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They Put Me Up for Three Weeks at a Holiday Inn….
…and called me a neuroradiologist. It was about 15 years ago. I had retired from full-time practice as a general radiologist. Still, I found that there was a need for an efficient radiologist to fill in on a locum tenens basis in hospital-based practices. Some had a shortage of radiologists due to hospitals firing their radiology group or other problems within that group.
The opportunities were endless. I generally only worked one week at a time with no back-to-back weeks, and I was very well paid. Because I was efficient, I was in high demand for situations that were understaffed and overloaded. That’s how I spent three weeks at a major hospital in Kansas City, filling in for an interventional neuroradiologist who had an independent practice separate from the main radiology teaching staff.
He had a neurosurgical partner who was qualified to perform interventional procedures, such as placing a catheter into a thrombus, causing an acute stroke. But he needed someone to read the many dozens of CT scans and MRIs each day that were part of the service.
So, although I was not technically a neuroradiologist, I was adequately qualified to interpret the studies that needed to be read. And I was staying at a Holiday Inn.
The unwritten rule of radiology is if you don’t know what you are looking at, at least describe it as well as you can. I was a very good radiologist because I knew my limitations. There were actually no situations in those three weeks where I was uncomfortable because of being in an unfamiliar situation. Although I had never read mass spectrometry MR scans for tumor evaluation, I had a cheat sheet that told me everything I needed to know; I just described the findings with exquisite detail. The real neuroradiologist would be back soon enough.
I also supervised radiology residents on the service and discovered they had somehow never learned that basic rule of radiology. They often seemed clueless about a study but would dictate a report just by copying and pasting previous reports without ever saying what they thought they were dealing with.
It was a learning experience for all of us. I felt like I made more of an impact in those three weeks than I had in a very long time.
Published in General
I’m not a neuroradiologist…
I was going to be a radiologist but it was a dying industry and I became a televisionologist instead. Clearer pictures, too.
Isn’t there HD radiology these days?
The really cool radiologists get to play with MRI machines!
Even ultrasound has come a long way.
MRI machines can be dangerous. A nurse in Redwood City, CA was injured last February when an MRI machine was turned on while a gurney was nearby.
It is a hazardous job. Somedays there were coffee grounds in my coffee and my afternoon nap would be disrupted by patients fainting or trying to die in the waiting room. Very hazardous, I say.
That’s precisely what makes them so cool!
I’ve done the design for several MRI installations. It was stressed to me the dangers of the magnetic field. One example I heard was about a fire extinguisher that was pulled into a magnet. The field is so strong that in that instance rather than going through the expense of shutting it down and restarting it they arranged for a tow truck and used its cable to pull the fire extinguisher from the magnet.
An $18,000 dollar fine seems lenient under the circumstances. And the story doesn’t indicate that anyone was fired. They’re lucky they haven’t killed anyone yet.
Why would it be expensive to shut down and restart?
The magnet is a huge current in superconducting wiring in a liquid helium bath. The superconducting wires are special in that below a certain temperature, they can flow the current without resistance. Normally, because the current is so large, you want to slowly put it in or take it out, because if you do it too fast, it’s too “turbulent” for the current to flow without resistance. This heats up the wires and causes a runaway effect, called a quench, which will boil off the liquid helium. In an emergency, you can’t do it slowly, so a lot of the liquid helium is blown off.
Based on a thread I found from three years ago, 100L liquid helium costs about $1500 plus shipping and handling. Typical MRI machines holds 1700L liquid helium. So, each emergency quench will cost $25K in just liquid helium, plus shipping and machine maintenance. This also doesn’t include lost income from the down time.
Okay, but from what I read that only applies to a fast cycle; the magnet can be energized and deenergized without losing the liquid helium. Which isn’t fast, but it can be done. Presumably in the emergency situation being detailed here, an emergency quench was required.
I found this information extremely interesting. Thanks @southernpessimist for an interesting post about a field foreign to must of us.
but, a Holiday inn!. They have a machine that lets you make your own pancakes!
Great post.
My faith in doctors’ ability to read an X-ray was seriously shaken at age 16.
I was a hospital volunteer and developed X-rays manually in a darkroom and then hung them on the light screen for review. One Saturday morning I came out of the darkroom with a new batch to be read and watched as a doc looked at the one X-ray still hanging on the viewer and commented that the shoulder of his patient (an older man) looked better than he expected. As a 16-year-old male I was acutely aware that the general outline in this side-view X-ray was that of a very well-endowed woman. Without saying anything I put the correct films on the viewer. Long pause… and the doc quietly took all the pics down and left, no doubt to dispense a high-quality diagnosis to his patient.
So, you were like Dave and “Chainsaw” from “Summer School” at the photo booth!
Accidents happen when people do not know what they are doing- while this was a bad it was not nearly as bad as the child struck in the head and killed by a ferromagnetic oxygen cylinder years ago while in a MRI machine (they make special cylinders for use in the MRI suite):
https://www.newyorkinjurycasesblog.com/2010/02/articles/wrongful-death/lawsuit-involving-death-of-six-year-old-boy-hit-by-oxygen-tank-while-undergoing-mri-test-settles-on-verge-of-trial-for-2900000/#:~:text=Michael%20Colombini%20had%20been%20undergoing,Michael%27s%20head%20as%20he%20lay
but not as funny as the ridiculous janitor who brought a steel cart into the MRI suite and had it “sucked” into the machine and then (in a big mistake) called the fire department to help him out rather than a member of the radiology department. The fireman, in their typical macho can do spirit, attached a cable to the cart and used their fire truck to tow it off- thereby causing about $1M in damages to the MRI.
but some accidents shouldn’t merit any compensation:
https://nypost.com/2023/02/09/lawyer-dead-after-mri-discharges-gun/
Typically there is a large button to trigger the emergency quench- and all the staff involved know it is an expensive proposition. There is a large array of specialized equipment for use in the MRI suite- oxygen tanks, gurneys, monitors etc. The suites have multiple signs warning about the danger posed by the magnet- so one has to work to not notice them.
Using a truck to pull something off the magnet will usually cause more damage than the cost of the quench.
Old Bathos, you have just shown how old you really are. Things may have improved but I am not sure. Images and studies are now all digital and viewed in isolation on a computer screen. I do miss those days when occasionally a well endowed technologist or other woman would inadvertently pose in front of a high intensity light screen wearing a sheer blouse. As every woman should know, every man’s mind is always in the gutter and there is a reason for that.
The small town where our daughter and her family live has a small hospital (both of our grandchildren were born there). But the limited volume of work (and thus limited income) for doctors limits the number of medical people (doctors and nurses) inclined to live there. There is only one surgeon, and he needs time not on call once in a while. So the hospital brings in a lot of traveling doctors and nurses. Most of them (including the visiting surgeon) stay at the Holiday Inn Express, which is the nicest of the three hotels in town.
Almost all of my work was performed before Obamacare. Medical care has gone down the tube but there is Holiday Inn.
Not if I find the cord and the outlet, they don’t.
Yes it was.
I’ve tried that, they’re terrible.