EJCAP Online 22(4), December 2012, English

4 Joe Morgan

4 Joe Morgan

What attracts you most in diagnostic imaging?

“Because it’s great” – great means OK, good, awesome, helpful, but mostly it means “fun” – this is going to be a brief discussion of how I started in radiology and how and why I continued in this specialty.

How did you discover your interest in this specialty?

I started as a technician working in a human hospital and then continued as a technician working in a veterinary teaching hospital – so I learned early the challenge of discovering how to make a diagnostic radiographic study. It was easy from there to move to the next step, which was to evaluate the radiographic study.

Please explain the “fun” part of diagnostic imaging to us...

I quickly learned the “fun” of having a job in which you have the privilege of being at work each day and enjoy the opportunity of being presented with unknown situations, each providing a challenge to find the correct answer. Some cases you will have seen before and you are very confident in the diagnosis to the point of being 99% certain, as it is said, “you can bet the farm on that one“. More challenging will be those that don’t seem to be as familiar and you tentatively suggest a diagnosis with a 50-50 chance of being correct. There will be yet other cases in which you are willing only to think in terms of a differential diagnosis and even then you will strongly recommend a fine needle aspirate for confirmation – the story often only reaches a conclusion thanks to the surgeon, or perhaps the pathologist and you can learn, sometimes embarrassingly, of the incorrect nature of your answer– it’s a fun trip if you were correct. If you were close or even totally wrong, you have the possibility of returning to the case and trying to learn what you did that was wrong. Did you simply miss the lesion, or did you identify it, but your evaluation was incorrect or was it something that was geographical and your earlier experience simply failed to pay off in your recognition of the disease?

Has the “fun” part changed for you over the years?

Well, there is the fun game that you can “play” after some additional years of experience when your “absolute” diagnosis is rejected by the pathologist and you are faced with the difficulty of having to explain “their” error and asking them to re-cut the tissue to obtain a more diagnostic section of the lesion since their first pathological evaluation is absolutely “wrong”.

Another part of imaging that is “great” is that you can’t exist alone – either you are working with a group in imaging and having the opportunity of attempting to justify your diagnosis within the group during morning rounds, or arguing with someone and telling them how their diagnosis is incorrect. Being “thin skinned” is not a good attribute for someone working in imaging since they will be challenged on a regular basis by others in the clinic.

In the absence of colleagues in imaging, you will deal regularly with clinicians as you try to convince them of the appropriateness of your diagnosis and advise them of what they need to do to confirm the diagnosis All these scenarios are fun and are challenging, especially rounds since they usually indicate the way the day is to progress.

How can we motivate the practice team to take the best possible images?

This is another part of the story: your relationship with your technicians, helping them to understand how they can make a study of more diagnostic value, and discussing with them how they can position the patient is a manner that projects a suspect lesion more clearly. Part of this deals with how you can encourage them in a manner that will help them in the future to provide you with a sound diagnostic study thus protecting you from making foolish errors in your diagnosis. Examples are, how to do stress studies, when to do comparison studies, when to do an oblique view, or when to add the opposite lateral view in a thoracic study. All these considerations help them see how they can simply make the lesion more obvious.

Would you have any suggestions on archiving and sharing images?

Part of this rather enjoyable life is the possibility of establishing an archive. In the past this was a file of 3 x 5 cards with notated case numbers that sent you to a bulky film storage room with dusty envelopes that were regularly searched to find the envelope of a patient with a particular diagnosis. Now with digital imaging the search for a case can be immediate and comparisons can be made between studies leading to a conclusion of “that’s exactly how this case should present”.

With the advent of digital imaging, doors have been opened widely and frequently you can consult among friends in other parts of the world. This opens the chapter on geographical medicine and provides the challenge of seeing cases that you hadn’t even known of before. How many people in the world can see the result of patients poisoned by the herbicide paraquat with its challenging, and unfortunately terminal, pulmonary and mediastinal changes?

All stories have to end sometime – consider now having the choice of entering an era with the possibility of continuing to work from your office in the evaluation of cases sent using teleradiology. Instead of losing all of this fun that you have experienced during your life time, you can continue into the twilight portion of your life sharing with others the knowledge you have gained throughout your life.

Any final thoughts?

Why would someone want to work with diagnostic radiology – “because it’s great” – what’s better than facing a challenge each work day, arguing with colleagues, and having it be fun. When describing my work to a grandson, he said “it’s like being a detective”! Perhaps that’s why I read so many mysteries these days. I continually face the question of “what is it” rather than “who did it” And finally, but always an important consideration, it is very uncommon to be bitten by a radiograph!

Joe Morgan

Author

Joe Morgan

jpmorgan@ucdavis.edu

After graduating from Iowa State Teachers College (1952), Joe Morgan qualified as a DVM from Colorado State University in 1960, where he became assistant professor (1960-1964) and later associate professor (1967-1968) in veterinary radiology before heading to Davis, where he became professor at School of Veterinary Medicine, University of California, Davis (1968-1993). Here, he later became Chief of the Radiology Service, at the University of California Veterinary Medical Teaching Hospital (1969-79).

He is a Diplomate of the American College Veterinary Radiology and of the European College Veterinary Diagnostic Imaging. He is past president and honorary member of the International Veterinary Radiology Association.

An Emeritus professor of the University of California since 1993, he has been a visiting professor in Canada (University of Prince Edward Island, 2001), Switzerland (University of Zurich, 2002, 2004, 2007, 2008), Norway (School of Veterinary Medicine, 2007), and has also been professor in the West Indies (Ross University, St. Kitts – 2003-2006; St Georges University, Grenada– 2007-2008, 2011-2012)

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What attracts you most in diagnostic imaging?

“Because it’s great” – great means OK, good, awesome, helpful, but mostly it means “fun” – this is going to be a brief discussion of how I started in radiology and how and why I continued in this specialty.

How did you discover your interest in this specialty?

I started as a technician working in a human hospital and then continued as a technician working in a veterinary teaching hospital – so I learned early the challenge of discovering how to make a diagnostic radiographic study. It was easy from there to move to the next step, which was to evaluate the radiographic study.

Please explain the “fun” part of diagnostic imaging to us...

I quickly learned the “fun” of having a job in which you have the privilege of being at work each day and enjoy the opportunity of being presented with unknown situations, each providing a challenge to find the correct answer. Some cases you will have seen before and you are very confident in the diagnosis to the point of ...

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Volume 22(4), December 2012 SPECIAL ISSUE

Veterinary diagnostic imaging, an introduction

Commissioned paper

An interview with Joe Morgan

Joe Morgan, one of the fathers of veterinary diagnostic imaging, tells us why he was drawn to this specialty