Teleradiology and Distance Running

I'm a distance runner. I got started with relatively small races during middle school (two to three miles at a time), but I lost interest in the competitive aspect and started doing it purely for fitness and the challenge of exceeding myself.

The mileage gradually increased over the years; at my peak during med school, I was doing about 10 miles in mountainous terrain every other day. I suppose part of my motivation was that stopping a day's run meant I would be back to studying that much sooner. In more recent years, I've settled in to the six to seven mile range. Which means that, yes, the title of today's column is a bit of an exaggeration. You can have your price of admission back if you feel cheated.

I never bring music or other distractions with me on my runs; it's just me, my surroundings, and my thoughts. Letting your mind do whatever it wants for an hour or more is an interesting pursuit; I recommend it. One's focus does tend to drift back to the physical exercise and prevailing conditions, and it's at such times that aches, pains, and plain old fatigue are most noticeable and pose their greatest threats to performance.

Being on in-house call during med school and postgraduate training, at times, had a similar feel. Granted, there's a big difference between 24+ hours of hospital work and one hour of physical exertion - not the least of which being the consequences for saying "screw this," and going home partway through.

Nevertheless, there's a certain sensation of slowly but steadily accomplishing something that, from the outset, looked too big a feat. Sometimes, you even look at it in hindsight, and think, "Did I really do all of that?"

For me, both pursuits are rendered doable by focusing as little as possible on incremental progress. During running, that means paying no attention to the passage of time or mileage (infinitely harder when one is stuck on a treadmill with all of its digital displays rather than covering real distance outdoors). Covering a call shift - or even a regular workday - looking at the clock is also a bad move, but so is keeping tabs on how many cases I've read. The more frequently I check on my status, the less progress I've made since the last time I checked - and the longer my task seems to last.

Anything taking me out of my "zone" is almost as bad. While running, this might mean stopping at a busy intersection, or pausing to tie a loose shoelace. While reading studies, the opportunities for self-interruption are more plentiful and insidious - indulging in personal phone calls, for instance, or even just text messages. Checking stocks, news, or Facebook. Each diversion brings productive momentum to zero, and subsequently returning to actual work entails fighting a sort of psychological inertia.

When I worked in outpatient imaging centers, or even in some hospital environments, sometimes this could not be helped. For instance, if PACS went down. Or if I managed to get totally caught up, and had no more cases to read at the moment. Sitting and waiting for more studies is a particularly painful way to watch the seconds slowly tick by, especially if compensation is tied in any way to your productivity.

It's one of the welcome changes I encountered when shifting into the teleradiology world - sharing in coverage of dozens of sites, I much more rarely found myself with nothing to do other than watch the clock. It's like Chris Rock's description of a career versus a job: With a career, "there ain't enough time in the day. Time just flies." But with a job, "there's too much time."

Of course, not everybody is a distance runner, built for long-haul endurance. Some find themselves better suited to sprinting. In radiological terms, I suppose that would involve shutting out all distracters for shorter periods of time and burning through cases at rates that I know I could never maintain for a full shift, peppered by more frequent breaks. Your mileage may vary, so to speak.