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Speaker 3: It's your uncle's ex wife who collects wind chimes, Ali Ward.
Speaker 3: So you, fine listener, are a bag of chaos. Just
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Speaker 3: It's a well known fact. I am deeply creepy. I
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Speaker 3: ever written a review for the first one, kasl TX,
Speaker 3: thank you for writing the review. I appreciate it. Okay,
Speaker 3: radiation it comes from radii, which is Latin meaning to
Speaker 3: emit light after the radiation involved in X ray technology.
Speaker 3: But since X rays were developed so long ago, we've
Speaker 3: got other types of imaging, so radiology now essentially means I'm,
Speaker 3: in a paraphrase, medical technology that lets us gaze upon
Speaker 3: our disgusting, wonderful guts and bones and stuff. Now, this
Speaker 3: ologist i'd met before through my very good pal Kara
Speaker 3: Santa Maria of the podcast Talk Nerdy. She's awesome. I
Speaker 3: was over at Kara's house while this guest was in town,
Speaker 3: and I kind of pulled Kara aside and I was like,
Speaker 3: do you think she would be on my podcast? And
Speaker 3: Kara was like, dude, she listens to ologies already. She
Speaker 3: totally would. And it was like when you find out
Speaker 3: that your crush likes you back, except platonically. And instead
Speaker 3: of going to the prom, she came over one evening
Speaker 3: and we sat on my couch to talk about lead
Speaker 3: smocks and foreign objects being stuck in people's bodies and
Speaker 3: me crying about brain imaging and DIY ultrasounds and very
Speaker 3: savage word family pranks and what kind of classic American
Speaker 3: hip hop is best to listen to when you're thirteen
Speaker 3: hours deep in images of brains and guts and just
Speaker 3: casually saving lives on a Wednesday. So she is a
Speaker 3: doctor doing a radiology residency. She's planning on a fellowship
Speaker 3: in interventional radiology. You'll find out what that is in
Speaker 3: a minute, and you will love her. Please my back,
Speaker 3: stay still or cuddle up under your heaviest blanket for
Speaker 3: radiologist doctor Vershauna Rosami ask you everything about your life
Speaker 3: and all of your secrets. That's not true Okay, so
Speaker 3: now you live in Texas.
Speaker 2: Yes, I live in Houston.
Speaker 3: Are you from Texas?
Speaker 4: So I grew up in Keller, which is a small
Speaker 4: town north of Fort Worth.
Speaker 3: Doctor Varshauna Ghirosami went to Baylor College of Medicine in
Speaker 3: Houston for her undergrad and then she got a master's
Speaker 3: in Texas. She went and did grad school and med
Speaker 3: school in Philadelphia, and then she headed back to Texas,
Speaker 3: back to Baylor. Were you excited to go back to Texas.
Speaker 4: Yes, I really wanted to come back to Texas. My
Speaker 4: parents live here. I just wanted to come back, and
Speaker 4: I want to do interventional radiology and Baylor has a
Speaker 4: really strong reputation for that. So that's why I chose
Speaker 4: that program. But I always thought about coming back to Texas.
Speaker 3: At what point did you know you wanted to do radiology?
Speaker 4: So this is really interesting because I never wanted to
Speaker 4: do a radiology what it sort of happened by accident.
Speaker 4: So I went into medical school wanting to be a
Speaker 4: general surgeon. I was gung ho general surgery. I did
Speaker 4: all the things for surgery, and I remember it was
Speaker 4: my very first clinical rotation as a third year med student.
Speaker 4: I was on my pediatric rotation and we get to
Speaker 4: do a one week subspecialty. And I wanted to do
Speaker 4: it in surgery and pediatric surgery, but the surgeon was
Speaker 4: out of town at this little hospital in Monmouth and
Speaker 4: in New Jersey. So they said, well, surgeons outtown, you
Speaker 4: have to do it in radiology.
Speaker 2: And I was like, oh man, it's going to be
Speaker 2: so boring. I don't want to watch people.
Speaker 4: Read these CT scans and X rays is going to
Speaker 4: be terrible. So I sat down at this workstation and
Speaker 4: there was a resident there and he'd saved all these
Speaker 4: interesting cases, so rather than have me watch him read scans,
Speaker 4: he let me work through these on my own, which
Speaker 4: was really interesting. And I should say, like watching someone
Speaker 4: read or do radiology is kind of boring. It's like, okay,
Speaker 4: watching someone write a paper, so they're going through the scan.
Speaker 4: You might not understand what they're doing, so it can
Speaker 4: be boring. But when you're doing it on your own,
Speaker 4: it's like figuring out a puzzle, like you're going through
Speaker 4: someone's body.
Speaker 2: And it was awesome. So that kind of hooked me.
Speaker 4: But I kept thinking about surgery and then I noticed
Speaker 4: on every clinical rotation I did like Obgyn. I really
Speaker 4: liked looking at the ultrasounds, and when I was on surgery,
Speaker 4: I love that rotation. But we'd always go down to
Speaker 4: the radiology reading room and ask the radiologists about the
Speaker 4: scans and you know, in preparation for surgery. And I
Speaker 4: loved how the radiologists were such good teachers and they
Speaker 4: always took the time to.
Speaker 2: Go through everything, and I knew I wanted to teach.
Speaker 4: I really liked that aspect of their medicine, but I
Speaker 4: knew I wanted to do something with my hands. Sorry,
Speaker 4: it's like a long So someone told me, maybe you
Speaker 4: should think about interventional radiology, which where we use image
Speaker 4: guidance to do procedures. So that would marry the two things,
Speaker 4: like I liked looking at images and I want to
Speaker 4: work with my hands. So then I did a rotation
Speaker 4: in interventional radiology and I totally fell in love with it.
Speaker 3: Can you explain two things? What is radiology and what
Speaker 3: is interventional radiology? I know that you handed me a
Speaker 3: pamphlet with an old white dude on the front, but
Speaker 3: I'm going to have you explained instand. I was sitting
Speaker 3: in bed writing this episode. It's a Saturday I'm not
Speaker 3: wearing pants. I haven't worn them all day. I wanted
Speaker 3: to describe the pamphlet that doctor Garasami brought me, but
Speaker 3: it was in the other room, which was approximately fifteen
Speaker 3: feet away. So I spent upwards of five minutes looking
Speaker 3: for a PDF of the same pamphlet online instead of
Speaker 3: just getting up, and finally I just got up and
Speaker 3: got it. So it has an older white dude wearing
Speaker 3: scrubs on the front.
Speaker 2: There you go.
Speaker 3: All of that just to tell you that, Okay.
Speaker 4: So radiology is the study of like images and making
Speaker 4: diagnoses based on images and then using that to do procedures.
Speaker 4: So not all So there's sort of a misconception that
Speaker 4: radiologists just sit in a reading room and look at
Speaker 4: their computers all day and they don't ever see patients
Speaker 4: or other doctors. That's not true. They all do some
Speaker 4: kind of procedures. So that we look at four different
Speaker 4: types of imaging, mostly ultrasound, X rays, CT.
Speaker 2: Scans, and MRIs.
Speaker 4: Those are like the four main imaging modalities, and there's
Speaker 4: many different subsets of radiology. So people specialize in neuroradiology
Speaker 4: where they may read, you know, brain cts and brain MRIs.
Speaker 2: They specialize in that or body.
Speaker 4: Imaging, which is everything from like the neck down to
Speaker 4: the pelvis.
Speaker 3: Is there a weird line in your neck where it
Speaker 3: stops being the head and.
Speaker 2: It starts being the body?
Speaker 4: You know, there's definitely some overallap Yeah, I know, it's
Speaker 4: a little like, oh I can't do that.
Speaker 2: That's below of the classical.
Speaker 3: Right, yeah, no, Like what's the thyroid that?
Speaker 1: I was like?
Speaker 3: What am I aside?
Speaker 5: So?
Speaker 3: I guess your head is just your skull and face
Speaker 3: and jaw, and your neck is part of your body.
Speaker 3: But then the whole thing is really part of your body.
Speaker 3: But if you think about your body, like where does
Speaker 3: your body really end? Given like air and space in
Speaker 3: your microbiome? What is your body? Honestly? You know what?
Speaker 3: These thoughts are starting to spiral into things that a
Speaker 3: college sophomore is staring a black light poster would say,
Speaker 3: So let's just move on.
Speaker 4: I mean, basically, we use images a real time X ray,
Speaker 4: ultrasound or to guide whatever procedure we're doing. So there's
Speaker 4: lots of different procedures.
Speaker 3: Like gallbladder removal and tumors and stuff.
Speaker 4: We don't do gallbladder removals because that would be surgery.
Speaker 4: But we do put drains in gallbladders and patients that
Speaker 4: can't aren't you know, healthy enough to go through a surgery,
Speaker 4: So we might divert their gall butter and have that
Speaker 4: like drain outside.
Speaker 3: But we do I'm so sorry.
Speaker 2: Into a bag.
Speaker 3: That's it?
Speaker 4: Really?
Speaker 2: Yeah?
Speaker 4: Yeah, if they're obstructed and they need to like you know,
Speaker 4: and they can't have their gallbladder remove, maybe they have gallstones,
Speaker 4: but they you know, maybe it's like a really sick
Speaker 4: eighty five year old and she can't get surgery or something.
Speaker 4: We might put a tube or a colla sestos to
Speaker 4: YouTube and earn.
Speaker 3: Is it like tapping a caprice son kinda?
Speaker 2: I A should think about it that way. Can we
Speaker 2: make it more satisfy.
Speaker 3: Just a bile flavored capris Son delicious? Tap it, drain it?
Speaker 3: Yeahbing on, Let's backtrack. Take a closer look at those
Speaker 3: four main imaging modalities, or the dark wizardry that radiologists
Speaker 3: used to stare into solid objects, including your brain and butt.
