The Thousand Word Image

There is no more credible a thing than an image. Seeing is believing. I’ll have to see it to believe it. A picture is worth a thousand words. Vision trumps other senses (McGurk Effect).

How are the words you choose to use, in the healing context of your presence, going to combat the fact that it has been visually shown that things are “messed up in there” ?

It is not our fault, us humans. Wilhelm Conrad Roentgen developed this lovely technology. About a month later, humans were using it clinically.  It is amazing. And I mean X-ray, CT-scans, MRI, fMRI, UltraSound… it’s all incredible. It was developed so we used it. We used it on people in pain, people with broken limbs, people with ailments of this nature or another, and that is the vantage point from which our opinions were based. We saw people with pain have strange looking images. We therefore conclude, that the changes we saw were the cause of the pain, and here we are today.

Post Hoc, Ergo Proctor Hoc. After this, therefore because of this. It is all in the development of the tool. We pointed our delicate and precise imaging tools at the sick, and we found sickness.

We never thought that causation was not the case. We mistakenly reverse thought-engineered the process.

You now have an image that looks atypical. Thusly, you need severe intervention… and fast.

Where is the silver lining? Only in small circles of thinkers, small circles on-line, small circles discussing ideas and connections and human heuristics and fallacies is there any progress towards unraveling this untamed destructive power of the negative image.

I tell you this, however. As infrequent as it occurs, an image can change your patient for the better. It can give them hope, it can help them understand. The image, and your communication, education and assurance.

Twice in my short career it has improved the condition of a patient beyond any physical treatment. I wrote about it once here. It occurred again a while back, a second time. Minus the details: he had a history of surgeries and did not want another one.  A small bulge was the result, not needing surgery. He reported to me, the very next day: “I saw my image, it doesn’t need surgery, I feel great. Nope, haven’t had leg pain. Heck like you said ‘if I do not think it’s dangerous, it won’t hurt, right?!” Discharged.

An image is worth a thousand words. If the power of our language is influential, my goodness, it pales in comparison to “seeing” it. The knife is sharp if it looks sharp. The person is a nice person if they look nice. The research looks legit because it has 150 references.

We have even changed language and meaning because we value a look. For example the word Peruse is used casually to mean glance at, to look over quickly. When in fact it means to study deeply, scrutinize or read in a thoughtful way. So somehow looking something over quickly, is the same as looking into something deeply. And today, we don’t know the difference.

What to do? Keep a white-board handy to draw out ideas and concepts for your patients (images!). Tweet at @AdamMeakins The SportsPhysio for some of his graphs on imaging studies in normal people. Print out the VOMIT poster (Victims Of Medical Imaging Technology) and display it. Click here and print out this powerpoint presentation (Abnormal Findings in Normal People, via Dr. R. L. Travis MD) from 2009 with tons of research on imaging. Maybe even have it all officially laminated in the clinic so that you can use these images to combat the fear mongering of the “bone-on-bone” “worst-I’ve-ever-seen” crowd.

Use you own thousand-words to make a positive difference. Re-frame pain.

Matt D

*obviously there are times when imaging is completely necessary. The pendulum has just swung far from necessary…as has the verbiage describing the findings.

2 thoughts on “The Thousand Word Image

  1. Pingback: A Year In Review: II | PTbraintrust

  2. Pingback: Patient Education Binder | PTbraintrust

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s