"As time has gone on," she said, "his interest in the community and the country and how we are stacking up both educationally or in other ways with the world has become a more prominent concern for him."
The subject inspired "America the Beautiful: Rediscovering What Made this Nation Great," Carson's more recent book. James said he isn't shy about sharing those concerns.
The combination of Carson's forthrightness, his stature in the medical community, and the spectacle of an African-American physician confronting Obama over his most controversial policy have caught the attention of the political world.
"I think it was refreshing to hear somebody speak plainly and talk about solutions and not talk about political rhetoric," said David Ferguson, executive director of the Maryland Republican Party. "I think there's always going to be a reaction, regardless of who is speaking, when somebody has solutions and a bold approach instead of the cyclical problems we're facing as a country."
Carson said he has been "deluged" since the speech with media requests and reaction, "95 percent of it positive." He said he believes it shows "an incredible thirst in this nation for common sense."
How long he stays in the spotlight could be up to him, said Paul Herrnson, a government and politics professor at the University of Maryland, College Park. Ross Perot, for example, kept himself relevant in the 1992 presidential election by persisting through his own ambition and financial independence. Given how far off the 2016 election is, that could be a tall task to attempt now, Herrnson said.
Some have criticized the breakfast address as an inappropriate political stunt. The conservative columnist Cal Thomas accused Carson of "lowering himself" by breaking with the tradition of avoiding politics at the 61-year-old event. Past speakers have included Mother Teresa, Bono, and former British Prime Minister Tony Blair.
But the comments weren't intended to stoke political controversy, Carson said. Nor, he said, did they appear to offend Obama.
"I think there is virtually no better setting than something like the National Prayer Breakfast to talk about the spiritual state of the nation," he said. "I believe the spiritual state of the nation is not good."
Carson said he hopes to spark independent thinking over partisan bickering. He has planned 10 international trips after his retirement from surgery to speak to youth about the importance of education. He also plans to continue speaking around the United States — something for which he is now likely to be in greater demand.
Many of those speeches are likely to touch on what Carson sees as a weakening of the nation's moral fiber that threatens the country's survival.
"We try to make everything equal now, every kind of family situation," he said. "We go into the schools and we say there's no outstanding people because we don't want this one or that one to feel bad.
"We're basically extracting reality out of everything so everybody can feel good. But ultimately making everyone feel good makes everyone feel bad."
A previous version of this article misstated how many siblings Carson grew up with, and also misstated the title of Carson's book that was made into a television movie. The Sun regrets the errors.
Dr. Ben Carson
Family: Married, three grown sons
Education: B.S. in psychology, Yale University; M.D., University of Michigan
Accomplishments: Named Johns Hopkins director of pediatric neurosurgery at age 33, the youngest to lead a department at the hospital. Was principal surgeon on the first successful surgery to separate conjoined twins in 1987. Led first successful surgery to separate twins conjoined at the top of the head in 1997. Awarded the Presidential Medal of Freedom, 2008.