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IR and Amity in the New World Order
I'm not really sure what to think of this new world. I am writing this nine days into 2021, and thus far I am unimpressed. Perhaps even disappointed. Thanks to COVID, California is being overrun; the Capitol building has been overrun; the economy has been overrun; and the entire populace seems overwrought. I can't help but wonder what tomorrow brings, but not in a fun Annie sort of way. Trepidation might be the word that comes to mind.
With all of this going on in the world, it seems trite (selfish?) to think of oneself and their relatively minor issues. One that keeps popping up for me these days, however, is the feeling that the time has passed for my generation of interventional radiologists. I mean, frankly, anyone in the succeeding generation could have told me that a few years ago; but as I look at fliers that come to me for IR conferences, I am struck that not only am I no longer being invited to them but more importantly that I hardly see any of my peers on the faculty list either. And, as condemnation of my not keeping up with our literature, I don't even recognize the names of most of those speakers. I am thinking of changing my computer login password to TaeCrowder (for those of you who don't get it, look it up. And watch more football).
Amazingly, there is something more important besides my own pity party, and I would address the following comments to my junior colleagues in the academy. You – regrettably – very well might not have the same experiences that my generation had. I mean that in several ways. First, the trend has been for radiology departments to find it necessary to cut back on academic time to have more clinical productivity out of all faculty members. Even more than us, you will be doing your scholarly work on Tuesday evenings and Saturday mornings. Second, IR continues to be under scrutiny by home departments/chairs as far as RVU productivity goes – not because we are working less hard, but due to political reasons (read: the RUC) largely beyond our control and despite heroic efforts by the SIR and ACR. Third, and tied into number two, I highly doubt that we will be able to keep up our salaries. In an astounding turn of events, in many radiology departments IR currently has to be heavily subsidized by other divisions. Fourth, and tied into two and three, we have in many ways lost our political clout due to the heavy price tag accompanying us, meaning that when your division head goes to the chair or president of your group for more resources, they go without the swagger we have had in the past but usually with tail tucked. These issues are probably just the way of the world right now, and nothing to be done about it.
The aspect of my career that I will miss the most, and that I'm afraid the next generation just won't be able to experience, is the camaraderie that my colleagues and I enjoyed. Much of this had to do with travel to conferences or meetings. Seeing the same faces around various tables as we tried to address the most pressing issues of the day, some successfully some not. Running into friends as we passed each other in the hallways at a non-IR conference where we expected to know nobody. Sitting at a moderator table or in the audience with someone with whom we shared a bond but hadn't seen in person since that last annual meeting. And working in the same room or laboratory together on research problems that needed to be addressed to hopefully further the field of IR. In our world, that camaraderie required travel, and while I bitched about it when I had to do it, I miss it dreadfully now. Not the travel itself, but that face-to-face communication, that connection and even affection we had/have for one another. I attribute many of the anticipated changes to this lack of travel, this new world order that will probably replace the old one with more virtual conferences and Zoom meetings. I see no way around this, honestly. The virtual world comes at a fraction of the cost, in both time and money, that the in-person world bears. Why would we go back to the good ol' days? The infrastructure is in place and tested, and there is almost no compelling reason to return to the old system – except to reclaim some of this lost camaraderie. I think I might have written about this bond between IRs in a prior editorial (I never read them – I'm a little shocked you do), but that is because to me this issue is central to our field, to how we have progressed to where we are today.
Perhaps I am wrong – I hope to God I am. Maybe the new normal will come with a new way to connect. In many ways, there might be more rather than less connection. At least with Zoom we can lay a virtual eye on one another with far greater frequency than we have in the past. It is far easier for us after all to be face-to-face (as it were) in the new world than the old. And I do keep hearing the argument that the next generation relates to one another differently than mine does, their having grown up in a partially virtual world already.
I take solace in the idea that the prior generation of IRs took pity on my generation like I am doing with the next. I can't help but go back to the words my grandfather said to my mother as he aged – that he sure wished her generation didn't mess up the world as badly as his did. If we did – and the current global environment would suggest so – I can say nothing but I'm sorry. And good luck with that.
I hate being negative with these editorials, and perhaps these are just the feelings of an old IR like they were the feelings of Heraclitus to your Democritus (for those of you who don't get it, look it up. And get to your art museum more). Let me finish by assuring the younger IRs among you of one thing. You are in the best, most innovative, most exciting, and most fulfilling of all fields of medicine. What you learned in fellowship/residency will become out of vogue in a few years – and that is terrific. You will be doing things that my generation didn't even dream of. Your creativity and raw enthusiasm will take you – and hopefully me – to horizons never before imagined. It is your world, and you will find joy, success, and yes, camaraderie in it.
15 April 2021 (online)
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