James Davis, MD, is a nephrologist who specializes in chronic kidney disease, autoimmune disease of the kidney, hypertension and kidney stones.
Dr. Davis sees patients at:
Barnes-Jewish West County Hospital, Medical Building Two, 10 Barnes West Drive, Creve Coeur, MO 63141 (314) 362-7603
Christian Hospital Professional Building One, Suite 202N, 11155 Dunn Road, St. Louis, MO 63136 (314) 362-7603
Vascular Access Center, 10435 Clayton Road, Suite 200, St. Louis, MO 63131 (314) 995-7081
North County Dialysis Center, 272 Mayfair Plaza, Florissant, MO 63303 (314) 859-1234
What happened in the course of schooling to influence you to choose your specialty in nephrology?
As a third year medical student, I remember sitting in conferences and morning report on my nephrology clinical rotation -- hoping I wouldn’t get asked a question about a patient’s acid base problems or low blood sodium or low blood potassium. Could I explain it, what was causing this? I think my zest to understand renal physiology was such that I made it my professional mission to fully understand it and be able educate others about it, as well.
Did you know that you always wanted to be a doctor?
Being a doctor was always in the back of my mind, but I felt it was a path too long, a bridge too far. I thought it was beyond my reach and wasn’t sure I could be entrusted with the decisions that doctors have to make every day to save people’s lives. As I learned more and journeyed deeper into my studies, I came to the conclusion that while intelligence helps, being dedicated and diligent is just as important. If you stay up that extra hour at night in order to figure out what is wrong with your patient, or help families understand why their loved one is sick and can’t get better, that commitment and compassion goes a long way.
What brought you to Washington University?
I spent the last 15 years of my professional career in private practice in Cincinnati, Ohio. For many years, I’ve thought about returning an academic environment where I can teach young physicians. As I approached the later stages of my career, I realized that if I didn’t return to academics now, I was never going to do it.
As fate would have it, I received one of those “new careers, new job opportunities” emails from the American Society of Nephrology’s career center. But instead of deleting it, I inadvertently clicked on it one Saturday afternoon. I found myself reading this wonderful job opportunity in St. Louis at Washington University. It sounded like it was tailor made for me. The job listing was for an experienced private practitioner looking for an academic opportunity, but to also go out and help build a community practice.
I replied to the email, fully expecting to not hear anything. Literally, within 10 minutes I received an email from Dr. Benjamin Humphreys, the Chair of the Division of Nephrology. We had a great dialogue, one thing led to another, everything lined up and about one year later, here I am.
Which aspect of your practice is most interesting?
There are so many aspects about the practice of nephrology I find interesting. But the most interesting part of my practice is sitting down with students, whether they are medical students, residents, fellows, nurse practitioners or physician assistants, and discussing a patient’s case. I enjoy the process of explaining to them why a patient’s sodium is low, why the potassium is low, why this patient can’t resolve his or her acidosis or can’t resolve some electrolyte disturbance. Watching the light go on as they gain a new understanding of something they were previously intimidated by is so rewarding and quite frankly the real reason I started in nephrology.
What new developments in your field are you most excited about?
The newest development I am most excited about is the implantable, artificial kidney. I believe that in my professional lifetime, we will be treating renal disease very differently and it won’t be with three-times-a-week hemodialysis or the every night treatment with peritoneal home dialysis.
Right now there are over 600,000 people in this country alone who are being treated with some form of dialysis and I think we can do better. I think we will be going away from the cumbersome means of treating end-stage kidney disease and towards more patient-specific and patient-centered methods that are more manageable.
I am optimistic that within the next few years we will see patient trials with the implantable, artificial kidney.
For someone with polycystic kidney disease, are there new treatments?
Polycystic kidney disease (PKD) is typically an inherited disorder in which clusters of cysts develop within the kidneys, causing them to enlarge and lose function over time. Until recently, we did not have effective therapies for PKD outside the standard treatments for kidney disease (like controlling high blood pressure). But there are now new, promising therapies that have been shown to slow the progression of cyst growth and cyst formation – even in patients with very advanced PKD. My goal is to delay the initiation of dialysis as long as it is safe for the patient.
