It’s not rocket science

              There is a phrase people use when they are implying that a task is not overly difficult.  “It’s not rocket science.”  For example, “You can totally file your own taxes.  It’s not rocket science.”  As if rocket science is the most amazing, difficult topic a human could ever master. 

              I assume, when a person uses the phrase “rocket science,” they are in fact referring to aerospace engineering.  Which doesn’t really impress me that much.  I was a chemical engineer throughout my twenties, and I would equate the branches of engineering in technical difficulty.  Sure, aerospace engineers design rockets that go to the moon and beyond, but we ChemE’s make Teflon and R-34 and bourbon.  We model catalysis and build fuel cells.  It’s all difficult, and all useful.  In fact, I think pretty much all types of engineering are difficult.  Except civil engineering.  They play in the mud.

              The other phrase people use to imply that a subject is not difficult is, “It’s not brain surgery.”  As if brain surgery is far and above, the most complicated, esoteric branch of medicine.  That’s insulting to other physicians.  What about cardiothoracic surgeons?  Is it a simple thing to crack open a chest, put the patient on cardiopulmonary bypass, and repair a stenotic cardiac valve?  What about oncologists or pediatric endocrinologists?  Or my branch of medicine, radiology?  I could argue that radiology, with the necessity of understanding all body systems, is more complicated than neurosurgery.  When preparing for our boards, we learned every bizarre, rare disease known to man.  Congenital rarities, exotic infections, and cancers almost never seen.  And we can find them using imaging tools; CT, MRI, ultrasound, nuclear medicine.  Not to mention mammograms and xrays.

              Many people don’t know much about radiology.  We perform a healthy number of different image-guided procedures:  biopsies using fluoroscopic, ultrasound, CT, and MRI-guidance, lesion localization with percutaneous wires and radioactive seeds, sentinel node injections, drain placements, chest tube placement, etc.

              Not only is radiology not well known to the lay public, it is unappreciated.  When I read a mammogram and find a nearly invisible 6-millimeter mass on a mammogram, is the patient grateful that I found a disease that would eventually kill her?  Because I found this early, she can now obtain treatment and enjoy a long, healthy life with her family?  Not so much.  What I see, rather than gratitude, is anger and distrust.  It’s a perfect example of killing the messenger.  Patients save their gratitude for the monkey surgeon who carves a chunk of flesh from their body and the radiation oncologist who punches buttons on his ray gun and the oncologist who recites a well-defined algorithm to prescribe chemotherapy.  I wonder if after all this treatment, when the cured patient on a cruise with her grandkids, if she ever thinks back to the pasty guy in the dark room who actually found the cancer, and made all this possible.

              So, do I think the common phrase when trying to say something isn’t that difficult should be changed to, “It’s not radiology?”  “Come on, you can change your own oil.  It’s not radiology.  You’re not trying to provide the differential diagnosis for an ill-defined, poorly-enhancing liver mass.”

              I actually don’t.  Because I don’t think radiology is the most difficult job in the world.  There are many I think work harder than me.  Roofers, farmers, schoolteachers, soldiers, to name a few.  On bad days, you can include police, firemen, and social workers.  Lots of jobs are hard. 

              But, there is one job I would argue is more difficult than all other.  That is parenting.  Parenting well, anyway.  Lots of people raise their kids with little or no rational thought.  That is not difficult, if you consider parenting and keeping a kid alive the same thing, that is.  But doing a good job parenting, constantly worrying and balancing punishments and rewards, work and fun, health and chocolate cake.  It’s an exhausting, terrifying, and often thankless job. 

              So the next time you want to use a phrase to indicate that something is not super-difficult, try saying, “It’s not parenting.”  Anybody can do rocket science.