Learning about Radiology (A Discussion with Future Generations)

Luther B. Adair, II, M.D.

There they were, my dad and my new cocker spaniel, Jocko (seemed like a great name at the time). It was no different a night than several other nights in 1982 when my father came home and trained Jocko in the concrete floored basement of our split-level, ranch-style suburban home. At the time, the stairs that led to the basement were open to the view of the basement from an unenclosed stair rail. As a 5-year-old, however, this was not a stair rail at all; it was a gymnastics paradise to display my ninjutsu expertise—plus a bonus view of my personal dog trainer and my new puppy. It does not get much better for a 5-year-old except for the frequent chastising I would receive for using the rail for that very purpose. “You will fall and hurt yourself,” was the usual caveat.  On this particular night, that warning would go unheeded and my grip would betray me. Gravity was there to teach me a lesson. I fell head-first and landed on the concrete. Now much of what happened later is recalled from a post-traumatic memory and what my parents later told me, but to make a long story short, I remember waiting a very long time in an unfamiliar emergency room.

I guess now would be a good time to tell you that my father was a neuroradiologist, the chairman of the Department of Radiology at the more familiar hospital, and a student of the great Juan Taveras (MGH Neuroradiology) during the dawn of the CT scan.  Needless to say, my father would not allow me to be evaluated with radiography alone and insisted upon having the hospital perform a CT scan evaluation of my head (imagine a time when routine brain MRIs from the emergency department weren’t the norm).  My father’s hospital did not have a CT scan. I eventually received a CT scan and a diagnosis of a concussion. Subsequently, my father was able to convince his hospital board to allow him to use his personal finances to help purchase a CT scan for the hospital where he was employed.

This story seems inane now because most hospitals in the U.S. have CT scans that are readily available. However, in many cases such ubiquity has become another spectrum of the same problem—the overuse of such technology and the radiation associated with the overuse.   There has been extensive controversy regarding the overuse of CT scans ordered by the emergency departments over the last six years—just “google” CT scan, pediatrics and CNN. Some argue that the legal system is causing doctors to practice defensive medicine. Others argue that the training of emergency personnel promotes a flippant approach to the use of diagnostic imaging.

Recently, my 8-year-old nephew suffered a head injury while playing and I realized after talking with his parents that the responsibility should also lie with the parents to understand their available options in similar circumstances. Hence the reason my company, Viewbox Holdings, LLC, and I decided to create our second (and most unlikely) product, a children’s book.

The book, Learning about X-rays with Lula and Ethan, is loosely based on my nephew’s experience and it attempts to educate the pediatric population about possible concerns around radiation exposure, but also explains its necessity in certain situations.  Most importantly, and aligning with the ACR’s Heart of Radiology campaign to educate the public about our role as radiologists, this book introduces readers, both parents and children, to one of their key health care providers—the radiologist.  This book was written for ages 7+ and features two children eating lunch and discussing one child’s experience of getting an X-ray.  Obviously, it is our desire that parents would never need such a resource, but given the trend of increased diagnostic imaging in the emergency setting, as well as the large numbers of allied providers joining the health care force over the next few years, we believe this resource will help families and providers.

It is our hope that any provider that treats the pediatric population has access to this resource for their patients (even radiologists in the outpatient or emergency waiting rooms).  You can purchase either the paperback version for $9.59 or the e-book for $4.99 directly from the publisher by following this link http://www.blurb.com/b/6950764-learning-about-x-rays-with-lula-and-ethan.  The book will also be available through Amazon, Barnes and Noble, and in the Apple iTunes Store where you can also find our iPad application for radiology trainees, Viewbox.  Because the information and message in Learning about X-rays with Lula and Ethan also aligns with the Image Gently Campaign, this non-profit organization has also agreed to endorse the book by placing it on their website: http://www.imagegently.org.   During the editing process, we received guidance and amazing support from the chair of the Image Gently Campaign, Dr. Donald Frush, as well as my sister, Dr. Candace Adair, who is a child and adolescent board-certified psychiatrist.  If you have any questions or comments please feel free to email me directly at luther.adair@viewbox.net.

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