“It was just a fluke,” says Ronnie James, recounting how in November 2023 he came to receive a consequential clinical test. 

He was in a Vanderbilt Health nephrology clinic, feeling good about his latest kidney function results. “Everything was good; I was doing OK, really.” And that’s when his nephrologist asked if he’d had an ultrasound lately. “I said, ‘No, do I need one?’”

Anna Burgner, MD, associate professor of Medicine, answered, “Well, no — but if you haven’t had one, why don’t we do it.”

As James describes it, within an hour he had completed the ultrasound and started the drive home to Paducah, Kentucky. Then he received a call from Burgner. He had a tumor on his left kidney.

The list of people in James’ life who’ve had cancer begins with his father, who died at age 52 with liver cancer, and two of his three sisters, one who died in 2011 with kidney cancer, and one who’s been successfully treated for breast cancer. 

He recalls becoming worried and nervous behind the wheel on Interstate 24. “Life in general went through my mind. But I knew if it was going to be taken care of, it would be at Vanderbilt.”

The following day, James’ confidence was bolstered by a first conversation with surgeon S. Duke Herrell, MD, professor of Urology. When James underwent surgery weeks later, postsurgical pathology confirmed the growth had been cancer.

Some 18 years before, James had accepted an invitation from a friend, Orrin Ingram, to join the Vanderbilt-Ingram Cancer Center Board of Advisors. Ingram was treated successfully for prostate cancer at Vanderbilt-Ingram in 2018 and today remains chair of the board, and James remains among the board’s members. Both men and their families are benefactors of Vanderbilt-Ingram and Vanderbilt Health. James and his wife’s recent gifts to Vanderbilt stem directly from his experience with kidney cancer.

Paducah sits on the western tip of Kentucky on the south bank of the Ohio River. Upon its founding in the steamboat era, the city became both an inland maritime hub and a railroad hub. Anecdotal evidence has led James to believe that his hometown has a carcinogenic environment. “I think a lot of it has to do with the manufacturing plants in this area. It could be the water; it could be air; it could be both — but it has been an issue,” he said.

James was born in 1950 into what he describes as a lower-middle-class household in Paducah, where his father worked as an engineer with a barge company and his mother worked at a hosiery factory. Growing up in a safe city, he paints an idyllic childhood capped by playing baseball in the city leagues. Following high school, he went into business as a residential builder, attending a local community college at night. In 1970 he married Paula Walker, also from Paducah. And in 1986 at age 36, having worked for 14 years in Paducah’s bustling maritime industry, he founded James Marine Inc. 

Starting out with 25 employees, James has built a company that today employs some 1,600 people at locations in Kentucky, Louisiana and Alabama. James Marine tugs barges of grain, fuel and chemicals up and down the Ohio and Mississippi rivers and their tributaries. At its dry dock facilities, the company services and repairs tugboats. They build and refurbish barges. They provide fueling and grocery services to river traffic and docking for vessels awaiting tows. While James remains the chair of the board and still goes into the office daily, his son, Jeff, has taken over management of the company as CEO and President.

Two months after surgery, using a tool James says resembled a caulking gun, Herrell removed a stent that had been implanted to keep James’ ureter open during healing.

Early in his recovery, James asked Herrell if he knew what caused his cancer. “He said, ‘Ronnie, if I knew that I’d have the Nobel Prize — we just don’t know.’”

James over the years has donated time and energy to a long list of civic, religious and maritime industrial organizations. His and his wife’s recent gifts to Vanderbilt Health are in honor of Burgner and Herrell. “I felt I was fortunate to be able to do something right out of the gate,” James said. “I asked them how they wanted to put the money to good use.” 

The two new funds are: the Paula and Ronnie James Family Faculty Development Fund, to provide support for faculty development in the Department of Urology Division of Endourology and Stone Disease, in honor of Herrell; and the Paula and Ronnie James Family Next Generation Fund, to provide fellowship program support in the Department of Medicine Division of Nephrology and Hypertension, in honor of Burgner, with the goal of supporting the Vanderbilt Nephrology Fellowship Training Program.

James, a cancer-prevention booster, urges everyone not to delay recommended screenings.