EP179: A Conversation with Dr. William James on Growth, Gratitude, and Dermatology

Insights on Success, Optimism, and Emotional Intelligence with Dr. William James

In this episode of The Girl Doc Survival Guide, Christine interviews Dr. William James, an Emeritus Professor of Dermatology with a distinguished career spanning over four decades. Dr. James shares his extensive medical background, personal anecdotes, and the importance of forming lasting relationships. He discusses key skills that have contributed to his thriving academic career, such as optimism, listening, and respect for others. The conversation also delves into emotional intelligence, handling medical errors, and the evolving nature of professional and personal growth. Dr. James emphasizes gratitude, altruism, and the value of human connections in achieving happiness and success in both life and dermatology.

00:00 Introduction and Guest Background

01:42 Personal Anecdotes and Relationships

02:48 Skills for a Successful Academic Career

04:50 Finding Meaning Beyond Work

05:28 Dealing with Mistakes in Medicine

08:08 Emotional Intelligence and Building Rapport

11:16 Career Reflections and Serendipity

12:30 Final Thoughts on Happiness and Gratitude

Transcript

Christine Ko: [00:00:00] Welcome to The Girl Doc Survival Guide! Today, I'm very pleased to be with Dr. William James. Dr. William James graduated from the United States Military Academy at West Point in 1972 and the Indiana University School of Medicine in 1977. He did residency training in San Francisco and spent 12 years at the Walter Reed Army Medical Center. He was chief there for eight years. In 1995, he joined the Department of Dermatology at the University of Pennsylvania School of Medicine, where he was the Paul R. Gross Professor of Dermatology. He's currently an Emeritus Professor, seeing patients by telemedicine at the VA. Dr. James was president of the American Academy of Dermatology in 2010. He has a amazing CV chockfull of many accomplishments. He's delivered over 360 invited lectures, received many local and national teaching awards. [00:01:00] He's published 400 articles, 40 book chapters, and has written or edited 23 books, including the 8th through the 14th editions of Andrew's Diseases of the Skin as well as two editions of the Atlas that goes with that book. He's also the Founding Editor and co-editor in Chief of Medscape Dermatology. He's trained over 160 residents and fellows during 32 years serving as a residency and fellowship program director.

I'm excited to talk to Bill today. Thank you for being here. 

William James: Thanks for inviting me, Christine. It's been a wonderful time in dermatology. We're all so lucky to be in it, and I appreciate your interest in talking to me.

Christine Ko: Yeah. First off, can you share a personal anecdote that tells a little bit about yourself that maybe all of those accomplishments don't necessarily tell us? 

William James: Sure. A recent story that encapsulates really what I think it's all about, and that's the relationships I've formed over the [00:02:00] years. Recently, from Spain, Dr. Jose Cubells wrote me just outta the blue. He was a rotator for a month in 2015. I remembered him. He was a wonderful physician even when he was fairly junior. He wrote and told me that he was grateful for the teaching that I had shared with him. We started to correspond, and we saw each other at the Academy and have recently co-written a paper about the lessons that we learned over years of practice. We get to reestablish relationships, and I'm lucky and feel blessed to have friends all across the country.

Christine Ko: That's great. Yes. He connected us too, Dr. Cubells, so that's nice. What are some skills that you think have helped you thrive in your long academic career? 

William James: I think one of the main things is that I'm optimistic. [00:03:00] I'm optimistic about people, life, and work. This helps me accept change, which happens all the time, of course, in medicine and in life in general. I look at change as the possibility of either life becoming better or an opportunity for me to become better. I was also taught by my parents to respect everyone and to treat all people well. Every interaction can have value. Everybody obviously has value. So I think that helps me to listen to everybody, to hear what they have to say, to learn what people have done in their life and what they've learned from it. And I think that's helped me. Listening, I think, is important in a lot of contexts, certainly with patients and with friends and family.

