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I'm a radiologist and writing helps me make sense of the world. Moreover, I like to critically reflect on all things radiological. This blog is to pass on snippets of insight I have gained through these reflections

Monday, 20 July 2015

How to be a famous radiologist

You may think, ‘Who is he kidding? There is no such thing’, and to a certain degree, you’d be right. Radiologists are rarely frontline macho types. In the grand scheme of most hospitals we are bottom of the heap, just above the pathologists. Even the hospital cockroaches will get their own personal parking space before we do.

Even the great and good of radiology have rarely broken through the surface tension of public consciousness. In medical circles, Sir Peter Kerley got his B-lines remembered but his A and C lines have sunk into obscurity. Henry Pancoast has an eponymous apical lung tumour in his honour but out of an estimated 8000 eponyms, he is a pretty lonely radiological name. No radiologist has won a Nobel prize but our own local-lad-done-good, Dr Brian Witcombe, won the Ig Nobel prize in 2007 for his pioneering work on the radiology of sword swallowing.

You might also think, “What right-minded radiologist wants fame?”. Surely we all chose radiology because we don’t have mile-wide egos. We are happy in our role; we don’t need to be praised or loved, we know we are in the best speciality. Although I’ve met some right prima donnas I can’t imagine a ‘rockstar’ radiologist, reporting whilst wearing cool shades and tight leather trousers. However, i suspect every radiologist would like to contribute something of worth to humanity or to be fondly thought of for their achievements.

Strictly optional for a radiologist

Even if you wanted to be famous, it is increasingly difficult. 20-odd years ago, the average hospital proudly sported 5 or 6 radiologists. Now most places have that many just specialising in MRI of the left nostril. As one individual of many, you are just a small cog in a much bigger machine. No matter how much heat, noise and light you create, you are just a voxel in a low resolution matrix.

It isn’t nice to hear, but we are dispensable. Departments now run happily without you. Sometimes this is deliberate. A famous radiologist was once asked ‘You are so terribly important and busy, who does the work when you aren't there?’ to which he responded, ‘Exactly the same people as when I am here’.

I know of very few genuinely ambitious radiologists. They are often worthy individuals who achieve much through hard work, long hours and exploitation of every ounce of their talent. Although many of them cannot remember the names of their children, are on their 3rd or 4th marriage by the age of 50 and tend to keel over from a heart attack shortly thereafter. 

Furthermore, ambition is never far from avarice or narcissism. No one likes the thankfully rare individuals that self-aggrandise; their hubris is noxious. They want power, status and money that is out of keeping with their abilities and achievements. They may achieve brief infamy but soon fade from view as they disappear up their own backside.

Most of those in official positions of power are there because they didn’t step back quickly enough when volunteers were asked for. Their time in the limelight is spent blinking, smiling nervously with an unmistakable glint of terror in their eyes.

Many of us spend a lot of time managing our departments. It is a crucial task to keep the clinical service running smoothly. But does anyone remember who led a business case to install a particular scanner? The only people guaranteed to read departmental protocols and policies are the people that write them.

Let's distinguish between managers and leaders. Managers are functional administrators, keeping the ship seaworthy. Leaders are at the helm, steering through choppy waters, unconcerned with a little water lapping over the edge. No one remembers those whose primary concern was stopping the boat from rocking. Bold leaders are remembered. But it is a rare individual that feels comfortable steering a huge rickety vessel down treacherous rapids.

Academic fame is near impossible now. The low hanging fruit of research have been picked. The days are long gone where a seminal paper could be achieved in a single afternoon with only a bottle of contrast, a long needle and a nervous-looking student volunteer. The profusion of radiology journals now means that any academic achievement is instantly diluted to homeopathic levels.


However, everyone always remembers a good teacher. They inspire and edify countless individuals over the years. It is easy to achieve: offer to teach and you are pushing at an open door. But I must say that the whole thing about “He who can, does. He who cannot, teaches” is utter rubbish. I’ve only had great teaching from great radiologists. Admittedly, we can’t all be great but if you do it with enthusiasm and a smile, you are half way there. The best bit is that teaching is a valid reason for taking a break from the daily grind. And after a decade or two of ploughing the same field, reporting Sisyphean piles of radiographs of mildly osteoarthritic joints, you most definitely need regular breaks.