In 1976 I began my career in the diagnostic imaging field as a Biomedical Engineer and initially I specialized in servicing Diagnostic Ultrasound systems in Ohio and Michigan. I moved to Alabama in 1979 and then to South Florida in 1980. As the company’s service manager, I covered the entire state, servicing diagnostic ultrasound systems. With the aid of my employer, I became a licensed pilot and flew all over the state of Florida in a private airplane, installing and maintaining Diasonics diagnostic ultrasound systems. I later hired service engineers around the State and used the airplane to fly in parts and provide technical support to the team of service engineers.
In 1986 Diasonics I was promoted into the Diasonics MRI division and I was tasked with the installation and maintenance of MRI systems in Florida. I was again promoted into a higher level of service management, when Diasonics began rolling out mobile MRI systems all across the USA. I took on the role of installing the MRI systems and teaching local service engineers how to maintain the MRI systems. I produced service manuals with graphic illustrations and was known by the service engineers as “Mr. Documentation”. I was given an frozen water award for my accomplishments in helping the company to grow its base of mobile MRI systems. Why “Frozen Water”? That was because one person coined by saying that some people are special and can literally learn how to walk on water, and the award I was given was for freezing the water behind me so that others could walk on water as well. My illustrations, technical publications and training manuals went on to become recognized by the upper management in the company, and I pitched the VP of Service with the idea of creating a “Technical Publications Department”. I spent many months working in the corporate office in South San Francisco to create what later became the company’s official MRI manuals for operating, installing and servicing the MRI systems on an International basis.
Each MRI system was installed in a shielded room that blocked out all electronic noise, radio frequencies and prevented interference with the Magnetic Resonance Imaging. The shielded rooms totally blocked all signals, and you could take a radio into the room and when the door was closed, you would never be able to pick up any stations. This kind of shielding was critical to the operation of the MRI systems because they had to pick up signals from the body that were so weak, that any leaked signals that might get into the shielded room could degrade the quality of the MRI scans. The earliest MRI systems were known in the beginning as Nuclear Magnetic Imaging Systems, however people were scared by the word “Nuclear” so the wording changed to Magnetic Resonance Imaging so that the public would more easily accept an MRI system into clinics that were equipped to scan patients with the very strong magnetic fields. The earliest MRI systems did not have much in the way of magnetic shielding, so if you walked into the scan room with a screwdriver, for example, the strong pull of the MRI system could literally pull metal objects right out of your hand, and they could wind up being thrust against the plastic outer cover of the MRI magnet. The MRI systems consisted of a very large tube and thin wires were wound around that tube to create a magnetic field of extremely high strength and patients would lie down inside the magnet while being pulsed with shifting magnetic fields and radio frequencies that parts of the body would accept then reflect back to sensitive receivers and computers to generate detailed images that showed all the tissues in the body in exquisite detail. Many MRI systems were installed in hospitals and imaging clinics, however smaller hospitals did not always have enough patients to justify a permanent MRI system, so they utilized a Mobile MRI system that might go to their facility one or two days each week. As a Mobile MRI Technical Specialist, I specialized in installing the mobile MRI scanners in the Eastern United States. They required an extensive amount of maintenance and generally each service engineer would have responsibility for one to three MRI systems. I would see to it that the new mobile system were working properly and although the service engineers went through a training course, I would teach the new engineers the ropes after they were assigned to maintain their own MRI systems. I assisted in the hiring of new service engineers, and went to military hiring expos to recruit men and women who were seeking civilian jobs after leaving the military. Most of these people were trained in electronics warfare, and needed guidance so they could become service engineers at a time when the company was growing at an extremely fast pace, as MRI systems were being installed all over the country at a very rapid pace.
For those of you who are not that familiar with MRI systems, I will try to describe the experience. Patients who were candidates for an MRI scan usually had some kind of an issue with their brain, spine or joints. MRI systems were one of the best ways to see the soft tissues of the body in very clear images, and the MRI scans provided superior images without any radiation, so it was one of the best tools for diagnosing patients who had brain, spine and joint issues. MRI exams were very expensive and due to the lack of MRI systems, patients were often put on a waiting list for the MRI scans. Both CT and X-Rays produced radiation, and since MRI produced such incredible results, it was considered to be one of the best imaging methods. It was very expensive and sometimes the patients could not tolerate the scan if they were claustrophobic. Many patients just could not cope with being pushed into the bore of the MRI scanner tube, because it would cause anxiety and you would feel like you were in a very tight space. Many people just could not tolerate being inside the scanner, and some patients would go in with the best intentions of being scanned, only to get anxious and eventually start climbing out of the scanner. Some patients would scream “Get Me Out of Here” as they clawed their way out of the magnet bore.
