This is a picture of my cute little ray-gun, with which I made bone pictures today. It’s a basic machine, and unlike most x-ray machines in current use it’s set up to shoot films. That means you need a darkroom and chemicals, and to re-load the cassettes, and develop the films in a processor. We trained on these kinds of machines in school, but the only place outside of school I saw any were in clinics for the poor, usually frequented by Latino patients. Hospitals and imaging centers either use cassettes that hold a sensing plate read in a computer scanner or the tables have a digital sensor interface that ports the images directly into a computer. Yet, here it is, La Machina Basica, way up North in an old port town.
Medical professionals perform procedures on patients that involve risk. If you do things the wrong way, you can hurt someone. That’s why you have to go through long processes to get State-provided permission (licenses) to take X-Ray images. It isn’t because of how hard or easy it is to learn or do the job. You have to go through accredited training and work full-time for FREE (under supervision) for about nine months before you qualify to take the licensing tests. If you pass, you can join a national registry. Your State will grant you a certificate stating they trust you not to screw up. Then you have to take a certain amount of hours of continuing education to retain and renew your license. When I worked for free, I worked only at places with digital systems. Some of my old classmates would be laughing if they saw this machine, but I respect it because it still works. It’s in good repair and it makes decent images.
Shooting on film is for manly-men, even if you are a woman. Any qualified tech can shoot on a digital system. You only have to get your exposure settings inside the ballpark. The computer will give you the leeway to adjust the contrast and borders of the image so it will always be ideal. On film, you can’t adjust anything once you take the shot. It is what it is. There’s little latitude. You have to get it right first time, every time. It’s kind of like photographing for Sports Illustrated. You can’t ask the home run hitter to swing over again because you were underexposed. Also, every tube is different. They wear out over time. That’s why you need an accurate technique chart for the machine you are working with.
It turned out the chart for this machine wasn’t accurate. I don’t know why. However, a good tech knows how to adjust after seeing a single exposure. Because film is unforgiving of mistakes, it’s preferable to develop and view the first film before shooting the rest of an exam. The first image I took was acceptable, but not ideal. The later shots were better, because I compensated for what wasn’t as good on the first one. I also made sure to take the least important pose first, so the ones illustrating the patient’s injury best would be clearer. X-Rays can’t be focused. They must be corralled and filtered, so the best wavelength rays get through the patient to the film. Proper exposure technique, good positioning and closely framing the intended target area all add to an image’s value for diagnosis.
I can’t tell you any specifics about the cases. Part of being a tech is that you swear to protect the privacy of any information that might identify a patient to someone not involved in their care. I can say that people who show up at an Urgent Care are suffering from minor emergencies. They may be wounded or have fractures or have been in a car accident, but they aren’t brought in unconscious and close to death as they may be at hospitals. Usually they can assist in their own exams, and can cooperate by shifting, holding their breath etc. The tables in hospitals must move, since sometimes the people can’t. I don’t have a floating table. I do miss that. However, my X-Ray tube changes angle, height and distance nicely. The controls that corral the rays into the desired rectangular shapes work well.
It took five months to take the tests and get the licenses before I could even apply for this part-time job. That’s how much of a privilege it is to be doing it. It’s patient care. It’s something I can do to make a direct difference for the better in the lives of people in need. It’s a way of closing the circle for me. When I was a teenager, I was a trained volunteer counselor at a Crisis Intervention Center. I did that for almost a decade, from high school through the time I worked in that film manufacturing factory (Oddest Jobs Ever Pt. 2). The center had some management crises of its own, and I quit doing it when I went back to college. I’ve done short stints of volunteering since, but I wasn’t involved in patient care from 1978-2005. Now the Wheel has brought me back where I began, into the river where wounds are washed.