November 04, 2022

Back to the (Grease Pencil) Future

David Mayer, MD, MS, FACR

The more things change, the more they (sort of) stay the same...

For all the gray hairs still practicing radiology or in retirement, there are always nostalgic memories of the way “we did it way back when.” Back in the days of “film” when we had view boxes and alternators to display our images (and nary a computer), there were clear plastic rulers at the reading station or in our white coat pockets, along with the trusty grease pencil (aka “china marker”).

Remember when a patient had too many abnormalities and the film was littered with red, black or yellow marks? In those days, many a memo was written in colored grease pencils as they were almost always the handiest writing implement.

A couple of decades or so before I retired in 2018, we started using PACS and the grease pencils began to disappear. For some unknown purpose, though, I always kept a few in my drawer and never expected the grease pencil to reappear as a regular “work” tool.

Just prior to COVID and about a year after I retired, my son-in-law introduced me to the world of sourdough bread baking. Now, you are no doubt wondering how a retired radiologist with handy grease pencils intersected with sourdough bread.

For those unfamiliar with sourdough baking, the whole process depends on maintaining your personal “starter” jar. The starter jar is a living brew of lactobacillus and yeast. And because of my bread baking hobby, I now have two pets — one is Dudley, my 77-pound standard poodle, and the other is my sourdough starter jar. Both need regular attention.

The dog gets walked and regularly fed his dog food. The starter also needs to be fed, but with flour and water. The dog receives his special, geriatric dog meals and the sourdough starter gets only high-grade bread flour. Both are also served only filtered water. No doubt, you’re now asking yourself, “What does all this have to do with grease pencils?!”

Before combining the sourdough starter with enough flour, salt and water to make a tasty batch of sourdough bread, the starter needs to be fed with daily or QOD feedings. (As part of the feeding process, the yeast converts starch into sugar, which has CO2 as one of its end products, yielding the blessed bubbles that allow bread to rise or beer to have a head.)

One needs to monitor the results of the feeding process by tracking the increase in size of the bubbling starter in the jar. With a clear jar and a handy grease pencil, little marks are made on the side of the jar, allowing the tracking of the yeast’s progress and optimization of the baking process before the starter runs out of food (flour) and sinks back to almost the original level.

Now here I am, after 25 years of digitization, back to the (bread) future with my trusty grease pencil in hand!