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Dartmouth Engineer - The Magazine of Thayer School of EngineeringDartmouth Engineer - The Magazine of Thayer School of Engineering

Just One Question: What Work Are You Doing in the Medical Engineering Field?

HEART HELP: Steve Johnson ‘75, Th’76 developed the algorithm for the microcontroller of this heart monitor.
HEART HELP: Steve Johnson ‘75, Th’76 developed the algorithm for the microcontroller of this heart monitor. Image courtesy of Steve Johnson.

I am the director of systems engineering at Angel Medical Systems. We are developing an implantable cardiac monitoring and alerting system that is designed to warn cardiac patients of potentially life-threatening heart conditions. After Thayer I then went on to get my M.S.E.E. at the University of Illinois, with a concentration on control theory and a thesis involving microprocessor applications. I then started working at Bell Labs, working on the very first commercial fiber optic transmission system. I started as a circuit designer but quickly found my calling as a systems engineer. My role through 20-plus years and at least three generations of fiber optic transmissions systems was in writing requirements and managing the high-level architecture and design of such systems. I then somewhat serendipitously landed in a newly formed medical device startup company, Angel Medical Systems, where my role has been primarily that of systems engineer. My main responsibility, particularly early on, was taking the fundamental ideas of the founders and specifying all the details for the software developers, so they could write the code for a reliable heart attack detector with high sensitivity (few false negatives) and high selectivity (few false positives). It was very interesting to me that the microcontroller we use as the heart of our implantable device has capabilities similar to the one I used for my B.E. project so many years ago.
—Steve Johnson ’75, Th’76

I am working in a field that blends engineering sciences into a form of high-tech drug discovery. My company, Trellis Bioscience, discovers antibodies from human blood that become therapeutics.
—Stote Ellsworth ’76

As a partner at Vanguard Ventures, I have invested in medical device companies. One, Asthmatx, produces a device designed to improve the quality of life and reduce asthma attacks in adults with severe asthma without the use of drugs. Results of the Asthma Intervention Research 2 trial demonstrated statistically significant improvements in quality of life measurements and reductions in attacks and emergency room visits in adults with severe asthma who underwent bronchial thermoplasty delivered by the Alair system.
—Tom McConnell ’76

I wrote the New Hampshire Mammography Network Registration database in 1996 and rewrote it a few years ago. Also, my firm, Sylvan Advantage, supports video software for medical simulation.
—Richard Akerboom ’80 Th’82

I have more than 20 years of experience in the biopharmaceutical industry, including evaluation of emerging technologies and leading technical development focused on business goals, organizational development, and the management of strategic partnerships. I am now CEO of ImmuRx. Previously I was CEO of MIST Inc., a breast cancer imaging company, and before that I led the development of a genomics-based technology platform at Millennium Pharmaceuticals. ImmuRx has just leased space in the Dartmouth Regional Technology Center. We are now trying to use a combination of agonists — molecules that bind to receptors to improve their function — in a metastatic melanoma vaccine that stimulates two receptors of the immune system at once to advance a kind of pincer move on cancer cells. While ImmuRx is working on fighting melanoma, applications could be broad, with potential to target cancer stem cells, bacterial or viral infections, and HIV/AIDS viruses.
—Dave DeLucia ’80

I am president and owner of the Atlas Group. We’re implementing a health care CIO dashboard and associated information technology [IT] process improvements in order to prepare IT infrastructure for electronic records, advanced diagnostics, etc. Our target market is small to medium organizations.
—Mark Tuttle ’80 Th’82

I have done venture capital investing in health care for the last 22 years — most of it at Morgan Stanley Ventures and now at Saints Capital. Twice I have teamed up with John Pavlidis Th’89 to build medical products companies. John was CEO and I was primary investor and chairman of R2 Technology, which makes products that significantly improve the detection of breast cancer from mammograms. Together we built the company and sold it to Hologic. We have teamed up again on a company named Estech, which makes products for minimally invasive cardiac surgery.
—Scott Halsted ’81 Th’82

I work within the facilities and real estate division of New York-Presbyterian. My primary focus is capital planning for facilities infrastructure, including campus utility distribution systems, central plants, and building systems and structures. We are in the middle of developing an eight- to 10-year infrastructure capital reinvestment program that could total as much as $600 million. I’m back in the world of facilities engineering, despite my background as an architect and project management consultant. During the past 15 months with the hospital, I have drawn heavily on my problem-solving and engineering training to quickly learn a new scale of equipment and planning.
—Glenn A. Grube ’82 Th’83

As a professor of materials science and engineering at Johns Hopkins University, part of my research involves characterizing the mechanical properties of biomaterials. While we have focused on human enamel during the last decade, we are expanding our studies to include other biomaterials such as cartilage.
—Tim Weihs ’83 Th’85

Bob Mighell ’85 Th’86 refurbishes used operating room equipment.
Bob Mighell ’85 Th’86 refurbishes used operating room equipment.

