My Kind of Medicine: Real Lives of Practicing Internists: James McCallum, MD.
Boxwoods are impressive, stately looking bushes. They are fairly substantial in size; large enough to serve as a barrier or hedge, for which they are often used, but they need to be trimmed often, and the trimming takes a lot of time. However, that does not bother 32-year-old Dr. James McCallum. That is where you will find him on any given evening—outside trimming his boxwoods. For him it is a cherished way of life and one he says is possible because of his decision to go into internal medicine.
Dr. James McCallum
“I think it is very important to have balance in your life, otherwise you will end up getting burned out,” he says. “A mentor of mine once told me that during his busiest years as a physician, he rarely saw his children. He said he regretted that, and I did not want the same thing to happen to me.”
Learning to Lead
Dr. McCallum currently works as a hospitalist and as Assistant Director for the third year internal medicine clerkship program at the U.S. Department of Veterans Affairs (VA) Hospital in Columbia, South Carolina. He completed medical school at the University of South Carolina in 2001 and followed with a residency with the Palmetto Health Alliance Program, which is affiliated with the university. Aside from taking in the large volume of knowledge students are expected to obtain, he says his main challenge in medical school was learning to believe in himself.
“The most challenging aspect of medical school is understanding that you have a great deal of knowledge and that you are capable of being a good doctor,” he says. “I see a lot of insecurity in both the medical students and the residents. They come in with a fašade of bravado, but they are really terrified underneath. I know, because it happened to me. I can remember being truly scared that I was a fraud and that surely someone was going to figure that out sooner or later.”
For Dr. McCallum, experience was the key for overcoming fear. He says the confidence came gradually, as he continued to take on additional responsibility. He also says a big part of banishing self-doubt is the experience of teaching newer students and residents. “When a second year resident takes an intern under their wing they realize they have learned what they were supposed to and that they are good doctors.”
Dr. McCallum decided to pursue internal medicine in his third year of medical school, because as he says, “it just fit.” He was intrigued by the thought process it demanded and likens being an internist to being a detective in the medical world. When asked why he would recommend a medical student pursues internal medicine, Dr. McCallum says it boils down to opportunity.
“There are a tremendous number of options involved,” he explains. “Internal medicine is always challenging because there is so much information and knowledge we need to know in order to do our jobs. We look at a bunch of clues and try to make a diagnosis of it. It’s never boring, because every patient is different.”
Trying to practice perfect medicine in an imperfect world has its frustrations. Dr. McCallum will tell you, despite the best of intentions or effort, that sometimes the outcome is not what you had envisioned. He says one patient in particular stands out in his mind as a learning experience.
“The patient suffered a large stroke and had appropriately been given thrombolytics at another facility. He subsequently developed a huge cerebral hemorrhage and was transferred to me because we had neurosurgical support available at our facility. When the patient arrived, there was nothing that the medicine service or the neurosurgery service could do for him, and he died later that day. It was a difficult situation for me because even though everything had been done correctly, the patient still had a dramatically bad outcome.”
In the “business of saving lives” as they say, becoming aware of your own mortality can be a strange and unwelcome event. Dr. McCallum experienced that feeling already, when he was in a room full of doctors. “I was at a medical school banquet when I suffered an episode of supraventricular tachycardia,” he explains. “My heart rate shot up to 240 beats per minute. After a trip to the emergency room and some testing, they determined I was fine. I spent several sleepless nights worrying about it however; even though intellectually I knew it was relatively benign.”
The episode gave Dr. McCallum a strong glimpse of the patient experience and a keen understanding of the physician-patient relationship. “I love what I do because I feel like I am really doing something to help patients. It is easy to come to work every day—I get to be the good guy.”
A Balanced Life is Good Medicine
For this native southerner, a balanced life is a better life. “I love my job,” he says, “but I think that it is unbelievably important to go to my four-year-old’s dance recital as well.” Dr. McCallum says being able to do things like that makes him a better doctor. He says he believes he is more productive at work when he is able to put it out of his mind when he goes home.
“I like to go home, spend time with my wife, mow the lawn, fix the dishwasher, and push my two-year-old on the swing,” he says. “I get to put my children to bed every night, and that is what I hope they remember in 20 years.”
His mentor would be proud.
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