WEBVTT 1 00:00:00.200 --> 00:00:02.960 Do you know what real power is? It's knowing you're 2 00:00:03.000 --> 00:00:05.719 on the same rate for energy all day, every day 3 00:00:05.759 --> 00:00:08.640 with a smart all day plan from board Gosh Energy, 4 00:00:08.839 --> 00:00:11.000 save up to eight hundred and eighty euro on dual 5 00:00:11.119 --> 00:00:13.519 fuel plus get a two hundred and thirty five. You're 6 00:00:13.560 --> 00:00:17.480 a welcome bonus switch today at Boardgosh Energy dot Ie 7 00:00:17.559 --> 00:00:21.719 Board Gosh Energy. Know your power estimation Saniel Biller twenty 8 00:00:21.760 --> 00:00:23.839 six hundred and twenty nine. Your new customers only thursch 9 00:00:23.839 --> 00:00:26.640 ofcentis Kentov Smart all day electricity unitrates in twenty nine 10 00:00:26.640 --> 00:00:27.679 percent of gus. 11 00:00:27.280 --> 00:00:31.079 You see pocush Energy dot E for fulties and ces Hi. 12 00:00:31.480 --> 00:00:35.359 It's your uncle's ex wife who collects wind chimes, Ali Ward. 13 00:00:35.719 --> 00:00:39.240 So you, fine listener, are a bag of chaos. Just 14 00:00:39.640 --> 00:00:47.520 organs and tubes, fluids, benign lumps, squishy miracles. Let's get 15 00:00:47.520 --> 00:00:49.759 to know what's inside you and me and me. I've 16 00:00:49.759 --> 00:00:52.479 got all of that too, But first, thank you. Thank 17 00:00:52.479 --> 00:00:54.439 you so much for listening to ologies, and thanks for 18 00:00:54.479 --> 00:00:57.799 telling your friends and co workers and your tax preparators 19 00:00:57.960 --> 00:01:01.320 about the show. So many new people listening lately, and 20 00:01:01.399 --> 00:01:04.439 it's all thanks to you guys for yacking about it. 21 00:01:04.840 --> 00:01:07.519 So thanks for supporting the show at patreon dot com, 22 00:01:07.519 --> 00:01:12.079 slash ologies too. This is a totally independent show that 23 00:01:12.239 --> 00:01:14.799 I just make and you guys help make it happen. 24 00:01:14.879 --> 00:01:18.000 So patrons are the ones who submit questions to the ologists. 25 00:01:18.280 --> 00:01:20.280 You can get in on that action, you know, for 26 00:01:20.319 --> 00:01:22.959 a dollar a month, twenty five cents an episode or 27 00:01:23.000 --> 00:01:26.439 more if you want, but no pressure. It's your pocketbook. Also, 28 00:01:26.519 --> 00:01:29.159 I just posted a twenty nine minute video on Patreon 29 00:01:29.280 --> 00:01:31.519 of me answering your questions about how the show is 30 00:01:31.560 --> 00:01:35.079 made and secrets and what's wrong with my hair? So 31 00:01:35.439 --> 00:01:37.519 join You can check that out if you want. You 32 00:01:37.560 --> 00:01:41.680 can also wrap the show with shirts, etc. At ologies 33 00:01:41.879 --> 00:01:45.359 meerch dot com, or you can support for a balance 34 00:01:45.400 --> 00:01:48.760 of zero dollars and zero cents just by tweeting or gramming. 35 00:01:49.000 --> 00:01:52.359 You can rate, you can review, you can subscribe on iTunes. 36 00:01:52.959 --> 00:01:57.319 It's a well known fact. I am deeply creepy. I 37 00:01:57.840 --> 00:02:00.359 read all your reviews. I do. I'm like a tiny, 38 00:02:00.359 --> 00:02:02.879 hairy vampire bat. I love them all, like this one 39 00:02:02.959 --> 00:02:05.359 that I just selected to read. I'm not gonna read 40 00:02:05.400 --> 00:02:07.799 the whole thing. I'm just going to do some selections. 41 00:02:07.879 --> 00:02:13.000 Kasel techs TX says I am a podcast at Ficionado. 42 00:02:13.199 --> 00:02:15.719 Because of a relaxed policy at work, I'm able to 43 00:02:15.719 --> 00:02:19.039 listen to several hours of podcast week, and I listened 44 00:02:19.080 --> 00:02:22.520 to many. That's a lot of podcasts. That's cool. Amazing job, Ali. 45 00:02:22.599 --> 00:02:25.080 You put on an excellent product and should be very proud. 46 00:02:25.360 --> 00:02:28.639 The way you engage your guests is natural, funny and contagious. 47 00:02:28.960 --> 00:02:31.360 I've been listening to podcasts since two thousand and seven. 