- Email: [email protected]
I Remember
Journal of Medical Imaging and Radiation Sciences
Journal of Medical Imaging and Radiation Sciences 47 (2016) 306-308
Journal de l’imagerie médicale et des sciences de la radiation
www.elsevier.com/locate/jmir
Feature Article
I Remember M. David Hansen, BA, BEd, RTR* Department of Medical Imaging, Island Health, Victoria, BC, Canada
The porter brought the requisition for x-rays into the tech station with the resigned air of someone who had seen it all and really was not interested in seeing any more of it. This arrival broke the spell of the short, quiet time the two evening techs were enjoying in between the bouts of furious activity that characterized the evening shift in the x-ray department of any good-sized downtown hospital. ‘‘Hot belly from Emerg,’’ was the succinct greeting of the middle-aged driver of the stretcher as she did an abrupt about face, leaving the requisition in its ‘‘here’’ slot, and the two techs rising to retrieve it. The techs were a pair seen in every department in every hospital in the country; one a recent graduate on her third or fourth tour of the 3–11 shift, and the other a weary, older man with years of diverse hospital experience behind him and another bunch to go before the minimum retirement age. Pairings such as these were the stuff that made the organization run; long experience teaching the novice the things they do not teach you in school, like when to break rules, which ones, and how to function in the minefield. Andrew Smith was 56-years old and had worked in hospitals in one role or another since he was 19. He was attuned to the subtle messages sent and received during a simple x-ray examination, and it was this acquired skill that he hoped to teach his young partner. Stacy Lindsay was a bright, intelligent 21-year old, eager to practice all she had learned in her three years of college, having just graduated three months ago. She really did think she had been taught all there was to know, because she had graduated near the top of her class and her teachers had said sodand they were very good. Andy took the requisition, read the details of what was required and why, and led the way to the hallway where the patient lay, swaddled in blankets. The object of their attentions was an old woman (fully 95 years old, as it turned out), face white as a ghost, and
* Corresponding author: Mr. M. David Hansen, BA, BEd, RTR, Department of Medical Imaging, Island Health, 1952 Bay Street, Victoria, BC V8R1J8, Canada. E-mail address: [email protected]
unfocussed eyes staring out from deep, hollowed sockets. A vague moaning sound escaped dry, thin lips and narrow, almost emaciated arms resting on the blankets, bony fingers picking at the covers. ‘‘Probably not totally compos mentis’’ was Andy’s first impression, but he never assumed. ‘‘Ok, three views of the abdomen is what they want, Stacy. Let’s get her on the table.’’ Pulling the stretcher alongside the x-ray table, they dropped the side rails and discovered the frequent result of abdominal distress in the elderly, the odor wafting around both of them. ‘‘Ewww,’’ grimaced Stacy, as she looked at Andy. ‘‘Can’t we ship her back to Emerg and let them clean this up?’’ she said hopefully. ‘‘I didn’t sign on for this.’’ ‘‘Well, actually, yes, you did. Patient care 101. Come on, let’s do it together and get on with things. You get the sheets and towels. I’ll get a pan of water. Gloves on. I’ll show you how we do this.’’ Up went the rails as they gathered what they needed. Returning to the bedside, Andy addressed his patient. ‘‘Mrs Anderson? I am Andy, and this is Stacy. We’re going to make your bed here and then take x-rays of your tummy. Ok?’’ Looking up, he instructed, ‘‘Stace, just roll her toward you, and I’ll do this side. I still remember my first time with a surprise like this, so don’t feel bad. You’ll remember this, too.’’ ‘‘How will I ever forget it?’’ I remember. The words seemed to ring in the old lady’s mind. I remember. I remember my Roger. I remember putting Roger in the ground after his stroke. He was only 72. Too early for such a vital man! The loss and heartache that goes with being married to the same man for 46 wonderful years and then burying him was almost too much to take. Roger, I miss you! The thought of the lonely days and nights to follow, sitting in our living room just
1939-8654/$ - see front matter Ó 2016 Canadian Association of Medical Radiation Technologists. Published by Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jmir.2016.04.006
thinking, always thinking, and of what life was like when we were younger. Oh, he was wonderful! Well, I’m not an elderly woman yet. Just 70. There’s more life to go. Get on with it. I must see to the children, and see how they are holding up. Well, I know they are adults now, but then, their Dad has died and it must be heartbreaking for them too. They never really knew him as a young man, as I did.
