Become a Creator today!Start creating today - Share your story with the world!
Start for free
00:00:00
00:00:01
Radiology II: Giorgios Bis
33 Plays5 years ago
Season 1, Episode 11: Dr. Giorgios Bis is a radiology fellow at Hospital for Special Surgery in New York City. Listen to George talk about interventional radiology and his Greek heritage.
Recommended
Transcript
Podcast Introduction
00:00:09
Speaker
You're listening to The Wound Dresser, a podcast that uncovers the human side of healthcare. I'm your host, John Neary.
Introducing Dr. Georgios Biss
00:00:20
Speaker
Today, my guest is Dr. Georgios Biss. Dr. Biss is a fellow in the Department of Radiology at the Hospital for Special Surgery.
Dr. Biss's Medical Education and Focus
00:00:29
Speaker
He received his medical degree from Wayne State University School of Medicine and completed his residency in diagnostic radiology at the Baylor College of Medicine.
00:00:38
Speaker
Currently as a radiology fellow, Dr. Vis focuses on musculoskeletal imaging, but his clinical and research interests have previously extended to cardiovascular and cancer imaging as well. George, welcome to the show. Hey, thanks, John, for having me.
Radiology Tools Explained
00:00:53
Speaker
I want to first discuss the clinical aspects of radiology. Some of the main tools you have as a radiologist are X-ray, CT, ultrasound, and MRI. Can you explain to our listeners under what circumstances you use each of these imaging modalities?
00:01:10
Speaker
Yeah, sure. So right now, I'm in musculoskeletal in a fellowship. So we use x-ray, just your standard playing film to look at any joint. We use CT, usually to follow fractures or to correct your follow-up. And then MR, which is to use for more soft tissue detail. So if you need a knee or a shoulder and you really need to look at tendons,
00:01:37
Speaker
and ligaments to assess for damage. That's where we use MR. In residency, however, every month we kind of covered a different subject. So you'd have a month of body, a month of chest, a month of breath. You'd cover the DR, et cetera.
CT Scans During COVID-19
00:01:58
Speaker
And probably the most
00:02:01
Speaker
Common modality then is CP. You get a CT abdomen pelvis to look for any abdominal pathology, chest CT, front sections, especially now with COVID. There's a ton of chest CTs being done to look for clots in the lungs or to see if someone has that kind of characteristic distribution for a coronavirus.
00:02:26
Speaker
But yeah, basically when you want more detail, you're going to want to go for MRI and your essential tool right off the bat is going to be your x-ray.
Musculoskeletal Imaging
00:02:38
Speaker
In terms of musculoskeletal imaging, can you talk about what falls under that umbrella and then how that differs from diagnostic radiology as a whole?
00:02:51
Speaker
Yeah, so in residency we would have our month of, you know, neuro, musculoskeletal, and by kind of doing this fellowship, you become more of an expert in just that one area. And so now what we do is image all the bones and the joints to assess for pathology. For example, you're in a skiing accident or if you have a meniscal tear or, you know, an ACL tear in your knee,
00:03:17
Speaker
You can look at hip pathology, like your hip labrum, your cartilage. You can assess if you need a joint replacement. And the same concept is used. We also do a lot of spine imaging at HSS. And at the same time, we're able to do procedures. So there's two ways of doing procedures under FLORO.
00:03:41
Speaker
machine or under ultrasound where you use the probe and you can find the pathology and you can do joint injections, things like that. You can inject some steroid around tendon sheets. So musculoskeletal is more, you know, not only figuring out what's going on with the patient, but it's also interesting because you could somewhat treat at the same time.
00:04:11
Speaker
Can you talk more about the communication channel you have with physicians and surgeons as a radiologist?
Communication in Healthcare
00:04:17
Speaker
So, I know, right?
00:04:20
Speaker
As a radiologist, you don't really see, you have little to no patient interaction. So how do you, first off, the first question there would be, like, what is this communication challenge with physicians? Like, are you kind of holding their hand in the sense that they don't know much about radiology or do they have a pretty good general background on what they're looking at when they look at MRIs or X-rays?
