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The alarm clock rings at 5:30 a.m. and is promptly met by the slap of Alice's hand looking for another eight minutes of sleep. In five minutes, she pops up, runs into the kitchen to feed the cat, and make the coffee. At 6:25 she is out the door. She stops by the local donut shop where she buys a large hazelnut coffee and finally reaches the hospital by about 6:45.

From 6:45 to 7:00, she sits in the tech lounge sipping the coffee, chatting with the other techs who are starting to arrive, and generally gets herself together for the coming day. At 7:00 she goes over to the front desk to find where she's been assigned for the day. Today it is CT. Aside from general radiography, Alice is a trained CT and interventional procedures tech. As such, she is generally assigned to CT, participates in the procedures schedule, and, the rest of the time is assigned to the "floor." All hospitals are different, but an x-ray department of any size has a "floor." It may well be called something else, but the floor is where the basic work of the department is carried out. The regular x-rays taken on inpatients and outpatients are done on the floor, the ER, the OR, and just about everywhere else. On the floor is also where barium enemas, UGI series, and IVPs are done.

At CT, Alice begins the paperwork that has crept insidiously into her job as it has into the jobs of nurses and other health personnel. At the same time, she calibrates the machine for optimal function for the coming schedule. The telephone rings; it's the ER, and they need a head CT right away. Alice finishes up the calibration procedure and calls for the patient. The paperwork can wait, but not for long or her supervisor, Audrey, will get on her (usually goodnaturedly).

It's 7:30 and the first patient is being scanned. The rest of the morning, until lunch at 12:45, will be a period of total frenzy. The hospital has a new fast scanner on order, but the order has been delayed a bit so that the hospital can get the money together.

Alice will have a schedule of outpatients who have been booked to fill in most of the morning's slots. That would be fine if everyone showed up on time, but people won't. Not only that, but Alice will have to place inpatients into available time slots when outpatients don't show up. If the ER is busy, all sorts of emergency scans will have to be fit into this already bulging schedule.

And then here is Dr. Jones who is walking down the hall with determination. He needs to get a CT scan on one of his inpatients right now, because if he needs to operate, he would like to get started. So he appeals to Alice's good humor and invariably gets his case scheduled.

So for the scanner, it will be in and out all day long, but not for Alice. Other things are cooking for her. A special procedure has been scheduled for 9, and Alice is next up to work in so-called special procedures. Interventional procedures is the more modern term, but one that just doesn't roll off the tongue as well. Radiologists are no longer content just to read films all day, perhaps do a bit of fluoroscopy, but basically read films and not interact directly with patients. The interventional radiologist is a hybrid between the old-fashioned radiologist and the surgeon.

Today there are a couple of cases scheduled. The case Alice has drawn is a runoff, an angiogram of the arteries that supply the legs.

For two hours, she will relinquish her post at the CT scanner and assist the interventional radiologist. Aside from her uniform, for two hours, she will have to wear an apron made out of lead to shield her from the radiation, a sterile gown, gloves, a surgical cap and a mask. Then she'll have to help clean up the room before getting back to CT so that the first shift can get off to lunch on time.

By the time she gets back to CT, the schedule is in maximum frenzy. The ER has been busy all morning and only a few of the inpatients are done. One of the radiologists decides to do a CT- guided biopsy that ties things up even more. The phone won’t stop ringing. Outpatients who have been scheduled are delayed and talking to themselves in the waiting room. Some are very angry. Everyone wants to know "when." And on top of everything else, the scanner is ready to crash.

At 12:45 the first shift returns reinvigorated, and Alice goes off to lunch with the rest of the second shift. During lunch for at least six months of the year, the radiology "people" fill up the steps of the hospital building across the way. Here the sun is warm and lets everyone including Alice "air out" before part two of the day begins.

Back to work. Part two is the shorter and easier part for Alice. She only has a little less than two hours to go. Things do wind down in the x-ray department after lunch. The floor is a bit busy, though, and Alice is asked to help out there.

"Alice, we have a barium enema coming from the floor, can you do it with Bernadette?" Bernadette is one of Alice's co-workers and good friends. They enjoy each other's company. One of the bonuses of coming to work each day is being immersed in the hustle and bustle of an active imaging department, including the patients, the doctors, her co-workers, and the countless interactions.

Alice and Bernadette start setting up for anot uncommon afternoon barium enema. They are told that the patient, a Mr. Jones, is very elderly and probably unable to retain the barium. Bernadette cuts to the chase, "Whose the rad?" She wants to know which of the radiologist crew will have the duty. Today Bernadette and Alice get lucky. They'll end up doing this procedure with Dr. Michael. He's fast and fun to work with.

Alice, in the meantime, is preparing this elderly patient for the test by taking a "scout film" of the patient's abdomen which will be used to judge the general appearance of the bowel, and as a comparison to the films with barium in the bowel. The patient is completely uncommunicative (Alice can get almost anyone to talk) so his help cannot be used to accomplish the goal of getting this enema done. Mr. Jones is not complaining; he just isn't completely aware. And he really needs this test to see if his bowel is obstructed.

So doctor and techs go to work preparing the interface between Mr. Jones's rectum and a big plastic bag filled with white, chalky barium. Doctor and techs have been through this procedure many times and have it down to a science. The large bowel is filled with the barium very slowly and carefully, and x-ray pictures are taken of the relevant areas. The patient has managed to hold everything in until now, but just barely. The situation is tenuous; Mr. Jones is about to expel the balloon that was blown up in his rectum and all the barium but not before Dr. Michael has completed his role in this procedure. Alice and Bernadette will be left with Mr. Jones to get the important "overhead views" of the large bowel. The little spot films that were obtained during the test are also helpful, but they do not take the place of the larger, clearer overhead films that Alice and Bernadette will get. No sooner has Dr. Michael left the room, when Mr. Jones makes his move. Bernadette and Alice will clean up without Dr. Michael knowing anything, which somehow doesn't seem completely fair.

It is 3:30 p.m. and Alice is bushed. She'll come alive again later, but for now when she gets into her car and turns on the radio.

Every fifth night and weekend, Alice is oncall for emergency CT and interventional procedures. The CT scanner is often working 24 hours a day, which means that every fifth night and weekend Alice is in and out all day doing scans and occasional procedures. But this day is done.

Interviewing Alice

Interviewer: Do you like your job?
Alice: I love my job. But sometimes it can be a pain in the butt.

Interviewer: What's bad about it?
Alice: All the stress. Everyone needs everything right now. Sometimes we just can’t accommodate. We can only do so much with what we have to work with.

Interviewer: What do you like about your job?
Alice: The patients, helping the patients. Making them as comfortable as I can. And I like the people I work with. (A big smile comes over Alice's face.)

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