Bill James is not one to toot his own horn, so we will do so here.
Dr. James shares some qualities with Louis A. Duhring: both are scholars, quietly studious, and interested in passing on dermatologic knowledge. Dr. James is one of those benevolent people who will go out of his way to say a kind word of inspiration and encouragement to young residents, students and junior faculty, thereby making those people want to be better versions of themselves.
Like a lot of self-effacing, thoughtful clinicians, Dr. James has written extensively. Lately, his areas of interest center around the importance of programs to develop clinician-educators and to increase the number of underrepresented minorities in dermatology residency training, as well as the use of telemedicine to increase access to dermatologic care. Through the years, he has inspired and trained countless residents many of whom have gone on to illustrious careers in academic medicine.
When did you first know that you were interested in medicine?
That’s a funny story, it wasn’t by design. My father was a supply officer in the Army, so when I went off to school I majored in Engineering with the mindset that military service was what I would also do. I wanted a school that would best prepare me for a military career. I was in my junior year at West Point and had taken some science classes, but was not pre-med. One day, in my thermodynamics class, another student raised his hand and said to the professor “You’re on the medical school advisory committee, aren’t you?” And I thought, well hey, there’s something that I could do that would involve science but I wouldn’t be sitting in front of a computer all day. So that evening I told my wife, who was my girlfriend at the time, I think I’m going to go to medical school. I didn’t have any of the proper classes or pre-requisites, but I went ahead and took the MCAT and must’ve had a dreadful score because I hadn’t studied or taken coursework for much of the test content. My father by that time was in Indiana, so that was where I qualified for in-state tuition despite not really having lived there, and I had secured funding from the Army. I was accepted to the medical school at the University of Indiana, contingent upon completing the remainder of my prerequisites. So, there I was in the summer sessions at Indiana University taking Biology 101 with a bunch of freshman.
If you could bring one dermatologist back from the dead to meet, who would it be and why?
Well, he’s not dead but the person that I love spending time with, and who I always look forward to seeing at meetings because he is just so wise and insightful is Dr. Sam Moschella. He was a Navy physician himself, and was the teaching chief at the US Naval Hospital in Philadelphia. He’s been doing work for years at the Lahey Clinic. Sam became interested in dermatology because of leprosy. He was stationed at Guantánamo Bay in Cuba and encountered his first leprosy patient there. Sam saw a patient that came in with ‘hives’ that did not respond to epinephrine, because the patient had leprosy. Later he worked at the military-run leprosy clinic in Carville, Louisiana, which is where we met. Sam early loves teaching and is invigorated by the environment of academic medicine. He told me he tried to retire once and hated it so much that he returned to practice and teach. He is still faculty in Burlington, MA, and is still publishing in his 90’s. (Dr. Moschella just co-authored an article in March 2017 in JAMA Dermatology on the use of Rifampin in leprosy.)
How did you come to work on Andrews’ Textbook?
It was when I was early faculty at Walter Reed in the 1980’s and I thought it was time that Andrews’ should have a new edition. I wrote to Richard Odom, since I knew him from my time at Letterman, and said if he should need help with the next edition, that I would like to work on it. This was pre-internet so it was a hand-written letter. He accepted my offer and off we went! (The 7th Edition was in 1982, and the 8th with Dr. James contributing was not published until 1990.) Flash forward a few years, and the next edition we brought Tim Berger on board. Tim and I were residents together, and he was a wonderful teacher and writer. Dirk Elston was a resident who trained with Tim and I during our time at Walter Reed, and I immediately recognized that he was someone very special, extremely intelligent, and I expected that he would go on to some great accomplishments, which is obviously the case. So, Dirk was a natural choice to bring on for the next edition in 2006 as Richard Odom began to scale back.
When do you feel like you have the most “flow” where you are so immersed in an activity that you lose track of time?
It is probably when I sit down to write Andrews’ textbook, since it is not merely edited by us but rather authored. It will be very early in the morning and I’ll have a stack of articles that once I start reading are so interesting that time flies by. I feel like in the process of writing I learn so much and it is such great opportunity to stay current and find out about some of the latest developments in our field.
What do you consider one of the most underappreciated virtues?
Sensitivity and thoughtfulness. I’m a bit of an introvert myself and generally more reserved and quiet. Sometimes, in residency interviews it can be hard to figure out who these people are, and the selection process may not favor them as much because people misinterpret introversion as being aloof. In general, I try to look for things on applications like a long-term commitment to service and the gold humanism awards and people who are focused on helping others or helping to advance the field.
What is your motto? Help others and be generous.
What words of wisdom do you hope your residency graduates always remember throughout their careers? To have generosity of spirit in their work with patients and in our profession.