Men Love Siri, Women Still Looking for Mr. Good Signal Strength Bar

A study in the current issue of Virtual Science has confirmed what many already suspect: men are falling in love with Siri. When Apple introduced Siri – the iPhone 4S virtual assistant – this past October, tech geeks became very excited. But few had the foresight to see that this excitement would also become a bad double entendre.

The just-published research was conducted by virtual scientists at the University of Wisconsin. Based upon telephone interviews with iPhone 4S owners, 79% of men in committed relationships (defined as completely monogamous for greater than 12 months, any recent office Christmas party activities of course exempted) found Siri to be a more desirable romantic partner than their current significant other. Despite the apparent strength of these data, the authors were quick to point out that the Siri preference may be overstated as the male study participants were all involved with women from Wisconsin.

The Siri phenomenon is not just a scientific one. The latest entry in the hugely popular Girls Gone Wild video series, Virtual Assistants Gone Wild, includes footage of Siri (some truly amazing stuff happens just past the 4 minute mark, or so I’m told) and is poised to be their biggest seller yet. Plus, the rumor mill has it that Esquire magazine’s 2012 Sexiest Woman Alive is setting up to be a close battle between Siri and Megan Fox.

Apple has been quick to notice these trends and will soon be offering Siri-themed apps through its iTunes Store. “Sexting Siri” will substantially expand upon her vocabulary and allow her to answer those personal questions to which she now refuses. The specific details of another app, “Siri Love You Long Time”, have not yet been made available, but a hardware purchase of some sort will be needed to take full advantage.

The Virtual Science study also asked women iPhone users about Siri, with 63% describing her as a vapid, catty ogress who they long ago disabled from their phones. When these women were then questioned about what they’d like in a virtual assistant, many expressed a preference for a yellow, nonverbal, smiley-faced character with glasses. When told that this description identically matches that of Microsoft Bob, the colossal Windows virtual assistant failure from the 1990s, the response would typically switch to “Well, just anything but that Siri b*tch”.

[The blogger reserves the right to occasionally go off topic and flat out make things up, and he did receive an iPhone 4S as a holiday gift]

This was originally posted in the Buffalo Grove Patch on 12/28/2011.

Foreign Body Misadventures

My introduction to the wild and wacky world of x-rays and foreign bodies came late one night during the first year of my radiology residency. I was asked to read an abdominal x-ray on a young woman, the concern being that a rectal thermometer had become misplaced – and inaccessible – within her urinary bladder. I asked the attending emergency medicine physician why the patient was certain that the thermometer was in her bladder rather than the appropriate – or other regional – orifice. The emergency doc paused, gave me a wry smile, told me she asked the patient the very same question and was given an angry reply. I’m paraphrasing after 20+ years, but the response was something along the lines of, “It’s in my #@!*% bladder – I’m not stupid!!”

X-rays done to locate a foreign body usually don’t lead to such acerbic confrontations, the most common situation probably being a cute toddler who accidentally swallowed a coin. But variants of “I have no idea how that wine bottle got in there” do occur fairly often, and I have yet to meet the radiologist without a foreign body anecdote. A book published earlier this year, Stuck Up! 100 Objects Inserted and Ingested in Places They Shouldn’t Be, has probably been long in coming. I do regret that it was written by three non-radiologists, the authors being two psychiatrists and an emergency medicine physician. I have known two radiologists who collected dozens of similar – and in my opinion better quality – images, one of whom I used to regularly beg to pursue publishing as a coffee table book. But to no avail.....

Before I come off callous and uncaring, let me assure you that I completely empathize with these patients who must be horribly embarrassed having to explain their predicaments. And the people described in such a book deserve anonymity and respect, as well as prompt and appropriate treatment for what can be a true medical emergency. I like to think that this is why my radiologist colleagues never “went public” with their collections. But the x-rays – and even more so the stories – can be fascinating, and the ones in Stuck Up! do not disappoint.

I personally have only a handful of noteworthy foreign body tales. In addition to the “thermometer debacle”, my most memorable – and disturbing – case involved a woman (despite my examples, men are much more likely to be involved in such incidents) who would bend and break razor blades prior to swallowing them. When asked why she broke them before ingesting, her reply – again paraphrasing – was very matter-of-fact, “They’d be far too big and difficult to swallow otherwise.”

