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submitted 10 months ago* (last edited 10 months ago) by Sterile_Technique@lemmy.world to c/imageai@sh.itjust.works

Idk if this is the work of AI, or just a 3D artist who didn't get very good instructions for their commission.

At first glance: nothing special, just a collection of random instruments; but when you start to dissect it under the lens of a surgical tech (the target audience for this image) it just gets worse and worse.

So let's dissect it!

First off, that isn't even a surgical backtable - it appears to be on some kind of supply cart, with a raised lip around the edges, and random rectangular holes for handles that have folded sheet metal along the edge. Technically you could throw an impervious drape of that and it'd be fine, but you generally don't see surfaces made to support a sterile field with raised edges that go above the field. The folded sheet metal is also a no-no, as the grooves around it collect and breed the hell out of bacteria.

None of it's draped. There's that greenish material under the tray and instruments, but stops short of the edges of the cart, so there's some REALLY high contamination potential going on there. You could get away with a field like that in dental (which is just 'clean' vs sterile), but again, this wasn't sent for a dental tech position.

Instruments from left to right, we're looking at:

  1. a scalpel that's for some reason separate from all the other sharps in the kidney basin.

  2. looks like a tissue forcep - that actually checks out.

  3. ...the only times I've seen a forcep like have been in ortho sets that have a lot of plates and screws - those forceps are to grab the tiny screws from their caddy, cuz they're hard to get your fingers around, and normal forceps tend to 'slip' around the head of the screw and send it flying across the OR.

  4. that's a sponge forcep, but the end is bent in a really odd way; and it doesn't have a ratchet lock, which isn't unheard of, but definitely not common for a sponge forcep.

  5. Dental explorer, which checks out with the whole not-really-sterile thing; except if it was a dental setup there'd be a lot more dental instruments.

  6. Fuck if I know. Doesn't help that the resolution isn't great, but the operative ends kind of look flat. Bowel clamps are shaped like that, but that is DEFINITELY not an open-belly setup lol. Also - the ringed end where your fingers would go is closed all the way, but the operational end is still open. If a real instrument looks like that, then it's damaged as fuck and needs to be thrown away.

  7. Either a kocher clamp or straight hemostat - hard to tell w/ shitty res. But they have have the same weirdness with the ratchet being closed w/ operation end still open.

  8. That looks like a potts scissor, which is usually for vascular surgery. Handle is janky as fuck though, and it's doing the opposite weirdness as mentioned before: it's operative end is closed all the way, but the handles are still a tad open.

  9. Mayo scissors, which are a go-to for cutting suture. Only weirdness here is the janky handle style.

...and that kidney basin in the upper right of the tray is just chock-full of WTF. So they're using it as a sharps container - that's normal, but they've got the scalpels facing one direction and needles facing the other... that's a good way to get stabbed. ALL of the sharps are resting on the edge, meaning if you bump them just right, they'll do a flip and launch off... that's a good way to get stabbed. They've got all their sharps in one spot, except for that one random scalpel on the left of the tray. Establishing a sharps zone and then not putting sharps in it... that's a good way to get stabbed. The scalpels and needles in the kidney basin all have the sharp end stuck into some gauze or something... that'll dull or bend the super fine end, reducing its effectiveness and generating snag points that'll cause a bit of unnecessary trauma. Between the three scalpels in the basin and the bonus one floating off to the left, a solid third of the instruments displayed are scalpels lol... are they doing a Wolverine cosplay in the OR?? The blades detach... you only need one scalpel handle - maybe two if you want one ready and on stand by. Also all of them are loaded with what looks like a #24 scalpel blade, which isn't very common; and is a fucking massive blade... I could see wanting ONE of those for something like an emergency C-section when you need to rip that skin open fucking NOW, but 4 of those monsters set up with an otherwise tiny collection of instruments? lol no. Those two syringes aren't capped, which is a good way to get stabbed; or labeled, which is a good way mix up your local anesthetic with something that could cause excruciating pain.

...there's just so much wrong with this image it's comical. I can't believe a fucking hospital would choose this over the millions of OR photos already floating around the web lol.

That was a fun rant to type up. If you actually read that wall of text, hope you got a kick out of it lol!

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[-] jubilationtcornpone@sh.itjust.works 52 points 10 months ago

This could be none other than the "brilliant" idea of some recruiter. The same people who, in my field (software engineering), don't know the difference between Java and JavaScript (two similar sounding yet completely unrelated programming languages) or expect 10 years of experience in a technology that didn't exist 4 years ago.

They know what a scalpal looks like ...sort of. That's where their medical expertise ends. This particular recruiter sat there looking at their masterpiece, hot off the AI press, feeling very pleased with themselves and their creative genius. Not having a clue that almost everything about the picture is wrong.

I wouldn't have known that either though so thanks for the really detailed explanation!

