Happy New Year!

I'm going to spend the next few days being as non-radiological as possible.

My family and I will be spending this time at a wild rumpus of folk music and dancing with 120 other pals.  We'll ring in the new year with singing, dancing and a ton of fiddle music, while someone else cooks and washes the dishes.  

Best wishes for a great new year to all.

Pandora's Other Box

Text-messaging and online social networks are just two of the current tools teens use to make their parents feel hopelessly old. Now it's their turn to feel like clueless geezers, because texting has moved on to the womb.

Expectant moms can now strap on Kickbee, a sensor-filled elastic band that turns fetal kicks into Twitters like the following:

Kickbee: I kicked Mommy at 06:45PM on Thu, Dec 18!

The UK Daily Mail is leading so far in the pun war with this headline:

Pregnancy belt allows unborn babies to open Facebook 'chat-womb'

Uterine hacking (so to speak) is no longer confined to caesarean deliveries. Geeky parents can now consider other possibilities, such as tracking fetal movements with GPS chips and ultrasonic fetal webcams.

Is that a tiny keyboard clutched in that fetal fist?...

(via Smart Mobs)

Text to Speech Just Got a Lot Easier

A new program called Textcast has just made it a lot easier for Mac users to produce audible speech from text files.

If you are a geek like me, your reaction to this is probably, "Dude, we've been able to do this for years."

If you're not a geek, then your response is more like, "Dude, who cares?"

Valid points, both. Let me first suggest why a non-geek would care about this technology. In a nutshell, text-to-speech software is part of my anti-boredom survival kit. Although I am endlessly capable of entertaining myself, my capacity for self-amusement is pretty limited when I'm driving.

I spend at least an hour per day in my car, commuting or running errands. This interstitial part of my life can be pretty darned boring. To keep from going nuts while driving, I listen voraciously to all sorts of audio files, including NPR broadcasts, podcasts and audio books.

However, for all the stuff that I can listen to, there are a zillion other things I'd love to hear but that just aren't available in audio format. For example, I'd love to be able to listen to newspaper stories and radiology journal articles in my car. This is where text-to-speech programs come in.

Text-to-speech software has come a long way. In the old days (5 years ago), most of these programs sounded about as lifelike as Gorgo the Space Robot. Fortunately, things are getting better. Nowadays this software is not only inexpensive, but produces fairly decent speech [1].

For the past few years I've been using several "voices" by Cepstral, which cost me a whopping $30 apiece for the premium editions. Depending on your tastes, they will sell you male or female voices speaking not only with American, but also British, German, Scottish, Italian French and Spanish accents.

Besides the vocal quality, another thing I like about Cepstral voices is that I can control them via the command line. If I want my computer to chat about its urinary habits in a British accent, I just type:

swift -n Lawrence -o ipee3.wav -p speech/rate=150,speech/pitch/shift=0.9 "I pee three times a day"

With several similar commands, I can automate the following process: 

1. grab a page of text from my web browser and save a copy in a folder on my computer
   
2. convert a whole folder of these text files into speech
   
3. shove these speech files into iTunes
   
4. move all of these speech files to my iPhone

If you are a non-geek, this process may leave you a bit cold. In fact, you'd probably rather take out your own spleen through your nose than write a shell script. For you, there is salvation, courtesy of BitMaki Software: Textcast will do all of this heavy lifting for you for $25.

I haven't yet figured out how to get Textcast to use any of my Cepstral voices, but it will use any of the built-in voices on my Mac, including a rather nice voice called "Alex". To my ear, Alex sounds at least as good as any of my Cepstral voices.

Some Clean-up May Be Necessary...

1. Convert the print version of a webpage

Textcast generally does a fine job of converting webpages to speech. However, it will convert every frakking bit of text on the page into speech. This includes headers, navigation bars, URL's, and other cruft. One easy way to clear a lot of this stuff off the page is to select a "print" version of that page, if available. For example, just about every article in the online version of the New York Times has a link to display that article with the headers, footers and nav bars stripped off.

2. Connecticut and Maryand must die!!

It's the odd radiology journal article that doesn't have the abbreviations "CT", "MD" and "MR" sprayed liberally throughout. Unless you want to hear "Connecticut", "Maryland" and "mister" in a lot of unexpected places, replace these abbreviations with "computed tomography", "em dee" and "magnetic resonance imaging", respectively, before converting your articles to speech.

3. Do some quick hand-editing before conversion

Before you point Textcast or some other program at a text file, consider doing a bit more judicious hand-editing. It's usually easy to spot large piles of cruft and delete them. Unfortunately, this can quickly become waaaaaaay tedious. If you find certain recurrent patterns of cruft (i.e. tables of content) scattered throughout your text, a quick global search and replace may be just the thing. For more complex patterns, geeks will want to trot out their grep tool on the command line to properly flense their files.

