Profile: Dr. Quíñones-Hinojosa

PROFILE: ALFREDO QUIí‘ONES-HINOJOSA

PBS Airdate: July 9, 2008

NEIL DeGRASSE TYSON: Plenty of great scientists have made a mark even though they came from humble origins. Albert Einstein, when he was younger, was a patent clerk. Dmitri Mendeleev, inventor of the periodic table of elements, was a poor kid who hitchhiked thousands of miles across Siberia just to go to college.

In this episode's profile, we meet a brain researcher whose journey of discovery was rife with challenges of its own.

It's early Monday morning, and Dr. Alfredo Quinones-Hinojosa, or Dr Q., as everyone calls him, slips into his lab coat, as routinely as Mr. Rogers puts on his sweater.

ALFREDO QUINONES-HINOJOSA: All right.

NEIL DeGRASSE TYSON: His day begins with a quick sprint through the lab to check on things, and, as always, a good wash.

ALFREDO QUINONES-HINOJOSA: Clean your hands. You can never clean your hands too much.

NEIL DeGRASSE TYSON: The pace here is fast because lives hang in the balance, lives that could be lost to a dread disease that, so far, has defied understanding.

ALFREDO QUINONES-HINOJOSA: What we're trying to understand in my laboratory is very simple. It's really not that complex. We're trying to understand, how does brain cancer originate and how does it spread?

NEIL DeGRASSE TYSON: To answer those questions, Dr. Q. and his research team are looking at neural stem cells which are taken from human brain tissue. These cells have the ability to become different types of mature brain cells.

Dr. Q. thinks that in brain cancer, something may go wrong with these cells, causing them to grow out of control and seed tumors that are frequently malignant.

ALFREDO QUINONES-HINOJOSA: Certainly, if it is malignant brain cancer...virtually...almost no possibility of cure.

NEIL DeGRASSE TYSON: If these cells are growing out of control, and if Dr. Q. and his team can determine why, then maybe one day they'll be able to stop or reverse the process, transforming brain cancer from a deadly disease to a chronic but manageable condition.

ALFREDO QUINONES-HINOJOSA: We are at the forefront of understanding human tissue, human cells.

NEIL DeGRASSE TYSON: It's hard to get human brain tissue to study, especially tissue from living patients. But Dr. Q. has a special connection. It turns out he has a close relationship with one of the country's top brain surgeons here at Johns Hopkins, Dr. Alfredo Quinones-Hinojosa.

ALFREDO QUINONES-HINOJOSA: Good morning. I have exciting news for you.

NEIL DeGRASSE TYSON: When he's not in his lab, he's with his patients.

ALFREDO QUINONES-HINOJOSA: A very, very benign menangioma. Yours was the size of a tennis ball. But the mass is all the way...right here.

Ah, look at you. You did cut your hair, huh? How are you?

DON (Surgical Patient): Just fine. How are you doctor?

NEIL DeGRASSE TYSON: Tomorrow, he will be operating on Don to remove a brain tumor, or lesion.

ALFREDO QUINONES-HINOJOSA: This is the actual M.R.I. You can see the lesion right here.

DON: That whole u-shaped area?

ALFREDO QUINONES-HINOJOSA: That whole u-shaped area.

DON: Well, I'd be lying to you, if I didn't say I was nervous.

ALFREDO QUINONES-HINOJOSA: Yeah, of course.

DON: I know I'm in good hands.

ALFREDO QUINONES-HINOJOSA: Well, I promise you—this is what I always tell my patients—I promise you that my goal is to get you in and out safe.

NEIL DeGRASSE TYSON: On the day of surgery, at the cashier's line at breakfast, he runs into Don's sister and brother-in-law, who asks him, in Spanish, "Are you ready?"

ALFREDO QUINONES-HINOJOSA: Listo.

NEIL DeGRASSE TYSON: This isn't a day for theory or larger questions. Today, as he walks into the operating room, the scientist is a surgeon. It's a transformation that can be seen in his eyes.

ALFREDO QUINONES-HINOJOSA: No doubt at that moment, okay? There's no place for doubt at that moment. Because that moment, when we're about to walk into the arena, into the operating theater, there's no place for mistakes and there's no place for errors. And I tell them, specifically, when we go in, it's going to be all positive energy. All that passion, all that training, everything that I have done in my life to prepare for that specific moment is going to come out. And we're going to go in together and we're going to take care of this.

NEIL DeGRASSE TYSON: Don's tumor, or lesion, is just millimeters from the part of Don's brain that controls his speech. Dr. Quinones has to keep Don awake and talking to make sure that they don't damage his ability to speak or make him mute, for life.

ALFREDO QUINONES-HINOJOSA: Alrighty, I want Don's mouth to be a little bit moist.

NEIL DeGRASSE TYSON: To be sure, they run a test first. As Don counts, Dr. Quinones stimulates his brain to locate those areas that determine speech.

DON: Thirty, uuuuuhhhhhhh...

VARIOUS IN O.R.: Are you okay?

DON: Yeah. Thirty one, 32, 33, 34, 35, thi...uuuhhh...

O.R. PERSON: You're okay.

DON: Thirty six, 37, 38.

