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WHO, WHAT, WHERE: SIR Gold Medalist James B. Spies, MD, MPH, FSIR 

12-21-2020 10:33

SIR Today 2019

SIR Today salutes each of the Gold Medalists with a personal look at their outstanding careers. Today, learn about James B. Spies, MD, MPH, FSIR. Profiles started Sunday with Alan H. Matsumoto, MD, FSIR, and Tuesday’s edition honors Daniel Picus, MD, FSIR. All stories will be available at sirtoday.org.

Dr. Spies, professor and chair in the department of radiology at Georgetown University Hospital in Washington, D.C., was SIR President from 2014-2015. He has been on numerous SIR committees and served as the 2006-2008 SIR Foundation chair. An international authority on uterine artery embolization (UAE) for fibroids, he maintains an active UAE clinical practice and has performed extensive research. 

SIR Today asked Dr. Spies to talk about important people, places and things that shaped his life and career. 

WHO: My many mentors

Several IRs were very formative in me choosing interventional radiology. The first was John Wack, MD, an interventional radiologist at Pacific Medical Center in San Francisco, where I did my internship. He was the first interventional radiologist that I saw practice, and he was the most respected radiologist in the hospital. Not only was he diagnosing conditions—mostly peripheral vascular disease at the time—but he also treated it. When there were complications, he went into OR with the surgeons to better understand the causes and to learn from those experiences. I said to myself, “If I am going to be a radiologist, this is the kind I ought to be.” I don’t know if Dr. Wack even remembers me from that time, but he had a big influence on my career direction.

The second huge influence was Ernie Ring, MD, at UC-San Francisco, one of the giants of interventional radiology. He arrived at UCSF from Penn the second year of my residency. Ernie built a great program, and I was fortunate to be there at the very beginning. Bob Kerlan, who was Ernie’s first fellow there, was another strong influence. Working with them solidified my commitment to go into IR.

The next person who was a huge influence was Bob Rosen at NYU, where I did my fellowship. Bob is a wonderful guy—very calm, funny, easygoing—great in a training setting. That year, there wasn’t a second attending, and he and I did essentially every case together. We did hundreds of cases, and most of my technical skills came from Bob. He was very skilled and a great teacher.

There are many others, partners and colleagues from other institutions: each one taught me something. The beauty of our field is that there are always new techniques, new skills to learn and many IRs continue educate me and influence my practice.

WHERE: Wilford Hall U.S. Air Force Medical Center

UC-San Francisco was where I first saw academic interventional radiology being practiced. NYU was the place where I spent the most intense part of my training. With that, I have to add Wilford Hall US Air Force Medical Center to my list of important places. I’d gone through medical school on an Air Force scholarship, and I owed four years back and was extremely fortunate to serve there. I had great colleagues. We had a strong section and at the time a 1,000-bed hospital with a huge clinical base. For a young interventionalist, it was a really wonderful experience. The clinical pathology, the patient population, the young physician group across the institution—it was a wonderful, collaborative place to work. After four years, I left with great skills and a lot of experience in managing patient care. The military gives you a lot of responsibility at an early stage of your career.

I'll never forget the first day I arrived at Wilford Hall. Just out of fellowship, I came in looking for the other two physicians and they said, ‘Oh, they're on temporary duty in the Philippines. You’re here by yourself today.’ Then they said, ‘Oh, by the way, your first patient is ready.’ It was a renal angioplasty from the axillary approach—not the easiest procedure. Never having been in the department, never having used their catheters, wires, et cetera, it was a real challenge. There were great clinically challenging cases throughout my time there. I was appointed chief of interventional radiology my second year, so I had the chance to develop administrative and leadership skills along with patient care skills. It was one of the best jobs I've ever had.

WHAT: Combining clinical practice with research

What do I love about this field? First, caring for patients. I'm known for one procedure, primarily—uterine embolization—but I've had a very broad experience and do lots of different things. I love going to clinic. I love getting to know patients. I love connecting with them and their families. I love admitting and caring for patients. And I love following up and seeing how they do. I love being a physician, and I just happen to be an interventional radiologist. 

One of the anchors of my career has been research. I love doing clinical research: having a question that can only be answered with a research study, designing and completing the study and getting an answer. I love doing this in the context of trainees and mentoring trainees in research. When we're having a discussion and someone brings up a question and I mention that there's not any literature on that, we begin to discuss how one could actually answer that question, and before you know it, we have an idea and a project. Taking a question and answering it with a well-designed study is what I've loved the most about my career. That’s led to opportunities to present that research at meetings across the world. It is in those venues that other questions arise, prompting new research ideas. The give-and-take of our scientific sessions has spurred me on throughout my career and really enriched my academic life.

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