Happy Birthday to the ABR

The American Board of Radiology turns 75 today.

The mission of The American Board of Radiology is to serve patients, the public, and the medical profession by certifying that its diplomates have acquired, demonstrated, and maintained a requisite standard of knowledge, skill and understanding essential to the practice of Diagnostic Radiology, Radiation Oncology and Radiologic Physics.

Happy birthday!

Zombies Invade Austin

It seems that my favorite town in Texas now has something besides the economy to worry about: zombies.

For details, check out the following clip from The Rachel Maddow Show (the zombie part begins at the 50 second mark):

My favorite part was the public service advice:

Run for cold climates.

Ha! I've been telling my Austin brother that for years...

There Must Be a Story Behind That Name

One of the great pleasures of traveling is getting to savor the tasty names that people give their towns and streets.

When I drove home from college, I would occasionally pass through the tiny town of Hye, Texas. Entering town, I'd pass a sign that said "Hye", and then, a few hundred feet later, see a sign that said "Bye" on my way out of town.

Since then, I've driven through Old Dime Box, TX, Truth or Consequences, NM, Boring, OR and George, WA.

However, England has been at this a lot longer than we have. They seem to have a definite lead in the wacky name department, as evidenced by this hilarious report just out in the New York Times.

And don't get me started on Austrian town names...

(via Movin' Meat)

Windows: Yesterday's Technology -- Tomorrow!

It takes a lot of computing power to sustain the rockstar lifestyle of an academic radiologist. Whether I'm reading my usual 4 GB of images per day or crunching numbers and statistics for research projects, I'd be dead in the water without my computers.

Therefore, I've spent quite a bit of my academic career dealing with medical center and radiology IT people. We generally get along just fine, but occasionally butt heads.

The main point of contention is that I am a Mac dude. IT has been on my butt for over 20 years to convert my office computer to a PC. However, despite their dire predictions and occasional threats of non-support, I have continued to thwart them. I grudgingly use our PC-based workstations to do my image interpretations, but use a Mac for everything else. It's not just my contrary nature -- the mix of Mac and open source programs I use in my research and teaching either isn't available on the PC (e.g. OsiriX) or isn't as easy to use.

It was therefore interesting to read that other medical centers and the new Obama administration have been having the same difficulties.

One member of the White House new-media team came to work on Tuesday, right after the swearing-in ceremony, only to discover that it was impossible to know which programs could be updated, or even which computers could be used for which purposes. The team members, accustomed to working on Macintoshes, found computers outfitted with six-year-old versions of Microsoft software. Laptops were scarce, assigned to only a few people in the West Wing. The team was left struggling to put closed captions on online videos.
Senior advisers chafed at the new arrangements, which severely limit mobility -- partly by tradition but also for security reasons and to ensure that all official work is preserved under the Presidential Records Act.

"It is kind of like going from an Xbox to an Atari," Obama spokesman Bill Burton said of his new digs.

(via Orac)

Tomographic View of Every Single Presidential Inaugural Address

Again, hats off to the New York Times, who posted yet another great interactive graphic. This one allows you to scroll through every U. S. presidential inaugural address since George Washington and see the most-used words in that speech.

This view of these speeches gives me the same feeling I get when I "slice" up a patient with CT or MR, and take a real-time stroll through their body from different angles. This Times chart gives a fascinating overview of the events of the times faced by each president, as echoed in their address. It also lets one to instantly dive down into the context of a given speech to see how a particular word was used.

For example, the word "women" was used more than twice in only 4 of the inaugural addresses in the past 100 years: by presidents Wilson, FDR, Bush-1 and Obama.

Wilson, FDR and Obama used the word respectively 4, 3 and 4 times, and then only in the context of the phrase "men and women". Bush-1 used "women" four times, and is the only president to have singled out the word "women" twice:

...There are young women to be helped who are about to become mothers of children they can't care for and might not love.

... who will throw a salute by himself when the flag goes by, and the women who will tell her sons the words of the battle hymns.

It must have taken the graphics gremlins at the Times a ton of time to create this Flash-based graphic. However, it seems like the process should lend itself to automation.

I'd love to have a generalized software tool that would allow me to grab multiple text and images sources and create an instant interactive concordance like this excellent Times graphic. Such a program could be an amazing tool for education. Any developers listening out there?

Awesome Panoramic Images from Inauguration

Today's New York Times has some awesome interactive panoramic images from the inauguration yesterday.