4. Use a medical phonetic dictionary

Medical and other technical journals contain a boatload of jargon. Thus, for your average AJR article, Textcast or Cepstral will mispronounce these words as badly as a TV doctor. Cepstral can help prevent this by letting you create a custom phonetic dictionary of your own particular jargon. Alex can likewise be taught certain words using Apple's VoiceOver utility.

5. Use a voice with a foreign accent

Here's one final tactic to make your text-to-speech sound less like a robot -- use a voice with a foreign accent. That way, when a word is oddly pronounced, the accent will cancel out the brain's tendency to interpret it as a speech defect. Don't tell your friends that you used a computer to produce these files -- they'll just assume that the speaker is Texan... 

---

[1] I would even call it life-like, albeit like a live person with a mild speech defect.

Holiday Gift Ideas for Radiologists

Vanessa at Street Anatomy just posted some great anatomy-related holiday gift ideas.

One of these could be just the thing to give your hard-to-shop-for, friendly, local radiologist...

A Solstice Present for Bio Majors

XKCD continues to be my favorite internet cartoon.

Speaking as a physics major who jumped ship to medical school, I especially enjoyed this latest strip (click to embiggen)...

MRI = Mind Reading Imaging?

Can you read someone's mind with magnetic resonance imaging (MRI)?

The short answer is: yes, of course -- we've done it for years.

However, don't get too spooked. The stuff that we are able to read has so far been extremely limited.

Consider the book as a metaphor for a brain. Until recently, we've only been able to read the shape of the book. However, functional magnetic resonance imaging (fMRI) has advanced to the point that we can now read some of the Cliff Notes of that book as well.

The latest issue of Neuron describes some fascinating work by Miyawaki et al: Visual Image Reconstruction from Human Brain Activity using a Combination of Multiscale Local Image Decoder. In this study, the authors presented simple visual patterns to volunteers. The authors were then were able to reconstruct the patterns seen from the volunteers' brains using fMRI. Check out the following reconstructed images:


As Michael Russell commented:

It looks like the JPEG compressor in the test subject's brain is set WAAAY too high.

Agreed. Even so: Wow.

The keys to this god-like power are topological maps of the cerebral cortex, such as the well-known sensory and motor homunculi first mapped out by Wilder Penfield.



It turns out that there are also retinotopic maps, connecting retinal stimuli to certain areas in the visual cortex. By imaging functional information directly from volunteers' occipital lobes with fMRI, Miyawaki et al were able to use such retinotopic maps to reconstruct what the subjects saw.

At the moment, it takes a lot of time and equipment to pull off this kind of mind-reading. So, by the time your coworker realizes that you've been undressing them in your mind, you will have already put their clothes back on and decided that they look a lot better that way.

In any event, this procedure will probably only work on information from the sensory and visual cortices, i.e. stuff that you are currently feeling or seeing. It won't work with stuff you are thinking or remembering.

No matter how many medical and legal uses we find for this technology, adolescent males of all ages will immediately leap to more prurient applications. What could horny geeks do with direct visual and sensory recording technology? The internet porn industry immediately comes to mind (so to speak).

For the moment it will be fairly easy to spot fMRI voyeurs -- just look for someone aiming a 7 foot ** roll of toilet paper at your skull. So, until this technology becomes a lot more portable, I won't be guarding my thoughts too closely. Sadly (or gladly), it will be a long time before nerds with iPhones can pull this off. However, that won't stop us from fantasizing about it...

(via Pharyngula)

---

** the approximate diameter of your typical fMRI scanner

Legs Optional Dancing

Dancing, particularly folk-dancing, has changed the lives of me and my spouse in ways we could never have imagined, and we both have 2 working legs.

As this video clip shows, legs are optional for awesome dancing, as long as the spirit is willing.

Cold Weather Emoticon

We're currently having a cold snap in my area. This is a relative term, of course. The girly-man winter weather here is probably considered T-shirt weather in the Midwest.

Having recently survived a few days of Midwestern chill in Chicago at the RSNA meeting, I can really identify with the latest episode of PartiallyClips...

Australia Braces Itself for Breast Deficit

I don't usually follow the breast literature, but this item caught my eye: 130,000 inflatable breasts have gone missing from a cargo ship bound from Beijing to Sydney.

Ralph, an Australian men's magazine, has urged anyone with information on these missing marine mammaries to contact them ASAP.

It's going to take me a while to shake loose the mental image of a sea full of C-cups...

(via Pharyngula)

Avian Genital Tongues

I've recently become a fan of the animated video blog at Deadpan, Inc.. Here's one of my favorites.



(via BizarroBlog)

Slap My Ass and Call Me Sally

My iPhone led me to the best meal I had in Chicago last week.

As I mentioned in an earlier post, my RSNA Survival Kit included an iPhone app called Urbanspoon. A random shake of the iPhone linked me to Heaven on Seven, a downtown restaurant specializing in Cajun cuisine.


