Vanderbilt’s Thomas Powers, M.D., has learned to see exceptionally well in the dark.
Powers, associate professor of Radiology and Radiological Sciences and clinical director of Emergency Radiology, provides nighttime imaging coverage for Vanderbilt University Medical Center and the Emergency Department (ED).
He’s a ‘nighthawk’ — what radiologists across the country call those who work the overnight shift — reviewing and assessing radiographs and CT scans, consulting with colleagues from Emergency Medicine, Trauma and elsewhere across the Medical Center and working to train Radiology residents and fellows.
Powers, who is retiring at the end of this month, is the only faculty member to be continually involved in Vanderbilt’s Nighthawk program since its inception 14 years ago. It’s a role he’s relished, for a variety of reasons.
“Interesting things happen at night; there’s a lot of action that takes place in the ED,” Powers said.
“You see a great many interesting cases and you have the opportunity to really make a difference, especially in the setting of trauma, and you have the opportunity to work more closely with the residents.”
With the region’s only Level 1 Trauma Center providing in-house Radiologists 24/7, it is no understatement to say that Powers has had many memorable evenings over the years.
There was the night several years ago when a patient who had been in the hospital for many weeks was brought down for a scan after taking a sudden turn for the worse.
As soon as the scan was performed, Powers saw that the patient had a massive pericardial effusion — a buildup of fluid around the heart. It was so big he knew this person was going to be in deep trouble very quickly. Powers bolted from the ED Reading Room looking for the patient and was told he was being taken back to his room.
“I ran toward the patient elevators and found his medical team doing CPR on the patient in the hall. So I yelled out that the patient had an enormous pericardial effusion. On the spot, one of the doctors performed a pericardiocentesis, which involves placing a needle through the chest into the pericardial sac and withdrawing the fluid — right there in the hall,” Powers said.
“This was probably 2 or 3 in the morning. The patient came back right then and there. Things like that are very rewarding. It’s nice to be able to help quickly to be able to be a part of helping save someone’s life.”
According to Powers, Vanderbilt’s nighthawk program was created “under the stellar leadership of former Radiology chair Martin Sandler, M.B., Ch.B., in 2000 in response to the Emergency Department’s growth and the need for faculty coverage at night.”
Powers and another Radiology faculty member alternated weeks, working from 6 p.m. to 6 a.m. Wednesday through Monday morning. Other interested faculty members and Radiology fellows covered Monday and Tuesday nights.
Currently, Powers alternates weeks with Matthew Day, M.D., assistant professor of Clinical Radiology and Radiological Sciences, but that structure will change after Powers retires. Beginning in July, the service will move to three Radiologists working five nights each, with Day being joined by Justin Long, M.D., and Nam Le, M.D., both of whom are completing their Radiology fellowships.
Powers’ contributions to the Nighthawk program and to resident training have been immense, said Reed Omary, M.D., M.S., chair of Radiology and Radiological Sciences.
“Dr. Powers’ dedication to patient care, love for teaching and warm interpersonal nature have made him such a terrific partner for our colleagues in Emergency Medicine and throughout the Medical Center. We have been extremely lucky to have him at Vanderbilt.”
Quickly and accurately assessing diagnostic images is a critical component of delivering the highest possible quality of patient care, and it’s an area that Powers excels at, said Corey Slovis, M.D., chair of Emergency Medicine.
“Tom is a master diagnostician as he reads film. It seems as the night progresses, rather than getting fatigued, Tom just continues to see things us mere mortals would easily miss.”
Powers received his undergraduate degree in electrical engineering from Duke and his M.D. from Vanderbilt in 1973. Except for a three-year stint in the U.S. Navy as a destroyer squadron medical officer, he has spent his entire career at Vanderbilt achieving board certifications in internal medicine, nuclear medicine and radiology. In addition to Sandler and Omary, Powers is especially grateful to those who helped train and guide him, including Grant Liddle, M.D., and Thomas Brittingham, M.D., whom he credits with instilling in him an extremely strong work ethic and always putting the patient first.
Powers has seen much change during that time, from Vanderbilt’s physical growth to the enormous advances in imaging technology. One thing that hasn’t changed, though, is the quality of the residents and fellows he helps train.
“What I’ll miss most is the interaction with the residents. It’s rewarding and a joy to work with them. Knowing that you’re doing something to help a patient, right there on the spot, and being able to teach the next generation of radiologists at the same time is immensely rewarding. It’s been a privilege to work with them. I am very proud of the fact that the residents have twice honored me with the Teacher of the Year award.“
After he retires Powers plans to continue to work with the residents, helping them prepare to take their Radiology board exams. He also plans to spend more time operating his amateur radio station and doing a lot more biking.
“I try to stay on the back roads, where it’s safer,” Powers said with a laugh.
