Dr Haroons Training Centre

A little extra knowledge ---MRI and CT

                                                                                     Most of us have graduate degrees and many have postgraduate degrees . But have you thought in your day to day life how much of that knowledge is applied in professional life . Lets be honest out of 20 years of schooling we use maybe 5 percent of the knowledge on a day to day basis . From anatomy of amoeba to differential equations we use just a fraction of that knowledge . 

Now we may argue that it is all the basics thats important and without which advanced knowledge cannot be studied . True , again imagine even in our field of radiology there are countless people who operate multicrore scanners without even formal qualifications . There are even ward boys who operate scanners in remote corners of india . The point is operating even a  advanced machine is easy . But using it intelligently and for the best possible outcome needs tremendous knowledge , actually specialised knowledge . In short knowledge has a value only when we expect the best outcome . 

In a field like medicine and of course in radiology that is very important . Sometime back what seemed like a casual friendly meeting of three doctors turned out to be amazing for the patient .  The patient was a young man who the surgeon suspected as having liver cancer . Liver cancer is deadly unless detected early . An ultrasound done by experienced radiologist as well as witnessed by the surgeon as well as me was negative . Since the suspicion was high and since ultrasound is not 100 percent accurate CT was proceeded with and that showed a suspicious tumor in liver . But even with CT in this particlar case the findings was not 100 percent . That happens as some tumors are like that . This was a case for MRI . But there was a problem . Patient wont fit inside an MRI with the usual bore size . 

Though it didnt require deep physics knowledge , bore sizes of most MRIs were known to me and i could suggest it . Of course a one minute measurement of his abdomen showed he will fit inside some scanners . Even as a technical radiologist it was really fascinating to know that one aspect of the "useless " knowledge which didnt involve complex radiology physics or radiology clinical aspects came to be very useful to the patient . Of course the extra knowledge of the surgeon in  pursuing his strong clinical suspicion as well as the radiologists keen observation helped in going many steps towards the problem solving tree . 

If it was done in the usual manner the surgeon wouldnt have the extra suspicion , the radiologist would have easily missed the finding since it was very subtle and if i hadnt remembered bore sizes of all the mri scanners we wouldnt have been able to proceed with MRI .

I report this firsthand because for an average diagnosis even for a radiologist or surgeon just  5 to 10 percent of what is learnt is enough . But to give the full impact sooner or later you need all your knowledge aquired over the years . Being in the training field i see both types of people . The people who think why advanced knowledge is needed and especially why pay for it and the people who try to aquire advanced knowledge in every possible manner . Be it radiology or medicine or other professional areas extra knowledge always saves your day or someone elses day if not today , definitely tomorrow . 

It was a rare day i skipped my lunch for a patient and had a late evening snack as compensation . Being in training field i dont skip lunches often . But i got an answer to the age old paradigm of what is the use of the extra 95 percent knowledge aquired since kindergarden . Maybe i should use the nursery rhymes more often :)  

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