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Radiologist Explores Self-Understanding via Medical Imaging in New Book

By Kayla Matthews

People often talk about how self-discovery happens through writing in a journal or practicing meditation. Indeed, people can often understand more about themselves through those activities. However, what if a richer understanding of self happened through a life-changing medical discovery, such as when a person went for a routine checkup and found out they had cancer? Cullen Ruff, MD, FACR, an associate professor of radiology at Virginia Commonwealth University, tackles that concept in a new book, Looking Within: Understanding Ourselves Through Human Imaging.

“Finding the time to write Looking Within has not been easy and has been a gradual process,” Ruff says. In fact, his effort was chronicled in Radiology Today nearly 12 years ago.

“Since the early years in my practice, I would try to write whenever I could make time, often on vacations. Gradually, I accumulated a collection of interesting cases that illustrate the variety of work we do in radiology, including different modalities and procedures, while featuring patients from all walks of life. These stories matured into a collection that solidifies the themes of the book,” he explains. “There were many periods where I put the project aside completely, sometimes for several years at a time. But once I had a critical mass of material, I was dedicated to seeing this book to completion.”

People often describe medical treatments and techniques so clinically that the human aspect gets removed. But how do patients feel after going through a medical procedure and receiving news that will forever alter their lives? Ruff explores the answer to that question by compiling nonfiction narratives about discoveries made by patients who went through medical imaging procedures.

Telling Patients’ Stories

Many situations, eg, having a broken bone, may necessitate medical imaging. But such procedures can also detect blocked arteries, see a foreign object in the body, or determine whether a person has a torn muscle. It’s not surprising, then, that Ruff’s book covers scenarios that could unleash a range of human emotions. For example, if a person gets a mammogram and receives an all-clear result, she will likely breathe a sigh of relief. Conversely, if a young mother feels a lump in her breast while showering and the mammogram confirms a cancerous tumor, she knows life will forever be different for her and her family. 

Looking Within includes six themed sections. There’s a segment on unusual cases as well as one detailing complications. The final part, “Reflections,” has a self-discovery portion. There are also glossaries of medical training terms and radiology definitions.

The stories are detailed, helping people imagine the scene as they read. Ruff also captures the complexity of humans while describing conversations he has had with some of his former patients and their families. Rather than focusing solely on the patients who received medical imaging and subsequent diagnoses, Ruff explores how other people who knew the patient reacted.

“I was inspired to write for different reasons,” Ruff says. “I have read a number of good books by talented physician authors, each of whom has shown insight from their respective fields, including surgery, emergency medicine, neurology, internal medicine, and psychiatry, to name a few. However, Looking Within, to my knowledge, is the first book of narrative nonfiction that explores the human side of human imaging. Radiologists see disease from a unique perspective, literally and metaphorically looking into people’s bodies, learning more about the individuals imaged, while also learning more about life in the process. Looking Within is written for general readers, but technologists, radiologists, and others in our field will obviously relate. The wisdom that people can learn from looking inside of ourselves is part of what I hope to share, beyond the interesting stories and images included.

“I was also motivated simply by people’s curiosity and fascination,” Ruff continues. “Even when studies are perfectly normal, people are so intrigued to know what we look like inside and what amazing feats can be performed by imaging technology that keeps improving. That awe and reverence are part of what I hope readers take away from reading Looking Within.”

The book includes photographs, mostly depicting abnormal medical imaging results, to help the reader understand what a radiologist sees just before they have to deliver unexpected news to a patient. Captions accompanying the pictures clearly describe what the image shows, including surrounding body parts. Ruff aims to give readers a better idea of what radiologists do and the crucial roles they play in the health care field. Besides providing a patient’s diagnosis, radiologists often contribute to care plans. They also offer insights into which medical imaging–related interventions may increase the quality of life for a person who just found out about a serious health problem. 

A Different Health Care Perspective

The short chapter vignettes in Looking Within illustrate the spectrum of what a health care professional can experience in this line of work. In the book’s final section, Ruff weaves together the threads created by the patients’ fascinating—and often heartwrenching—stories. He begins by discussing how important it is for people to appreciate good health when they have it. Even among those lucky enough to go through most of their lives free from catastrophic illness, the unexpected can happen at any time.

Ruff clarifies that illnesses can also help people feel gratitude for good health. Most everyone has been through short periods of feeling under the weather and felt especially thankful after returning to normal. Some individuals even frame well-being by comparing it with their illness. After recovering from an upper respiratory infection, a person might wake up from the first night in a while of sleeping soundly and remark that they almost forgot what it was like to slumber without being interrupted by a bout of hacking coughs. Ruff also points out that even though such events feel unexpected to the people who experience them, there are typically a variety of factors—such as age, lifestyle choices, and family history—that can lead to a person’s diagnosis.

Even making all the right choices for health does not guarantee a long, illness-free life, however. One of Ruff’s points near the end of the book is that a person only gets one life, and they need to make it count. 

People often think of medical imaging as a way to learn what’s going on in the body, and it does serve that purpose. However, as Ruff demonstrates, the results can have a more profound impact. Medical professionals will undoubtedly recognize familiar scenes within its pages, but Ruff’s writing is accessible to readers from any background.

Looking Within is presently available for purchase; more information is available on Amazon.

— Kayla Matthews is a health care journalist and MedTech writer. Her work has been featured in Medical Economics, Healthcare Innovation, HIT Consultant, and Health IT Outcomes. More information is available at her personal tech blog, ProductivityBytes.com.