For the last 15 years I have owned a company, World Medical Equipment, that refurbishes operating room equipment such as surgical tables, lights, and sterilizers. We shipped equipment to 42 states last year. I did my B.E. thesis under John Collier, designing instrumentation to put in artificial hips.
—Bob Mighell ’85 Th’86

I am on the board of directors of KidsCareEverywhere, which is focused on improving the delivery of pediatric medical care in developing countries. Our current primary project is delivering pediatric emergency medical diagnostic software to developing countries (Vietnam and Cambodia at the present time). We place this advanced software application — which contains a complete set of diagnostic and treatment data and procedures that are all peer reviewed by global experts — in the hands of local clinics in underserved areas. This application of modern technology to understaffed areas significantly improves the quality of care and the knowledge and effectiveness of the local staff. My role involves actively helping with technology distribution models. My day job focuses on clean-tech companies and venture capital.
—Eric Miller Th’85

After 12 years in the medical device industry and eight years in high tech, I have gone into business with a partner to form IMC Services, providing Internet marketing services to small- and mid-sized scientific instrumentation and medical technology companies.
—Carrie Fraser ’86 Th’87

I am currently associate professor and residency program director in the department of emergency medicine at Louisiana State University Health Sciences Center in Shreveport. I am the person responsible for training medical school graduates in three years to be emergency physicians who are able to practice anywhere on their own. I currently have 21 residents (seven per year). I developed our program from scratch in 2003 when I originally came to Shreveport from a faculty position at the Medical College of Wisconsin. The education that I received in analyzing systems while at Thayer has helped me tremendously in understanding physiology, which I use every day while seeing patients in our emergency department. Also, faculty that I met at the Thayer School provided role models for me that I referred to when I became an educator. I particularly remember the teaching styles of Professors Horst Richter and Lee Lynd as being the most inspirational.
—Thomas K. Swoboda ’88 Th’88, M.D.

I work for Boston Scientific in the cardiac rhythm management area (implantable defibrillators, pacemakers, and cardiac resynchronization devices). I am the VP of business strategy, responsible for decisions regarding new product and new technology investments in our portfolio. Medical devices are a highly regulated space. Given the lead time in development, testing, and regulatory review, the quality of these up-front investment decisions are critical. I weigh the potential patient benefit (symptoms, mortality), resulting market size and potential adoption, and overall benefit to the health-care system against several risks (clinical, competitive, etc.) and a finite investment pool. Thayer prepared me well for this role, as success is based on an appreciation and understanding of technical development across multiple disciplines and an understanding of economic modeling, decision analysis, and portfolio management that I began to develop in the Thayer M.E.M. program (and later supplemented with an M.B.A).
—Peter Sommerness ’90 Th’91

In 2002, I founded Endless Loop Software in Gainesville, Florida with my husband Peter Schoaff (Cornell ’90). With a B.E. and an M.E.M. from Thayer, I wanted to bring ideas and innovations from academia to the marketplace. Medical and public health-related software projects have been a great opportunity to contribute leadership based on our broad engineering, computer science, and business background. One of our earliest projects involved working with faculty at the University of Florida on a Web-based clinical research platform. That application was eventually licensed to Clinipace and is now known as Tempo. From its initial start-up phase, we worked closely with Clinipace, applying our extensive experience in taking ideas from concept to production-scale commercial quality systems. Clinipace is now a successful digital clinical research organization that focuses on improving the management of clinical research in order to save money and time while empowering project stakeholders to make informed, data-driven decisions. Recently Endless Loop Software has begun exploring opportunities to assist international non-profit organizations with the management, evaluation, and assessment of public health initiatives. Increasing innovation and improving efficiency of health care in low-resource areas is our shared goal.
—Christine Baldanzi Schoaff ’90 Th’92

I started a company recently, ODOS (which comes from the Latin abbreviation for “right eye, left eye”) Industries Inc., and am working to develop and market electronic medical records for the eye-care industry. I’m also a practicing eye surgeon.
—Kevin Cranmer ’92, M.D.

