I’ve followed the phenomenon of Ben Carson’s popularity among the GOP base with a mix of bemusement, irritation, and, like most of you, disbelief. What prompts me to submit my first blog entry is the pervasive misuse of the word “smart” by journalists of all stripes when describing Dr. Carson. We’ve all seen a variation of this point in almost every story: “He is obviously very smart because he is a neurosurgeon but…”. Even journalists I admire confess confusion at how he can be so smart yet harbor such outlandish ideas.

As a neurologist in practice for 20 years and one who has worked closely with many neurosurgeons I can assure you, Dr. Ben Carson is not smart. Not even close. He is a painfully ignorant person. This is an easy point to defend. We are all familiar with the litany of uninformed, intellectually shabby statements he has made over the last few months; a list that I won’t waste electrons repeating.

“Smart” is a multifaceted cognitive feature composed of excellent analytical skills, possession of an extensive knowledge base that is easily and frequently augmented, possession of a good memory, and being readily curious about the world and willing, even eager, to reject previously accepted notions in the face of new data. Being smart includes having the ability to analyze new data for validity and, thinking creatively, draw new insights from existing common knowledge.

I’ve had the pleasure of working with a few smart doctors. One of the smartest, a hematologist (specialist in blood disorders) told me when I was finishing my residency that we shouldn’t call ourselves neurologists, hematologists, etc., until we have practiced for at least 20 years. I’ll never forget his soft southern drawl when he said that it takes “ ‘bout that long to learn enough of your field to call yourself a real specialist”. This from a man who had an encyclopedic database on board, a wondrous ability to think through and quickly organize the salient facts of the most complex cases, and, by the way, was also one of the most self-effacing, non-egotistic people I’ve known. He was an example of how those with superior skills and smarts don’t need to advertise how good they are.

My point is that neurosurgeons are not automatically smart because they are a neurosurgeon. To get through training and have any sort of practice they must be disciplined, have immense ego strength, a reasonably good memory, and have mental and physical stamina. However, like many other doctors, they are not always smart. Neurosurgeons, like other surgeons, can be outstanding technicians but that is different than being intellectually brilliant. A truly brilliant internal medicine specialist once told me that “you can train anyone to perform a procedure”. I’ve seen surgical assistants, not doctors but physician’s assistants that specialize in surgery, perform technically difficult procedures with stunning alacrity. It’s the old rule: do something enough times and you will get damn good at it.

The feature shared by neurosurgeons far out of proportion to other doctors is a large ego. All doctors can be accused of having big egos but more than other specialists, neurosurgeons- Ben Carson is exhibit 1 in this regard-have pathologically large egos. You know, the kind of ego that requires not one large self-portrait prominently displayed in an ostentatious mansion but a second of Mr. Ego sitting with Jesus; at the right hand of Jesus.

So, professional journalists, bloggers, and all those who post comments at Daily Kos and elsewhere, please stop using the word smart to describe Dr. Carson in the first clause of your sentence. Leave that one out and stay with the subsequent clauses detailing his ignorant beliefs, intellectually sloppy policy proposals and profound lack of smarts.

If there is any interest in this essay I will be happy to explain, from the perspective of a practitioner, why his proposals for health-care are stunningly unworkable and, well, dumb.