Speaker 3: Can I make you tell me run through the four
Speaker 3: different modalities ultrasound, MRI, CT scan, X X ray. I
Speaker 3: know that those are like just a big breathing for you.
Speaker 3: But I only found out the difference between as CT
Speaker 3: scan and MRI like a year ago.
Speaker 4: Does like most radiologists probably when they started training, like
Speaker 4: I didn't know.
Speaker 3: I was like, which one uses X rays? I thought
Speaker 3: radiology was only to do with X rays. But MRIs
Speaker 3: and ultrasounds don't use actual X rays, right, so what
Speaker 3: is like? What's the difference?
Speaker 4: Oh?
Speaker 3: And also CT scans used to be called cat scans.
Speaker 2: Yeah right, people still call them cat scans.
Speaker 3: What's the difference?
Speaker 4: Nothing, That's just like an easy way of saying CT scan, Okay.
Speaker 3: Side note, CT stands for computed tomography and cat CT
Speaker 3: stands for huted axial tomography. The axial it just refers
Speaker 3: to the way that the machine spins around you, taking
Speaker 3: a bunch of X rays as it goes. So CT
Speaker 3: scan it's the up to date wave of saying cat scan.
Speaker 3: It's a new easier phrase with more syllables. CT cat
Speaker 3: one's got two syllables. Anyway, Pay attention, because this is
Speaker 3: radiology in a nutshell. This is how it works.
Speaker 4: I guess within all the different specialties we probably use
Speaker 4: some variation, maybe use more CT or MRI in certain specialties,
Speaker 4: but I mean I can go through like how we
Speaker 4: generate those images. Yeah, so ultrasound basically is sending a
Speaker 4: sound wave and measuring the echoes back. Then different tissues
Speaker 4: will send those sound waves back at different speeds, and
Speaker 4: then we use that to construct an image. So that's
Speaker 4: like briefly ultracent. And then X ray, you know, like
Speaker 4: X rays just like a form of you know, like
Speaker 4: one part of the electromagnetic spectrum. We send X rays
Speaker 4: from a source to through the tissue, and then tissue,
Speaker 4: depending on how dense it is, will attenuate or stop
Speaker 4: the beams. And so like bone is very dense, it
Speaker 4: tends to stop a lot of the X ray beam,
Speaker 4: where something that's air filled, like the lung would let
Speaker 4: a lot of.
Speaker 2: X rays pass through it.
Speaker 4: Then those all those X rays are sent to a
Speaker 4: detector and then an image is generated from that. And
Speaker 4: CT scan is like an X ray, but it's like
Speaker 4: a moving X ray and it's two dimensional. So that's
Speaker 4: how they reconstruct that image.
Speaker 3: Oh, so they a CT scan kind of revolves around you,
Speaker 3: so it's like an X ray that does loop d
Speaker 3: loops in a spiral around you, and then it creates
Speaker 3: kind of like almost like a three D image of
Speaker 3: your inside.
Speaker 4: Yeah, Like that's a two D image that we can get.
Speaker 4: We can scroll through or step through, like looking through
Speaker 4: your feet up through your.
Speaker 3: Body in an MRIs or magnet. Yeah.
Speaker 4: So an MRI so most tissue, most tissue in our
Speaker 4: body is made up of water, which in water has
Speaker 4: a lot of hydrogen atoms. So an MRI generates a
Speaker 4: magnetic field and we measure how the hydrogen atoms spin
Speaker 4: and what's their angle relative to this field, and we
Speaker 4: use that to generate an image. So that's different from
Speaker 4: CT and X ray and that it's not ionizing radiation.
Speaker 4: It's not you know, causing radiation. It's just a magnet
Speaker 4: that's sending a pulse, which.
Speaker 3: Is crazy to me. I had to learn what an MRI,
Speaker 3: the difference between a CT scan and MRI for a shoot,
Speaker 3: and I I was in the hotel room the night
Speaker 3: before and I remember being like, wait, wait, wait, all
Speaker 3: of your hydrogen atoms in your body line up?
Speaker 4: Yeah, we send a pulse to line them up and
Speaker 4: then we see how they like fall down or the
Speaker 4: you know speed or angles at which they fall down.
Speaker 3: How come you can be in the MRI tube all
Speaker 3: of your hydrogen atoms are lining up like soldiers, and
Speaker 3: it just is like doop de doop. Do you know that?
Speaker 4: Yeah, I don't really understand the physics of that yet.
Speaker 2: That is something that I'm still learning in my training.
Speaker 3: So essentially, your body has tons of hydrogen atoms like
Speaker 3: water fat lots of hydrogen, so we're made up of
Speaker 3: maybe sixty percent hydrogen, and hydrogen has an unpaired proton,
Speaker 3: which also has a magnetic spin. So when you have
Speaker 3: a strong magnetic fiel around you, like an MRI machine,
Speaker 3: these hydrogen atoms respond by lining up. So the machine
Speaker 3: throws out radio frequency pulses too, which causes the protons
Speaker 3: to spin again in the other direction, and that energy
Speaker 3: change can be detected by the imaging equipment to figure
Speaker 3: out how dense and what kind of tissue you've got
Speaker 3: going on. This whole process makes a sound like a
Speaker 3: foghorn and a car alarm had a love child that
Speaker 3: had a lot of opinions. Now that is very very
Speaker 3: super super nutshell and not textbook. Don't at me, that's
Speaker 3: just the basic like what the hell is happening of it?
Speaker 3: In case you've ever been in the clangy to getting
Speaker 3: peeped at by magnets. Have you ever had to get
Speaker 3: a medical imaging done for yourself?
Speaker 2: Yeah, I have.
Speaker 4: I've I tore both on my ACL, so I've That's
Speaker 4: probably why I used that as an example earlier.
Speaker 2: Yeah, dude, happened dumb stuff.
Speaker 3: What kind of dumb stuff?
Speaker 4: I played like intramural basketball in college and I tore
Speaker 4: my right ACL then and then I played flag football
Speaker 4: in med school for like five minutes and tourn ACL.
Speaker 3: I thought people in college who played flag football were
Speaker 3: only in Zema commercials, like they were only in like
Speaker 3: deer commercials, you know, like of like a happy, amazing
Speaker 3: group of college people just being just having fun out
Speaker 3: on the field.
Speaker 2: Yeah.
Speaker 4: I had to hang up the cleats after that, man,
Speaker 4: So I've had but yeah, I've had those MRIs done.
Speaker 4: And yeah, the magnet's noisy, And even for someone who
Speaker 4: was I wasn't in radiology residency at the time. I
Speaker 4: was in medical school, but even someone who is medically literate,
Speaker 4: it was kind of scary and like it's weird, it's noisy,
Speaker 4: you don't know what's going on. You're in there for
Speaker 4: like forty five minutes. But it gave me some perspective
Speaker 4: on what it's like to be a patient in that
Speaker 4: magnet and maybe getting like a head you know, a
Speaker 4: brain MRI. How much scary that would be when something's
Speaker 4: around your brain?
Speaker 3: Yeah, have what kind of tools do you have to
Speaker 3: have in your pocket, like psychologically to help patients, because
Speaker 3: I mean TMI, but I had to get a brain
Speaker 3: AMRI last year and my mom has a mess so
Speaker 3: like I'm familiar with like brain imaging and it's kind
Speaker 3: of scary. But I had to go in because I
Speaker 3: thought maybe I had a brain tumor, just like a
Speaker 3: pituitary tumor. They're like, let's check it out. So I
Speaker 3: was like, Okay, well, I'm just going to go by myself.
Speaker 3: It's fine. And I got to the hospital. As soon
Speaker 3: as I checked in, I started sobbing. I totally totally unexpected.
Speaker 3: I was just like hey, what And then like the
Speaker 3: radiologist was like hugging me and like why good, like
Speaker 3: wiped mascara off my face. She's like, you can be fine.
Speaker 3: You're gonna be fine because it's just like you're you're
Speaker 3: right in the threshold of knowledge you might not be
Speaker 3: prepared to take. Yeah, definitely, Like how do you do
Speaker 3: you ever have do you ever see patients just fucking lose.
Speaker 2: It all the time?
Speaker 4: And I'm so glad to hear that a radiologist was,
Speaker 4: you know, able to comfort you before you know, getting
Speaker 4: the scan done and everything. And when we can, for
Speaker 4: people who are really anxious, we can sedate them. We
Speaker 4: can give people value and help them relax. But I
Speaker 4: think just talking to someone and explaining, you know, what's
Speaker 4: going to happen and how we're doing the how we're
Speaker 4: doing the the MRI.
Speaker 2: Is really helpful.
Speaker 4: And a lot of times people will give you headphones
Speaker 4: to listen to They may they probably didn't do that
Speaker 4: because you were getting a brain MRI, but yeah, with
Speaker 4: my knee, I remember they did. So it helps drown
Speaker 4: out the sound of the magnet. And in pediatrics sometimes
Speaker 4: they give kids these little glasses where they can watch
Speaker 4: a movie, oh, to help distract them. Yeah, so we
Speaker 4: have those kinds of tools to help, you know, patients
Speaker 4: go through these scans.
Speaker 3: If you have some shit going on that's not good,
Speaker 3: particularly with like neuroimaging. Do you ever have to have
Speaker 3: a poker face where you're like, Okay, I see you later,
Speaker 3: missus Wilson And then you're like, oh, Wow, she's screwed
Speaker 3: or do you like the Because I think that's always
Speaker 3: what's so scary when you're when you're getting diagnostics down
Speaker 3: as a patient is how long till I find out?
Speaker 3: And if it's something's wrong, will I find out now?
Speaker 3: Or will I just go about my business for two days?
Speaker 3: And you know what I mean.
