WASHINGTON — Before Ben Carson accepted President Trump’s offer to become secretary of housing and urban development, a friend implored him to turn down the job to preserve the reputation he had earned as a brilliant neurosurgeon and lost, in part, as a politician.

The confidant, Logan Delany Jr., who was the treasurer of Mr. Carson’s 2016 presidential campaign, described HUD as a “swamp” of “corruption.” He predicted in an email that Mr. Carson’s “lack of a background in housing” would make him prey to the department’s career staff and political appointees, as well as predatory lobbyists.

To drive home the point, Mr. Delany appended a link to an obituary of Samuel R. Pierce Jr., the Reagan-era HUD secretary whose reputation as a trailblazing black corporate lawyer was tarnished by accusations that he steered contracts to Republican cronies.

Mr. Delany’s most dire prediction has not materialized. But many of the other problems outlined in the memo have come to pass during Mr. Carson’s first year running a sprawling $47 billion-a-year community development bureaucracy that provides rental subsidies for about five million families and oversees people living in 1.2 million units of public housing. And Mr. Carson’s own lapses in judgment — combined with the questionable behavior of his family and his reluctance to aggressively engage Mr. Trump — have left him at the margins of the cabinet.

Mr. Carson, people close to him said, has been whipsawed by a job he has found puzzling and frustrating — so much so that he considered quitting during recent wrangling over the department’s budget.

“There are more complexities here than in brain surgery,” Mr. Carson said in an interview last week. “Doing this job is going to be a very intricate process.”

Mr. Carson’s efforts to steer the agency toward programs that foster self-sufficiency, one of his stated goals, have been undermined by staffing mistakes, his indecisiveness and a president indifferent, at best, to the department’s mission of helping the poor, according to two dozen current and former HUD and administration officials.

All of this has been exacerbated by Mr. Carson’s tin ear for politics — such as the damaging disclosure that he had looked the other way when subordinates spent, at a time of savage budget cuts, $31,000 to buy him a new mahogany dining room suite for his office that included a pair of $1,000 side chairs.

“I think you have to come to the job with a sense of what the duties and responsibilities are,” said Representative Al Green, a Texas Democrat and frequent Carson critic. “If you don’t come with that sense, and the doctor didn’t, it doesn’t matter what your intentions are, you aren’t going to succeed. We are seeing that now.”

“Secretary Carson has to step up,” said Senator Kirsten Gillibrand, Democrat of New York, who voted against his confirmation a year ago.

HUD, created in 1965 as a Great Society response to a growing urban crisis, is a lot less powerful than its vast portfolio suggests. It is mostly a conduit for congressional appropriations and a caretaker for a patch quilt of existing anti-poverty programs.

Mr. Carson accepted the job after an intense multiple-call-a-day barrage from Mr. Trump, who saw a chance to infuse HUD with the self-help philosophy that was the theme of Mr. Carson’s presidential campaign. His model is his own mother, a domestic worker who rescued her two sons from poverty, roach-infested apartments and the low expectations of their teachers.

But he has not yet been able to get serious buy-in from Mr. Trump or secure commitments from his staff on the programs he favors, especially his plan to create thousands of community centers geared toward fostering self-sufficiency. In part, this is because the president views him as a secondary player, a nice guy unlikely to make waves.

While Mr. Trump treats him with respect, he views him as a beta “winner,” not as a “killer,” the alpha in his organizational taxonomy, according to several White House officials.

That lack of influence was painfully apparent during the internal debate before the release of Mr. Trump’s budget, which would help pay for increases in military and Homeland Security spending with steep cuts to HUD’s Community Development Block Grant and core housing programs.

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