Sunday, May 11, 2014

American Roentgen Ray Society Annual Meeting, May 7-9

This year I made a relatively brief appearance at the ARRS. I was scheduled to give a 10 minute keynote address on MR contrast agents for liver imaging and to deliver a rousing MR safety talk during the last session of the last day of the meeting.

I am not a big fan of 10 minute talks, not because they are not useful, but because they are so difficult to conceive and deliver successfully. When preparing such a talk, I remind myself that Abraham Lincoln only needed a little over 2 minutes to deliver one of the greatest speeches in history (and kill zombies). In the future, I think I will change my intro. to the following:

"One score and six years ago our vendors brought forth on some continent a new contrast agent, conceived in the laboratory, and dedicated to the proposition that all contrast agents are not created equal.

Now we are engaged in a great contrast war, testing whether that agent, or any agent so conceived and so dedicated to MR imaging, can long endure…"

The MR safety gig I owe to one of my former residents who pleaded with me to fill in for a “real” MR safety expert who had withdrawn from the program last year unexpectedly. To my surprise, both members of the audience were awake for most of the talk. Of course, I haven’t seen the evaluations yet… 

Speaking of that, I am always amused by the CME evaluation process. Before I started lecturing at CME meetings, I never believed in ghosts. However, I have no other explanation for a meeting at Disney World in Orlando, FL where I spoke to an audience of seven people and received 30 favorable evaluations (and seven mediocre ones). The other phenomenon I find interesting is that, no matter how amazing I think a presentation might be, there is always 1% of the audience that hates me. I used to think that there must be an old girlfriend of mine in every lecture I give, but then I decided that it was extremely unlikely that the only girl I dated before the age of 30 was following me around on the lecture circuit just to give me bad evaluations.
The evaluations I like the best are ones that make a good observation or constructive comment like, “When explaining how the Schroedinger wave function describes the energy levels of hydrogen, it would be helpful to mention its relationship to Heisenberg’s matrix mechanics…” Instead, I mostly get things like, “the guy who talked about renal masses should get hair implants”, or “The diffusion-weighted imaging talk was a waste of my time because I do mostly barium”.

Of course, none of us are perfect when we fill out evaluations. On some scales, 1 is good and 5 is bad. On other forms, it is the opposite. I’m now convinced that all of my bad evaluations are simply innocent mistakes. At the last SAR meeting, I went to Dave DiSantis’s workshop on writing CME questions and thought his presentation was awesome (for a workshop on writing CME questions). I was so pleased that I mentioned him specifically in the evaluation at the end of the meeting. Unfortunately, as I discovered when reviewing the completed evaluations from that meeting, I mistakenly thought the question said “effective”, when in fact it said, “Ineffective”.  Sorry Dave, I owe you a good bottle of something for that one. Jessica, if you are reading this, we need to change that!

Getting back to the ARRS… the meeting was awash in SAR members this year, most of whom were giving talks (all great) and actively serving on committees. Here’s only a few of the members I was fortunate enough to run into.


Dinner with Jeanne Horowitz (back row, NWern), Peter Humphrey (Private practice in Montana), and Carolyn McCarty (U of NM, which she refers to as the Eberhardt Institute).



Meghan Lubner (U of Wisc), Cooky Menias (Mayo Scottsdale), Perry Pickhardt (Former SGR Visiting Prof., U of Wisc), Andrew Smith (U of Miss). Cooky and Perry showed an interesting array of enteric foreign bodies during their talks in case anyone is into that sort of thing.


Desiree Morgan (Last year’s Igor Laufer VP and a tough act to follow, U of Alabama), Paul Nikolaidis (NWern), Raj Paspulati (Case Western), Venkateswar Surabhi (UT Houston) at the GU scientific session.


Steve Kraus (Children’s Hospital of Cincinnati), Jane Wang (UCSF)


Selfie with Cynthia Santillan (because selfies are cool, UCSD). Cynthia was competing with me for the few remaining attendees during the last sessions of the meeting.


Andrew Rosenkrantz (NYU) delivering a great keynote address on free-breathing enhanced MRI.



Here’s what attendance looked like for the speakers who are not in the SAR.

Saturday, May 3, 2014

April 25-26, Las Vegas, NV

Recently returned from a CME course, Body MRI Summit, organized by fellow SAR member Koenraad Mortele (Beth Israel Deaconess) and offered by IAME. Other speakers included SAR members Paul Nikolaidis (Northwestern), Bashir Taouli (Mt. Sinai), and Antonio Westphalen (UCSF). These guys are all great speakers with an amazing knowledge base (in case anyone is looking for great speakers with an amazing knowledge base). Koenraad was a former SGR Visiting Professor, so I was able to get some sage advice between talks, strip clubs, and gambling. OK, so we didn’t really visit any strip clubs, didn’t gamble, and went to bed before midnight every night, but we still had fun discussing MRI protocols and geopolitics. Now that I think about it, I’m not sure which sounds worse.



I tried to recruit one of the other speakers, Ivan Pedrosa (UT Southwestern, on the far left of both pictures), to join the SAR (my goal is one new member per trip). He would be a great asset to the society-- brilliant mind, great speaker, and nice guy (like all SAR members). If any of the two people likely to read this blog know Ivan, please talk to him about joining!

On the way back to Winston-Salem, I took the red eye and was thrilled to have received an upgrade. I dozed off after about an hour, only to have been awakened by the sound most radiologists fear more than the call pager - “Is there a doctor on board?” If you have ever been in this situation, you know the stages: denial (I’m not really a doctor, I’m a radiologist), anger (this is all Obama’s fault!), bargaining (if you just let me sleep, I’ll donate my honorarium to Doctors without Upgrades), depression (I feel like I’m on call with no resident), and acceptance (yeah, I know most of you stopped at denial, but it could happen). As I climbed over the guy next to me (who was engaged in self-pity for having sat next to one of the doctors on board), the flight attendant directed me to the back of the plane. Now, had this been a code in a radiology department, I would have sent my resident (if I could find one that wasn’t studying for the boards). Instead, I hurried to the back of the plane, wondering how many psychiatrists, radiologists, pathologists, and dermatologists I was passing on my way. I also noted that I was able to traverse the entire length of the plane in light turbulence without bumping into a single person, leading me to conclude that flight attendants must have been bumping into me for sport all these years. Fortunately, I was not the only provider to respond to the call and everything turned out fine in the end, despite my confusing the sphygmomanometer tubing for an enema tip.


On a side note, when I am in the southwest, I try to take a couple of extra days to pursue my other passion- astronomy (FYI, another amateur astronomer in the SAR—Mark Lockhart, UAB). In this case, I took a side trip to Death Valley, where I spent some quality time with the coyotes while photographing the night sky. For anyone planning a trip to Vegas, it is worth an extra day or two.
Death Valley at night

Death Valley during the day


 I was fortunate to have seen a kangaroo rat on this trip (one advantage of being the only human being for miles around in the middle of the desert at 1 am). As many of you might know, the kangaroo rat is known for its remarkably long loops of Henle that allow it to have the most concentrated urine of any mammal (other than a radiologist on a busy call weekend). Much of our knowledge about renal physiology is courtesy of this cute little rodent. For more information on kangaroo rats, try http://en.wikipedia.org/wiki/Kangaroo_rat. You might want to skip the part about their mating habits…it’s pretty graphic.