This is an edited excerpt from Robert Wachter's “The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age,” reprinted with permission from McGraw-Hill. Copyright 2015.
When I was a medical student in the 1980s, the beating heart of the Hospital of the University of Pennsylvania was not the mahogany-lined executive suite, nor the dazzling operating room of L. Henry Edmunds, Jr., HUP's most famed cardiac surgeon. No, it was in the decidedly unglamorous, dimly lit Chest Reading room, where all the X-rays were hung on a moving contraption called an alternator that resembled the one on which the clothes hang at your local dry cleaner. Controlled by a seated radiologist operating a foot pedal, the machine would cycle through panel after panel until it arrived at your films. The radiologist took his foot off the pedal, the machine ground to a halt, and the dark X-ray sheets were brought to life by intense backlighting.
At Penn in the 1980s, everybody — and I mean everybody, from the lowliest student to the loftiest transplant surgeon — brought films for deciphering to the late Wallace Miller, Sr., a crusty but endearing professor of radiology and one of the best teachers I've ever known. For students like me, time spent with him was at once exhilarating and terrifying. “What's this opacity?” he asked me once, the memory burned into my hippocampus by that cognitive curing process known as overwhelming anxiety. “A … a pneumonia?” I stammered.
“Mooiaaa,” retorted The Oracle, an unforgettable signature sound uttered as Miller smartly turned his head away in mock disgust. I loved it. We all did.