Friday, July 24, 2009

Haphazardly Hunting Hieronymus

We visited the wonderful Metropolitan Museum of Art in New York today. As with any museum of this stature, there is way too much stuff to see, even with a dozen visits.

My secret master plan for handling big art museum overload: chop the impossible down to something I can actually do. In my case, that means hunting for Hieronymus Bosch. I can't see everything in the museum, but I can darned well see all of their Bosch collection. Other than than, I just wander around randomly until I get tired.

It's a humble plan, but it's my plan.

Why Bosch? Beats me. I ran across some of his quirky and troubling work during my formative years, and it appealed to me oddly. His works are rare enough world-wide, with only 25 currently attributed to him. They are so rare on this side of the Atlantic that finding any of them is often an interesting challenge all by itself.

Finding anything at the Met also turned out to be a real challenge. Besides being huge, its hallways are convoluted enough that the best docent advice I got was to walk in some general direction for a while, and then to ask someone else. It was rare that any of the specific directions I got from them turned out to be helpful.

For a while, it was tricky finding a docent who had even heard of Bosch. Finally, though, I found two of them on the second floor. Both, however, told me that the Met had no actual Bosch -- just one that was "painted in the style of Bosch".

Our Bosch-ward course through the museum was probably pretty similar to the classic 3-dimensional drunkard's walk. However, our wanderings finally led us to the room of the imitation Bosch, which was titled Christ's Descent into Hell.

This painting was accompanied by the following blurb:
The panel was painted during a Bosch revival in the sixteenth century, when the artist's fiery scenes of hell were enormously popular throughout Europe, and especially in Italy, where they were prized for their nightmarish and visionary qualities.
However, we were delighted to find, just two paintings away, an actual Bosch, titled Adoration of the Magi.

Not one of his more bizarre works, but pretty swell nonetheless. Its blurb:
Long thought to be a later pastiche, this Adoration of the Magi can now be placed among Bosch's earliest autograph works ca. 1470-75. The salient features of its underdrawing, the tunnel-like perspective, and certain of the rather wooden figure types with sensitively rendered faces are closely related to Bosch's Ecce Homo in the St├Ądel Kunstinstitut, Frankfurt, of approximately the same date.
Thus endeth my current round of Hunt for Hieronymus. My cumulative Bosch-score for the U. S. now shows New York in a tie with Washington, D.C., with one H-point apiece. Given the current planetary paucity of Bosch's, I may be running out of U. S. cities that actually have one. However, I'll keep an eye out for him on my next trips to Los Angeles, Chicago and San Francisco.

Bone Scans and DNA Testing by Major League Baseball

The New York Times published a very interesting piece a few days ago called Baseball's Use of DNA Raises Questions.

The impetus for these tests:
Dozens of Latin American prospects in recent years have been caught purporting to be younger than they actually were as a way to make themselves more enticing to major league teams.
Apparently, such players have been able to borrow the birth certificate of a younger child from some other family.

Can these tests actually reveal one's age? In the case of DNA, no. However, it can be used to check whether a given player is actually related to the parents listed on the birth certificate. According to the Times, this alone was enough to void the signing of a Yankee prospect last year from the Dominican Republic.

In the case of a bone "scan", I presume the Times actually means a bone age study, in which an X-ray of a subject's hand and wrist (and sometimes other body parts) is compared to a standardized atlas of age-matched X-rays for various ages. How reliable is a bone age study? Not very.

I interpret these occasionally in my practice. When I give my estimate of someone's skeletal age, it is accompanied with considerable variation -- usually one standard deviation equals about a year. In the specific case of a boy with a chronological age of exactly 16 years (192 months), the mean of the expected skeletal age is 195.3 months, where one standard deviation = 12.9 months. From these figures, we can calculate that 95 % of 16 year old boys should have a skeletal age varying between 169.2 and 220.8 months, i.e. 14.1 and 18.4 years old. This 95 % confidence interval of 4.3 years makes a bone age study pretty darned unreliable.