‘‘There you go. Warm and comfy, now. We’re going to move the mattress over to the examination table now.’’ Andy kept speaking in his normal, low voice as he did his preparations for dragging the stretcher mattress over to the x-ray table, Stacy on one side, he on the other. ‘‘Why do you keep talking to her like she hears you? I doubt there’s much going on inside there,’’ said Stacy, in a puzzled tone. ‘‘I mean, seriously, do you expect that she really has any functional cognition?’’ Looking at Dorothy Anderson, he replied, ‘‘Maybe, maybe not. But I wouldn’t want to be wrong. Who really knows what is going on that we cannot see?’’ I remember that Halloween night like it was yesterday! The kids were all dressed up in their costumes, ready to go out and plunder the front doors of the neighbourhood for awful candy and collecting for UNICEF at the same time. Roger and I would hold the fort, watching our new television set that he had just bought at Eaton’s (as long as he could adjust the rabbit ears properly!) and do our part by taking turns at the front door. It had been a busy day, Roger at construction sites all day, and me trying to get in the last of the tennis sets for the year. It was too cold for it really, but who knows when the first snow will fall? In the kitchen before dinner, Roger let his hand slip up from around my waist and go exploring in areas that had me thinking of things a long way from dinner. ‘‘You still turn the fires on, you know’’, he murmured in my ear, and I just about spilled the gravy. I kissed him hard on the lips and chased him away with expensive promises that I would be sure to keep, but later. He grinned and took his tall slim body back to the living room. He always could get me going.
‘‘Here we go.’’ Andy pulled the mattress across. The old lady groaned and began to pick at the air, looking for something to hold on to. He took her hands and held them close to her own body, feeling the wasted rack of her bones under the thin blankets. She soon settled down, and they began to position her. Stacy locked the x-ray tube into its over table and image receptor position. ‘‘How did you do that, Andy? You just held her hands and she stopped squirming. I can’t do that. I mean, there is absolutely nothing we have in common. I am, like, a hundred years younger than she is. We are definitely tuned to different stations.’’
I hold a good job, a responsible job, in the Burrard Dry Dock, keeping the massive amounts of paperwork straight, ensuring everybody gets paid from all these wartime contracts. BDD builds a ship every 100 days to put on the water against the Germans. I know these are just cargo ships, but they’re important nonetheless. My Roger is overseas doing something with the Royal Canadian Engineers in Belgium or someplace. I get letters, but they’re so old, they don’t/can’t say much about where he is anyway. We’ve only been married for three years, but it seems my whole life revolves around him already. God! It sounds like we’re an old married couple! Janey wants me to go to the dance downtown tomorrow night with her, and I might just do it. It’ll keep my mind off what could be happening over there. No! Don’t even think that. For all I know he’s chatting up one of those French women at this very minute. Auggh! Stop thinking, Dorothy, you’ll go mad. I remember when we met. He was at UBC and I was at Pittman College and Janey took me to a crush at a frat house. He was so shy; I thought he’d melt into the woodwork. He just stood there watching the crowd, and sipping a beer, looking uncomfortable, like his shorts were too tight. I walked over to him and asked him to dance, and I thought the resulting blush was cute, it was so red. He took my hands in his, with those long, strong fingers, and I really knew then and there. And he really did have gorgeous eyes. Talk about melting.
‘‘Ding Dong.’’ The plain supine abdomen image bled up on the console monitor, showing large areas of black throughout. ‘‘This is not good,’’ thought Andy, and they prepared to move the mattress back onto the stretcher and try to get his patient to sit up for erect views. ‘‘One, two, three, go!’’ The mattress slid effortlessly back to the stretcher. ‘‘Ok, Stacy, you get a cassette, and then lift the head of the bed up while I bend her up, Ok?’’ Wheels locked, tube aimed horizontally, he put both arms behind her frail, bony back and, cradling her head, bent her at the waist to a sitting position. Stacy put the hard cassette behind her, and Andrew gently laid her against it. Involuntary groans escaped the dry pale lips, as he again raised the side rails and locked them in position. As he stuffed foam sponges in at the side to prop her up, Andy thought he could see acknowledgment in Dorothy’s eyes and fleeting understanding. ‘‘Ok, Stacy, let’s do these two quickly.’’ One after the other, the two x-ray techs took a chest x-ray and an image of the abdomen to be compared with the supine one done previously. When they were finished, they lay the head of the stretcher down halfway and tucked in the blankets. ‘‘Let us see what we’ve got here.’’ Stacy said, as they watched the images come up on the cassette reader. On the stretcher, Dorothy Anderson’s eyes closed.
