© Earnie Grafton/Reuters Ben Carson, a retired surgeon popular with Tea Party conservatives.

The black man courting crowds of white conservatives doesn’t seem like the same guy that H. Westley Phillips once idolized. Phillips still relishes the day he heard Ben Carson inspire minority students at Yale University with his story of persistence. He can still feel the nervous anticipation he had while waiting in line to shake Carson’s hand.

After the speech, Phillips followed Carson’s path and began to study neurosurgery.

“I had come from a public school in Tulsa and came from a single-parent household and thought I was the admissions mistake,” said Phillips, now 27. “But he gave me the comfort to know that if I did struggle — and I thought I would — that I wouldn’t have been the first, and there are ways to handle it. The message he gave was this backup artillery when times were hard.”

For many young African Americans who grew up seeing Carson as the embodiment of black achievement — a poor inner-city boy who became one of the world’s most accomplished neurosurgeons — his emergence as a conservative hero and unabashed critic of the United States’ first black president has been jarring.

Carson has been a black icon since 1987, when he became the first person to successfully separate twins conjoined at the backs of their heads. He was a rare and much-desired role model: a black man who became known for his intellect, not for telling jokes or shooting basketballs.

Posters of Carson hung on bulletin boards in classrooms. Reading “Gifted Hands,” his 1992 autobiography, was practically a rite of passage.

But now retired from his medical career, Carson, 63, has become known more widely since using his speech at the 2013 National Prayer Breakfast to offer a conservative critique of U.S. health-care and spending policies, while standing a few feet from President Obama.

[That time Ben Carson called President Obama a ‘psychopath’]

In the ensuing months and years, Carson’s attacks grew sharper — deriding Obama’s signature health-care law as the “worst thing to have happened in this nation since slavery” and, in the pages of GQ, likening Obama to a “psychopath.” Carson’s 2014 book, “One Nation,” assails a decline of moral values in America and its government.

As Carson prepares to announce his candidacy for president on Monday in his home town of Detroit, his political base is now whiter and more rural.

Carson’s personal accomplishments — and the work he has done to help black communities — still garner respect and pride among African Americans. Yet, while he has been a conservative for as long as he has been famous, many worry that he risks eroding his legacy in their community and transforming himself into a fringe political figure.

Some black pastors who were Carson’s biggest promoters have stopped recommending his book. Members of minority medical organizations that long boasted of their affiliations with him say he is called an “embarrassment” on private online discussion groups.

“Has he lost his sense of who he is?” said the Rev. Jamal Bryant, a prominent black pastor in Baltimore, where Carson lived for decades when he was director of pediatric neurosurgery at Johns Hopkins Hospital. “He does not see he is the next Herman Cain.”

Mark Terrelonge, 26, who is in his final year at Stanford University School of Medicine, said he feels his heart sink every time another clip of Carson shows up on his Facebook feed.

Reading “Gifted Hands” as a teenager, Terrelonge said he saw Carson’s story as an affirmation of his own ambitions to become a doctor. Never before had he heard of a black man in the upper echelons of medicine. But Terrelonge, who is gay, was stung when he heard Carson say that homosexuality was a choice.

“I don’t know how to say it exactly,” Terrelonge said. “I don’t want to attack him because he’s done great things in medicine, but the role-model aspect of him has kind of diminished in my life.”

Carson, too, is trying to fully understand his new place in black America. He spoke recently at the National Action Network, the civil rights group headed by the Rev. Al Sharpton, who once ran for president as a Democrat. Carson also issued a statement criticizing Baltimore demonstrators protesting after the death of Freddie Gray — urging parents to “please take control of your children and do not allow them to be exposed to the dangers of uncontrolled agitators on the streets.”

In an interview, Carson said he laments that many in the black community “drank the Kool-Aid and think I have forsaken them.”

“People write things. They say things. It saddens me,” Carson said. “There are forces in this country that really like to foster division and conflict, particularly in the black community, because they don’t want the synergy of them working together. Because that would advance them.”