While bone age studies may be of dubious value, they don't lead to a lot of ethical dilemmas. DNA testing, on the other hand, does.

So far, MLB only seems to be using DNA testing to help verify a player's age. However, it's not hard to imagine how they might use other genetic information as well.
Mark Rothstein, a professor of bioethics at the University of Louisville School of Medicine, said: “The funny thing about this all is that the most famous baseball player with a genetic disorder was Lou Gehrig. Would they have signed him if they knew he was predisposed to A.L.S.?”

Wednesday, July 22, 2009

Hand Dryer Fu

After a tasty but messy dinner tonight, I went to the restroom to wash my hands. No paper towels for this restaurant -- they had an Xlerator XL-SB dryer. This creature cranks out a torrent of air and sounds like a jet engine revving up. The manufacturer claims this will dry your hands in 10 - 15 seconds, a lot faster than those girly man hand dryers we've all tried to use for years.


I'm a bit skeptical of this claim, as was the reviewer for the Poop Report. Though this device truly honks , my hands took more like 20 - 25 seconds to dry. In my case, this just meant more time for mischief.

As the air blasted the water off my hands, I noticed that my hand position was similar to the one I used to use for two-hand whistling. With a few conscious positional adjustments, my hands began to howl with loud keening sound. This was fun, so I played with my intonation and tone for a while. Finally, however, I realized that it was giving the willies (so to speak) to a guy at a nearby urinal. So I stopped. For now.

We have five more days in Manhattan. Hopefully I can find another one of these units. If so, The Phantom of the XL-SB will ride again...

Autostitching the Big Apple v 4.0

Since it was next door to our hotel, we took a college tour of the Juilliard School this morning. Looks like a swell place, but probably not the best fit for my son, whose musical tastes, shall we say, are somewhat orthogonal to most Juilliard norms. I did use part of the tour time to grab this quick Autostich panorama of the Paul Recital Hall there, using 6 images:

Then we hopped the D train up to the Bronx, and watched the Yankees beat the Orioles 6 - 4. It's a very nice stadium -- if they can consistently fill it up with enough hungry and thirsty fans every game, they might just be able to make payroll on their team of millionaires. I grabbed two panoramas -- an exterior view (3 images), and an interior view (28 images):

The Orioles hit two successive home runs in the last inning, which elicited some interesting crowd behavior from the Yankee fans.

The first was caught by a lady about 50 feet from us. The Yankees fans began yelling, "Throw it back! Throw it back!" Then, when she tossed it back to the left fielder, they all cheered. We were puzzled by this behavior, so my brother quizzed a local about it. Apparently, home run balls hit by Yankees are highly prized and kept. Balls hit by opposing teams are regarded as offal, and are expelled back onto the field as waste.

The same thing happened with the next home run ball to right field. From our left field seats, it looked like a mighty amoeba snarfing up a food particle and then spitting it back out in disgust.

Tuesday, July 21, 2009

Autostitching the Big Apple v 3.0

I hope it doesn't seem as if I've gone completely off the deep end about Autostich here in NYC. It never came up at all during most of the things we did today, including several tasty meals, the Hayden Planetarium show or the Broadway production (Westside Story) we saw this evening.

However, we also spent the afternoon at the wonderful American Museum of Natural History, where there were way too many large photogenic objects that were beyond my ability to resist. Here are my favorites, along with the number of images I used to create them.

Ginormous Northwest Native American dugout canoe, 6 images:

Same canoe, different angle, 3 images:

Views from both ends of the Hall of Biodiversity -- a stunning way to convey the concept of just how many species we have on this planet, 4 and 5 images, respectively:

Beryl exhibit in Hall of Minerals. Stills like this are easy to get with the iPhone even in low light -- pasting the phone against the glass case steadies it as well as any tripod -- 7 images:

Ichthyosaurus skeleton, 2 images:

Pterodactyl skeleton, 2 images:

Brontosaurus, 8 images:

Tyrannosaurus rex, 8 images:

Stegosaurus, 12 images:

Triceratops skull, 4 images:

Triceratops skeleton, 4 images:

Mammoth and mastodon skeletons, 4 images:

Tomorrow, Autostitch meets the new Yankee Stadium!