Speaker 4: Like, so typically when we're reading the scans, we're in
Speaker 4: a reading room that's like dark with these huge monitors,
Speaker 4: and we're far away from the patient, so we don't
Speaker 4: always get to I mean, we usually don't get to
Speaker 4: tell the patient like, oh, I saw.
Speaker 2: This, and I can tell you immediately.
Speaker 4: We read it, and we dictate a report and it's
Speaker 4: sent to the electronic medical record and then your primary
Speaker 4: physician may tell you.
Speaker 2: But when we're in the er, we're reading.
Speaker 4: Emergent scans in the EER, if we see something emergent,
Speaker 4: we'll call the physician immediately and they'll tell the patient.
Speaker 4: But when we're in that diagnostic reading room, we don't
Speaker 4: get to communicate that to the patient.
Speaker 3: Right because there's so mighty protocol steps that I'm sure
Speaker 3: it has to go through.
Speaker 4: Yeah, and there's just so many studies, like we're just
Speaker 4: crushing studies.
Speaker 3: Oh my god, you can't pop up like a gopher
Speaker 3: and be like.
Speaker 2: Hey, whoa, yeah, exactly.
Speaker 3: Go to Disneyland tomorrow, man, serious, live it up. Do
Speaker 3: you have friends that text you pictures of the inside
Speaker 3: of their guts and be like.
Speaker 4: Hey, have a look at that whole time, really all
Speaker 4: the time, and not just like the inside of their guts,
Speaker 4: but like rashes and stuff. And I'm like, man, I'm
Speaker 4: not a dermatology just or like, you know, just my
Speaker 4: family member has this like weird you know, she's getting
Speaker 4: nauseated every time she eats chips.
Speaker 2: I'm like, I don't know, Like that's not my job.
Speaker 3: Do you ever see someone like out and about, like
Speaker 3: in line at the grocery store or like on a
Speaker 3: plane or something, and you're like, oh, I could definitely
Speaker 3: tell that they have like a certain condition that they
Speaker 3: may or may not know about.
Speaker 4: Yes, really yeah, Like you know, sometimes we'll see people
Speaker 4: that are like really like short of breath and they
Speaker 4: have like really ademitous legs.
Speaker 3: Yes, ademitis means casually kin squishy because of retained water.
Speaker 3: So next time you feel bloated, just say mine, my mi,
Speaker 3: I am an adematist Fox today. Also, that's not really
Speaker 3: a joking matter, because please take care of yourself for real.
Speaker 4: So I'm like, they probably have congestive heart failure or something,
Speaker 4: you know, just like stuff that we saw a lot
Speaker 4: of in medicine.
Speaker 3: Would you ever tell someone No, I don't think I could. Yeah,
Speaker 3: that's not really legal.
Speaker 2: Huh yeah. Someone's like it's probably crossing some line.
Speaker 3: Soone's like, I'm just here to watch the boat show,
Speaker 3: Like what are you doing?
Speaker 2: Just let me live my life.
Speaker 3: So what else does doctor Gerasami working as an interventional
Speaker 3: radiologist do?
Speaker 4: So I'm so excited about like the neuro interventional radiology
Speaker 4: that we do.
Speaker 2: It's awesome.
Speaker 4: We do a lot of spine injections like I was
Speaker 4: talking about, but we do endovascular work, which means we
Speaker 4: work in the blood vessels, which is a lot of
Speaker 4: what interventional radiology is.
Speaker 2: So I can just give you.
Speaker 4: An example of a really interesting case. We had a
Speaker 4: lady that came in about sixty something, came in with
Speaker 4: a cute left sided arm and leg weakness and like
Speaker 4: left sided facial troop. So she's probably having a stroke stroke.
Speaker 4: So she comes into the er, she gets a head
Speaker 4: CT like, that's what we would do right off.
Speaker 3: The bat, and they ordered a CT scan where they
Speaker 3: injected contrast to look at the blood vessels to see
Speaker 3: if there's a clot causing her stroke, and one of
Speaker 3: the diagnostic radiologists saw something that looked a little funky.
Speaker 4: I was on call that night, and I called my attending,
Speaker 4: the neuro interventional radiology attending, and we brought this patient
Speaker 4: into the interventional radiology suite. We went in through an
Speaker 4: incision in her groin, which is what we do for
Speaker 4: a lot of interventional procedures.
Speaker 2: So back in the.
Speaker 4: Day when you did surgery, we would open the patient
Speaker 4: totally up. But interventional radiology is going through vessels, making
Speaker 4: a small incision and using X ray guidance to know
Speaker 4: where you're going. So we go on through her right
Speaker 4: femeral artery. We're going up to her aorda, up to
Speaker 4: her internal carotids and looking at the vessels in her
Speaker 4: brain by injecting contrasts and taking real time X ray.
Speaker 4: Like I was talking about before, contrast is going into
Speaker 4: a certain location and then it's just not going past that.
Speaker 4: So I think that's the area of the thrombus. And
Speaker 4: that's what's causing her left sided weakness. Wow, the blocker's
Speaker 4: on the right side and it's causing the west side
Speaker 4: of weakness.
Speaker 3: Right.
Speaker 4: So we put another catheter up through the vessel all
Speaker 4: the way up there and it's kind of attached to
Speaker 4: a little vacuum.
Speaker 2: Whoa, and you sucked the clot out.
Speaker 4: And right after the procedure, we asked her to like
Speaker 4: move her.
Speaker 2: Left arm and leg and she could whoa. It was
Speaker 2: so cool.
Speaker 4: That was like one of those moments where I was like,
Speaker 4: this is why I'm a doctor.
Speaker 2: Oh my god, it was so.
Speaker 3: Badass's that's like the most heroic version of unclogging a
Speaker 3: drain ever, you know what I mean? Like, got it?
Speaker 2: Now?
Speaker 3: Where are you while all this is going on? Are
Speaker 3: you six feet away? Are you cross the room? Are
Speaker 3: you operating a robot? Like? How are you imaging while operating?
Speaker 4: We're right there, so you know, we're standing right by
Speaker 4: her groin where we're using that access to manipulate wires
Speaker 4: and catheters up to her brain. And there's an X
Speaker 4: ray and that's like over her head wow neck.
Speaker 3: So it does seem like surgery as well as radiology,
Speaker 3: Like how is it not in terms of the nomenclature.
Speaker 3: How is it not radiological surgery as well? You know
Speaker 3: what I mean?
Speaker 4: Yeah, I think it's not surgery because we aren't cutting
Speaker 4: the patients open and we're just making a small incision.
Speaker 2: So I mean, I like to think.
Speaker 4: Of it as image guided, minimally invasive procedures. Okay, because
Speaker 4: when this woman came out of her procedure, she just
Speaker 4: had a little band aid on her ground, like a
Speaker 4: one centimeter incision, and we were like, we were just
Speaker 4: up in your brain something clought out.
Speaker 3: That's nuts.
Speaker 4: Yeah.
Speaker 3: I just feel like if the guy that like trims
Speaker 3: your gums is an oral surgeon, like what you do
Speaker 3: is surgery, you know what I mean, Like you're up
Speaker 3: in there through the brain. Just like when you were
Speaker 3: a kid, were you ever fascinated with like X ray
Speaker 3: glasses or invisibility cloaks or anything sci fi like that.
Speaker 4: No, I don't think I was. That's so interesting. I
Speaker 4: was really into blocks and building, huh. And my mom
Speaker 4: said that they never bought me barbies because I was
Speaker 4: never interested and people would come to visit and like
Speaker 4: I got like one or two as a child growing up,
Speaker 4: and I took their heads and like legs off and
Speaker 4: she was like all right, like Jeffrey Dahmer, like no,
Speaker 4: or Barbie's for you, it may make you.
Speaker 2: Feel any better.
Speaker 3: We had Barbies and once my sister and I read
Speaker 3: about Joan of Arc and we're so inspired that we
Speaker 3: cut off our Barbie's hair and burned her at the
Speaker 3: stake in the yard. I remember my mom came out
Speaker 3: to be like Rice Ronies, what are you jo We're like,
Speaker 3: she's Barbie of Arc.
Speaker 2: But that's awesome.
Speaker 3: We took a ken head and put it on a
Speaker 3: snake's body once, put it in a crazy I don't know.
Speaker 3: The eighties were a weird time.
Speaker 2: They were a weird time.
Speaker 3: But do you feel a little bit like a detective?
Speaker 3: Like do you like puzzles and mysteries? Yes?
Speaker 4: That was like what I what really attracted me to
Speaker 4: radiology is I loved the puzzle. Every scan, every X
Speaker 4: ray is a puzzle and you just do that all.
Speaker 4: I thought it was so fun. It's also mentally exhausting,
Speaker 4: really yeah, Like I leave every day feeling like I
Speaker 4: just took like the boards or ly Sam because it's
Speaker 4: so tiring, but it's so fun.
Speaker 2: It's just never boring, and.
Speaker 3: Do you do a lot of it real time while
Speaker 3: the patient is kind of in the bay getting the scan,
Speaker 3: or do you get it and then spend two hours
Speaker 3: looking at everything slice by slice.
Speaker 2: It depends.
Speaker 4: So if it's something not urgent, like an outpatient you know,
Speaker 4: shoulder hip MRI, we may do that you know later,
Speaker 4: and may take a couple hours. For things that are emergent,
Speaker 4: like someone comes in a motorcycle crash and they get
Speaker 4: a head to toe CT, we're reading that very quickly,
Speaker 4: within minutes. So the patient will come in, they'll get
Speaker 4: scanned in the er scanner, and the trauma team will
Speaker 4: walk in as the CT is being done.
Speaker 2: Oh wow, And.
