Editorial
“You’re Not Santa Claus!” Richard H. Daffner, MD, FACR “Yes, Virginia, there is a Santa Claus 1”
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ast year, I published a Christmas fantasy in the December issue of the Bulletin, entitled “Letters to Santa 2”. This holiday season, let me tell \you of an encounter with a real live Santa Claus. I was interpreting bone x-rays and CT scans in our reading room at Allegheny General Hospital one hot, steamy August day, several years ago before I retired. I was asked to do a “wet” read on the hand of an eight-year-old boy, who had fallen from his bicycle and complained of pain in his left thumb. The bones of children are not completely fused, and there are many epiphyses (growth centers) in the hands (and feet). Some radiology departments, including those in children’s hospitals, routinely obtain comparison views on all bone radiographs of their patients. As an experienced MSK radiologist, I don’t advocate routine comparisons, trusting my skills to determine whether an abnormality is present. Furthermore, to reduce the radiation exposure a child receives, I occasionally obtained selective comparison view(s) whenever I was in doubt. More commonly, when I knew the patient was still in the radiology department or the ED, I
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would do something most radiologists wouldn’t do. I would physically examine the patient. And so it was that I was concerned with the epiphysis at the base of the first metacarpal on the eight-year-old’s hand. I called the technologist and asked her to bring the boy back for me to examine his hand. Jody, the tech, brought the boy and his mother back to the reading room for me to examine his hand. “You’re not Santa Clause!” the lad exclaimed as soon as he saw me. I looked at Jody and saw a wide grin on her face. She had told the boy they were going to meet Santa Clause. “Why do you say that?” I asked. “Where’s your red suit?” “Well,” I replied, “It’s summertime. It’s too hot for my red suit.” “And your beard is too short,” he added. “Well, I trim my beard in the summer, so my face doesn’t get too hot. I’ll let it grow longer in time for my Christmas Eve visits.” “Really?” “Yes, really. Now, if you’re a good boy, I’ll visit your house on Christmas Eve and bring you gifts. But if you’re naughty, I’ll still visit, but I’ll leave you a rock.” “Oh, I’ll be good, Santa. I’ll be good!” “I’m sure you will be,” I said.
All the while, during our conversation I was palpating his thumb and at the same time looking at his face to see if he winced as I pressed on the area of concern. By engaging him in conversation, he was not aware I was pressing on his injured hand. He had no tenderness, and I concluded his hand was normal. Before he left, I told his mother nothing was broken, for which she thanked me. I did not need to get any comparison views. As they were leaving the reading room, the boy turned around and said, “OK, Santa, let me hear you say it.” I looked at him, smiled, and in my deepest voice, I said “Ho! Ho! Ho!” So, why did my technologist tell the boy they were going to see Santa Claus? Well, at that time, I was about twenty pounds heavier, and like the prototypical Santa Claus, I had a protuberant belly (which did not shake like a bowl of jelly, as per Clement Moore’s poem3). Although I was asked many times if I had ever considered playing Santa, I never did. However, I do recite Moore’s poem (complete with nightshirt and cap) during Christmas concerts my band performs at retirement homes. Where did Santa Claus come from? Historians agree Santa is a legendary character originating in Western Christian culture who is said to bring www.acms.org