Five other famished radiologists humored me and went there for dinner one night, mostly on the basis of my iPhone being really cool, and despite the hotel concierge's lukewarm comment:

I haven't actually heard anything negative about the place...

The sign at the door promised about all the spicy and hot food we could handle -- my favorite names: "Slap My Ass and Call Me Sally", "Ass in the Tub" and "Hot Bitch on the Beach".

This promise of heat was continued inside, where a whole wall of the restaurant is covered from floor to ceiling with hot sauce bottles. We thought this was pretty handy, just in case we somehow ran through all 15 bottles of hot sauce already sitting on our table.

As we sat down, we ran into an encouraging colleague from Atlanta. He loves the place enough to eat there every year, and would have given the food 5 thumbs up if he just had a few more opposable digits.

There were way too many tasty-sounding things on the menu for one meal. Being a displaced child of the South, I would love to have tried them all, but somehow forebore. None of us were hungry enough to go for "Jimmy's Big Ass Rib Special", but we were mightily tempted by tall, chilled Hurricanes and a sour cocktail called a "Mother Pucker".

I had a cup of jambalaya, followed by a plate of grilled shrimp and andouille sausage on rice with ravigote sauce. As my dad would have said, it was larruping.

A caveat on dining with multilinguals...

Our group of six didn't match the American monolingual stereotype. Among us we had native or fluent speakers of several languages, including English, Spanish, French French, French-Canadian French, and Nepalese, as well as a smattering of phrases in Russian, Hungarian and Ukrainian. During the evening, we shared many linguistic adventures from the workplace, including the following:

1. The word "focus" gives native French speakers huge difficulties. Their every instinct, especially when tired or distracted, tells them to pronounce it as if saying "fornicate us".

2. The tilde can occasionally be critical in medical Spanish. The simple question, "¿Cuantos años tiene su hijo?" normally means "How old is your son?" However, if you want to see the whites of a mother's eyes, just drop the tilde and the question becomes "How many anuses does your son have?"

3. The phrase "go outside and let the ducks kick you" is an unspeakable profanity in Ukrainian.

A caveat when dining with physicians...

The more physicians at one table, the more likely it is that the conversation will swerve abruptly into medical matters. We were pretty well-behaved until the French radiologist at our table wondered if American andouille sausage was made from actual pig intestine, like the stuff he ate back home. This led to questions about which actual anatomic part of the pig intestine (duodenum? jejunum? ileum? colon?) was used for sausage. By the time this topic finally ran its course, the conversation had further devolved into speculations about whether certain intestinal diseases actually led to tastier sausage (I'll have the backwash ileitis, with a side of Crohn's...).

Non-physicians may be interested (or disgusted) to know just how many classic descriptions of anatomic pathology use food terms (bread-and-butter pericarditis, currant-jelly stools, coffee-ground emesis, salt-and-pepper skull, etc.). I and my fellow radiology residents once considered writing a paper on this very topic, and were able to name 50 examples just off the top of our heads. It's probably good advice to not shop for food or do an autopsy when you're really hungry.

A word on portion size...


Come to Heaven on Seven hungry but be prepared to share. The waitress brought one of my pals a piece of chocolate cake almost as big as his head. That and the key lime pie I ordered were pretty darned good, but way too much for the six of us to finish.

In the words of the Governator, I'll be back.

A Crazy Guy Who Blogs About Radiology

Overheard from an old friend and colleague one evening at RSNA:

"...there's this crazy guy who blogs about radiology under a pseudonym."

Gosh, I thought -- that sounds interesting.

So I asked, "Ummm, what pseudonym would that be?"

"He calls himself the Samurai Radiologist. I've been looking everywhere for a guy wearing video goggles at the meeting. He hasn't shown up at any of the places I've looked."

I suppose that Lamont Cranston and the Scarlet Pimpernel agonized over revealing their secret identities to friends. However, I didn't, because I don't have as much at stake as they did.

My pseudonym is just a way of separating my more turgid prose as a university professor from some of the wacky-ass things I feel free to say in this blog. To its credit, the university I work for has much bigger fish to fry, and could probably care less what I say here.

So, with no flash of lightning, no thunderclap, and no swirling cloak, I unmasked myself. Something along the lines of, "Uh, dude -- I'm the Samurai Radiologist. I left the goggles in my hotel room". **

If you see someone looking vaguely pseudonymous at your next radiology meeting, introduce yourself -- it might be me. At worst, it may start an interesting conversation with some other worthy person.

---

** I did show him the goggles the next day, and he pronounced them very cool.

RSNA Survival Kit Update

MyVu Crystal video goggles

The MyVu Crystal video goggles I mentioned earlier were a big hit with the flight attendants on my trip home from RSNA. Neither of them had ever seen a set of these, even among the business geeks in first class. One attendant was intrigued enough that she stopped the whole beverage service to take the MyVu for a short spin. Her one-word review: "Awesome!".