Speaker 4: So they'll expect you to go through it real time
Speaker 4: with them very quickly, And that's kind of where you
Speaker 4: grow up in radiology. I remember doing that rotation as
Speaker 4: a first year resident and I was like, oh no,
Speaker 4: I don't want to look stupid in front of the
Speaker 4: whole trauma team for real. It's and it's like time's
Speaker 4: a ticken, Yeah, exactly, times ticken, And what you say
Speaker 4: is important for their operative plan. So you know, we'll
Speaker 4: go through the skin quickly and just point out the
Speaker 4: big stuff liver lacerations, broken bones, things like that where
Speaker 4: we think bleeding may be coming from.
Speaker 3: So have you, based on your work and imaging, decided
Speaker 3: like that you're never going to ride a motorcycle.
Speaker 4: Yeah, I can never ride any motorcycle. Like this is crazy.
Speaker 4: These people come in with the worst of pelvic fractures,
Speaker 4: but we're always like, why do people keep doing this?
Speaker 2: Oh? Why?
Speaker 3: It's like I I would not sit on the top.
Speaker 2: Of a car, Yeah, why would I?
Speaker 3: Just why? It's like driving a car but without the car.
Speaker 3: I get it. It's quick, it's the fuel economies top
Speaker 3: of the line. But I just had a boyfriend that
Speaker 3: rode a motorcycle and I was like, every time it'd
Speaker 3: be like, well if you die by now, like it's
Speaker 3: so dangerous.
Speaker 2: They get and just gnarly pelvic fractures. We had one.
Speaker 4: Guy who we were doing an embolization on for his
Speaker 4: pelvic bleeding, and he also had a very like severe
Speaker 4: de gloving injury of his little thigh, which, if you
Speaker 4: don't know what degloving is, it's like kind of what
Speaker 4: it sounds like, but it's like your skin and your
Speaker 4: muscles being like, you know, just peeled off.
Speaker 3: Oh that's gonna be no for me. Yeah, So do
Speaker 3: you have a strong stomach, because if you went into
Speaker 3: if you were willing to go into surgery, like I can't.
Speaker 3: I can barely salt raw chicken without like breaking down
Speaker 3: and crying, Like how do you what kind of stomach
Speaker 3: or what kind of resolve do you have to have
Speaker 3: in order to put someone who might be hamburger meat
Speaker 3: ye on a slab?
Speaker 4: Yeah. I think a lot of us have really strong stomachs.
Speaker 4: I think a lot of surgeons do. And there's only
Speaker 4: one thing that grosses me out. And it's a sound
Speaker 4: of like spit in your mouth. So like when someone's
Speaker 4: like intubated and they make the like spit noise. I'm like,
Speaker 4: that's the old that's the only thing you could pri
Speaker 4: sugn a gallbladder, but like saliva grosses alima grows me out.
Speaker 4: Like I can deal with poop and pee and blood
Speaker 4: just like blood everywhere, and I can't handle spit.
Speaker 2: Yeah exactly, is like my bye, I did ever matter?
Speaker 4: By?
Speaker 2: Oh my god?
Speaker 3: Oh I had another question. I'm gonna have to cut
Speaker 3: this out because I can't remember. Oh yeah, so I
Speaker 3: had a boyfriend. He was telling me the story before
Speaker 3: I met him. He got into a car accident okay,
Speaker 3: rear ended and he had to go in. He was
Speaker 3: messed up, like he lost a tooth. His neck and
Speaker 3: back were all messed up, right, So he went in.
Speaker 3: He had to get an MRI. I think it was
Speaker 3: an MRI, not a catscan whatever, and he was in
Speaker 3: bad shape, but he got He found out how much
Speaker 3: it was going to cost without insurance, and he went
Speaker 3: outside and threw up. This is from the just from stress.
Speaker 3: Why I think it was like thirteen thousand dollars or something.
Speaker 3: Why is imaging so so so expensive?
Speaker 4: The machines are very expensive. They cost like millions of dollars,
Speaker 4: and the time that we use the machines is very valuable.
Speaker 2: So that's why.
Speaker 4: I mean, I don't know why, like an MRI costs
Speaker 4: like I have five thousand dollars or ten thousand dollars, like,
Speaker 4: I don't know how it gets assigned that number.
Speaker 3: I think it seems worth it just to purchase your
Speaker 3: own MRI, just in case you need it. Let's talk
Speaker 3: about ultrasound goop. Okay, the hell is that stuff?
Speaker 2: The gel?
Speaker 4: Yes, the gel helps create an interface between the ultrasound
Speaker 4: transducer and your body because air doesn't let sound travel
Speaker 4: very well through it, so we use the gel to
Speaker 4: help the sound waves like go to the body and
Speaker 4: like come back.
Speaker 2: What is the gel? I don't know what it's made
Speaker 2: out of?
Speaker 4: Them, I should look that upoud.
Speaker 3: It's made out of elf tears. You always see that
Speaker 3: in TV shows. Were like this like big yeah, this
Speaker 3: big party goop of like like on a pregnant bill.
Speaker 2: Yeah, and it's always cold.
Speaker 3: Always freezing. I've gotten an ultrasound of my thiraid before
Speaker 3: and they're like you're like, oh, goop it up. What
Speaker 3: is the goop? What is the goop? So she emailed
Speaker 3: me later to say quote, I asked like four radiologists
Speaker 3: what this was made of, and no one knew. So
Speaker 3: I felt better about myself. So then I went I
Speaker 3: did a little more digging your buddy, your pop's aw here.
Speaker 3: I found out that ultrasound gel is polyecrylamide and it's
Speaker 3: made up of glycerin and propylene glycol a bunch of stuff.
Speaker 3: But I stumbled on this one forum where someone was
Speaker 3: asking what to use if you run out of it,
Speaker 3: and folks are like chiming in that aloveragel or lotion
Speaker 3: works for their home doppler machines. And then I was like,
Speaker 3: what some people have ultrasound machines a home. I don't
Speaker 3: even have a dishwasher anyway, I guess to check in
Speaker 3: with fetuses and like get a jump on parenting. So
Speaker 3: Tom Cruise apparently was doing ultrasounds on Katie Holmes and
Speaker 3: baby Syrie Crews, and the American College of Radiology did
Speaker 3: not like it. One Yale doctor through the following shade quote,
Speaker 3: if mister Cruz and ms Holmes want their child to
Speaker 3: be a film star, they should wait until it is born.
Speaker 3: I hope that Yelle doctor also does skin grafts, because
Speaker 3: that was a sick burn.
Speaker 1: Oh.
Speaker 3: I have a question. You know those airport X ray machines.
Speaker 3: Oh yeah, they're always like, don't worry, it doesn't do
Speaker 3: anything to you. And I'm like, you're looking inside of
Speaker 3: my body to see if I'm smuggling any like drugs
Speaker 3: or weaponry. How much radiation do those airport scanning machines have?
Speaker 4: That is such a good question. Yes, I love this
Speaker 4: question about radiation dose. So the back ground radiation that
Speaker 4: you're exposed to just by living and doing your daily
Speaker 4: activities is about three milli siverts. And a severt is
Speaker 4: like an SI unit that we use to say, like
Speaker 4: if one sivert is like equal to a five point
Speaker 4: five percent chance of getting cancer.
Speaker 2: Okay, so now we're.
Speaker 4: Talking about milli sivertsh So three milli siverts is just
Speaker 4: your background exposure to radiation, just like walking around doing
Speaker 4: what you do.
Speaker 3: Quick aside, what exactly is radiation and where does it
Speaker 3: come from? So it's defined as the emission of energy
Speaker 3: as electromagnetic waves or as high energy particles that cause ionization.
Speaker 3: What is ionization? I looked this up and I'm reading
Speaker 3: it verbatim. It's when an atom or a molecule acquires
Speaker 3: a negative or positive charge by gaining or losing electrons
Speaker 3: to form ions. So do what you will with that information.
Speaker 3: It's none of my business. So there's background radiation we
Speaker 3: experience every day, just from space and the sun and
Speaker 3: uranium in the soil, et cetera. But in the case
Speaker 3: of airport scanners, it's said that they're about zero point
Speaker 3: zero two micro siverts per scan. That's what they thought.
Speaker 3: But then it turns out the technicians we're just measuring
Speaker 3: them wrong. Oh the good news is it might only
Speaker 3: be a tenth of what they thought it was. They
Speaker 3: took ten measurements and a lot of them forgot to
Speaker 3: divide by ten. Okay, guys. But I also went and
Speaker 3: looked at scans to see what the people at the
Speaker 3: airport are looking at. And they can totally see your
Speaker 3: junk and boops and stuff, see all of it. Anyway,
Speaker 3: speaking of poops.
Speaker 4: And something like a mammogram would be like zero point
Speaker 4: four milli siverts, So like the equivalent to like six
Speaker 4: or seven weeks of just daily radiation, which is nothing.
Speaker 4: I know, Like people always worry about getting exposed to
Speaker 4: radiation when they get a chest X ray or a
Speaker 4: CT scan, But when you think about what you're exposed
Speaker 4: to daily, it's not that much. And we're talking about
Speaker 4: milli siverts and one severt would be a five point
Speaker 4: five percent chance of getting canccer what if I.
Speaker 3: Travel a bunch, Yeah, and I'm going through those things
Speaker 3: all the time and on airplanes all the time.
Speaker 4: Yeah, So I like across country flight and an airplane
Speaker 4: is like point oh three milli siverts or something like that.
Speaker 2: That's like the background radiation that you would get.
Speaker 4: So all this radiation, I mean you have to get
Speaker 4: exposed to a certain amount of radiation before you would
Speaker 4: you know, maybe get something.
Speaker 3: Start to cook your own body.
Speaker 2: Right.
Speaker 3: What happens when you're exposed to radiation? Like what's the
Speaker 3: risk here? Is it changing your gene expression? What's going on?
