When is a Radiologist Not a Radiologist?

Juggling a physician’s perspective and a layperson’s view can be a tricky juxtaposition at times.

I recently used some vacation time for a road trip. I got into this habit a little bit before the pandemic made flying even more of a hassle than it was before. It is nice to travel entirely on your own schedule, especially if you have a pet/housesitter who might alert you that something is up with this pooch or that cat, and you need to hurry home.

Traveling on your own schedule is also handy if the points of interest at your destinations are not conveniently clumped together within walking distance, and the area doesn’t happen to have a robust transit system with which you are sufficiently familiar. This was the case with a recent trip, which had a few stops in and around Philadelphia. One was the Mütter Museum, which is focused on “medical oddities.”

Strolling around in this museum, one can see an impressive collection of pathological specimens and blurbs about their histories. There is a remarkable collection of skulls, a “soap lady,” some doc’s extensive collection of swallowed foreign bodies and probably the worst case of megacolon ever. Most of these displays are at least passingly familiar to those have gone through medical school.

While wandering around this place, I had a strange feeling, one I have had before but never to this degree: My doctor/radiologist self and my, for lack of a better term, “civilian” side were kind of clashing.

Under most circumstances, I am in one role or the other. Firing up my workstation for a radiology shift, attending conferences or administrative meetings, I’m in doc mode. When I am off duty, hanging around with family/friends or just bumming around my house, I’m not in doc mode. I have likened this to being a comic-book character. If it is time to be a physician, I mentally do the equivalent of Bruce Wayne putting on his Batman garb. Professional episode over, I take off my Superman cape to resume life as Clark Kent.

It’s not always clear-cut. Sometimes there are occasions to briefly put on or remove the cape. For instance, when I am hanging around with family and friends, someone may ask me a medical question or produce a CD of his or her latest X-ray, MRI or CT scan and ask if I’d be willing to pop it into the nearest computer and give my appraisal. Alternatively, when an appliance repairman comes by the house during the day when I’m otherwise plugging away on my workstation, my interactions with him aren’t exactly going to be doctorly.

Those tend to be isolated affairs. After they are dealt with, I resume whatever I was doing — socializing as a non-doc or working as one — for perhaps the remainder of the day. On rare occasion, however, the cape gets donned and removed multiple times in succession. For instance, there may be a day when the appliance repairman comes by on the same day as visits from a handyman and housecleaner. Every time the doorbell rings or I sit back down at my workstation, my role shifts yet again.

Flip-flop enough times in a short interval and I wind up in a weird sort of “cape half-on” frame of mind. The doc and the non-doc are both trying to take my helm. It can be difficult to get back into the groove of efficiently reading my normal volume of cases if I was working or chatting like a “normie” if I am in a social setting.

At the Mütter Musuem, I experienced this in a relatively new way. On the one hand, all of the stuff on display is medical, and my doctorly self can appreciate it on a professional level. On the other hand, some of it is kind of humdrum if you know medicine. If my cape is off, I am in a frame of mind that can be as wowed by it all just like any other visitor to the place but then I won’t be appreciating the extra depth of detail I could as a physician.

Then there is the perspective of my lady, who has been to the museum before and regularly asked both of my personae what they thought. To the caped me: Did I learn about this in medschool? Do I ever see that on a scan? To the un-caped me: Isn’t this weird? Just imagine living with this condition or knowing someone with that one.

The near unique aspect of the situation was that I could appreciate everything around me in either of my roles. In most circumstances, one of my personae is unquestionably better suited. I can shift into that role and stay that way as long as it is relevant. In that museum, however, I wanted to be of both minds to get the full experience of everything around me and it was a little mentally exhausting. It was sort of like trying to see the world around me normally but also with my eyes crossed.

I am sure that plenty of docs don’t have such a bifurcated mind. Maybe my pre-medical sense of self was just too strong (or stubborn) to let itself get molded into a single, unified personality as it absorbed med school and postgrad training. Perhaps I am of suboptimal mental cohesiveness, and there’s a DSM-5 code for my situation.

For those psych-oriented, though, I’d say that any such diagnosis would be of the ego-syntonic type. As enervating, even uncomfortable as it can be when I’m flip-flopping to the point of being cape half-on, I enjoy having the mental partition. Sometimes, it’s just nice to sit back and marvel at simple things like the elegance of anatomy as it has evolved, an appreciation that is all too easy to lose if one is jaded by education and experience.