Planes, Trains, and Automobiles (Part 2): The NYU Morton A. Bosniak head to toe imaging conference.

SAR member Nicole Hindman presents me with a plaque at the NYU Head to Toe course that honors Dr. Mort Bosniak (right). 

After my brief stay in Boston, I boarded a train to Manhattan. I was lucky that the AV guy for Koenraad’s course was familiar with the trip and could give me some helpful advice. First of all, if you ever make this trip, take the Acela (express) train from the South Station. It makes the trip in little over 3 hours with very few stops, and the seats are the equivalent of first class on most domestic US flights (without those little hot moist towels that I never quite know what to do with). By boarding at South Station, you will have your pick of seats. The train has a “quiet car” (no loud conversations or cell phones) and a nice snack car. If you want to enjoy some coastal scenery, sit on the left side of the train (facing the direction of travel), although the sun can be an issue on this side early in the day. 

The Acela from Boston to New York

The NYU head-to-toe course was the first CME course I ever attended (back in 1988), and it is a fantastic course for general radiologists interested in a comprehensive multimodality, multispecialty imaging review. Now, over 20 years later, I was returning as the Bosniak lecturer, an honor made even more special by having Dr. Bosniak in attendance. Mort is an amazing guy, as sharp and accomplished as anyone you’ll ever meet. Of course, this could be said about any of the NYU abdominal imaging faculty, but few radiologists in the world can claim such a sustained impact on the field of medicine as Dr. Bosniak.

I always thought it would be cool to have a classification system named after me, but all the good diseases and organs were already taken by the time I started my career. The spleen was still up for grabs, but the best I could come up with for a classification of splenic lesions was L1 = cyst and L2= something else. My favorite classification schemes are the ones that have as many categories as there are reported cases (how do these get published?). Now, I am just content to classify nonmedical things, like Dallas drivers (L1 = crazy idiots and L2 = me). Why Dallas? See my next blog post!

Many people who don’t live in New York think of New Yorkers as loud and pushy. That’s probably because many of the people who do live in New York are loud and pushy. But it’s nothing personal. New York City is a loud and crowded place. Even the New Zealand rugby team couldn’t cross Times Square during the holiday season in less than 30 minutes. Even so, the people of New York have no problem waiting patiently for a good falafel.

No, this isn't the cab line at RSNA. These people are waiting for falafels.

The NYU group of abdominal imagers doesn’t have to be loud or pushy. Their contributions to our field speak for themselves. I was truly privileged to have spent an evening with such a talented group of imagers. It’s no secret that NYU consistently churns out some of the most influential leaders in abdominal imaging year after year. I asked former SAR president Alec Megibow how they do it. I think he said the secret is “good falafels”, but the restaurant was a little noisy, and I might not have heard him correctly. SAR members Alec, Nicole Hindman, Hersh Chandarana, Andrew Rosenkrantz, and Gen Bennett all gave outstanding talks during the abdominal part of the conference.

Dr. Bosniak tries to give me a big hug. Hersh (left) holds him back

Members of a truly extraordinary Abdominal Imaging section from left to right: Hersh Chandarana, Morton A. Bosniak, Nicole Hindman, Alec Megibow, Genevieve (Gen) Bennett, Andrew (Andy) Rosenkrantz, Krishna Shanbhogue. This picture was taken at Michael Jordan's Steakhouse in Grand Central Terminal. Michael Jordan couldn't be in this photo because someone had to take the picture. He was holding the camera between his knees.

Nicole Hindman and I had a nice discussion about unknown film panels over lunch. Be sure to cheer for her at this year’s SAR unknown film panel in Coronado. And here’s some more advice for her in case she needs it:

1) If you don’t know what something is, tell a joke.

2) If you don’t know what something is and can’t remember any jokes, pretend you are choking.

3) When the other team gets a case right, make a face like, “duh, the janitor* could get that one”.

4) When the other team gets a case wrong, make a face like, “have you thought of becoming a janitor*?”

5) If the janitor* looks like he/she might get the case before you do, quickly spill something.

6) When the panel is over, regardless of how you think you performed, immediately erase it from your memory. That’s what everyone one else in the room will be doing.

