreamily. “I feel so lucky to be here. Why me?”Then he tells the story about how he almost died. This was April 14, 1989, when Quiñones was a 21-year-old illegal immigrant working as a welder on a railroad crew in central California. He fell into an empty petroleum tank, an 18-foot drop, and tried to escape by climbing up a rope that had been tossed down by rescuers. “As I was going up, my whole life unrolled in front of me. I saw my parents crying, my friends, everything.” At the top of the tank, he says, he clasped a co-worker’s hand and fell back into the tank, overcome by fumes. He woke up in an intensive care unit. It was the first time he had seen the inside of a hospital.“I’ve always felt that everything that has happened since then has been a gift,” he says. “I don’t think I was meant to go beyond that.”The degree to which Quiñones, an assistant professor of neurosurgery since last year, has exceeded expectations is a subject of recurring wonder, for him and for others. The basic narrative—penniless Mexican teenager jumps the border, learns English, and goes to Harvard Medical School to become a brain surgeon—describes such an implausible arc that one is tempted to look, in vain, for the catch. (“It’s too good to be true,” says a close friend, Harvard neurobiologist Ed Kravitz. “But it’s true.”) And then there is the irrepressible star of this unlikely fable, Quiñones himself. Meet him and he will grin broadly, envelop your hand in a handshake, then give your shoulder a proprietorial squeeze. He greets everyone he meets like this, something his parents taught him a long time ago. In lesser hands it might come off as fake-chummy artifice, but Alfredo sells it, effortlessly. “Human behavior is strange—we treat people differently based on where they’ve been or where they are rather than who they are,” he says. “I try to treat everyone with the same respect, whether they are millionaires or the poorest person that you can conceive of. I always shake their hand and touch their shoulder. I try to standardize that.” As Henry Brem, chair of neurosurgery here, says of the curiously driven character who joined his brain tumor team last year, “He’s not a person who accepts no. He’s a person who always wants to go beyond expectations. He wants to do what other people say is impossible.”If that’s what he’s looking for, Quiñones has definitely come to the right place. His research focuses on the possibility of using neural stem cells to stop or even repair the damage wrought by incurable brain cancer, the devastating high-grade gliomas that, for most patients, are now all but a death sentence. Under Brem, who helped develop the Gliadel chemotherapy wafer treatment that has extended average survival rates for those with recurring malignant brain tumors by a small but significant eight weeks, Hopkins has become a frontline leader in the battle against brain cancer. It’s the sort of hopeless cause that holds a powerful allure for Quiñones, who knows a few things about being told what he can and can’t do. “I wonder if subconsciously I was attracted to this field, just like I was attracted to coming to the United States,” he says. “Even though people said there’s no possible way, I stuck with it and gave it my best.” He applies that same attitude, he says, in the laboratory and the operating room. “I could have picked something else and had a better quality of life. My patients, they die. It’s depressing. It hurts. But I refuse to believe that there’s nothing we can do. I’m absolutely adamant about it.” The tour of Alfredo Quiñones’ past begins with the three pictures, a triptych of artifacts from an earlier life: his family’s dusty yellow gas station; the chain-link border fence in Calexico, California, that he climbed in 1987; the beat-up truck camper that served as home when he was a migrant farm worker in the San Joaquin Valley. The snapshots sit on a bookshelf in his office, incongruous amid the framed degrees and awards. First born of six children, Quiñones grew up in a village outside Mexicali, the desert capital of Baja California, a few hours southeast of San Diego. He started working in the gas station by the time he was 5, he says, selling corn and hot dogs to drivers to make some extra money for the family. “I was very advanced for my age,” he says. “I couldn’t wait for things to happen. I had to go and get them.”His family was poor, especially after the Mexican economic crisis of the early 1980s, which left his father jobless and the family hungry. Nevertheless, Alfredo excelled in the public schools, scoring well enough to earn a place in a local college in his early teens. By the time he was 18, he’d graduated and had a teaching license. But instead of teaching in Mexico, he decided to join his uncles and cousins who had already made the passage to El Norte. “My original plan, just like many people who come to the United