Alex works in “Diagnostic Imaging”, which is how the medical community (at least in Alberta) lumps together X-Ray, Ultrasound, Computer Tomography (CT, aka “cat scan”), and Magnetic Resonance Imaging (MRI). I gather Nuclear Medicine is also included in this, though I’m not really clear on that.
Once upon a time, X-Ray was the lowest rung, where everyone started, where you learned the basics and understood the practice, and then you went off to gain more education to do the other modalities. To no-one’s surprise, those times have changed and people can jump right into their preferred field. I’m going to come back to that point…
Alex has been taking x-rays for over twenty years. She knows the practice, she knows the process and procedure. And yes, that means it does become a bit rote – it’s a very rare situation when she gets to take an image she hasn’t already done at least 20 times in the previous month. So two years ago, Alex decided to test herself and gain certification to step up to MRI.
I need to stress one thing: You don’t just go to an evening seminar and get to take MRIs. (The same can be said of the other modalities, there’s a lot involved, especially where ionizing radiation is involved, such as x-ray and CT, never mind the really nasty stuff that comes through Nuke Med.) This is a full course load, you have to go to a school that is certified to teach the program, you have four semesters of study and tests, a final exam, and then you’re allowed to write for the CAMRT (Canadian Association of Medical Radiation Technologists, the national “school” that certifies everyone in this field).
This was started at the tail end of COVID. That alone should suggest the difficulty – all online classes with the Northern Alberta Institute of Technology (NAIT), which is based in Edmonton. As it would turn out, this wasn’t the real reason for online – the “second discipline” students, those coming from other modalities, usually X-Ray, are all online. On the first discipline students – those going into MRI right off the bat, actually go to class. I’m going to come back to that point…
The first week, Alex nearly quit, and I don’t blame her. It was cracking open physics textbooks and, quite literally, learning it all over again. But it was worse than the stuff you might have done in high school. Remember “interference patterns” when you did the light slit test? Odds are, your teacher didn’t explain the real physics behind that, which requires a decent understanding of quantum physics. Yep, all that weird Schrodinger stuff. I have a decent understand of it, but nothing like Alex had to deal with.
You see, MRI is literally quantum physics. The geniuses who created this technology realized that, with the right electromagnetic signal (yep, radio), you could cause hydrogen atoms to tilt on their spin axes. That in itself isn’t the amazing part – it’s that when you turned the signal off, the atoms snap back to their preferred alignment, which sends out more signals, which are then captured by receivers, and the relatively presence or absence of those induced signals is what helps generate an MRI image.
And where things get even more difficult: those images are in 3D. Unlike an X-Ray, which is a 2D representation of a singular view through a piece of anatomy, an MRI is a representation of a specific “slice” in 3D space. And you can dial those slices in 3D space to reconstruct an entire joint, for example, so it’s possible to view it from any angle you wish, all without surgery.
This kind of “any sufficiently advanced technology is indistinguishable from” magic is also why MRI wait lists are a year or more: there’s simply not enough magnets for all the images doctors want taken.
With some words of encouragement (which is literally all I could offer), Alex pressed on. Every semester was a new, more difficult challenge, more details and more techniques. All online, all self-lead (but on a schedule). She made friends with Virginie, and they ended up supporting each other through the program. To date, they have yet to meet, or even speak to each other.
I knew Alex was a studier when we met. We discussed our respective university experiences and I knew at the time that she was the better student, hands-down. And this just proved it: she made the Dean’s List. For every single semester. She set the bar in the house; the rest of us are on notice.
Then came the practicum.
Every student has to do an unpaid practicum to get the hands-on experience needed to fully graduate. Alex has seen hundreds of students in her time, all cycling through the various hospitals and clinics to get the practical experience taking X-Rays. She thought she knew the program.
She was placed in one of the hospitals in town (I won’t say which one, but it wasn’t the one she’d wanted to be at), which had several magnets and a fairly prominent staff from whom she could learn. Or at least, that was the intent. As it turns out, this particular hospital’s MRI staff is known to be a bit of a disaster.
First, all of them are first discipline: they’ve never taken an X-Ray or done an Ultrasound. So they don’t understand what it is for a second discipline student to come in with a wealth of experience and be told to “go fold towels”. To say it’s insulting is an understatement.
Which, as Alex discovered during her practicum, means that first discipline students frown on second discipline because “they don’t know what they’re doing”. This is because first discipline students actually go to school, and get to practice on a real MRI machine long before they show up for practicum. Second discipline students only get a virtual simulator.
What’s the big deal?, you ask, how much difference can that make? Well, think of it this way: when you take an x-ray of a wrist, there’s basically two views: one from the top and one from the side. About the only other thing you account for is the wrist size. If you need to take an MRI of a wrist, there seems to be about as many different approaches as there are staff in the department, and pretty much every one of them is wrong according to everyone else.
This differing of opinions didn’t help Alex any as she went from person to person, trying to check off all the positions she needed to have completed during her practicum, as the technique she would use with one person “wasn’t right” with the next.
Suffice to say, the animosity started Day 1.
Worse still, the practicum supervisor was gone for the first month on vacation, without backup. And the manager was on medical leave. Effectively, the clowns were left to run the circus and no-one was going to fix it.
With time running out, Alex reached out to her NAIT teacher for help. There was no escalating within the hospital. The teacher related that the location was a known problem, and Alex’s experiences were ammunition to get the budget back to do site visits, which had apparently been cut (thank you, Provincial Government cutbacks). But in the meantime, Alex still had to get her images.
Thus, in early April, we went up to Edmonton for the weekend. Alex worked evenings directly with her teacher at one of the Edmonton hospitals, while the kids and I … well, often just ended up in the hotel room because Edmonton, infuriatingly, closes down at 4pm. Unless you want to go to The Mall, that is.
But the weekend was valuable, knocking off all but three of the positions Alex needed. All possible in the remaining weeks back on her practicum site. Her happiest day was when the last one was signed off. She never had to return. She arranged to spend the rest of her practicum at her regular hospital, working with people she already knew, and who knew the difficulties she had experienced.
Then came the finals, which were cumulative of two years of intensive study. She passed the NAIT exam with flying colours (of course), and “passed” the CAMRT the next week (unlike NAIT, CAMRT is merely pass/fail, no mark is revealed).
Today, Alex worked her first paid MRI shift. It’s orientation, which is needed for anyone starting in a new position in a hospital, but at least she gets salary for this one. It’s been a lean four months, though we’ve done far better than I expected. Still, it’ll be nice to have Alex’s salary back.
“Pride” doesn’t really express the feeling I have. Nor is “amazement” or “awe”. I suppose there’s a blend of the bunch, “Prawezment”, if you will. I always had faith that Alex would pass, even if it seemed out of reach at times, but I think having the reinforcement might have helped. Either way, it’s a huge achievement and I am relieved that this part is over
Though, now, do I consider a second degree? The thought has cross my mind…