ALFREDO QUINONES-HINOJOSA: I know, in my heart, that this is a tough fight. I know that the chances that I may have a significant impact on this disease are not very good. As a matter of fact, to be honest with you, the odds are overwhelmingly against me succeeding in this field, as far as finding a cure or a better way to treat brain cancer. But so were the chances of me sitting here with you today, when I came to this country, 20 years ago.

NEIL DeGRASSE TYSON: Chances were about all Alfredo had in 1987, and they were slim to none. He was a Mexican citizen, poor and desperate to come to America, when he jumped this fence and snuck into the country as an illegal alien.

ALFREDO QUINONES-HINOJOSA: It is tough to be poor. It is tough to be poor in the United States; imagine how much more difficult it is to be poor in poor countries. And it's tough to survive in that environment, to be honest with you. I think that it was pretty clear to me that this is what I needed to do.

NEIL DeGRASSE TYSON: Alfredo grew up in Mexicali, just across this wall, at the California border. Neither of his parents made it past the first grade, the same grade little Alfredo was in when he started managing the finances of his father's gas station.

ALFREDO QUINONES-HINOJOSA: By the age of five, I was already working. By the age of 10, I was a major contributor.

NEIL DeGRASSE TYSON: What little the family had disappeared, along with the Mexican economy, in the 1980s, and Alfredo jumped the fence at 19. He became a migrant worker in the San Joaquin valley.

ALFREDO QUINONES-HINOJOSA: At first, I was thinking, I am going to take over the world with this. I am going to go back to my country triumphant, and I am going to be making a lot of money. Then I get my first check, about $130 a week, and I realized this might take a little bit longer. This is hard work.

NEIL DeGRASSE TYSON: He lived in this trailer for about a year, all by himself.

ALFREDO QUINONES-HINOJOSA: It was a palace.

NEIL DeGRASSE TYSON: Alone and depressed, Alfredo made it to Stockton, where he shared a room with other family members and enrolled in English classes at San Joaquin Delta Community College. There, he met Anna.

ANNA QUINONES: I kept seeing him walking across this, like, little area, where everybody would sit and relax, and I would see him just fly by, very fast: shoo, shoo.

NEIL DeGRASSE TYSON: They became friends, but didn't date for another two years.

ALFREDO QUINONES-HINOJOSA: I just never...you know, I never thought...I mean, it's my insecurities. How can this beautiful woman be interested in a guy who has nothing?

ANNA QUINONES: I saw something in him right away, that he was different. And I think that's one of the reasons why I was attracted to him, because I could see, like, the fire within him, that, you know, someday, somewhere, something fabulous was going to happen with him.

NEIL DeGRASSE TYSON: Alfredo kept moving quickly. From Berkeley, he went to Harvard Medical School. He became a U.S. citizen; married Anna; had three kids, a dog and a cat; did his residence and post doc at U.C. San Francisco; and started his lab, and became a surgeon at Johns Hopkins.

Four hours into Don's operation, Dr. Quinones removes the tumor, leaving Don's speech intact. Don has already agreed to give Dr. Q.'s lab samples of his brain's fluid and tissue from the tumor. And Don, his brain open, and with Dr. Q.'s fingers literally inside of it, says...

DON: Take as much as you want.

ALFREDO QUINONES-HINOJOSA: Isn't that amazing? I can take his speech away just like that. Just by going a millimeter over. By taking a small vessel, a microscopic vessel that you cannot even see, anything can change radically. And yet he said, "Take as much as you want."

NEIL DeGRASSE TYSON: Don doesn't know that he's just given his tissue to a research team full of hungry overachievers, who understand that ending their week, every Friday night, with a lab meeting to discuss their research until 10:00 p.m., is just part of the price of working with Dr. Q.

JASON CHANG (Student): I'm from San Francisco. I went to University of California San Francisco Medical School.

STUDENT 1: ...sophomore at Johns Hopkins University.

STUDENT 2: ...from MIT.

STUDENT 3: I'm from Oxnard, California.

STUDENT 4: ...Ecuador.

STUDENT 5: ...from India.

STUDENT 6: ...Wakefield, Rhode Island.

NEIL DeGRASSE TYSON: Dr. Q. is sharing some of the amazing opportunity he's had. But he's also got a lab to run, and if he can't move fast enough to accomplish his dream, he's hoping one of these young people will get the chance.

ALFREDO QUINONES-HINOJOSA: I have to recognize that I may never be able to have a significant impact on brain cancer, so my duty is to train those future generations.

NEIL DeGRASSE TYSON: In Dr. Q.'s version of the American Dream, rigorous, sometimes endless work leads to more and bigger dreams.

Earlier that day, just two days after his surgery, Don went home—living proof of Dr. Q's American Dream—living, to dream some more.

Profile: Alfredo Quiíñones-Hinojosa

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Image credit: (Alfredo Quiíñones-Hinojosa) © Chris Hartlove 2006

Anna Quinones

Alfredo's wife

Alfredo Quinones-Hinojosa

Johns Hopkins University www.hopkinsneuro.org/pituitary/doc.cfm/expert/Alfredo_Quinones-Hinojosa