48 00:02:31.800 --> 00:02:34.199 That's old school, and I have a lot of podcasts 49 00:02:34.199 --> 00:02:37.000 I really enjoy. This is the first podcast I have 50 00:02:37.120 --> 00:02:41.039 ever written a review for the first one, kasl TX, 51 00:02:41.599 --> 00:02:45.719 thank you for writing the review. I appreciate it. Okay, 52 00:02:45.879 --> 00:02:50.960 radiation it comes from radii, which is Latin meaning to 53 00:02:51.120 --> 00:02:55.680 emit light after the radiation involved in X ray technology. 54 00:02:55.960 --> 00:03:00.719 But since X rays were developed so long ago, we've 55 00:03:00.759 --> 00:03:04.560 got other types of imaging, so radiology now essentially means I'm, 56 00:03:04.599 --> 00:03:07.639 in a paraphrase, medical technology that lets us gaze upon 57 00:03:07.639 --> 00:03:10.599 our disgusting, wonderful guts and bones and stuff. Now, this 58 00:03:10.680 --> 00:03:14.000 ologist i'd met before through my very good pal Kara 59 00:03:14.039 --> 00:03:17.000 Santa Maria of the podcast Talk Nerdy. She's awesome. I 60 00:03:17.039 --> 00:03:19.360 was over at Kara's house while this guest was in town, 61 00:03:19.520 --> 00:03:21.319 and I kind of pulled Kara aside and I was like, 62 00:03:21.560 --> 00:03:25.919 do you think she would be on my podcast? And 63 00:03:26.000 --> 00:03:29.759 Kara was like, dude, she listens to ologies already. She 64 00:03:29.960 --> 00:03:32.479 totally would. And it was like when you find out 65 00:03:33.240 --> 00:03:36.639 that your crush likes you back, except platonically. And instead 66 00:03:36.639 --> 00:03:38.800 of going to the prom, she came over one evening 67 00:03:38.800 --> 00:03:40.319 and we sat on my couch to talk about lead 68 00:03:40.360 --> 00:03:43.159 smocks and foreign objects being stuck in people's bodies and 69 00:03:43.199 --> 00:03:47.000 me crying about brain imaging and DIY ultrasounds and very 70 00:03:47.400 --> 00:03:51.280 savage word family pranks and what kind of classic American 71 00:03:51.360 --> 00:03:53.919 hip hop is best to listen to when you're thirteen 72 00:03:54.000 --> 00:03:57.960 hours deep in images of brains and guts and just 73 00:03:58.120 --> 00:04:01.039 casually saving lives on a Wednesday. So she is a 74 00:04:01.080 --> 00:04:04.840 doctor doing a radiology residency. She's planning on a fellowship 75 00:04:04.879 --> 00:04:08.039 in interventional radiology. You'll find out what that is in 76 00:04:08.080 --> 00:04:11.599 a minute, and you will love her. Please my back, 77 00:04:11.919 --> 00:04:15.879 stay still or cuddle up under your heaviest blanket for 78 00:04:16.160 --> 00:04:39.560 radiologist doctor Vershauna Rosami ask you everything about your life 79 00:04:39.680 --> 00:04:42.839 and all of your secrets. That's not true Okay, so 80 00:04:43.000 --> 00:04:45.120 now you live in Texas. 81 00:04:45.439 --> 00:04:46.759 Yes, I live in Houston. 82 00:04:47.000 --> 00:04:47.920 Are you from Texas? 83 00:04:48.000 --> 00:04:50.279 So I grew up in Keller, which is a small 84 00:04:50.319 --> 00:04:51.439 town north of Fort Worth. 85 00:04:51.680 --> 00:04:55.360 Doctor Varshauna Ghirosami went to Baylor College of Medicine in 86 00:04:55.480 --> 00:04:58.120 Houston for her undergrad and then she got a master's 87 00:04:58.160 --> 00:05:01.120 in Texas. She went and did grad school and med 88 00:05:01.160 --> 00:05:04.319 school in Philadelphia, and then she headed back to Texas, 89 00:05:04.360 --> 00:05:08.519 back to Baylor. Were you excited to go back to Texas. 90 00:05:08.839 --> 00:05:11.040 Yes, I really wanted to come back to Texas. My 91 00:05:11.639 --> 00:05:14.759 parents live here. I just wanted to come back, and 92 00:05:15.000 --> 00:05:17.319 I want to do interventional radiology and Baylor has a 93 00:05:17.360 --> 00:05:20.160 really strong reputation for that. So that's why I chose 94 00:05:20.199 --> 00:05:23.680 that program. But I always thought about coming back to Texas. 95 00:05:24.000 --> 00:05:26.399 At what point did you know you wanted to do radiology? 96 00:05:26.959 --> 00:05:29.800 So this is really interesting because I never wanted to 97 00:05:29.800 --> 00:05:33.600 do a radiology what it sort of happened by accident. 