I have been taken to hospital three times for X-Rays. (Five if you count a walk-in when in America and subsequent UK care, but I’ll leave that out).

The first time I was hit by a car when I was about eight or nine. I don’t remember very much about it, other than using tent poles as makeshift crutches when I went back to school as it eased the pain. The hospital was a blur- I remember it being full of rather sinister bulbous curved black or cream enamelled machines, as were dentists at the time.

My second trip was when I was about fourteen and I managed to get my right foot run over by a bus. It was on Northumberland Street (the busiest street in Newcastle) but as the bus was cornering at the time the pressure on my foot was reduced somewhat. I went crashing backwards, I couldn’t stand up and my shoe was ruined. When the ambulance driver arrived, he looked at me lying on the pavement and said:

“Thank Christ for that, we’d been told that a young lad was trapped under a bus”.

I had a trip to the RVI and stopped on the way in to the building for what felt like ages whilst the A&E clerical dragon interrogated me. I then went to casualty, where they peeled off my trashed shoe & blood soaked sock, examining the damage. They reckoned that I probably only had bruising, but an X-Ray would confirm it.

The porter then trundled me off to X-Ray (following the yellow lines on the floor) where I waited my turn. Radiography was fairly simplistic in those days- they slipped a piece of film into a cassette, stuck it under or behind your injury on the apparatus (often called a Bucky holder, although the term “Bucky” is applied to various bits of gear, including the room itself), maybe slapped a few lead sheets on you, wiggled the Doctor Evil Death Ray contraption then ran away behind screens. There were were a few loud buzzes and then back they came.

X-Rays are a form of electromagnetic radiation, the same as light, heat and radio waves. They have the properties of being able to penetrate most things and it takes a very dense material like lead to stop it. They are just up the spectrum from Ultra-Violet light but not visible to the human eye. They are also rather bad for you as they can cause tissue damage in a similar way to radiation exposure. They are comparatively easy to make- any thermionic valve (or vacuum tube for ‘merkins) can do so with high enough voltage applied. Actual X-Ray tubes are complex, expensive and inefficient. The purpose of all the gubbins is to focus the X-Rays onto the cassette evenly the same way as an optical projector does.

After having my foot X-Rayed, I then sat outside again, getting more and more angry with my foot throbbing something rotten. It takes time to develop X-Ray film, it takes time to hand it to me in a big envelope and it takes time for the Porter to show up again.

“You sound a big grumpy, bonny lad, that’ll be the shock kickin’ in”.

He was right, it was.

My third time was after my recent fracture. The ambulance lowered my trolley straight down a ramp contraption and through the doors of the A&E straight to the emergency room. There was a momentary pause here, mitigated by the Paramedic having filled in several forms with me on the journey. I was then taken into the resuscitation area. This had three or four trolleys, lots of extra lighting and numerous medical gadgets covering the walls. It looked very clean, smart, modern and fit for purpose, but after all, this was the room where life or death decisions happened. I was met by the trauma team (there seemed to be about eight of them) who busied themselves attending to me, fitting a Cannula in the crook of my right arm, fitting a drip, connecting electrodes to the machine that goes ping, cutting off my trousers and examining the wound. I was given Morphine and also Gas & Air to distract me. An overhead X-Ray machine was stored in the corner and it looked a much tidier device than the 50s sci-fi B-Movie contraptions of my childhood. This looked right for the job, stylish, functional, a pleasant cream colour on the powder coating and not too intimidating. One of the staff tracked the unit across, pulled it down on delicately balanced gimbals, placed the cassette under my leg, twiddled a few controls and then said in a loud voice “X Rays”, at which time the team disappeared into the mist as if they were giving out free fivers in the lobby.

The lead doctor was happy to chat with me whilst working. He advised me that my Greek God of Dreams Class A drug levels were quite expensive on the street for God’s own medicine. Another Doctor (who was a Mister from his badge) helicoptered in and surveyed what was going on with a critical eye. On my asking the original Doctor if being a Mister made him important, I was given a potted history on the differences between Doctors, Misters, Surgeons, Registrars, Consultants etc. and how it varied depending on specialisation and qualification - ending with a twinkle and “so he thinks he is…”

By this time the X-Rays had come back, so they had a look. The Tibia was sheared and somewhat shattered. The Fibula was also broken, but they weren’t overly bothered about that. They said I’d be admitted and be sent for surgery later, likely to be a pinning. In the meantime, they’d align my leg and set it in a temporary cast.

They then advised me that this would be a bit uncomfortable so that I should enjoy the Entonox. After a bit of stretching, pulling and swearing (by them, not me) there was a loud Twang noise from inside my leg. After a short pause, I became aware of being looked at by several pairs of eyes and Doc asked me if I had heard that. After a short pause back, I said “heard what?”and they all laughed! Sometimes it is best to keep a sense of humour…

They took another couple of X-Rays, then plastered me up and I was sent off to the Ward.

I was X-Rayed again after my surgery in Theatre using a portable unit, but I was unconscious at the time. (The Physios were not able to trackdown these X-Rays on my dischatge day).

Last Friday, I returned to the Hospital for an Out-Patients appointment. Here I was X-Rayed in the Emergency X-Ray Suite. They had three X-Ray rooms and I chatted to the Radiologist about how the modern system worked. They had a Philips Digital Diagnost system and it no longer uses film- the cassette that gets put under the injury is actually a digital imaging unit, a “Bucky unit detector”. It then gets plugged into a Computed Radiography Reader, a sort of docking station. (I was interested to read on the Philips website that it is 3000 x 3000 pixels with 14 bit resolution. We looked at the images on a large flat screen and then she sent it to the acetate printer.

Whilst I was waiting for the Porter, I looked at the barcodes on my X-Ray envelope. This gave an interesting audit trail of my events- 1st X-Ray 5:23pm, second X-Ray 5:38pm, third on Saturday morning at 9:10 (suggesting about an hour for my surgery) then the final set just then.

Back in the clinic, the Doctor advised me that the Theatre set were on the computer, had not been printed out and therefore effectively no longer available to the staff as no-one quite knew how to work the new system, gesturing towards a switched off PC Monitor. From the Trust website:

The directorate will soon finalise the installation of a multi-million pound Picture Archiving and Communication System (PACS), commonly called a digital x-ray system. No longer will x-rays be lost and should you be referred to another hospital we will be able to send them your digital x-rays.

Yea, right, one day…

These X-Rays aren’t mine (you can’t get a copy for your Blog, unlike Foetus Ultrasound, I did ask!) but the repair is similar.