Seems like this kind of image would be a swell tool for teaching radiology, if only one were clever enough. I will ponder how to do this.

What Would Woody Say?

In a further ironic twist, a video clip of Pete Seeger singing This Land is Your Land is now back on YouTube, courtesy of a German news channel. Thanks, N24!



What Would Woody Say about this? Here's a copyright warning he included on his recordings in the early 40's.

This song is Copyrighted in U.S., under Seal of Copyright # 154085, for a period of 28 years, and anybody caught singin it without our permission, will be mighty good friends of ourn, cause we don’t give a dern. Publish it. Write it. Sing it. Swing to it. Yodel it. We wrote it, that’s all we wanted to do.

(via John Hodgman)

This Land is Our Land

The video clip I linked to yesterday of Pete Seeger singing "This Land is Your Land" on the Capitol Mall has since been removed from YouTube by HBO, who claims copyright for the broadcast.

In that clip, Pete sang the following verse:

There was a big high wall there that tried to stop me;
Sign was painted, it said private property;
But on the back side it didn't say nothing;
That side was made for you and me.

Apparently, the irony of this is completely lost on HBO...

(via John Hodgman)

Let's Keep Grownups in the White House

My recent post about Rachel Maddow garnered an interesting comment. Rather than post my reply there, where it would be buried down below the fold, I thought I'd share it here.

Paa said:

Let's see if I understand...
Katrina was a kitten, rather than a man eating lion, OK.
Bush was Edward Scissorhands rather than Indiana Jones.
Wonder how radiologists look running a real code?

@ Paa:

We will apparently have to agree to disagree concerning the wit of Rachel Maddow. However, I'm pretty sure that her point was that Bush handled the response to Katrina very badly -- not the more concrete interpretation that Katrina was a wimpy storm.

On the other hand, I could be wrong. Maybe she did mean to suggest that Bush's isolation from real life and real people is frighteningly close to that of Edward Scissorhands. If so, she crafted her simile with such subtlety that it went whiffling right over my head. If this is the case, my respect for Rachel Maddow has only deepened.

You may have intended your final question to be rhetorical, but I'll give it a shot anyway. How do radiologists look running a real code? Hopefully, like we're grownups giving it all we've got.

If "real" means doing CPR at a car crash 20 miles from town with no in-house amenities such as drugs, crash carts, and on-call specialists, I know exactly how that feels. If "real" means restarting a friend's heart with an AED on an island way too far from a hospital, I also know how that feels. Compared to these two events, every one of the in-house codes I ran my during internship was a walk in the park.

What if the code in question is a 300 year hurricane called Katrina? I'm pretty sure the country would be a lot better off with even a bottom-feeding radiologist running the disaster response than it has been following Bush's paltry effort.

So, here's my inauguration day wish for all of us: regardless of which way we lean politically, let's do our best to keep grownups in the White House from now on, starting today at noon, Eastern Standard Time.

Anatomically Explicit Cake

The Cake Wrecks site posted some swell anatomically explicit cakes last week. Unlike the treats made by some bakeries, these are actually safe for work. At least my work.

These cake decorators are welcome to make a birthday cake for me anytime. That is, assuming they can find enough gray icing to make a proper radiology cake...

(via Anita Anderson)

This Land is Your Land

Pete Seeger has been one of my musical and political heroes for most of my life. Although I've heard him sing this Woody Guthrie song a zillion times, it especially moved me in this Obama Inaugural Celebration performance with Woody's original lyrics:



(via John Hodgman)

White House Goes Digital

A Post-Holiday Health Quiz

Test your medical knowledge with the following true/false questions:

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1. sugar causes hyperactivity in children

2. suicides increase over the holidays

3. poinsettias are a poisonous plant

4. a large fraction of body heat is lost through the head

5. nocturnal feasting makes you fat

6. there are ways to prevent or cure a hangover

7. you should drink at least 8 glasses of water a day

8. we only use 10% of our brains

9. hair and fingernails continue to grow after death

10. shaving hair causes it to grow back faster, darker or coarser

11. reading in dim light ruins your eyesight

12. eating turkey makes people especially drowsy

13. mobile phones cause considerable electromagnetic interference in hospitals

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Done? Grading should be easy, since all 13 questions are almost certainly false. While some of these myths lack sufficient evidence to confirm them, others have been well-studied and proven wrong.