98 00:05:35.199 --> 00:05:37.120 So I went into medical school wanting to be a 99 00:05:37.160 --> 00:05:40.439 general surgeon. I was gung ho general surgery. I did 100 00:05:40.480 --> 00:05:43.680 all the things for surgery, and I remember it was 101 00:05:43.720 --> 00:05:46.680 my very first clinical rotation as a third year med student. 102 00:05:46.800 --> 00:05:50.199 I was on my pediatric rotation and we get to 103 00:05:50.199 --> 00:05:52.240 do a one week subspecialty. And I wanted to do 104 00:05:52.240 --> 00:05:55.319 it in surgery and pediatric surgery, but the surgeon was 105 00:05:55.360 --> 00:05:58.720 out of town at this little hospital in Monmouth and 106 00:05:59.360 --> 00:06:03.639 in New Jersey. So they said, well, surgeons outtown, you 107 00:06:03.639 --> 00:06:04.639 have to do it in radiology. 108 00:06:04.639 --> 00:06:05.639 And I was like, oh man, it's going to be 109 00:06:05.680 --> 00:06:07.360 so boring. I don't want to watch people. 110 00:06:07.079 --> 00:06:09.360 Read these CT scans and X rays is going to 111 00:06:09.439 --> 00:06:13.800 be terrible. So I sat down at this workstation and 112 00:06:13.839 --> 00:06:16.519 there was a resident there and he'd saved all these 113 00:06:16.560 --> 00:06:20.839 interesting cases, so rather than have me watch him read scans, 114 00:06:20.839 --> 00:06:23.040 he let me work through these on my own, which 115 00:06:23.120 --> 00:06:26.720 was really interesting. And I should say, like watching someone 116 00:06:27.000 --> 00:06:30.399 read or do radiology is kind of boring. It's like, okay, 117 00:06:30.519 --> 00:06:34.040 watching someone write a paper, so they're going through the scan. 118 00:06:34.120 --> 00:06:37.720 You might not understand what they're doing, so it can 119 00:06:37.800 --> 00:06:39.879 be boring. But when you're doing it on your own, 120 00:06:40.319 --> 00:06:42.240 it's like figuring out a puzzle, like you're going through 121 00:06:42.240 --> 00:06:43.079 someone's body. 122 00:06:43.160 --> 00:06:46.600 And it was awesome. So that kind of hooked me. 123 00:06:46.759 --> 00:06:49.959 But I kept thinking about surgery and then I noticed 124 00:06:50.000 --> 00:06:55.399 on every clinical rotation I did like Obgyn. I really 125 00:06:55.480 --> 00:06:58.360 liked looking at the ultrasounds, and when I was on surgery, 126 00:06:58.920 --> 00:07:02.199 I love that rotation. But we'd always go down to 127 00:07:02.240 --> 00:07:05.519 the radiology reading room and ask the radiologists about the 128 00:07:05.560 --> 00:07:08.639 scans and you know, in preparation for surgery. And I 129 00:07:08.680 --> 00:07:13.199 loved how the radiologists were such good teachers and they 130 00:07:13.240 --> 00:07:14.279 always took the time to. 131 00:07:14.240 --> 00:07:16.120 Go through everything, and I knew I wanted to teach. 132 00:07:16.160 --> 00:07:20.959 I really liked that aspect of their medicine, but I 133 00:07:21.040 --> 00:07:23.560 knew I wanted to do something with my hands. Sorry, 134 00:07:23.560 --> 00:07:27.680 it's like a long So someone told me, maybe you 135 00:07:27.680 --> 00:07:31.279 should think about interventional radiology, which where we use image 136 00:07:31.279 --> 00:07:36.120 guidance to do procedures. So that would marry the two things, 137 00:07:36.120 --> 00:07:39.120 like I liked looking at images and I want to 138 00:07:39.120 --> 00:07:41.519 work with my hands. So then I did a rotation 139 00:07:41.600 --> 00:07:44.240 in interventional radiology and I totally fell in love with it. 140 00:07:44.480 --> 00:07:48.639 Can you explain two things? What is radiology and what 141 00:07:48.800 --> 00:07:51.519 is interventional radiology? I know that you handed me a 142 00:07:51.519 --> 00:07:54.319 pamphlet with an old white dude on the front, but 143 00:07:54.480 --> 00:07:57.480 I'm going to have you explained instand. I was sitting 144 00:07:57.519 --> 00:08:00.480 in bed writing this episode. It's a Saturday I'm not 145 00:08:00.480 --> 00:08:02.920 wearing