States, was to make a lot of money and come back to my country,” he says. “It took me about a year to realize that that was a false dream.”Once he’d jumped the border, Quiñones pulled weeds in the cotton and tomato fields outside of Fresno. He spoke no English and, at 19, wondered if he’d made a mistake. One day he told a cousin that he wanted to go to school, learn English and leave the farms forever. “He looked at me and said, ‘Are you crazy? This is your future. You came to this country, just like us, to work in the fields.’” This, Quiñones says, was a wake-up call. “If he hadn’t told me that, I’d probably still be back there.” He called his parents, who by this time had resettled with three of his younger siblings in nearby Stockton. They picked him up and drove him back to live with the family in a one-room apartment in downtown Stockton. He found work at a railroad company, where his first task was shoveling sulfur. “Imagine! I kept asking myself, Why the hell did I leave the farm? But I knew that if I kept working and giving it all I got, eventually things were going to turn around.” In 1988, Quiñones signed up for English classes at the local community college. And things turned around. When Anna Peterson met her future husband at San Joaquin Delta College in 1990, she was just out of high school; Alfredo was the long-haired Mexican guy who seemed to be perpetually late for something. “I was intrigued, because he was always in such a hurry,” she says. “He was at sort of a slow run, all the time.” The young Alfredo was clearly headed somewhere, fast. He tutored other Spanish-speaking students in math and science courses and joined the debate team to practice his English. His preparation was impeccable, but his accent was indecipherable. He won second place in a tournament at San Jose State. “I think our main weapon was the fact that our opponents couldn’t understand what I was saying.” By 1992, he had quit the railroad crew for good and won a scholarship to Berkeley, where he decided to major in psychology. “The areas that I found most difficult were where I had to write or speak,” he says, “and almost all the psychology tests were papers. I’d have nightmares about those essay exams, but I needed to challenge myself. I kept my GPA up by taking calculus and physics and chemistry, because those were easier.” An early mentor in the psychology department at Berkeley, neurobiologist Joe Martinez, recalls Quiñones as “one of the two best undergraduates I’ve ever had.” Now at the University of Texas at San Antonio, Martinez recalls, “Alfredo knew nothing about neurobiology when he got into my lab, but it really captured his imagination. The level of motivation, but also the people skills he had, were amazing.” Quiñones considered law school, but—inspired in part by a grandmother who had been a respected curandera, or village healer, back in Mexico—he decided on medicine. Medical schools lined up to offer him scholarships. Martinez, who ran an advancement program for minority students, encouraged Quiñones to choose Harvard, introducing him to Ed Kravitz and his famous Harvard neurobiology lab. In a pre-matriculation summer research program in Kravitz’s lab, Alfredo earned the nickname “Lucky Quiñones” after his success in a partial cloning project of a receptor involved in lobster molting. For Kravitz, a former Bronx street kid who made full professor at Harvard by 30, there was an immediate connection. “We both traveled an unusual route to get where we were,” he says. “We bonded right away.” Quiñones also distinguished himself at Harvard with his efforts on behalf of other students from lower-income backgrounds, becoming a leader in the pre-matriculation program he had once attended. “Alfredo arranged for visits from students, picked them up at the airport and gave them a place to stay,” Kravitz says. “That’s another of his strong points—he really reaches back to help people.” At this point, the Lucky Quiñones story becomes a blur of accolades: Heaped with research fellowships and academic honors, he graduated cum laude and, now a newly minted American citizen with an infant daughter in tow, gave the commencement speech for his Harvard med class of 1999. Internship and a surgical residency at the University of California, San Francisco, followed. It was here that Quiñones found his medical mission. As a second-year resident, he was brought in to help translate for the Spanish-speaking family of a patient with a malignant brain tumor. The young man, as Quiñones recalls, was not unlike himself: 19 years old, about to go to Berkeley, “the hope of his family.” He died a little over a year later. “Over the course of the next year, I saw him go from being a strong kid to just deteriorating and dying,” Quiñones says. “I saw his body just given up to the disease. I saw his family tormented and in pain. And I thought, ‘This could have been me.’”