Let me tell you a short story to show you how amazing radiology is.

We get cases from all over India - from literally every corner of this vast country. One of our clients from the interiors of Uttar Pradesh sent us a case of a patient Ms Aarti (name changed). As is protocol, they had to submit the clinical history and symptoms of the patient. The patient had suffered a fall from her bike. This is the history of a standard trauma case, and the protocol for a diagnostician is clear – check for fractures and haemorrhages; we’ve reported lakhs of these kinds of cases and see almost a thousand every day.

One of our Radiologists had reported the case as a “as non-haemorrhagic contusion with haemorrhagic focus” – basically he diagnosed an injury to the brain with a little bleeding. Something kept him from submitting the report and he requested for a collaboration with me. When I asked him what he wanted help with, he simply said “Dr, I feel there is something off with this patient”. With the amount of training we do and the number of cases we see, we have all developed a bit of a “spidey sense”!

The moment I loaded and viewed the case, I asked to be connected with the patient. I wanted to get the exact history from the patient. This was more than just a fall. She claimed that she felt weak and had a seizure just before she fell, which means that the accident was only the consequence! We had to find the cause. Since we reverted quickly and the patient was still there, I immediately suggested a contrast-enhanced CT. In 30 minutes, the new scan was in front of us and the result was clear – a ring-enhanced lesion with a central core of calcification – neurocysticercosis (Tapeworms in the brain. Yes, as crazy as it sounds, it’s one of the most common and most commonly misdiagnosed diseases). The fact that I had seen cases like this from this geography - where pork is commonly eaten - allowed me to zero in on the diagnosis. As expected, she said that she was a regular pork eater.

As a doctor, I know how important my work is. But there are some cases that make me realise how incredible my profession can be. This case sounds like its straight out of House M.D!

Radiologists are the bridge between a few lines of history and the ultimate diagnosis. Radiologists are not just image readers, they are detectives. Our radiology training helps us find clues (image findings), but our clinical understanding and knowledge is what allows us to solve the case. Why our work is even more amazing and even more challenging is that if we solve the puzzle, many a time, we save a life. Finally, radiologists also must be storytellers, and doctors must easily understand the narrative that we have created in a case and be in a position to make a decision. This comes through the 3Es – Experience, Empathy and Excellence. Each condition is necessary, none alone is sufficient.

Ah well, I just got called for another case. Let’s see what culprit is making my patient cough blood…