James Neil Gilliam, MD—the career arc of a patient-oriented translational clinical investigation changemaker in rheumatologic skin disease

Abstract

James Neil Gilliam, MD, was an American academic physician who was trained in internal medicine, dermatology, dermatopathology and rheumatology. This "quadruple-threat" profile of postgraduate medical training provided him with a rather unique perspective on genetically-complex, environmentally-impacted human autoimmune disorders such as lupus erythematosus (LE). Both the skin and vital internal organs can be damaged by LE autoimmunity. And, LE is clinically-expressed quite variably from one individual to another making prognosis difficult. As such it can be very challenging to know what the optimal treatment approach might be for new patients presenting with this potentially-fatal disorder. Dr. Gilliam's major career focus was to better understand the complex relationships that exist between the clinical expression of LE in the skin and vital internal organs. In the late 1970s, Dr. Gilliam first described a new clinical form of LE skin disease that he designated as "subacute cutaneous LE." Subacute cutaneous LE would subsequently serve as the linchpin for a new classification scheme for LE skin disease that would later become known as the "Gilliam classification" of LE skin disease. In addition, he was among the first to apply modern immunologic insight to the classification of cutaneous LE. This work was carried out in the Divisions of Dermatology and Rheumatology and the Department of Dermatology at the University of Texas Southwestern Medical School in Dallas, Texas (UT Southwestern) starting in 1972. Dr. Gilliam served as the Founding Chairman of the Department of Dermatology at UT Southwestern in 1982, 2 years before his untimely death. Dr. Gilliam's clinical research accomplishments were matched by his ability to identify and encourage like-minded young people. A high percentage of his trainees went on to successful academic research careers and leadership positions in American Dermatology. Dr. Gilliam's untimely death from cancer deprived several generations of dermatologists and rheumatologists the benefit of his warm support and insightful guidance. In addition, American Dermatology and Rheumatology leadership organizations were deprived of his strong leadership skills.

Richard D. Sontheimer: “inveterate curiosity” is the fundamental character trait of a “doctors’ doctor”

“…This led to a controversy in the field concerning the relationship between calreticulin and the Ro/SS-A ribonucleoprotein particle system, the basis of which has never been fully been resolved. The interested reader is referred to a recent, more in-depth earlier discussion of this issue by the author in this journal (4). I feel that this bit of scientific controversy negatively impacted my ability to continue to be successfully in competing for NIH research funding.…”

“…It is not surprising that many doctors' doctors have studied under the preceding generation of doctors' doctors. My Mentor, Dr. James N. Gilliam, who was the consummate doctor's doctor had an enormous impact on my personal career direction in medicine and the later success of that career path (4).…”