Your GP has referred you to a radiologist for a routine examination because you have told him that you feel fine - apart from a bit of a cough, or a touch of indigestion, or occasional constipation, or some other minor symptom which has nothing to do with the reason for visiting your GP in the first place (a routine medical for travel insurance, for example) - and before you have even signed the radiologist's Medicare assignment form you have been given a death sentence.
A radiologist would like to spend his professional life only discovering disease in his patients at a stage when the disease is completely curable.
But, unfortunately for the principal and secondary players in this short vignette of life, like the mythical Irish Spirit that heralds the death of a family member, the radiologist is the Banshee of the medical profession.
The radiologist tries to evade the depressing reality of his role as harbinger of your impending demise by the self-delusion of selective recall, desperately clinging to the memory of the all-too-infrequent past instances of his serendipitous discovery of a curable serious disease.
The frivolous misuse of scarce resources, time and expertise by the worried well, this bunch of self-absorbed whingers, is a source of great frustration and irritation to doctors who are flat-out trying to cope with the daily avalanche of the genuinely unwell.
For the radiologist, there is no comfort in his usual interminable role as the excluder of lethal disease to reassure the worried well - the Google-searching, self-diagnosing hypochondriac legions of the "It's not cancer, is it, Doc? brigade.
And conscious of the knowledge, skill and dedication required for the recognition and interpretation of the frequently subtle changes of disease on radiological images, and the complex cascade of logic, knowledge and experience required in reaching each and every consequent radiological diagnosis, the anger and frustration at radiological colleagues who fail to approach their responsibility with dedication is understandable. (Hi, Chris)
One such colleague, when I asked him how he coped with the stress of the frequent malpractice suits brought against him, told me that it wasn't an issue for him. That from the moment a complainant's lawyers contacted him, it became the problem of his Medical Indemnity Insurance company. (Hi, Richard.)
Pitfalls in diagnosis are many, and the harm caused by radiological over-diagnosis and under-diagnosis can be catastrophic, with associated error-related iatrogenic fatalities being, unfortunately, not rare.
Here, the radiologist has progressed from Banshee to Morrighan, the Celtic warrior goddess who determined who would walk off the battlefield and who would be carried away on their shield. (Hello again, Chris.)But, unfortunately for the principal and secondary players in this short vignette of life, like the mythical Irish Spirit that heralds the death of a family member, the radiologist is the Banshee of the medical profession.
The radiologist tries to evade the depressing reality of his role as harbinger of your impending demise by the self-delusion of selective recall, desperately clinging to the memory of the all-too-infrequent past instances of his serendipitous discovery of a curable serious disease.
The frivolous misuse of scarce resources, time and expertise by the worried well, this bunch of self-absorbed whingers, is a source of great frustration and irritation to doctors who are flat-out trying to cope with the daily avalanche of the genuinely unwell.
For the radiologist, there is no comfort in his usual interminable role as the excluder of lethal disease to reassure the worried well - the Google-searching, self-diagnosing hypochondriac legions of the "It's not cancer, is it, Doc? brigade.
And conscious of the knowledge, skill and dedication required for the recognition and interpretation of the frequently subtle changes of disease on radiological images, and the complex cascade of logic, knowledge and experience required in reaching each and every consequent radiological diagnosis, the anger and frustration at radiological colleagues who fail to approach their responsibility with dedication is understandable. (Hi, Chris)
One such colleague, when I asked him how he coped with the stress of the frequent malpractice suits brought against him, told me that it wasn't an issue for him. That from the moment a complainant's lawyers contacted him, it became the problem of his Medical Indemnity Insurance company. (Hi, Richard.)
Pitfalls in diagnosis are many, and the harm caused by radiological over-diagnosis and under-diagnosis can be catastrophic, with associated error-related iatrogenic fatalities being, unfortunately, not rare.
Hence, the radiologist practices his profession in frustration, hope and disappointment, too frequently inflicted with the role of Bearer of Bad News.
Perhaps the rampant lions that support the escutcheon of the Royal Australian and New Zealand College of Radiologists coat of arms should be replaced by banshees.
As William Laidlaw wrote: " There are two basic kinds of professional. There's the professionalism that does something well enough to earn a living from it. And there's the professionalism that creates a commitment so intense that the earning of a living happens by the way. Its dynamic isn't wages but the determination to do something as well as it can be done".
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