Monday, July 20, 2009

Autostitching the Big Apple, v 2.0

I tried out a few more panoramas again today in Manhattan, using my iPhone 3GS and Autostich.

The image on the left was built from four shots of a tower crane which was hauling up a big container of wet cement up many stories into the sky. The waviness of the tower is, fortunately, an artifact of the process, as well as my inexact positioning of the camera.

Vertical panoramas seem to be a weak point of Autostitch -- at least when one is pretty close to the subject. The following shot of Rockefeller Center (built from 11 shots) demonstrates this well -- the actual main building is much taller than it appears here. Autostitch's big brothers may well have settings to control for this prominent shortening effect.

While the kids were sacking and pillaging the M&M and Hershey store in Times Square, I stayed outside and shot 20 shots that were combined into the following panorama, covering about 135 degrees. The black areas in this and the prior shot make it easy to see where I should have gathered a bit more data.

My most successful shot was the sign at the Staten Island Ferry. The algorithms in Autostitch had little trouble with a purely horizontal pan. Four shots were combined to form this image.

Despite some of the distortions revealed with these shots, I'm quite happy with the results. I'll try to grab a few more panoramas while we're here. The Yankees vs. Orioles game on Wednesday afternoon in the new stadium should be a fine time to experiment.

Sunday, July 19, 2009

AutoStitching the Big Apple

We just spent the day visiting a few cultural icons here in Manhattan. This seemed like a fine time to play with a new iPhone app called Autostich, which merges multiple separate pictures into a much larger panoramic image.

I've actually used one of this program's big brothers (Calico) for several years to stitch together mountain photos from my big Nikon into cool panoramas. Both programs are based on image-processing research from the University of British Columbia, which has licensed its algorithms to other developers, including Industrial Light & Magic. We also use similar software at work to stitch together life-sized vertical panoramas of the entire human spine from several smaller shots.

To kick things off, here are 4 iPhone 3GS photos of the Time Warner Center at dusk...

The resulting AutoStitched panorama shows a bit of distortion, but still looks pretty swell.

With a bit of PhotoShopping, it looks even better.

We visited the 5th Avenue Apple Store, which is extremely keen for many reasons. Even in a town with a lot of eye-grabbing architecture, this store stands out.

All of the action at this 24 x 7 x 365 store takes place in a giant underground room beneath the cube. Here's a hasty 6-picture panorama of this store, which earns more money per square foot than Tiffany's:

We also spent some time at the American Museum of Natural History. Here's a panorama of the foyer, which is filled with dinosaurs, including a big brachiosaur. This image was stitched together from fifteen 3.0 megapixel images.

My one-word review: awesome.

It's been quite a while since I have gotten so much pleasure for a buck ninety-nine. It's also pretty incredible to know the sort of image-processing power I now carry in my pocket.

Holy crap.

Saturday, July 18, 2009

Made Men

We flew to NY City today for a week with my brother and his kids. A courtesy copy of the July/August issue of Manhattan magazine awaited us in our room. My spouse made sure that I read the following two paragraphs from a restaurant review on page 100...
"Il Molino!" a friend squealed when I told her I'd be visiting the storied West Village Italian restaurant for dinner. I'd been in New York for more than a decade and had passed the large plate-glass windows with their drawn eyelet curtains hundreds of times, but had never actually dined there. "I love that place," she chimed "They give you so much free stuff!"

A week later my friend Lawrence and I crowd into the waiting area near the restaurant's entrance, coming within earshot of a group of thick-necked guys with bellowing voices. "Made men?" I ask Lawrence. "From the sound of it, actually radiologists, " he says.

