Ghosts in Radiology

Radiology has its ghosts. There’s ghosting-artifact (most commonly in MR, but the term has been used in other modalities). Ghost-reading: Someone without credentials or even a local license provides a low-cost interpretation, and then a legit rad signs that report with his own name. Plus various imaging-findings that got the word attached to them (“ghost meniscus,” “ghost vertebra,” etc.).

All of which might be interesting things, but not my focus today. Instead, another term that’s not specific to our field, but can be highly relevant: The social phenomenon of “ghosting.”

Most of us are familiar with the concept, even if we don’t know it by that name. I only learned this bit of slang a few years ago. It wouldn’t be the first time I’ve emerged from under a rock to join the rest of vernacular-society, but perhaps this column will serve to do the same for a few readers out there who are as unhip as I.

Ghosting refers to unilaterally ceasing communication with someone. Passively, without warning or declaration of intent. You just stop taking their calls, responding to messages, etc. You effectively become a ghost of the person they thought they had a relationship with. Most probably first experience this behavior during the breakup of a romance.

If you’re doing the ghosting, you might see nothing wrong with it. Or you feel some measure of guilt, like telling a “white lie.” Yes, maybe it would be nobler of you to stand up and tell the other party why you’re parting ways…but your reasons could be perceived as hurtful, might even spark a confrontation with worse consequences. Better to take the path of least resistance and hope they get the hint or have enough other stuff going on that they’ll hardly notice your absence.

Being ghosted, on the other hand, doesn’t leave you with much sympathy for your ghoster. Don’t they owe you more than that? Some measure of respect, an understanding of what you did (or didn’t do)? Or at least an “It’s not you, it’s me” story so you don’t indefinitely question yourself over the matter? It can be downright infuriating: They snuck away like a thief in the night, too lazy to give you the closure you deserved.

Folks might get introduced to ghosting during awkward breakups in gradeschool, but the practice of quietly retreating from an unwanted relationship is far more widespread. Healthcare included, despite what one might have hoped for regarding the behavior of “professionals.” Small wonder that the radiologist, a common poster-child for social ineptitude or avoidance, is no exception.

You might experience ghosting, for instance, if you’re supposedly in a partnership-track and ask about your status…but the current partners don’t intend to make you one (if they ever did). If the raise or end-of-year bonus you expected has failed to materialize. You might be ghosted by someone who’s not completing a task for you—a shared project, something you delegated, or even something you requested of a superior. Heck, you could be the one who completed the task, and whoever asked it of you might avoid responding because they don’t want to deal with the results.

You can be ghosted by folks with whom you have the most tenuous of connections; as long as there is a reasonable expectation of response, there’s the opportunity to ghost. I’ve previously written of the unfortunate prevalence of ghosting in the radiology-recruitment world: An awful lot of would-be employers fail to answer inquiries, leaving job-seekers in the dark about what happened to their applications: Being considered? Rejected? Lost in the ether?

Being ghosted professionally can be tougher to deal with than personally. At least with a vanishing social contact, you can work through your side of things and eventually shrug it off. Not so much if the individual ghosting you has something you want/need, or, worse, is someone you still have to work with; every time you see the perpetrator, it’s an annoying reminder. Especially if the ghost ever requests something of you.

Something I’ve come to understand in the fullness of time: Chase as few of those ghosts as you possibly can. It’s a waste of your time and energy, and even if you catch them it probably won’t be worthwhile. They’re scared of confronting you; in addition to whatever they originally didn’t want to discuss, if they face you now they do so as a coward. If you do wind up interacting, avoid referencing their ghosting-behavior (tempting as it may be to watch ‘em squirm more).

A ghost has tried in a very passive way to tell you “no” without actually saying the word. Trying to pry out a “yes” won’t generally get you what you want; they might speak affirmatively but their subsequent actions will rarely live up to it. They’ll do a halfhearted job if they do it at all. They might even resent you for cornering them, and find ways to punish you for it.

Accepting the unspoken “no” doesn’t get rid of all ghosts. Some come back to haunt you. Maybe testing the waters to see if they can continue the relationship without having to address whatever issue they were trying to avoid. Or maybe they just like playing head-games. I’d suggest keeping such folks at arm’s length; if they were comfortable ghosting you once, they’ll surely do it again. Why give them another chance to let you down?

One trick I’ve used: Sometimes, you really need that ghost to finish what it started, or you know that nobody else would fill its shoes as well. I’ve had success offering “bait” to come back. A useful bit of information, or some assistance I can provide. The sort of thing I can hold off on delivering, or parcel out, such that the ghost won’t get what it wants until it’s given me what I need. Not a maneuver you want to overuse: There are multiple ways it can go awry, and once a ghost learns you’ve got such tricks up your sleeve, it can become very circumspect about your offerings…or extra-clever about getting them without giving anything in return.