Friday, 16 December 2016

Mister Unsafe



I'm pretty sure you will have heard of J.S. Bach, and quite possibly C.P.E. Bach, too. If you're a real student of the Baroque, you'll know about J.C.F. and J.C. Bach as well. There are others. But I'm pretty sure I have just encountered a new member of that talented and multi-initialled family: M.R.I. Bach.

I was in the hospital on Thursday afternoon having an annual MRI scan, a follow-up to some surgery I had a couple of years ago. If you've never had an MRI, you've missed out on a truly unique experience. There's nothing quite like it, especially if you've ever been an aficionado of "altered states". It's rather like the sort of thing they would put you through in order to assess your suitability for astronaut training. Although, regrettably, there are no rewards for stoical displays of the Right Stuff, beyond knowing you won't have to do it again for another year. Phew.

First, you must submit to interrogation: do you have any piercings, any non-permanent dentures, any metal body parts, any embedded shrapnel or metal splinters – basically anything that might rip your body apart when exposed to a powerful magnetic field? Do you now, or have you ever had one of the following list of bizarre medical conditions? Don't just laugh, please say yes or no. Yes, we know you're unlikely to be pregnant. So, have you had an MRI before? Good, then I don't need to tell you what to expect. Did you react to the muscle relaxant or the intravenous contrast substance with the unmemorable name? Sign here. Now get your kit off, and put on two of these ridiculous gowns, one on the front, one on the back. Ha ha, no, never heard that joke about feeling like a shepherd in the school Christmas Nativity play before. So how are you with needles?

Now, they do know that undergoing MRI is a deeply unpleasant and disorientating experience. In fact, they place a panic button into the hand on the end of the arm that does not have a tube on a needle sticking into it. Why? Because they are going to slide you head-first into a narrow, enclosed receptacle, not unlike a mortuary cabinet, which some people, lacking the Right Stuff, find intolerable. The morbidly obese may well find it impossible; there's not much wriggle-room in there. Deliberately so: you're not expected to wriggle at all, or even twitch. Make the slightest shift, and they'll start all over again. It's like getting a portrait done in a Victorian photographer's studio. Except the exposures are much longer.

You are also given earplugs and a pair of headphones, because MRI is noisy. Very, very, very noisy. And very, very, very, very repetitive. And occasionally it gets much LOUDER, followed by a profound silence, then it SUDDENLY gets more bleepy, like a car alarm, followed by an intense grinding sound...  It's all a bit like some 1960s sci-fi film, or a Marvel Comics scenario. You half expect to emerge bullet-proof, like Luke Cage, or endowed with some other bizarre superpower. Tinnitus Man! No loud noise can ever startle him!


You can choose to listen to music through the headphones, something which in the past I've declined – I like to take my torture straight – but this time I thought, why not?

"What have you got?", I asked.
"We've got everything!", they said.

Oh, really... I decided not to ask for the rare but exquisite first album by The Bhundu Boys (you do have to lie very, very still for half an hour, and jit, whilst jolly, is not very calming) so I opted for Bach. J.S. Bach, obviously.

As my ordeal by magnet began, something that sounded quite like the first Brandenburg Concerto started to trickle through my spongy earplugs. Now, not surprisingly, everything with a metal component in it kept within the MRI suite has a red "MR UNSAFE" sticker on it. (Great name, no? "They call me ... Mr. Unsafe!"). Clearly, proper headphones, being essentially metal'n'magnet affairs, are not "MR safe". I suspect these special MR-safe headphones must work on a similar principle to a yoghurt pot on the end of a taut string, or pressing an ear to the party wall to hear what the neighbours are saying listening to. The sound quality was abysmal: it was like being on the worst telephone on-hold service ever.

However, once the beeps, buzzes, and rhythmic grinding of the machine got going, it suddenly all became incredibly interesting. I was listening to a demented but compelling mashup of distorted Baroque orchestra and industrial electronica. I know the Brandenburgs backwards (well, not actually backwards, but you know what I mean) so the various interruptions and overlays of the MRI machine's robotic grunts and warblings were interweaving intriguing aleatory counterpoints across the over-familiar music, like interference patterns in a pond. Or perhaps more like Robert Rauschenberg rubbing out that drawing by Willem de Kooning, or even those naughty Chapman Brothers defacing Goya prints. I found I was actually enjoying myself; in fact, I was dipping in and out of some sort of trance state, accompanied by vivid eyelid movies. Talk about the Right Stuff! John Cage would have been proud of me.