While often sad, such sagas provide a unique window and insight into human behavior. People do peculiar things, some of which are dangerous and require medical attention. And – for better or worse – unexpected metal in the human body can make a really cool x-ray.

This was originally posted in the Buffalo Grove Patch on 12/20/2011.

Thanksgiving, Tom Robbins and Other Oxymora

I’m not working this week, so no medical musings from me as I take my vacation responsibilities very seriously. But lots of meandering…..

I am without a doubt one of the world’s least well-read people, so the idea of me blogging about literature is as much of an oxymoron as “least well-read”. The only time I read for pleasure is on vacation, and I began this one by finishing the book I started months ago during my last break from work, Tom Robbins’ Fierce Invalids Home from Hot Climates. I really like Tom Robbins, but I completely understand why many people don’t. His novels are audacious, absurd, larger-than-life and beyond far-fetched. But there are two things about his writing that I in particular appreciate and enjoy. He confronts life’s most important and contentious subjects (ie, the ones we should never discuss over Thanksgiving dinner) with bold humor, and – especially for an XY author – he creates strong complex female characters. David Mamet should probably spend some time with Mr. Robbins before he next attempts to put an XX into one of his works.

Near the very end of Fierce Invalids, there’s a passage that curiously got me thinking about Thanksgiving and why I like it so much. Domino – the book’s most multidimensional woman – says, “[N]o matter how valid, how vital, one’s belief system might be, one undermines that system and ultimately negates it when one gets rigid and dogmatic in one’s adherence to it.” While the spirit of Thanksgiving – the idea of being thankful for what you have – is every bit as religious as counting one’s blessings, the day itself is an oddly secular – and uniquely American – celebration.

Beginning with the obvious, there’s nothing remotely similar to fasting involved, the idea of a Thanksgiving fast another oxymoron. You don’t have to give anything up in order to respectfully honor the day. And you get to watch professional football when the overeating is finished, this of course only after the strong complex female characters and all of their male counterparts – even the Mamet fans – have together cleaned up the mess. There are no presents to be purchased, and there’s nothing remotely controversial about it. Have you ever heard of a store clerk being instructed to say “Happy Harvest Celebration” instead of “Happy Thanksgiving”? Or seen a bumper sticker on a car that reads “Keep the ‘Thanks’ in Thanksgiving”? Of course not. Thanksgiving is beautiful and special this way – it’s inclusive of all people of all faiths, and even of those with no faith.

For the three or four of you who have made it to the end of this ramble, I want to sincerely wish you a Happy Thanksgiving. And hopefully Detroit loses to Green Bay, as the Bears’ road to a wild card berth has become far more difficult with Cutler perhaps out for the rest of the regular season.

This was originally posted in the Buffalo Grove Patch on 11/21/2011

The death of Apple CEO Steve Jobs has drawn renewed attention to alternative medicine, most of it non-flattering. Jobs had a rare form of pancreatic cancer, insulinoma, which has a better than 75% cure rate when conventional remedies are utilized. Jobs delayed standard treatment – namely surgery – for 9 months while he instead explored dietary therapy. Whether or not his foray into alternative medicine led to his death is pure speculation, but his story does show that you can be brilliant, creative and wealthy yet still make questionable decisions about your own health.

Much of my day-to-day work as a radiologist involves assessing the response of cancer to various medical and surgical treatments, using tests such as CT, PET scanning and ultrasound to actually measure tumor sizes and changes in such over time. Most cancers respond favorably to conventional therapies, but – sadly – some don’t respond well to anything. I have on only very few occasions encountered patients who have opted for alternative regimens over traditional ones, Mr. Jobs’ story thankfully the exception in my experience rather than rule.

