So we jump from the OR to the dark rooms of diagnostic imaging. Well, they’re not permanently dark. They have light switches and stuff. I just think they haven’t been used since the hospital was built.
It was a short, 4-day week because of Thanksgiving, so I had to try and pack as much of this huge specialty into every day as I could. And it is huge. Radiography, fluoroscopy, CT, MRI, angiograms, ultrasound… and for each of those there’s a little sub-list of general, GI, obstetrics, etc etc. So what I found is not ever going to be a full understanding of what goes on every day on the main floor of the Alex, but I’ve put together a rough sketch of the stuff I found the most important. Please to enjoy!
(Also, I’m on hiatus for a bit – 2 weeks off, BOOYAH!! Off to Maui, I’ll send lots of sunshine-soaked love to y’all.)
The where: Edmonton – Royal Alexandra Hospital
The good: there’s more variety than I thought within radiology. As I touched on above, there’s about a gazillion imaging methods and each has their own twiddles and tweaks and protocols that you can play with in order to get the maximum usage out of each. I actually couldn’t see everything within my week and I know I missed a few interesting interventional radiology cases. So my worry about being stuck in a dim room reading x-rays for weeks at a time was rather unfounded. I did CT in the morning, X-ray and MRI in the afternoon, maybe a PICC line insertion in the middle somewheres or checking out an ultrasound-guided liver biopsy.
The residents are phenomenal. Given the staff are so busy (getting to that), they’re some of the only people who have the time to spend teaching idiot medical students that it’s not a lung mass, it’s consolidation. And post-call, too. An interesting observation: very few women around. The residents think it has something to do with the kind of people radiology attracts and maybe about the visual-spatial skills you need to acquire to turn that 2D x-ray into a mental 3D image of somebody’s abdomen. And it’s not just the residents; the techs and other staff are great, too! Everyone’s very nice about guiding that aforementioned idiot student through the twisty-turny bowels of the DI department.
Such cool pathologies. Seriously. Massive meningiomas, perforated bowels, pneumothorax, weird but benign cysts… you see it all. It’s very cool to have a couple of fingers and toes in pretty much every aspect of medicine.
The not-so-good: the radiologists are so, SO busy. And they don’t have any protected time to teach, even if they’d wanted to. So for a lot of mornings I would just be hanging over someone’s shoulder, occasionally asking questions but not enough to make myself a nuisance and put them behind. So essentially having students costs them money. We’re actually asked to be considerate and not stay with a single preceptor all day, never mind all week. It’s absolutely not the radiologists’ fault, but it still sucks, especially when you find a few that you really click with. It was definitely one of the most awkward weeks because of that; lots of those moments hovering in the doorway, waiting them to finish dictating a case and hoping that this is the person you’re looking for.
In a similar vein, there’s a higher concentration of less-than-stellar personalities than I’ve seen so far. Just among staff, mind you. And I’m so early in my clerkship, I’m sure I’ll see lots more in the future, heh. Again, it could be because they’re resentful of having this annoying creature in the room that slows them down and costs them time and money… but sometimes I feel like it was just a rather sour disposition.
This was the first time I’ve ever been exposed to such a level of backhanded put-downs that go on between the specialties. “Oh, those GPs/internists/orthopods/etc, look at this pneumothorax they missed.” It sucks. Yes, people miss stuff, no one’s perfect. Even veteran radiologists have to make difficult calls that aren’t always correct. Why can’t we all act like adults and show other physicians the respect they deserve?
I hate to say it, but a lot of this week was rather boring for me. I realized just how much I dislike sitting in the same room for hours on end, especially when I’m not being actively engaged and just trying to learn through osmosis. As one of the residents pointed out, this is NOT representative of radiology. Just of radiology electives. It’s just because no one has the time to take things at the med student’s speed, to really let you try analyzing on your own.
The verdict: Not top of my list. I feel like, rather unfortunately, those first few days were so boredom-heavy, my opinion may have been made up rather early on. So if you want to do an elective in radiology, try to figure out sooner rather than later who has the time and the energy to show you some cool cases and really walk you through them. Slowly. Because that’s when I learned the best and learned the most.
Ciao, see you for rural family medicine!