Speaker 4: So radio ionizing radiation or like UV radiation, what causes
Speaker 4: breaks in the DNA? And your body has ways, your
Speaker 4: cells have ways of repairing that DNA, but sometimes it doesn't.
Speaker 2: The DNA just gets wonky and it's on it's.
Speaker 4: Replicated in this like wonky state, and that's how you
Speaker 4: get cancer.
Speaker 2: So that's how radiation would cause cancer.
Speaker 4: Okay, but you'd have to get, you know, exposed to
Speaker 4: a significant amount for that to happen.
Speaker 3: Okay, good to know. That puts me at ease a
Speaker 3: little bit.
Speaker 2: Good.
Speaker 3: And the other thing is about the airport scans is
Speaker 3: you can always opt out and then you get like
Speaker 3: a free Yeah, you get the full you get the massage.
Speaker 2: Yeah.
Speaker 3: Someone And if you've been traveling and you're a little
Speaker 3: lonely and then someone just comes and caresses your back
Speaker 3: looking at her weapons.
Speaker 2: I didn't refuse a scanner.
Speaker 4: They just were like, you're getting the pack down and
Speaker 4: I was like, all right, whatever.
Speaker 3: I saw a guy get a pat down the other
Speaker 3: day and he just willingly dropped his pants and they
Speaker 3: were like, sir, sir, you can keep them on. And
Speaker 3: he was like he was so like indignant that he
Speaker 3: was getting patted down. He was like, have a look,
Speaker 3: look at everything, and they're like, sir, please.
Speaker 4: I like how they do the back of the hand
Speaker 4: like it's less invasive when they're like rubbing your vagina.
Speaker 2: We're like, okay.
Speaker 3: They're like, I can sense less, but just enough.
Speaker 2: I feel slightly less violated.
Speaker 3: I guess if you listen to the gynocology episode right now,
Speaker 3: you're thinking about vulva taxonomy, and I'm proud of you
Speaker 3: for that. Kiddo, on a first or second date, I
Speaker 3: only let someone touch me with the back of their hands,
Speaker 3: giving me.
Speaker 2: That front hand.
Speaker 3: No front hands till marriage. Okay, I have questions from listeners. Okay,
Speaker 3: are you ready for a rapid fire? Oh my goodness,
Speaker 3: you can take as long as you want to answer these.
Speaker 3: I call it rapid fire.
Speaker 2: Man.
Speaker 3: I never hold anyone a good but before we take
Speaker 3: questions from you, our beloved listeners. We're going to take
Speaker 3: a quick break for sponsors of the show. Sponsors. Why sponsors,
Speaker 3: You know what they do? They help us give money
Speaker 3: to different charities every week. So if you want to
Speaker 3: know where Ologies gives our money, you can go to
Speaker 3: Aliward dot com and look for the tab Ologies gives back.
Speaker 3: There's like one hundred and fifty different charities that we've
Speaker 3: given to already, with more every single week. So if
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Speaker 3: of money but you're not sure where to go. Those
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Speaker 3: this ad break allows us to give a ton of
Speaker 3: money to that. So thanks for listening and thank sponsors. Okay,
Speaker 3: your questions. Gary Jungling wants to know, are radiologists always
Speaker 3: afraid of becoming sterile or getting cancer? That is like
Speaker 3: right to that is?
Speaker 2: That's a good question.
Speaker 3: Good question.
Speaker 4: So being exposed to radiation is a occupational risk, especially
Speaker 4: in a field like interventional radiology, where you are exposed
Speaker 4: to more radiation than a diagnostic radiologist.
Speaker 3: Why is that?
Speaker 2: Because you're using.
Speaker 4: Real time X ray like I was saying, and so
Speaker 4: you're standing next to the machine that's producing the X rays.
Speaker 2: Okay, so we wear lead suits.
Speaker 4: Oh so we wear like a lead thyroid collar, whoa
Speaker 4: a lead vest, and like a lead skirt and that
Speaker 4: helps reduce some of the radiation.
Speaker 2: We wear leaded glasses.
Speaker 3: Wow, so we all let it up. What about lead poisoning?
Speaker 3: I wasn't sure if I was just being paranoid, So
Speaker 3: I looked into it and last year the American College
Speaker 3: of Radiology published a paper that minced no words. This
Speaker 3: was the title quote, lead aprons are a lead exposure hazard. Dang. Okay.
Speaker 3: So they collected one hundred and seventy two lead garments
Speaker 3: worn by radiologists, and they took down the age and
Speaker 3: the appearance of the aprons, not the radiologists anyway. Sixty
Speaker 3: three percent had detectable lead dust on the surface, and
Speaker 3: the shittier the apron looked, the more lead dust was
Speaker 3: typically found. Now, interestingly, garments kept on hangers had fewer
Speaker 3: positive lead tests, So maybe you need new lead garments.
Speaker 3: I found a site that has a whole catalog and
Speaker 3: it was very fetching. Different patterns, different colors, skirts, thyroid collars,
Speaker 3: and even things called gonad shields which resemble large eye patches.
Speaker 3: So keep your radiation garments looking fresh and unhazardous. You
Speaker 3: can replace old ones or hang them up in a
Speaker 3: fashion that would make even Mommy dearest proud. I buy
Speaker 3: you beautiful drusses. You shrieked them like a shrug. But
Speaker 3: no matter how you hang them, those lead blankets they're
Speaker 3: hecking comfy right Whenever they put the lead blanket on
Speaker 3: me at the dentist and like this rules never take
Speaker 3: this off.
Speaker 2: Oh it's so like heavy, I know.
Speaker 3: Ever, like they sell those anxiety blankets when you're like,
Speaker 3: oh yeah, I could just go to the dentist and
Speaker 3: hang out there all day.
Speaker 4: I find the lead very comforting too, because it's just
Speaker 4: like you know, isn't It's just fitted to you. But
Speaker 4: when you're in these procedures for really long and you're
Speaker 4: wearing a sterile gown, mask and gloves and everything over it,
Speaker 4: you can sweat.
Speaker 3: A lot, so you might get stinky, but nut sterile. Yeah,
Speaker 3: So do radiologists worry about that or do you feel
Speaker 3: pretty well protected?
Speaker 2: I feel pretty well protected.
Speaker 4: But we wear radiation badges that measure how much radiation
Speaker 4: we're exposed to, so you'll get a warning if you've
Speaker 4: you know, been exposed to too much radiation, and we
Speaker 4: can reduce used to amount of radiation we're exposed to,
Speaker 4: not just by wearing the lead by, but by also
Speaker 4: imaging smaller parts of the body, so you take a.
Speaker 3: Lot of percussions.
Speaker 2: We do.
Speaker 3: Okay, good Megan. See great question, Meghan. Weirdest thing they
Speaker 3: have seen inside someone?
Speaker 2: Man, this is such a good question. We actually.
Speaker 4: People like to talk about the things that patients put
Speaker 4: in their butts. I think the weirdest thing I've not
Speaker 4: seen anything super weird. Someone had a rolled one of
Speaker 4: those like old school rolling deodorant things.
Speaker 3: A roll on, Yeah, like a wet like a band
Speaker 3: roll on.
Speaker 2: Yeah for butt stuff.
Speaker 3: Now, whoa, that's a butt stuff?
Speaker 4: Yeah, but I mean people, I heard about someone who
Speaker 4: put a beer bottle in there, like a corona.
Speaker 3: Man, you can Amazon Prime anything you need these days
Speaker 3: pretty anonymously. So after this interview, the doc and I
Speaker 3: exchanged a series of text messages from radiology textbooks, and
Speaker 3: I honestly I don't know where to start. I will
Speaker 3: say PSA, if you would like to experiment with pleasures
Speaker 3: involving forbidden orifices, to hit up Amazon Prime free shipping,
Speaker 3: get yourself something rubber. I was treated to photographs that
Speaker 3: looked like a gauzy human body was being haunted by
Speaker 3: the ghosts of a beer bottle, or, as one text
Speaker 3: message from another radiologist said, quote, beer bottles are child's play.
Speaker 3: This is a nineteen seventy nine left Bank Bordeaux, which
Speaker 3: is a wine bottle.
Speaker 2: You know what I mean.
Speaker 3: So the most common improvised rectal foreign body, as medicine
Speaker 3: politely demurrors seem to be containers that once held alcohol.
Speaker 3: What are the chances gatorade bottles? Two leaders of mister Pibb.
Speaker 3: They just don't seem to incite insertion experiments quite in
Speaker 3: the same fashion. But still One X ray image entry
Speaker 3: on a radiology site, and yes, I googled some one
Speaker 3: was called Radiopedia reported that aerosol cans are a relatively
Speaker 3: common improvised rectal foreign body and in this one just
Speaker 3: stunning illustration of X ray versus CT scan imagery. Oh
Speaker 3: my god, I was sent a photo from one super
Speaker 3: famous case that involved a synthetic human fist. This is
Speaker 3: a forearm up to the elbow that has just simply
Speaker 3: gotten away from someone just slipped up out of reach there,
Speaker 3: and in the X ray it's blurry and faint. It
Speaker 3: takes a minute to see it and get your bearings,
Speaker 3: kind of like a faded superimposition. But by comparison on
Speaker 3: the CT scan it's like watching a three D imax
Speaker 3: documentary about fisting. I will put it on the Patreon
Speaker 3: page for the truly curious. But no matter what, the
Speaker 3: lesson here is just don't opt for items that shatter. Okay,
Speaker 3: Corona long next are like, don't look at me, man,
Speaker 3: I know right, that's not what I'm here for.
Speaker 2: Exactly.
Speaker 3: I have to deliver beer to your mouth. Have you
Speaker 3: ever seen anyone swallow anything weird like car keys.
Speaker 4: Or Yeah, we did extrays on a patient that swallowed
Speaker 4: razor blade.
Speaker 2: She's swallowed like parts of a spoon.