00:04:44
Speaker
Yeah, good question. So it depends. If you're working in the ER, there's a bunch of specialties that might be putting in a request.
00:04:54
Speaker
So in terms of the layover, I think that's what part of the question was. They kind of want the results fast. So whether there was just a trauma, you happen to be in the ER, the whole team is with the patient and the scanner and, you know, your computer where you can see all the images usually right next door.
00:05:17
Speaker
that team, give those providers all of the results. You can tell them what you see on the spot. When things aren't as urgent, you kind of have more of an outpatient kind of center where you can read from.
00:05:37
Speaker
Most everybody in their specialty does have a good grasp of reading their own imaging, especially at HSS. Both orthopedic surgeons are phenomenal.
00:05:50
Speaker
We're there to find, to kind of fine-tune and to check, you know, all the timier structures and make sure that we're not missing anything. Our expertise also comes more in handy with cancer, you know, follow-ups, not thinking of therapy, or just that incidental lesion that you might find that that referring doctor might not know, but, you know, having to go through the training, I guess that's where really we can
00:06:18
Speaker
shine and add more benefit. I know a big thing physicians often reach out to radiologists about at least musculoskeletal imaging and MRI really is checking out for infection. Can you talk about sort of the process of looking for infection on radiographs?
Detecting Infections with Imaging
00:06:41
Speaker
Sure. So it's always nice to have a comparison.
00:06:46
Speaker
And that way you can see when someone was normal to the tiny, tiny changes when something goes wrong. And when you see an infection, when you trace the cortex of the bone, you start to see little erosions or little reaction along the bone. And in the right setting, you could say that this might be an infectious process. When you get more advanced imaging other than an X-ray,
00:07:16
Speaker
It could be quite obvious. For example, if you get an MR, it's just going to look bad. It's going to look, you know, really swollen, really edematous, because of all that soft tissue detail that you're not getting on an X, right? So in the MRI, you're going to see just tons of edema. You're going to see changes in the skin. And if that infection went all the way down to the bone, you could see a change in the signal characteristic of that underlying bone, and then you
00:07:48
Speaker
And then that would change obviously the antibiotic that that person would need.
Post-Operative Radiology Checks
00:07:55
Speaker
Are there any other things like physicians or surgeons will reach out to you specifically about to check on radiographs? That they're kind of using you as a backstop to make sure they're not missing anything?
00:08:09
Speaker
Sure. So immediately post-operative has been a crucial time to make sure that nothing is left in the patient and the unwanted needles or instruments, et cetera. So they will call from the operating room and have a screen to make sure that there's no foreign body, you know, especially before they close. Usually then you see a train or, you know, a sponge or something and you let them know.
00:08:36
Speaker
Other things on the spot, if they put a feeding tube, you want to make sure that's in the stomach. We just had a case where it actually went into the lung. So you want to be there to, you know, let them know proper position of tubes. If you get a line, usually that goes the right side of your heart. You want to make sure it's in good position. When patients are intubated, you want to check the position of the endotracheal tube.
00:09:05
Speaker
So there's a lot of times that they call, so these are more urgent findings. And then lately, I guess on call, now for our hospital, you want to get back to them quick. For a head CT, usually for a stroke, or a chest CT to look for a pulmonary embolism. Those are probably the most common ways that they reach out to us.
00:09:32
Speaker
You know, the tools, like I said, that you use for radiology. I imagine you have a lot of routine cases, you know, things where your MRI, your X-ray, your CT is very effective and very, you know, you can get a fairly routine diagnosis just by using those tools. But are there other places where you're looking at maybe even specifically a musculoskeletal imaging where
00:09:58
Speaker
right now the research and the technology is there where you say, I can't really make an accurate diagnosis based on MRI or whatever tool you're going with?
