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At Lucens, we believe that every medical professional has a unique story worth sharing. Our "Behind the Scrubs" series pulls back the curtain on the diverse journeys of remarkable individuals in healthcare. Through candid interviews, we explore the challenges, triumphs, and pivotal moments that shape careers in medicine.
These stories embody the Lucens philosophy: there's no one "right" way to build a fulfilling medical career. By showcasing various paths, we aim to inspire, guide, and connect the next generation of practitioners. Whether you're a student, resident, or established professional, these insights offer valuable lessons and fresh perspectives on the ever-evolving world of medicine.
Join us as we go "Behind the Scrubs" and discover the human stories that make medicine such a rewarding field.
In this edition: James Rhee MD
What draws an Emergency Medicine specialist to dive into the complexities of Toxicology? James Rhee MD shares his journey, from pivotal moments in his training to the unexpected ways his “inner nerd” shaped his career. With candid reflections on the challenges, misconceptions, and innovations shaping his field, James offers insights and advice that will resonate with anyone navigating their own unique path in medicine.
How did your journey into medicine begin?
Within my family, there weren't many physicians. My mother's father served as a neurosurgeon in Korea which gave me a little bit of insight into the field.
But for me, as a kid I always had in the back of my mind practical skills, practical knowledge. Sometimes I would wonder about a world where we didn't have natural conveniences - what if everything blew up and we were left to our own devices?! In terms of things that would definitely be highly valuable in that society - healing skills would be right up there. So that was the starting point, I think.
What path did you take in your education?
I went to college at the university of Michigan and I initially was majoring in biology at their college of literature, science and arts. For some reason, I equated biology as the study of the human body. And of course I learned that biology is all encompassing includes like a lot of plants and a lot of other invertebrates. And that wasn't as appealing to me.
I transitioned my major from biology in a slightly unusual way. I just happened to find someone in my dorm who was studying for her classes in movement science - the study of motor controls, with a lot of neuroscience and biomechanics. I started looking at the stuff that she was studying and I was immediately drawn to it. It ended up serving as a great foundation for me in medicine and beyond.
How did you choose your specialties?
My specialty is primarily emergency medicine. I chose it as it aligned closely with my vision of myself as being a physician. In my mind, that meant in the scenario of someone needing help and someone calling for a doctor, emergency medicine seemed to be the field that captured being able to use my skills in all situations.
I also have a sub-speciality focus. That came about as I was doing my residency around the turn of the century. During that time, one of the events that serves as a milestone was the 9/11 Twin Towers airplane bombing. That spurred this era where there were concerns about other events, including biological and chemical terrorism events. I started looking at what I was doing, and one of the things that I thought would be useful knowledge was having increased knowledge in toxicology. I have to say, the area of toxicology also appealed to my inner nerd…!
"I'm using AI in my own practice to create more personalized information for our patients that's specifically tailored to why they came in and what we found. It's about using technology to create better patient education and facilitate communication.”
You mention your 'inner nerd' - how does that manifest in your work today?
Over the past 20-plus years that I've been in practice, what we're starting to see that may be truly disruptive is the integration of artificial intelligence and machine learning. I've seen AI already being used to help radiologists identify things they may not be initially looking for - for example, catching a rib fracture when they're focused on looking for something else in the chest.
I'm using AI in my own practice in perhaps an unconventional way. When we send patients home from the emergency department, we typically give them pre-printed aftercare instructions. What I've started doing is creating more personalized information for our patients that's specifically tailored to why they came in and what we found. It's about using technology to create better patient education and facilitate communication.
Are there misconceptions about your specialties?
One of the biggest misconceptions, and this isn't just from the public but even from other specialties in medicine, is about what the emergency department can actually do. A lot of people presume that the ED has everything at its hands or has all the capabilities of the whole hospital. The reality is that the emergency department is actually very resource limited - we're just one point within the whole healthcare system.
I remember distinctly a patient who came in because he had a lot of nasal congestion and wanted us to somehow suck all the mucus out so he had no more left! That's a bit extreme, but it shows how sometimes people's expectations don't align with the reality of what we can deliver in the emergency department.
When it comes to toxicology, there's a common misconception that there's always an antidote that's going to be the cure for whatever poisoning occurred. While antidotes are potential treatments, they're just part of a bigger picture. For most patients who present after an overdose, most of the care being delivered is largely the care we deliver to anyone else who's very sick - good healthcare is what helps stabilize these patients and get them back to baseline health. The antidote is just one targeted intervention for a specific poison or toxin.
I think a good analogy is what we saw with COVID. A lot of people were looking for that one cure for COVID. But by and large, what helped patients most significantly was the delivery of good healthcare. For the sickest patients, as long as we're delivering great critical care and supportive care, that was the best thing we could do.
What's the most critical skill in emergency medicine that isn't taught in medical school?
Communication.
In emergency medicine, we can have these very limited patient encounters and we can also wind up being the person who delivers life-changing news to a patient that affects them for the rest of their lives. Sometimes we're dealing with sick patients who won't remember us because they're so sick they're not aware of what's going on, but their family does. Talking to family members and conveying important information to family or friends is critical to what we do. It is quite a responsibility to make sure we get that communication just right.
"We have these limited patient encounters and sometimes we're the person who delivers life-changing news that affects them for the rest of their lives. It's quite a responsibility to make sure we get that communication just right."
Who have been your key mentors?
For me, Dr. Tom Regan in med school helped develop me as a student interested in emergency medicine and allowed me to shadow him. In residency, our program director Dr. David Howes helped steer the whole program and cultivate the ethos within it.
During residency, Dr. Linda Drulinger, who became department chair, and Dr. Bob Mulliken (who sadly passed away), who served as medical director, were both models of emergency physicians with different approaches that were equally valid.
In toxicology, I learned from Dr. Steve Aks at Cook County, Dr. Tim Erickson at UIC, and Dr. Mike Wahl at the Illinois Poison Center. Most recently, when I needed to transition to an operational leadership role, Dr. Thom Mayer provided the support and foundation I needed.
"Throughout the years, most people will find they may not have that one mentor, but multiple people who help shape them into who they ultimately become."
What advice would you give to young physicians today?
It's very easy in today's world to not reach out. We're living in an information age where we have access to so much information that's readily accessible. The potential pitfall is that instead of reaching out to a senior colleague or faculty member, you might try to figure it out on your own through Reddit or TikTok.
Even if young doctors do reach out, they often only do it after they're pretty certain of their answers. They do a lot of background work beforehand. For some people, that makes sense, but does take away from the spontaneity of discussion and the organic learning that can happen through conversation.
"Don't be fixated on a certain career path. It's okay to be flexible, and it's okay if you don't wind up exactly where you thought you were going"
What’s the one piece of advice you would give to yourself when you were just coming out of residency?
I would tell myself that don't be fixated on a certain career path. It's okay to be flexible, and it's okay if you don't wind up exactly where you thought you were going.
Our journey to becoming physicians and excelling in our field can often consume us, yet life holds so much more beyond our careers. It's okay to embrace and follow the new paths that open up before us along the way.
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