pants. I haven't worn them all day. I wanted 146 00:08:02.959 --> 00:08:07.279 to describe the pamphlet that doctor Garasami brought me, but 147 00:08:07.439 --> 00:08:09.879 it was in the other room, which was approximately fifteen 148 00:08:09.920 --> 00:08:14.600 feet away. So I spent upwards of five minutes looking 149 00:08:14.639 --> 00:08:18.839 for a PDF of the same pamphlet online instead of 150 00:08:18.920 --> 00:08:21.319 just getting up, and finally I just got up and 151 00:08:21.319 --> 00:08:23.879 got it. So it has an older white dude wearing 152 00:08:23.920 --> 00:08:24.720 scrubs on the front. 153 00:08:24.800 --> 00:08:25.160 There you go. 154 00:08:25.480 --> 00:08:28.319 All of that just to tell you that, Okay. 155 00:08:28.079 --> 00:08:32.840 So radiology is the study of like images and making 156 00:08:32.879 --> 00:08:37.320 diagnoses based on images and then using that to do procedures. 157 00:08:37.360 --> 00:08:41.559 So not all So there's sort of a misconception that 158 00:08:41.679 --> 00:08:44.039 radiologists just sit in a reading room and look at 159 00:08:44.039 --> 00:08:47.360 their computers all day and they don't ever see patients 160 00:08:47.440 --> 00:08:51.159 or other doctors. That's not true. They all do some 161 00:08:51.320 --> 00:08:54.919 kind of procedures. So that we look at four different 162 00:08:55.000 --> 00:08:59.480 types of imaging, mostly ultrasound, X rays, CT. 163 00:08:59.399 --> 00:09:00.440 Scans, and MRIs. 164 00:09:00.480 --> 00:09:05.960 Those are like the four main imaging modalities, and there's 165 00:09:06.000 --> 00:09:10.120 many different subsets of radiology. So people specialize in neuroradiology 166 00:09:10.120 --> 00:09:13.159 where they may read, you know, brain cts and brain MRIs. 167 00:09:13.279 --> 00:09:15.639 They specialize in that or body. 168 00:09:15.360 --> 00:09:17.879 Imaging, which is everything from like the neck down to 169 00:09:17.919 --> 00:09:18.679 the pelvis. 170 00:09:18.960 --> 00:09:21.000 Is there a weird line in your neck where it 171 00:09:21.080 --> 00:09:22.120 stops being the head and. 172 00:09:22.039 --> 00:09:23.159 It starts being the body? 173 00:09:23.200 --> 00:09:26.440 You know, there's definitely some overallap Yeah, I know, it's 174 00:09:26.480 --> 00:09:27.919 a little like, oh I can't do that. 175 00:09:27.919 --> 00:09:29.519 That's below of the classical. 176 00:09:29.320 --> 00:09:31.200 Right, yeah, no, Like what's the thyroid that? 177 00:09:31.200 --> 00:09:31.679 I was like? 178 00:09:31.799 --> 00:09:33.080 What am I aside? 179 00:09:33.080 --> 00:09:33.159 So? 180 00:09:33.200 --> 00:09:35.120 I guess your head is just your skull and face 181 00:09:35.159 --> 00:09:37.320 and jaw, and your neck is part of your body. 182 00:09:37.399 --> 00:09:39.919 But then the whole thing is really part of your body. 183 00:09:40.200 --> 00:09:41.759 But if you think about your body, like where does 184 00:09:41.799 --> 00:09:45.960 your body really end? Given like air and space in 185 00:09:46.000 --> 00:09:48.960 your microbiome? What is your body? Honestly? You know what? 186 00:09:49.200 --> 00:09:52.200 These thoughts are starting to spiral into things that a 187 00:09:52.240 --> 00:09:54.360 college sophomore is staring a black light poster would say, 188 00:09:54.360 --> 00:09:55.080 So let's just move on. 189 00:09:55.519 --> 00:09:58.679 I mean, basically, we use images a real time X ray, 190 00:09:59.120 --> 00:10:04.360 ultrasound or to guide whatever procedure we're doing. So there's 191 00:10:04.559 --> 00:10:06.440 lots of different procedures. 192 00:10:06.679 --> 00:10:10.120 Like gallbladder removal and tumors and stuff. 193 00:10:10.360 --> 00:10:12.960 We don't do gallbladder removals because that would be surgery. 194 00:10:13.039 --> 00:10:15.399 But we do put drains in gallbladders and patients that 195 00:10:15.480 --> 00:10:19.519 can't aren't you know, healthy enough to go through a surgery, 196 00:10:19.639 --> 00:10:21.799 So we might divert their gall butter and have that 197 00:10:21.879 --> 00:10:23.799 like drain outside. 