[-] aard@kyu.de 9 points 10 months ago

The same people who, in my field (software engineering), don’t know the difference between Java and JavaScript

The same people who don't understand that zip codes are not unique to a country, and do a zip code search on recruiting platforms without also setting a country. And then offer you to move to their country (at your expense) when you explain them the concept of zip codes and countries.

[-] PlutoniumAcid@lemmy.world 50 points 10 months ago

You need to send this exact text back to the recruiter. I only know a few of the words you used but I am left with the clear impression that you really know your stuff!

[-] Sterile_Technique@lemmy.world 25 points 10 months ago

Lol thanks! If I was going to give that recruiter any feedback, it'd be to include the pay and benefits in their pitch. They can "we're a family!" and "top-notch patient care!" me all day long, but if they want my hours they need to tell me what I get in return. Drives me nuts when employers aren't up front about shit like that.

A bit of googling on that hospital (ThedaCare) shows they treat their employees like absolute shit - sounds like they lost a good chunk of their radiology department because those staff found out they were being underpaid, and took a job at a different hospital. They even gave ThedaCare the opportunity to counter-offer, but ThedaCare instead went to the court system to block them from leaving. There was no non-compete agreement, and this is all in an at-will employment state. ThedaCare literally asked a judge if it could have slaves, rofl.

...and perhaps most terrifyingly, the judge actually rolled with it for a couple days, although it did eventually get thrown out.

https://www.postcrescent.com/story/news/2022/01/21/what-we-know-ascension-thedacare-court-battle-over-employees/6607417001/

https://www.nytimes.com/2022/01/24/us/thedacare-lawsuit-wisconsin.html

https://www.businessinsider.com/thedacare-asks-judge-block-workers-leaving-higher-pay-competitor-2022-1?op=1

Yeah I don't think I'll be applying there. >_>

[-] uis@lemmy.world 6 points 10 months ago

but ThedaCare instead went to the court system to block them from leaving

Is it US? Because this is the only one country I know that has slavery.

[-] Sterile_Technique@lemmy.world 5 points 10 months ago

Is it US?

Yes.

Because this is the only one country I know that has slavery.

If only. Humans are pretty horrible to each other all over the globe. We have entire markets dependent on slavery like chocolate; one of the richest fucks on the planet right now got to where it is via enslaving emerald miners. Russia's made the news several times recently for enslaving POWs.

I'm sure the list of modern examples of slavery is much, MUCH longer, but that's a few off the top of my head.

[-] uis@lemmy.world 3 points 10 months ago

*where corpos go to court to sue people that don't want to be slaves

[-] Sterile_Technique@lemmy.world 3 points 10 months ago

...yeah that one might be unique to 'murica.

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[-] Deceptichum@kbin.social 39 points 10 months ago* (last edited 10 months ago)

I don't think that's AI, the tools keep their shape far too well.

Here is what the AI got when I tried to recreate this:
https://i.imgur.com/wvCRtSz.png

See how truly cursed the scissors are? And the cotton balls actually look like cotton balls here.

I'd lean to 3D, especially with the way the chromatic aberration going on there and the clearly defined shapes.

[-] IndefiniteBen@leminal.space 12 points 10 months ago

Yeah I also think it's a 3D render. The chromatic aberration, the shadows, the specular reflection of the metal, the lack of camera sensor noise; something about the lighting just looks off.

It looks way too consistent to be a composite image of some kind.

[-] andxz@lemmy.world 4 points 10 months ago* (last edited 10 months ago)

You're both completely correct. The biggest tell is probably the fact that the sheet is essentially floating above the tray.

[-] IndefiniteBen@leminal.space 3 points 10 months ago

What is "evidence of bad ambient occlusion"?

[-] thedirtyknapkin@lemmy.world 9 points 10 months ago

yeah, everything op pointed out are things a person would screw up because they don't know the tools. I'm also gonna call this non-ai 3d corporate art. the only part of this that feels remotely ai are the cotton swabs, but that could easily just be because it's hard to make a good 3d cotton swab.

[-] Sterile_Technique@lemmy.world 8 points 10 months ago

Oh wow... Yeah that's cursed as fuck. I wouldn't even be able to give a good break down on that image, cuz every instrument looks so alien.

[-] Aspaldiko@feddit.de 6 points 10 months ago

I really like the mirror-scissor.

[-] BananaOnionJuice@lemmy.dbzer0.com 4 points 10 months ago* (last edited 10 months ago)

Mirror-scissor that's triple fingered and then there's the one fingered scissor

[-] Deceptichum@kbin.social 6 points 10 months ago

Its the N64 controller of the surgical world.

