Stay in Your Lane!



“Stay in your lane!” they yelled, as I barged into the OR.  The self-righteous Neurosurgeon glared at me icily as I marched over behind him.  “Get the hell out of here – I’m in the middle of Mrs. Jones’ brain, and her Glioblastoma!!!  What do you think you’re doing ?!?” he yelled.

“I’m the Neuroradiologist, you inconsiderate fool” I shouted back.  “I know she’s got a Glio – that’s why I’m here!!” I screamed back at him.

“Time and again I see these people come back, and their tumors ALWAYS recur.  It’s obvious to any fool that you never resect enough – I’m here to demand you excise that tumor with wider margins, and I won’t leave until I see that its done properly!”.

“Stay in your lane!” they yelled at the oncologist’s office, as I stomped into the infusion center.  “These doses are insufficient – it’s obvious!!” I exclaimed.  “These poor people with Small Cell Lung Cancer – they get better for a while, and then I see read their CAT scans, and their tumors always come roaring back a year or so later!  Why do you stop their treatment before the cancer is gone – don’t you care if they get cured?!” I demanded !!

“Stay in your lane!” they demanded at the hospital’s Breast Cancer Working Group’s monthly meeting.  “We are following the current guidelines, and constantly tracking our statistics to modify our treatment and surveillance regimens.” they claimed.  “But I still see women dying from breast cancer every year – it’s obvious all you care about is getting paid – if you cared at all about these patients, you’d start screening Mammograms in their teens, and do them every 6 months for life!! I don’t need to read the literature to know you need to be doing more!!” I cried.

“Stay in your lane!” the Internist insisted when I barged into his afternoon hypertension clinic.  “These people already have high blood pressure, and medication compliance is my number one problem in treating it; the last thing they need is some uninformed loudmouth screaming about alternative therapies and making things worse!” he fumed.  “Really?!” I demanded.  “How many of them have had CT Angiograms to exclude a treatable Renal Artery Stenosis?” I asked, fixing him with my own, righteous icy stare.

Did any of this actually happen? Of course not – I may be Board Certified in Radiology, with Certification in Neuroradiology and a Senior Member of the American Society of Neuroradiology, but that doesn’t make me an expert in anything except Diagnostic Radiology and Neuroradiology.

I’m comfortable with that – I know that if I do my job well, I can help my colleagues in Neurosurgery, Oncology, Internal Medicine, etc., take advantage of the incredible power of modern diagnostic imaging to optimize the care of their patients.  I can help the ER doctors take care of their patients with chest pain, headache, and even those with gunshot wounds.

But it doesn’t mean I can make useful judgments about clinical care and decision making for which my education and training has not provided me with their expertise.

I own firearms. I have a concealed carry license, and I practice and train with my firearms in one way or another every single day.  I make sure that I handle firearms as responsibly and skillfully as possible, and I do everything in my power to minimize the odds of me ever having to use my firearm to defend my life, or the life of a family member, friend or neighbor.

But if that awful day comes, if I am wounded I hope I am lucky enough to have a doctor as skillful and knowledgeable as Dr. Haughey taking care of me.  I won’t offer her advice on Emergency Medicine, and I won’t ask for her advice on firearms, tax shelters, or anything outside her area of training and expertise . I want her to stay in her lane, because that’s what she does best.


—Tom Vaughan, MD is a neuroradiologist in private practice in Louisville, KY.  He is a shooting enthusiast who believes in individual liberty and personal responsibility.

All DRGO articles by Tom Vaughan, MD