Snow Daze

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“This is the fast lane, folks...and some of us like it here.”
—Hunter S. Thompson

And some do not.

Fast enough for you these days? Deep breath. Before it spirals out of control, let’s talk slow, but just for a few minutes. Okay, this is a dirty little secret of radiology. I don’t think for a MINUTE we’re alone in this, but … come a little closer and listen up.

We love snow/rain/storm days.

Yes. You heard that correctly. We LOVE them. Particularly, bad nor’easter snowstorms, with salt on the roads, snowplows out and school cancelled and maybe even with a little flickering of the power. Not going full off, you understand, just an occasional flicker.

Why? Well, some of us may ski, and some like to play in the rain, and there are undoubtedly a few that have nice fireplaces at home, where they can cuddle up with the spouse, drink some hot chocolate or a favorite hot adult beverage, maybe watch a great old movie on TV, or turn on some great jazz or classical music and just enjoy the silence.

BUT… we ALL love watching that worklist disappear.

You know how it feels with the ever-expanding work volumes, and the modern era of “diagnostic imaging,” which as far as I’m concerned means, “let the imaging make all the diagnoses.” That list grows and grows and grows, and at times when you think you may have it managed, someone turns out to have disabled a link somewhere, and it gets turned back on and, voila! another 25 cases hit you. Speed, bubba. You can’t rest.

You imagine the evil specter of the turnaround time, or “TAT,” monster lurking around the corner, there are monthly QA figures pending, and someone is away (always the person who can be counted on to read those brachial plexus studies), and you have this inability to leave undictated cases. So the day expands and you keep drinking coffee and cranking and you just wish that something would keep people away for a day. Or maybe two.

And then, it’s snowing like hell! You go, weatherman! Keep adding to the expected totals. Sure, throw in some gusty wind predictions, too. Nothing like a little blizzard to keep people at home for a few hours. How about a full-bore run for batteries, milk, and bread at the Shop-Rite and no one in the imaging center? I’ll take it for a day or so.

Best part of all? Working those days. There is some form of psychic gratification about reading real-time that is hard to explain. It makes me think of my fellowship, with the GE 8800 CT scanner that put out scans I could look at individually every five seconds or so on a console or—in the even more remote past—working with an Ohio Nuclear Delta-25 CT scanner that was a rotate-translate machine with a viewfinder that you peered through and pretended you were a submarine commander.

You’d look in the eyepiece and watch the image created as the beam rotated around the patient. It segmentally created an image before your eyes (well, over two minutes or so). Buzz and thunk. Buzz and thunk. You could review the patient’s history, go pull a few articles, read them and come back in time to pontificate about how you didn’t see anything on the scan (Are you kidding me? All you saw were ventricles.), but you should see … .

So, the list will grow again tomorrow, or the day after. I’m reveling in the real-time reads now and thinking about the past. Keep doing that good work. Mahalo.

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Phillips CD.  Snow Daze.  Appl Radiol.  2021;50(6):56.

By C. Douglas Phillips, MD, FACR| November 06, 2021
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About the Author

C. Douglas Phillips, MD, FACR

C. Douglas Phillips, MD, FACR

Dr. Phillips is a Professor of Radiology, Director of Head and Neck Imaging, at Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, NY. He is a member of the Applied Radiology Editorial Advisory Board.

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