[-] Evia@lemmy.world 4 points 10 months ago

From right to left, lol at n.2

[-] lakmaran@feddit.de 39 points 10 months ago

It‘s like the images IT people get where some person holds a soldering iron on the hot part to a CPU on a motherboard. For a programming position, nothing to do with hardware. SMH

[-] Moira_Mayhem@lemmy.blahaj.zone 3 points 10 months ago

Stock photos can create a strange reality if you take them on face value, women ridiculously excited at a forkful of salad, groups of people over 5 have token representation, periods are blue for some reason, No one in the bar actually drinks and just keeps raising their glasses in generic joy and celebration.

All to market to us.

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[-] mvirts@lemmy.world 20 points 10 months ago

At first I was like WTF is the about, now I'm like WTF were they thinking. Great writeup 😁

[-] Toldry@lemmy.world 16 points 10 months ago

I just wanna express appreciation that there is a surgical tech amongst us and we're not all just software dudes (myself included)

[-] Sterile_Technique@lemmy.world 15 points 10 months ago

Woo!!

I've been told quite a few times that I missed my calling for IT. Our nurses love to bitch about our RIDICULOUSLY ARCHAIC charting software, and I'll take one look at it and notice one of the tabs at the top of the window says "Macros" and my first response was "have you ever messed with that tab? A lot of the repetitive shit your charting looks like it could be automated!" and they'll just stare blankly at me "...wtf is a macro?"

Or I'll walk past the manager's office to see him working on an Excel sheet, while punching numbers into a physical calculator... like, dude, idk what you're working on, but if you're holding a calculator while working on Excel, you're doing it wrong lol.

...apparently shit like that makes me a tech genius to the average boomer.

So... I'm with y'all in spirit if nothing else.

[-] SzethFriendOfNimi@lemmy.world 16 points 10 months ago
[-] Sterile_Technique@lemmy.world 20 points 10 months ago

Rofl I haven't seen that... and yup, been there. I've had med students come up to my backtable with their gloves or some other random peel pack, then just toss the entire peelpack onto the table.

For my non medical peeps: the contents of a peel-packed item is sterile, but the outside is not. Think of a thing of string cheese (WHY ISN'T MORE FOOD PACKAGED LIKE STRING CHEESE?!?!) - you could completely immerse the thing in literal poison; but then open it in a way that the package is peeled away from the cheese so that the cheese never actually contacts the outside of the package. Keep opening it until the cheese falls onto a plate; and it's completely safe to eat. ...so, the med student above basically walked up to my plate, and just chucked the poisonous packaging onto it, meaning the rest of the food on the plate is now fucked.

[-] LazaroFilm@lemmy.world 5 points 10 months ago

If you sterilized your food, it’s also probably fucked.

[-] Sterile_Technique@lemmy.world 7 points 10 months ago

Might be a bit crispy around the edges.

...or saturated with something incredibly toxic, depending the sterilization method.

[-] psud@lemmy.world 3 points 10 months ago

Pressure canned foods (eg tinned fish) are poor-man's autoclaved

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[-] lambdabeta@lemmy.ca 16 points 10 months ago

I'm also wondering what's in the top-left. Is it a bowl of stones?

Wait! I figured it out.

You were close with C-section, but got the direction wrong. Clearly this is getting ready for urgent replacement of gizzard stones! :)

[-] Sterile_Technique@lemmy.world 12 points 10 months ago

yeah I was going to grill those too, but figured it's probably just a shitty render of cotton balls... but honestly between those, the gauze pads in the kidney basin, and those circular pads under the dental explorer, we've got three types of dressings, none of which have radiopaque strips of any kind, which is another no-no for most types of surgery.

[-] IndefiniteBen@leminal.space 16 points 10 months ago

I'm guessing the recruiter made a text post and then looked for an "eye-catching" surgical tool image to make the post stand out.

Why would they directly send you an image with a recruitment message? Because they were lazy and just copied their recruitment post from elsewhere?

[-] haui_lemmy@lemmy.giftedmc.com 14 points 10 months ago

It was a lot of fun to read. Thank you very much. You‘re the type of expert I want working in the hospital I go to.

[-] Sterile_Technique@lemmy.world 3 points 10 months ago

Thank you!!

[-] ipha@lemm.ee 12 points 10 months ago

This looks like bad photoshop rather than AI. A lot of the edges are too square and the shadows are inconstant.

Even without knowing much about OR prep, this is firmly in uncanny valley.

[-] Sterile_Technique@lemmy.world 18 points 10 months ago

Self-plagiarizing from another comment:

The weirdness with things like the closed handles and open working ends are what really makes me think it's AI.

Say you needed a pair of just normal scissors, so you hop on some online store and start browsing pictures, and come across this abomination:

Like, you know it's supposed to be scissors, but it's also just wrong as fuck.

[-] lolcatnip@reddthat.com 10 points 10 months ago

Since you seem to know about this stuff... What's the deal with kidney-shaped basins in medical settings? Why that shape?