M.D. Hansen/Journal of Medical Imaging and Radiation Sciences 47 (2016) 306-308
307
What a terrific day! It is my sixteenth birthday. The sun is shining, school is out, and I feel like the world is my oyster! My mom gave me a new bathing suit and the whole gang is going down to Willows beach to swim. This early in the summer, the water is still a little cold, but we really don’t notice it. Neither do the boys, who are giving me the kind of looks I always hoped they would, I guess. I think this suit might be showing a bit too much skin, although the skirt part is long enough. It doesn’t matter, though; we’re all having a good time. Most of us have a dime to spend for an ice cream later (except Billy Donovan, whose dad is out of work again), and maybe something else. Sally Brennerman says I tease the boys too much, but I don’t know what she means. I just smile at them, that’s all. My Dad says that Mr Bennett in Ottawa has a plan to help all those poor people who can’t find work that we see all over the place. I hope it works, because I feel sorry for them. I wonder why they can’t find work?
As Stacy completed the datawork for the exam (it used to be paperwork, but now it’s computer datawork), Andy slowly wheeled the stretcher back to the emergency department and Dorothy Anderson’s cubicle. As he walked, he spoke to herdto the back of her head, reallydnot knowing if she could hear, or understand any of it. ‘‘Well, Dorothy, I’ll take you back to Emerg now, and the doctors will have a look at the pictures, and see what’s what. I think we can see what’s causing your tummy troubles, so that’s a good thing.’’ As he backed her into the cubicle, he looked directly into her eyes and said, ‘‘Take care, Dorothy. Be well.’’ Dorothy opened her eyes and looked back. A small, fleeting smile came over her lips, and she closed her eyes. She is running in the back yard, the ribbon holding her beautiful brown hair streaming out behind her. The ball her brother had thrown has gone over her three-foot high head and rolled under the old wheelbarrow leaning up against the fence. As she bends to retrieve it, she scrapes her forehead on the rough edge of the wheelbarrow, and it begins to bleed. She grabs the ball, and with screwed up determination on her face throws it back to her brother with all the force her tiny limbs can muster. It sails over his head. With a satisfied, crooked grin she goes over to her mother who looks in horror at the trickle of blood at the side of her face.
308
‘‘Dorothy Susan Douglas! What have you done?’’ Enveloping the girl in her arms, her mother dabs at the small wound and presses a cloth to staunch it. Dorothy looks up and smiles, ‘‘You take good care of me, mummy. Will you always take care of me?’’ ‘‘Yes, dear. Always.’’ And Dorothy Susan Douglas holds on tight to her mother, and thinks grand thoughts of the future, and wonders what it might bring.
Andy Smith packed up his things as the shift drew to a close. Young Stacy had already left, and he had finished his shift report to the night tech. He thought again of the old woman he and Stacy had x-rayed earlier, and who had died an hour ago in the emergency department. When she had looked back at him in the ER and smiled, Andy could see that she was at peace with where she was going that night. With all his experience with such people, Andy was at least glad he had been able to show Stacy the humanity of the people who came to them for help; that in the process, the old lady had completed the transition from abstract patient to an actual, real person. ‘‘How frail the body becomes as age advances and takes its unfair toll on both the physical and mental capacities of people. I look at the faces around me here, and they think I’m from another century,’’ he thought. ‘‘Do not go gentle into that good night, Andy, and stop feeling sorry for yourself.’’ But the thought persisted. We all get old, and we were all young once. Once, I was madly in love, and my life stretched out like a clean beach, not a mark on it, my footprints in the sand would be the only relief. Now, I look back at the chaotic wreckage on that beach and think how absolutely.cluttered a life can get. We were all young once. And we all get old.