I answered a number of these questions as true, but hey -- I'm a radiologist -- what do I know about clinical medicine? My pediatrician spouse also missed a few, but fared better than I did.

These questions were compiled and researched by Rachel Vreeman and Aaron Carroll, pediatric researchers at the Indiana University School of Medicine. Their results [1, 2] are freely available on the British Medical Journal site, and make for a fun read. I especially enjoyed reading about the questions I got wrong.

The authors conclude:

Physicians would do well to understand the evidence supporting their medical decision making. They should at least recognise when their practice is based on tradition, anecdote, or art. While belief in the described myths is unlikely to cause harm, recommending medical treatment for which there is little evidence certainly can. Speaking from a position of authority, as physicians do, requires constant evaluation of the validity of our knowledge.

For extra points, try some of these questions out on your friends -- better yet, on your doctor.

(via Freakonomics)

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1. BMJ 2007;335:1288-1289
2. BMJ 2008;337:a2769

Step Away from the Tip Jar...

Just read this article about an armed robber in Paris who was stabbed to death with a sushi knife by angry waiters when he tried to steal their tips.

The next time you eye a radiology tip jar, just keep in mind that we are armed with barium enema bags...

(via Waiter Rant)

Rachel Maddow Rocks

Rachel Maddow nailed it on MSNBC this evening with her simile for George W. Bush's handling of Hurricane Katrina:

"...like Edward Scissorhands handling a kitten..."

Self-Adjusting Eyeglasses

I still remember the day my dad took me down to get my first pair of glasses. I was 6 years old, and had no idea why I was at the optician's. That is, until I put the glasses on.

Seeing life come into focus for the first time was for me a bit like Dorothy stepping out of a black and white Kansas into all the colors of Oz. I kept putting my glasses on and off for quite a while, just to convince myself that this new vision was really real.

I suppose it's therefore a bit ironic that I ended up in radiology, shunning color to work in a world that's All-Gray, All-The-Time.

But I digress.

Glasses were a miracle to me. I could now see the blackboards at school. I could see snow-capped peaks off in the distance. Heck, I could even see the frakking house across the street!

Decades of wearing corrective lenses have since led me to take this miracle for granted. I'm not used to waiting more than a few days for an optometry appointment. If LensCrafters doesn't have the color of frames I want or takes more than an hour to make my new prescription, I get cranky.

It was, therefore good for my soul to read about physicist Joshua Silver, and his plan to bring glasses to the planet's poorest people. It was also quite humbling to learn that one of the biggest barriers to universal eye correction has been the medical profession itself.

Don't get me wrong -- doctors are not trying to keep glasses away from people who need them. The problem is that most people have to go to an eye specialist with expensive optical gear before they can get their glasses. This isn't so bad in a country where every mall has at least one optician. But it sucks somewhat more if you live in sub-sahelian Africa, where there's only one optometrist per million people.

This is where Joshua Silver comes in. His brilliant 1985 epiphany: what if you could adjust your own glasses? What if you didn't need expensive optical gear or a specialist? What if these glasses could be made cheaply?

After 2 decades of work, he now thinks he has the answer: self-adjusting glasses that are simple enough for almost anyone to use. The basic concept: the thicker the lens, the greater the correction. Using this idea, he has created glasses with tough plastic lenses containing inner sacs of clear fluid. A wearer can adjust the amount of fluid in these sacs by turning a dial on a syringe until their vision is just right.

The current model of these glasses is like Henry Ford's model A -- it comes in just one model and just one color: black. So far, Silver has distributed 30,000 of these goggle-like glasses to people in over 15 countries. However, he's just getting started. His Secret Master Plan: get these glasses to everyone on the planet who needs them, which could be up to half of all living humans. I must say that the mental image of 3 billion people all wearing Woody Allen glasses makes me a bit dizzy.

In a recent Guardian article on Silver's invention, we hear the story of a tailor from Ghana,

whose sight had deteriorated with age, as all human sight does, and who had been forced to retire as a tailor because he could no longer see to thread the needle of his sewing machine. "So he retires. He was about 35. He could have worked for at least another 20 years. We put these specs on him, and he smiled, and threaded his needle, and sped up with this sewing machine. He can work now. He can see."

For me, stories like this help to neutralize a lot of the depressing crap on the news these days. My soul would smile even more if Adaptive Eyecare, Dr. Silver's research group, had a PayPal button on their website. I'd love to donate a small bag of cash to this excellent work.