Occasionally, the music would stop, and a muffled, faraway voice with a heavy Belfast accent dribble through the headphones and earplugs.

"Wiff-waff nibble nork?"
"Wha'? Can't hear!"
"WIFF-WAFF NIBBLE NORK? Doughnut movie egg!"
"Um, OK!"

And off we would go again. On and ON and on and ON ... You get the picture. By the end of my session, and the fourth electro-magnetically "prepared" Brandenburg, I was convinced M.R.I. Bach was a bankable proposition, even if a suitable cocktail of intravenous muscle relaxants and a lengthy period of enforced immobility might be a necessary precondition. I could even start a club – MR UNSAFE? – although it's true that MRI machines are notoriously and prohibitively expensive.

When they finally wound me back out into reality, I was almost tempted to ask for another go. Maybe next year. It seems like an appropriate way to start the festive season.


10 comments:

Thomas Rink said...

In my research work as a graduate student, my main method was Electron Paramagnetic Resonance (EPR). This method is related to 1H-NMR, which is the basis for MRI; the difference is just that in EPR, you take the resonance spektrum of an unpaired electron, as opposed to the spectrum of protons in NMR. My supervisor was Dr. Heinz-J├╝rgen Steinhoff, a fine guy and a real gentleman. He always wore a fob watch on a chain instead of a wrist watch. Not because of the looks, he told me. He decided on this watch after ruining yet another wrist watch by forgetting to take it off before reaching for the sample in the resonant cavity. The magnetic field in our lab machines was enough to kill it. The field strength employed in clinical MRI machines is up to 10 times as strong (resolution depends on it)! This is sufficient to jerk a massive wrench over some metres. For humans (and other living matter), however, the magnetic field is harmless.

We had "Mr Unsafe" in the lab, too. His profession was being an Electrician, and he was a keen aspirant for the Darwin Award. I once witnessed him running a magnetron from a microwave oven with the protective cover removed. He found the oven in the public bulky waste collection, and took it to work with the intent to repair it there and sell it afterwards.

I hope the result of your MRI scan will be fine!

Best, Thomas

Mike C. said...

Thomas,

Funny you should mention that -- as is usual with the NHS, I was kept waiting for quite a while, and asked a nurse what the time was. But, of course, nobody in the entire unit was wearing a watch, or had a phone! There wasn't even a wall clock. Not sure how they know when their shift is up...

The thing I find hilarious is the wave of doubt I experience whenever I'm asked these preparatory questions: hmm, *do* I have a pacemaker, or a metal plate, pin or piercing somewhere that I've forgotten about? Have I ever broken a limb? Or maybe I *do* have some of these diseases and conditions, but haven't yet been diagnosed? What then?

Mike

Martyn Cornell said...

Then there's the Welsh cousin, Sospan Bach. I'm sure you must have heard Switched On Bach from Wendy (originally Walter) Carlos - any similarities to MRI Bach?

Mike C. said...

Martyn,

[Studiedly ignoring that first sentence] I seem to recall "Switched On Bach" was quite tuneful... MRI Bach is more like standing near a reversing dustbin lorry with a very small transistor radio tuned to Radio 3.

Mike

Thomas Rink said...

Mike,

just take it easy like my father-in-law: After rupturing a muscle fiber while unloading his lorry, he was delivered to the emergency ward. When they asked him whether he suffered from any allergies, he told them "only against stupid questions". Of course, it would have been wiser to tell them about his allergies against certain antibiotics; but being offered the opportunity for a witty reply - priceless!

Now back to being serious: If you have a conductive insert like e.g. a steel nail to fix a broken bone, or a body piercing, this would act like a short-circuit for the magnetic field and heat up. Pretty much like a pot on an inductive cooker. On the other hand, the current which drives the magnet coils has to increase accordingly. I don't know whether the machine will detect this and shut down, though. Anyway, the resulting MRI pictures won't turn out ;^)

Best, Thomas

Best, Thomas

amolitor said...

Have you run across PDQ Bach?

Mike C. said...

wasn't he the less-famous brother of LOL Bach?

Mike

Mike C. said...

Sorry, following a quick google I see you're serious! Answer: no, but that looks fun, and I'll check it out (after breakfast!).

Thanks,

Mike

Frank Harkin said...

Mike, what a perfect description of a MRI scan. I had my first earlier this year and it was quite an experience - but your re-telling of your experience just had me smiling all the way through!

Mike C. said...

Thanks, Frank -- I'm quite the MRI veteran now, onto my sixth (I think, maybe seventh?)...

Mike