The charge on the goggles was ample for 3 hours of video. My brain wore out long before the charge on its battery.

RichardSolo 1800

A significant downside to devices like this are that you have to remember to charge them before a flight. I got so engrossed chatting with pals at my meeting that I forgot to top off my iPhone and battery extender before heading for the airport.

Chicago's O'Hare airport may be a world leader in AED deployment, but it is a world loser in deployment of power outlets for travelers. I finally spotted a cloaked outlet next to a vacant boarding gate and grabbed a few more amp-hours of charge.

As I sat there charging 4 geeky devices, I had a sudden Doh! moment, when it occurred to me that I already possessed a battery extender far more puissant than the 1800. My fully-charged laptop has a huge lithium battery that could power my iPhone all the way to Japan. Even though the seats back in steerage never have enough room for me to use my laptop as a computer, there is always plenty of space to use it as an iPhone charger.

On the other hand, the WiFi at O'Hare was pretty zippy -- fast enough to grab another movie off iTunes before boarding.

Geek cred re-established, I had an otherwise uneventful flight home.

Elevator 2.5

The RSNA is holding its annual meeting at McCormick Place: a multiplex of huge and bizarrely-lit barn-like structures.

Radiologists work all day in the dark, and often commute both ways in the dark this half of the year. We therefore tend to be a bit pallid as a group. This natural pallor is not improved by the odd, not-found-in-nature spectrum of the overhead lights here.

After spending the morning wandering through crowds of corpse-hued radiologists, a lunch-time elevator ride added briefly to my sense of unreality. I did a double-take while punching in my destination, and pulled out my iPhone for the following picture:


Google led me to a floor plan of level 2.5, but so far, not to any explanation of how it got numbered thusly.  If McCormick Place were built by Microsoft, I'd conclude that the level has been out of beta for a few years now, and is now finally safe enough for general use.  Even so, most experienced users would wait a few floors and get off on level 5.0. 

Whatever the reason, I suppose we can be grateful that at least they named it using the metric system. History suggests that it could have been a lot worse...

RichardSolo 1800 Update

I briefly posted a few days ago about the RichardSolo 1800 battery pack. Here's a quick update from the RSNA battlefront on this device.


After lunch today, a friend noted that her iPhone was down in the red. Mine was down to about 40%, so out came the 1800 -- an hour later, her phone was back up to 100%. Another hour later, mine was back up to 85%.

Collectively it seems that we got just under 1.5 full charges out of the device -- an encouraging first test.

Made it to Chicago

I made it safely to Chicago (and the RSNA meeting) from a place that is at least 20 degrees warmer. It was a fine flight until the last 30 minutes, when we descended into a cloud. We then experienced enough bumps to make us think we were hitting snowballs during the rest of our way down.

.
Chicago currently has about an inch or two of accumulated snow on the ground. The iPhone picture above from my hotel room hints at some of the drear awaiting one without. The wind coming in off Lake Michigan feels at times like it could strip the flesh right off one's face.

Fortunately, I bought all of my winter hiking gear along except for one key ingredient: the polypro underwear. Alas, the Chicago branch of REI is about 3 miles away from my hotel -- a tad too far for me to feel like walking in this weather. I'm only here for a few short days, so I'll just pretend that my legs aren't that cold.

RSNA Survival Kit No. 6

I'm flying off to the RSNA meeting in 2 days. Besides the usual clothes and anti-boredom gear, I'll be taking along the two presentations I'll be giving there.

After working like a slave on these presentations for the past two months, I'm taking extra measures to insure that they make it safely to Chicago with me. This is a whole lot easier than it was in the days of academic yore, when 35 mm slides ruled the earth.

I'll be putting digital backups of each talk on my laptop, several USB memory sticks, a university SFTP server and in my shiny new Dropbox account. To my computer, Dropbox looks like a 2 GB memory stick, but resides out somewhere in Amazon's S3 server cloud. The clever gnomes at Dropbox have created versions for Mac, Windows and Linux that all work the same way.

I've been storing stuff in clouds (servers) of my own for many years, so this is no new concept for me. What is new is the extreme ease of use and the deep intelligence that the Dropbox dudes have rolled into their product.

Since I'm a radiologist, I'll use a visual metaphor. Suppose you want to make a cup of coffee:

Alas, most network storage solutions look like this:


You know you want a cup of coffee, but how the hell do you get this thing to make it?

By contrast, Dropbox works like this:

The other thing I like about Dropbox is the several intelligent things it does to quietly keep me from fubaring my files. I can't improve on Rands' well-written account of this: Dumbing Down the Cloud.

(via Daring Fireball)

RSNA Survival Kit No. 5

I'm probably not the only radiologist who has longed for some virtual way of chewing their leg off to escape the trap of a truly boring presentation. I therefore did something a little wacky 2 weeks ago, while assembling my RSNA Anti-Boredom Countermeasures Kit™:

Most items in this kit have so far been extremely practical. The latest addition is there purely because I thought it would be cool. After eyeing ads for the MyVu Crystal video goggles for a few months, I took the plunge and bought one for my iPhone.