Speaker 3: So first intervention is getting those things out.
Speaker 4: Right, Yeah, especially like something like a razor that's gonna,
Speaker 4: you know, be getting things on its way down.
Speaker 3: Do you have to go in and do like laparoscopic surgery?
Speaker 3: Where does that go? How do you escalate that case?
Speaker 5: So?
Speaker 4: I mean for us, we would read the x ray
Speaker 4: and we'd be able to tell the surgeons where it was,
Speaker 4: or maybe the GI physician who would go down and
Speaker 4: scope it and try to fish it out.
Speaker 3: That seems what do you do put a magnet on
Speaker 3: a string?
Speaker 2: I don't know.
Speaker 3: Yeah, so don't swallow the stuff, guys nice says, really
Speaker 3: dumb question. Why do certain types of ultrasounds feel so uncomfortable,
Speaker 3: particularly abdominal and pelvic ones.
Speaker 4: Because sometimes we have to push down really hard to
Speaker 4: get a better picture, So you might feel a lot
Speaker 4: of pressure when someone's pushing on your stomach or like
Speaker 4: on your kidneys.
Speaker 3: And the other thing is if you're ultrasounding something, chances
Speaker 3: are there's something funky going on down there.
Speaker 4: Yeah, there's something that brought you there. Also, like ultrasounding
Speaker 4: your bladder is like uncomfortable because it makes you feel
Speaker 4: like you have to peekes true, so.
Speaker 3: Does anyone ever peed on a table?
Speaker 4: Not with me, but I wouldn't be surprised. We also
Speaker 4: asked when we do pelvic ultrasounds, we ask patients to.
Speaker 2: Have a full bladder, and we may give them.
Speaker 4: Fluids or have them drink a lot of water because
Speaker 4: like it was, like we're talking about air is not
Speaker 4: a really good medium for like allowing sound waves to pass,
Speaker 4: so fluid in the bladder like gives us a good window.
Speaker 4: So that's like another trick or whatever. But it's really
Speaker 4: uncomfortable when we're looking at your uterus and we're pressing
Speaker 4: on this full bladder.
Speaker 2: I've had a lot of patients who are like, I
Speaker 2: really need to be a need to be you need
Speaker 2: to be any like just a lot. Please.
Speaker 3: You're like, that's the point. It's working out just as
Speaker 3: I wanted to. Yeah. Jennifer Buzz asks do you ever
Speaker 3: harness the radiation in your workplace for your own purposes?
Speaker 3: For example, leaving your pet tarantula next to it and
Speaker 3: then coaxing it to bite you, making rocks glow, et cetera. Also,
Speaker 3: do you ever wear the lead shield just for fun
Speaker 3: or for exercise?
Speaker 4: Man, I should wear that lead shield for exercise, like
Speaker 4: go on like a little run with it.
Speaker 3: Up and down the stairs in the hospital.
Speaker 2: Yeah, that would be nice. No, I've never done that,
Speaker 2: And I mean, I don't think we.
Speaker 4: Use enough radiation to do anything like really exciting.
Speaker 3: To become a superhero or anything. No, I guess the
Speaker 3: kind of illegal probably rumph. Well, Jennifer Buzz, if she
Speaker 3: does do that, then she shouldn't get the idea from you.
Speaker 3: Bob wants to know what kind of fun cool things
Speaker 3: have you scanned after hours?
Speaker 2: Ooh, I don't do that. We're not like allowed to.
Speaker 3: Would they know? Would they be like, wait a second,
Speaker 3: this MRI has been used twelve times today, not eleven.
Speaker 4: Oh yeah, they would definitely know. To do that, we'd
Speaker 4: have to like, you know, put it under a patient.
Speaker 4: That would be medical frauds.
Speaker 3: Yeah, it's not like using the microwave.
Speaker 4: Yeah, so I haven't done that. Sorry, that's not interesting.
Speaker 3: You've also never been to jail, and that is true.
Speaker 3: Jack Keller wants to know why are we still using
Speaker 3: such old technology? Isn't there something more modern that's less dangerous?
Speaker 3: That is a little bit of shade thrown an X rays.
Speaker 3: I know it is debating here.
Speaker 2: Yeah, I like it.
Speaker 4: I mean they've been around forever, that's true. X rays
Speaker 4: have but I'm I mean they're still good. Yeah, you know,
Speaker 4: it's a little bit of radiation. Just getting a chest
Speaker 4: X ray gives us a lot of information about a
Speaker 4: patient and we can use that as like a screening
Speaker 4: tool to get more advanced imaging like a CT or
Speaker 4: an MRI, or decide if the patient needs a procedure,
Speaker 4: so this Yeah, these things have been around forever, but
Speaker 4: they work and they're safe.
Speaker 3: What do you think about the history of X rays?
Speaker 3: Where didn't Edison try one on like an intern and
Speaker 3: ended up killing him? Like he tried it like a
Speaker 3: million times? Have you heard that story?
Speaker 4: No?
Speaker 2: I haven't. My probably should have.
Speaker 4: But I know about like Renan who like invented the
Speaker 4: X ray in like the first X rays of his
Speaker 4: wife's hand.
Speaker 2: And you can see a ring.
Speaker 3: Oh yeah, that's cute. Was it cute?
Speaker 2: Well?
Speaker 3: William Rocken, the German Man whose name I probably just
Speaker 3: mispronounced in eighteen ninety five discovered and named X rays
Speaker 3: after X because it was an unknown ray for radiation,
Speaker 3: made the first medical X rays of his wife's hand
Speaker 3: and it looks kind of like a fuzzy X ray.
Speaker 3: You can see she's wearing a ring in it, and
Speaker 3: upon seeing it, she said, I have seen my death.
Speaker 3: But I don't know. Germans are so goth. Now, as
Speaker 3: for edison history with radiology, Clarence Madison Dally was an
Speaker 3: employee of Thomas Edison, and after many, many, many many
Speaker 3: experiments with X rays, he developed carcinoma on his hands
Speaker 3: and then arms despite amputations, died. Thomas Edison was quoted
Speaker 3: in nineteen oh five as saying, quote, don't talk to
Speaker 3: me about X rays. I'm afraid of them. So he
Speaker 3: was like, I don't fuck with X rays. Of course,
Speaker 3: this was early on, while we were still like writing
Speaker 3: donkeys to work and indoor plumbing wasn't really a thing,
Speaker 3: and we didn't know a bunch of stuff anyway. Moving on,
Speaker 3: April wants to know, is being big boned really a thing?
Speaker 4: Oh hmm, yeah, I guess some people have like bigger
Speaker 4: or more dense bones.
Speaker 2: I mean, you could find this out if you've got.
Speaker 4: A DEXA or a bone scan. But whereas like you're
Speaker 4: just big boned, you're not fat. I don't know about that.
Speaker 4: Like this subcutaneous tissue doesn't lie, Like if there's a
Speaker 4: lot of tissue there, then it's not your bones.
Speaker 3: I guess could you say I'm just ample with subcutaneous tissue?
Speaker 2: Yes, I have an abundance of subcutaneous.
Speaker 3: Tish, And that's why my bathing suit doesn't fit. You're welcome,
Speaker 3: which I'm in that. I mean both of us.
Speaker 4: Why my pants split this week, That's why my pants
Speaker 4: split this hashtag diet stars on Monday, both of us.
Speaker 3: I feel like we're speaking from a place of ripped pants,
Speaker 3: so we are not throwing shade.
Speaker 2: I get it.
Speaker 3: For the sake of transparency, I'm just going to come
Speaker 3: out with it. The week that we recorded this, both
Speaker 3: myself and doctor Garret saw me separately totally randomly had
Speaker 3: wardrobe malfunctions involving uh trouser ripping, So she as she
Speaker 3: got into an uber and nice slacks, and myself as
Speaker 3: I foolishly tried on jeans that I had not worn
Speaker 3: in some time, trousers zero points sabcutaneous tissue in the
Speaker 3: lead with two points. Greg wants to know where are
Speaker 3: we with three D printing and AI integration as tools
Speaker 3: for radiology today, Like how much improvement in medical imaging
Speaker 3: technology are can we expect within the next couple of years.
Speaker 4: Oh, I'm so glad he asked this because we were
Speaker 4: talking about AI artificial intelligence at this conference. So we
Speaker 4: use some computer aided detection or some form of artificial
Speaker 4: intelligence now, like especially in mammography, we use something called
Speaker 4: CAD or computer aided detection to help us find lesions
Speaker 4: in breasts like masses that we may not see just
Speaker 4: like little tiny things. And that's just a tool that
Speaker 4: the radiologist has to make sure they're being very thorough
Speaker 4: and looking at everything. And we've that's probably what we
Speaker 4: started with and now we're expanding that to looking at
Speaker 4: things in chest X rays and cts. But what this
Speaker 4: talk that I went to today was from these radiologists
Speaker 4: in Stanford we're talking about, was that they won't replace
Speaker 4: radiologists necessarily. We still you know, it may notice that
Speaker 4: some things wrong, but you have to use the context,
Speaker 4: like you have to know the medicine and understand what
Speaker 4: that the meaning of that finding is. So these are
Speaker 4: all just tools, but they are definitely changing the way
Speaker 4: that we read scans.
Speaker 3: Is it kind of like you can be a writer
Speaker 3: and and spell check helps, but that doesn't make you
Speaker 3: a writer. It's a tool, but not you can't rely on.
Speaker 2: Yeah, something like that.
Speaker 4: And I think those algorithms for recognizing, you know, findings
Speaker 4: and imaging are just getting better and better.
Speaker 3: Do you have to consent to have your images put
Speaker 3: in that database?
Speaker 2: I think so, I think they must. Yeah.