198 00:10:24.279 --> 00:10:26.360 But we do I'm so sorry. 199 00:10:26.240 --> 00:10:26.960 Into a bag. 200 00:10:27.159 --> 00:10:27.480 That's it? 201 00:10:27.519 --> 00:10:27.720 Really? 202 00:10:27.759 --> 00:10:28.279 Yeah? 203 00:10:28.360 --> 00:10:30.600 Yeah, if they're obstructed and they need to like you know, 204 00:10:30.639 --> 00:10:33.080 and they can't have their gallbladder remove, maybe they have gallstones, 205 00:10:33.120 --> 00:10:35.559 but they you know, maybe it's like a really sick 206 00:10:35.600 --> 00:10:38.720 eighty five year old and she can't get surgery or something. 207 00:10:38.759 --> 00:10:40.759 We might put a tube or a colla sestos to 208 00:10:40.840 --> 00:10:41.519 YouTube and earn. 209 00:10:42.279 --> 00:10:45.120 Is it like tapping a caprice son kinda? 210 00:10:45.519 --> 00:10:47.440 I A should think about it that way. Can we 211 00:10:47.519 --> 00:10:49.080 make it more satisfy. 212 00:10:49.120 --> 00:10:54.480 Just a bile flavored capris Son delicious? Tap it, drain it? 213 00:10:54.639 --> 00:10:58.320 Yeahbing on, Let's backtrack. Take a closer look at those 214 00:10:58.480 --> 00:11:04.039 four main imaging modalities, or the dark wizardry that radiologists 215 00:11:04.080 --> 00:11:07.399 used to stare into solid objects, including your brain and butt. 216 00:11:07.799 --> 00:11:12.639 Can I make you tell me run through the four 217 00:11:12.679 --> 00:11:18.240 different modalities ultrasound, MRI, CT scan, X X ray. I 218 00:11:18.279 --> 00:11:21.120 know that those are like just a big breathing for you. 219 00:11:21.480 --> 00:11:23.840 But I only found out the difference between as CT 220 00:11:23.960 --> 00:11:26.039 scan and MRI like a year ago. 221 00:11:26.360 --> 00:11:29.759 Does like most radiologists probably when they started training, like 222 00:11:29.879 --> 00:11:30.559 I didn't know. 223 00:11:30.639 --> 00:11:32.639 I was like, which one uses X rays? I thought 224 00:11:33.080 --> 00:11:36.200 radiology was only to do with X rays. But MRIs 225 00:11:36.200 --> 00:11:40.440 and ultrasounds don't use actual X rays, right, so what 226 00:11:40.559 --> 00:11:41.840 is like? What's the difference? 227 00:11:41.919 --> 00:11:42.039 Oh? 228 00:11:42.039 --> 00:11:45.200 And also CT scans used to be called cat scans. 229 00:11:45.320 --> 00:11:47.480 Yeah right, people still call them cat scans. 230 00:11:47.639 --> 00:11:48.360 What's the difference? 231 00:11:48.639 --> 00:11:52.720 Nothing, That's just like an easy way of saying CT scan, Okay. 232 00:11:53.120 --> 00:11:59.039 Side note, CT stands for computed tomography and cat CT 233 00:11:59.240 --> 00:12:04.000 stands for huted axial tomography. The axial it just refers 234 00:12:04.000 --> 00:12:06.720 to the way that the machine spins around you, taking 235 00:12:06.759 --> 00:12:09.440 a bunch of X rays as it goes. So CT 236 00:12:09.600 --> 00:12:11.879 scan it's the up to date wave of saying cat scan. 237 00:12:12.279 --> 00:12:17.559 It's a new easier phrase with more syllables. CT cat 238 00:12:17.759 --> 00:12:21.360 one's got two syllables. Anyway, Pay attention, because this is 239 00:12:21.639 --> 00:12:24.600 radiology in a nutshell. This is how it works. 240 00:12:25.240 --> 00:12:28.039 I guess within all the different specialties we probably use 241 00:12:28.399 --> 00:12:33.080 some variation, maybe use more CT or MRI in certain specialties, 242 00:12:33.120 --> 00:12:36.519 but I mean I can go through like how we 243 00:12:36.879 --> 00:12:42.879 generate those images. Yeah, so ultrasound basically is sending a 244 00:12:42.879 --> 00:12:47.200 sound wave and measuring the echoes back. Then different tissues 245 00:12:47.240 --> 00:12:51.559 will send those sound waves back at different speeds, and 246 00:12:51.600 --> 00:12:56.039 then we use that to construct an image. So that's 247 00:12:56.080 --> 00:12:58.840 like briefly ultracent. And then X ray, you know, like 248 00:12:59.000 --> 00:13:01.600 X rays just like a form of you know, like 249 00:13:01.679 --> 00:13:05.360 one part of the