Tuesday workout: 4 mile run, 1 mile walk
Wasn’t in the mood to push myself, and so I didn’t….one of the nice things about running without a specific race you’re training for. I run as often, as far, and as long as I feel like, and there’s no guilt when it’s shorter or slower than the day before.
Yesterday I worked in the ED until around 8:30 pm. Working as a radiologist in the ED or in any area that has a high volume of studies to read can be challenging. As a radiologist, you’re trained not to miss anything. Someone might be come into the ER and get scanned after a trauma. The trauma team is primarily concerned about whether there’s any major organ injury that might threaten the person’s life immediately. We are primarily concerned about that, too, but we also have to look at everything else. What if there’s a 3 mm nodule in the lung that could turn into a lung cancer? That may not threaten their life now, but it could in the future! A pulmonary nodule is not hard to miss if you have a ton of time to go over every single slice of the CT scan slowly, but when you’re rushed, you could easily miss a small nodule.
In the ED, though, time is not your friend. If you spend 30 minutes meticulously analyzing every slice of a CT scan making sure nothing goes unnoticed, then there’s a delay in reading other scans, some of which could be life threatening if not addressed immediately. So there’s a constant tension of trying to balance the desire to be meticulous with the need to move on and be quick and not let the ED get backed up. I guess what I’m trying to say is that in radiology and in medicine in general, you have to learn to live with uncertainty, and I think that that is one of the hardest things to learn to do as a physician.
Most physicians are driven, perfectionistic, type A personalities. It’s hard to get into medical school without being so! Combine that personality type with the fact that mistakes made don’t just affect some profit or bottom line…they potentially affect someone’s life. And yet, doctors are human, too. We make mistakes just like everyone else. We don’t know the answers to everything. It’s inevitable that we’ll have to make decisions we’re not 100% sure on, or in an effort to see increased numbers of patients, we won’t have the luxury of getting to spend as much time on one patient as we want. We have to learn to make the best decision possible with the information and time that we have available, accept that there will always be some uncertainty involved, and then move on and focus on the next patient. It is a skill I am still working on. It is also a skill that can be applied to many other things and to life in general.
Speaking of not knowing everything….I went to a lecture last week about diffusion tensor imaging. What? Don’t ask me to explain cause I don’t fully (or even nearly) understand it, but basically it’s an imaging technique used to map out different nerve tracts in the brain. I am always in awe of how complex the brain is. How certain fibers and connections form to help us form memories, talk, move, think, dream, see, etc. The mind is a beautifully complex thing, and there is still so much we don’t know or understand. Some people seem to think that science and religion are dichotomous, and yet the more I learn about various things in science, the more the complexity of it all reaffirms my belief in a higher power.
DTI and DSI imaging of the brain: Different colors represent different nerve fiber tracts and reflect the direction of the tracts.
How true all you say! The pressure of perfection is grueling–especially in Emergency Radiology!! Well said!