13th
Radiology—Ok, I see the draw!
So I shadowed a radiologist at UCSD Hillcrest today. Not sure shadowing is the right word this time around; radiologists, true to reputation, sit in a dark room all day reading images. Still, it was a fascinating experience that definitely turned me on to radiology (just like every one else!).
I should mention that my shadowing experience began at 9am, a far cry from the 6am appointment I had with the pediatric cardiologist a few days prior. While I’m not averse to working hard and spending a considerable portion of my existence working in the hospital, there is no doubt that there is an appeal with this sort of schedule.
Radiology is different than other specialties in another important respect, too. For most radiologists, their work is a quantity—not a place and a time. Let me explain: if you’re an internist, you have an appointment with patients X, Y, and Z, at 8, 9, and 10am. You will do procedures A, B, and C on said patients. Radiologists—when they’re not on-call, and if they’re not interventional—simply have a pile of work, a set amount of images they need to read and analyze before the day closes. This arrangement, while common in the regular working world, is very uncommon in medicine.
The imaging techniques used by radiology are powerful ones. CT scans in particular, while delivering a (somewhat dangerous) high dose of radiation, truly do image the entire body. One is able to spot all kinds of pathologies with this impressive imaging technique. Ultrasound is safer but tells us less. And interventional radiologists do cool things, too, though I didn’t get to chance to witness their trade.
We spotted everything from gallstones to gassiness using CT imaging. I saw what a liver suffering from cirrhosis looks like. The liver’s usual tissue has been replaced by fibrotic, or “scar,” tissue. This shows up as “scalloping” or nodules on the screen. (By the way, once again, most of the time I didn’t know what was going on—especially with ultrasound—but some things I certainly picked up and am happy to report them now.) I saw what a cancerous growth looks like—white and dense. The metal bits that help to keep a hernia sown shot *definitely* show up white. Everything that is dense does. By contrast, gas in the belly shows up black—it isn’t dense at all. I hesitate to tell you how this one patient ended up with gas in organs surrounding his colon—it involved his prostituting himself and an over-eager customer who wasn’t using the traditional instrument…but I digress. In a word, you can really see everything with CT scans—it is an incredibly powerful diagnostic tool. And therein, along with the hours, lies the draw.
My thought at this point would be that unless I were to do something interventional I would not want to be a radiologist. Sitting in a dark room, however good the schedule is, is not appealing to me. We will see how that sentiment holds up, though.
