Two years before Martin Luther King Jr. was killed, a teenager named Carl Dukes listened to the Nobel Peace Prize winner deliver soul-searching sermons at his hometown church in Atlanta.

"I always knew when he was coming because the whole front pew was reserved for politicians," Dukes recalls. "It was a time of change."

The would-be physician, classical concert pianist, family man and social activist was coming of age in the company of many influential African-American leaders during one of the most racially turbulent times in United States history.

"I was lucky to be surrounded by Black intelligentsia for as long as I can remember," says Dukes, now a nephrologist in southeast San Antonio, where he and three like-minded African-American professionals have owned their building since 1999. Dukes hopes this model inspires younger cohorts who don’t live so far from his own early life experiences.

"The objective is not only to provide medical care, but also to demonstrate alternatives to what many young people see on the streets," Dukes says.

Dukes was raised in a working-class family and attended segregated schools in the 1960s that lacked resources. Dukes says his father, a postman, played a prominent role in this future physician’s unfolding.

"It goes without saying that my father was a major factor in my life," Duke says. "He taught me about survival in a racist society and how to be prepared should we ever 'get a break.' He was a source of intellectual stimulation, character and courage."

After high school, Dukes left Atlanta for New York to attend Cornell University, where he earned his bachelor's degree in mathematics before attaining his M.D. degree from the University of Rochester.

While serving his internship and residency at the University of Alabama in Birmingham —where he was the first African-American to serve as chief medical resident—the young doctor cared for two of America’s most publicly recognized racists: the former governor of Alabama and segregation proponent George Wallace and the former Alabama sheriff Jim Clark, who led violent arrests of hundreds of peaceful civil rights protesters in 1965.

"Wallace was a paraplegic and Clark had gall bladder trouble, and there they were in my care," Dukes recalls. "Tables turned. A moral victory."

Upon completing his fellowship at Rochester and specializing in nephrology at the University of Texas Health Science Center at Houston, and after serving clinical and consulting roles in both the UTHSC and M.D. Anderson Hospital in Houston and the UTHSC in San Antonio, Dukes entered private practice in 1983.

He has held executive appointments with prominent local hospital systems and was clinical investigator for a Bristol-Myers Squibb study in 2000. For the last two years, Dukes received "top doctor" honors from the American College of Physicians. He also helped bring prostrate cancer screenings to the east side as a member of the Sigma Pi Phi fraternity, which partnered with the Cancer Therapy and Research Center on the outreach project.

Dukes non-surgically treats the diseases that affect the kidneys. He is most interested in comprehensive and caring management of diabetes and hypertension and how each impacts kidney functions and disease progression. As a consequence, Dukes primarily treats patients who require dialysis and manages a 28-station dialysis unit on the east side.

Far from the first "artificial kidney" of 1913, today's hemodialysis systems are impeccable, incorporating a plethora of safety monitors, alarms and circuitry. Dukes' unit is state-of-the art, sterile and comfortable. On any day of the week, he can treat up to 84 patients.

While only three or four dialysis units like his exist on the east side, others like them are cropping up all over San Antonio. According to Dukes, the exponential growth in patients and treatment centers is easy to explain.

"Better cardiovascular treatments have resulted in fewer heart-related illnesses or quicker and longer-term recovery from heart problems and have enabled people to live longer," he says. "But as a result, the incidence and prevalence of diabetes is increasing."

Despite 13-hour days, Dukes says the rewards of practicing medicine are profound.

"Knowing something I did is multiplied is gratifying," he says. "For example, getting a woman with kidney disease through her pregnancy and seeing her child grow into a young adult—that is a blessing."

Other physicians, including Dr. Joseph Marotta, refer to Dukes as "a doctor's doctor."

"[Dukes] is highly educated and a national speaker [and] a cutting-edge nephrologist, yet he relates to his patients in a way they understand," Marotta says.

The toughest part of practicing medicine is the battle Dukes fights with managed care providers, who systematically are taking control of patients' care, he says, while sidestepping doctors.

"The challenge is to do what is best for the patient in an environment of mindless bureaucratic restrictions and policies that are not necessarily in the patient's best interest," says Dukes. "So I fight with them. I may not always win, but at least I've made an effort."

On the other hand, Dukes is encouraged by medical inroads. Among these are better immunotherapy for transplantation, increased availability of genetic information about certain types of kidney disease and advanced dialysis thanks to better dialyzer membranes and dialysis delivery systems; his own system plays a key role.

Like King, Dukes has a dream: to do his part to eradicate his enemies of kidney disease, particularly in African-Americans in whom it is prolific, as well as social ignorance.

Engaged in realizing this hope, Dukes is involved with two longstanding fraternities: Sigma Pi Phi and Alpha Phi Alpha.

"The community service we do is focused on salvaging young African-American men from the ravages of dysfunctional families and communities," he says.

Dukes is tenacious, yet compassionate; empathetic, yet enthusiastic; and a resurgent personality at every turn. This shows in his upbeat oratories about medicine, music and the mechanical brains behind his life-saving dialysis unit. This shows in his everyday dealings with patients and healthcare providers. And this shows in a revealing charismatic smile and shining eye that brighten all spaces occupied by this Renaissance man.