Where are you going, where have you been: Brrrrrrrrroston part 1: Brigham and Women’s Hospital

Members of the Abdominal Imaging Division at Brigham and Women’s Hospital, including SAR members Nisha Sainani, Ramin Khorasani, Director Stu Silverman, and Anik Sahni.

I just returned from a visit to Brigham and Women’s Hospital, Massachusetts General Hospital, and Boston University Medical Center, and once again, the weather gods had seen fit to punish me. It was cold (how cold was it, you ask?). It was so cold that Chuck Norris would have had to put on a t-shirt. On my walk to the Brigham from my hotel, I noticed I could no longer feel my extremities. I didn’t have a thermometer, but as a uroradiologist with a moderately full bladder I had no trouble coming up with a rough estimate of the outside temperature.

By measuring the time to freezing and factoring in my age and height, the estimated osmolality of urine, the half-life of alcohol in the body, and the wind chill, I came up with an approximate outside temperature of 18 degrees.

In Boston, the number of uroradiologists per capita is fairly average, so such sights are relatively uncommon. In Ann Arbor Michigan, on the other hand, you really have to look where you step. By the way, it is a myth that urine can freeze before hitting the ground during micturition from standing height in any temperature extreme present on the surface of planet earth. However, it is not a myth that frostbite can result from testing this hypothesis, so better just take my word for it. If don’t want to take my word for it, you can consult the MythBusters episode on this topic in which they failed to freeze a simulated stream of urine at -70 degrees F. One last word of warning… MythBusters did show it was possible to suffer a mortal wound from a falling icicle, so be careful out there.

Fortunately, Brigham and Women’s radiology department was as warm as it was welcoming. SAR member and former President Stu Silverman and I had a great discussion about balancing career ambitions with expectations and life in general (bottom line: make your life/career what YOU want it to be, not what others want or expect it to be). I also got a tour of BWH’s amazingly integrated and accessible radiology IT systems from the equally amazing Ramin Khorasani, MD, MPH. The systems he helped implement make protocoling, patient scheduling, and accessing real-time productivity and quality metrics nearly effortless. Their ANCR system (Alert Notification of Critical Results) provides for painless documentation and closed loop communication of critical results with referrers. Anyone nterested in informatics should pay a visit to BWH and consult Dr. Khorasani’s many trend-setting papers on the topic. One word of caution… this high tech IT stuff is great as long as it remains focused on improving patient outcomes. Unfortunately, I suspect this will all end with the eventual enslavement of humanity (or at least the enslavement of radiologists).

I was able to catch up with SAR board member Bill Mayo-Smith on my visit. In case anyone was wondering where he disappeared to, he's returned to Boston!

I also had a chance to tour BWH’s 5700 sq ft AMIGO (Advanced Multimodality Image Guided Operating) suite. This environment integrates a fully functional operating suite with a 3T MR scanner and a PET/CT scanner. The 3T MR system moves into the operating suite on a ceiling mounted rail system, so there is no need to move the patient. At the time I visited, the PET/CT did not have a mobility solution, but I’m sure they are working on one.