Tuesday, February 24, 2009

Grand Rounds Vol 5. No 23 is up


The latest issue of Grand Rounds is up at The Blog That Ate Manhattan.

This week's episode has a food-related theme. My contribution is filed under "Lunch". Since my comic is set in a noon conference, it is technically on topic. Also, as TBTAM points out, further relevance comes from a veiled reference to an important food group.

Sunday, February 22, 2009

Samurai Radiology Comics No. 002

This is a true story.  

File it under the heading of "Things You Wish You Hadn't Said in Noon Conference".

(click to embiggen)

Sunday, February 15, 2009

Doctors' Opinions of the Financial Bailout Package

What do different medical specialties think of the bailout? Here's a sample...
The Psychiatrists thought the whole idea was madness, the Radiologists could see right through it, and the Surgeons decided to wash their hands of the whole thing.
Check out the whole list of specialties at The Happy Hospitalist.

(via Movin' Meat)

Anatomic Valentines for Your Sweetie

For Valentine's Day, I don't think I can improve on my post from last year.

You should be able to find a "heart" there to suit even the most jaded valentine on your list.

Thursday, February 12, 2009

Grand Rounds, Vol 5, no. 21

The latest issue of Grand Rounds is up at The Health Care Blog.

Happy Darwin Day 2009


Happy 200th birthday to Charles Darwin!

I'm on the clinical schedule today, so I probably won't be able to mark the occasion other than with a mental hat tip and this post. However, as I move through my workday, I'm sure that I'll run into many little bits of Darwinian detritus in my patients.

If you prefer to mark this occasion by a wild rumpus, check out the Darwin Day website. There you will find a list of over 200 local events where you can celebrate Darwin and his grand ideas about as much as you can stand.

Wednesday, February 11, 2009

Five Out of Five Radiologists Agree

We had to reboot our PACS workstations several times today. Alas, this happens all too commonly.

After a particularly demoralizing crash, I called a brief work timeout. I gathered my four residents and fellows together for a few minutes of catharsis, and showed them the Onion video I posted yesterday. My instructions:
"Whenever you hear the word 'Sony', substitute the name of our 'POS PACS Vendor'".
We spent several hilarious minutes with tears rolling down our cheeks. It's not often I need to thank an Onion for making me cry.

Tuesday, February 10, 2009

Not Safe for Work

NSFW is an appropriate term for the video clip below. Alas, it also applies to our web-based radiology-information-system (RIS) when it's having a bad day.

Sony didn't build our RIS -- it was some other Enormous Multinational Company. However, this video summarizes really, really well the frustration that many of us feel with our EMC POS RIS...

(click here if embedded clip doesn't play properly)

(via Daring Fireball)

A Busy Work Day in Radiologyville

Unlike private practice radiologists, I live the rockstar lifestyle of the academic radiologist. Up in my ivory tower, some of my work is done by serfs (residents and fellows), freeing up time for teaching and research projects.

However, even an academician's caseload can be pretty high. On our busy days, our workload edges way up into private practice territory. We had so many cases to read today that it felt like we were trying to drain a bathtub that was being filled by a firehose. In other words, a lot like the video clip below...

Friday, February 6, 2009


ARRS + ACR heart.png
The American Roentgen Ray Society (ARRS) and the American College of Radiology (ACR) announced today their intent to be BFF:
The governing boards of the American College of Radiology (ACR) and the American Roentgen Ray Society (ARRS) have reached an agreement in principle for a strategic integration that would leverage the unique strengths of each organization and provide the potential for enhanced service to radiologists and medical physicists seeking continuing medical education, quality and safety programs and a strong voice in Washington.
Non-radiologists could probably care less about this announcement.  However, as a member of both of these fine groups, I wish them well on their betrothal. Combining the educational prowess of the ARRS with the political clout of the ACR could make for a mighty group indeed.

My main concern is what they will call this new "strategic integration". At the very least, I'm hoping for an acronym that doesn't suck too badly. I just can't think of any way to pronounce "ARRS-ACR" that doesn't sound like a synonym for glutealgia.

