There are times when Brandi Nicholson, MD, is content sitting in a dark reading room, listening to background music over a cup of coffee as she studies patient images.
But that’s only part of her job as a breast imager. She also is responsible for delivering imaging and biopsy results to patients. That news is often good but not always. Dr. Nicholson knows guiding patients through an often-vulnerable time in their lives is a key part of what she does.
“There’s a lot of handholding and support,” she said. “I try to be reassuring when I can. If I recommended a biopsy, it’s because it could be cancer. So, I have learned to never promise or guarantee outcomes. But the nice thing about breast imaging is most women do well, so you can try to stay positive in almost every case and keep a patient optimistic.”
Patient contact is one of the reasons Dr. Nicholson enjoys her work. Formerly on the academic side, she now spends all her time in clinic. Breast imaging is a field that requires being able to understand the emotions that patients are experiencing.
“Often it’s just listening and asking if they have questions, seeing if there’s anything else I can address for them,” she said. “Fortunately, I get more hugs than tears.”
Dr. Nicholson and her colleagues are particularly busy this time of year because of Breast Cancer Awareness Month. She works for Charlottesville Radiology, LTD; Sentara Martha Jefferson Hospital; and Sentra Health.
Thanks to social and legacy media, it’s easier to get the word out about the need for some women to get mammograms. That causes a fall rush to clinics.
“It would be nice from a clinical perspective to have as many people come in January as want to come in October,” Dr. Nicholson said. “But we’re ready. We know every year it gets busier now.”
She makes time to give back to her field by serving as chair and question writer for the ABR’s Diagnostic Radiology Qualifying (Core) Exam Breast Committee.
ABR exam committees are charged with developing questions that are rigorous but not unfairly complicated. The exams test knowledge examinees are expected to have at certain points in their careers.
“Ideally, we want (examinees) to get them all right because that means they studied and learned a lot, and they’re going to be safe when they go into practice,” Dr. Nicholson said. “Most of our questions are things that we want all practicing radiologists to have experience with and know to be safe.”
Question writers benefit by participating, too. They come from varied practice types and different parts of the country. Dr. Nicholson finds the virtual and in-person sessions to be prime opportunities to learn.
“As we’re creating questions and putting them together, we’re always learning,” she said. “Most physicians like being lifelong learners. It’s one thing that drew us to the field of medicine. We like school. We like learning. Working with other radiologists and writing questions fits that life-long learning desire.”
Dr. Nicholson’s committee recently met in Chicago to compile their portion of the Qualifying Exam. Because most of the group’s sessions are held remotely, the team is excited when it has the chance to get together in person.
“I enjoy the comradery,” she said. “It’s really fun at dinner and hanging out at lunch and just small talking and getting to know people who you see again at national meetings. It gives you then a social circle when you are at those national meetings to recognize faces and feel more comfortable.”
She started at Iowa State University as an engineering and design architecture major. A fan of math and science topics, she eventually switched to biology. Nearing the end of her undergraduate days, she opted to attend medical school at the University of Iowa.
After earning her medical degree, Dr. Nicholson completed both a residency and breast imaging fellowship at the University of Virginia. But it was a different craft that ultimately steered her toward radiology.
“I like making and looking at art,” she said. “I think radiology fits well with a visual sort of skillset. I’ve always thought it was fascinating that we could look at imaging of a patient and be able to tell sex, age, some pertinent medical history, and whether they were healthy by looking at pictures. It’s like a puzzle.”
It’s a puzzle that stretches from the reading room to a patient appointment, hopefully resulting in good news during Breast Cancer Awareness Month or any other time. Dr. Nicholson says it’s the right job for her.
“I would tell anybody who likes patient interaction but wants variety with procedures and some time alone that breast imaging is a perfect fit,” she said.
