In my household, this time of year is filled with excitement and enjoyment. While I would prefer if the warm days of summer lasted a bit longer, I can’t deny the appeal of the festive period that comes with the cooler months. Among the many holidays, Halloween is our favorite, hands down.
When Halloween lands on a weekday, like it does this year, our daily routines often limit how much we can celebrate. For many adults, this means staying home and welcoming the few trick-or-treaters that brave our neighborhood. There comes a time when one transitions from being the excited child collecting treats to the gracious adult providing them or ensuring the house is suitably spooky for visitors.
Despite these adult responsibilities, we still enjoy little nostalgic escapades when we can. Just last weekend, my partner and I found ourselves at a quirky local event where adults could partake in trick-or-treating. She wore a fabulous Bride of Frankenstein outfit, while I donned my popular Michael Myers costume from the movie Halloween. It was a hilariously entertaining evening, partly thanks to some humorous mishaps with the haunted house’s set-up, which made the costumed staff quick on their feet to stay in character and guide us along.
This fun indulgence reminded me of the relationship dynamics seen in healthcare consultations. There’s a mutual exchange: the patient or referring physician must provide a solid groundwork—taking the patient’s medical history, initiating proper examinations, and determining which specialist to consult with a succinct reason for the consultation request.
In parallel, this is not too different from how trick-or-treaters work for their candy. They must come up with creative costumes and make the effort to visit homes that are handing out sweets. Proper trick-or-treat etiquette—saying “trick or treat,” staying in character, and being pleasant—certainly doesn’t harm their chances of getting a better haul.
On the other side of the equation, consultants, including radiologists, sift through the information they receive and seek out additional details if necessary. Ideally, they provide clarity and perhaps a plan of action, much like handing out a satisfying, full-sized candy bar instead of miniature treats.
Yet, sometimes, consultations provide less satisfying results—a vague differential diagnosis akin to getting a fun-size Snickers—or a negative result that doesn’t clarify the patient’s symptoms, much like an unwanted hard candy. At worst, the study may be misdirected or poorly executed, as disappointing as a closed door when a trick-or-treater rings the bell expecting candy.
Consultants often feel they’re not the only ones who may miss the mark. If visualizing a fair system evaluating each party’s contributions, many consultants might point to others, especially when imaging orders lack a solid clinical history or rationale. Radiology fields have long reflected on these shortcomings, noting times when clinicians, burdened by heavy workloads, provide only basic or vague information. There may also be instances where detailed input is limited by software, or where the patient’s condition is too complex to succinctly summarize.
Nevertheless, just as we experience busy workdays filled with endless tasks and interruptions, our patience can wane. Encountering multiple requests for vague imaging reasons can feel like a disrespectful teenager demanding candy without a noteworthy costume. Hospitals sometimes order studies without contrast for the sake of efficiency, akin to the same kid hitting the same house repeatedly because they know it’s unlikely they’ll be sent away.
When radiologists feel unsupported in controlling imaging protocols, it’s reminiscent of setting up a table full of goodie bags with a "please take one" note, only to find the first child has grabbed them all and knocked over the table. Despite these irritations, they emphasize the good experiences, like a particularly polite child with a charming costume or a referring physician providing a sharp, relevant history that significantly aids pinpointing an accurate diagnosis.
These experiences, though varied, reflect the cyclical exchange between indulger and indulged, whether in handing out candies or in navigating the intricate, collaborative dance of medical consultations.
About The Author
