Why Ultrasound?

I fell into Ultrasound by accident. It is not that I might not have eventually chosen the field myself, had I been given the chance to look it over, I just never really got that chance. I started out as a Radiologic Technologist, like many of my contemporaries. My first employment after completing my Radiology education was in a medium sized hospital in a medium sized town deep in the bosom of the massive state of Texas. Almost all of the Technologists there performed X-rays as well as another specialty. I knew I would eventually become trained in another modality, be that CT, nuclear medicine, angiography or ultrasound. There was no MRI in ordinary hospitals in those days, although I had been to a conference where it was mentioned as a new and exciting field that was being tested in research facilities. Careers like Radiologic Physician’s Assistant and PET were not even on the horizon. That is how old I am. But at the time, I was a young pup, just out of school, miles away from my hometown and eager to learn whatever I could in furthering myself in my career.

When I arrived, there were two Ultrasound Technologists, neither was registered, but both were very well entrenched in their positions. That is to say they had both been employed by the hospital for several years, and I saw no evidence that either had any desire to give up their positions. The management team at the hospital did not have a problem that neither held a registry in Ultrasound, many Sonographers at the time did not. They did require that all Technologists hold a registry in Radiology within six months of hire. As I had not yet sat for that exam, I focused my attentions on becoming registered. At that time Radiologic Technologist registries were given four times a year; I had graduated and been hired in August, so the first available test was in October.

Soon after I passed the exam, one of the Ultrasound Technologists surprisingly quit. That left the other to do all of the scanning and to take all of the after-hours call. The only thing I knew about this Sonographer was that he had a bit of a problem with boundaries, specifically boundaries regarding other’s personal space; he had a habit of getting too close to people. He also, it turned out, had a habit of saying inappropriate things. As his co-workers all gave him a bit of leeway, this personality flaw was not so much of a problem when he was dealing with them, but was a huge problem when it came to patient care. I later learned he had been counseled regarding this several times before, but soon after the first Technologist quit he crossed a line that cost him his job. His dismissal left the hospital in quite a predicament, and in need of a Sonographer fast.

Before he was let go, he had begun to train another Radiologic Technologist in the discipline. In those days, on-the-job training was the most common way to learn, so this was not unusual. It was probably the way both he and his counterpart had been trained. Unfortunately, the Technologist had completed only a couple of weeks with him, so she was not a viable option to take over the scanning responsibilities. The hospital began recruiting a trained person. That is when they hired Bonnie.

Bonnie had worked at the hospital as a Radiologic Technologist a few years before but left because she had wanted to learn Ultrasound and had seen no opportunity there. She hired on at another hospital in town where she received the training she wanted, and she took full advantage of it. Bonnie was passionate about Ultrasound. She was also good at spreading that passion around. Once hired back at our facility she stated she wanted to begin working after Christmas, as she already had plans to return to her hometown of Cincinnati for a couple of weeks over the holidays. Because of the dire needs of the department she was convinced to start the first of December and assured she would be given the vacation time she needed.

The plan was for her to continue to teach the Technologist who had been training in a few simple exams, as if there are simple Ultrasound exams. How to see a gallbladder; how to find a fetal heartbeat. Enough to suffice in an emergency. Nothing else. The real work of training would begin when she returned. She had three weeks before leaving. They had worked together for two weeks before Bonnie went to the department head to tell him there was no hope. This Technologist had no passion for learning. Bonnie was getting nowhere, and she could not and would not continue to teach when she felt there was no desire or effort on the part of the student.

There was one week left before Bonnie’s vacation began. The department head called me into his office for a chat. Would I be interested in learning ultrasound? “Yes, yes,” I said. I was excited. He told me I had one week to learn the basics. I was skeptical to say the least.

For the next week, I spent every minute I could in the ultrasound suite with Bonnie. I learned very little, but at the time it seemed like a lot. I felt I could find a gallbladder, find a fetal heartbeat, and there would be no scheduled exams during her two weeks off, just the occasional emergency room or labor and delivery patient. I could handle that, I thought confidently. Boy, was I wrong.

On Christmas Eve, I was called in a bit before midnight. Labor and delivery had a woman in labor with a term pregnancy, but they could not hear a heartbeat. They needed the exam to be done bedside.

Unplugging the machine and moving it was quite difficult as it was hooked up to several different devices that needed to be removed in a specific order. Bonnie had not bothered to teach me this order because, as she explained, I would never be asked to go portable. But now, here I was looking at the mass of cords and splices and connectors on the backside of the unit. Unplugging this one, plugging in that one, I finally decided I must have it right and headed off to the floor.

When I arrived, the patient was screaming; the doctor was screaming; the nurses were screaming. I put the probe on top of the screaming woman’s bare abdomen and saw…nothing. I couldn’t penetrate into her belly. I had no idea why. I didn’t know enough to recognize what was at fault, the machine, myself, the patient. I tried everything, all the while the screaming continued. After several minutes, but what seemed like hours, I was told to stop and just go home. I did.

When I got there, even though it was now 1:00 a.m. and even though it was now Christmas morning, and even though I knew my boss had a family with small children who were anxiously awaiting the arrival of Santa Clause–who would not arrive if they were not asleep–I called my boss. I didn’t care if I woke the whole family. I was calling to tell him that I was not going to be a Sonographer. I wanted nothing more to do with this training. And there was nothing more he could say to convince me it would be worth it. He did not try. He told me to go to sleep, not answer my phone, and he would call the hospital and inform them that we would not have anyone on call for ultrasound services for the next few days. He told me we would discuss this more after Christmas.

The day after Christmas, when we all returned to work, it was decided that I would do ultrasounds during the day when I had a Radiologist’s support, but not after hours. Upon Bonnie’s return, we would assess it further.

By the time she had finished her vacation I had convinced myself that I would tell her to find someone else to train. But oh, I forgot about her passion. Bonnie’s passion was contagious. She told me she knew I had it in me. She said I had been set up to fail, and that what had happened wasn’t fair, but if she had enough time, and I had enough gumption, we could make this work. She had faith in me, and because of her passion, I had faith in her. Through her words and her excitement about the profession, I gained a little faith in myself as well. I became excited about learning again. And so, in spite of such a rough beginning, I took on the challenge of becoming a Sonographer. I have never looked back. I have never regretted that decision. And I am still very thankful and indebted to Bonnie.

So back to the question of why ultrasound? For me, it is simple; I love it. I love the challenge; I love the autonomy. I love that every day is different, that every patient is different. I love that there are so many questions that need answering every time I place a transducer on a human body. I love the fact that I am frequently humbled by what I see. I love the interaction, with patients, with other Sonographers, with interpreting Physicians, and with ordering Physicians. I love solving a riddle, and I love learning. Being a Sonographer means never completely mastering the field. There is never an end to the education. Boredom does not come with the job. There have been significant changes in the field since I first started, and I expect it to change significantly more before I am done. That is another of the things I love. I also love spreading some of that passion that was instilled in me when I began. I owe that to Bonnie. I have an obligation to pass on what I received. Passion cannot be contained.