Part of the interview day for these emergency residency positions involves a tour of the department. One day, on tour at a particularly endowed emergency room, the attending was showing the applicants his department's various assets: a paperless ordering and patient tracking system, the PACS radiology computers, and a pair of new ultrasound machines.

"Profiency in reading ultrasound, as you know, will be increasingly important as you advance in your training," the attending intoned.

I had a great case during my first ED month where we used ultrasound to rule out testicular torsion in a guy with... a lot of pain. And I had just been hearing about new uses of ultrasound. I thought I could make an impression during the tour, so I interjected, "You know, just recently, it was shown that ultrasound is superior to X-ray for pleural effusion."

"That's right," the attending agreed. "Ultrasound is quickly proving its worth for rapid imaging of lungs, hearts, galbladders..."

I thought back to my torsion case. Should I mention it? Or just echo his sentiments? Or say nothing and let the tour continue?

I said, "Scrotums."

Everyone was quiet. Maybe my timing was off, and I spoke a few moments too late. But the seconds ticked by and still, no one spoke.

"Um..." I continued. "See, we had this neat case where doppler ultrasound ruled out testicular torsion... Yeah."

"Oh, good," the attending smiled. "I just thought you might have Tourette's."