I should point out that this is not a picture of me. However, if you spot one of these headsets on someone in the meeting crowd, it might be me. Introduce yourself and find out.

So far, the Crystal works as advertised, and displays a virtual 640 x 480 TV screen of acceptable clarity, brightness and color. In a quick test, the virtual screen appeared about 30% wider than our 27" home TV screen when viewed from our living room couch. The audio quality for the built-in earbuds is also quite acceptable.

One caveat for myopic users: if you normally wear glasses, you will also need to order their Myvu Clip-on corrective lens kit. Otherwise, it will be like watching a TV from across the room with your glasses off. Their clip-on kit comes with -2 and -4 diopter options, as well as a blank template you can use to get a custom prescription from your eye doctor.

If I don't see you at the meeting this year, I now have a whole new excuse...

RSNA Survival Kit No. 4

The latest addition to my RSNA Anti-Boredom Countermeasures Kit™: a battery extender for my iPhone.

I must say that my iPhone battery life has been pretty good so far. On my last flight to Chicago, I was able to watch 3 hours of videos and still have plenty of power left. On the other hand, surviving a whole day of tedious presentations is going to take a lot more juice than that.


I was therefore delighted when my new Richard Solo 1800 arrived 2 days ago, just in time for RSNA. This creature has enough power to give a nearly-depleted iPhone a complete charge.  For some reason, it also includes a built-in LED flashlight and laser pointer.  No feces.

The next logical step: start looking for a bladder extender...

(via Daring Fireball)

Radiology Needs a Hot Dog Cannon

OK, this video frankly has nothing at all to do with radiology. I don't care.



On the other hand, a lot of next week's presentations would be hugely improved if RSNA had an official mascot break up the tedium by firing hotdogs (and better yet, emergency espressos) up into the crowds of captive radiologists.

(via Daring Fireball)

Exploding Job Offers

How well does a radiology residency prepare you to negotiate for fellowship positions and jobs? Not too darned well, I'd say.

Joel Spolsky speaks to this in his latest Joel on Software post. His advice is aimed at college students, but is also extremely relevant for any young physicians trying to claw their way up the food chain:

If you’re a college student applying for jobs or summer internships, you’re at something of a disadvantage when it comes to negotiation. That’s because the recruiter does these negotiations for a living, while you’re probably doing it for the first time.

I want to warn you about one trick that’s very common with on-campus recruiters: the cynical “exploding offer.”

In a nutshell, recruiters make time-limited offers to pressure recruits into taking a job. I got this kind of pressure when I was job hunting, and it still goes on. According to one of our recent applicants, a competing radiology fellowship director gave her 45 frakking minutes to make a decision. To her credit, she turned that job down.

Read Joel's post for several great tips on dealing with this kind of sleazy behavior. I wish I had known this stuff years ago.

RSNA Survival Kit No. 3

Another tactic for surviving the RSNA meeting: getting some exercise.

One of my favorite ways of exercising in Chicago is to visit the Chicago Barn Dance Company's great Monday night contra and square dance.

After a long sedentary day at the meeting, a group of us are planning to go and shake the McCormick Place dust off our feet by dancing to hot, live, old-time fiddle music at the Bethany Church hall. As the Barn Dance site suggests:

Start the month off right by dancing to the fine old-time fiddling of Aubrey Swift, leading Grand Ol' Aubrey. Jo Mortland presents a mix of squares and contras guaranteed to lower your brain age by years.

Newcomers session is at 7:30 pm. Hope to see you there.

RSNA Survival Kit No. 2

I'll be asking a lot of my iPhone at RSNA this year. Besides the usual anti-boredom countermeasures, I'll be testing whether several new apps will make my brief visit to Chicago a bit easier.

Restaurant Apps

I'll be eating out most evenings in Chicago, so restaurant applications will be handy.

One of my favorite restaurant apps is Urbanspoon, which I mentioned previously in Dining Out for the Indecisive. It's worked pretty well for me here at home, but I'm looking forward to testing its away game while I'm in Chicago next week.

A test just now for cheap food in the Magnificent Mile area wants to send me to Heaven on Seven, a Cajun cuisine spot on N Wabash. I might just give that place a try.

Another restaurant app I've got my eye on is OpenTable, which will let me find and book open tables at restaurants all over the country. A quick query for a downtown Chicago steak quickly offered me the following 3 times at Morton's:

General search app:

One could just use the Safari browser on the iPhone for general searches. However, the Google Mobile App does a nice job of optimizing Big Google for the phone's smaller screen. Besides, the Google gnomes have just added a very cool new feature: Voice Search. This feature uses the iPhone's proximity sensor to trigger a voice search when you hold the phone up to your ear.