Limitations in Musculoskeletal Imaging
00:10:13
Speaker
Yes and no. Usually you can nail it right there on the spot. Certain instances where you can't, let's say there's
00:10:26
Speaker
with pain and you think you find the cause and you don't really know that's the cause then you could kind of do a test injection with an anesthetic so you kind of combine something more diagnostic to see oh you know if we inject this then truly yes this is where the pain is coming from because it's a mixed picture getting the diagnosis you have you know the referring physician who is there with the patient that does a physical that doesn't expand
00:10:58
Speaker
For example, you could have a herniated disc in your back and not even know it. It could be completely asymptomatic. So sometimes by doing more like interventional techniques, you can kind of change that diagnosis.
00:11:14
Speaker
If not, there's a few times you could refer to nuclear medicine. They have a whole bunch of tests in nuclear medicine for that. And then when we don't know what something is, then you can also refer for a biopsy and actually get a tissue sample that way.
00:11:33
Speaker
Yeah, you just sparked another question in my head here in that often when people come in to say like the hospital for special surgery or or any musculoskeletal provider in general, right, that one of the big things is pain, right? So how much do you take into account pain and making your diagnosis when sort of
00:11:52
Speaker
When pain, you know, somebody saying they have pain is such a qualitative thing as opposed to a quantitative thing, right? It's kind of hard to pin down. People experience pain differently. The way they say they have pain is not necessarily the same person to person. Yeah, exactly. There's only so much that you can do, unfortunately.
00:12:17
Speaker
Usually our techniques are mixing a little anesthetic with the steroid and hopefully that can give that patient relief for a few months. That's kind of where the diagnosis comes in on imaging. If something is surgical, then no matter what you do, hopefully those injections can work for a few months, but if the underlying cause
00:12:42
Speaker
is something that's ruptured or something that has to be fixed. Then you have to go to the surgery or your best outcome with that sort of patient.
Radiation Risks Discussion
00:12:53
Speaker
One thing from a patient perspective that I know is always brought up in radiology is the radiation from CT and X-ray. And what should patients know about that risk and how much radiation they're getting when they receive those exams?
00:13:13
Speaker
So it's kind of, I know there's a lot of hype about it, and I agree. And you kind of want to limit the radiation, use as low as reasonably achievable, especially in pediatrics. In pediatrics, they should not be using, you know, or to a minimum, like CT. CT has a lot of radiation for a kid.
00:13:36
Speaker
We just don't know long-term what exactly that might do. So we want to limit it in children. However, you know, every woman over the age of 40 is going to need a mammogram. We know that these are safe. We know that, you know, your everyday chest x-ray, it's probably not going
00:14:01
Speaker
zero radiation with that. So when we can use ultrasound to look at an abdomen or a joint, we should be using that. MR is also safe. There's no radiation with MR. So the tricky situation is if you're a female who's pregnant, let's say you've been in an accident, that's up to that referring doctor to really make sure that they need that, you know, to make sure that that risk, those, the pros of, you know, missing something.
00:14:31
Speaker
will outweigh the cons. So basically, yeah, those two scenarios are with kids. But fortunately, with kids, most patients actually can't be solved with just an x-ray or ultrasound. But I mean, having said that, I think you get radiation every time you go on a plane. No one really thinks about that. True, this is a much higher dose. But yeah, that's kind of the way we think about it. Yeah, I think certainly,
00:14:59
Speaker
People get themselves in trouble looking on the internet and not understanding the facts and actual risks associated with it. So I think as long as you're under the supervision of a medical provider, you should be in good shape, right? Oh, yeah, true. And basically, if you're ordering that CT, you have a specific reason. There's an issue that you need. And if it could be followed with another modality, I mean, sure. And then you follow it with something else.
Dr. Biss's Career Journey
00:15:30
Speaker
I want to talk a little bit more about your experience in radiology. I guess first off, can you describe how you decided to go into radiology as a specialty? Sure. So I switched my mind a few times. At first, I liked orthopedic surgery. And then I liked plastic surgery. And then having rotated in medical school,
00:15:56
Speaker
I kind of didn't like that surgeon lifestyle, and there's a demonic there. It's called the road to happiness. And so R stands for radiology, O is ophthalmology, A is anesthesia, and D is for dermatology.
