In 1985 pediatric neurosurgeon Benjamin S. Carson Sr., M.D., faced a dilemma. He believed that a hemispherectomy—removal of half of the brain—was the best way to help a girl with severe epilepsy who was suffering constant seizures. A senior physician, a well-known neurologist, disagreed. Carson performed the surgery anyway. “I risked my career because I asked myself why I became a neurosurgeon, and it was to give patients the best possible existence,” he told the 100 students graduating in the Class of 2012 in his commencement address on May 21.In any difficult situation, he continued, he asks four questions. “What’s the best outcome if I do this? What’s the worst outcome if I do this? What’s the best outcome if I don’t do this? What’s the worst outcome if I don’t do this?”Carson, director of pediatric neurosurgery at Johns Hopkins Medical Institutions, received national attention in 1987 for the first separation of twins joined at the back of the head. His hardscrabble beginnings—a poor student and troublemaker who grew up in poverty in Detroit—followed by his transformation into an eminent surgeon have been the subject of a documentary and a TV movie. Among his many awards is the Presidential Medal of Freedom, which he received in 2008. Carson’s belief in the power of education is such that he and his wife established the Carson Scholars Fund, which has awarded more than $4.5 million to scholars in 45 states.Not all of his groundbreaking surgical attempts have been successful. In 1994 in South Africa he attempted to separate twin infants who were joined at the head. Both died because only one had a working heart and the other had no kidney function. When he returned to the same hospital in 1998 to operate on 11-month-old twins who were joined at the head, he was hesitant. This time, the complex 28-hour procedure worked; the twins are healthy and are now in ninth grade. “When you tell someone their loved one is doing well,” Carson said, “that’s the best feeling in the world.”Several faculty members received awards at the ceremony. The Bohmfalk Prize was awarded to Lawrence Rizzolo, Ph.D., associate professor of surgery (gross anatomy) and of ophthalmology and visual science, for basic science teaching, and to Lloyd Cantley, M.D., C.N.H. Long Professor of Medicine (nephrology) and professor of cellular and molecular physiology, for clinical teaching. The Leah M. Lowenstein Award was given to Mark Mercurio, M.D., M.A., professor of pediatrics (neonatology). Margaret Drickamer, M.D., professor of medicine (geriatrics) and associate professor of nursing, received the Alvan R. Feinstein Award. The Leonard Tow Humanism in Medicine Award was given to David Hersh, M.D., Ph.D., assistant professor of pediatrics (hospitalist). The Francis Gilman Blake Award for outstanding teacher of medical sciences was given to two faculty members: Andre Sofair, M.D., M.P.H., associate professor of medicine (general medicine) and of epidemiology (microbial diseases), and Cyrus Kapadia, M.D., professor of medicine (digestive diseases). Nicholas Blondin, M.D., and Jason Prescott, M.D., Ph.D., shared the Betsy Winters House Staff Award.The class gift was given to HAVEN Free Clinic, in appreciation of its training of student volunteers in compassionate patient-centered care.