[-] Sterile_Technique@lemmy.world 15 points 10 months ago* (last edited 10 months ago)

Idk if this is the textbook answer, but what I personally use them for most often is for catching fluids during a washout.

Say your thigh has a nasty infection - like a deep wound, pus all over, tissue is dying, not a good time. So you get sent to the OR, where we'll irrigate the fuck out of it, trim out all the tissue that looks like it's dying, then irrigate the fuck out of it again, then irrigate some more. We're talking like 5 liters of saline being shot into your wound and allowed to just flow right back out. If we let that just hit the floor, we'd be ankle-deep in a coctail of saline, blood, pus, and whatever pathogen is causing the infection, so enter the kidney basin: the curve shape allows it to conform to the curve of your leg, so if I hold that below your wound while the surgeon is blasting it with saline, it'll catch the mess before it hits the floor. I'll generally hold with with my fingers wrapped around the bottom of it and thumb around the inside of the basin; that way I shove a suction tube between my thumb and index finger so that the tip of it is resting at the lowest point in the basin. So, as nastiness falls into the basin, it's immediately sucked up out of our sterile field.

Other than that, I like to put all my fine/sharp instruments in the kidney basin at the end of a case, shove the basin full of sharps into a side of my instrument set, pack the other instruments around it, and send them to our sterilization department like that. That way whoever gets my dirty set in decon can very clearly see where all the sharps are, so they don't get stabbed when they're sorting out and wash all the instruments. Some techs will just dump all the dirty shit into the tray with no logic or organization, and it all just looks like a bloody metal birdnest, which is a fucking nightmare to deal with in decon (I used to work in sterile processing, so I know the pain).

[-] Dagwood222@lemm.ee 10 points 10 months ago

My two favorite medical blunders in TV/movies.

Nasal cannulas. Almost never see them applied correctly.

EMS treating a patient by having them sit on the back of the ambulance.

[-] QTpi@sh.itjust.works 8 points 10 months ago

I feel this! I'm a Medical Laboratory Scientist and all the unholy abomination stock photos of blood tubes with COVID antigen test results written on the tube.... There was a subreddit just for shitty science stock photos.

[-] Moira_Mayhem@lemmy.blahaj.zone 8 points 10 months ago

I like this post because it goes a long way to proving that highly technical jobs have depths of nuance that your average laymen will never even consider.

Like when you see 'hacking' in movies, as an IT guy it makes me hardcringe every time.

Another example of this is how Hollywood portrays 'poor' families as having houses 3x larger than anything you could ever afford and two cars but they are just making sad faces all the time.

Because that's what struggling is to hollywood writers, they lack the nuance to understand what being poor really means.

The problem is that these media images being made are MORE compelling to people who don't understand the nuance. That tray of utensils looks fine to me as a knowlessman and I would feel that whatever content was hosting it was medically reliable.

You as a professional know it is ridiculous only because you have the practical experience that the artist lacked.

The real danger is when people start believing the artist more because of how much more aesthetically pleasing they can make their misunderstandings, and trust me it is a real danger.

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[-] LazaroFilm@lemmy.world 8 points 10 months ago

Have you done a reverse image search? I bet the recruiter didn’t use an ai to make the image but downloaded a random image off google that looked good enough to them and moved on, and that image happened to be AI generated.

[-] MrJameGumb@lemmy.world 6 points 10 months ago

I think it's a normal photograph. The photographer probably found a bunch of miscellaneous "medical supplies" at a thrift store and keeps them specifically for this purpose. I'd bet they used the same tools for other videos about dentists, podiatrists and proctologists lol

[-] Sterile_Technique@lemmy.world 15 points 10 months ago

It's definitely a 3D render - look at the 'cotton balls'. The weirdness with things like the closed handles and open working ends are what really makes me think it's AI.

Say you needed a pair of just normal scissors, so you hop on some online store and start browsing pictures, and come across this abomination:

Like, you know it's supposed to be scissors, but it's also just wrong as fuck.

[-] uis@lemmy.world 6 points 10 months ago

Not a doctor, but for me those syringes look very sus. I don't think is it ok for needles to touch anything that isn't patient's skin.

[-] Moira_Mayhem@lemmy.blahaj.zone 3 points 10 months ago

That's fine if that pad they are resting on is sterile but its still not good practice as someone could get inadvertently jabbed.

[-] Donkter@lemmy.world 3 points 10 months ago

Lol as a non doctor I didn't even know they made scalpels as big as the ones in the tub there! If they're as sharp as regular scalpels that's one hell of a delicate hand you need.

[-] Sterile_Technique@lemmy.world 6 points 10 months ago

Most scalpels are two parts: a reusable handle, and a single-use blade.

Both parts come in a ton of different shapes and sizes - all just depends on the intended use.

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this post was submitted on 21 Jan 2024
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