electromagnetic spectrum. We send X rays 250 00:13:05.399 --> 00:13:09.399 from a source to through the tissue, and then tissue, 251 00:13:10.600 --> 00:13:13.840 depending on how dense it is, will attenuate or stop 252 00:13:13.919 --> 00:13:17.960 the beams. And so like bone is very dense, it 253 00:13:18.000 --> 00:13:19.679 tends to stop a lot of the X ray beam, 254 00:13:19.720 --> 00:13:22.080 where something that's air filled, like the lung would let 255 00:13:22.120 --> 00:13:22.600 a lot of. 256 00:13:22.600 --> 00:13:23.639 X rays pass through it. 257 00:13:24.120 --> 00:13:27.519 Then those all those X rays are sent to a 258 00:13:27.559 --> 00:13:30.720 detector and then an image is generated from that. And 259 00:13:30.840 --> 00:13:33.480 CT scan is like an X ray, but it's like 260 00:13:33.519 --> 00:13:37.639 a moving X ray and it's two dimensional. So that's 261 00:13:37.679 --> 00:13:39.279 how they reconstruct that image. 262 00:13:39.559 --> 00:13:42.600 Oh, so they a CT scan kind of revolves around you, 263 00:13:43.159 --> 00:13:45.039 so it's like an X ray that does loop d 264 00:13:45.120 --> 00:13:48.159 loops in a spiral around you, and then it creates 265 00:13:48.240 --> 00:13:51.519 kind of like almost like a three D image of 266 00:13:51.559 --> 00:13:52.120 your inside. 267 00:13:52.240 --> 00:13:54.120 Yeah, Like that's a two D image that we can get. 268 00:13:54.320 --> 00:13:56.720 We can scroll through or step through, like looking through 269 00:13:56.759 --> 00:13:57.759 your feet up through your. 270 00:13:57.639 --> 00:14:00.960 Body in an MRIs or magnet. Yeah. 271 00:14:01.039 --> 00:14:04.279 So an MRI so most tissue, most tissue in our 272 00:14:04.279 --> 00:14:06.679 body is made up of water, which in water has 273 00:14:06.679 --> 00:14:10.039 a lot of hydrogen atoms. So an MRI generates a 274 00:14:10.039 --> 00:14:14.320 magnetic field and we measure how the hydrogen atoms spin 275 00:14:14.440 --> 00:14:16.879 and what's their angle relative to this field, and we 276 00:14:16.960 --> 00:14:19.840 use that to generate an image. So that's different from 277 00:14:19.960 --> 00:14:23.360 CT and X ray and that it's not ionizing radiation. 278 00:14:23.480 --> 00:14:27.320 It's not you know, causing radiation. It's just a magnet 279 00:14:27.559 --> 00:14:29.679 that's sending a pulse, which. 280 00:14:29.600 --> 00:14:32.440 Is crazy to me. I had to learn what an MRI, 281 00:14:32.559 --> 00:14:35.240 the difference between a CT scan and MRI for a shoot, 282 00:14:35.240 --> 00:14:38.240 and I I was in the hotel room the night 283 00:14:38.279 --> 00:14:42.320 before and I remember being like, wait, wait, wait, all 284 00:14:42.360 --> 00:14:45.720 of your hydrogen atoms in your body line up? 285 00:14:46.320 --> 00:14:48.200 Yeah, we send a pulse to line them up and 286 00:14:48.240 --> 00:14:51.080 then we see how they like fall down or the 287 00:14:51.200 --> 00:14:53.320 you know speed or angles at which they fall down. 288 00:14:53.519 --> 00:14:55.519 How come you can be in the MRI tube all 289 00:14:55.559 --> 00:14:58.080 of your hydrogen atoms are lining up like soldiers, and 290 00:14:58.120 --> 00:15:00.559 it just is like doop de doop. Do you know that? 291 00:15:00.840 --> 00:15:03.679 Yeah, I don't really understand the physics of that yet. 292 00:15:03.759 --> 00:15:05.919 That is something that I'm still learning in my training. 293 00:15:06.639 --> 00:15:11.000 So essentially, your body has tons of hydrogen atoms like 294 00:15:11.120 --> 00:15:14.240 water fat lots of hydrogen, so we're made up of 295 00:15:14.240 --> 00:15:19.159 maybe sixty percent hydrogen, and hydrogen has an unpaired proton, 296 00:15:19.399 --> 00:15:22.960 which also has a magnetic spin. So when you have 297 00:15:23.080 --> 00:15:26.519 a strong magnetic fiel around you, like an MRI machine, 298 00:15:26.559 --> 00:15:31.320 these hydrogen atoms respond by lining up. So the machine 299 00:15:31.559 --> 00:15:35.559 throws out radio frequency pulses too, which causes the protons 300 00:15:35.960 --> 00:15:39.240 to spin