Today was an interesting day to say the least. I had the opportunity to shadow a physician’s assistant, Matt Markell, in Christie Clinic’s radiology department. Matt was very welcoming and made sure to explain his observations and findings in the eighty some radiographs we saw in the three hour time span. He typically analyzes 150 to 200 bone density graphs and x-rays per day as he sits in front of a panel of three state of the art high pixel monitors (two of which the images are displayed on; those cost about $10,000 each). The room is rather subtle and dark, a cozy sleeping environment I might say. However, the work was not as tedious as I imagined it would be. There was much variety in the images we saw today, one minute Matt would be analyzing an x-ray of the chest for emphysema and the next he would be looking for ankle fractures on a foot x-ray. As you may imagine, this job would require a keen eye and conscientious knowledge of human anatomy and pathology.
One thing I was particularly fascinated by was the convenience of the voice recognition dictating system. Matt has a template readily set up for cases he commonly sees. He could then simply note any obstructions or deficiencies where the computer accurately inserts his statements. Often times doctors order x-rays or bone density graphs if they have concerns about certain aspects of a patient’s health. After images are taken, they are run by the radiologists or PA’s (such as Matt) to analyze and diagnose. The radiologist then dictates on each image, noting any and all abnormalities as well as rules out or confirms the doctor’s suspicions. An impression or “referring synopsis” is included to highlight any major findings. This makes it easier for doctors to quickly and efficiently review the patient’s graphics.
Part of Matt’s job is to conduct fluoroscopes and arthograms. I was able to witness a fluoroscopy today, which is a very common procedure to assess the upper GI (gastrointestinal) tract—includes the esophagus and the stomach. It requires the patient to ingest barium sulfate, a contrast medium visible on x-rays. The patient is asked to swallow the barium a number of times while standing in different positions to assess the 3D structure as best as possible. This technique induces gas production in the esophagus, and can be uncomfortable to the subject. I was offered some to try but it didn’t look very appealing. It was really cool, however, to see the fluorescent real time images. One can see the mechanisms at work as the patient swallows the substance and the course it takes down the body.
I found it quite fun learning more about the body and its anatomy as a whole. However, Radiology would not be a field of interest for me because of the lack of patient interaction. It’s important to me to get to know the person behind the image. I would have liked to see the process in which MR and CT images are analyzed, but those are generally handled by the doctors, but I was able to see how they were taken. This experience showed me how vast the field of medicine is and how essential each branch is to the other because the body functions as whole, not as separate units.
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