Patients should be treated seriously, but that doesn’t mean there aren’t some head-scratching moments in a radiologist’s day.
A very strange thought occurred to me the other day while at work, and it made me stop right in the middle of what I was doing and caused me to reflect for a moment. I was reading ultrasounds that day, and one of the technologists came in to the reading room to go over a case that she had just completed.
The order was for an ultrasound of the scrotum, and as I was listening to the tech tell me the patient’s symptoms, and what the referring physician’s request said. She told me that the patient did not speak English, but that he came with a family member who did speak English, and had offered to interpret. I thought to myself, that’s convenient. Now, at least we can get some additional history, and maybe even find out where the patient is feeling discomfort, or what is bothering him. The tech went on to tell me that the patient was a 50-year-old man with right sided testicular pain. Fair enough I said, as I asked the tech what she saw, and proceeded to bring up the case on PACS. She then told me that the family member who did the interpreting for the patient was, in fact, the patient’s 14-year-old daughter, and that she had insisted on being in the room during the exam. It was at this point that I dropped what I was doing, pulled my eyes away from the monitor, and said to the tech, “What?” She said, yes the patient’s 14-year-old daughter (and the father) had insisted on her being present during her father’s scrotal ultrasound exam.
As I reflected on the situation and thought about how I would feel, and how strange and uncomfortable it would be for my own daughter to watch me have a scrotal ultrasound, I imagined that maybe the situation is different, in different cultures. Oh well, just another routine day at work. It was then that I thought it would be amusing if I were to compile a brief list of some of the many humorous and strange medical encounters that I have experienced in my short career.[[{"type":"media","view_mode":"media_crop","fid":"26884","attributes":{"alt":"","class":"media-image media-image-right","id":"media_crop_4209332789796","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"2566","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 200px; width: 200px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":" ","typeof":"foaf:Image"}}]]
Sticking with the ultrasound theme, I remember the time when I was in the room helping out one of the techs perform an OB ultrasound (US) on a third trimester fetus. While scanning the patient, and going over the relevant fetal anatomy with the patient, the patient leaned over and asked me, “If I eat a cheeseburger, can you show me my baby eating the cheeseburger, too?” I looked over at the tech standing next to me and we just rolled our eyes.
Or how about the patient who was having twins, and told the tech that she would be naming her twins, Lemonjello and Oranjello, and when asked how she came up with those names, she replied, “Jell-O pudding is my favorite dessert!” Or how about the patient who presented for a pelvic US, and proceeded to moan during the transvaginal portion of the exam, and then asked to have it repeated after the tech had finished. Are you kidding me?
Then of course, are the many strange but true requests that doctors write for their patients. For instance, US pelvis: “evaluate fibroids” in a patient who has had a hysterectomy. Or, US pelvis: “evaluate ovaries and follicles for fertility work up” in a 12 year old (Seriously?). Or US great toe: “ingrown toenail.”
Then, of course, I will never forget the one time when a young female patient that was sent in for a CT abdomen. The doctor’s note said, “weight gain, and increasing abdominal distention.” The patient was placed on the CT scanner, and after the scout localizer was done, I told the tech to stop the study immediately, and get the patient up off the table. She looked at me once, and then back at the monitor to see that the patient was pregnant, and carrying a near term infant! I had to control myself with all my willpower, when I called the referring physician to tell him that I had figured out why his patient was gaining weight, and her abdomen was getting more and more distended. Come on!
Another classic encounter occurred to me during my first year in practice, when one night when I was on call, I received a call from one of the X-ray techs telling me that the emergency dept was requesting a retrograde urethrogram on a patient who had sustained “penile trauma.” When I arrived at the hospital and entered the fluoro room with the patient waiting there, I asked him what had happened, he told me that he had been doing gymnastics, and that he fell and landed on his penis. That was when his girlfriend, who was sitting next to him, suddenly interrupted and said, “No, that ain’t true. Maybe you were doing gymnastics naked on me, but we was having sex, when your penis just up, and broke in half!”
But even though these stories are amusing and humorous, and add some degree of levity to the daily grind of work, it never diminishes the seriousness of our job as physicians, and our role in helping to take care of our patients to the best of our ability.
The Reading Room: Artificial Intelligence: What RSNA 2020 Offered, and What 2021 Could Bring
December 5th 2020Nina Kottler, M.D., chief medical officer of AI at Radiology Partners, discusses, during RSNA 2020, what new developments the annual meeting provided about these technologies, sessions to access, and what to expect in the coming year.