I've always been kind of a patient, calm person, and that's probably one reason this interview's not gonna be more lively than it is because I'm calm. But it reminds me of a Japanese [00:04:00] proverb that I like that says, If you want to go fast, go alone. If you want to go far, go together. I enjoy people that are around me. I know my work is meaningful and I enjoy it. I want to be the best at it. I wanna be the best for patients and for my colleagues and students.

I tend to set high goals. If you work at things, you can get better, and you can improve yourself. So that's what I try to do. There's always more to learn. There's always ways to improve. I'm persistent. I don't give up. So I think that's helped me as well. 

Christine Ko: When you said your work is meaningful, I agree. I think the work that a physician does is meaningful to an individual patient that you see, but also more broadly with the research that we do. Are there other ways you also find meaning other than work? 

William James: Whether or notit's a form of religion or not, but an attitude of feeling blessed, of feeling grateful, of reflecting on life in a positive [00:05:00] way. Appreciate your friends, certainly, and your family, your colleagues, your patients. Every patient is important.

Christine Ko: An attitude of gratitude. 

William James: An attitude of gratitude. That's right. 

Christine Ko: You shared with me that your daughter was misdiagnosed for much of her life, so she wasn't diagnosed until age 32. There's misdiagnosis and error in medicine. I make errors. None of us intend to, but we're only human. On the patient side or the parent side, seeing a misdiagnosis being made, how do you stay optimistic?

William James: Yeah. Obviously nobody's perfect, right? I make mistakes. You've said you make mistakes. . Everybody does. We wanna try to get better, whether it's through reading, whether it's through asking advice of other people, whether it's through other types of efforts. The main thing about when I make a mistake. The first thing you wanna do is you wanna admit it. Admitting to yourself and to others that you [00:06:00] weren't at your best or you stumbled, but you wanna make it better.

And how can you make it better? Ask for their advice, apologize. Admitting that things didn't go well, having that upfront, and apologizing for any type of subsequent problems that develop. If you can do that and go with a mindset that you're gonna try to get better, that you're gonna try to improve and not at least make the same mistake again if you can, and then you move forward. I don't think it dampens my optimism. I think it's just a part of life, really, that everybody's gonna have a bad day or they're not gonna know everything they need to know.

And as long as people are open, honest, sincere, and trying to do their best, I'm all for 'em. These days there's less trust in physicians than there has been in the past. And I think that we want them to trust us. If it's clear that things haven't gone the way that we'd like them [00:07:00] to go, or if we've made a mistake, it's not hard for them to figure that out. And I think that they appreciate someone with enough candor to tell them and explain to them, not just tell 'em I made a mistake, but give 'em the context why it happened. Tell them how you try to help them in the future. Or if they prefer to see another physician, get them to the best person that can take care of their particular problem, redoubling your efforts to try to not let this happen with them or anyone else again. I think they appreciate that and I think the more rapport you have with people, the more they can trust you and, and they're willing to forgive and move forward. 

Christine Ko: Yeah. I think that it's a skill too, to be able to admit that you're wrong or did something wrong. And I do find that it doesn't necessarily get any more [00:08:00] pleasant to have to do that when I have made a mistake. But I think it does become a little easier 'cause it's a skill.

A couple times you've talked about rapport, whether with patients or the relationships that you've made throughout your career with either trainees or people across the country or internationally. I do think that's broadly about emotional intelligence, forming relationships, building rapport. Emotional intelligence is something that I've been working on. I think it really started with my kids and just trying to really understand what's going on with them. Do you have tips on that?