Speaker 3: I think that's nice though. Yeah, I mean, you know,
Speaker 3: if it can help someone else attribution, yeah, you know,
Speaker 3: put your put your guts in the library, and the
Speaker 3: gut the gut berry. Carolyn Steele wants to know. I
Speaker 3: had a hip arthrogram last year and found out afterwards
Speaker 3: about Chuck Norris's wife and the gadolinium toxicity thing. Is
Speaker 3: this madness or should I be concerned? I want you
Speaker 3: to know by the way ILI word don't know what
Speaker 3: most of those words meant.
Speaker 2: Yeah, that's fine.
Speaker 3: Gadolinium toxicity and a hip arthrogram. I do know what
Speaker 3: Chuck Norris is, but address that.
Speaker 4: So gatolinium is the type of contrast that we use
Speaker 4: in MRIs. So we didn't talk about this earlier when
Speaker 4: we talked about imaging, but we use contrast to help
Speaker 4: opacify or make the blood vessels more dense, or the
Speaker 4: tissues that are being fed by blood vessels may look
Speaker 4: brighter on a scan. There are people that you know
Speaker 4: may not respond well to gattolinium. It's processed by your
Speaker 4: kidneys and eliminated by the body through your kidneys, So
Speaker 4: if you have kidneys that aren't.
Speaker 2: Functioning well, that puts you at a greater risk.
Speaker 4: And some people can get toxicity from gattolinium even though
Speaker 4: they didn't have problems with their kidney. So this is
Speaker 4: just a you know, like a very rare risk.
Speaker 3: Chuck Norris and his wife Gina are suing. Get this.
Speaker 3: I just looked it up for ten million dollars. Also,
Speaker 3: then I went down a rabbit hole about Chuck Norris
Speaker 3: trivia Brazilian jiu jitsu black belts which he has, tooth veneers,
Speaker 3: which he also has mustache memes. But then I hit
Speaker 3: some stuff about political affiliations and a stopp being fun. Anyway,
Speaker 3: as long as we're on a downbeat. This episode was
Speaker 3: recorded a few weeks ago, and this next question comes
Speaker 3: from a patron and an ologite and an Internet friend
Speaker 3: of many years who I just found out passed away
Speaker 3: suddenly today. So I'm so sad to hear it. I
Speaker 3: know he loved when I read his name and his questions.
Speaker 3: He loved the show. He was an awesome friend to
Speaker 3: the pod, So please raise a glass and send some
Speaker 3: good cosmic vibes to his wife. Chris Brian Edge wants
Speaker 3: to know are people too worried about the side effects
Speaker 3: from imaging.
Speaker 2: No, they're not too worried.
Speaker 4: I think that people just don't know, and I didn't
Speaker 4: really understand you know, I couldn't really quantify what was,
Speaker 4: you know, how much radiation I was being exposed to
Speaker 4: from an X ray versus how much I was being
Speaker 4: exposed to just by living my life. So I think
Speaker 4: that's a really valid question. And I like when patients
Speaker 4: ask that and we can explain it to them, and
Speaker 4: I feel like we can dispel some of the like
Speaker 4: fear and myths behind getting you know, imaging done.
Speaker 3: So okay, So it's a valid questions, a valid question.
Speaker 3: Hillary Maser wants to know, how do you radiologist learn
Speaker 3: to read images that just look like fuzzy blobs to
Speaker 3: the uninitiated.
Speaker 2: Man, it's really hard.
Speaker 3: Yeah, So you're like, that's why my doctor.
Speaker 4: Now, I mean, you know, uh, you kind of have
Speaker 4: some idea in medical school because you get exposed to
Speaker 4: some imaging. You look at a little bit of ultrasound
Speaker 4: and CT and MRI through medical school, so you have
Speaker 4: some framework and you know where the organs are relative
Speaker 4: to each other. So you have a little bit of
Speaker 4: an approach. So people tend to develop a search pattern.
Speaker 4: Maybe they start looking at the lungs and then the
Speaker 4: heart and then the bones or whatever on a CT scan.
Speaker 4: So we you know, try to approach things methodically and
Speaker 4: systematically and you know, ask for help, look at resources,
Speaker 4: but it takes a long time. There's a lot of anatomy.
Speaker 4: We're doing all the anatomy in the entire body and
Speaker 4: in weird like three dimensional like rotated ways, So it's complicated.
Speaker 3: I imagine it must be like if you don't know
Speaker 3: a language, well, it would be really hard to discern
Speaker 3: regional dialects. But if you have spoken it for years,
Speaker 3: you would be able to say, like, oh, are you
Speaker 3: from Philadelphia or you know what I mean? Yeah, little things,
Speaker 3: the more familiar wire or something, it must get easier
Speaker 3: to pick out abnormalities.
Speaker 4: I'm so glad you use that analogy as language, because
Speaker 4: this is what I felt like it was when I
Speaker 4: was a first sure radiology resn't. I was like, I
Speaker 4: don't know the language. I don't know what you guys
Speaker 4: are talking about, like million sieverts, what's that?
Speaker 3: Yeah?
Speaker 4: And the physics of radiology is very complicated. So I
Speaker 4: feel like now I speak the language and I can
Speaker 4: understand what people are talking about.
Speaker 3: Paulo Hanley wants to know, you know, if you're behind
Speaker 3: the scenes when a patient is getting a scan, do
Speaker 3: you have any stories of like good news where you
Speaker 3: where you saw something where you're like whoosh, all clear?
Speaker 3: Like are there any of those like feel good moments?
Speaker 4: All the time we get, you know, scans for people
Speaker 4: where they're you know, have like vague abdominal pain.
Speaker 2: You're like, oh no, like what's this gonna be? Be anything?
Speaker 2: And we're just happy when it's like not something terrible.
Speaker 3: I would just like to take a moment to impart
Speaker 3: a family story. So my older sister Janelle used to
Speaker 3: get migraines and one day I went to visit her
Speaker 3: in Detroit and I asked her how her head was feeling.
Speaker 3: She got really serious and she told me she's glad.
Speaker 3: I asked she's been to the doctor and they discovered
Speaker 3: a growth, and she waited until I had tears on
Speaker 3: my actual face. Also, it was my birthday, to clarify
Speaker 3: that this was her way of announcing that I'd be
Speaker 3: getting a niece or nephew. The growth was a baby,
Speaker 3: her head was fine. She just is a rascal, and
Speaker 3: I'm still shaken. It was a great prank and a
Speaker 3: great joke, but it was my birthday crying. But my
Speaker 3: nephew is super cool, So all is forgiven. Now what
Speaker 3: if you were growing shards of a skeleton that's not
Speaker 3: a baby.
Speaker 4: It is exciting when you see something unique that's like
Speaker 4: a learning opportunity, but usually something that's like fun and
Speaker 4: interesting for a radiologist is probably not good for the patient.
Speaker 4: So we try to like, you know, understand that or
Speaker 4: like remind ourselves of that.
Speaker 3: You're like, you have a terotoma? Yeah, and they're like,
Speaker 3: fuck you exactly have you ever seen a tarotoma?
Speaker 2: Yes? I have. They're so cool. They have like teeth
Speaker 2: and hair inside of them. They're awesome.
Speaker 3: What do they look like? I mean, I've seen pictures.
Speaker 3: If you really want to say cut down on your snacking, well,
Speaker 3: all you have to do is google images are to tarotomas,
Speaker 3: and you will not the sound.
Speaker 2: Of someone's secretions.
Speaker 3: But like, what was the first time you saw a terotoma? Like,
Speaker 3: just to get you up. A tarotoma is a random
Speaker 3: ball of bones or teeth or hair or tissue. It's
Speaker 3: like a ball of hair that just grows inside some
Speaker 3: people for decades for no reason. They aren't even tax deductions,
Speaker 3: and no one gives you their seat on the bus.
Speaker 3: If you're growing one so.
Speaker 4: It was like an ultrasound of it was a pelvic ultrasound.
Speaker 3: Oh, so it was like on the ovary. Yeah, it
Speaker 3: was what are those called a den some kind of dermoid. Dermoid.
Speaker 4: Yeah, so we saw a little bit of calcium and
Speaker 4: we saw this kind of like wavy pattern that was
Speaker 4: like the keratin or hair, and we're like, ooh, we
Speaker 4: give the MRI I have this, oh god, And then
Speaker 4: yeah we could.
Speaker 2: Yeah, it was pretty neat.
Speaker 3: Do those people get to keep the tarotomas if they want?
Speaker 2: No, Oh you mean when they're removed.
Speaker 4: Yeah, no, they we send them to pathology because the
Speaker 4: pathologists have to slide the tissue and make sure there's
Speaker 4: like no underlying kids or anything. So you never get
Speaker 4: to I know, people ask to keep weird things. They
Speaker 4: ask to keep everything.
Speaker 3: I mean, if I grew teeth in my butt, I'd
Speaker 3: be like, I work seventeen years on that. I got
Speaker 3: an extra se seriously, like so gross. They come from
Speaker 3: the word for a monster, Oh they do, yeah, terotoma.
Speaker 2: It does sound really terrible.
Speaker 3: Yeah, it comes from well, if you're like I grew
Speaker 3: a monster in my body anyway, awesome. Mike Milsheer wants
Speaker 3: to know, is it true that X rays are actually
Speaker 3: visible to the naked eye?
Speaker 4: Uh?
Speaker 3: No, okay good. Jennifer Overbe wants to know. Our dental
Speaker 3: X rays worse because radiation is shooting directly to your head.
Speaker 3: My mom told me this at some point. Now, every
Speaker 3: time I go to the dentist, I'm sure that it's
Speaker 3: taking off.
Speaker 2: No, there are really low dose.
Speaker 3: Krista Avanpato wants to know. I know there are so
Speaker 3: many mixed opinions about mammograms and ultrasounds for a woman.
