Jones fracture

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A Jones fracture is an injury to the fifth metatarsal bone of the foot. The fifth metatarsal bone is at the base of the small toe, and the Jones fracture occurs in the midfoot area (the top of the bone).

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    June 23, 2012 at 5:51 pm

    Fighting for Truth, Justice, and the Radiological Way

    By Eric Postal, MD | June 22, 2012

    ——————————————————————————–

    Recently, in response to a column I wrote about a contrasting pair of radiologists (one did no wrong, the other no right), there was a comment suggesting a single Jekyll/Hyde character, fulfilling both roles. He might showcase his darker side when being a nice guy just wasn’t getting things done (such as in the face of less noble individuals elsewhere in the health care system).

    I happened to see the comment while visiting Peru, and the answer stared me in the face almost as soon as I left my hotel that morning: a strangely large proportion of local taxis, decorated with the Batman emblem. While I never did get a clear answer as to why this was, the message was resoundingly clear to me: I believe our champion has been in print and film for decades.

    Like us, Batman works best in the dark, and employs sonic gizmos the likes of which we and our ultrasound techs can only dream. In the normal course of events, we might not be all that different from Bruce Wayne, Bat’s civilian alter ego — smart, capable at work, perhaps a little eccentric or even harmlessly dorky. Rewriting Wayne to be a radiologist for this purpose wouldn’t be too hard. Everybody outside of our specialty thinks we’re billionaires like Bruce, and I’ve seen a few reading rooms reminiscent of the Batcave.

    When injustice rears its ugly head, and society’s (or the health care system’s) usual mechanisms of keeping order and reining in bad behavior aren’t up to the task, Batman steps just outside of the normal boundaries of the rulebook and takes care of business. Bats doesn’t wait for a warrant before swooping into the villains’ hideout. Meanwhile, the police and courts are hamstrung by red tape, ineptitude, and/or corruption.

    Consider the scenario: A frequent offender clinician in the ER orders yet another pre/postcontrast chest/abdomen/pelvis CT in a 5-year-old to “rule out pathology.” The frustrated radiologist covering the service has already tried everything to stop this — politely offering the clinician some help in protocoling studies and guidance in writing more useful histories, then more firmly educating the individual with literature about excess radiation and the ACR’s appropriateness criteria.

    The clinician doesn’t budge, and the radiologist escalates his efforts. Eventually, the clinician complains about the perceived radiologist interference, and an interdepartmental mess ensues, after which there are plenty of hard feelings and still no change in the clinician’s behavior. Who will help our tormented radiology citizen?

    Cut the scene to the hospital’s parking lot at night, where the clinician is exiting to head for home. Batman, having heard of the situation through his usual sources, emerges from the darkness to have a little chat with the clinician. No political wrangling with hospital committees, no he-said/she-said — just some blunt discussion of the facts, with a suggestion that Bats might make a return visit if the clinician doesn’t change his/her ways. Perhaps the clinician’s favorite CT-order-writing pen gets a little roughed up in the process.

    The health care field rogues’ gallery is at least as populous as that of the super baddies in the funny papers. Our hero could easily spend all of his time confronting members of the insurance, med-mal, and MC/MA fields. Perhaps a few folks from the professional societies, too. His civilian alter ego might have little time left over to read films.

    Unfortunately, Batman seems to be particularly high-profile in the media right now, what with his latest movie about to hit the screens. It could be tough to reinvent him as a radiology figurehead at the moment, and DC might make some unreasonable demands (such as money) for his usage. That being the case, we might have to settle for someone else. Perhaps one of Bats’ precursors, from a decade or three earlier: The Shadow. He’s not getting much press at the moment, and has a similar motif. As a bonus, even his moniker sounds more radiological.

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