George & Susan Karam with Drs. Coe and Cobbs
In every new issue of Letters to Tinsley, we interview a senior resident to learn more about the trainees that the residency calls friends and colleagues. We also interview an alumnus to learn about their current practice and the impact that UAB Residency training has made upon them.  For this edition, we have a very special interview with resident Susan Karam with a bit of a twist.  Susan’s father, Dr. George Karam, is a graduate of UAB internal medicine residency and served as chief medical resident from 1980-1981.  He is now the Paula Garvey Manship Professor of Medicine and Director of the Louisiana State University Health Sciences Center Department of Internal Medicine in Baton Rouge. We wanted to explore the deep family connections that make UAB the place that we know and love and asked the Drs. Karam to offer their insight into their experiences with UAB and how family shaped their path to Birmingham. (SK: Susan Karam. GK: George Karam)

How did you decide to pursue a career in medicine?

SK: My first real thought of being a doctor came when I was about 3 years old. I had this bad habit of picking mosquito bites to the point that they would become infected. My father warned me that I would have to visit a dermatologist if I continued with my bite picking ways thinking that this would scare me.

GK: My threat did not have the desired effect, rather her eyes lit up when I said dermatologist. She wanted to know everything about dermatology, and I think it was the first time a pre-K student ever had such a specifically chosen career path.

Why did you choose UAB?

GK: It was not until October in my fourth year as a medical student that I chose to do Internal Medicine. I was going to do family medicine and go back to my hometown of Oakdale, LA to practice. I felt comfort with the safety net of staying in LA and having my office close to all my family.  Then, I received a challenge from a close friend of mine Sam McClugage (whose son is currently a Neurosurgery resident at UAB) to take a risk and step out of my comfort zone. I decided to do Internal Medicine and considered UAB at the urging of another close friend, Tommy Thompson, with whom I was a fraternity brother in Sigma Chi.

SK: My dermatology dreams quickly changed when I experienced it as a medical student. Honestly, I didn’t think it was the right fit for me. Although now the idea of having Botox at the ready does seem kind of appealing (this was followed by the Susan Karam laugh that we all know and love.) Seriously however, I always had a natural inclination toward internal medicine because of what I saw my father doing on a daily basis. As far as UAB was concerned, he always reminisced about his time here with such a passion that it was hard not to be curious about what made this place so special to him. I did an away rotation at Cooper Green just before it stopped its inpatient services.  I knew CGH was not going to be around by the time I would be a resident, and I had the option of going to UAB hospital to get a more “realistic” experience.  My father encouraged me to stay because it was likely that never again would I have the chance to experience a true charity hospital setting. I also had Dr. Heudebert and Dr. Willett as my attendings, so that was incredible.  At Cooper Green, I got to experience what my father told stories about in regard to the people who make UAB special and the patients that we are fortunate to serve.  UAB has this culture and atmosphere where people are extremely talented, enjoy what they do and have not forgotten our most important responsibility: to care for our patients. 

What is one of your favorite stories about your time her at UAB?

SK: I really enjoy the times when I can have my friends (many of whom are other residents) over to my apartment for a nice meal and to decompress from being in the hospital. We would discuss difficult patients, frustrating hospital situations, but most of the time we would talk about things that were not work related, like regular people.

GK: This story is from the late 70s/early 80s in a time with no duty hour restrictions. We would be on inpatient rotations 10 months a year and take Q3 day call that would last 30 hours. Nearly every night, the on call residents would congregate in the cafeteria and we would have a meal prepared by the short order cook. She would make something that we affectionately called the “Left Main,” a sandwich with double buttered/ toasted bread, 2 inches of ham and melted cheese with a large order of French fries. We would all get one and solve the problems of the world. We would discuss medicine, our personal lives, world events, sports and everything in between. Two things happened with that time. One, we would get to follow patients through the natural history of their disease without having to worry too much about getting the work done within a strict time limit. Now, I see residents so worried about the duty hours and scurrying to get work done in time so they don’t leave too much work to do for our other colleagues. Second and more importantly, we developed relationships with our patients and with each other. When I see Susan and her friends congregating at her apartment, I am reminded about those times. To be fair, Susan and company are usually eating some kind of refined crawfish étouffée with a nice wine rather than our “Left Main” sandwich and fries.

Quick Facts about the Drs. Karam

Favorite doctor (real or fictional):

SK: Dr. Guy Waguenspack who was her mother’s pediatrician and exemplified empathy and compassion for all his patients.
GK: St. Luke and the ideal of the priesthood of medicine. He also likes Alan Alda’s Captain “Hawkeye” Pierce from the TV show MASH. Please see Mr. Alda’s commencement address to the graduating class of Columbia Medical School from 1979.

Least Favorite Medical Term/phrase:

SK: “There’s nothing we can do” because there is always something that can be done.
GK: “The data is.” People don’t know their plurals.

Favorite thing to do in Birmingham:

SK: Saturday lunch at Bottega Café
GK: visiting Susan whenever I can

If you could do another profession what would it be:

SK: I would own a wine and cheese shop that would also have a great book collection.
GK: Something involving good storytelling. I would own an antique shop and call it S.A.C.E. after all my daughters’ first initials.