In-Flight WiFi -- At Last!!

Boy, do I love red-eye flights. Not. We just took one from LA to New York on an American Airlines 767. Great plane, great weather, great flight, and great service, but still -- a red-eye.

The intrinsic horror of this kind of trip was mitigated somewhat by learning that the plane had WiFi available for $5.95 per flight. I've somehow always missed flights that featured this, but finally hit the jackpot last night. I did sleep for a few hours along the way, but spent at lot of time at both ends of the flight consuming internettage via my iPhone 3GS.

The bandwidth was not too shabby. Here's a screenshot from not too long after takeoff:


My brother's family awoke to a pile of short messages and screenshots sent during the flight, such as the following:


Somewhere over Pennsylvania, I checked the bandwidth again. Much zippier downloads this time, probably because all of the other bandwidth hogs were now lying obtunded elsewhere in the plane.


Of course, your mileage may vary -- things might be a lot different during a blue-eye flight, when a whole planeload hits YouTube at the same time.

Hopefully, WiFi up high will soon spread to most major flights. I would love to used to this service, and think $6/flight is a good value. I just hope I never get as jaded as the dudes nailed by Louis CK below...

Wednesday, July 15, 2009

Buy Art Instead

I spotted this bumper sticker a few weeks ago at a fiddle festival in Port Townsend, WA, and grabbed a quick snapshot with my new iPhone 3GS.

As a radiologist, I'm a real sucker for anatomic art. I wish I could find out more about this bumper sticker -- however, I can't find anything about "Pindellopia" on Bing or The Google.


Tuesday, July 14, 2009


I've spent entire years without ever uttering the word "oleophobic".

That changed a few weeks ago when I upgraded my iPhone 3G to a 3GS. There's a lot to love about the new hardware and software goodies added to this phone.

However, I find some of the subtle touches even more impressive. My favorite is the iPhone's new oleophobic screen. The roots "oleo" (fat) and "phobic" (fearful) tell it all -- the coating on the screen repels oils, particularly fingerprint oils.

In two years of iPhone usage, the cumulative finger oils I've left on my screens probably weigh more than the iPhone itself. The new screen doesn't completely eliminate fingerprints and smears, but it sure cuts them down a bunch. Even when they finally become noticeable, a quick swipe on my shirt clears them off right away.

This humble feature is pretty addictive, and like most addictions, makes you want more, more more... What I want more of is oleophobic screens everywhere else in my life: on my laptop screen, on my flat screen TV, on my PACS workstation, on my kitchen appliances, and on my car's windshield. But most of all, what I really want to know is:

Dude, where's my oleophobic glasses??!!

Gigapixel Image of an Ant

I love this .28 Gigapixel image, formed by stitching together 40 scanning electron microscopy images of an ant. This particular image is part of the NanoGigaPan project.

It would be extremely cool to use this technology stitch together multiple hi-res medical images.

Hat tip to John Gruber of Daring Fireball, who puts it thusly:
The intersection of horrifying and wonderful.

Monday, July 13, 2009

Grand Rounds Vol. 5, No. 43 is Up


This week's edition of Grand Rounds is hosted by Joe Kim at the Medicine and Technology blog.

This week's episode includes my latest post on finding the optimal background music for dictating ICU chest films.

What is the Best Background Music for Dictating ICU Chest Films?

I was on call this weekend, where I dictated reports on about two hundred ICU chest films. This turned out to be a fine time to test an iPhone app called White Noise, which was a software pick of the week on last week's MacBreak Weekly podcast by Scott Bourne and Alex Lindsay.

White Noise generates random background sounds to replace the background sounds you already have, but don't want. Besides playing actual white noise, this app also plays brown, pink, blue and violet noise as well as other sounds, including 6 different intensities of rainstorm.

