The Virginian-Pilot
© July 29, 2012
– As told to Pilot business editor Dave Mayfield
I’ve been doing ultrasound since 1977. I was one of the first in the area. The technology was very basic when I started. It was very exciting, though. I compare ultrasound, this may be off the wall, to “Star Trek,” when the guy runs that little machine over someone’s body and gives a diagnosis. The only difference is, I have to touch them. I still, after all these years, think it’s cool.
My first patient all by myself was an OB patient, a lady who was pregnant with a baby that had severe abnormalities that we did not know about until we did the ultrasound. It was a significant abnormality of the baby’s brain. I don’t think it was a good outcome. That was a tough introduction, and it was very scary because I did not expect my first scan to be so drastic. I guess it made me realize how what we find just affects lives so dramatically.
With ultrasound, it’s up to me to show the radiologist what’s going on with the patient. It’s very technician-dependent, probably more so than any of the modalities that are out there now.
When I started, I worked with a machine that had an articulated arm, a fixed arm, as opposed to a flexible cable that we can move freely today to get images. We can get all kinds of angles now, but back then, we were very limited in the angles and our area of imaging. We would have to physically wrestle with the machine. I still have a lot of upper-body strength from that.
Over the years, it’s developed into quite an unbelievable modality. For children, you can look for pyloric stenosis, where the stomachs are small. We look for foreign bodies in soft tissue. We look for breast masses daily, which is a lifesaver. With the newer transducers and the newer technology, the things that we have, it has just made such a big difference.
Ultrasound can’t go through air or bone, so you have to work around those things. It has to do with the elasticity of things. Once you can work around all that, you can get better images.
I have taught, oh, for so many years, and I’ll see students I’ve taught, and they are probably at every facility in the area. I’ll see them at local get-togethers, like at the radiology Christmas party. Sometimes I don’t even recognize them because I taught them so long ago.
You can tell when somebody has more of a knack for it than not. They have to be detail-oriented.
When I look at a picture, I look at everything. It drives my sister nuts when I’m watching commercials because I’ll pick out the tiniest little thing in the picture. But that’s what ultrasound’s about. We look at everything in the picture. We may be doing a gall bladder picture, but we’ll see something in the aorta or we’ll see something in the liver or in the whole surrounding picture. You have to have that “Where’s Waldo?” mentality to pick out the tiniest detail from the whole image, and every image.
You have to know what things are supposed to look like, and if it doesn’t look like that, then you have to figure out why. Is it your settings, or is it something with the patient? Is it positioning? You can’t just let it go. You have to keep looking at it a different way, angle, get them to hold their breath, press a little bit harder, and if it’s still there and it still looks funny, you may not know what it is, but you better measure it and show it to the doctor.
I usually have a good rapport with my patients. By getting them to relax and talk about whatever else, to pass the time, they have a good experience, and I get a good study. Sometimes it’s their animals, their children, their job.
(Being on) call is probably the most frustrating thing. One week a month, seven days in a month. And I’ve been doing it for 34 years. I have a little beeper, and it goes off, and it says: Please come back in. Stop what you’re doing right this moment, and come in. Pretty much every time we’re on call, we get called in. When you’re on call, you can never plan anything. You cannot put a pie in the oven. You cannot go the movies. You cannot go out to dinner.
But all in all, I just thoroughly enjoy ultrasound, and I enjoy working here. I love my patients.
I think that 3-D is going to be much bigger in the future. I think it’ll become standard on new machines. I hope I see that day.
Medicare has recently started screening ex-smokers for aneurysms. You can see a bulging. You can see an aorta that’s starting to swell, and you’ll get an abnormal measurement. If they can keep an eye on that, it would be a great benefit.
I have seen men come in here with 6-centimeter aneurysms that they knew nothing about. And I was afraid to send them out the door. They can do surgery to repair that. It’s people like that they’re going to save.
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