The admiration many blacks have long felt for Carson differentiates him from past black conservative presidential candidates such as Cain, the former pizza executive who briefly rose in the polls during the 2012 primary, Carson’s political supporters say. He has won the Presidential Medal of Freedom, awarded by Republican President George W. Bush, and the Spingarn Medal, the top honor given by the traditionally liberal NAACP.

His stature, Carson supporters say, helps him combat the perception that the far right is exclusive and out of touch. Critics, these supporters say, underestimate Carson’s potential impact on the race at their own peril.

[He’s already a famous surgeon and author, so why is Ben Carson toying with a long shot presidential bid?]

“I would be elated if the left felt this too shall pass and he is just the chocolate flavor of the election cycle,” said Vernon Robinson, a fellow black conservative and chairman of the National Draft Ben Carson for President Committee. So far, Robinson said, the group has raised $16 million.

“Despite everything so far,” Robinson said, “he still has a reservoir of residual admiration.”

Carson’s renown — and his stature in black America — dates to his early years as a pediatric neurosurgeon at Johns Hopkins. Even then, Carson said, he always felt a sense of duty to help advance his race.

When the hospital started to receive publicity in the late 1980s for its attempt to separate German twins conjoined at the back of the head, Carson took the unusual step of asking not to be initially identified as the lead surgeon.

He said he worried that the procedure might not be treated as groundbreaking or important if the media and the broader public saw a black man in charge.

“Historically, when black people had done things of a scientific nature, many times either it wasn’t appropriately covered or someone else received most of the credit,” he said.

“And I was thinking what more of a tremendous thing it would be for young black kids to know something of this magnitude and this complexity was done by someone who looked like them,” Carson said.

After the surgery, Carson — young and soft-spoken — stepped forward. Intrigued journalists became “more interested in me than they were in the twins,” Carson recalled with a chuckle.

Someone suggested he write an autobiography. Agents kept calling for him, Carson said, “and then I thought to myself, ‘I should write a book.’ ”

“Gifted Hands” chronicles his unlikely journey into medicine. His mother, a devout Seventh-day Adventist, raised Carson and his brother alone. She taught them that they could be anything they wanted to be. Carson was the worst student in his class and suffered a debilitating anger after his father walked out on his family, he wrote.

The autobiography described how Carson’s mother barred television from the house and mandated her children read two books a week. He wrote that he prayed to God to cleanse him from his angry feelings. His grades soared, and he went on to graduate from Yale and then the University of Michigan Medical School.

He became the youngest director of pediatric neurosurgery at Johns Hopkins and the first black person to hold the position.

Carson said his agent expected the memoir to sell about 14,000 copies. According to its publisher Zondervan, the Christian arm of HarperCollins, it has sold 1.7 million.

Religious leaders in the black community emphasized the spiritual overtones and recommended the book to their youth groups. Teachers saw the narrative of achievement and social mobility and taught the book in their schools.

The legend of Ben Carson took flight. He became a regular speaker at graduations and churches, encouraging parents to find positive role models for their children — particularly black men. He asked them to instill pride by teaching minorities about the many inventions of black people, including the traffic light, the gas mask and the hair products of entrepreneur Madam C.J. Walker.

He founded a nonprofit called the Carson Scholars Fund. The group has distributed nearly $700,000 for scholarships to middle- and high-schoolers, awarding them with big trophies so academic success could be put on the same plane as athletic success.

Carson has also raised money to refurbish libraries in nearly 150 of the country’s poorest schools. A Detroit public school was named for him, as was a medical school in Nigeria. By 2009, “Gifted Hands” was adapted to a made-for-TV movie.

Matt Dean Campbell, 25, remembers being tucked into bed growing up in South Florida as his mother read “Gifted Hands” to him. His mother, a domestic worker, struggled to pay the bills, but she wanted to imbue her son with stories of uplift, he said.

Campbell, now a high school teacher near Miami, said he has drawn on that message any time he has faced adversity. He was one of the slowest sprinters on his track team at the University of Michigan, Campbell said. He graduated as the captain. He continued pushing himself, because “that’s what Ben Carson would do.”