again in the other direction, and that energy 301 00:15:39.360 --> 00:15:42.600 change can be detected by the imaging equipment to figure 302 00:15:42.600 --> 00:15:45.759 out how dense and what kind of tissue you've got 303 00:15:45.799 --> 00:15:50.000 going on. This whole process makes a sound like a 304 00:15:50.039 --> 00:15:54.000 foghorn and a car alarm had a love child that 305 00:15:54.080 --> 00:16:02.399 had a lot of opinions. Now that is very very 306 00:16:02.480 --> 00:16:06.360 super super nutshell and not textbook. Don't at me, that's 307 00:16:06.399 --> 00:16:08.759 just the basic like what the hell is happening of it? 308 00:16:08.840 --> 00:16:11.879 In case you've ever been in the clangy to getting 309 00:16:11.919 --> 00:16:15.159 peeped at by magnets. Have you ever had to get 310 00:16:15.519 --> 00:16:17.279 a medical imaging done for yourself? 311 00:16:17.679 --> 00:16:18.200 Yeah, I have. 312 00:16:18.399 --> 00:16:22.000 I've I tore both on my ACL, so I've That's 313 00:16:22.039 --> 00:16:23.960 probably why I used that as an example earlier. 314 00:16:24.440 --> 00:16:26.960 Yeah, dude, happened dumb stuff. 315 00:16:27.039 --> 00:16:28.039 What kind of dumb stuff? 316 00:16:28.360 --> 00:16:33.159 I played like intramural basketball in college and I tore 317 00:16:33.519 --> 00:16:36.559 my right ACL then and then I played flag football 318 00:16:36.679 --> 00:16:40.639 in med school for like five minutes and tourn ACL. 319 00:16:41.399 --> 00:16:44.480 I thought people in college who played flag football were 320 00:16:44.519 --> 00:16:46.919 only in Zema commercials, like they were only in like 321 00:16:47.000 --> 00:16:51.320 deer commercials, you know, like of like a happy, amazing 322 00:16:51.360 --> 00:16:53.720 group of college people just being just having fun out 323 00:16:53.720 --> 00:16:54.240 on the field. 324 00:16:55.000 --> 00:16:55.240 Yeah. 325 00:16:55.360 --> 00:16:57.840 I had to hang up the cleats after that, man, 326 00:16:58.200 --> 00:17:01.600 So I've had but yeah, I've had those MRIs done. 327 00:17:01.759 --> 00:17:06.960 And yeah, the magnet's noisy, And even for someone who 328 00:17:07.119 --> 00:17:09.880 was I wasn't in radiology residency at the time. I 329 00:17:09.920 --> 00:17:13.799 was in medical school, but even someone who is medically literate, 330 00:17:14.079 --> 00:17:16.920 it was kind of scary and like it's weird, it's noisy, 331 00:17:17.119 --> 00:17:18.680 you don't know what's going on. You're in there for 332 00:17:18.720 --> 00:17:22.119 like forty five minutes. But it gave me some perspective 333 00:17:22.240 --> 00:17:24.400 on what it's like to be a patient in that 334 00:17:24.440 --> 00:17:27.200 magnet and maybe getting like a head you know, a 335 00:17:27.200 --> 00:17:30.359 brain MRI. How much scary that would be when something's 336 00:17:30.559 --> 00:17:31.319 around your brain? 337 00:17:31.440 --> 00:17:34.480 Yeah, have what kind of tools do you have to 338 00:17:34.519 --> 00:17:39.079 have in your pocket, like psychologically to help patients, because 339 00:17:39.599 --> 00:17:42.079 I mean TMI, but I had to get a brain 340 00:17:42.160 --> 00:17:45.839 AMRI last year and my mom has a mess so 341 00:17:45.960 --> 00:17:48.160 like I'm familiar with like brain imaging and it's kind 342 00:17:48.200 --> 00:17:50.039 of scary. But I had to go in because I 343 00:17:50.039 --> 00:17:52.599 thought maybe I had a brain tumor, just like a 344 00:17:52.640 --> 00:17:55.200 pituitary tumor. They're like, let's check it out. So I 345 00:17:55.240 --> 00:17:57.720 was like, Okay, well, I'm just going to go by myself. 346 00:17:58.000 --> 00:18:00.279 It's fine. And I got to the hospital. As soon 347 00:18:00.319 --> 00:18:05.400 as I checked in, I started sobbing. I totally totally unexpected. 