All in all, it was a great visit at a great time of year. No one decks the halls better than NYC! The only downer was the drive to the airport when it was time to go home (the automobile part of my journey). It should have been a 10 minute drive, but I think the driver was going too fast, as all the clocks at the airport showed that an hour and a half had elapsed at LaGuardia (Stephen Hawking would laugh at that one even if you didn’t).  It didn’t matter, though, because the flight was delayed while the flight crew battled their way to the airport through the impenetrable grid lock of New York’s rush (ha!) hour. 

No one does the holidays like NYC!

One of many imaginative holiday displays

A winter wonderland

*In reality, janitors are hardworking and intelligent members of a noble profession who are often unfairly and inaccurately depicted in jokes as ignorant, lazy, or unambitious by comedians who lack the inspiration and/or talent to create new/novel material. To see what janitors are really made of, read about the story of nursing home janitor Miguel Alvarez. 

Planes, Trains, and Automobiles (Part 1): Clinical MRI course sponsored by Harvard Medical School and Beth Israel Deaconess.

SAR member Koenraad Mortele (BID) runs a few excellent CME courses throughout the year held in Boston at the Marriott Long Wharf. I was fortunate to have spoken at the December Clinical MRI course on the topics of MRI artifacts and MR angiography. As a rule, I try to never turn down an invitation from Koenraad, as I know the experience will be as fun as it is educational. Never wanting to squander anyone’s money, I was able to find a one-way air fare to Boston from Charlotte for only $67! From there I took a train to NYC, but I’ll cover that trip in the next post.

The Harvard/BID MRI course director, Koenraad Mortele

On the fun side, I enjoyed night-time Boston all decked out in festive lights for the holidays and had an authentic Italian meal in the North End with Koenraad, Jorge Soto (BU), Steve Winn (see Maine Medical Center/Portland, ME post) and Koenraad’s current fellow and Steve’s former resident, Elena Resnick. 

Koenraad, Steve, me, and Jorge at Trattoria il panino in the North End

On the educational side, we learned that not everyone over the age of 35 knows what the word “detumescence” means. This point likely needs some clarification, only a little of which I can provide, as the wine at dinner was as good that evening as the food and the company. I’m not sure how we got on the topic, but I think there was a legitimate ultrasound imaging segue, and I do remember Steve (a former large animal veterinarian) telling us about how studs (of the horse variety) have to be restrained prior to performing their duties lest they overly enthusiastically engage the mare and suffer a penile fracture and subsequent detumescence. At some point in the discussion, Elena claimed that the word “detumescence” was actually an age discriminator and that she could tell with reasonable certainty if someone was over or under the age of 35 based on their familiarity with the term (i.e. people under the age of 35 don’t know what it means). 

Elena is the one next to Steve

Of course, we subsequently did what all good scientists would do… we put the hypothesis to the test by asking a random sample of subjects (couple at the next table) if they knew what the term meant. The null hypothesis was supported when they claimed to be both over the age of 35 (although they didn’t look it) and unfamiliar with the term. 

This nice couple was having a quiet dinner before we came along. They claimed to be over the age of 35 but were unfamiliar with the term "detumescence". This supported the null hypothesis (n=2, p > 0.05). 

None of us was willing to provide our subjects with the definition of detumescence, so they had to look it up on their smart phones. Not to be outdone, however, they countered by asking if we knew what the word “borborygmi” meant (while I admit that much of the material in these posts is completely fabricated, I can assure you this story was not). Fortunately, we had been SGR members, so this challenge was easily addressed.

We also learned at lunch that lobsters caught in the winter taste the same as lobsters caught in the summer (apparently, this question had been dogging Koenraad for some time, so he had been avoiding winter lobsters all these years). We were fortunate that one member of our group had done a presentation in school many years ago on lobsters and could give us an impromptu tutorial.

As expected, the MRI course was great, but an unexpected highlight was when a gentleman named Jeffrey Sprague came out during a coffee break and led the audience in rejuvenation exercises. 

The audience does rejuvenation exercises during a break. My dejuvenating lecture on MRA followed. 

Sadly, he got better course evaluations than I did.