In hopes of finding a more pleasing arrangement of these letters, I helpfully fed "ARRSACR" into an internet anagram server. Alas, that server was stumped by this letter combo. However, when I fed in "The ARRS and ACR", I got a lot more hits (4537). I didn't bother to read them all, but did like "Rad Rat Ranches", "Rather Rad Scan" and "Drear Trashcan". Hopefully, this merger will make good financial sense, and not turn out to be "Errant Rad Cash".

Of course, there is a certain amount of redundancy between their two maiden names. Maybe they could get by with just one "American" between them. Likewise "Radiology" sort of implies "Roentgen Ray" and "College" is a synonym for "Society". What we're looking for here, is some new name that means:
Big American Radiology Society
While they probably won't pick this exact name, they could sure do a lot worse acronym-wise than BARS.

I guess we'll just have to wait until July 1 to learn just which group got dibs on naming rights in their pre-nuptial agreement.

Wednesday, February 4, 2009

Samurai Radiology Comics No. 001

I had a lot of fun making the comics for an earlier post this week, so I thought I'd try it again.

This is a true story, told to me by one of my truly brilliant attendings long, long ago...

(click to embiggen)

Another Use of Radiology to Stop Smoking

We use chest X-rays all the time to diagnose the horrible diseases caused by smoking.

100 points to Gryffindor (Saatchi & Saatchi London) for this creative adbin, which shows another clever use: to graphically show the effects of smoking on the lungs.


(via Street Anatomy & MarketingBlurb)

Tuesday, February 3, 2009

Putting the P in iPhone


I often listen to my iPhone while editing my radiology reports. At other times, I carry my earbuds draped around my neck like one of those internist dudes carrying a stethoscope.

This backfired last week during a call of nature, when my earbuds slid off my neck right into the line of fire, shall we say.

Oddly enough, the Apple website doesn't have a single tech support note containing the word "urine".

So, I cleaned and dried my desecrated earbuds as best I could, using simple nearby tools. Once I felt safe putting them back in my ears, the left earbud was dead.

The main silver lining for me is that the iPhone itself stayed in my pocket. Otherwise, I have a feeling that this would have totally voided, so to speak, my warranty.

Samurai Radiologist Featured on Medscape Pre-Rounds

As this week's host of Grand Rounds, I am featured in this week's edition of the Medscape Pre-Rounds interview (alas, viewing this may require login).

Grand Rounds - Vol 5, no. 20

Grand Rounds no 5 vol 20.png

Welcome to the latest edition of Grand Rounds!

This edition coincides almost exactly with my first anniversary as a blogger. Therefore, as a loose theme for this week, I've suggested an anniversary theme, and have asked contributors to write about something cool or imporant that they have learned in the past year.

Read on to find out what has recently crawled out of the tasty brains in the medical blogosphere...

Introducing Our Leadoff Post

Many of us do stuff with no expectation of pay, and blogging usually falls into that category. Although we blog for many reasons, most of us are probably in it just for the eyeballs -- we don't expect to convert our posts into large bags of cash. If we do manage to boil down a piece of our life into a set of useful insights, we'd like to get credit for said insights.

This is a common theme in the world of academic medicine. We give away research findings and data all the time. We tell the world: "Read this. Use this. Extend it. Just give us credit for the work we did." Even if this academic output doesn't get us promoted or invited to speak in swell places, we still expect to receive this basic currency of academia: getting credit for our ideas. Giving credit where it is due is also a standard practice in the incestuous world of blogging, where we endlessly quote and link to each other.

Linking to and extending the ideas of others is fair game. However, there is also a dark side to linking and quoting. Many of us have already noted blogbots mirroring bits of our content to certain robosites, probably to up their ad revenue. To me, these isolated events have so far been merely irksome. However, when someone sets up an automated strip-mine that grabs all of the intellectual output of thousands of blogs, it goes far beyond galling and becomes outrageous.

This is a long-winded way of introducing our lead-off post by Val Jones: How the Health Blogosphere was Scammed -- required reading for all health bloggers.