For the majority of your patients, what has caused their kidney failure?
For the majority of patients in this country, the primary causes of end-stage kidney disease are diabetes and hypertension.
However, over the years I’ve had many patients with diabetes who have kept their blood sugar level under control, but for some reason still develop kidney disease.
We are just now starting to understand the disease mechanisms and genetics of the progression of chronic kidney disease. This knowledge will help us make better predictions on which patients with diabetes or hypertension are more predisposed to developing end-stage kidney disease, while others are not.
Where are you from?
I grew up in Maysville, Kentucky -- a small town on the Ohio River. It was the home of Rosemary Clooney and the Clooney family -- our claim to fame. I lived in Maysville until I joined the military at the age of 17. I went to college at Morehead State University in Kentucky and medical school at the University of Kentucky in Lexington. I’ve been in Cincinnati for the last 20 years and am brand new to St. Louis in 2018.
How so you like St. Louis so far?
There are several parallels I would draw with Cincinnati. They are both average-size Midwestern cities, the weather is similar and they both fancy themselves baseball towns. But as someone who has lived in Cincinnati for 20 years, I would freely admit St. Louis is much more a baseball town than Cincinnati ever was.
Everybody is a Reds fan on opening day. But around the middle of May, by the time the Reds are 10 games out, there is not much interest in the team! We haven’t had a lot of post season success in a number of years. St. Louis is a baseball-crazy town.
I would also say about St. Louis, and this might sound a bit contrived, but everybody we’ve met here has been very welcoming and friendly (not that folks in Cincinnati aren’t friendly). But I’ve been struck by how people in St. Louis have gone out of their way to make us feel at home. I think St. Louis is a wonderful city.
Which particular award or achievement is most gratifying?
I received the University Hospital Doctor’s Day award when I was a fellow at the University of Cincinnati in the division of Nephrology and Hypertension. The nursing staff votes for a particular member of the house staff who they felt most embodied several traits – humanism, compassion, empathy, as well as a sense of collaboration with the nursing staff.
When the announcement was made at the awards ceremony, it suddenly all made sense to me. We are all in this together -- the nurses, techs, clerks, doctors, patients and their families. We are all part of this team and there is no one who is any more important and no one’s time is any more valuable. I strive to be that person who respect’s everybody’s time, who listens and takes into account the patient’s and family wishes. It helps everyone feel more involved in the treatment decisions.
There is no question that receiving this award was a memory I will cherish always. That award still hangs in my office.
What is the best advice you’ve received?
One piece of advice came from an older resident when I was in medical school. He said, “Nobody cares how much you know, until they know how much you care.” I’ve tried to approach my practice this way and in a very humble manner. Sometimes all you can do is hold a patient’s hand, and sometimes that is all they need. Sometimes that makes them feel better than anything else you can do for them.
Another piece of advice is something I tell everybody I work with – all the students I teach and quite frankly, any young physician. That advice is to treat patients the way you would want your mother, father, spouse or sibling to be treated. Treat that patient like he or she is a very important part of your family. If you do that, it doesn’t make this job any easier, but it does help you sleep at night.
If you weren’t a doctor, what would you like to be doing?
Vocationally, I can’t see doing anything else -- I really can’t. I think this is what I was put here to do. I’m not going to cure cancer, but I’m going to be right there to hold your hand when you are going through your treatments. I tell young medical students, if your heart is not in this, you don’t have any business being a physician.
But if I wasn’t a doctor, what would I like to be doing? I’d probably own a little boat and a dive shop in the Florida Keys. My wife and I love to scuba dive in our spare time. I can’t think of a better way to enjoy life.
What does the ribbon on your lapel stand for?
The ribbon on my left lapel is a pride ribbon. Equality is something I feel strongly about. We have a great country and one of the greatest strengths of our country is our love for each other. In this day and age, we need to focus on that a lot more than we do now.