Wet Read: Lifetime learning, my way

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Train people well enough so they can leave, treat them well enough so they don’t want to.“

—Richard Branson

Undoubtedly, the best part of academic practice, in my opinion (and this IS my column and therefore it can reflect MY opinion), is all these wonderful people that you get to help train. Medical students. Residents. Fellows.

They are all (the vast majority, anyway) caring, thoughtful, and smart folks. They flatter you just by being there. They want to do what you do. They trust you to help them along. It’s pretty awe-inspiring. I like it more and more every day. You train them all up and then, suddenly, they are gone. Out into practice. Working, doing that good work just like you do. Gone forever.

Or… they’re NOT.

I love my trainees. Awesome people. But here’s an oddity of life that I am experiencing these days. Happens pretty frequently. I get emails from former juniors: “Hey, how are things? Everything good? I am doing well, working hard. But, hey, I saw this case yesterday and here are some images, what do you think?”

They send along nice images. Sometimes they’re even annotated with arrows to the queried finding. All HIPAA compliant, of course. No identifying data anywhere. We do this right. And, on occasion, there are huge numbers of images.

This, my friends, is a consult. In any other circle, this represents “billable hours.”

I view this with mixed emotions. Definitely this plays to my ego. The Professor in me bubbles up with pride, and I switch into Dr. House mode: This may be unsolvable to you, mere mortal, but I can figure it out. Why, obviously that’s a case of Marchiafavi-Bignami variant. My standard wild-ass response is sarcoid. In fact, the odder it is, the more likely I’ll say sarcoid. That’s the fun side; the ego side.

Lurking right next door in the shadows, however, the accountant in my brain is whispering, “Where’s the scratch?” After all, am I not being consulted? Thanks is nice, but as they say, it doesn’t pay the bills. Sometimes I get repaid with a drink at a meeting. That’s nice. I’ve even been treated to dinner (that’s way better). But I’m still waiting on that candy-apple red Porsche.

I’ve come to view these consults as just another leg of the academic journey. My juniors didn’t really leave — they just went to another site. Maybe another time zone. They are still learning, as am I. In fact, when I stop learning, I will likely not enjoy another day of this. And for now, I still enjoy doing this good work immensely.

So, don’t stop sending those cases. I really can figure some of them out. Or I’ll send them to one of my mentors. Because you shouldn’t for a moment imagine that I don’t need some help from time to time. I pester more people than you do, and on a much more frequent schedule. Keep doing that good work.


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Phillips CD.  Wet Read: Lifetime learning, my way.  Appl Radiol.  2018;47(7):48.

By C. Douglas Phillips, MD, FACR| July 06, 2018
Categories:  Section

About the Author

C. Douglas Phillips, MD, FACR

C. Douglas Phillips, MD, FACR

Dr. Phillips is a Professor of Radiology, Director of Head and Neck Imaging, at Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, NY. He is a member of the Applied Radiology Editorial Advisory Board.

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