My day begins slowly. The alarm is set to a gentle piano-based theme to coax me out of my twitching stage IV REM. With a 25hr body clock, I am ill-suited to early mornings. Well, mornings full stop, really. A lark I am not. My first act is to grunt morning greetings to family members. They aren’t morning people either, their greetings similarly guttural. I then scratch the cat and feed him as otherwise he’d mither endlessly until fed and scratched. A double espresso kickstarts my brain before I slinging some black pudding around the pan with a few mushrooms. I find a pork-based breakfast a ba ..read more

There is a common myth of an old Chinese curse that runs, “may you live in interesting times”’. Although it isn’t old or Chinese, it seems apt to describe the last few years. I can barely remember the simpler and more care-free times before 2020. All the things we took for granted, all the things we missed so much in various lockdowns are slowly returning. Many of us had never seen viral pneumonitis back then. Many of us never want to see it again. The covid pandemic is by no means over and it may never truly disappear but there have been many curious changes of the last two years. In the ear ..read more

An "exclusiometer"? Although Professor Sir Howard Middlemiss died nearly 30 years ago, his memory lives on. A radiological giant of his time, I once heard a quote attributed to him that further elevated him in my mind. It was said that he wanted a sign put up in the reception area of the radiology department of the Bristol Royal Infirmary that said, “We are not in the business of exclusion”. This adage could equally be a rallying cry for twenty-first century radiologists. Particularly if you have high clinical standards and loathe sloppiness of medical thought, word and deed. Specifi ..read more

The great thing about a career in medicine is that everyone can find a niche. An old medical friend said radiology was definitely the best choice for me; locked in a dark room. Such was the cliché about radiology; a boffinish speciality for introverts who were bright enough but best kept away from patients. Imagine my surprise on day one of radiology school when most of the consultants were affable and ebullient. When I was a young(er) radiologist, this ‘talking to patients’ notion was seen as a luxury extra. The implication was that we weren’t there for that kind of thing. Radiology was a te ..read more

We’ve all been to disappointing lectures by noted experts. The reasons vary but a mild anticlimax is commonplace. Perhaps your medical hero has an unexpectedly reedy voice and bad teeth. Or they come across a bit weird: nasty-and-sinister weird, not pleasant-yet-eccentric weird. It has been said that a professor is like an undescended testicle: difficult to find but when you do then they are often malignant. Nevertheless, keynote speakers consistently pull in the crowds, flocking to gather the pearls of wisdom that drip from their cherry lips. However, what often follows is anaesthetic induct ..read more

Our dear Royal College has decided to formalise, nay, mandate reflective practice from every Fellow. It is now embedded into ongoing professional development. This news may have completely passed you by, but this is official as of 1st Jan 2011. We are now required to provide evidence of reflective learning. More specifically, this is required by the RCR for “online CPD activities (and all Category II CPD activities)”. We are not alone, the RCR is one in a long line of UK Royal Colleges who have introduced such a system. Some will have read this and made a PFFFFFFFTT noise as they involuntaril ..read more

Site-specific cancer multidisciplinary team meetings (MDTs) are a prominent feature of the working lives of all Fellows of the RCR, radiologists and oncologists alike. We attend them dutifully yet we rarely question anything about them. OK, we moan like hell when they don’t run smoothly but that is about it. I contend there are aspects of MDTs that are strikingly unusual. First is the love: hate feelings that MDTs engender. On one hand, few relish them. They are tolerated at best, made passable by decent colleagues. Part of this is their reputation as a time-occupying lesion; the preparation ..read more

My trust is about to introduce a new Hospital Information System. Being an earnest sort, I accepted an invitation to go along to a 2 hour briefing session specifically aimed at consultants. The audience were uncharacteristically lively; both of us asked a number of questions. The system looks very good and will undoubtedly be huge improvement. I’m not saying our existing PAS system is old but the Science Museum have said it is of historical significance and could they please have it when we’ve finished with it. One aspect of this briefing did stick in the craw a little. It isn’t overtly pedan ..read more

We all want to be able to quickly and accurately predict troublesome patients. By this, I mean that with a mere glance you just know that a patient is either moments from death or, alternatively, that they are about to steal your mobile phone. The Fellows of the RCR are neither effete or squeamish but they do come to enjoy vaguely compliant and, well, alive patients. Few revel in the undignified business of resuscitating those who have impolitely attempted to die in the department. At any rate, it is an Official Good Thing to spot trouble early nowadays. We are exhorted to call in the cavalry ..read more

Well, after 2 years of writing, editing, rewriting, re-editing and so forth, I am proud to announce the publication of the book form of the The Rules of Radiology. It's a 213 page hardback book which dotted with lavish illustrations by my Uncle, John Charlesworth. Each of the first 50 Rules has it's own short chapter where they are explored, explained and detailed.  As usual, there are plenty of decent jokes and lots of thought-provoking discussion of important topics. Crucial in these difficult times, it contains much straight-talking guidance on how to thrive in today's challenging medi ..read more