Wednesday, October 19, 2011

Radiology and me

One thing you don't learn very much about in medical school is radiology. If you want to learn radiology, you basically have to do radiology residency. During anatomy class, there was a radiologist who used to lecture to us sometimes, but by the time I figured out what a "sontimeter" was, the class was almost over.

During my ICU rotation, we would have X-ray rounds. For me, this was basically, Look at This Abstract Art Exhibit rounds.

Finally, in my fourth year, I took a radiology elective because I heard it was EASY. Unfortunately, I took the elective at a semi prestigious med school, just because it was in the city where my boyfriend lived. I don't think I had ever truly felt like an idiot before I took that class. I consider myself to be a fairly intelligent person, but when it came to radiology, I just didn't get it.

Of course, it didn't help that the class was made up of future radiologists. I remember on the first day of the class, the clerkship director went around and asked us what field we were going into:

Clerkship Director: "So what are each of you going into?"

Girl #1: "Radiology."

Girl #2: "Radiology."

Guy #1: "Radiology."

Guy #2: "Radiology."

Me: "Endocrinology."

[everyone gasps/giggles]

Clerkship director: "God, why?"

Like I said, I just didn't get it. I would look at the images and not understand how other people in the class could tell what was wrong with the patient and I couldn't. It was humbling.

During my intern year, I decided I wasn't going to be a radiology idiot anymore. If I was going to do a residency in internal medicine, that meant I needed to learn how to read chest and abdominal films. And I tried... I really did. When I was rotating in the ER and there was some downtime, I'd bring up random chest films on the computer and try to read them.

And you know, it's not that easy. I still remember on an ICU call, we got a chest X-ray on a sick patient, and my senior resident read it. The patient died that night, and the next morning, the attending pointed out a small pneumothorax that she missed. It almost definitely wasn't the cause of the patient's death, but the resident burst into tears.

In any case, by the end of that year, I was okay at reading chest x-rays and sort of okay at abdominal films. Then I switched the PM&R residency and that was the end of that.

Actually, that's not entirely true. I can still read KUBs since we order them all the time to look for retained stool.


  1. This morning I MIGHT have confused Situs Inversus with "backwards chest xray."

  2. yeah it's def an art form. i'm guessing radiologists are the same people that can always see the 3D cross eyed thing in the sunday comic section. I love radiology, but it's way too abstract for me to handle.

  3. I can't do those 3D things very well either.

  4. I truly do appreciate your candidness, it truly does inspire me. Thank you Fizzy :)

  5. 'Sontimeters'? Yes, the french do pronounce it 'sontimetr-uh' and the proper english pronounciation is 'sentimeter', but why are the two mixed together? 'I can use a french accent so it makes me sound more snooty, but rolling the 'r' at the end is too much trouble'? ;-)

  6. Ugh I'm the same way. Luckily almost no one gets just an Xray anymore and CT scans are easier haha.

  7. I am so glad that I never have to be the one to read an x-ray for NGT placement or central line placement. I never had any idea what exactly I was looking at and I lived in fear of dumping levophed into the patient's lungs. Usually I would hide and wait for the attending to get paged about it.

  8. Rather have xray than CT. CT has too many things in cross section, implying I somehow know anatomy. Couldn't point out the common bile duct on a CT if I were asked.