MRI Exam

My MRI technician seemed competent enough and left the room as I slowly unbuttoned shirt and trousers. I wanted to be the first person in the morning while everyone in the MRI facility was still fresh. I arrived before an 8:00 am appointment, spending ten minutes glancing through a waiting room pamphlet entitled “Magnetic Resonance Imaging – An Inside Look.” It was supposed to inform and calm the fears of MRI first-timers during check-in, but had someone actually included an idiotic pun as part of its title? An “inside look” indeed. The booklet was helpfully illustrated in a cartoon-style for morons. 

The first page asked “What is magnetic resonance imaging (MRI)?” before answering itself, “It’s a way to look inside the body without using X-rays.” I hoped the rest would prove more enlightening. Further explanation wasn’t all that reassuring, to wit, “Your body is composed of tiny particles called atoms. Under normal conditions, the protons inside these atoms spin randomly.” 

I paused a moment. Was this why I occasionally feel disoriented listening to local newscasts? And what happened to all the molecules I learned about in high school? I continued reading. “A magnet creates a magnetic field which causes the protons to line up together and spin in the same direction, like an army of tiny tops,” the prose intoned. 

Who in heck wrote this? Five-year-olds are mesmerized by armies of tiny tops all spinning in the same direction, but I wasn’t captivated quite yet. Magnets don’t normally generate anything other than magnetic fields. Was I, in my seventh decade of life, anticipating my protons lining up together like tiny tops? I assumed my protons have figured out how best to align themselves without outside assistance after all these years. 

The pamphlet continued, “A radio frequency (RF) signal is beamed into the magnetic field, making the protons move out of alignment – similar to what happens to a spinning top when someone hits it.” I suddenly remembered a childhood wooden top bouncing off my grandmother’s kitchen walls accompanied by shrieks of alarm. Would my body’s protons begin bouncing off walls when they were moved out of alignment by a radio frequency signal? I read on, more disconcerted. 

“When the signal stops, the protons move back to the aligned position and release energy. A receiver coil measures the energy released by the disturbed protons and the time it takes, and a computer constructs an image on a TV screen.” I pondered the words, “the protons move back to the aligned position.” Why did the writer use the singular word “position” instead of plural “positions?”  Would all my spinning protons gather into a single golf-ball-size cluster-position instead of their previously normal happy positions? Where would this new golf-ball-size cluster reside? How would I greet my wife later in the day? “Hi, Honey, I won’t be eating dinner tonight because I feel really heavy on one side. All my protons have moved back to one aligned position.” 

Besides, how much energy is released during a typical “proton alignment” process? Would I become a walking grenade? How “disturbed” were all of my protons going to be after realignment? Would I feel a little buzzed while they were quieting themselves, like a Friday night martini? How do they know to resume their original positions? Would I have the same outward appearance or look like an alien in “Invasion of the Body Snatchers?” I guessed I shouldn’t bother asking the MRI technician. 

But what was I to make of the next section called, “Understanding the Risks and Benefits?” Why was it necessary to bring up the subject of risk at all? “At the scanning site, due to the strength of the magnetic field, you must remove all metallic objects before scanning. For example, jewelry, glasses, zippered clothing, nonpermanent dentures and credit cards must be removed.” What happened to people who don’t have “nonpermanent dentures” but permanent dentures? Would their permanent dentures turn into six-inch balls of exploding debris? 

I took the pamphlet into the changing room and snuck a last glance at it, discovering a perturbing statement, “In general, an MRI scan cannot be done if a person’s body contains a metal object that contains iron – the object may be moved out of place by the magnetic force.” Yes, I could foresee a problem with long-forgotten surgical staples suddenly exploding like shrapnel from internal recesses, flying through the air and sticking to huge surrounding magnets. I left the changing room to discover a second business-like technician, clipboard in hand. 

“I know you’ve been asked this already,” she said, “but do you wear a pacemaker, or have defibrillator wires, surgical implants, plates, screws, or prostheses in your body? Have you ever had surgery, a gun-shot wound, or imbedded metal in you that you’re aware of?” She inspected me closely as if I were hiding something under my flimsy hospital gown. “Come with me,” she commanded, leading me into the next room with a ceiling-high, ten-ton, evil-looking machine with a hole in its side into which I would soon be inserted, but could hardly accommodate my shoulders. 

Handing me a pair of ear plugs, she said, “Take your shoes off and lie down. There’s a lot of noise when the machine operates so put these in.” I had been wondering if I should insert the plugs into other orifices than ears. “After you’re settled in, you cannot move until the scan is complete. Here’s a panic button to push in case you need it or something goes wrong. This should only take 25 minutes. Don’t worry.” She seemed unconcerned that “something might go wrong.” How was I supposed to know how something was “going wrong?” If “something went wrong”, I might be slightly too dead to push a panic button. 

BZZZZZ … the noise was incredibly loud and went on for more than a half-hour. Suddenly there was silence, followed by bangs and clanks, and I felt myself sliding into light. Maybe this is what being born was like. 

I donned my clothes and returned to the waiting room to read the last page of the pamphlet while the receptionist finished paperwork. There was a final comment I had missed, “Though the use of magnetic fields is not thought to be harmful, short and long-term side effects are unknown.”  

Whoa! I didn’t especially mind long-term side effects, years in the future, like after I’m buried would be good, but what sort of assurance was a statement “short-term side effects are unknown?” Did this mean I might, through no fault of my own, begin dropping favorite activities like reading, writing, alcohol, and long walks in the fall, not necessarily in that order? 

Walking back to the car, thankful it was over, I was dismayed to find I still couldn’t predict where the Dow Jones Stock Index was headed the next day.