Crossed Fingers

"Good luck in the New Year", they say... I don't really believe in "Lady Luck". Although I like fortune cookies like the next guy and wouldn't throw out a stack of lottery tickets if they were given to me, I think this "concept" has not been useful to me. When doing any medical procedure, it's not a good idea to expect or wish that you are lucky. Imagine a surgeon who says: "Let's keep our fingers crossed that these screws are in the right place!".
I've often emphasized being prepared and having a checklist for xray students. Then I tell them don't rely on luck -- that there is no luck involved here -- when there are so many factors effecting the quality of the final image. Like my Magic Forest painting here, the hidden specters in the rocks and the trees are always out there to get you -- to prove that you don't know what you're doing.

Your Big Day

When you "sign on" to work in health care, you're most likely going to work some holidays. New Year's eve and day aren't exceptions. I admit, it feels strange to work when so many are partying, but then there's always next year. You arrive at the Xray department and it's just another day. For the patients, that's not the case at all. I've "xrayed" people in the first moments of their lives and the last. It's been the day of their daughter's wedding or even the bride in her wedding gown who slipped on the dance floor. It's been a child's first time skiing or a woman's last run down the slopes (by the way --it's always the last run down the slopes for that particular day!). More than once, I've taken a patient's xrays before, during and after surgery. There are many big days in a person's life and often someone from radiology has been there. For those taking the xrays, it's just another day. Or is it?
Painting: Dawn at Sprague Brook by Timothy Kerr.

Jeepers Peepers

Have the "eyes of medicine" become the "eyes of security"? It would seem so, if you read the Associated Press article in today's paper. An X-ray security scanner designed to detect weapons through a person's clothing is causing quite a controversy. This comes to no surprise to this X-ray technologist but not for the privacy concerns described. Sure, you can often see delicate anatomical details on an X-ray image that you wouldn't want most strangers to see. The real issue to me is the practicality of it. Consider the "simple" case of trying to determine if your kid's Halloween candy is sabotaged or not. Look at this simulated set of three x-rays. Each shows an object from a different perspective in two dimensions. Would you be able to guess from the top image that you're looking at a lollipop? In your mind, overlay this with other pieces of candy and you can imagine the task at hand. Now, think of an airport security situation where you'll be instructed to turn sideways for additional images to be analyzed. I hope the security officer is well trained. I'm skeptical but it would sure beat a cavity search!

The Shadowmakers

You're doing a crossword puzzle and the clue for 52 across is "xray technologists". I'll give you a moment to think of the answer. It's twelve letters long and evidently found in crossword puzzle dictionaries according to a patient

I xrayed yesterday.

The answer is (drum roll please):"Shadowmakers". I like the simple, low-tech and mystical sound of it. Radiography does share many qualities to cast shadows, such as elongation and foreshortening. Every time you position the xray tube you are controlling this Invisible Sun (the name of a song by Sting?). You set the angle and distance that the beam intersects the patient's anatomy. You can also peer around bony obstacles. Look at these two lateral elbow images. The nontraditional method on the bottom allows you to see the radial head without superimposition by the ulna. The tube angle is set at 45 degrees. I use this axial projection only when a patient can't be convinced to extend his or her arm for the normal positions. All radiographs have distortion and generally it's something to avoid, but when you need to provide one more image -- a little angle goes along way. By the way, don't be surprised if I answer the phone at work with "Hello Shadowmaking Department, Tim speaking, how may I direct your beam?".

Tech Tribute

Growing up in the 1960's, I had a fascination with Africa. I think a large segment of the US population must have had similar romantic notions about it. Movies back then included Born Free -- about an unlikely family who chose to move to the savanna and make lions a big part of their daily life. TV shows included Cowboy in Africa, where Chuck Connors lassos wildebeests and ostriches, ostensibly to save them from themselves. Daktari (Swahili for Doctor?) was part comedy revolving around a white veterinarian who chose to "talk to the animals" and make them better. And who could forget the National Geographic Specials? My family even had the Catholic Mass sung in Swahili on a record sent from a missionary. I ate this stuff up. I wanted to go on safari.

Years past and somehow famine, wars, plagues, Ebola virus and AIDS made Africa a little less desirable as my next sunny vacation spot. I did keep up with things African to a degree -- by things like listening to the BBC on the radio (just like my father did!). Now, thirty-five years later, I have the pleasure of working with one of the most patient and reliable persons I have ever met. I'll call him "Outa Afreeka", because he truly is as an immigrant from Ethiopia. "Outa" has a wisdom beyond his years, he thinks before he speaks. His patience is exemplary -- he once had a speeding ticket reduced because the judge was so impressed that Outa had sat waiting for three and a half hours for his turn to be heard. We often talk about Africa: its past and present, its cultures and geography. I told him the story of the explorer Dr. Livingstone. He told me of falling into a construction pit and nearly drowning. I introduced him to liverwurst, he brought me some flat bread. And so it goes. You never know where your life leads to. Kudos to this "Buffalo Soldier".

Rectus Abdominus and Artimus

During the course of any day at work, there is always something else going on. One day it's a blizzard outside, another day it's the melodrama of daily life. Some diversions are created intentionally.

One day I decided we all should have gladiator names. I had seen the movie Gladiator (where Russell Crowe plays a human veggiematic -- slicing and dicing his way to stardom in ancient Rome). We discovered that medical terminology worked great for gladiator names -- one full bellied tech became Rectus Abdominus. I was then designated the title Artimus by that same tech, a fusion of my name with my extracurricular activities. Unfortunately, not everyone appreciated their gladiator names. Would you like being referred to as Crowe Magnum? In any case, it helped get us through the day -- laughing as the "bus let out" into the Radiology Department.