Thursday, May 19, 2011

What's Up? Doc?

So, last month I took some advice I've been offered many times over the years by friends, acquaintances, total strangers and family and got my head examined.

It wasn't my idea I hasten to add, but I had reported to Doc Rubberglove complaining that the cough I hadn't shaken since Thanksgiving was leaving me with day-old headaches and in one case almost made me pass out.

I've been serially sick since mid-November and spent every holiday in bed begging for an end to it all. every time I was starting to feel well some twillup would come into work hacking like a Dickensian consumptive and it would start all over again1.

The coughing would cause violent headaches which would, as I say, last all day. I would also get disoriented, at one point having to sit down for a few minutes while the world stopped spinning.

"It could be an aneurysm just waiting to blow!" screamed the doctor, driven mad by the thought of a procedure that he wouldn't be able to perform himself (and therefore bill for). "You need a head MRA."

"Wossat?" I asked, highly suspicious and still sporting bruises from the last round of "tests".

"It's like an MRI, but with an 'A' in it where the 'I' should be. It detects aneurysms. Mostly".

And so, after An Interlude With Insurance Paperwork it came to pass.

On the appointed evening I presented myself and announced that I was there to get my head examined. I was made to fill out some paperwork, which by some miracle of twentieth century technology had finally been mostly done from the extensive computer records that get sent everywhere except to the clipboard with the ballpoint pen, usually, giving the patient something to do in the four hours before they actually see a doctor. This paperwork was mostly a survey of the metal I might have in my body. Then I was told to lie down on a platform, a plastic gridwork mask was fastened over my face and I was slid into the magnet for the most boring ten minutes I've had since the last time I was in a Magnetic Resonance Scanner.

These machines are basically a huge magnet with a radio source and some really smashing computers hooked up to them. They put you in the magnet, which is really strong, and all the rotation axes of the hydrogen atoms in the water in your body line up along the lines of magnetic force like a bunch of bar magnets. Then they shine "white" radio noise through you and all those atoms suck in exactly one photon of a given frequency of radio "light" and flip over to point the other way. The frequency that each atom likes to suck on depends on the local geography, who it's neighbors are and stuff like that. Then they switch off the radio waves so that - and this is the clever bit - the atoms can flip back. When they do that they take their own sweet time, again depending on local factors, and they spit out an identical photon to the one they swallowed. See, it's hard to sort photons out from the sort of radio sources we can make cheaply, so you catch and detect them on the way back. Clever, like I said.

Where was I?

Oh right. You do this over and over, varying all sorts of stuff I left out, and then you let the computer have at it using Fourier Transform techniques, which is a hard sums way of taking a gazillion goes at the same thing and averaging them out so they make a lot of sense. Then more computers and clever software use that data to draw the pictures.

A true miracle of engineering and science. An object lesson in what the human race can achieve when its cleverest minds get cracking, given enough time and money3.

While I was lying in the noise and boredom I suddenly felt my wedding ring and the silver ring I wear on the matching finger on the other hand begin to jiggle around. I would have taken off these items of jewelry4 but they shrank a few years after I put them on and now they won't come off. I alerted the technician to the situation by falsetto shrieking, thrashing around and other restrained and manly methods of indicating All Was Not Well, but he told me to calm down and not to worry.

Easy for him to say. I didn't mind having the rings melt under the influence of Extreme Applied Science5 but there were two reasonably good fingers inside them that I use, off and on, on a daily basis.

Still, it wouldn't do to not be seen to have confidence in the man behind the big desk o' knobs and dials - I was British and in danger of letting the side down in front of an American who deserved to see the legendary British Stiff Upper Lip in the Face of Adversity at work, so I relaxed and let the test proceed with only an understandable amount of minor whimpering and the odd bladder leak any time the machine went "clonk" too loudly.

Eventually it was over and I was about to leave when the technician asked me if I wanted the pictures.

"Doesn't my doctor get those?" I asked, my face contorting as I attempted to parse any hidden meaning from the technician's question.

"Of course" he answered, "but you get a copy too if you want it."

This was a first. Normally getting a look at the pictures medical technicians take of your insides is marginally more difficult than getting a look inside Fort Knox without an invitation. Of course I said I wanted the pictures, and so I had to hang around another half hour or so while they were burned to CD-ROM along with the viewer to properly display them.

This was boffo on many levels. I would get to take a look at pictures of yet another of my organs, always a joy unless it's the skin - I've grown a little tired of that one to be honest6 - I would get to see any problem with the pipes and conduits before Doc Rubberglove could sell me on any bogus "brain transplant" procedures that were not needed and it would prove to that vile harridan Mrs Stevie that contrary to her Theory of Me I emphatically do have a brain in my head.

I rushed home, booted my laptop and inserted the CD-ROM. Then I figured out the viewer software and it was all aboard for a quick journey through the hippocampus with stops in the medulla oblongata and visual cortex.

The first thing I noticed was the old brain was less wrinkly than in pictures I saw in school textbooks. "This not look good" I thought, then realized that I was thinking it with the brain in question. The recursion of that had me crossing my eyes while I tried to figure out if I was on safe ground, rationalization-wise here. I had no desire to blow out part of the damned thing in a stupid accident because of inadequate warnings on the CD-ROM or "everyone knows" precautions I was unaware of due to not having been to medical school and having an education that didn't include MRAs because they hadn't been invented yet then.

I eventually sorted it out and went on to find the part where the arteries show up. They looked OK to me, but as I said I have no formal medical training, just what I picked up from watching "E.R." on the TV, and most of that made me feel unwell.

This was the point when Mrs Stevie came home and in-theater.

"Excellent timing, wife!" I said. "Come and see the pictures of my brain." Boy was she in for a come-uppance.

"It's see-through!" She said. "That doesn't look right. Where everyone else has brain cells all you have is what looks like two lengths of cable TV wire hovering in the middle there. I'd get that looked at if I were you"

"What? No you daft woman! That's just the way that picture came out! Those "wires" are the major blood vessels! Look, here's a picture of the outside"

"Looks a bit smooth to me. I've seen one on the internet. It's supposed to look a bit like a big pile of sausages, all wrinkly. That looks like an odd-shaped balloon"

"What?" I screamed incredulously. "The only time a brain looks like sausages is if you make one out of sausages! You can't use the fake brain from that How to Haunt Your House at Halloween website as a baseline to assess brain wrinkliness! These pictures show a brain, a real brain mind you, in the very pink of health! The only surprising thing is that nowhere are there old pan-shaped scars on it or bruises that spell genuine copper bottom! That brain is in excellent condition and will go for years yet!"

"Pfft! You'd be better off with the sausages if you ask me." And with that she went out to do whatever she does when she isn't harassing me.

The whole thing gave me the worst headache I'd had in months.

  1. I was close to murdering one of our consultants who refused to leave his post no matter how much phlegm he vented into the office biosphere and who kept the circle of adult→child→rest of kindergarten→child (again)→adult+world going relentlessly the entire time2
  2. This stratagem has backfired somewhat inasmuch as the budget has expired and all consultants are now being furloughed for 10-20 pay-free days.
  3. Of course, most of the money belongs to one kind of person and most of the vision lives in the minds of another sort, but that is just another symptom of The Human Condition
  4. Especially the gold one. I can't tell you how many times that has ruined a blooming romance over the years
  5. Especially that gold one. See comments above
  6. It's too big for one thing, gets too red in summer and has little tags sticking out of some of it that I have to get taken off sometimes

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