Thoughts of an A&E doctor considering radiology.
Whilst doing a night shift in the emergency department, I was asked by one of the nurses to see a young man who presented with a swelling and disfigurement of his right shoulder after being involved in a fight. Wondering how people can be so awake that they can fight at 3 am, I went to see the patient and found my colleague's description was indeed accurate.
The patient, who was not exactly sure how the injury happened, was holding his arm across his body and had a tender bulge at the front of his shoulder. Everyone was convinced it was a case of anterior shoulder dislocation so we treated the pain and sent the patient for an x-ray.
Then came the surprise. The shoulder joint was completely fine. The head of the humerus was sitting nicely against the glenoid fossa on all shoulder views. At this point, I winked at the radiographer and said “the beauty of radiology, is that it shows us the truth”.
“the beauty of radiology, is that it shows us the truth”
The combination of a tense muscle haematoma and a patient too angry at the fight to remember the exact mechanism of trauma had made everyone believe that it was a dislocated shoulder causing the problem, an emergency requiring urgent attention. However, when we had the imaging, everything became as clear as the detailed images my radiographer colleagues were able to obtain.
This scenario, preceded and followed by many other similar scenarios, always makes me think of how wonderful it must be to be a radiology specialist who can, while sitting in a dark room, reveal the truth that may be hidden in the shadow of variable clinical factors.
It must be amazing to be able to answer other colleague's queries and questions in order to reduce diagnostic uncertainty, helping colleagues to make decisions regarding treatments.
It must be be wonderful to be called to save a life or treat severe illness using keyhole interventions, or guide other doctors and surgeons as to where to target treatments and surgery. It's magical to put a plastic device covered with a gel on someone’s body to get an image of what is happening inside and displaying it on a TV screen near the patient's bed.
It must be a huge responsibility to be able to use radiation, which can cause harm if used inappropriately, and to manage various requests from all other departments, prioritising some and refusing unjustified requests.
It must be great to be a Radiologist.
This post was written by Dr Mohammed Noaman, an A&E doctor in Birmingham (UK) at the time of publishing.
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