Speaker 3: What's the right age to start them? And if someone
Speaker 3: has a risk factor like family history, should they start
Speaker 3: them earlier? So are there any new innovations in the
Speaker 3: works that might replace mammograms? And Christa, I'm gonna guess
Speaker 3: that you had an uncomfortable mamogram. Yeah, I've never had
Speaker 3: one myself. Have you ever had a mammogram?
Speaker 2: I haven't.
Speaker 3: No, they just squish your squish your boob.
Speaker 4: I mean I've seen them. They look really uncomfortable.
Speaker 2: Yeah.
Speaker 4: So we typically start them at age forty unless they've had,
Speaker 4: you know, some risk factor. If they have like firstigree
Speaker 4: relatives that have breast cancer, we may start them ten
Speaker 4: years before okay, But people with like women who are
Speaker 4: thirty five or younger and have very dense breasts may not.
Speaker 4: They usually don't get mammograms, they'll get breast ultrasounds because
Speaker 4: your breast issue is so dense.
Speaker 3: Do you think they're gonna have different modalities for imaging
Speaker 3: that doesn't involve like making a fruit roll up out
Speaker 3: of your boob. It does feel it does. I don't
Speaker 3: feel like they squish it into like fruit leather.
Speaker 4: The reason that they do that is so they can
Speaker 4: spread out all the tissue and it's like less so
Speaker 4: it helps us.
Speaker 2: Like scan through it and see things better.
Speaker 3: Doctor Gurusami says that in higher risk patients, like those
Speaker 3: who might have the BRCA G mutation, a contrast enhanced
Speaker 3: breast MRI can detect breast cancer. Has a sensitivity of
Speaker 3: up to ninety percent with the MRI versus thirty eight
Speaker 3: percent for mimography or ultrasounds. So versus thirty eight percent,
Speaker 3: pretty good way to go. Contrast enhance it breast MRI.
Speaker 3: Tuck those stats in your breast pocket like a kerchief.
Speaker 3: In all of this, though, with any of the discomforts,
Speaker 3: you're like, it's better to be uncomfortable for fifteen minutes
Speaker 3: than to be not alive.
Speaker 2: Yeah, that's I use that kind of message a lot.
Speaker 3: This shit I've been through for one to two months
Speaker 3: of having a hair free face. You know what I mean,
Speaker 3: what's one thing about your job this sucks or about
Speaker 3: radiology that frustrates you?
Speaker 2: Let me think. I mean it's tiring.
Speaker 4: Like, so we sit a lot when I'm not doing
Speaker 4: interventional radiology stuff. When I'm not doing procedures and I'm
Speaker 4: doing the diagnostic part, I'm sitting a lot and I'm
Speaker 4: just like sitting for like fourteen hours and it's so busy,
Speaker 4: And I think sometimes people think there's a misconception that
Speaker 4: we just sit in that room all day and we
Speaker 4: don't talk to patients or we don't do procedures, and
Speaker 4: that's not true. But I think because we're like sitting
Speaker 4: in the room is like dark and we like can
Speaker 4: listen to music that we're not working hard, but it's hard.
Speaker 3: What kind of jams do you pump?
Speaker 4: Oh, all kinds of jams, Like on nights we were
Speaker 4: like old school bone thugs.
Speaker 5: Really while you're diagnosing like all sorts of crazy stuff. Yeah,
Speaker 5: that's fantastic, actually, bone thugs is like kind of appropriate considering.
Speaker 2: That it's not kind of quiet. Oh yeah, bone.
Speaker 3: Bugs, Like you're looking at bones.
Speaker 2: This is true. Never thought about that.
Speaker 3: It's a little fun fact. Until radiology was developed, scientists
Speaker 3: had no idea that the busy bone was connected to
Speaker 3: the wishbone, and the wishbone was connected to the lazy bone,
Speaker 3: the lazy bone was connected to the crazy bone. The
Speaker 3: crazy bone was connected to the flesh and bone. So
Speaker 3: this societ is only going to matter to you if
Speaker 3: you're familiar with the bone thugs and harmony roster. What
Speaker 3: is your favorite thing about what you do or the
Speaker 3: most rewarding aspect or something that's just super really piques
Speaker 3: your curiosity.
Speaker 4: I love that radiology is like so technological and so
Speaker 4: it's always changing, like with the artificial intelligence and with
Speaker 4: interventional radiology, we're always coming up with new techniques to
Speaker 4: like get in the brain or get to where we're going.
Speaker 4: And I just love that it's always changing. And I
Speaker 4: like the puzzle of reading the scan and I love
Speaker 4: working with my hands.
Speaker 2: It's just for me, it's it hits everything.
Speaker 3: So after the interview, doctor Karasami A. Rishanna emailed me
Speaker 3: some links. And at the very end, she said quote,
Speaker 3: we talked about my least favorite part of my job,
Speaker 3: which was when people thinking I was just relaxing listening
Speaker 3: to bone thugs rather than mainlining CTS, MRIs, et cetera.
Speaker 3: But I think what goes hand in hand with that
Speaker 3: is that radiologists really have an image problem. She goes
Speaker 3: on to say, I realize the irony in saying this,
Speaker 3: given we are imagers. Reading someone's scan allows you to
Speaker 3: see them in a way they may never be able
Speaker 3: to see themselves. It's weird and beautiful and so damn
Speaker 3: interesting to see your inerts the way we do. Have
Speaker 3: you ever gotten anything back from patients where they were
Speaker 3: really kind of surprisingly grateful for what you do? Does
Speaker 3: anyone ever bring you donuts or anything?
Speaker 4: No, but one of my co residents got a bunch
Speaker 4: of socks. What they were all like compression socks, which
Speaker 4: would have actually been really helpful because we're standing, but
Speaker 4: they were just like nice wool socks, and it was
Speaker 4: really sweet because it is cold in the angio sweet
Speaker 4: or or procedures.
Speaker 3: That's really sweet. Yeah, So thank you radiologists. Honestly, some
Speaker 3: radiologists are the first line between like you and a
Speaker 3: box of Kleenex, Like I will never forget going in
Speaker 3: for the MRI and just that's nice crying and having
Speaker 3: someone be like it's okay, it's gonna be okay.
Speaker 2: Like that's so good to hear.
Speaker 3: It's almost like dealing with like shelter dogs or something
Speaker 3: where you're like they're going to be shivering and kind
Speaker 3: of scared.
Speaker 4: And breast radiologists deal with this a lot because you know,
Speaker 4: like for women, I think sometimes we feel like our
Speaker 4: breasts are just taking time bombs and you know, you
Speaker 4: have to go on and get that mammogram, like you
Speaker 4: have to go get your kownoscoviy or whatever.
Speaker 2: And when you know, may.
Speaker 4: Need another study or an ultrasound, the radiologist is right
Speaker 4: there with you and they're explaining things to you. And
Speaker 4: I think that part of radiology that you know, real
Speaker 4: direct patient care is really helpful.
Speaker 2: Yeah, meaningful.
Speaker 3: I mean, it's crazy that you are a conduit to
Speaker 3: so much knowledge about someone's body, Like it's kind of true.
Speaker 3: You're like an interpreter between like me and my body.
Speaker 3: You're like, okay, let me let you know what's going on,
Speaker 3: Like that's pretty cool.
Speaker 2: Your insides.
Speaker 3: I know loog in my guts. Thank you for letting
Speaker 3: me ask you so many questionscome.
Speaker 2: I hope I was helpful.
Speaker 3: Next time I get any kind of body scan, I'm
Speaker 3: just gonna send it to you for sure. Don't send
Speaker 3: me yoursh so save the rashes for your dermatology friends people.
Speaker 3: Now for links from this week's episode, head to ali
Speaker 3: Ward dot com slash ologies or for super sensitive pictures.
Speaker 3: You can become a patron for as little as a
Speaker 3: dollar a month at patreon dot com slash ologies. That
Speaker 3: means you get to ask ologist questions and also see
Speaker 3: photos in this case that are too delicate for Instagram.
Speaker 3: Doctor of Varshanagharasami is on Instagram and Twitter, but uh,
Speaker 3: much like the things that you have wedged in Eurectum,
Speaker 3: her accounts are private. I myself am very publicly at
Speaker 3: alid with one L on Twitter and Insta, and ologies
Speaker 3: is at ologies on both. Now to wrap the podcast,
Speaker 3: to start some conversations about it, and also cover your
Speaker 3: nude body, you can head to ologiesmerch dot com for
Speaker 3: shirts that's what shirts and pins and dad hats. The
Speaker 3: proceeds help support the show. They let me pay my
Speaker 3: amazing merch folks Shannon Feltis and Bonnie Dutch, as well
Speaker 3: as editor Prince in the Kingdom of Podcasts, Stephen Ray Morris.
Speaker 3: Thank you Aaron Talbert and Hannah Lippo for being admins
Speaker 3: in the online science party that is the Ologies Facebook group.
Speaker 3: The music for Ologies was composed by Nick Thorburn. And
Speaker 3: please do not forget to ask smart people dumb questions.
Speaker 3: Just do it. They're so fun and learning stuff and
Speaker 3: making connections is why we're all here on the planet.
Speaker 3: And while you're at it, while you're asking smart people
Speaker 3: dumb questions, tell someone today that they are great and
Speaker 3: you're glad that you know them. Okay, Now for my secret.
Speaker 3: At the end of the show, I I too, like
Speaker 3: pluck a hair off of my body and I just
Speaker 3: didn't grasp it right and instead I curled it and
Speaker 3: it was really upsetting. I just curled it like gift
Speaker 3: wrap ribbon and I was like, come on, sometimes it happens. Okay,
Speaker 3: Bye bye, pacodermatology, mombiology or doo zoology, lithology, ninology, meteorology, paratology, ethology, zeriology, ethnology.
Speaker 3: Coop it up.