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The Superpowers - and Limitations - of Radiologists


The invisible gorilla study was about appreciating my abilities and limitations. The more I read, the more focused I become, but I don’t want to miss any gorillas.

Was I trained to do this like Jason Bourne, or am I a superhero?

I often wonder about why I chose to do what I do. I have reflected on the intellectual satisfaction of radiology, its generalist nature, lifestyle factors and personal relationships I happened to develop along my course and that directed me to this profession. I haven’t thought too much about whether I was born to do this though.

A recent study showed that radiologist could overlook an image of a gorilla that was outlined on a chest CT slice. There were many takes on this in popular culture: that we are all human; that radiologists get too focused on one thing: that we don’t look at unimportant things. But the researchers took this to mean that radiologists, like many others, have an ability to focus on a task to the exclusion of other tasks. In fact, they indicated that they have more of a chance than the general population to miss the gorilla, because of their highly focused attention. Makes sense, right.

But why is our attention so honed? Was it that way when I was a resident? Was I part of a secret government program that implanted a subconscious ability to focus attentively on just what I wanted to look for? And is that only a visual tool? Or do I have that ability across the board?

My bet is that I had that aptitude before I ever became a radiologist, as a cognitive skill. Most people probably have it to some degree. But that talent was reinforced repeatedly over time to make it what it is now. Ongoing training helped it to evolve to what it is today. It was unlikely that there was a spontaneous mutation to make it happen. Perhaps I even subconsciously chose radiology because of it. Or maybe it just made radiology a little easier for me than others. 

As it turns out, it may also make life a little harder for me. As for most superheroes, radiology superpowers can also be your weakness. When we hone in on one thing or pre-determine what is or is not potentially going to be there, we can have a serious problem - and miss the gorilla in the room. 

And if we find something, we can get so intensely focused on it, that we fail to look for what else is there, what my attendings used to call “satisfaction of search.” So for me this study was about appreciating my ‘super’ powers but recognizing my obvious limitations. I hope to continually remind myself to be open-minded and to use my whole process even in the face of a positive finding, because I suspect the more I read, the more focused I may become. Being focused may mean I’ve evolved as a radiologist, but I don’t want to miss my ancestral roots on a CT as a result.

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