Since founding Acumen in August 2002, we have received FDA clearance on three products, published a number of scientific papers, and established a strategic relationship with Medtronic, one of the largest distributors of medical devices in the world. I am the inventor of the Insight endocardial visualization catheter, and was involved in early-stage IP development and bench-top prototyping. I am the contributing inventor of the Spirit and C315 lead delivery catheters. As founder, president, and CEO of Acumen, I raised $12 million and managed the company from product concept through development, regulatory clearance, and finally product distribution.
—Nick Mourlas ’92 Th’93

I have found my way from engineering into public health. After I left Thayer I went down to Boston to work in a biotech firm in toxicology. During the evenings I finished an M.P.H. in epidemiology and biostatistics at Boston University. I left the biotech firm and started a full-time doctoral program in occupational epidemiology at the Harvard School of Public Health and graduated with a Sc.D. in 2000. I am now a principal owner of Colden Corp., an environmental health, industrial hygiene, and safety firm. As an occupational epidemiologist I help my clients figure out why people get sick at work. We work in heavy industry and institutional settings such as educational facilities and hospitals, as well as network television and major motion picture sets. I get to see how things are made and produced every day (food, television shows, power, glass, movies, paper, pharmaceuticals). It is the perfect combination of engineering analyses and medicine — I identify the hazards in a process or environment and the methods to mitigate or engineer out the hazard and understand what health effects are possible.
—Shannon R. Magari Th’94

I’m an anesthesiologist at Dartmouth-Hitchcock Medical Center. I have participated in some medical device development and currently am one of four people on a patent for an ultrasound probe holder to facilitate the placement of regional anesthetics. I also use my fluid dynamics training every day when I am caring for cardiac patients in the utilization of transesophageal echocardiography and pressure transducers for intraoperative assessment and management. Yet, what I still love the most is taking care of patients. What I use every day that I learned through Thayer is the analytical framework of approaching a problem and the process of constructing a solution. This is where my engineering experience has not only been very useful to me, but, most importantly, it has benefited my patients.
—Brian Spence ’95 Th’96, M.D.

The Minneapolis-based company I work for, Sophrona, offers online patient communication software to ophthalmology practices nationwide. I handle the strategic and operational management and the development of Sophrona’s Sage Portal, a customizable, secure, online communication portal for patients.
—Marc-Francois Bradley ’96

CLEAR RESULTS: Andrés Dandler ’97 Th’98 heads a design team that developed the hand-held acne gadget Claro.  Image courtesy of
CLEAR RESULTS: Andrés Dandler ’97 Th’98 heads a design team that developed the hand-held acne gadget Claro. Image courtesy of Andrés Dandler.

After designing consumer telescopes for five years, I became a senior designer at a medical device company. I came to appreciate the high-level design and quality work ethic that goes into designing medical devices. After being employed there for five years, I was inspired to provide more value to my former employer and other clients by forming my own niche design team, Dandler Design, which specializes in designing medical devices. My background is in mechanical design, and my firm can handle projects from start to finish: concept definition, industrial design (the artistic “vision” for the product), mechanical engineering, management of vendor relationships, and production start-up, both in the United States and abroad. Right now we’re involved in developing a hand-held acne gadget, Claro; an ultrasound device; and a complex automated external defibrillator. Each of these is in a different stage of development. I manage about 10 engineers, most of whom work for me remotely. I really enjoy the minimalist infrastructure of running a company from my iPod touch, laptop, and cellphone!
—Andrés Dandler ’97 Th’98

I currently work as a program manager at HeartWare Inc., which makes left ventricular assist devices. My role is to manage all activities required to get the devices from a concept stage through clinical trials, and, ultimately, to commercialization worldwide.
—Heather Harries Th’97

After completing my Ph.D. in biological engineering at MIT and a postdoctoral fellowship in a cardiology lab, I am now an assistant professor and associate biophysicist at Harvard Medical School/Brigham and Women’s Hospital, while also teaching a biomechanics class at MIT. My research focuses on studying the effect of mutations that cause muscular dystrophies on the mechanical properties of biological cell (e.g. muscle cells) and how these changes can contribute to the disease. In particular, we are studying how mutations in nuclear envelope proteins, such as lamin, can render cells more sensitive to mechanical stress and affect their mechanotransduction signaling. Insights gained from this work can lead to a better understanding of the molecular mechanism underlying laminopathies, a diverse group of diseases including Emery-Dreifuss muscular dystrophy, Hutchinson-Gilford progeria syndrome, and familial partial lipodystrophy. To achieve these goals, we are developing novel experimental techniques to study nuclear mechanical properties in intact cells and isolated nuclei, investigate the physical coupling between the nucleus and the cytoskeleton, and examine how changes in these properties can affect the cellular response to mechanical stimulation.
—Jan Lammerding Th’97

