Wet Read: Are you smarter than a radiologist?

By C. Douglas Phillips, MD, FACR
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Dr. Phillips is a Professor in the Departments of Radiology, Neurosurgery, and Otolaryngology-Head and Neck Surgery, and the Director of the Division of Neuroradiology in the Department of Radiology, University of Virginia Health Systems, Charlottesville, VA.He is also a member of the editorial board of this journal.

I hate reality TV shows. They are not real in any traditional sense of the word, but likely are "real" in a TV sense of the word. If I had to live with any of those jerks on many of those shows, I'm afraid that someone would be getting a beating. Maybe me, maybe them. My stint on "Survivor" might end with me holding the other contestants' heads under the water, one at a time, individually. On the other hand, I LOVE some of these silly game shows. Try your luck, see if you know something, fill in the blank, pick a suitcase. Those shows are fun. Dumb, random chance. Occasionally, a chance to actually know something and win. I love to watch people finally get their 15 minutes of fame, then panic in the limelight, and lose it-they can't even answer correctly when asked their name. It makes me think of two things-the oral boards, and every day in the reading room.

Host: So, Are You Smarter Than a Radiologist? Here's our contestant, Dr. Margaret Ostosis, a surgeon. How are you?

Margaret: I'm happy to be here. I want to take some of that radiology money home!

Host: Great attitude, Margaret! Let's play! Here's your first question. You're given a complicated chest X-ray with a partial pneumonectomy, 5 indwelling lines, and 2 prior studies, both of which were significantly rotated. There's a prior chest CT from an outside hospital in the referring clinician's office across town. You've got 6 seconds to dictate the report! Go!

Margaret: What is all this? Can I call a friend? I don't know much about this patient!

Host: Oh, time's up! You were supposed to know, without any provided history, that the patient may have a single misplaced venous line and call the ICU. Your malpractice carrier will be upset! So sorry. Let's try your second case.

Margaret: Hey, this isn't what I expected!

Host: Hey, Margaret, tough! Your second case is a series of films from a contrast GI study of a postoperative patient who didn't cooperate very well and was very uncomfortable. You spent an hour on this study, and there's lots of motion! But, you've got history this time. The history is "Rule out pathology"! Go!

Margaret: What the…?

Host: You've got 2 seconds left, Margaret.

Margaret: Hey, I can't figure out what is going on here! What is the…

Host: Sorry, time's up again! No points! You were supposed to see that very small anastomotic leak, then call the surgeon and the fellow on call who's covering the service. OK, it's time for our all-or-nothing round. The case is a plain film of an extremity. Easy stuff, Margaret. Are you ready?

Margaret: Are you kidding? I'll crush it.

Host: Okay, here it is.

Margaret: Umm, it's an ankle. I can get this.

Host: Time is running out Margaret.

Margaret: I see it! I see it! A tiny fracture right here! Ha! I WIN!

Host: Sorry Margaret. That's a normal variant, a vascular groove. The film was actually normal. We're sorry. No money for you! You're NOT AS SMART AS A RADIOLOGIST!

This game show would have a small audience, but I think it would be a blast. I've been told that our jobs are not as difficult as we think they are, but they are infinitely more difficult than anyone else on the planet imagines they are. Sometimes, I'm amazed we do as well as we do.

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April 03, 2008
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