Hats off to the airport radiologists

Having worked with radiologists a lot, I have great respect for their specialty. The job is indeed a very difficult one. Without seeing the patient (the most difficult part of what they do), they have to thoroughly comb through every image put in front of their eyes and give us their assessment of what’s abnormal and what’s not. Their interpretation will be one that other doctors will hang their hats on and base complex management decisions upon. We will report the result back to anxiously waiting patients and family members; the reading taken as final and absolute.

However, unlike laboratory results, imaging results are not binary. In fact they are often highly subjective. All frontline doctors who have been in practice for any significant length of time have come across situations where due to their own innate suspicions, they request a “second read” to make absolutely sure. This request can be made with a phone call or a trip, usually downstairs, to the “dark room” (it is usually during these trips that physicians really appreciate the job that radiologists do). Sometimes the initial read is changed after further information is conveyed about the patient’s clinical status. We’ve also all seen situations where different radiologists come to differing conclusions about the image placed before them. It’s understandably very tough, especially with uncertain or difficult diagnoses.

But moving away from the radiologists we’re all familiar with, I’d like to talk about another often overlooked arena where people work tirelessly to scan the images placed before their eyes. Dedicated professionals who do a job that is vital for public safety. As someone who travels a lot through airports, both domestically and internationally, I’m sure that I’m not the only doctor who frequently looks at the people scanning the screens at security and thinks to myself, “Hmm, they’re just like radiologists!”

Every few seconds an image passes across their screen for scrutiny. They don’t have very long to decide if something needs a more detailed look. Sometimes you catch a glimpse of the screens as you walk past and it all appears very jumbled up in peoples’ suitcases and bags (not like the human body which always has the same basic structure). There’s a complete mish-mash of random items to look at contained in bags of all shapes and sizes.

Only last week I was at an overseas airport and a young man scanning the screen stopped the belt and quickly told a colleague, “Check that bag, I think it has an iPhone in it.” Sure enough, the lady with the bag apologized and the bag was rescanned after the iPhone removed. Unlike medical radiologists who can work to a certain degree on their own time terms, they can’t stop and pause for very long as the conveyor belt moves along and long lines of people ready to catch their flights are waiting to get through. The most they usually have is a few seconds to conduct their analysis. No blinking allowed. No distractions allowed. They are undoubtedly trained thoroughly and undergo vigorous testing before they are allowed to do the job, but I would hazard a guess that it’s nowhere near the several years that medical radiologists have to train for. There’s also no doubting that being a medical radiologist is more complex in most ways and requires detailed scientific knowledge, but who could argue against the fact that both jobs are equally important in terms of safety and potentially saving lives?

Since so many of us in the medical profession fly regularly, let’s thoughtfully appreciate these dedicated professionals next time we walk past them at the airport. As you stand in line, you can see how focused they are on what appears on the screen in front of them. The job requires the utmost concentration and vigilance while they are on duty. With the unfortunate and troubled times we live in, we mustn’t ever forget these “airport radiologists” who strive every day to keep us safe when we fly. Going through security can seem frustrating sometimes, especially when lines are long, but they do a fantastic job. Whether they are our own Homeland Security or other international personnel — hats off to them.

Suneel Dhand is an internal medicine physician and author of Thomas Jefferson: Lessons from a Secret Buddha and High Percentage Wellness Steps: Natural, Proven, Everyday Steps to Improve Your Health & Well-being.  He blogs at his self-titled site, Suneel Dhand.

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  • John C. Key MD

    From time immemorial, governmental security workers have been ruthlessly efficient in pursuit of their lofty goals. Draw your own conclusions.

  • Chris, MD

    i wholeheartedly agree with paying respect to our radiologists and our TSA workers. thanks for your thoughts.

    however, your statement “unlike laboratory results, imaging results are not binary” caught my attention and i think minimizes the laboratory’s role. while some lab results are reported as “positive” or “negative” many are far from binary and quite a bit more complicated than many care providers realize. knowing this can prompt a similar “second look” at lab results that don’t quite make sense with the clinical situation. additionally, i know the subjectivity of interpreting biopsies may not be realized by most.

    i believe it behooves providers ordering tests or reading biopsy reports to realize that things aren’t always as black and white as they may seem from a “positive/negative” result or single number representing a complex situation (and snapshot in time). pathologists and laboratory directors are as eager to work as consultants as radiologists and other specialists and aren’t tapped as often as we might be to assist in difficult clinical scenarios. we believe that doing so will minimize errors and in the end be best for patient care.

  • toolate

    TSA workers get their spot with a GED and 40 hours of training. They’re not required to have any sort of background in the military or the police. They have no understanding whatsoever of radiology, radiation, body scanners and most of all, common sense. That’s why we have them groping and humiliating old and disabled people. They meddle with peopIe’s prosthetics, stomas and insulin pumps. They sit behind their iron curtain and giggle at passenger’s deformities. They have the right to sexually assault you and you have no way to defend yourself. The TSA is a disgrace, a collection of low level, poorly mannered, uneducated people, who were given the authority to stick their hands where only a loved one or a doctor should – and that only for your own good and WITH your permission. What they’re doing is assault, all the the name of useless security theatre. If doctors did what they did they’d be in jail. I always thought that doctors should stand up to protest this. Instead, this? Shaking my head.

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