As a test, I said "Gino's East, Chicago" -- one of my favorite Chicago-style pizza places. The app toodled when it was through listening, and sent the following waveform off to Google central:

A few seconds later, that screen was replaced by this one, with just the place I was looking for on North Wells:

Now it's all very well to play with this stuff thousands of miles from Chicago, when there's nothing at stake. However, as Helmuth von Moltke put it:

No battle plan survives contact with the enemy.

I'll let you know how these apps hold up under battlefield conditions, when 30,000 famished radiologists simultaneously duke it out for dinner next week. Wish me luck.

RSNA Survival Kit No. 1

A meeting as large as the Radiological Society of North America involves lots and lots of waiting -- for planes, trains, buses, food, lectures, friends, cabs, bedtime, etc.

This year my iPhone will be a major part of my anti-boredom kit during all of these interludes. I'll have it full of books to read, games to play, and applications to make my stay in Chicago a tad more comfortable. This post begins a series on some of things I'm stuffing into my RSNA Survival Kit this year.

The following YouTube video will make 4:34 of some delay a little more tolerable:



(via kung fu grippe)

Samurai Radiologist Interviewed by RSNA News

In a shameless bit of self-promotion, I now point you to the latest online edition of RSNA News.

The News interviewed me and several other gadget hound/radiologists about our favorite techie tools. Mine, of course: the iPhone.

Besides quoting radiology alpha geeks, the article also lists some morsels from the upcoming RSNA meeting in Chicago. Look for me and other discerning attendees at Wii, iPhone, and podcasting talks, while the great unwashed masses are off hearing about barium and billing.

RSNA Looms

The giant, annual intergalactic conclave of radiologists known as the RSNA moves relentlessly towards us. This juggernaut transpires November 30 - December 5, and I have to go.

Every year after Thanksgiving, hapless planetary radiologists fly off to Chicago to spend a week wandering around an overpacked convention center, sweating in overheated buses, and eating overpriced food. Then there's the weather -- even the Chicago tourist board can't say much good about this time of year there. Good times.

Then, there are the technical exhibits. These last two words don't well convey the huge radiology bazaar that unfolds in McCormick Center. Imagine a double-sized warehouse store, packed with imaging gear and populated by the denizens of a Star Wars bar. These alien creatures will dress in three piece suits and lie in wait on every aisle, all ready to buy your soul. Looking for bargains? Guess again. This is medical equipment, so think CostMo, not CostCo. First-timers tips: read this book, know your escape routes, don't make eye contact and keep moving.

On the plus side, it will be a chance to see a lot of old friends, learn what's new in my field, and visit some of the great Chicago museums and restaurants.

I'm giving two RSNA presentations this year, which explains much of my silent running on this blog for this month. In preparing these talks, I am handicapped by wanting to do a really good job. Sadly, greatness requires a lot more work than mere competence, so I've been focused pretty intently for the past few weeks. However, a little work-avoidance behavior is good for the soul. I've therefore resurfaced briefly for a few posts, and then it's back to the PowerPoint mill for me.

Osirix App Now Available for iPhone

OsiriX , the wonderful open-source Mac image viewer, just announced the availability of an iPhone version.

Like a lot of imaging software, OsiriX lets one look at X-rays, ultrasounds, CT and MR images. Besides merely viewing, it also lets one reconstruct 3D images and rotate them around.

Unlike most imaging software, OsiriX is written by radiologists who also happen to be clever programmers. Also unlike most imaging software, OsiriX doesn't require a second mortgage. The full Mac-based version is free, and the iPhone app is $20.

Why should a non-physician care about Osirix? Because this little app will let you carry around a library of your own personal medical images. Even in my prior life as an internist, I always urged patients to keep their own copy of their more important images. The OsiriX app finally makes this easy and portable.

In the radiology biz, we call prior imaging exams "old films", and they can be staggeringly useful to a patient and their physicians. One of my patients once avoided having a risky lung biopsy simply because he happened to have an old film at home as a curiosity. This old film showed us pretty convincingly that the potential lung cancer we saw on his new film was actually a benign granuloma, and was unchanged over the intervening decades.

How do you get copies of your own images? Ask your local radiology department to burn you a CD in DICOM format. Most departments will also include free image-viewing software on the disk. If you're a Mac owner, download a copy of OsiriX, which will read virtually all of these disks, even if written by PC's.

If you're a geeky radiologist, you're probably already playing with the new app. If you're a non-geek, ask your teenager or local radiologist to put it on your phone for you.

Maple Leaf Rag Played by Scott Joplin

The YouTube comment on this clip states simply:

Maple leaft Rag, recorded on Pianola Roll actually played by Scott Joplin

I first heard this Joplin classic at a college friend's home decades ago. After dinner, he sat down at the family pump organ and played the heck out of this tune.

The tune's ability to blow me away remains undiminished. Hearing it from its author's own hands is an even greater treat. I'm going to smile a lot more today.

