Guest Editorial: I think you’ve had enough…

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.

At this time of the year here in central Virginia, as in much of the rest of the United States, the days are short. In all honesty, it can get a bit depressing coming to work in the dark, working all day (in the dark), and going home in the dark. If not for the constant volume of cases presented on the PACS, and the smiling, happy faces of the residents and fellows, you could imagine that you were still sleeping in bed, dreaming of the work day. Ha! Wrong! Everyone is grumpy and looks a bit worn, and all are tired. What to do for some psychic uplift? How can we improve that outlook on life? I'm going to ignore any and all temptations to think about the illegal means (John Prine's "Illegal Smile," eh?), and concentrate on the common denominator: Coffee, naturally.

I think radiologists consume more coffee per capita than any other population group. I base this on my own personal experience and on the observed habits of a number of radiologists in this center. My control subjects are the other specialists who frequent the same coffee stands, and the other staff and visitors who wander by. As radiologists, we love coffee. We need coffee. We don't trust those who don't want it. Juan Valdez is on our societal emblem, isn't he? I'm sure others will lay claim to that title. Surgeons, fishermen, police officers, nuclear power plant engineers, and countless others may feel that they hold the title, but we all know that radiologists win. Why? Well, there are a number of reasons.

First, we need the mental acuity that caffeine provides, the sharper edges, kind of like an edge-enhancement algorithm on the workstation. In fact, it is probably just as effective. Second, our hours are ever-extending. I promise to painfully remind the next person who jokes with me about my "banker's hours" that I am here early, almost never have a defined lunch time, and work until we are pretty much done. Individuals who cover the evenings for their practices work until the next person shows up to work some more. Coffee wakes you up early in the day. It stands in for the midday caloric intake. When the shadows get longer, it gives you a little kick of energy to do that last couple-mile stretch of work. Coffee, coffee, coffee.

Additional coffee benefits? Yes, absolutely. Social time to see the surgeon who operated on that weird thing you saw yesterday. Sweet, I was right! Time to talk to the residents and fellows without the press of more cases waiting for dictation. A walk to the coffee cart gives us some time to work out the kinks and to keep those pesky emboli from forming in the legs. Aerobics! Who says we don't get exercise? What better way to flush the toxins from your system? Three large coffees almost equal the volume of the Tennessee Valley Authority dam projects. Go kidneys, go! As my friend Dr. Mirvis points out, there is something very cerebral about the appearance of a person holding a cup of coffee poised close to his or her lips. Hey, it's the thinker (and drinker).

We can all do without the tachycardia that may result, but as I keep reminding people, just don't go for the triple espressos. Doubles are fine. Balance them with a beta blocker. If you get jittery on occasion, avoid procedures that day. Sweaty forehead? Same caution. Although I am not bothered by the intermittent rage that may result from the vessels pounding in my forehead, I understand that some are. Best to avoid coffee by the potful if you're scheduled for some touchy negotiations with the hospital administration.

The American College of Radiology should buy stock in the major coffee producers, I think. Or, perhaps, a coffee plantation in Colombia.