Blake Feldman ’17, Staten Island University Hospital

Blake-FeldmanDuring the past Spring Break, I had the pleasure of spending three days at the Staten Island University Hospital with Dr. Sanjiv Bajaj ’02, a remarkably capable and experienced radiologist. As a pre-med freshman, I still have yet to decide on my ultimate medical career goal, so I used the opportunity to learn about the field of radiology. This experience was a perfect glimpse into the duties and day-to-day work of a radiologist.

The Staten Island University Hospital is fortunate to have a large and expansive imaging department, with several of a variety of imaging machines, skilled technicians operating those machines, and experienced doctors analyzing those images. After a harrowing journey into Staten Island from Princeton, I headed into the very heart of that imaging department. There, I met with Dr. Bajaj at about 10 am, though he had already been up and about for two hours prior to my arrival. On the first day, the other student, Kevin, and I spend the majority of our time in what was called the “Radiology bullpen.” The bullpen was the major hub of the radiology department: images from everywhere in the hospital would be uploaded to the hospital’s network, where they would then be downloaded, viewed, and analyzed by experts.

The bullpen was equipped with four work stations, each with two large monitors, two larger monitors, and a very comfortable chair (a necessity when one spends a good deal of time sitting and analyzing images). Additionally, each workstation had a dictation microphone with which the radiologist could turn speech into text on the screen. This allowed Dr. Bajaj to quickly document his thoughts and observations without being slowed by the time it would take to type.

Several other people, doctors or graduate students, would also work with Dr. Bajaj in the bullpen, gaining experience by analyzing images and observing Dr. Bajaj. Occasionally, Dr. Bajaj would look at the dictations of the graduate students and make small constructive comments on their work, ensuring that those students are well prepared for their future careers.

The work consists of viewing and analyzing images including ultrasound, CT scans, various magnetic resonance imaging scans, and more. The images displayed abdomens, skulls, chests, and the occasional arm or leg. Dr. Bajaj was able to make out discrepancies in the images, subtle patterns of shading or brightness that indicated to him symptoms, and he used that information to diagnose the patients. To me however, most of the images looked remarkably similar, I was unable to make heads or tails of all but the simplest of x-rays. Because of the wide variety of possible images, Dr. Bajaj and the other radiologists have to have an excellent knowledge of numerous types of scans, as well as near perfect memory for internal human anatomy. I now understand that to pursue such an avenue of medicine would require a great many years of difficult study, hopefully with successful results.

Kevin and I sat with Dr. Bajaj until about 10 pm that evening, stopping only once to grab a sandwich from a nearby café and then eating it in the bullpen. The volume of images to be viewed was enormous, and the work required Dr. Bajaj to eat at his desk, but he remained positive. Dr. Bajaj told us that for him, radiology was a great job. His favorite thing to do was to diagnose patients, and that was the brunt of his work, just viewing images and making diagnoses. He wasn’t missing the human interaction component of medicine because he was constantly interacting with students, either teaching or supervising. He seemed quite happy to do his work, which was very nice to see.

The next morning, we continued the work of the previous evening, tearing through image after image and observing Dr. Bajaj’s work. After some time, Kevin and I left Dr. Bajaj temporarily to work with another expert, Dr. Omar Arnuk, a neuroradiologist. Dr. Arnuk, as opposed to ultrasounds, spent the majority of his time looking at CT scans in the brain. Because CT scans show the density of material, Dr. Omar was able to see fluid-filled spaces and areas of blood flow in the brain. His highly specialized knowledge of the brain allowed him to see subtle differences in the images on his monitor which allowed him to diagnose the possible ailments of the patients.

On the final day, Kevin and I were able to see actual imaging take place. We sat with an MRI technician and observed patients enter the machine and watched as images of their internal anatomy appeared on screen. We learned that the MRI scanner technology is able to take an image and from that image extrapolate views from the top, side, and front, giving radiologists a great deal more information to work with. The imaging procedure was very short, safe, and remarkably effective, making the MRI an excellent medical tool.

Viewing the work of Dr. Bajaj and Dr. Arnuk, SIUSand spending time in the SI University Hospital has given me a wealth of experience for a possible career in radiology. Before this opportunity, I had only vague thoughts about the daily work of a radiologist, and the education the job required. Now, however, after observing and speaking with hospital staff, I have a much greater appreciation and understanding of the radiology field, and will one day be able to make a more informed decision about my career path.