Radiology Month

As soon as I came back to Germany I had my new rotation waiting for me; radiology.  As a physics major in undergrad, I really liked the concept of radiology.  Using x-rays, magnetic fields, and other physical phenomenon for medical purposes is fascinating to me.  So it was no surprise to me to be interested in the field of radiology.  Though the physics behind the field is interesting, I was weary of the mundane tasks that I might have to do.  Staring at a computer screen all day wasn’t something I would call fun.  Nonetheless, I did not have experience in the field and was willing to explore it. My schedule was broken up into four 1-week blocks as follows; a week of X-ray, CT scan, MRI, ultrasound. 

My first two weeks were in the Medizinische Klinik. The radiology reading room was definitely something that I did not expect.  A large room with a skylight, albeit with shade to avoid sun glare, lighten up fairly well. There were several computer stations with large vertical high-resolution monitors that were used by the radiologist. As in anesthesia, the bulk of the work was done by the Assistantaerzten. The X-ray department had a senior “resident” who signed off on the junior residents’ radiographs. The interesting thing was that a senior with 4 years or radiology experience could be considered a junior in the x-ray department because he did not rotate through the department enough yet.  In all the system is set up so that the residents have to have a certain number of images that they have read and transcribed.  A computer system keeps track of all the reads, though the residents must personally keep track of what modality of images they have read (X-ray, CT, MRI…etc.)  Most rotations are done in 6 month blocks.  This makes its interesting when a 3^rd year resident might be rotating into a CT scan rotation for the first time.

Computer for pulling up images, laptop for writing down results 

A senior resident flanked by two junior x-ray residents

The first day I became acquainted with my colleagues as well as reading x-rays. After the next day, I started to read them on my own, providing an oral report to a junior resident who would then write a full report. Of course my German language skills made for some difficulties in interpreting the images. What I might identify in English, I had not yet mastered in German. Writing was even more difficult, as this was not simple German to converse with, but medical speak. In spite of these difficulties I enjoyed my time there.

CT was rather different as there was only one dedicated CT scan reader.  Unfortunately this made it difficult to read images on my own, both due to lack of other computer stations, and the increase complexity of the images. As stated in a previous post, Heidelberg has very complex patients that it treats. Many were there post surgeries with anatomies not easily understandable. Even so, I did get to read images on my own and write my own mini-reports, though only in English.

There was a funny thing that happened during the rotation.  Around 11am one of my residents calls me up and says we have to go celebrate.  I was totally confused. “What are we celebrating?” I thought.  We went into the lounge area, and sure enough were champagne glasses filled with bubbly, and donuts. Two colleagues of theirs had passed their boards and this was celebratory break. Have to say, I never experienced anything like this in the USA, nor do I think this would ever be allowed.  Everyone had a glass, chatted a little, and then simply went back to work; such an odd experience.

I also had an embarrassing experience there as well.  On the last day of the two weeks in the Medizinische Klinik I brought in Russian waffle cakes that my wife had made.  The department head was walking around and saying Hi to everyone.  I had met him earlier and he seemed very friendly.  I was sitting in a corner reading CT scans when he came around and asked me a question in German.  In my surprise of being asked a question in German and seeing the department head I did not understand what he said except for one word, “mitnehmen” which means to take with.  In my panic I thought he wanted me to take my computer with me somewhere, ie to move out of the station.  To my horror, he starts motioning me to sit down and starts to laugh and ask in English.  He was asking if he could take a Russian waffle cake with him.  I embarrassingly said yes and sat back down.  Embarrassing myself in front of the department head was simply too much.

My next two weeks took place in the Chirurgische Klinik, the same building as my anesthesia rotation.  I spent the next week side by side the radiology resident reading the MRIs as they came in.  Although my resident was nice, this was the most boring of all the rotations.  I did not have the ability to read the MRI’s by myself due to limited computers, and lack of images.  It was complicated by the fact that my resident was utterly embarrassed by her English, which made things harder to understand especially for concepts that I had not previously heard in German. However I did learn a lot, and even got to have a scan of my shoulder! (A torn labrum that I was already aware of clinically though never had scans before done on it.)

The last week was the most fun. I spent time in the ultrasound department.  In the mornings we would scan the patients in the ICU and intermediate care units. Afterwards would have outpatients come in for scans.  My residents were great about pushing me to scan images on my own and report my findings to them. I was the most comfortable with this rotation as both I had plenty to occupy my time with and I got to interact with patients more. I even got to use my Russian! Though translating from Russian to German through my English mind became rather tough. I learned the most during this block and had a lot of fun too!

Everyone was very receptive in the field and were great to be around.  I did notice that people that go into this field are the same in Germany and in the US.  They tend to be more reserved, smart, and not as socially active.  I guess medical fields do cross international boarders too!