Dmitriy of the Trusted.MD blog has additional commentary on this same scam.


Leslie of Getting Closer to Myself describes the not-so-happy first anniversary of seeing her rheumatologist for the first time.

What if you have something that can't be cured? The chief psychiatrist at How to Cope with Pain suggests some alternative goals.

Lessons Learned

IcedLatte at Medical Marginalia has learned how expensive fresh food can be in Ohio. She therefore offers some budget ideas for the dietarily challenged.

Medaholic reminds us that there is more than just medicine to life.

Jay and Louise of Colorado Health Insurance Insider have learned that the invisible hand of the market sometimes acts more like an invisible fist to patients with pre-existing conditions. As moles inside the insurance industry, Jay and Louise have an interesting vantage point on The Failings of the Free Market in Health Care.

A one-armed person can be a real drag -- just ask Richard Kimble (or my spouse). The worst part for me after biceps surgery: learning to use toilet paper with the wrong hand. The best part: Dude, I'm a radiologist -- I could do all of my work in a body cast. Jenni of ChronicBabe has recently visited this territory, and shares her experiences in "What I've Learned from Being One-Armed".

Dr. Zhang of The Cockroach Catcher straddles two themes this week. For one, he just celebrated a one-year anniversary of blogging and publishing a book. Also, this year he finally learned the cause of a mysterious coma that afflicted one of his patients 30 years ago.

Doc Gurley shares an important thing she has learned this year in America -- Most expensive pee in the world. Gee, I may never be thirsty again...

Have your psych patients stopped responding to the usual sessions and drugs? Maybe it's time to drop that girly-man stuff and try pro-wrestling. It worked for the Mudphudder. Check it out in Can You See What the Mudphudder is Cooking?

Alvaro Fernandez of SharpBrains shares some recent highlights and reflections on cognitive health.

The Skaw, a humanist-turned-medical student, writes The Humours blog and has submitted Baby Steps to this episode of GR. Come for the insights of a larval physician, stay for the really neat typographical visualizations of the brachial plexus.

The eponymic Laika of Laika's MedLibLog chronicles her journey from Web 1.0 Padawan to Web 2.0 Jedi in What I learned in 2008 (about Web 2.0). It's also her first blogoversary -- congratulations!

Diabetes Blogs

The prolific diabetes bloggers have earned their own category this week.

Allison from Lemonade Life just celebrated an anniversary of her own: fifteen years since her diagnosis of Type I diabetes mellitus. For this anniversary, she asked her readers to share something good that is going on in their lives and then describes her own fifteen years of something good in the face of Something Bad.

Amy of Diabetes Mine has learned the impact of harnessing the collective wisdom of an online community. This wisdom has been collected into an eBook called Nuggets of Wisdom from the Diabetes Community.

Wouldn't it be great if you could drop your serum glucose level merely by blogging about it? Kerri of Six Until Me points out that great diabetes blogging doesn't necessarily equate to great serum glucose control.

Other Chronic Diseases

Now that the U.S. has elected its first black president, maybe it's time to start breaking other barriers, such as electing a gay woman the next time. Duncan Cross suggests a less obvious barrier, and wonders if we will ever see a person with a chronic illness be elected to the U.S. presidency...

Barbara at In Sickness and in Health points out that chronic diseases affect not only patients, but also their spouses in Invisible Illness: a Two-Way Street for Couples.

Dean Moyer of The Back Pain Blog comments on a recent study of massage therapy for pain control in his post: Back Pain Relief and Massage Therapy.

Humor in Medicine

Bob at the Insureblog points out the real reason some people are fat.  If this is true, I'm going to start wearing a mask 24 x 7 from now on.

Ves at Clinical Cases and Images has some tough news for cello players carrying the diagnosis of "cello scrotum". The original physician who described this particular disease has come clean, and now tells us that the syndrome doesn't actually exist. So soldier on, cello dudes -- good luck in finding scrotal surcease elsewhere.

Dr. Shock writes about the dark side of medical humor: derogatory and cynical humor towards patients that can emerge as part of the professional socialisation process of physicians.


