Roy Exum: What? No PET Scanner!

Monday, September 16, 2013 - by Roy Exum
Roy Exum
Roy Exum

I had a pesky little problem with bones breaking during my sleep back in May and, while I am now on the mend, I had so many diagnostic scans in the months that followed I fear that someday soon some of my parts will appear transparent when I look in the big mirror. There are three types of scans today’s doctors use and – trust me – I’ve had dozens that help figure out the problems that are inherent to an old soul who still rides a little too hard and fast.

Yet imagine my total surprise – shock is a better word – on Sunday morning when I read in the Times Free Press that Erlanger Hospital, our region’s Level One trauma center, does not have a PET scanner. This summer I had three radiological procedures at Mayo Clinic and, when I learned that Erlanger was just now applying for a “Certificate of Need,” my dismay quickly turned to outrage.

The lack of a PET scanner is a classic example of what has befallen “my” hospital after over a decade of terrible leadership and glaring oversight. It is one thing to decry a terrible void in capital projects but altogether another to learn one of the best diagnostic tools in mankind’s fight against cancer and other catastrophic disease has been lacking at Chattanooga’s top health provider. Oh my goodness, I wanted to sit in the floor and cry!

Now, let me give you a little primer from a layman: A CT scan, commonly called “a cat scan,” works like an X-ray, great at painting a 3-D picture of bone injuries, lung and chest imaging, and detecting some cancers. This usually takes about 10 minutes and is so common Erlanger has even one next to the Emergency Room area.

An MRI (magnetic resonance imaging) uses powerful magnetic fields and radio frequency pulses to produce detailed pictures of organs, soft tissues, bones and other internal body structures. Differences between normal and abnormal tissue is often clearer on an MRI image than a CT. Usually it sounds like 18 drunks fighting in a kitchen, lots of banging and scrapping and rattling inside a near-claustrophobic tube for about 30 minutes.

Erlanger has the best MRI machine in town; now with comfortable headphones instead of ear plugs so the patient can listen to the radio instead of the machine grinding its teeth. Further, the technicians are fabulous. And here’s a tip: If you count the songs on US-101, figure each one is about three minutes long and you can easily figure how much longer you have to stay in the tube. Then again, I’ve had so many that usually I sleep.

The best of all – depending on insurance -- is the PET scanner (Positron emission tomography) PET scans provides metabolic information which is read at the same time as either a CT or MRI, the later providing anatomic information. PET scans have been around a quarter of a century and to learn Erlanger has yet to install one leaves me gasping.

According to the newspaper article, Memorial Hospital, Chattanooga Imaging and the Diagnostic Center are among those who already have PET scanners but I can hardly believe Erlanger, especially with the UT College of Medicine program, has never gotten around to modernizing such a critical area in today’s high-tech war against cancer. And what a Godsend it is to have a CEO like Kevin Spiegel in place to finally recognize the aching void.

Since Spiegel’s arrival in April, he has provided the leadership Erlanger has been sorely lacking. Last week I was with him for a few minutes and – since it was on Sept. 11 when we remember 9/11 – he ducked his head into a meeting where Erlanger’s in-house Emergency Medical staff was hosting EMTs from many nearby counties. Spiegel saluted the over-flowing crowd and praised their roles as invaluable first responders. Only later did I learn Erlanger’s instructors were helping the EMT’s with their required in-service training – at no expense.

“The dream is for the hospital to serve the region in every aspect of health care. Part of that service is the help in areas the general public rarely sees but really needs in case of an emergency,” said the new CEO. “I am so pleased with our emergency facilities and, as the safety-net hospital for the region, we are proud to be the primary provider.”

That is why, in my opinion, it is stunning to learn Erlanger doesn’t have a PET scanner. The hospital is the process of applying for a Certificate of Need from the state in hopes of acquiring the latest model of the high-tech scanner in the near future. The legal instrument should be able to be obtained easily, due to the number of Erlanger patients and the growing need for better diagnostic tools.

A list of other key improvements is also being implemented and Erlanger is responding to Spiegel’s plans. “We can’t do everything at once but we are doing something constantly. We are doing something in a lot of places at once, too! I hope to have a Chief Operating Officer in place in the near future and a management team that will make a huge difference in the future of the hospital,” he promised.

But, my goodness, why hasn’t Erlanger – of all places – had a PET scanner until now? My goodness gracious.

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