00:16:12
Speaker
So I kind of, you know, I always wanted to have a family and not, you know, be completely overworked. So I wanted to pick one of those with a better lifestyle. And I mean, they're all important. I just couldn't get into ophthalmology knowing
00:16:27
Speaker
like what we knew and how much we had to go through, just the eyeball itself, I just couldn't do. Same thing with Durham, a great job, great profession, and I just didn't have the passion to do that. So I was between anesthesia and radiology, and I was actually like 80% into anesthesia. And I switched out on my third year of med school,
00:16:52
Speaker
after rotating through OBGYN where I saw a bunch of CRNAs kind of doing the procedures, doing epidurals, and I was hesitant because I was worried that would potentially become a field of nursing one day and not a field of medicine. Even though there needs to be an anesthesiologist present, my understanding at that time was that kind of
00:17:16
Speaker
bounced and managed different operating rooms at the same time. And I didn't want to do that. I kind of wanted to be then someone, you know, someone, I just felt more needed, I guess, as a radiologist because, you know, things are hard. You might open a chest x-ray as a doctor of internal medicine and not know what you're looking at. These things are very difficult, especially peats. I mean, they look
00:17:44
Speaker
They're not like just little humans, they're like aliens. You kind of really know kind of what you're looking at, so I felt a little more job security. Although I did really like pharmacology and, you know, the surgery kind of aspect of anesthesia, I just thought it would be safe.
00:18:01
Speaker
And I also like everything from head to toe. And radiology is literally everything from head to toe, whether it's, you know, neuro, chest, body imaging, breast, musculoskeletal. So I kind of kept that up. I just kind of like the diversity of the cases at the same time.
00:18:23
Speaker
after the four years. So going into radiology, you have to do an intern year. That was mostly in internal medicine. And then it was four years of radiology where you kind of learn the bulk of everything. And then this one year fellowship is just more specialized within one area. And I guess maybe because I originally wanted to do orthopedic surgery, that's probably how I got into musculoskeletal radiology.
00:18:49
Speaker
So, yeah, still, I guess, working with bones and joints and part of one of those advanced imaging and interventional techniques now. Yeah, that's cool. Actually, can you talk more about that intern year? What kind of stuff do you do? You said it was mostly internal medicine. Is it just kind of a long internal medicine clinical rotation feel? Yeah, so why they do that?
00:19:17
Speaker
not sure, but if you go into a specialty, for example, if you go into surgery, you've got five years of surgery, and you just go into it. Same thing for medicine. It's a three-year-long residency, and you just start. Now, if you're doing a specialty like ophthalmology, anesthesia, derm, radiology, they kind of suck this intern here out of you before you go in.
00:19:38
Speaker
And during that year, you rotate like, I think I had three or four months on the floors in internal medicine. You have a month in the ICU, a month in the CCU. You have a month in the ER. I had a month on surgery and outpatient. I think a month of outpatient medicine. And then I had a few electives, which I took radiology.
00:20:09
Speaker
The other thing I mentioned earlier, compared to other physicians, radiologists have little to no patient interaction.
Patient Interactions in Radiology
00:20:16
Speaker
How do you feel about this aspect of radiology? Yeah, so I think that's not entirely true. There are patient interactions on every rotation, whether we're on neuro.
00:20:30
Speaker
You do a lot of lumbar punctures. We used to put in physical chemo, basically into the patient's through the spinal fluid. We had, you know, four months back to back and residency of interventional. So that was all absent strangeness, biopsies.
00:20:49
Speaker
We placed a lot of lines. We put in ports. We placed tunnel dialysis catheters. We did a lot of cancer work and a lot of trauma work as well. So that's not entirely true. Like, yes, some days I could be diagnostic where you're just in front of a computer. But even now, about half of my weeks, I'm in a clinic and I'm seeing patients and I'm doing procedures on them.
00:21:13
Speaker
You could make it, I guess, more diagnostic if you would like. You could just kind of have that set up in your practice as part of your contract. But I like getting up and I like interaction and being patient.
