JILL WRUBLE, D.O., has many stories to tell. She is a radiologist, a former U.S. Army major, a faculty member at two medical schools, a mother, an endurance athlete, and a guitarist. Three years ago, Wruble started a new story. She became concerned with the explosion of “incidentalomas”—abnormalities that appear on tests ordered for a different purpose and which trigger a cascade of additional medical testing. “This phenomenon yields not only unnecessary patient anxiety but also extraordinary and disproportionate expense,” Wruble explains. “Less than 1 percent of these abnormalities are significant, but overall, pursuing them is harmful and very costly.” Those costs add up: to more than $200 billion a year.
Wruble examined her files and realized she had “amazing examples of pathology and over-intervention.” She started reading everything she could on the subject and then enrolled in courses in related topics such as bioethics, probability and statistics, critical thinking, and philosophy. While the subjects were fascinating, finding a way to educate physicians and the public about the problem proved to be a challenge. “Lectures at radiology conferences can be extremely dry,” she says. “So among other things, I set out to study the art of storytelling.”
After moderating a panel on incidentalomas in Washington D.C., she gave a TEDx talk at the University of Pennsylvania. Her goal was to “open minds and change instinctive responses when patients and physicians are confronted with incidental test findings.” The 14.5-minute presentation took enormous effort to prepare. “Distilling it into something that succinct was so hard,” she says. “The challenge was figuring out how to weave difficult content into an engrossing narrative.”
Wruble’s own mind was set on medicine from an early age. Her father is a D.O., and she was drawn to osteopathic medicine’s holistic approach. “In high school, I became interested in nutrition, wellness, and fitness,” she says. After graduating from Williams College, she attended NYIT College of Osteopathic Medicine. Like her father, Wruble served in the U.S. Army Medical Corp and had a hardship deployment in Korea. “l have a huge regard for the military,” she says. “I worked with extraordinary, selfless, brave people who wanted to help others. It shaped me.”
Today, Wruble is a radiologist at the Veterans Medical Center in West Haven, Conn., and a faculty member at Yale Medical School and University of Connecticut Medical School. She continues to study incidentalomas and how best to develop standards for additional testing. Equally important to her is writing memorial biographies for Williams College classmates who have passed away. She says, “No matter how great or small their résumés might seem, everyone has a story.”