Radiology Workflow Shortcuts

Modern radiology practice is one of high-volume, high-precision visual inspection. Our moment-to-moment visual attention is our singularly essential sensory resource, and we should design our workflow to conserve it. Visual distractions, no matter how brief, should be minimized. Push notifications, invocations of popup menus, glances down at the keyboard, saccades up to a toolbar, and even visually localizing the text cursor in a report all should be avoided.

Example: we have to switch our primary click tool constantly, say from a selection cursor to a 3D-localizing homing tool. I’ve witnessed one of our venerable attendings accomplish this by the following: right click to invoke the tool palette, pause, mouse toward the tool palette expansion command, click, pause, mouse toward the 3D localizer tool, click, mouse toward the X button to close the tool palette, click; then left click to actually use the 3D localizer; and then once again right click, pause, click on the default tool, then click on the X. A tedious and distracting six-second side quest that could be executed with keyboard shortcuts in a near-instantaneous sequence of keystroke, click, keystroke.

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Podcast Roundup

Here’s a roundup of the podcasts to which I’m subscribed. These shows comprise the media that I consume regularly as I don’t watch television. They tend to be educational, scripted, high production-value shows with only a few unscripted interviews sprinkled in. I listen while commuting, running, or cooking. Most shows I play at 1.5x speed on Apple Podcasts, but the music-related episodes I play in real time.

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2021 in Retrospect

Coronavirus, year 2. We’re ending on a sour note, in contrast to the burgeoning promise from last year’s end. I got my first Moderna vaccine dose on 12/31/20 and with it the hope we’d never see a crushing spike in cases again. Depressing that this is the new normal, huh? That this blasted virus can roll around and just ruin plans over and over again. I especially feel for my emergency medicine, internal medicine, and family medicine colleagues who continue to bear the burden of the pandemic on behalf of all of us. Not just in the realm of the hospital, but on behalf of the country as a whole. Thanks, guys.

All right, here’s my annual habit of public reflections. Not much to say.

Radiology

Firstly, I officially declare my radiology class the best class.

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Tiny Desk Moments

NPR’s Tiny Desk Concerts are spectacular. They’re a YouTube series of small-scale, exquisitely produced sets from the NPR music office in Washington DC which focuses mostly on quirky indie rock. In its long run since 2008, Tiny Desk has hosted a deep roster of musicians, both small and big names, and the intimate setting facilitates unique takes often lost in hyper-refined studio album versions or live stadium sets.

Tiny Desk has broadened my horizon of music, far beyond the comparatively staid classical music from my childhood. I’ve hardly listened to them all (they’re thrice weekly now), but let me tell you about five memorable moments:

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The Toll of Radiology Nights

Radiology night shifts are a frenzy. Maddenly, absurdly difficult. An older internal medicine doctor once asked me “oh, do you get to sleep during your call shifts?” and I scoffed. Sleep?! We hardly have time to go to the bathroom!

Labeling radiology nights as “call” is misleading, suggesting that we only spring into action when some rare clinical circumstance occurs (like checking if a baby’s bowel is twisting itself off). “Night float” gets closer, implying a skeleton night crew takes over to cover overnight emergency issues (like if a patient in the scanner requires special attention). I mean, we do those things too, but the commodity of modern radiology is incorporated real-time into many diagnostic workups, so we’re basically ALWAYS needed.

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Soymilk Alchemy

Making soymilk is like alchemy. Turning America’s underappreciated cash crop into a delectable, smooth drink feels like magic. However, this recipe is not for the faint-hearted. It requires a good amount of niche home kitchen equipment and a couple hours of work.

You might be surprised by the scale of America’s soybean crop. It’s second only to big corn and far outstrips wheat and every other crop, but it has low visibility to the average consumer because almost all of it is pressed into vegetable oil and livestock feed and/or exported. Tofu, tempeh, edamame, soy sauce, and soymilk comprise a vanishingly small percentage of the crop.

This project started back in September 2020, when my college friend Alvin and I were discussing pandemic cooking projects. He had been reading some soybean scientific literature and refining his formulation for “delicious, reproducible soymilk” using a few uncommon techniques like applying boiling water to soak and slow-cooking. Then, in the winter, several times I tried buying bottled soymilk from Chinatown and found it overly sweet and—even worse—spoiled and slimy. I asked my friend for tips, and he generously shared his recipe notes and even supplied me with a starter bag of soybeans (thanks!!).

Since then, I’ve cooked 24 batches, so most weeks. There’s been lots of titration, experimentation, and tasting. We’re finding soybean skins and okara crumbs everywhere in the kitchen.

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