See photos of Ben Carson on the campaign trail

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SPARTANBURG, SC - FEBRUARY 20: Republican presidential candidate Dr. Ben Carson walks around greeting people at the Beacon Drive-In restaurant on the day of the South Carolina Republican presidential primary in Spartanburg, SC on Saturday Feb. 20, 2016. (Jabin Botsford/The Washington Post)

Ben Carson ought to get ready, because things are about to get very difficult for him. In fact, we can probably start the clock on the demise of his presidential candidacy.

Okay, so that’s a little dramatic. But today we saw the first national poll, from the New York Times and CBS, that puts Carson in the lead in the Republican race. Yes, it’s only one poll, and yes, that lead is within the margin of error, meaning he may not actually be ahead (the poll averages still have him trailing Donald Trump by a few points). But he’s clearly leading in Iowa, and this poll will be taken as a cue for the press to give him more scrutiny than he’s gotten so far. Carson has been getting more media attention, but that focus will intensify now. And it won’t be good for him.

Ben Carson has placed first in a national Republican presidential primary poll, pushing Donald Trump into second place for the first time since June. Deborah Lutterbeck reports. (Reuters)

In a year in which outsiders are all the rage, Carson is the most outsidery of all. Ted Cruz is a U.S. senator who built his identity by hating the institution he’s a part of and everyone who’s in it — but he’s still a senator. Carly Fiorina is a former CEO — but she ran for office before and has been involved in politics for some time. Even Donald Trump is less of an outsider than Carson. He may be just as ignorant about policy, but there’s a surface plausibility to him being president. He runs a company, you can see him on TV ordering people around, and he’s got a plane with his name on it.

With each passing week, however, Carson has been gaining. All of his shocking statements on things like Muslims not being allowed to run for president unless they publicly disavow their religion, or Obamacare being the worst thing since slavery, or that the Jews might have stopped the Holocaust if they had more guns, only seem to have helped him win support for his campaign. But there’s a limit to everything.

As of now, Ben Carson’s actual plans for being president will get much more attention. And even Republicans may not be happy with all of what they hear.

Take, for example, Carson’s plan to shut down Medicare and Medicaid and replace them with health savings accounts. From a policy standpoint, it’s utterly daft. But it’s also about as politically unwise as you could imagine. Medicare is one of the two most beloved government programs there is. Even though Republicans would love to get rid of it (in part because its success stands as a constant rebuke to their belief that government can’t do anything right), they always insist that their plans to cut or transform it are really about “strengthening Medicare to make sure it’s there for future generations.” They know that saying anything other than that they love the program and want it to exist forever is somewhere between treacherous and suicidal.

That doesn’t stop Democrats from charging that Republicans want to destroy the program, an attack that usually works. And with Carson, there wouldn’t be any doubt — he does want to end Medicare.

What else does he want to do if he becomes president? His ideas are almost absurdly vague, a fact that will become more and more evident as he gets more attention. Go to the “Issues” section of his web site, and you’ll search in vain for anything resembling an actual proposal. When he is asked about particular policy issues, he tends to offer something so simplistic and divorced from reality that it often seems like it’s the first time he’s ever thought about it. How might he change the tax system? Well, how about a tithe, like in the Bible? (Or actually not like in the Bible, but never mind that.) How would that actually work? He doesn’t know, and barely seems to care.

Carson certainly checks off many of the standard Republican boxes: overturn Roe v. Wade, balanced budget amendment to the Constitution (as idiotic an idea as either party has ever produced, but that’s a topic for another day), show Russia who’s boss, more guns, and so on. But as he’s forced to talk more about a Carson presidency, he’s likely to get lots of negative coverage growing out of his own lack of understanding of government.

You see, the journalists covering Carson come from that same Washington world he finds so alien, and they’ll be drawn to talking about his unfamiliarity with it. This has nothing to do with liberalism or conservatism — someone like Ted Cruz, who’s every bit as conservative as Carson, can have a conversation about the presidency with reporters in which they’re all inhabiting the same planet. They can ask him a question about something like defense spending or Social Security or foreign policy, and while his answers might be oversimplified, they won’t make the reporters say, “Oh my god, did he just say what I think he said?”

You might reply that Donald Trump knows just as little as Carson, and also gives ridiculous answers to policy questions. But Trump’s ability to blow through those questions (“When I’m president, it’ll be terrific!”) is possible because his supporters don’t really care about the answers. They’re not party loyalists who are concerned with ideological fealty or electability.

But Carson’s support right now is centered on evangelicals and older Republicans, and they’re more pragmatic than you might think. Yes, they’ll support someone like Carson for a while — just as they gave Rick Santorum and Mike Huckabee victories in Iowa — but that support isn’t permanent. Once other Republican candidates start going after Carson for wanting to eliminate Medicare (Donald Trump has already started), many of Carson’s voters are going to say, “Well that’s not going to go over too well,” and even, “I’m not sure I like that.” The more attention he gets, the less electable he’s going to look.

Am I being premature? Perhaps. Carson is so popular with evangelicals in part because they’ve known him for years (his autobiography is a common assignment in Christian home-school curricula everywhere). His combination of a calm, soothing manner and absolutely radical ideas has proven compelling to a healthy chunk of the Republican electorate. It’s entirely possible that he could sustain this support enough to win Iowa and then receive all the glowing coverage such a victory would produce. And the very fact that he’s doing as well as he is makes for a fascinating story. But it isn’t going to last.

Ben Carson is a renowned pediatric neurosurgeon and Republican contender for the White House in 2016. Here’s his take on Obamacare, homosexuality and more, in his own words. (Julie Percha/The Washington Post)