William James: I think it is something that evolves over time. The more that you actively listen to people and try and figure out where they're coming from and where they want to go, what the reasons are that they think the way they think. I grew up in a military family. We moved all over, Europe when I was in [00:09:00] elementary school. All over the country, went to three different high schools in Massachusetts, Kansas, and graduated from one in California. All of those experiences roll into trying to pay attention to all the different people and all the different perspectives. If you do that long enough you do get a sense when you hear someone or you see someone's, physical movements. You learn to, I think, interpret things better and better over time. And that gives you more empathy and more compassion for them and for where they're coming from. And if you know where they want to go, that helps you to be able to get 'em to where they want to go. Patients, students, a lot of people; getting people where they want to go is what we wanna do as a doctor. It's something that develops over time as long as you're thoughtful, reflective.

Christine Ko: I really appreciate that you said that it was moving around a lot and really [00:10:00] seeing so many different perspectives and cultures. My brain tends to want to stereotype. I don't mean stereotype in the way that we usually use that like stereotype someone who's a woman or Asian, if I just take two of my characteristics, but even skin diseases, we stereotype. Psoriasis is a certain way, on elbows and knees, but sometimes it's body folds, right? Inverse psoriasis. We categorize them. Stereotyping is negative, but it's a type of categorization. And I think that what you were saying is the more broadly we can think and at the same time, more specifically, like each person is really unique and an individual. They're not gonna be like anyone else. The place they wanna end up may not be anything that I've ever imagined for myself. But it's valid if that's what that person really wants. I also [00:11:00] appreciate that you said it evolves that how you've built relationships and create rapport does evolve over time.

William James: We change over time. What's gonna make people happy in the long run: Their understanding of themselves and people around them. All those things evolved.

Christine Ko: At this point in time, having evolved to the point that you have, is there something that you wish you had known earlier?

William James: I don't really reflect to rehash things and second guess myself. But I reflect more for the gifts that are given to me and life in general. I'm pretty happy accepting the way life has gone. Each dead end can be very useful to learn a lot from. Over time in my career, i've gotten interested in different things over the years. Immuno dermatology, a certificate in laboratory medicine, did contact derm,, I took over the acne clinic And I've enjoyed all those things. Having a niche helps you in academic medicine, but I don't think there's any hurry to find it. And you can always change. For three years at the Academy, I [00:12:00] had a thing, Masters in Dermatology, and I asked doctors who were towards the end of their career to come and give 10, 15 minute talk on their career. So many times serendipity came up, it's like, gee, I thought I was going this way, but then this happened. Next thing I know I'm doing this, and I love it.

Christine Ko: I think that's really wise. There can be lots of twists and turns that are just unexpected. Being flexible and being able to adapt to it is good. Do you have any final thoughts? 

William James: A lot of people have as a goal that they wanna be happy in life. I spent some time reading some about happiness, and a Penn professor named Dr. Seligman that's written on this extensively. His conclusion was that people are happiest when they spend the least time alone. Dermatologists certainly have a lot of people around them all during the day. And so I think that helps us. People that pursue personal growth. We've just talked about that quite a [00:13:00] bit. Having a growth mindset and trying to get better at things. People that pursue intimacy. Kindness, listening to people, appreciating each person for who they are. That's helpful. We found that altruism is a good thing. It helps people elevate their own mood when they do something for someone else that isn't necessarily gonna help them. That reminds me really of a quote from Winston Churchill that says, You make a living by what you get, and you make a life by what you give.

And finally he found that if you take time to savor and be grateful. It's like when your mommy's put you in bed at night and she say what three things went well today or what are grateful for in life or whatever. That's not a bad thing to do, to think about how, how lucky you are to be in dermatology and to have the kind of friends and relationships you've made over time. Just to be [00:14:00] grateful for the gifts you've been given. Those are five characteristics of happy people.

Christine Ko: Summarizing it that way really does emphasize how lucky we are to do what we do as physicians. Because you aren't alone as a physician, right? As a physician, you have a patient. So there's already someone there. And there definitely is an altruistic part of the profession, to be helping someone else.

Thank you so much for your time, Bill. It was really nice to talk to you about these things. 

William James: It's been wonderful having this conversation. Christine. Thanks for asking.