348 00:18:05.440 --> 00:18:08.920 I was just like hey, what And then like the 349 00:18:09.000 --> 00:18:11.759 radiologist was like hugging me and like why good, like 350 00:18:11.839 --> 00:18:14.599 wiped mascara off my face. She's like, you can be fine. 351 00:18:14.640 --> 00:18:17.480 You're gonna be fine because it's just like you're you're 352 00:18:17.559 --> 00:18:20.480 right in the threshold of knowledge you might not be 353 00:18:20.559 --> 00:18:23.200 prepared to take. Yeah, definitely, Like how do you do 354 00:18:23.279 --> 00:18:25.960 you ever have do you ever see patients just fucking lose. 355 00:18:25.759 --> 00:18:27.079 It all the time? 356 00:18:27.279 --> 00:18:30.039 And I'm so glad to hear that a radiologist was, 357 00:18:30.720 --> 00:18:34.039 you know, able to comfort you before you know, getting 358 00:18:34.039 --> 00:18:36.759 the scan done and everything. And when we can, for 359 00:18:36.839 --> 00:18:40.200 people who are really anxious, we can sedate them. We 360 00:18:40.240 --> 00:18:44.880 can give people value and help them relax. But I 361 00:18:44.880 --> 00:18:48.200 think just talking to someone and explaining, you know, what's 362 00:18:48.240 --> 00:18:50.799 going to happen and how we're doing the how we're 363 00:18:50.799 --> 00:18:52.240 doing the the MRI. 364 00:18:52.240 --> 00:18:53.119 Is really helpful. 365 00:18:53.319 --> 00:18:56.319 And a lot of times people will give you headphones 366 00:18:56.319 --> 00:18:58.000 to listen to They may they probably didn't do that 367 00:18:58.000 --> 00:18:59.759 because you were getting a brain MRI, but yeah, with 368 00:19:00.079 --> 00:19:02.720 my knee, I remember they did. So it helps drown 369 00:19:02.759 --> 00:19:09.000 out the sound of the magnet. And in pediatrics sometimes 370 00:19:09.039 --> 00:19:11.880 they give kids these little glasses where they can watch 371 00:19:11.880 --> 00:19:14.880 a movie, oh, to help distract them. Yeah, so we 372 00:19:14.920 --> 00:19:17.480 have those kinds of tools to help, you know, patients 373 00:19:17.720 --> 00:19:18.720 go through these scans. 374 00:19:19.200 --> 00:19:22.839 If you have some shit going on that's not good, 375 00:19:23.559 --> 00:19:27.720 particularly with like neuroimaging. Do you ever have to have 376 00:19:27.759 --> 00:19:30.039 a poker face where you're like, Okay, I see you later, 377 00:19:30.079 --> 00:19:34.000 missus Wilson And then you're like, oh, Wow, she's screwed 378 00:19:34.160 --> 00:19:37.480 or do you like the Because I think that's always 379 00:19:37.480 --> 00:19:40.079 what's so scary when you're when you're getting diagnostics down 380 00:19:40.119 --> 00:19:43.519 as a patient is how long till I find out? 381 00:19:44.119 --> 00:19:46.759 And if it's something's wrong, will I find out now? 382 00:19:46.839 --> 00:19:48.640 Or will I just go about my business for two days? 383 00:19:48.680 --> 00:19:49.319 And you know what I mean. 384 00:19:49.359 --> 00:19:54.119 Like, so typically when we're reading the scans, we're in 385 00:19:54.160 --> 00:19:56.759 a reading room that's like dark with these huge monitors, 386 00:19:56.799 --> 00:20:00.000 and we're far away from the patient, so we don't 387 00:20:00.160 --> 00:20:03.079 always get to I mean, we usually don't get to 388 00:20:03.119 --> 00:20:04.759 tell the patient like, oh, I saw. 389 00:20:04.559 --> 00:20:06.079 This, and I can tell you immediately. 390 00:20:06.640 --> 00:20:08.960 We read it, and we dictate a report and it's 391 00:20:08.960 --> 00:20:12.640 sent to the electronic medical record and then your primary 392 00:20:12.640 --> 00:20:13.759 physician may tell you. 393 00:20:13.839 --> 00:20:16.599 But when we're in the er, we're reading. 394 00:20:16.359 --> 00:20:19.480 Emergent scans in the EER, if we see something emergent, 395 00:20:19.559 --> 00:20:22.839 we'll call the physician immediately and they'll tell the patient. 396 00:20:23.440 --> 00:20:26.039 But when we're in that diagnostic reading room, we don't 397 00:20:26.720 --> 00:20:28.839 get to communicate that to the patient. 398 00:20:28.599 --> 00:20:31.880 Right because there's so mighty protocol steps that I'm sure 399 00:20:31.880 --> 00:20:32.720 it has to go through. 400 00:20:33.000 --> 00:20:34.799 Yeah, and there's just so many studies, like we're just 401 00:20:34.880 --> 00:20:35.880