M.D. Hansen/Journal of Medical Imaging and Radiation Sciences 47 (2016) 306-308
Journal of Medical Imaging and Radiation Sciences 47 (2016) 306-308
Journal de l’imagerie médicale et des sciences de la radiation
www.elsevier.com/locate/jmir
Feature Article
I Remember M. David Hansen, BA, BEd, RTR* Department of Medical Imaging, Island Health, Victoria, BC, Canada
The porter brought the requisition for x-rays into the tech station with the resigned air of someone who had seen it all and really was not interested in seeing any more of it. This arrival broke the spell of the short, quiet time the two evening techs were enjoying in between the bouts of furious activity that characterized the evening shift in the x-ray department of any good-sized downtown hospital. ‘‘Hot belly from Emerg,’’ was the succinct greeting of the middle-aged driver of the stretcher as she did an abrupt about face, leaving the requisition in its ‘‘here’’ slot, and the two techs rising to retrieve it. The techs were a pair seen in every department in every hospital in the country; one a recent graduate on her third or fourth tour of the 3–11 shift, and the other a weary, older man with years of diverse hospital experience behind him and another bunch to go before the minimum retirement age. Pairings such as these were the stuff that made the organization run; long experience teaching the novice the things they do not teach you in school, like when to break rules, which ones, and how to function in the minefield. Andrew Smith was 56-years old and had worked in hospitals in one role or another since he was 19. He was attuned to the subtle messages sent and received during a simple x-ray examination, and it was this acquired skill that he hoped to teach his young partner. Stacy Lindsay was a bright, intelligent 21-year old, eager to practice all she had learned in her three years of college, having just graduated three months ago. She really did think she had been taught all there was to know, because she had graduated near the top of her class and her teachers had said sodand they were very good. Andy took the requisition, read the details of what was required and why, and led the way to the hallway where the patient lay, swaddled in blankets. The object of their attentions was an old woman (fully 95 years old, as it turned out), face white as a ghost, and
* Corresponding author: Mr. M. David Hansen, BA, BEd, RTR, Department of Medical Imaging, Island Health, 1952 Bay Street, Victoria, BC V8R1J8, Canada. E-mail address: [email protected]
unfocussed eyes staring out from deep, hollowed sockets. A vague moaning sound escaped dry, thin lips and narrow, almost emaciated arms resting on the blankets, bony fingers picking at the covers. ‘‘Probably not totally compos mentis’’ was Andy’s first impression, but he never assumed. ‘‘Ok, three views of the abdomen is what they want, Stacy. Let’s get her on the table.’’ Pulling the stretcher alongside the x-ray table, they dropped the side rails and discovered the frequent result of abdominal distress in the elderly, the odor wafting around both of them. ‘‘Ewww,’’ grimaced Stacy, as she looked at Andy. ‘‘Can’t we ship her back to Emerg and let them clean this up?’’ she said hopefully. ‘‘I didn’t sign on for this.’’ ‘‘Well, actually, yes, you did. Patient care 101. Come on, let’s do it together and get on with things. You get the sheets and towels. I’ll get a pan of water. Gloves on. I’ll show you how we do this.’’ Up went the rails as they gathered what they needed. Returning to the bedside, Andy addressed his patient. ‘‘Mrs Anderson? I am Andy, and this is Stacy. We’re going to make your bed here and then take x-rays of your tummy. Ok?’’ Looking up, he instructed, ‘‘Stace, just roll her toward you, and I’ll do this side. I still remember my first time with a surprise like this, so don’t feel bad. You’ll remember this, too.’’ ‘‘How will I ever forget it?’’ I remember. The words seemed to ring in the old lady’s mind. I remember. I remember my Roger. I remember putting Roger in the ground after his stroke. He was only 72. Too early for such a vital man! The loss and heartache that goes with being married to the same man for 46 wonderful years and then burying him was almost too much to take. Roger, I miss you! The thought of the lonely days and nights to follow, sitting in our living room just
1939-8654/$ - see front matter Ó 2016 Canadian Association of Medical Radiation Technologists. Published by Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jmir.2016.04.006
thinking, always thinking, and of what life was like when we were younger. Oh, he was wonderful! Well, I’m not an elderly woman yet. Just 70. There’s more life to go. Get on with it. I must see to the children, and see how they are holding up. Well, I know they are adults now, but then, their Dad has died and it must be heartbreaking for them too. They never really knew him as a young man, as I did.