Even in my relatively quiet reading room, there was a surprising variety of annoying background noises this weekend, and White Noise did a fine job of covering them all. This got me to thinking about another topic from the same podcast, where Scott and Alex debated whether there were optimal background sounds for different activities. What would be the best background for dictating ICU chest films?

I listen to a lot of audiobooks and podcasts when performing mindless tasks like laundry, dishwashing or commuting. However, I find these way too distracting for cognitive work like film interpretation. So, I designed a quick and dirty controlled study on myself (n = 1), pitting White Noise against three different styles of music: Cajun/swing (Red Stick Ramblers), heavy metal (Metallica), and baroque (Glenn Gould playing Bach's Goldberg Variations).

My results are summarized in the bar chart above, where the vertical axis shows the number of minutes it took me to read 10 ICU chest cases while listening to a particular background. Despite my dubious experimental design, the results are intriguing: I seem to be about twice as efficient while listening to Bach as I am while listening to Cajun/swing. Just in case the first run of Bach was a fluke, I did an additional run of 10 films on a few more of the Goldberg variations. This second run was pretty similar to the first Bach run. However, before I could replicate runs on other styles of music, I ran out of films to interpret.

Taking this at face value, maybe these results are not so surprising. Maybe Lewis Thomas was right when he said:
Music is the effort we make to explain to ourselves how our brains work. We listen to Bach transfixed because this is listening to a human mind.
A quick googling of this topic shows that I am not the first to tread this ground. I quickly found a paper by Cassidy and MacDonald, titled "The effect of background music and background noise on the task performance", published in 2007 in the journal Psychology of Music (vol. 35; pp 517-537). One of their conclusions:
In conclusion, the current study has highlighted the detrimental effect of sound (noise and music) on task performance, in comparison to silence...
(Oops -- forgot to collect data for silence alone...)

They also found that introverts (e.g. radiology nerds) find music and noise more distracting than extroverts (e.g. orthopedic surgeons). Hmmm...

I also ran across a recent article on the work of Warren Brodsky of Ben-Gurion University, who has studied the effects of music on high-risk driving behavior. In a nutshell: fast music makes you drive faster -- and less safely.
For example, while listening to a piece of music, drivers are immersed in much cognitive work including aural analysis and processing of the music components at various levels related to understanding, operations of short- and long-term memory, emotions, and of course extra-musical associations which continually surface from music stimuli.
In other words, music may not relax your brain -- it may make it work even harder.

Nevertheless, I'm not quite ready to give up on music just yet. So, to add some rationality to my rationale, I'll collect some more data the next time I'm on call. Just in case silence is actually golden, I will add an arm to the study in which I dictate to silence alone. However, despite the growing evidence that background music is distracting, I secretly hope that Bach wins again.

Friday, July 10, 2009

The Future of Folk Music is in Great Hands

My day job is teaching radiology to residents and fellows. This educational model of young whippersnappers learning from the geezers is also pretty common in the world of fiddle music.

It's a huge pleasure to see young radiologists and young musicians coming into their powers, especially when one sees them making diagnoses or playing tunes that even the geezers find challenging.

This was definitely true last week at the Festival of American Fiddle Tunes. It was hard to hear some of the young musicians play without feeling like a giant truck was coming up fast in my rearview mirror. Here are two examples of the many talented teens at Fiddle Tunes:

First, listen to Emma Beaton (cello) and Tatiana Hargreaves (fiddle) play the living heck out of this old fiddle tune...

Finally, watch the 204 Trio, with Lea Kirstein (cello), Scott Leach (fiddle), and Ethan Jodziewicz (bass) play their arrangement of Liz Carroll's tune: "Lost in the Loop".

I'd say that the future of folk music is in great hands...

Wednesday, July 8, 2009

Capo -- Cool Tool for Musicians or Radiology Residents

If you are a musician, the word "capo" brings to mind the device that we guitar and banjo players clamp on the necks of our instruments to change key.