Most of us love sharing war stories about our medical adventures. However, when some of these war stories happen in a real war, sharing them can have unexpected ethical implications. Canadian Medicine tells the story of a Canadian doctor whose journalistic ethics collided with the somewhat different ethical obligations of a physician when he published a story about a dead soldier.

Even humble radiologists have been the targets of corporate marketing. Film companies, contrast makers and MR manufacturers have all tried to buy my soul at one time or another. David Williams of the Health Business Blog discusses why we should ban CME sponsored by pharmaceutical companies.

Do patients lie to their doctors? Dude, how would I know? -- I'm a radiologist! However, Dr Rich at the Covert Rationing Blog is not, and shares his thoughts on this topic.

Why are Division I colleges like cheerleaders? Because they'd both rather date jocks than kids with high SAT scores. I don't blame Nancy Brown of Teen Health 411 for being peeved about this inequity. For further details, read SAT Scores and Athletics.

The recent birth of octuplets in California raises a zillion ethical points: should a single unemployed mother of six kids try to have more kids? Should she seek or be given fertility treatments to try to have a lot more? Dr. Bates of Suture for a Living covers these and other issues in Eight Too Many.

Other Delicacies

Daniel at Neuroanthropology weighs in on the design of effective waiting rooms. Apparently, cool magazines aren't enough -- the cultural expectations of waiting also matter.

For those of you already reeling from the recent peanut recall, here's some more bad news from Allergy Notes: it would seem that childhood peanut allergies affect mothers' quality of life more than fathers'.

Doc Childneuro of the Mind, Soul and Body blog takes on a tough topic: dignity.

Dr. Rosh at Receiving interviews one of the leading lights in emergency medicine: Mark Reiter.

Monday, February 2, 2009

Radiology Action Comics


Anyone who has ever published in a scientific journal has run head-first into the Instructions for Authors page of said journal. Usually the stylistic rules for a radiology paper are stodgy but sensible.

I was tickled to learn that the alternate universe of comic book publishing has its own grammatical and lettering traditions, as nicely depicted in this illuminating post by Nate Piekos.

For example, the word balloon in the image above commits the venial sin of...

I generally disapprove of placing a balloon over a border unless absolutely necessary due to space constraints. If at all possible, you're better off butting balloons to a border.
However, I have redeemed myself in the panel below by not using...



Sound effects lack punctuation with the one exception of when you intend to seem cartoony. A noise is not a word, and the emphasis and design aesthetic you impart when designing your sound effects should be enough to give it "punch".
I'll have to keep these style points on speed dial in my browser. They'll come in really handy when I put together the next issue of Radiology Action Comics™...

(via Daring Fireball)

Boy, Did That Year Go By Fast!


Today is my first anniversary as a blogger. Boy, did that year fly by quickly!

Despite initial worries about finding something to say, I am somewhat amazed to find that 228 posts have somehow transpired here. I started the blog with the idea of writing mostly about radiology. I think I've mostly managed to do that. However, after perusing the list of tags that have accumulated over the year, I can see that I've also veered off into a few other directions. I must say that I'm looking forward to seeing what will crawl out of my brain over the next year.

Regular writing teaches several lessons. One of the most pleasant things I've learned from this experience is just how much fun it is to write when I’m not on deadline, and the only editor I have to please is myself.

I’ve spent my whole career writing scientific manuscripts, book chapters and other academic fodder. However, scientific writing tends to be pretty darned formulaic -- it’s rarely great literature. This blog is the first thing that I’ve ever written just for the fun of it.

As a way of marking this bloggoversary, I'll be hosting tomorrow's episode of Grand Rounds in this space with a loose anniversary theme.

Don't touch that dial...

The Banjo Rules on Saturday Night Live

Saturday Night Live was especially excellent this past Saturday, mostly because of host Steve Martin. My favorite moment was when he stepped on stage with his banjo and cut loose with an original song punctuated by some great clawhammer banjo licks.

The icing on the cake was today's New York Times article on this very topic.