‘‘There you go. Warm and comfy, now. We’re going to move the mattress over to the examination table now.’’ Andy kept speaking in his normal, low voice as he did his preparations for dragging the stretcher mattress over to the x-ray table, Stacy on one side, he on the other. ‘‘Why do you keep talking to her like she hears you? I doubt there’s much going on inside there,’’ said Stacy, in a puzzled tone. ‘‘I mean, seriously, do you expect that she really has any functional cognition?’’ Looking at Dorothy Anderson, he replied, ‘‘Maybe, maybe not. But I wouldn’t want to be wrong. Who really knows what is going on that we cannot see?’’ I remember that Halloween night like it was yesterday! The kids were all dressed up in their costumes, ready to go out and plunder the front doors of the neighbourhood for awful candy and collecting for UNICEF at the same time. Roger and I would hold the fort, watching our new television set that he had just bought at Eaton’s (as long as he could adjust the rabbit ears properly!) and do our part by taking turns at the front door. It had been a busy day, Roger at construction sites all day, and me trying to get in the last of the tennis sets for the year. It was too cold for it really, but who knows when the first snow will fall? In the kitchen before dinner, Roger let his hand slip up from around my waist and go exploring in areas that had me thinking of things a long way from dinner. ‘‘You still turn the fires on, you know’’, he murmured in my ear, and I just about spilled the gravy. I kissed him hard on the lips and chased him away with expensive promises that I would be sure to keep, but later. He grinned and took his tall slim body back to the living room. He always could get me going.
‘‘Here we go.’’ Andy pulled the mattress across. The old lady groaned and began to pick at the air, looking for something to hold on to. He took her hands and held them close to her own body, feeling the wasted rack of her bones under the thin blankets. She soon settled down, and they began to position her. Stacy locked the x-ray tube into its over table and image receptor position. ‘‘How did you do that, Andy? You just held her hands and she stopped squirming. I can’t do that. I mean, there is absolutely nothing we have in common. I am, like, a hundred years younger than she is. We are definitely tuned to different stations.’’
I hold a good job, a responsible job, in the Burrard Dry Dock, keeping the massive amounts of paperwork straight, ensuring everybody gets paid from all these wartime contracts. BDD builds a ship every 100 days to put on the water against the Germans. I know these are just cargo ships, but they’re important nonetheless. My Roger is overseas doing something with the Royal Canadian Engineers in Belgium or someplace. I get letters, but they’re so old, they don’t/can’t say much about where he is anyway. We’ve only been married for three years, but it seems my whole life revolves around him already. God! It sounds like we’re an old married couple! Janey wants me to go to the dance downtown tomorrow night with her, and I might just do it. It’ll keep my mind off what could be happening over there. No! Don’t even think that. For all I know he’s chatting up one of those French women at this very minute. Auggh! Stop thinking, Dorothy, you’ll go mad. I remember when we met. He was at UBC and I was at Pittman College and Janey took me to a crush at a frat house. He was so shy; I thought he’d melt into the woodwork. He just stood there watching the crowd, and sipping a beer, looking uncomfortable, like his shorts were too tight. I walked over to him and asked him to dance, and I thought the resulting blush was cute, it was so red. He took my hands in his, with those long, strong fingers, and I really knew then and there. And he really did have gorgeous eyes. Talk about melting.
‘‘Ding Dong.’’ The plain supine abdomen image bled up on the console monitor, showing large areas of black throughout. ‘‘This is not good,’’ thought Andy, and they prepared to move the mattress back onto the stretcher and try to get his patient to sit up for erect views. ‘‘One, two, three, go!’’ The mattress slid effortlessly back to the stretcher. ‘‘Ok, Stacy, you get a cassette, and then lift the head of the bed up while I bend her up, Ok?’’ Wheels locked, tube aimed horizontally, he put both arms behind her frail, bony back and, cradling her head, bent her at the waist to a sitting position. Stacy put the hard cassette behind her, and Andrew gently laid her against it. Involuntary groans escaped the dry pale lips, as he again raised the side rails and locked them in position. As he stuffed foam sponges in at the side to prop her up, Andy thought he could see acknowledgment in Dorothy’s eyes and fleeting understanding. ‘‘Ok, Stacy, let’s do these two quickly.’’ One after the other, the two x-ray techs took a chest x-ray and an image of the abdomen to be compared with the supine one done previously. When they were finished, they lay the head of the stretcher down halfway and tucked in the blankets. ‘‘Let us see what we’ve got here.’’ Stacy said, as they watched the images come up on the cassette reader. On the stretcher, Dorothy Anderson’s eyes closed.
