Perhaps best known as a textbook writer, 2018 SIR Gold Medalist Karim Valji, MD, FSIR, is a professor of radiology and chief of interventional radiology at the University of Washington in Seattle.
One of his three textbooks, The Practice of Interventional Radiology, now in its third edition, is known to many radiology residents and IR fellows as the “Valji book.” Dr. Valji also served as editor-in-chief of the Journal of Vascular and Interventional Radiology (JVIR) and as a member of SIR’s Executive Council.
SIR Today asked Dr. Valji to talk about an important person, place and thing that shaped his life. Answers have been edited for length and clarity.
WHERE: University of California, San Francisco (UCSF)
In medical school, I got very interested in cardiology because it was a highly regarded specialty with a strong intellectual side and the opportunity to do procedures. So I moved from Boston to San Francisco to train in internal medicine at UCSF. At that time, interventional cardiology was barely a subfield, and most cardiologists spent a lot of their time caring for patients with chronic conditions. By the time my internship was over, I realized that internal medicine had not been a great choice for me. I was really a frustrated surgeon. I wanted to spend most of my time doing procedures. I wanted to fix problems directly and quickly and then move on. So now what to do? It was 1983, when interventional radiology was barely recognized as a field. But UCSF had two of the pioneers of IR: Ernest Ring, who had just come from the University of Pennsylvania to start up an IR service, and his junior colleague Bob Kerlan. I remember seeing those fellows doing rounds on their patients on the wards and saw them do procedures on some of my own patients. So even though I really had no interest in radiology itself and no hands-on experience with IR at all, I took a huge leap of faith and applied to radiology programs solely with the intention of doing IR. The specialty turned out to be a perfect fit for me.
WHO: Dr. Joseph Bookstein
Between finishing a second year of medicine at UCSF and beginning radiology residency at UCSD, I had a six-month block of time with nothing to do after moving to San Diego. I had always had a strong interest in spending my career in an academic setting, but I had never done any research. I wrote a letter to Joseph Bookstein, then chief of angiography at UCSD. He was one of the founding fathers of vascular IR and heavily involved in research. I had a long block of free time and asked if I could work in his lab on some research project. He wrote back within days, and I ended up in his lab for six months learning how to do animal experiments. He gave me the project of developing an animal model for a new technique he had just invented, which he called pulse spray pharmacomechanical thrombolysis. And I was hooked — academics was it. During residency, I was as likely to be working on a manuscript as doing my required radiology textbook reading. Joe was an old-school, East Coast-type — very serious, demanding, incredibly hard-working. He intimidated a lot of people in the department, but we really hit it off and ultimately developed a very close professional relationship and friendship. Joe continued to be my mentor — and really a father figure — through residency and fellowship and the early years on the UCSD faculty. Sometimes he drove me nuts, but he pushed me hard, and I so respected his brilliance, work ethic and integrity. He and I used to joke that we couldn’t believe people paid us to do what we did because we loved it so much.
I got my obsession for books and respect for good writing from my mother. I had an amazing AP English teacher in high school who taught me how to write well. Honestly, I love writing about IR as much as I love doing IR. Since college, I had a dream of writing a textbook, and a sabbatical year at UCSD allowed me to do just that. And then two more editions of the book followed. Writing every book was a labor of love. And I think my passion for clear, organized writing helped me greatly as editor of JVIR. If I got a manuscript for the journal that had some very important ideas but was badly written, I would often spend a lot of time editing it myself, line by line, because I took pleasure in helping authors with great ideas polish their articles to make them easier for readers to understand.
I’ve met a lot of young IRs who feel drawn to the idea of research and academics but are turned off by the act of writing. But most anyone can learn to do it reasonably well. Use other scientific papers as a model. Just start by putting your thoughts on the screen as they come to you, sentence by sentence, don’t worry about syntax or spelling or details. Then take that very rough draft and gradually sculpt it — revising and revising and revising, sometimes putting it aside for a while — until you can’t find any other way to improve it.