Radiologist: Story telling has value for medical imaging, health technology

Richard Gunderman is into stories.

Asked to give an annual oration on diagnostic imaging at the Radiological Society of North America's annual conference in November, the professor and vice chairman of the department of radiology at Indiana University (pictured) eloquently recalled his encounter with an 89-year-old man who had a history of dementia and multiple falls. Unbeknownst to him, his patient, Charles B. Huggins, was a Nobel Prize winner in medicine for his work showing how hormones could be used to control the spread of some cancers. That encounter, Gunderman said, left him regretting that while he had treated his patient correctly and professionally, he had failed to comprehend the true story of his Nobel laureate patient.

Now, Gunderman has written a book about imaging, filled with stories about the physicians and scientists who developed the technologies we use today, the patients whose lives have been affected by those technologies, and how imaging has changed the way we view the world around us.

Gunderman took some time to talk about his new book--and the importance of stories--with FierceMedicalImaging.

FierceMedicalImaging: Why did you write the book?

Gunderman: Many people, including those who work every day in radiology, don't know very much about the dramatic effect imaging has on multiple aspects of our lives. They may know that radiologists use CT scans to diagnose appendicitis, but aren't aware of, or haven't given much thought to how X-rays have changed our understanding of the history and structure of the cosmos, or helped us understand the structure of important molecules in human health and disease.

I wanted to tell that story, and I also wanted to try to present the history of imaging and its impact on our current view of the world in a way that lay readers would find engaging and enlightening.

FMI: In the book, you write about imaging's impact on medicine and science, as well as on the arts, literature, and music.  Why was it important to illustrate those kinds of connections?

Gunderman: I worry that we live in an increasingly fragmented world, under conditions of information overload that sometimes buries us under an avalanche of fact and we don't have time to sit back and think how things fit together. Showing medical imaging's effect on our worldview is a great opportunity to do just that--to see how history, culture, philosophy, medicine, and the natural sciences fit together and how understanding each one of them a little better, helps us understand the others, as well.

FMI: As a Beatles fan, I particularly enjoyed the story about how the rise of the Beatles helped spur the development of computed tomography. Talk a little about that.

Gunderman: It's quite ironic and remarkable that as a small boy, Ringo Starr almost died of a condition [appendicitis] that today we routinely identify with ultrasound and CT imaging. And, that it was the incredible revenues generated for [the Beatles' record company] EMI by the sales of the band's records that ended of making it possible for an EMI engineer [Sir Godfrey Hounsfield] to pursue what, to some, might appear to be a really hare-brained idea--that you could shine X-ray beams from multiple directions through a box to see what's in the box without opening it.

Hounsfield ended up producing one of the most important innovations in medicine of the 20th Century.

FMI: In your oration at RSNA, you talked about the importance of learning about patients' stories. That theme comes across in your book, as well.

Gunderman: We don't tell stories, and we perhaps don't even recognize stories when we hear them, so we fail to benefit from them. We are shaped in part by the rules we learn, the facts we memorize, and the stories we hear, and if we don't take time to recognize and share good stories then we are stunting our own development, and that of radiologists who come after us.

There is a whole human dimension to the patient that, if we are aware of it and take the time to get to know it, enhances our sense of dedication and our sense that we have a real opportunity impact a patient's healthcare and life.

Sometimes we need to fan the flames of professional inspiration and dedication, and I think those kinds of stories do that. That was certainly the case of the story I told at RSNA about Huggins. Knowing that story helped me appreciate more deeply how the images we see are just part of the story, and often just a superficial part.

Editor's note: This interview has been edited for length and clarity.


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