M.D. Hansen/Journal of Medical Imaging and Radiation Sciences 47 (2016) 306-308
307
What a terrific day! It is my sixteenth birthday. The sun is shining, school is out, and I feel like the world is my oyster! My mom gave me a new bathing suit and the whole gang is going down to Willows beach to swim. This early in the summer, the water is still a little cold, but we really don’t notice it. Neither do the boys, who are giving me the kind of looks I always hoped they would, I guess. I think this suit might be showing a bit too much skin, although the skirt part is long enough. It doesn’t matter, though; we’re all having a good time. Most of us have a dime to spend for an ice cream later (except Billy Donovan, whose dad is out of work again), and maybe something else. Sally Brennerman says I tease the boys too much, but I don’t know what she means. I just smile at them, that’s all. My Dad says that Mr Bennett in Ottawa has a plan to help all those poor people who can’t find work that we see all over the place. I hope it works, because I feel sorry for them. I wonder why they can’t find work?
As Stacy completed the datawork for the exam (it used to be paperwork, but now it’s computer datawork), Andy slowly wheeled the stretcher back to the emergency department and Dorothy Anderson’s cubicle. As he walked, he spoke to herdto the back of her head, reallydnot knowing if she could hear, or understand any of it. ‘‘Well, Dorothy, I’ll take you back to Emerg now, and the doctors will have a look at the pictures, and see what’s what. I think we can see what’s causing your tummy troubles, so that’s a good thing.’’ As he backed her into the cubicle, he looked directly into her eyes and said, ‘‘Take care, Dorothy. Be well.’’ Dorothy opened her eyes and looked back. A small, fleeting smile came over her lips, and she closed her eyes. She is running in the back yard, the ribbon holding her beautiful brown hair streaming out behind her. The ball her brother had thrown has gone over her three-foot high head and rolled under the old wheelbarrow leaning up against the fence. As she bends to retrieve it, she scrapes her forehead on the rough edge of the wheelbarrow, and it begins to bleed. She grabs the ball, and with screwed up determination on her face throws it back to her brother with all the force her tiny limbs can muster. It sails over his head. With a satisfied, crooked grin she goes over to her mother who looks in horror at the trickle of blood at the side of her face.
308
‘‘Dorothy Susan Douglas! What have you done?’’ Enveloping the girl in her arms, her mother dabs at the small wound and presses a cloth to staunch it. Dorothy looks up and smiles, ‘‘You take good care of me, mummy. Will you always take care of me?’’ ‘‘Yes, dear. Always.’’ And Dorothy Susan Douglas holds on tight to her mother, and thinks grand thoughts of the future, and wonders what it might bring.
Andy Smith packed up his things as the shift drew to a close. Young Stacy had already left, and he had finished his shift report to the night tech. He thought again of the old woman he and Stacy had x-rayed earlier, and who had died an hour ago in the emergency department. When she had looked back at him in the ER and smiled, Andy could see that she was at peace with where she was going that night. With all his experience with such people, Andy was at least glad he had been able to show Stacy the humanity of the people who came to them for help; that in the process, the old lady had completed the transition from abstract patient to an actual, real person. ‘‘How frail the body becomes as age advances and takes its unfair toll on both the physical and mental capacities of people. I look at the faces around me here, and they think I’m from another century,’’ he thought. ‘‘Do not go gentle into that good night, Andy, and stop feeling sorry for yourself.’’ But the thought persisted. We all get old, and we were all young once. Once, I was madly in love, and my life stretched out like a clean beach, not a mark on it, my footprints in the sand would be the only relief. Now, I look back at the chaotic wreckage on that beach and think how absolutely.cluttered a life can get. We were all young once. And we all get old.
M.D. Hansen/Journal of Medical Imaging and Radiation Sciences 47 (2016) 306-308