I was ten years old and the advertisements in the back of the Superman comic book showed a man with glasses looking at his hand and seeing through the skin to the bones. The glasses were advertised as “X Ray Vision” glasses for one dollar. I knew that Superman had Xray vision and if I could just get those glasses . . .

That afternoon, I pinned a red towel to my back. My mother refused to allow me to tie the towel around my neck because I might “hang” myself. So we pinned the towel corners one to each shoulder. Little did she know I was about to do something as dangerous as the possibility of choking. I climbed up on the roof of the “garage apartment” as we called the one bedroom apartment next to our house and decided I could fly like Superman. If I could fly, I wouldn’t need Xray glasses!

I jumped and fell about eight feet landing square on my back. The blow knocked the wind out of me and still remember lying on the ground unable to breath. I couldn’t get my breath. Luckily, my daddy was out in the yard “piddling” (that means doing little odd jobs, not relieving oneself) and saw me fall. He came over immediately and kept telling me to breath. That was what I was trying to do! Eventually I got my breath back and was able to go into the house. I don’t know how I managed not to break anything. But that little incident bought me enough empathy from my parents that I convinced my mother to order the “X ray Glasses” from the comic book.

Of course, when the glasses arrived all they did was make something look blurry enough you thought you were seeing the bones inside. It was another scam against a young comic book reader like the “submarine” I acquired which was nothing but a cardboard box. Little did I know that one day, I would truly be the man with Xray vision!

Do you know your radiologist? I’m sure you know your internist, family practice doctor, OB/GYN doctor and so forth. Few people realize that if you have any kind of Xray or imaging study, particularly in a hospital or imaging center there is a radiologist responsible for reviewing those studies and dictating a report with the findings and a diagnosis. These doctors work in the shadows behind the scene but are absolutely essential to patient diagnosis. I know, because I am a radiologist.

Becoming a radiologist was NEVER my plan! In fact, one day I want to write a book about my life entitled, “Never My Plan!”. I was halfway through my internship in internal medicine the year after I graduated from medical school and realized I had made a huge mistake. I was miserable. I hated my internship. This was NOT what I wanted to do. I started looking at other residencies and one day, while working the emergency room, ran into my friend, Randy Brown down in radiology at LSU Medical Center. I’ve shared this story before, but I realized God was opening a door I never considered walking through and I ended up in the radiology residency program the following July.

After 4 years of residency and a short fellowship, I started working at Willis Knighton Medical Center with a group of radiologists. That was 42 years ago! I have never regretted the decision. I have been a “shadow merchant” since July 1980!

What does a doctor with Xray Vision do, exactly? I describe a radiologist and his practice with my character, Dr. Jack Merchant in “Shadow Merchant” and “Merchant of Justice”.
At the core of each hospital is a department of Radiology. Like very department in the hospital, radiology has its own drama, struggles, and personal quirks. It is here patients receive diagnostic imaging studies that range from simple X-rays all the way to PET scans.

The cover of “Shadow Merchant” features part of my daughter’s MRI of her brain by her permission, of course.

Xrays most people understand. You know, “hold your breath” when they take a “picture” of your lungs. Or that possible fracture you might have when they Xray your hand. However, the field of radiology includes CAT scanning with an Xray device that produces “slices” through the human body and can reconstruct those slices into 3D images. MRI uses massively powered magnets and no radiation to produce images of just about anything in the entire body. Just slide right into that tube over there! Ultrasound uses sound waves to produce fancy “sonar” images of many parts of the body. Nuclear Medicine uses radioactive tracers tagged to certain chemicals that can image body organs and evaluate their function as well as their anatomy. PET scans are a special kind of nuclear medicine study using a combination of nuclear pharmaceuticals and CAT scans for evaluation of almost any kind of cancer.

Mammography consists of 3D Xray imaging of the breast to rule out breast cancer. The gold standard for breast diagnosis in the twenty first century is the radiology controlled breast imaging centers where a patient arrives with a complaint related to their breasts and they don’t leave until there is an answer using mammography and ultrasound. In today’s world, the radiologist not only diagnoses a possible breast cancer but will discuss those findings with the patient and set them up for a biopsy under imaging guidance by the radiologist. Radiologist work hand in hand with breast surgeons, radiation therapists, and oncologists in the science of the diagnosis of breast cancer.

Most other types of biopsies are performed by a radiologist using CAT scan or ultrasound guidance. Most elective spinal taps are now performed by radiologists using Xray guidance which is much better for the patient. Interventional radiology, a field within radiology has exploded in the past decade and IR doctors now do all kinds of invasive diagnostic procedures or treatments using imaging guidance. And of course, the radiologist still performs upper GIs and barium enemas to look at the digestive system.

When I started out in radiology the field was not nearly as technologically advanced and I have had to LEARN a lot to keep up with the advances. In fact, I attend educational meetings every year just to keep up with the new advances and most of the subspecialties I mentioned above require regular recertification on a regular basis. In our practice group, we have subspecialty radiologists who are more expert in their areas. For instance, my subspecialities are breast imaging and PET scans. This way, our group can cover all of the new advances without every member learning every new advance as that would be almost impossible. This is how complicated this field of medicine has become.

Next time you show up for a “test” in radiology, pay attention to the technologists and the nurses and be aware there is a radiologist in charge who will be responsible for making your diagnosis or delivering your therapy. And, I would suggest you ask the name of your radiologist for the day. We would appreciate it!