What is Radiology?

From the pen of Gopal Punjabi, MD, one of our Radiologists at HCMC.

Man says to a Radiologist, "So what is it that you do, exactly?"

119 years ago, a German physicist put his wife's hand in front of a tube and obtained an iconic image of a hand with rings. He called these rays "X-rays", and for the first time human beings could peer inside a living intact human body. These rays were promptly harnessed for medical use and shortly thereafter my tribe, the radiologist, was born. Ever since, be it from random strangers in cafés and bars or in trains or planes, or from familiar family members or friends at festive gatherings, even from date and fiancé alike, every radiologist has dealt with an existential question, "So what is it that you do?"

Dr. Punjabi Talking to a Reporter Photo

Let me try to answer that question. Of course technological advancement means that today we use sound waves and magnets as well to image the human body, but the name radiologist has stuck. I am an engineer and an artist. I use a dazzling array of technological brushes to try to paint an accurate picture of what is going on inside your body. I am a goalkeeper. I try to keep you from harm, and stop the medical team from scoring on its own goal. I am constantly trying to get the information I need by using the least amount of radiation or sound energy. I make sure that if you have an allergy to contrast dye, you are pre-medicated. I make sure we use every method at our disposal to reduce the likelihood of harming your kidneys with dye, including using the least amount of dye necessary.

I am the traffic cop in the hospital. I steer my colleagues to the best imaging modality in your specific situation. I might steer my colleague to refer you to a specific specialty that might find the answer for you or treat you ("Mr. D needs to see a thoracic surgeon"). Sometimes, I go to bat for you, and try to stop what I believe is an unwarranted imaging exam. I am the student and the teacher. I am the medical magpie; I need to know something, often a lot, about everything. I go to meetings and seminars to learn from experts, and after I pass away, I will continue to live on in some small way in the dozens of brilliant minds that I teach today.

I am the harbinger of good news ("That tumor is benign, Mrs. R"). Often, I am the first person to know what is wrong with your body, and sometimes, I know what is going on even before you have risen from the scanner. (You ask, "So why don’t you tell us that right away?" and I say, "That is a discussion for a different day.") Without your knowledge, I am your cheerleader. I celebrate small victories, like when the PET scan shows your cancer is in remission, and grieve the small setbacks. I pray for miracles too (please let that not be a tumor), but prepare for the worst always (I will still call the surgeon).

I am a macroscopic pathologist and a microscopic surgeon. I can predict what the pathologist will find on tissue samples, sometimes obviating the need for an invasive procedure. Sometimes with great success, I can treat what ails you.

I am a spouse and a parent, a child and a sibling. Even though I expect to be held to the highest standards, most nights I am able to sleep well, knowing I did my best in the battle of the day to keep you healthy, in this long, long war we will all lose in the end.

Like a child I am struck with wonder at all that the human body can do, and of all that the human mind can devise to help me detect what ails the body. Most of all, I am constantly humbled by the trust placed in me, that I am chosen to be (in a phrase borrowed from author Jhumpa Lahiri) your Interpreter of Maladies.

I hope this answers your questions about what it is that I do. For the record, I tell the teacher sitting next to me on the flight to New York, "Oh, I read X-rays and that sort of thing".