00:21:27
Speaker
Same thing on even a breast rotation. If they come in for their mammogram and you see something, there are some centers like mine and residency where that same day, we could do an ultrasound. You have to get up and do an ultrasound and if you do see something in the breast, you can biopsy it at the same time as well. So there's definitely patient interaction. Okay. So you're even doing interventional procedures at HSS?
00:21:53
Speaker
Yeah, yeah. Upstairs on the third floor, we have a full ultrasound department. We do kind of a pendant sheath injection.
00:22:01
Speaker
joint injections, we do nerve studies, and then in Saguaro, we do hip and knee aspirations. Like you were asking before, if you can't tell if something is infected, well, you could kind of put a needle into the joint and see if you, you know, suck out any fluid, see if there's any pus or anything that you then sent to the lab. But that's another way of, oh, we don't really know what's going on here, so let's just
00:22:27
Speaker
Let's see what comes out of that joint. Do we do that? I know we do a ton of back injections as well. Nice. I imagine, I guess, with the injection stuff, do you work with a lot of anesthesiologists, pain management physicians, et cetera? Or is that sort of a...
00:22:46
Speaker
No, not usually. So the referring position will pick the level based on their clinical exam, L3, L4, L5, and then the right or left side of the body. And then we will inject, we kind of base that nerve root as it comes out with anesthetic and steroid. But the work office has been done before. We just place the medicine in the right spot.
00:23:16
Speaker
You're saying that the work of those other pain management physicians has already been done at another point? Or are you saying it's completely separate from whatever you do? Exactly. They've seen the patient. They've assessed that it's coming from a nerve. If it's coming from a facet, we can inject the facet.
00:23:37
Speaker
is multifactorial so I mean they're much better at clinical diagnosis and usually they're spot on and you know we kind of we kind of go by what they order to level at the side of the body. Got you.
AI and Machine Learning in Radiology
00:23:54
Speaker
Another thing that's been interesting to me that I've been starting to hear more and more about in radiology is the role that machine learning and AI is going to play in it. Have you seen evidence of this where machine learning is going to be used to sort of do more routine cases and then the radiologists are going to kind of work on the more nuanced complex cases? Or is this something that maybe is still far in the future?
00:24:22
Speaker
far in the future, I think that you're still going to need an MP to sign off. I mean, you can probably train that machine, but there's a lot of nuances. I mean, based on seeing thousands of studies, you know, if a patient is like, imaged in a wrong orientation or a wrong position, you know, you still know how to look at that and assess, or if something is covered, you kind of
00:24:48
Speaker
You know, you have other views. I don't think a machine could ever be that smart. But it's going to definitely have to be double checked. But I have heard promising things with that. And at least, I don't know, maybe if they can, you know, help on some of the easier studies, and then you can just kind of double check that computer's work. I think that would be awesome. But I don't know how they would do something more advanced.
00:25:14
Speaker
Yeah, I think exactly what you're saying, right? The feedback I've gotten with somebody who was talking to me, he's working kind of on some software for something like this for a healthcare company. And he's saying that, yeah, it's really just to take some of that workload off the radiologists that they currently have with more of this routine stuff and let them do, A, more of the complex diagnostic cases, and I guess also perhaps more interventional stuff, right? Yeah, yeah. I mean, that's pretty cool. I'm off for that.
Greek Heritage and Healthcare Perspective
00:25:47
Speaker
The other thing I find interesting about you and I wanted to talk about more is your Greek heritage and how that informs your perspective on healthcare. I actually went on a study abroad trip to Greece where we discussed Asclepius, the god of medicine, Hippocrates, and just really the Mediterranean lifestyle as a whole.
00:26:10
Speaker
is the pillars of that, right? Is sort of this convivial eating, socializing, ample physical activity, and of course, the Mediterranean diet. So do you think that we're missing some of this in our healthcare system? And if so, how can we flip the needle on it? Yeah, I can answer that. First, I'm curious, where did you go when you studied abroad?
