Mai-Lan Ho, MD 

Associate Professor of Radiology
Nationwide Children’s Hospital and The Ohio State University

The AAWR Mentorship Corner is intended to stimulate interest in and discussion of advanced topics in leadership and mentorship. Additional society resources for mentorship include the AAWR Pocket Mentor (free to members) and AAWR Mentorship Files at http://tinyurl.com/aawrmentor. Readers are invited to submit mentorship topics and suggestions for future columns.

The Art of Medicine: Where Technology Meets Humanity

We are in the midst of the fourth Industrial Revolution, in which artificial intelligence, sensor technologies, and interconnection are rapidly transforming the way we live, work, and think. Radiology, being a highly data and technology-driven specialty, is poised to lead these exciting advances in digital and precision health. With the global pandemic further accelerating innovation and collaboration, big tech and automation are penetrating industries and markets worldwide. At the same time, we have witnessed many potential dangers of AI including algorithmic bias, socioeconomic inequality, deepfakes, cyberterrorism, and market volatility.

The need for human supervision in the digital world has been emphasized by key thought leaders and is reflected by the value of relationships, communication, and ideation throughout human history. As machines take over the more routine aspects of human work, we have the opportunity to design human-machine partnerships that optimize creativity and maximize social intelligence. In truth, change is the only constant during these uncertain times. A transdisciplinary approach with holistic integration of the physical, biological, and social sciences will help us adapt and proactively shape our future.

As individuals, how do we embrace our humanity and contribute to our communities, both professionally and personally? We must each celebrate our uniqueness and diversity, with disparate backgrounds and viewpoints contributing to the collective whole. As a classical violinist for several years, I reflect on how involvement in the arts has influenced my practice as a radiologist and physician.

Telling a Story

Since radiologists are not front-facing, reports are our primary mode of communication with referring clinicians and patients. Yet radiology reporting is becoming a lost art, amid the ever-increasing case volumes and shift toward structured templates and lexicons. As a specialty, we need to contemplate our communication practices and ensure we are not losing the “shades of grey” that distinguish human interpretation from AI-powered algorithms. 

I approach reports as expository writing: main idea, prioritized supporting facts, conclusion. Per the opera singer Plácido Domingo, “the high note is not the only thing.” You need to identify the musical line with melody, supporting harmonies, local and global peaks/valleys. When dictating, I try to tie data together logically (Occam’s razor), utilizing a Bayesian approach to account for the relative probabilities of clinical symptoms, labs, and imaging findings. However, one must eschew “satisfaction of search,” as there may be multiple/unexplainable etiologies at play (Hickam’s dictum).

A Greater Purpose

During the 18th century, philosopher Edmund Burke introduced the concept of the sublime, inspiring an artistic movement that combined the subjective-internal (emotional) and objective-external (natural) worlds. While Enlightened scientists focused on knowledge discovery and rational reasoning, Romantic artists encouraged creativity and imagination. Sublime experiences inspire emotion, reverence, and awe that surpass conventional thought and language. For example, listening to music or viewing a natural wonder can evoke feelings of cosmic consciousness and transcendence.

My experiences playing solo, chamber, and orchestral music have taught me a great deal about group dynamics and communication. Good musicians assimilate and integrate data (visual, auditory, kinesthetic) in real time among themselves, their colleagues, the conductor, and the audience. As with any profession, engaging players of diverse backgrounds enriches the group’s depth and breadth of understanding. At its best, the orchestra operates as a unified ecosystem, with multiple interacting parts functioning in perfect synchrony.

Conductor Leonard Bernstein once remarked, “I’m not interested in having an orchestra sound like itself. I want it to sound like the composer.” That is, leaders are responsible for looking at the big picture and crafting an overall vision that their followers can understand and appreciate. Once their roles and responsibilities have been clarified, group members can put aside their personal egos and work toward the greater good.

The Road to Mastery

Centuries ago, access to classical music was reserved for the wealthy and privileged. Today, open-source sheet music and YouTube masterclasses can be downloaded by virtually anyone, anywhere. Child prodigies keep getting younger, though the early focus on technical achievement over true artistry often leads to early burnout and frustration in adulthood. 

The great cellist Pablo Casals stated that “the most perfect technique is that which is not noticed at all.” In other words, a virtuosic performance may dazzle the audience with its brilliance, but is nevertheless constrained by the player’s capability. Truly masterful technique empowers a player to choose from an infinite range of expressions and exercise artistic restraint, such that the end result becomes solely about the music. Similarly, I have noticed that the best teachers make difficult concepts easy and enjoyable to understand. Having mastered the material, they are readily able to distill down to the essentials and inspire enthusiasm in learners.

Based on the infinite mindset, there is no true perfection; therefore all people should strive to become the best versions of themselves. Life is a marathon, not a sprint—have the courage to define your own meaningful personal journey, rather than chasing haphazard goals and societal perceptions. George Leonard’s Mastery explains that experts spend the majority of their time “on the plateau” of intentional practice, which enables continuous and limitless improvement.

Human Performance

From a classical music concert to a professional medical conference, every live performance is different and unique. As exemplified by television talent competitions, people still prefer emotive renditions with minor mistakes over technically perfect but robotic routines. 

Know your audience: a dynamic, engaged group can greatly augment the energy and enthusiasm of a performer. On the other hand, listeners who are distracted, disengaged, and/or disruptive can adversely impact everyone’s experience. For medical educators, tailoring the content and style of a lecture with real-time interaction and feedback can help maximize success. It is commonly said that “amateurs practice until they get it right; professionals practice until they can’t get it wrong.” Realizing that there will always be environmental factors outside their control, professionals need to keep pushing their limits, thus ensuring they can reliably deliver in any given moment.

Barry Green’s The Inner Game of Music discusses expert approaches to decrease performance anxiety through mental rehearsal, adversity training, minimizing negative self-talk (Self 1), and encouraging open awareness and focus (Self 2).