I spent half my career in Pittsburgh. I did my residency at Pitt and developed an interest in head and neck imaging. I met my wife Carole at Presbyterian Hospital, and my three children were born at McGee. There are a lot of connections—and Pitt connected me to the world.
When I first entered as a resident, Ralph Heinz was chair, and the Department of Radiology was much more compact than now. The new residents—Joe Bensy, Chris Modic, Dave Royal, Don Haas, Ray Halt, and I—entered a profession going through huge changes. We had a great three years together learning the intricacies of angiography, plain films, and other procedures. In our last year, computed tomography was entering the scene, and modern imaging was just beginning.
But the most striking thing about the department then might have been the accents of the staff radiologists. Not quite British. What, then? We realized that many of our teachers were from Australia. An international tax agreement made it advantageous to both the young Australians and to the department. The Australians were incredibly practical: “This is how you do it,” and “No, you do it this way,” or, if it wasn’t clear, then, “Let’s see what we can figure out.” It was a no-nonsense approach that has stood up to years of practice. Australian David Herbert went on to become the Director of Radiology at UPMC Presbyterian.
There were other visitors from other lands. Jim Murray and Donny Ormond were from Ireland, and Bo Jacobsson was a visiting professor from Sweden. This international group formed a major part of our social group. Every Friday we gathered at the Black Angus, and we took a raft trip down the Youghiogheny River every year. In my senior year, Jacobsson invited me to spend a year in Gothenburg doing pediatric radiology and pediatric angiography. This Pitt connection led to a fantastic year of learning, and I got to travel all over Europe.
Back at Pitt, Klaus Braun mentored me through more angiography. I did some otolaryngology imaging—laryngography and sialography and some tomography of the temporal bone. The new chair of otolaryngology, Eugene Myers, wanted to emphasize imaging, and a small department at the Pittsburgh Eye and Ear Institute was built. This department had two tomography machines, some plain films and fluoroscopy, and the ever-useful pneumoencephalography room. The pneumoencephalography unit was installed backwards, making it impossible to do a pneumoencephalogram. The unit was still used for plane films of skull and temporal bone. But something else was missing: There was no radiologist to run it.
I didn’t really apply for the job. I wasn’t that interested in “head and neck radiology” then. However, there was an incentive. The chair of radiology, Bert Girdany, offered to send me to Paris to study temporal bone imaging for six months with Professor Jacqueline Vignaud at the Rothschild Foundation. This was arranged through Chuck Kerber, another superstar of the Pitt program. More amazing Pitt connections.
On my first day back at Pitt, as I sat in the reading room, I heard a booming voice in the hallway. I knew that voice: Jonas Johnson, a classmate from Upstate Medical in Syracuse. My work at Pitt with Johnson, Gene Myers, and other otolaryngologists such as Barry Hirsch, Don Kamerer, and Mark May helped me figure out what I now know about imaging of the head and neck. I’d tell them the tumor went to here, and they came back from the OR to say no, it was over there. We built our knowledge base together. This was particularly important as computed tomography and then magnetic resonance came into use.
The imaging changes were not the only change. Thomas Detre pushed the hospitals and University of Pittsburgh toward a more academic role. He built a group to focus on skull base surgery. Ivo Jannecka, Laligham Sekhar, and Vic Schramm were involved, and skull base imaging became more of my interest. Again, the surgeons were my teachers as we worked through the intricate details of the skull base. Long hours in the dissection lab helped us understand why tumors would go this way or that. What were the landmarks? How far could the surgeons go? They wanted to know exactly where the tumor margin was so they could devise an approach. It was an amazing time.
When the Eye and Ear Institute was incorporated into the larger UPMC department, we had neuroradiology to one side and the new MRI suite down the hall. Chip Jungreis had a major interest in angiography of skull base lesions, so we worked together every day. Manny Kanal could answer any question about MRI. Bill Rothfus always had a good explanation. We learned from the technologists and from each other. Ellen Tabor and Jane Weissman were trainees and then teachers. Everyone was right next door.
I’ve now been away from Pitt for more than 25 years—but all my opportunities derive in some way from the incredible strengths of the Pitt programs and the people I worked with there. The training was amazing from the first day of the residency program until the day I left.
You’ve heard the saying “Lead, follow, or get out of the way.” There’s another path that I relate to my Pitt experiences: “If you don’t see something coming, it might just carry you along pretty far.”