00:26:35
Speaker
I went to, it was for two weeks, real short stint, Athens and Nalthblio, which was more of a short town. I don't know if you... Oh, nice, nice, yeah. There's like a castle up there. Yeah, you've been there? Yeah, I've been there, yeah, in like high school. Beautiful. Yeah, nice. Yeah, well, first, pre-Pena Health, just with medical terminology. Growing up, I had to go to Greek school.
00:27:05
Speaker
You know, my grandparents spoke Greek, so instantly I was slightly ahead and just understanding the medical terms because I just kind of knew what the disease was before you've been hearing it. Greek definitely helps with that.
00:27:21
Speaker
And then, yeah, I think I read an article came out a few years ago about there's one certain island where all these other people were living like into their 90s and like
00:27:36
Speaker
I think they said some certain amount of people over 100 was more than anywhere else in the Mediterranean. And they're wondering why. And that guy, one guy that they interviewed basically said what you said, they don't eat processed foods. They don't get stressed.
00:27:55
Speaker
There's a mix of your mind and your body when you're eating, I guess, a lot of olive oil. I think that definitely helps with inflammation. You eat a lot of nuts, walnut. I mean, their diet is pretty lean. A lot of fruits, a lot of vegetables.
00:28:18
Speaker
I think low consumption of wine that's also in there in the Mediterranean diet, that's controversial. I'm going to stick with gas, go with it, glass, order you. Right on. What else? Yeah, unfortunately, there's a lot of more smokers out there, but I mean, the pure Mediterranean diet is essential. It's proven.
00:28:47
Speaker
I don't want to eat a lot of fish, a lot of omega-3s. Yeah, I guess it works. And then psychologically, too, you need a good support system. The country's orthodox. A lot of people, I would say, are more religious than in America. So whether they get that social interaction from there or from another community, I think that definitely plays a role. But yeah.
00:29:17
Speaker
Yeah, I mean, you basically outlined the curriculum of the course we took right there. So it's definitely sort of, it sounds like it's embedded sort of in the culture. I'm myself of Italian heritage, so we got some of that Mediterranean influence as well. And I know, unfortunately, it kind of gets diluted a bit here in the States. But going back to sort of the question, though, do you think this can
00:29:46
Speaker
How can we bring a little bit more of this to our healthcare system, you know?
00:29:52
Speaker
i've got that would be on the level of primary care as it's not going to be you know your surgeon if you can advise this when they're about to take out your appendix but it's not going to be a billy o b g y and then it's not going to be here maybe if you're a neurologist if you've had a stroke you want to you know i keep healthier but it's probably going to come down to the primary care level probably a good time during your physical you know kind of and i bring up those points that
00:30:20
Speaker
that's fish and nuts and you know that sort of thing it's probably beneficial limit that fast food um exercise is medicine as well so yeah take the stairs walk when you can i mean they're common sense things but they they actually work when you exercise it you know
00:30:47
Speaker
I mean, this stuff is proven. You know, if you have a blockage that you exercise, that might save your life one day because you have a collateral, you know, pathway. So you never know. How do you incorporate the Mediterranean lifestyle into your own life?
00:31:05
Speaker
I guess it was just built in growing up. I mean, kind of had a lot of Greek food my whole life, a lot of spinach pie, a lot of fruits and a lot of vegetables. So it's not really incorporating. It's just kind of my palette at this stage of my life.
00:31:27
Speaker
I feel like I have to point out to our listeners that your middle name is Constantine, which proves that we're listening to the OG straight from the source. Actually, my longtime neighbor who no longer lives across the street from me, his name is Constantine.
00:31:48
Speaker
And he actually played for the Greek national water polo team. Oh, sweet. Yeah, and then he became the water polo coach over at Princeton. Oh, cool. Definitely a good name. So I might have to name my kid Constantine. Go for it. Yeah, my first name was a no brainer because you have to meet your child basically after your father's father and both of my grandparents are named George.
Personal Interests and Future of Radiology
00:32:18
Speaker
No brainer for me. All right. Well, I'm going to give you a series of fast paced questions that tell us more about you. So what's your favorite place to travel in Greece?
