One of my favorite movies is Eternal Sunshine of the Spotless Mind. Perhaps because it takes place where I grew up (Long Island). Perhaps because of its theme.
This is a multilayered, nonlinear movie, but if I had to encapsulate its themes, they would be the inevitability of life and the pain of loss.
Once I was an expert witness in a trial. The attorney asked me “Dr. Schweitzer you’re a radiologist, aren’t you?” To which I answered, “Yes.” The attorney then asked me, “You look at images only and don’t see patients?” And I said, “Yes, as a radiologist I interpret images of patients without physically seeing them.” He then said, “you don’t know how much pain my client is in” and then followed that with “doctor, you can’t see pain can you?” For the latter, I am embarrassed that I said “yes, we cannot tell from the images, what pain your client is in.”
In nearly every scene of Eternal Sunshine of a Spotless Mind there is a vignette of loss. One poignant scene shows a mother holding a little league trophy in the brain cleanser’s waiting room. The camera pauses just for a fraction of a second and we, the audience, realize she has lost a young son, and wants to escape from even the good memories. When the pain is unbearable, the protagonist wishes to erase all memories that are related to that pain. Although this is an old movie, filmed at the dawn of the brain mapping revolution, there is a seminal scene where a character’s brain is being scanned to identify the location of the memories that will be erased. In the background, just for a few milliseconds, they actually show an archaic MRI image.
In fact, I gave an incorrect response during that deposition — images can see pain. Over the years, JMRI has received many, many papers related to this. My answer was not only wrong, but a manifestation of some ignorance on my part.
Advances in science are inevitable. Even if this movie came out a decade earlier, we could predict that shortly we would see pain. This was probably clear to most of the early researchers in fMRI.
These scientific advances are evolutionary, rather than revolutionary. Hence, we don’t see how advanced we have become unless you look back.
Evolution is inevitable. Hence, it was inevitable that we could see pain. It is also inevitable that we can’t see what we will see until we look back later. That is our loss, but nothing to grieve about.
Mark E. Schweitzer, MD
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Virendra Kumar Yadav MTech, Shalini Sharma MD, Satyajit Maurya MTech, Rakesh K. Singh MSc, Jitendra Saini MD, Preeti Jain MD, Rana Patir MCh, Sunita Ahlawat MD, Sumanta Das MD, Sandeep Vaishya MCh, Sumeet Agarwal PhD, Anup Singh PhD, Rakesh K. Gupta MD
Page: spcone | First Published: 19 June 2025
Fragmented Intratumoral Thrombosed Microvasculature (FTV) in Glioblastoma IDHWT. The Figure Illustrates a Representative Slice from an Enhancing IDHWT GLIOMA Patient in the Analyzed Dataset, Featuring Pre-Surgery Flair, Post-Contrast T1-W, and SWI Images (A-C). (D) SWI Image, with Orange and Blue Arrow Pointing to FTV and Normal Vessels, Respectively. (E) A Zoomed-In View of the FTV and Normal Vessels. Tumor Subcomponents are Overlaid on the Post-Contrast T1-W Images (F), While the Intratumoral Susceptibility Signal (ITSS) Vasculature Mask Derived from SWI Images is Depicted in (G). (H) The ITSS Vasculature Alongside the Tumor Subcomponents Overlaid on the Post-Contrast T1-W Images, with (I) Presenting a Zoomed-In View of this Overlay. (J-L) The Corresponding rCBV, Ve, and Ktrans Images. The Orange and Blue Arrow on rCBV Map Shows the Low and High Values for the FTV and Normal Vessel, Respectively (M). (O) The Concentration Time Plot for Healthy (Blue Curve) Vessel and FTV (Orange Curve). (P-U) The Histopathology Images. H&E Section (2003) Showing a Highly Cellular Tumor with Palisading Necrosis (Arrow) (P). (Q) H&E Section (4003) In High Magnification Showing a Highly Cellular Glial Tumor. The Tumor Cells Show Moderate to Marked Pleomorphism. (R) H&E Section (1003) Showing Numerous Thrombosed Vessels (Arrow). (S) H&E Section (2003) In High Magnification Showing Thrombosed Vessel. (T) Strong Positivity for OLIG2 Immunohistochemistry. CD34 Highlights Endothelial Cells in Dilated and Thrombosed Vessels (U). Flair = Fluid-Attenuated Inversion Recovery; T1-W = T1-Weighted; SWI = Susceptibility-Weighted Imaging; rCBV = Relative Cerebral Blood Volume, KTRANS = Volume Transfer Coefficient; Ve = Fraction of Extravascular and Extracellular Space Volume). By Yadav et al. (258-270)
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