Got Rain? UCSF Medical Center

Speaking of prostates, I just returned from UCSF where I gave the Earl Miller Memorial lecture. Since there isn’t much I can teach the UCSF group about prostate MRI, I chose the topic, “How Radiologists can add Value to the Management of Patients with Crohn’s Disease”. This will also be my topic for the ESGAR meeting in Paris this year and will present an opportunity to highlight the efforts and achievements of the SAR disease focused panel on IBD to our colleagues in Europe.

Derek Sun, Michael Ohliger, Jane Wang, Ben Yeh, Antonio Westphalen, Ron Zagoria, John Mongan

There’s no place like California. The on-going drought ensured perfect weather for my visit (although I would have gladly suffered the rain to help out the farmers). The pre-visit checklist they sent me included the usual inquiries about my topics and disclosures in addition to a few nonstandard questions that you would only find on the West Coast: Will you be drinking white or red during your talk (I chose white)? Will you be wearing clothes (yes, but only because I don't have any ties that match my skin color)? How many wives will be accompanying you to dinner (oops, sorry, that was last month)? Unfortunately, drinking wine during my talk didn’t improve the quality of my delivery nearly as much as it improved my perception of it.

Lunch at UCSF was nothing like lunch at Indiana. No gigantic fried pork sandwiches for one thing. Instead, I had the free-range, gluten-free, organic squash soup in a fully recyclable bowl made by fair trade craftsman using eco-friendly, sustainable methods (I’m still not sure what a free-range squash is. At UT Southwestern, we have free-range residents). For dessert, I had a green tea enema. 

The views on campus are stunning, but the real show-stopper at UCSF is the faculty. Their friendly, relaxed demeanors belied the incredible depth and breadth of their expertise and range of accomplishments. I particularly enjoyed catching up with former SUR president and Wake Forest co-worker Ron Zagoria. Ron taught me much about GU radiology and nearly everything I know about leadership during the years we worked together at Wake. I also enjoyed some one-on-one time with Emily Webb, Dave Avrin, Ron Arenson, and Ben Yeh. I plan to tap into Ben’s extensive knowledge of spectral CT as we ramp up our program at UT Southwestern.

The view from the Library.

I also had the pleasure of all-to-brief encounters with many SAR members, including SAR president elect Judy Yee, prostate guru Antonio Westphalen, MRI prodigy Mike Ohliger, hyperpolarized Carbon-13 aficionado and former IEC participant Jane Wang, PET/MR advocate Spencer Behr, US disciples Tara Morgan and John Mongan, and heir to the Workshop throne, Stefanie Weinstein.

Judy Yee, Emily Webb, and Ron Zagoria get soused before my talk. Good move. 

The next time you visit San Francisco, consider making the two hour drive (30 minutes if you routinely drive in Dallas or LA) down to Point Lobos State Reserve. Few places in the world combine such spectacular scenic vistas and wildlife diversity so close to a major metropolitan area. While there, my family and I spied sea lions, harbor seals, sea otters, and even a few whales from the rocky cliffs overlooking Monterey bay. Volunteers set up spotting scopes at numerous locations throughout the park to provide visitors with close-up views of the animals. If you plan a trip, avoid the weekend. The park can absorb the crowds well enough, but the limited parking options forced us to park far from the entrance. 

One of many spectacular views along the coast at Point Lobos.

We capped the day off with a seafood dinner at Fisherman’s Wharf in Monterey, stalked the entire time by hungry seagulls. 

Looking for handouts. Can you find the bird that photo-bombed him?

Indiana University: Definitely not a fly-over program

No SAR visiting professorship would be complete without a visit to Indiana University. SAR member Dean Maglinte makes certain of that! Former VP Desiree Morgan dropped by for some talks last year, and they've been raving about it since. Because lecturing on the pancreas was part of her gig, she threw a pancreas party for the residents that stole the show- my show! How was I supposed to compete with a pancreas party? Dean had requested prostate MRI as my topic, and despite delivering what many would consider a seminal talk, every one there viewed Desiree with such vast deference that even my best joke (“Rectum? Damn near killed him!) couldn't get a rise out of the audience (at least the residents should be better prepared for their ABR digital exam now). While I’m sure there are some places in the world where a prostate party would be welcome, University of Indiana wasn’t one of them. Word of advice for next year’s Igor Laufer professor- everyone loves a party, so pick an organ that goes well with punch and cookies.

IU residents and fellows

My first night in Indianapolis, Dean Maglinte and SAR member Kumar Sandrasegaran treated me to dinner at St. Elmo steakhouse, where they are known for their fiery hot shrimp cocktail consisting mostly of fresh horseradish. Horseradish, a perennial plant of the Brassicaceae family, has been used for years as a medicinal for sinus disorders. I can vouch for its effectiveness, as well as its deliciousness, as St. Elmo’s fire effectively denuded the mucosal lining of my entire upper respiratory tract.

Not for the faint of sinus: The shrimp cocktail at St. Elmo's.

The IU Abdominal Imaging faculty impressed me with their academic productivity and teaching efforts despite RVUs in the upper quartile. I sensed that their deep commitment to the academic mission sustains them through these challenging times. For many of their scientific endeavors, they benefit from an impressive, fully integrated radiology/pathology database. They also integrate daily, organized teaching efforts into the workflow to ensure the best possible experience for their residents and fellows.

Kumar Sandrasegaran running a reading room conference for the residents.

My visit wasn’t all work and no play. My tour of the Methodist hospital campus was a thinly veiled attempt to justify my riding the “people mover”. This consists of an automated, elevated light rail train that runs a regular route above the streets of Indianapolis between hospitals (supposedly the only private line of its type to run over public streets). It lends a Disneyesque quality to the Medical Center, when it isn’t catching fire (which it did less than a month after opening). For more facts about IU's people mover, try the following: http://en.wikipedia.org/wiki/Indiana_University_Health_People_Mover

The IU people mover- more fun than Disneyland

I also witnessed first hand something more dangerous than a people mover fire (even if the lethal effect takes years to develop)- the pork tenderloin sandwich. The heart of this official state sandwich of Indiana (yes it really is the state sandwich) consists of an enormous breaded and fried slab of pork.

The state sandwich of Indiana. Yes, that's a normal-sized bun. 

My last night, I enjoyed a memorable dinner with members of the Radiology Department, including interim Chair Himanshu Shah and many colleagues from the SAR. As might be expected in the presence of such a diverse and talented group, the dinner conversation ranged from the origins of wine to the benefits of a clean colon. I try to learn something new from every place I visit, and that night I learned that Princess Diana regularly engaged in the practice of colonic cleansing (go ahead, google it). Having experienced a thorough colonic purge the last time I ate pizza at the Miami airport, I can’t say I’m a fan (although I did get an idea for a novel CT colonography prep involving iodine-labeled mozzarella). Whether it was the late hour or our raucous banter, the restaurant was thoroughly cleansed of diners by the time we left. 

SAR members at IU from the left: Marc Kohli, Dean Maglinte, Kumar Sandrasegaran, and John Lappas. It took the photographer so long to set up this shot that Kumar fell asleep.