These aren’t the pixels you’re looking for

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“I sense a great disturbance in the Force.”

—Obi-Wan Kenobi in
The Empire Strikes Back

We are now participating in another Star Wars phase with yet another Star Wars movie. In contemplating this, I was reminded of a previous Star Wars scene and (obviously) a radiology correlate. I think most of you (movie fans and geeks, for sure) remember the scene from the first movie, Episode 4: A New Hope. Obi-Wan makes a few gestures and the Imperial stormtroopers suddenly see things the Jedi Master’s way: “These aren’t the Droids we’re looking for.”

It has resurfaced in the new movie. Mind-control. Okay, we’ve all seen radiologists do the same.

Let me set the scene: You’re in the reading room and you’re working, reading some studies. Clinicians en masse descend on you. “Let’s look at patient Mindbender, please?” You pull it up.

“We were concerned about this dot here. That looks like a lesion to us.”

You look. You don’t see anything. They touch the monitor, a sure sign of their seriousness. “There.”

You look again. Still nothing. And then, my friend, you muster the Force and do some serious Jedi mind-trickery. “Oh, that’s nothing.

Maybe some artifact.” They aren’t buying. “It’s exactly where the lesion should be.” “Nope. Just a few spurious pixels. Nothing.”

What I suggest now is that you wave your hands. More Obi-Wan like. “These aren’t the pixels you’re looking for.”

It is my experience that the hand wave is key. It’s almost like sleight-of-hand; your diversion. You can artfully spin your fingertips if it feels right. I think I’ll start wearing hoodies to work so I can be real Obi-Wan like. Pull it down just a little over my forehead. They may just repeat after you if you pull that off.

I’m amazed how well this radiologist mindtrick works. Even with the real skeptics, like neurosurgeons. They may take a little more hand- waving, though. You know the real problem here comes up if anything—and I mean anything—eventually turns up in that location. “I knew there was something there, but that radiologist did something to me! Made me forget all about it.”

I’ve had the pleasure of working with a few people who were indeed Jedi Masters at this. The best ever was a nuclear medicine colleague who explained away a few pixels in the middle of a lung study by looking carefully, pondering for a few minutes, and then stating, “Oh, I know what those are. They are JOOTTs.” Instant clinical attention. “What are JOOTTs?” they asked, already imagining the disease those letters stood for. My colleague gathered herself and said quietly, “Oh, you know. Just One Of Those Things.” I think she waved her hand. It sure befuddled me. It also led to a retreat by her tormentors. Stormtroopers, be gone!

Bash on, friends. Mahalo.

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Phillips CD .  These aren’t the pixels you’re looking for.  Appl Radiol.  2016;45(2):52.

By C. Douglas Phillips, MD, FACR| February 03, 2016

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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