When I look, see, but don’t recognize.

On the sitcom Friends, first-time pregnant Rachel sees an obstetrician for ultrasound, nods her head and smiles as the monitor shows her future child.  Then, she returns home and exclaims, “I don’t see it!”

Radiology trainees struggle with the fear of “not seeing it” as well.  As a radiograph, MRI or ultrasound displays on screen, at first we just see nothing.  Then, there is the proverbial sinking feeling in the chest as we slowly come to the realization that something is amiss.  Something doesn’t look quite right – except we don’t see it.  It can be intensely frustrating, resolved only by a supervising radiologist pointing with a finger, and we think, “ah, I knew I saw something.”

There is something about that initial sinking feeling when we see something is wrong without consciously knowing why.  It shows that we are now aware of our ignorance (as opposed to unaware – which is infinitely worse).  It’s the strange category of unknown knowns, where we don’t yet consciously know something that we can already pick out.

It is a sign of learning.

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