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Former science 'hater' now only Bermudian in hospital's new MRI Department

When the King Edward VII Memorial Hospital's magnetic resonance imaging (MRI) facility opens in the new year, it will be with a young Bermudian as the senior imaging technologist.

The appointment of Rona Glasford, BSc, RT(R), (MR), comes as no surprise to those who know her academic record and capabilities, for she was a star student at both Quinnipiac College in Hamden, Connecticut, where she gained her Bachelor of Science degree in Radiologic Science, and this year at Michigan State University, where she topped her class in the MRI programme, completing the course with a 95 percent honours grade.

"Being an older student was an adjustment and the course was a challenge, but I did really well throughout the programme, and coming back home I know I did the right thing," Miss Glasford says. "I now have my licence to practice from the American Register of Radiologic Technologists."

She was seconded by the Bermuda Hospitals Board (BHB), where she has been employed as a radiographer, and is now eagerly looking forward to the day when she can begin her new job.

For the foreseeable future, she will be the only trained and certified Bermudian staffer in the MRI department, although hospital authorities are working on strategic staff planning and subsequent training of other personnel. Each MRI course takes nine months to complete.

Perhaps what makes Miss Glasford's story more impressive is the fact that, as an honours student at Warwick Secondary School, she "hated" science. Instead her focus was on child development, so much so that after school and during the holidays she worked in day care centres - experiences that made her realise she "did not want to be around a bunch of kids" for the rest of her life.

With what she describes as "timing and luck of the draw" she wound up working in dentist David Dyer's office, and found that she liked the dental hygiene field, but was also attracted to radiography, so one day she sat down and wrote out the pros and cons of both, including salaries, shift work, and opportunities for promotion, and decided radiography was the way to go.

"I liked the options it led to," Miss Glasford says.

Thus it was that she attended Quinnipiac to spend the next four years gaining her BSc.

"It has led me to MRI after coming home and seeing that there was no-one qualified," Miss Glasford says.

"There is a definitely a market for MRI scanning in Bermuda, no two ways about it, given the number of people who go abroad, and incidentally it will also be cheaper to get an MRI in Bermuda than in the US."

The young woman was chosen to take the MRI course at Michigan State through a selection process based upon her commitment to diagnostic imaging and the BHB, her leadership skills and other qualities.

"I am ecstatic that I was chosen, and I am so looking forward to it," Miss Glasford says. "I think it is something Bermuda should have had a long time ago, so I am happy that finally we will be able to offer this service."

The MRI facility is projected to be in service by the new year. It will be delivered as a fully equipped, ready-to-go unit, or "cassette", which will be attached to the eastern wall of the Emergency Department nearest to the hospital's main entrance, with an access door cut into the wall of the Diagnostic Imaging Department. Such is its size and weight that transferring it from the docks to the hospital from the docks is expected to take many, many hours. Once it is installed, traffic access to the Emergency area will be reduced to one lane.

"The cassette will include the actual MRI unit, together with its computer component, as well as the computer system which the technologist will operate," Miss Glasford says.

Initially, the MRI Department will be open from 9 a.m. to 5 p.m. Monday to Friday, and since the average examination time is 30 to 90 minutes, it will process six patients a day.

Contrary to popular belief, MRI is not the ultimate diagnostic tool to replace X-rays, ultra sound or CAT scans. Rather, it has its place in the overall diagnostic imaging arsenal. For example, due to the long examination time, it cannot be used as a key diagnostic tool in emergency situations where speed is vital in determining the course of a patient's treatment. Nor can it be used on patients with some types of metal implants and devices, such as pacemakers, in their bodies.

"MRI is great but it is still not the ultimate modality for all the problems people have," Miss Glasford says. "It depends on the patient's condition and what the doctors are looking at. Some things are better diagnosed by ultra sound or X-ray. Where MRI excels over X-rays is in conditions such as multiple sclerosis, herniated discs of the spine, rotator cuff injuries of the shoulder, and meniscus tears of the knee. MRI advantages include there being no radiation, as in X-rays, and also it is non-invasive, meaning patients don't have things stuck into them, and you don't need dyes to see detail."

MRI uses magnets to obtain images by using the body's hydrogen atoms to send signals to a computer, which then converts them into an image that can be read, filmed or stored in the computer. Imaging technologists like Miss Glasford must ensure that they obtain quality images for the radiologist to read, as well as paying close attention to patient and personnel safety and comfort.

Because of the way in which this diagnostic equipment works, the supine patient must remain absolutely still in a confined space for upwards of 30 minutes. This can present problems, particularly for the claustrophic and those with involuntary movement problems. The machine is also very noisy. Like all technologists, Miss Glasford is well aware of these conditions, and has been trained to deal sympathetically with them. She also hastens to set the record straight.

Microphones allow constant communication between technologist and patient, and technology allows for the examination to be carried out and stored in segments, thus giving anxious patients a welcome break from time to time. To combat the noise, and perhaps calm the patient, they can bring with them a favourite cassette or CD, which can be played over the machine's sound system during the examination.

For those who don't want to see the proximity of their surroundings, the eyes can be covered, if requested, or in extreme cases the patient's physician may prescribe a tranquilliser. For obvious reasons, children are sedated. There is certainly no question of anyone being "trapped" in the machine for up to 90 minutes with no possibility of getting out until the examination is completed.

"Patients can always terminate or halt the process if they need to come out for a break."

In addition to MRIs, the equipment is also capable of doing magnetic resonance angiography (MRA) examinations, for vascular diagnoses of aneurisms of the head or thorax, and blockages or narrowing of major blood vessels - another "plus" for Bermuda's patients.

Looking back on what it has taken to reach this pinnacle in her career, and justifiably proud of her success, Miss Glasford urges other young Bermudians to follow her lead.

"Set your goals and go for them," she says. "As basic as this is, put your head in your books and do whatever it takes to be successful. And don't under-estimate yourself. I didn't leave high school thinking I was going to be a senior MRI technologist. It was a matter of not under-estimating myself."