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More Pearls AfootMore Pearls Afoot

John E. Heffner, MD, FCCP; Steven A. Sahn, MD, FCCP; Susan M. Harding, MD, FCCP
Author and Funding Information

From the Department of Medicine (Dr Heffner), Oregon Health & Science University; Providence Portland Medical Center (Dr Heffner); The Oregon Clinic (Dr Heffner); Medical University of South Carolina (Dr Sahn); and Division of Pulmonary, Allergy & Critical Care Medicine (Dr Harding), University of Alabama at Birmingham.

Correspondence to: John E. Heffner, MD, Providence Portland Medical Center, 5050 NE Hoyt St, Ste 540, Portland, OR 97213; e-mail: john_heffner@mac.com


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(1):5-7. doi:10.1378/chest.12-1985
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An enduring memory for those of us trained during the 1970s in pulmonary and critical care recalls the daily ritual of concluding bedside rounds by walking to radiology, where we suspended our patients’ cut films on a vast wall of view boxes. As our huddle of physicians moved down the illuminated rows, we trainees were mesmerized by the ability of master attending physicians to synthesize the clinical findings we presented with the shadows they saw to create a cohesive diagnosis and plan. The annual CHEST conference was even more memorable. There, a roomful of attending physicians routinely “solved” the most challenging clinical dilemmas we could throw their way as unknowns. We trainees left both dazzled by the clinical pearls we learned, but also committed to honing our own diagnostic skills. Helping patients by solving tough clinical questions in arguably the most diverse and difficult-to-learn specialty in medicine, pulmonary critical care, is not only professionally gratifying but also a lot of fun. As Sherlock Holmes enthused when facing a new mystery, “Come Watson, come!…The game is afoot.”1

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