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The Tungsten Sledgehammer


A letter to the radiologist dedicated to over-radiating patients.

Dear Dr. Kilpatient,

It is a pleasure to notify you that you are the inaugural recipient of the Tungsten Sledgehammer Award. Although there was initially some concern that it might be difficult to select a single most-worthy physician in the ranks of our hospital’s staff, your tireless efforts in the emergency department placed you head and shoulders above the rest.

You have earned this distinction as a result of your clear dedication to radiating patients under your care. Where others might have been deterred by the potential harms of excessive exposure and/or tempered by the “Image Gently” and “Image Wisely” campaigns, you stuck to your guns and did things your way. Indeed, the Sledgehammer Award is so named precisely for its decidedly non-gentle imagery.

Even in the face of pushback from concerned radiology staff, you did not relent. Using CT when ultrasound or MRI were indicated. Insisting on noncontrast scans when contrast was warranted (“I’ll rescan them if I need to,” as you’ve often been heard to say...inspiring words!). Routinely including the chest in scans obtained for purely-abdominopelvic pathology. The committee has been particularly impressed by your insistence on whole-body pre/post/delay contrast studies in all trauma patients…be they 5, 15 or 50 years of age.

You may be interested to know of another honoree this year-Dr. Zapem of interventional cardiology is this year’s recipient of the Leadfoot Award, given for most gratuitous usage of fluoroscopy.

You are encouraged to have plaques, pins and whatever other memorabilia you choose made with the Sledgehammer’s logo on them, such that patients and healthcare professionals alike will, at a glance, know your diagnostic tendencies. You might even find it inspiring to change your cellphone’s ringtone to Peter Gabriel’s hit tune of the same name, so they will know you’re coming even before they see you.

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You are also encouraged to make a note of your award on your Curriculum Vitae, such that prospective future employers and partners will know of this distinction you have justly earned. Our committee would be more than happy to serve as a reference in this regard.

If, as with award-winners in many other venues, you believe you are not deserving of the Tungsten Sledgehammer, rest assured that the committee will be reassessing statistics of diagnostic radiation in our facility on an annual basis. If there is anyone more worthy of the Sledgehammer, it will pass on to them next year.

On the other hand, considering your evident dedication to radiating as many patients as much as possible, perhaps you are eager to remain in the running. Our advice, then, would be to stay the course and change nothing about your ordering habits.


The Sledgehammer Subcommittee

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