There have been a lot of 'weird' things that happen here. Things that surprise me and make me scratch my head in wonder. Weird things like a young child who had a terrible wound to the head, whom we all wrote off as another tragic result of war - only to have him walk out of the hospital with his father 4 days later. Weird things like doing CPR on a labrador after they were medevaced on an Osprey (Marine transport helo, capable of fixed wing flight as well), Sadly, he didn't make it. Weird things like ICU physician trying to grow a garden in the middle of Afghanistan - it didn't take. But there have only been a couple of moments where I thought - 'that is just dumb'. Here is dumbest.
To be a Role III hospital you have to have certain capabilites, including multiple surgical specialties, a CT scan and an ICU. We are able to take care of about 99.9% of the things that come though the door. I can't even imagine what it costs to run this place with all the supplies and manpower, but its a lot. There was a recent article in the New York Times that estimated that for every troop the US deploys here it costs the taxpayers about 600K to 1 Million dollars. One would think, then, that anything that could save money would be a welcomed addition. This seems not to be the case and in fact it seems we are spending more than ever. Enter an absolutely non-essential, useless piece of expensive equipment. Actually three of them - MRI scanners! Some of you may think, wait, MRI's are good, they can diagnose a lot of things that xrays and CT scanners can't, and to some extent you would be correct. However, there are a couple of major problems with these. First, when we order MRI's we usually have a specific question we want answered that will change how we manage the patients. In the time I've been here I could honestly say that I have contemplated needing an MRI once - on a patient with a spinal fracture, I wanted to see if there was an injury to the cord. Other than that, even if we do know the answer then we can't do anything about it anyway - so whats the use. Second, the MRI should be very patient friendly, meaning we should be able to get the patient in and out easily. Well, the MRI is in the back of an 18 wheeler parked out in back of the hospital on a sloped foundation near the medical waste and laundry. Sweet. It also has no ramp, just stairs. I suspect we will have as many injuries while transporting the patients on a gurney up those damn stairs. Thirdly, MRI scanners are generally in use in areas that aren't prone to sand storms. I can see the first time they leave one of the doors ajar and a sand storm comes through and ruins a 1 million dollar (conservative estimate) piece of equipment. Not only that but MRI's attract metal and according to geological analysis Afghanistan sand has one of the highest ferric (iron) contents in the world. So the first time we turn it on we may create an attraction similar to Disney's Space Mountain - it will be called 'Indoor Sand Storm Carosel'. I'll be the first in line.
According to NGO statistics Afghanistan only has one functioning MRI in the entire country - and its in Kabul, a long way away. So one could look at this as something that could be useful for them. But, alas, they are not authorized to use it - so strike four. Overall, with the work to build the concrete foundation, the transportation of the machine and the set up, I think we are probably in for around 3-4 milsky - each. Pretty good use of taxpayers money.
Now, should I choose Admirals Mast or just a straight Courtmarital?
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| For sale - MRI - used only once. |
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