(via kung fu grippe)

Weird Body Quiz

In a desperate attempt to take my mind off the "E" word today, I stumbled across The Weird Body Quiz at the New York Times site. It's probably a good thing I went into radiology instead of specializing in weird body facts -- I scored a paltry 60%.

This quiz is taken from a list of unusual medical questions compiled by a surgeon and her teenage daughters called "Why Don't Your Eyelashes Grow? Curious Questions Kids Ask About the Human Body". Sounds like just the place to get some just-in-time CME on boogers, hiccups, pee and farts.

All Ballot's 'Een

Two very topical black & white Dan Piraro cartoons really nail how many of us are feeling this evening.

(via BizarroBlog)

Lay Research

The latest PartiallyClips strip suggests an intriguing second life for some of the high tech gear we've got lying around our radiology department. So many possibilities, so little time...

Happy Halloween!

One of my co-workers is a Jedi of balloon art. She graciously allowed me to post one of her latest works:

I spend a lot of my work time looking at skeletons, and appreciate the extra details she put into the lumbar spine and sacroiliac joints (as seen from behind).

Grand Rounds - Vol 5, no. 5

This week's edition of Grand Rounds is up, hosted this week by Pallimed, a hospice and palliative medicine blog.

My contribution to this edition concerns the little-known Banjo Center of the Brain, and is listed in the comment section.  Look for "We need a banjo to OR 3 stat!"

Hoedown Throwdown

This short video was posted to YouTube about 10 days ago by mikehoye, who says:

I got off the subway at Bloor and Yonge last night, and this is what I saw; some buskers with a fiddle and a banjo were playing, and these four other guys just started to pop it and lock it, apparently just for the hell of it. It cheered me right up.

Cheered me up too.

Always a Doctor, Even in the Dying of the Light

Medical skill is not commonly associated with writing ability. For that reason, it's always great to find physicians who not only break that stereotype but smash it to pieces.

I'd like to recommend Always a Doctor, Even in the Dying of the Light by Kenneth Weinberg, M.D., an emergency room physician who just wrote about the death of his radiologist father in the New York Times.

I don’t know how he stayed alive so long with blood counts that I, as an emergency physician, associate only with patients at the edge of death; I don’t know why his blood felt cold; and most of all, I don’t know why his dying brought no tears to my eyes.

Was it because after his memorial service, determined to celebrate his life, my brothers and I bought Champagne — and then, at my mother’s request, went into his closet, tried on his old clothes and staged a spontaneous fashion show, causing the assembled wives and grandchildren, and my mother, to laugh for an uproarious hour?

Or was it because he died at home, surrounded by those he loved, in such stark contrast to what I experience so often at work: all of those patients circling the drain on trips between nursing home and emergency room, and then dying alone with no one to feel their blood turn cold?

Thank you for sharing this with us, Dr. Weinberg. Your account moved this radiologist to tears.

(via PalliMed)

The Blind Men and the Elephant and the Donkey

"Blind monks examining an elephant" by Itcho Hanabusa

Anyone doing medical research for more than 20 minutes soon learns that they can get wildly different results depending on just how they slice and dice their data. A wonderful example of this appeared a few days ago in the New York Times. Tommy McCall, former information graphics editor of Money Magazine, poses an intriguing question in his short op ed piece: Bulls, Bears, Donkeys and Elephants:

Since 1929, Republicans and Democrats have each controlled the presidency for nearly 40 years. So which party has been better for American pocketbooks and capitalism as a whole? Well, here’s an experiment: imagine that during these years you had to invest exclusively under either Democratic or Republican administrations. How would you have fared?

His conclusion, summarized in an impressive-looking graphic:

As of Friday, a $10,000 investment in the S.& P. stock market index would have grown to $11,733 if invested under Republican presidents only, although that would be $51,211 if we exclude Herbert Hoover’s presidency during the Great Depression. Invested under Democratic presidents only, $10,000 would have grown to $300,671 at a compound rate of 8.9 percent over nearly 40 years.

The implication is that the stock market has a very strong liberal bias. Your reaction to this is probably either "Oh, shit!!" or "Dude!!", depending on your political orientation. However, don't touch that dial.

An excellent follow-up post by Theodore Gray, co-founder of Mathematica, gives a quite different picture of this data. Gray created a wonderful interactive model to look at the same question, but using the Dow index (1897 - 2008) rather than the S & P. I downloaded it and had a ton of fun playing with it. Using the same assumptions as McCall, his initial model looks very similar:

However, what if one adds some very basic assumptions to the model? For example, many long term investors plow their stock dividends right back into buying more stock. If anything, this makes the Democrats look a lot better:

But wait, there's more.

What if we assume that it takes a while for a new president's policies to take effect? Not an unreasonable assumption, considering that one of the few things with a bigger turning radius than a Humvee or an aircraft carrier is the U.S. economy. What if we allow 12 months for this to happen? What if we also consider the effects of inflation and decide not to blame the whole darned Great Depression on the Republicans? The results now seem to vindicate the red staters:

But wait, there's still more!