00:32:36
Speaker
So my grandparents' hometown is Naffbakdos, and that's about two and a half hours west of Athens. And it's right in the middle, but it's on the water. It's beautiful. There's crystal clear beaches, there's a castle, incredible food, there's good nightlife. And also when I go, I like going out to the islands. So, Ionian islands are really, really gorgeous, really mountainous, really green.
00:33:04
Speaker
beaches ever those are kind of on the coast like facing Italy on the west coast and then all of the cyclades I mean every time you go you get more ideas about coming back and a new trip from the route. I try to go almost every summer so I've been a lot throughout my life. Wow that's awesome. Somebody was telling me that a really good island to go to is Mykonos. Have you been to Mykonos? Yeah it's a little it's
00:33:34
Speaker
More like the Miami kind of, Greece. It's definitely going to be more luxurious and, you know, more party centered, gorgeous beaches there. It's going to be more expensive than the other Greek islands. But yeah, definitely. If you're going to go your first time, you're going to go, you're going to see Mykonos and you're going to go to Santorini and you're going to love them. And then I guarantee you're going to, you're going to go back in the future to another island.
00:34:05
Speaker
Sounds good. Another thing we haven't mentioned yet, you're a Michigan Wolverine. What's your favorite thing to do in Ann Arbor? It's funny. So I just went through to kind of see how the city
00:34:24
Speaker
to see what's changed, and it's completely changed. Granted, I was in, you know, four years in Texas and one year in New York, so obviously any place is going to change, but I don't know if you've been there recently, but a lot, a lot has changed. There's a lot new restaurants everywhere. I used to live kind of behind Main Street. Main Street's pretty much, look sustained, there's a few new spots. Still has its charm, you know, well-capped.
00:34:48
Speaker
But on campus right where the special royale is There's like a ton of more like gorgeous housing and apartments. Yeah, that's all gone up Charlie's got a facelift. I mean all of these do looks pretty Pretty new Housing and all that. I think it's pretty standard. That's not really changed there. But yeah the city the city looks beautiful and
00:35:17
Speaker
So what's your favorite thing to do there though? Basically see friends. I remember it used to be a really big booty city. Can't really enjoy that now with coronavirus, but yeah, going out trying new places. We were a big fan of skips. The occasional football game. Yeah, walking through the dyad, getting coffee, all of that.
00:35:45
Speaker
That's funny, the last Wolverine I had on said they were a big fan of Rick's, so go figure. Last thing I wanted to ask you was...
00:35:55
Speaker
What's the biggest change you see coming to radiology this decade, the 2020s? Let's see. Right now, I'm involved in a few projects. One is looking at the cartilage in the thumb to see if that correlates to clinical outcomes. So we can use MRI to look at cartilage mapping.
00:36:18
Speaker
Um, especially it's kind of interesting because then everyone using their phones on their cell phone, you know, to the tax and all that, who knows, maybe in 40 years we're all going to need, you know, first carpal, metacarpal joint injection. Um, other than that, we just develop new techniques, nothing groundbreaking. Let's say there's another paper I'm working on.
00:36:42
Speaker
you look at your hand kind of where your hand, where your, where your hand rests when you're on a mouse, there's like a bony prominence there on people get pain there. That's your piece of triquetral joint. So we're looking at a way to, you know, inject that to kind of put a needle behind that bone, put any steroids, get a pain there. Uh, no, nothing. Nothing's so crazy. I would say.
00:37:07
Speaker
There's a lot of work, as you know, you're better than this. I am working in the MRI lab. I'm imaging patients around metal, which is super cool.
00:37:21
Speaker
imaging, not a lot of places will put you in their scanner. There'll be so much artifact. So it's what you're working on and everybody at HSS that you can get super pristine imaging like around metal. And I think that's, you know, that's relatively new within the last three years. So I think that's biggest change recently and musculoskeletal. That's definitely important. The MRI lab appreciates the shout out.
00:37:51
Speaker
All right, Dr. George Biss, thanks for joining the show. Yeah, thanks for having me. Any time. If you have any other questions, let me know. Thanks for listening to The Wound Dresser. Until next time, I'm your host, Jon Neary. Be well.