However, Capo also refers to a new and rather swell Mac program for learning tunes from recordings. Capo does this by playing a torrent of music at a speed slow enough for one to comprehend. Here's the really cool thing: it does this without changing the pitch of the music!

The following screenshot shows Capo playing "Heather Bonne", a swell tune I snagged last week at a jam session at the Festival of American Fiddle Tunes.

As a fiddle player, I learn a lot of tunes from field recordings made at festivals, jam sessions and concerts. Although I'm a quick study, some intricate or especially twisty tunes are a lot easier to learn when slowed down in this way. Then, once I've worked out the notes, I can play along with the original at a slower speed until I've learned it well enough to play it at full speed.

Capo is not the first Mac program to do this job. I've used The Amazing Slow Downer and Transcribe for years. These fine programs work quite well, but their interface clearly shows their original Windows roots. Capo, on the other hand, was born on the Mac, and is simply gorgeous. It also ably meets the classic Mac software test: "Can I use this without reading the instructions?"

How is this relevant to radiology? The fiddler in me would answer, "Bite me -- who cares!" However, the radiology geek in me would point out that music isn't the only thing you can slow down with this application. If I were the sort of person who transcribed lecture notes or speeches, Capo would be a huge help.

I could also imagine using this app for learning other languages. I suspect that Capo would work pretty well in slowing down foreign language broadcasts to a more understandable pace. It may also be useful among native English speakers separated by their common language. As a long-displaced Southerner, I have gotten pretty good at decoding the Uzi-paced speech patterns of Yankees. However, newly displaced immigrants from below the Muffin-Biscuit Line may find Capo handy for this now and then.

But wait, there's more: Capo is currently on sale at half-price. I paid full price when I bought it a while back, but am now considering grabbing a few extra licenses as gifts for deserving pals.

The only thing that would make Capo even better would be to release an iPhone version. I've suggested this to Capo's developer, so don't touch that dial...

Radiology Blog Compendium

The folks over at e-Health News Blog have compiled a list of Top 50 Blogs to Help You Further Your Healthcare Career.

My blog is listed there under Medgeek Toys. I would add only that if something I mention on my blog helps you further your career, I'd consider it a tool rather than a toy. Besides, "tools" are tax-deductible, and "toys" are not. :)

Why is Six Afraid of Seven?

The title of this post is in honor of today's date, which is the answer to the question posed in the title:

Because 7 8 9!

My son liked this joke when he was four. I still like it.

So there.

Tuesday, July 7, 2009

Back in the Saddle Again...

I spent much of April through June preparing for many talks at many meetings, which involved 3 trips to the East Coast in one month. Great fun, but a bit draining.

To recharge, I just spent all of last week with my son at the wonderful Festival of American Fiddle Tunes in Port Townsend, WA.

I first went to Fiddle Tunes back in 1985, and have been back many times since. This year I spent my mornings in a truly excellent swing fiddle workshop by Kevin Wimmer, afternoons in an exhilirating bandlab led by the Red Stick Ramblers, and evenings until real-late-thirty jamming with pals. After a week of this much fun, going back to work was actually kind of restful.

Besides spending many hours pushing an analog stick back and forth over an analog sound box, I spent a few hours recording some highlights with my new iPhone 3GS and my Flip Mino HD recorder. In past years, I've taken several bags of technology along with me to this festival. This year, it was mostly a bag of chargers for the items above, and a laptop to dump files to every night.

The 3GS came pretty darned close to being the One True Device last week. Besides tuning my fiddle, its built-in video recorder grabbed a lot of fine musical homework for me for the rest of the year. In previous festivals, I've recorded tons of audio. However, video is light-years better -- the 3GS let me record not only the music, but also the bow strokes, fiddle finger positions, guitar and banjo chords, body language, and smiles of the musicians. It would be pretty hard to go back to mere audio files alone after this.

It's also very nice to have the time and energy to blog again.