Jim served 25 years in the U.S. Navy. He was emergency medicine residency director and deployed twice to busy combat support roles in Afghanistan. In Afghanistan, he developed an interest in combat medicine ethics and the psychological aspects of trauma relating to physicians working in difficult and under-resourced, environments. He later taught widely on the subject. Upon retiring as a captain from the Navy in 2013, he became a medical missionary and moved to Chogoria Mission Hospital in rural Kenya, helping to start a family medicine residency with faculty from four mission agencies. He continued to encounter psychological trauma, in cross-cultural medical missionary practice, and was heavily involved with the growth of the hospital chaplaincy program, with whom he shared the theology of illness, healing, and death. In 2021, Jim and his family moved from Kenya to Virginia, where he now serves as VP of Partner Strategies with MedSend. In this role, he oversees the Longevity Project, preparing and supporting MedSend Grant Recipients to handle the burdens which are unique to cross-cultural healthcare. He works closely with the mission organizations with whom MedSend partners to support them in their challenging responsibilities.