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Sara McLaughlin, a teacher in Virginia Beach who works with troubled middle-schoolers, thought the book would be perfect for her class. Students wrote essays about Carson’s resilience and got queasy when they watched the surgery scenes from the movie.

“Is this the same Ben Carson who is running for president?” she recalled a student asking.

Then came more questions: But he’s not a politician, he’s a doctor. Why would he run? A reading assignment became a civics lesson.

McLaughlin said she could offer no answer.

“It’s funny,” she said. “A lot of people are asking the same thing.”

Presidential politics was not originally in Carson’s plans, he said.

Retirement, he said, meant relaxing in his Florida home, playing golf, maybe a television appearance here or there.

That all changed after his appearance at the 2013 National Prayer Breakfast. It was the second time Carson was invited to speak at the event. The first time, in 1997, he made quips about the unfairness of HMOs. But this time, he went further. With repeated references to his tendency to be politically incorrect and offend the “PC police,” he offered an alternative view of health-care reform in which people would simply have private accounts to pay for their own care with pre-tax income. He railed against the debt and tax policies that seek to force the wealthy to pay a higher share than others — endorsing a flat tax, similar to tithing.

Carson, who does not often speak with notes, insisted that this was not a political speech but an exhale of frustration of the state of the country. But then new admirers started suggesting he run for president. Within days, the Wall Street Journal published an editorial proclaiming “Ben Carson for President.” He began thinking maybe he should.

The political turn was unexpected for many who knew him. The Rev. Frank Reid of Bethel AME Church in Baltimore found it “astounding.” When they were at Yale together, Reid said, Carson was universally regarded as brilliant and hard-working. Reid could not recall Carson participating in student activism because he was too busy studying with his future wife, Candy, in the library.

When Carson first promoted “Gifted Hands,” Reid invited him to his church so his congregation could hear the story. But if Carson were to speak today, Reid said he would ask him to come in for a “family session, with our leaders, behind closed doors, to find out what is really going on.

“I am hedging about what to say, because you cannot take away the impact that he’s had,” Reid said. “But before we turn on the brother, we have to hear him out. As shocking as some of the things he’s said are, I would rather have a discussion than attack someone who has done respectful work.”

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Carson says he is willing to put his legacy aside to do what he thinks is best for the country. Still, it matters to him.

Sitting at the Sheraton Hotel in New York last month, Carson seemed anxious as he prepared to address the National Action Network a few hours later. This audience, a mostly black group seeking the advancement of black people, used to be an easy crowd for Carson. But times had changed.

“I have no idea how they are going to receive me,” Carson said.

As Carson waited to go on stage, Sharpton pleaded with the crowd to give him a fair hearing. Carson got some applause when he reiterated his belief that marriage was between a man and a woman. He said it was “a bunch of crap” for critics to say he doesn’t like black people anymore.

“I love black people. My wife is a black woman,” he said.

Then came the Carson of old, borrowing parts of the speeches he used to give in the 1990s.

He talked about the need for black role models and the importance of teaching young people about those black inventors. His voice shook as he described the horrors of growing up in neighborhoods crippled by drugs and overrun by rodents, and of losing families members to gun violence. He asserted that hard work and faith were able to lift him — and anyone else — out of poverty.

The crowd rose to their feet.

The next week, Carson returned to more comfortable terrain for a prospective GOP presidential candidate: the convention of the National Rifle Association. There, he spoke of how he thinks the need to control gun violence on the streets does not outweigh the need to combat “radical Islamic terrorists.”

Days later, he appeared at a fundraiser for a faith-based medical clinic in the lush upstate South Carolina city of Greenville. He talked about the importance of putting God first and speaking honestly. The emcee of the event said Carson would help fill in the gap of having “good, godly leaders to stand up for what is right.” The neurosurgeon received another standing ovation.

Carson then sat at a table to sign copies of his books. A line of mostly white attendees formed. Near the end was Landry Assinesi, a 19-year-old student at Piedmont College in Georgia who came back home to listen to Carson speak.

Assinesi said he never read “Gifted Hands,” but he devoured “One Nation.” Reading Carson’s words, Assinesi said he found a new political hero.