Between fairy tales and current urban fantasy, we all know enough mythological solutions to ridding ourselves of villains. Never mind Kim Harrison, Christine Feehan or Kelley Armstrong – werewolves and vampires are not among the good guys. Vampires? Religious symbols (crosses, Holy Water, Mogen Davids, etc – depends on the vampire) a wooden stake, decapitation, fire or sunshine. It might not be easy, but the method is clear. Werewolves – silver is deadly. Elves – cold iron. Evil Witches? Water if you are Baum writing the Wizard of Oz, or drop a house on them.
Then you come to fairies. Not the Fae (see elves above) but those flitty little Tinkerbell type creatures. Fairies are supposed to be good creatures, a positive influence. Helpful even. In everything I can find, the only remedy (recommend by Charlaine Harris in the Sooky Stackhouse series) for fairies is …. lemon juice.
Somehow, right now that is just not blood thirsty enough. There is not even a consensus on whether pulling off their wings would accomplish anything. There is a good idea fairy who desperately needs to be exterminated.
The particular idea that will not die? Placing an MRI in theater. Yes, an MRI is standard medical equipment in the US, Canada, Australia and Europe. We don’t want one under any circumstances.
Why? Oh let me count the reasons while reassuring you that no one, not a radiologist, not a trauma surgeon, a logistician, a hospital commander or anyone with a working brain wants anything to do with having an MRI here. It has no role, absolutely none, in combat care. We are here for combat care.
Let me explain – and this is a multifunctional negative.
- Logistics. MRIs are expensive – 2.9 to 4 million $. There are very specific site requirements which include stand-off from existing buildings (i.e. lots of money to move things around and create an absolutely level location inside the hospital compound), clean power (excuse me? We have generators), and protection from vibration.
- Our hospitals are next to the flight lines. Planes are taking off and landing. Mortars are being lobbed at the tarmac on a very frequent basis. Vibration knocks the magnets out of line which makes the machine non useable until recalibrated.
- Personnel – you have to have techs who can run it and radiologists who can read the MRIs. These are technical and training issues which require major support and experience (credentials). You need maintenance (contractor full time at big bucks since none of the militaries train techs – MRIs come with maintenance contracts for a very good reason).
- Purpose – combat care? You can’t MRI anyone with metal fragments. Speed? CTs are fast, MRIs are so slow that people have major issues with holding still. Exactly how many of our combat casualties do you think are completely metal free? How many seriously injured patients would you want to delay 30-45 minutes in getting them to the OR? If you want an MRI, you would first have to CT the patient to make sure they are metal free adding additional procedures and a significant radiation exposure.
Why this keeps coming up is that “you need it for mTBI” – aka concussive care. Answer: no. Not in the acute phase. If they get better – they can go back to duty. If not, they are going to leave theater. MRI findings don’t matter. It is a medical condition with medical clinical guidelines and practices. We don’t do procedures on normal people for curiosity and if you aren’t normal, it doesn’t matter if an MRI is normal – you are not going back to duty.
So that leaves us with the following – if you need an MRI – 95/100 you also need other medical people/ procedures /support that is better provided in a garrison environment. This is a combat zone, not a sports treatment center.
Why won’t this fairy go away? I have answered the mail on this particular piece of mail every couple of weeks since I arrived in theater. All I can figure is that it really isn’t a good idea fairy after all but some sort of black magic terrorist who is trying to divert time and attention from real problems so that someone can feel like “they did something new.”
I don’t even thing Ghostbusters will work.