And, you can read it in the final paragraph of Gray's article. The ending conclusion is too good to spoil here. I will say that I found it really comforting, considering current market conditions.

I guess that the old Sufi/Jainist/Buddhist/Hindu story of the blind men and the elephant is still just as relevant as ever. I'll leave the last word to American poet John Godfrey Saxe (1816 - 1887), who penned one of the best known versions of this tale. The final stanza of his poem says it all...

So oft in theologic wars,
The disputants, I ween,
Rail on in utter ignorance
Of what each other mean,
And prate about an Elephant
Not one of them has seen!

(via TheZorg)

Grand Rounds - Vol 5, no. 4

Cost-saving automated external defibrillator storage. (A) Vending machine. (B) Advertising box. (figure used with permission)

This week's edition of Grand Rounds is up, hosted this week by the Anesthesioboist.

She groups this week's posts into a movie theme. My contribution, AED Lessons from Japan, appears under the heading of Educational Materials (our section's personal movie theme: Elf).

The Banjo Center of the Brain

I've used my banjo in a number of venues, but I've never brought it in to work. Looks like some Nashville neurosurgeons have beat me to it.

Bluegrass legend Eddie Adcock recently underwent brain surgery to treat a hand tremor. During this procedure, his surgeons placed electrodes deep into his brain to stimulate the thalamus at just the right spot to inhibit his tremor.

Alas, the banjo center of the brain is not an area well-known to neuroanatomists. To pick the optimal location for the electrodes, the surgery was performed under local anesthesia while Eddie played his banjo. He was thus able to update the surgeons in real-time as to whether the tremor was better or worse, letting them get the lead placement just right.


The BBC has posted some remarkable video and audio clips recorded during this surgery. The audio beginning at the 3:49 marker moved me the most. In this bit, the BBC interviewer asks Mr. Adcock to play the banjo with his stimulator on and off. The difference is pretty clear, even to the non-bluegrass ear.

Losing the ability to play is a special terror we musicians know, even for those of us who earn our living some other way. I went through this recently following a biceps tendon repair. The first few months were depressing for me because I couldn't bow my fiddle in my ginormous bionic elbow brace. However, once I was able to drape said brace over my guitar and play a few minutes every day, my spirits picked up considerably.

So, here's to the Vanderbilt neuro boys. There are a lot of musicians and music lovers out there who would happily line up to buy them a few drinks. If it would help us to play like Eddie Adcock, I know that several of us would also line up for our own set of electrodes.

(Hat tip to Anita Anderson)

Master of Understatement

Paul Krugman, economist, Princeton professor, and eloquent op-ed columnist for the New York Times, is also a master of understatement. In his first blog posting this morning, he wrote simply:

A funny thing happened to me this morning …

His initial reaction to the "funny thing":

My immediate conclusion was that was an obviously fake Swedish accent.

Bush's Last 100 Days

As of today, George Bush is down to his final 100 days in office. What will he do with this time? Here are some ideas from his predecessor...

A Gray Slate in '08

After careful consideration of the issues, I've decided which candidate I'm backing on November 4th. No red or blue party for me, I'm voting gray...

A Subprime Primer

If your economic training matches mine (single mandatory college economics course), you may find the following slideshow handy in understanding the current subprime mortgage fiasco.

Caveats:

1. you'll need to view this in "Full Screen" mode to read most of the text
   
2. some of the language is crude, though perhaps not crude enough

Subprime Primer

View SlideShare presentation or Upload your own. (tags: subprime mortgages)

(via Presentation Zen)

Radiologist Steps Down as Head of NIH

Elias A. Zerhouni, M.D. retires as director of the National Institutes of Health (NIH) at the end of this month.

Dr. Zerhouni stands out as being the first radiologist to lead this august organization, and has accomplished quite a bit during his tenure, despite lackluster presidential support. I'm especially proud of his standing up to Bush on stem-cell research.

As reported by Nature News, in his testimony to the Senate in March 2007,

...he said that US science would be better served with access to more stem cell lines. In a competitive world, he told senators, "it is important for us not to fight with one hand tied behind our back here."

The timing of his retirement is interesting, as it takes place about 4 days before the upcoming presidential election. Again from Nature News:

Zerhouni, 57, said that he was leaving before national elections on 4 November so that there would be no question of his lingering into a future administration.

"I felt that it was very important, for the sake of NIH, to not just stay and have the [next president's] transition team think: NIH is taken care of. They have a decent director. Let's focus on other things," he told reporters on a conference call.

I hope that the next president does indeed put a high priority on medical research, and in finding a worthy successor to Dr. Zerhouni.

Easy as Pi

XKCD presents a sextet of intriguing sex positions.

In this context, at least, a natural log is not as natural as one might think...