A few years back I performed an ultrasound on a woman who had been treating her breast cancer for 4 months with dietary therapy – perhaps similar to what Mr. Jobs tried – by an alternative practitioner based locally in the northwest suburbs. She was by all accounts intelligent, informed and perfectly reasonable, but she was adamant against having breast surgery. Her alternative medicine practitioner had told her that the dietary regimens were working and that her cancer was shrinking. But she was misinformed. I measured the size of her tumor and had a comparison study from the time her cancer was initially biopsied, and it had doubled in size. Based upon this information, she opted for breast conservation surgery – lumpectomy, the standard traditional treatment – and will hopefully not suffer any adverse consequences because of this delay, as her disease was still localized at the time she decided to abandon alternative medicine. But it frightens me that otherwise logical people can be taken advantage of like this, the lure of something labeled as “natural” and “noninvasive” – yet completely unproven – somehow worth such a significant risk.

I have in particular always found it infuriating that some proponents of alternative medicine sincerely believe that there’s a conspiracy against them by those of us who work in the conventional world. I have found the exact opposite to be true. I have seen a complete unwillingness by alternative medical practitioners to subject their treatments – most of which are expensive (these are nearly always cash-only services not covered by insurance) and some of which are frankly dangerous (please look up “coffee enema” if you doubt this) – to any objective scientific testing. I would be proud to be part of any research that could prove that an easy-to-tolerate dietary therapy shrinks cancer, but no one has ever asked me to do so. And as a radiologist who measures tumor sizes daily, I am perhaps the perfect person to be involved with such a study.

A Google search of “Buffalo Grove” and “alternative medicine” will return approximately 600,000 items. While the vast majority are not relevant to treating cancer this way by a local practitioner, the few that certainly are show up near the top of the list. I sincerely invite any of these people to work with me in evaluating their treatments. If I am wrong and these therapies can be shown to work, then alternative medicine gains credibility and these practitioners will rightfully be able to reap any and all benefits. But if unbiased testing continues to be refused, then these individuals are simply selling snake oil. And I wish they’d stop.

This was originally posted in the Buffalo Grove Patch on 11/16/2011.

I'M LOOKING THROUGH YOU

Everyone should have their own cocktail party story, especially if it can clear up confusion about you or help make you sound more interesting than you really are. I am a diagnostic radiologist, but many people incorrectly assume that I take xrays (this would be a radiologic technologist) or treat cancer with therapeutic doses of radiation (this would be a radiation oncologist). I am instead the person who sits alone in a dark room reading xrays, mammograms, ultrasounds, MRIs and CT scans. It’s less lonely and more interesting than that sounds, but it would probably make for horrendously dull reality TV. In any event, when asked about my profession, I tend to highlight the CT aspect, as most people know what it is (and have probably had at least one during their lives). And if I feel fine with how the conversation is going, I will tell my one and only cocktail party story.

The scientific research involved in the development of both CT scanning and MRI occurred at roughly the same time, but CT managed to become a routine medical test nearly 20 years before MRI did. The surprising reason for this is…..the Beatles. If not for the Fab Four, CT might have taken decades – or longer – to be in widespread use. This technological revolution is able to quickly, painlessly and accurately diagnose serious and sometimes life-threatening conditions, having replaced more invasive procedures including exploratory surgery.

In 1962, on the recommendation of an (at the time) obscure music producer named George Martin, the Beatles were signed to a recording contract by EMI, the acronym for Electronic and Musical Industries. EMI started out working with military technology and electronics. But when it purchased Capitol Records in the 1950s, it soon became a major force in popular music.

A middle-aged EMI electrical engineer named Godfrey Hounsfield lead the team that built the first all-transistor computer. Because of this success, the company gave Hounsfield the freedom to pursue his own independent research. Hounsfield conceived of a way to get xrays and computers to come together and create three dimensional images. With a little help from his musical friends (specifically four straight years of Beatles’ record sale profits kept from the taxman), Hounsfield and EMI were able to manufacture and install the first commercial CT scanner in 1971. Hounsfield won the Nobel Prize for Medicine in 1979, was Knighted by the British Empire in 1981 and passed away in 2004 at the age of 84. His name lives on as the Hounsfield Unit (HU), a quantitative measurement of tissue density as determined by CT. From me to you, it’s better to have something in your body with a low HU than a high one.


[Commenters are encouraged to see how many Beatles’ song titles they can find hidden in this little vignette, but no prizes are being offered]

This was originally posted in the Buffalo Grove Patch on 11/08/2011.