At the time that I first began servicing MRI systems in 1986, there were only a few MRI scanners in the entire State of Florida. The technology was really quite new and the general public had no idea that you could get an MRI scan. That quickly changed as more and more MRI systems were being installed and physicians began to realize that MRI was a superior way to image some parts of the body. Patients were typically booked for an hour long scan and in the late 80’s, the scans usually cost around $3000 per scan. If a patient backed out of the scan, the scanner would sit idle for an hour while waiting for the next patient to show up, so naturally, the owners of the imaging center were not happy with having patients periodically back out of their MRI scan. They tried sedating many of the patients and those who might not tolerate sedation, would drink an alcoholic beverage before going in for their scan. Many patients did not know they were claustrophobic until they were pushed into the scanner. If the patient became anxious and backed out their scan, it would automatically disrupt the patient scan schedule. The last thing the imaging centers wanted was to have an MRI scanner sitting idle for an hour, waiting for the next patient to show up. While speaking with one of the Radiologist who had invested in the MRI imaging center, he expressed serious concerns about the losses due to claustrophobic patients. That was when I came up with the idea that if the patients could listen to music, they might be more inclined to go ahead with their scan if they were borderline claustrophobic. I had suggested to the Radiologist that they consider allowing the patients to listen to music in the scanner, however that was not something that could be easily achieved. The strong magnetic field of the MRI scanner was problematic, because it would certainly interfere with the operation of most headphones and earphones, because headphones produce sound using moving diaphragms that internally vibrate based on magnetic fields. When placed inside the MRI scanner, most headphones would not function correctly. On top of that, the headphones would be made of metal materials and if they were inside the MRI system, they would likely interfere with the delivery of the very sensitive images being captured from brain and body tissues. Despite that challenge, I felt that there was a way to produce sound and pipe the audio into the patients ears. The Radiologist at one of the new imaging centers told me that if I could find a way to make a sound system work, he would gladly buy whatever materials I thought I might need to get it working.
Long before I began my career working as a Biomedical Engineer, I worked servicing stereo sound systems and was very familiar with all the latest equipment, headphones and I admit that I was an audiophile just waiting for the opportunity to create a custom stereo system. So the idea of finding a way to build a working prototype that would help the patients to wear headphones was a challenge that truly intrigued me. In my career, I had flown on airplanes for a couple decades, and often they had passed out stethoscope style pneumatic headphones on the airline flights. I figured that if I found some way to pipe the sound into one of those pneumatic headphones, that the patients could wear them inside the scanner without causing any interference to the MRI scanner. I first set about finding the source of how the airlines had produced sound at the passenger seats in airplanes. I located the company that had made the parts that were imbedded into the armrest of the airline seats, and then began to use those parts to drive the sound into the acoustic headphones. I rigged up a stereo system, added a mixer and a microphone, enabling the technologist to talk into the microphone and then wired it all up so that the MRI tech could act as a DJ, playing music for the patients. The first MRI stereo was a real hit and soon the other MRI centers in the local area began to ask if I could build a similar sound system for their facility. The doctors were finding that the sound system positively affected their bottom line, because very few patients were aborting their scans. In fact, the technologist would simply ask the patients what kind of music they liked, and rather than feel creeped out by the enormous MRI scanner, they simply laid down and chose their favorite radio station.
Unfortunately, there still were some additional challenges that I faced at that point. An MRI engineer in the South Florida area had heard about the new sound system, so he decided that he would try to copy mine and he installed one at another nearby facility. Unfortunately, his kept blowing the small airline audio driver, because those were not really made to handle the powerful amplifier that they tried to use to overcome the MRI scanner noise levels.
I also had some difficulties with blowing the airline audio devices, so I had already evolved my earliest sound system so they were using a box that resembled a shoebox and inside were two heavy-duty audio drivers that could withstand the strong power amplifier needed to provide higher quality sound at levels that would have blown the smaller airline armchair audio driver.
The sound systems were catching on and I realized that I had overcome several challenges that others had not been able to achieve, and the idea that these new sound systems could be a commercial success gave me some thought about filing a patent. I sought some advice from an attorney friend who suggested the best intellectual property attorney in the local area, and after several draft proposals, it looked like I had a viable patent. Unfortunately, I began to have some concerns that I might be creating a conflict of interest with the company that I worked for, and did not want to cause an issue with my main employment. The other challenge that I had was that the best attorney around was also one of the most expensive around, and he kept asking me to review the patent documents for new revisions and answers from the USPTO, so he could file another version with the patent office. I started to see where I was going to find myself owing a substantial amount of money for the patent work, and in the end I would have to give up the rights to the patent or potentially lose my job if I tried to sell the sound systems. This was quite a dilemma, and I really needed to keep my job, so I quietly pursued ways to make the sound systems as kits that could be sold without my being directly involved. Unfortunately, I gave up the pursuit of the patent, because I feared the cost of the attorney fees would be prohibitive. Eventually, this led to other individuals who began to copy my design. One such company built a similar box that housed the audio drivers, and they made their box inert, so it could be used in the scan room without being affected by the magnetic fields. Their sound was never as good as mine, however the guy must not have had the conflict of interest issues, and he pursued the commercial manufacturing of specialized audio equipment to customize his sound systems. I chose a different path, using high quality sound systems such as Sony and later Bose, to produce the best quality sound. Although my boxes were not inert, I found ways to make sure they could be secured inside the scan room and ensure that patients could hear exceptional quality music even with the thunderously loud MRI scanning. I came up with the idea to use earmuff style headphones and designed them with twin tubes so the patients could enjoy true stereo sound. The outer ear muff style earpieces directed the audio directly into the patient’s ears at the same time they surrounded the outer ears with layers of foam and plastic shields, thus creating headphones that would reduce the noise from the MRI scanner.
The sound systems we made back in 1986 are still in operation, and although we have improved the technology over the years, we still offer the best quality sound available. I am quite proud that we still offer the best MRI patient stereo systems and by selling them in kit form, we have always kept the pricing affordable.