The Tarmac

The world continues to revolve.  I’m a child of the 80s and 90s.  I take refuge in the lyrics of my time:

 “I must've dreamed a thousand dreams

Been haunted by a million screams

But I can hear the marching feet

They're moving into the street

Now, did you read the news today?

They say the danger's gone away

But I can see the fires still alight

They're burning into the night. 

There's too many men, too many people

Making too many problems

And not much love to go round

Can't you see this is a land of confusion?”

~Genesis - Land of Confusion

In these times, we cling to the things we know, the ones that let us take our minds off, even for a moment, the barrage of negativity beamed into each pupil every minute of every hour.

My outlet is to write.

I’m not much of a social media person. Much to the disappointment of my talented marketing lead, I tend to believe most people can see right through it.

Instead, I write to remind myself how I feel about a particular subject and to keep myself honest about why I started down this path. I write to share my thoughts with my amazing team, to keep close friends and colleagues informed about what we’re up to. The world has become quite distracting lately, and my reason for writing today is to renew my focus and to share where I believe we’re heading in imaging -- and as a company in this space.

I always come back to this theme of experience --the idea that situation and circumstance shape a person’s understanding far more deeply than any intellectual or conceptual explanation. The experiential is where adages like “walk a mile in someone’s shoes” come from. It’s universal, running through ancient philosophy, religion, and everyday life. And yet it’s a lesson we as humans never fully grasp, because truly grasping it requires “the experience” itself -- which makes the struggle unsurprising. It’s interesting that we can intellectually understand the concept of experience because we all fundamentally live it. Yet we rarely extend enough grace toward that understanding when we haven’t shared a similar experience ourselves. Even as I write this, my mind wanders in all sorts of directions.

Me: “But shouldn’t I write another paragraph about consciousness?  And then maybe quantum??

My mind: “Focus, Avez.”

Me: “Wait -- what do you mean by ‘My mind’?  Isn’t ‘Me’ and ‘My mind’ the same?

So anyway… where was I…

AI is talked about endlessly in our current moment. I wouldn’t blame you if your first reaction to that sentence is to roll your eyes and think, “Great, another article about AI on LinkedIn.” But I’ll do my best to offer something different and some compelling arguments as we go.

Coming back to experience – close your eyes. My mind: “You made this mistake last time! They can’t read now!” Me: “You are me and I am you! But also, point taken.”

Correction: Open your eyes and read this, but imagine this experience.  You’re sitting on a plane.  You have a window seat.  You prefer window instead of aisle because you can look out the window and the flight attendants don’t bump into you with their carts and stuff.  Anyway, you’re on the plane and it’s about to taxi for takeoff.  You look out the window and there’s that guy with that orange wand thing and he’s guiding the plane back.  You feel the plane move and turn.  As you look out your small window again, the plane is turning towards the tarmac.  The jet engine revs a little and then less as the plane pilot musters enough power to give it a little push to move forward.  This happens several times as you make it down the tarmac, closer to the takeoff runway.   The plane makes one final turn as you look out the window.  You see all the burned tire marks and the white lines and you recognize the classic signs of the runway.  The plane stops.  You get that giddy, slightly nervous feeling in your stomach.  The pilot comes on the speaker “flight attends, please take your seats for takeoff”.   The feeling starts to amplify.  Your mind says “I hope this goes well” and then you brush away that thought knowing the statistics and the numerous flights you’ve taken.  The jet engine amps up.  Here we go.

Everyone reading this can relate to the experience. I won’t cheapen it with a cheesy, obvious metaphor like “AI is like a plane taking off!”

But, I will have you focus on the mundane part.  Remember when you were just sitting in your seat and looking out the window?  Or when the plane was making small turns here and there on its way to the runway? Can you zero in and notice the scene? Did you see the lights on the tarmac? The arrows pointing towards the direction of the runway or the lights blinking on the side of pavement?  Did you notice whether the grass was cut in the islands in between or if they didn’t manicure it and let the weeds run wild?  Did you feel the bumps in the tarmac or was it smooth and freshly paved?

Experiencing something is made up of many elements -- emotion and memory come to mind, but also familiarity and understanding. It’s the cohesion of all these pieces that leads to our collective “oh, I know what that feels like…” I can’t pass that feeling on to you without those elements, but I can help you understand it intellectually and conceptually. The imperfect fallback.

The spaces between the moments before takeoff often go unnoticed. If the tarmac lights didn’t blink, if there were no directions toward the runway-- what if the guy with the orange wands wasn’t there? What if there were no tarmac at all? We’re always more captivated by the exhilarating parts than by the path that leads us to them.

My experience over the past two and a half years building with AI has been exhilarating, but it’s felt like all runway and no tarmac. Think about that -- how long before you’d start to wonder how you even got there? When do we take off, and where will we land? Lately, it’s dawned on me that radiology -- and imaging more broadly -- demands greater attention to the mundane. The pavement. The lights. The guy with the orange wands.

Fundamentally, the pieces required for takeoff and landing still need to be built. I believe agentic AI is the path forward. Right now, the tarmac-to-runway elements are woefully inadequate to harness this profoundly remarkable technology. Integrating and deploying AI feels like trying to taxi a plane for takeoff on a dirt road -- you can do it, but it’s clearly not ideal.

So then it begs the question -- why is this the case? My perspective may be controversial, and my solutions bold. I’m a contrarian by nature -- as most entrepreneurs are -- and I believe innovation thrives in the free market of ideas. Building standards by consortium and consensus might have worked when technological leaps were measured in decades, but it makes little sense in the exponential curve of paradigm shifts with AI.  Advanced, sci-fi level dream scenarios are available now, yet we lack the underlying layers to execute them seamlessly and elegantly.  Like a fully paved tarmac with lights guiding the plane to the runway, AI needs its own equivalent “tarmac.”

In the coming weeks, we’ll be announcing some bold moves. RSNA 2025 is shaping up to be another breakthrough -- not just for us, but for the field as a whole. We’re building a movement, together with our industry partners across clinical practice and AI technology providers.

Let’s get back to feelings and experience.

My mind: “This is a LinkedIn article.  These people don’t care about your ‘feelings’.”

Me: “You’re not the boss of me!! Actually…wait.”

I’ll let you in a little on how I feel about the social spheres in my life. My closest friends are just as crazy as I am, and I love them for it. I’ve always been drawn to curious people. I take people along for the ride -- those willing to let go and dream with me. Not everyone joins, but enough do. I’ve kept the same posse of boldly outrageous friends since college. Two decades later, we’re still close, talking almost every day and meeting at least once a year.

As with life, it carries over into work. RADPAIR is a collective of highly skilled, bold, and curious people -- and our partners are strikingly similar.

So what am I trying to say? If you’re reading this and want to be part of this journey -- if you want to help shape the future of imaging and seize the moment -- we’d love to have you partner with us. Let’s pave the tarmac, set up the lights, get the guy with the orange wands, and take off together toward the future of imaging.

On a final note -- yes, the world is a crazy place. But it’s also exciting, and filled with so much love and joy.

Let me leave you with one of my favorite childhood jams. I promise you’ll enjoy the experience:

https://www.youtube.com/watch?v=7jH05dt9R68&list=RD7jH05dt9R68&start_radio=1

Written by: Avez Rizvi - CEO and Founder, RADPAIR.