I am a postdoc at UC Berkeley, using engineering approaches to study HIV biology. I recently accepted a job as assistant professor of biomedical engineering at Yale, where I will establish my own lab to pursue related research on host-virus interactions. Biological systems are characterized by complex networks of chemical and physical processes about which we have incomplete information. Engineering approaches — including quantitative experimental measurements, model-driven analysis, and rational approximations — are particularly well suited to advancing our understanding and control over biological network function. My research applies engineering principles to understand how viruses, particularly HIV, rewire chemical networks that control host cell communication leading to viral pathogenesis. A better understanding of how viruses alter cell communication might allow us to identify novel anti-viral targets and design more effective treatment strategies.
—Kathryn Miller-Jensen ’97 Th’98

I am an associate professor in the biomedical engineering department at Vanderbilt University. I do research on the elastic properties of soft tissue in murine systems concerned with breast cancer and tibia fracture healing. I also do work in image-guided surgery of the brain, liver, and kidney, and I work in the imaging field of elastography. I am a co-founder of a company that sells an FDA-approved image-guided liver surgery system — the only one of its kind.
—Michael I. Miga Th’99, Ph.D.

SURGICAL AID: Working for Cardica, Nate White ’99 engineers instruments for heart bypass surgeries.  Image courtesy of Nate White.
SURGICAL AID: Working for Cardica, Nate White ’99 engineers instruments for heart bypass surgeries. Image courtesy of Nate White.

I have been involved with medical device engineering for the last eight years. The company I work for, Cardica, designs and develops products for facilitating open-chest and closed-chest (totally endoscopic) bypass surgery anastomoses. Our products are incredibly cool and complex mechanical systems.
—Nate White ’99

I worked for three years at Stryker Orthopaedics. I worked on acetabular implants while in-house and then specialized in prototype instrumentation as a consultant. I have since quit and am in my third year of medical school at the Mayo Clinic. I will probably make it back to engineering someday. Bill Shields ’03 Th’04 still works at Stryker as an engineer, and Nick LaVigna ’00 Th’02 is in the field as a technical sales rep after designing Stryker’s hip navigation system from the engineering standpoint.
—Brian Graner ’01 Th’02

I work at Myriad Genetics as a process engineer. Patients with a family history of breast or colon cancer consult with the doctors about genetic factors that can contribute to their risk of contracting those types of cancer. Their blood is drawn and sent to us. We analyze the blood for mutations in specific genes that are known to have a profound impact on a patient’s likelihood of getting cancer. To handle the large volume of samples, we employ robotics and automation in an assembly line to assemble the reactions. As a process engineer, I ensure that our assembly line is running efficiently.
—Ben Miller ’01 Th’03

OPERATING ROOM: Derek R. Jenkins ’02 DMS’06, M.D. (right) performs a posterior spinal fusion. His research focuses in part on clinical outcomes of surgical techniques in orthopedic surgery.  Photograph courtesy of Derek R. Jenkins, M.D.
OPERATING ROOM: Derek R. Jenkins ’02 DMS’06, M.D. (right) performs a posterior spinal fusion. His research focuses in part on clinical outcomes of surgical techniques in orthopedic surgery. Photograph courtesy of Derek R. Jenkins, M.D.

I work in a field combining engineering and medicine. I am about to start my third post-graduate year of study in orthopedic surgery at Lenox Hill Hospital in Manhattan. With a degree in engineering sciences and biology from the College and an M.D. from Dartmouth Medical School, I feel well prepared for a career as an orthopedic surgeon. My research interests focus on the biologic response to wear particle debris from total joint replacements, and clinical outcomes of surgical techniques in orthopedic surgery.
—Derek R. Jenkins ’02 DMS’06, M.D.

I develop vaccines as an associate director of product development at Emergent Biosolutions in Maryland.
—Katya Kovalskaia Th’02

MAP QUEST: Erin Morse '02 Th'03 is engineering software for surgical navigation systems, such as this one (which can also be seen in the sick bay of the new Star Trek movie.)
MAP QUEST: Erin Morse '02 Th'03 is engineering software for surgical navigation systems, such as this one (which can also be seen in the sick bay of the new Star Trek movie.)

I am a software engineer, specializing in hardware interfaces, for Medtronic Navigation in Colorado, engineering software for surgical navigation systems. The systems are used by surgeons in the operating room to help navigate instruments through the body. It’s kind of like GPS for brain surgery! My last project was to modify our system so it can be used in conjunction with surgical microscopes.
—Erin Morse ’02 Th’03

For the past three-plus years I have worked on many different medical devices through conception, design, and production — including transcutaneous skin vaccinations, a drug delivery device for weekly in-home injection, and a non-invasive temperature measurement device.
—Brian Mason ’03 Th’04, ’05

I work as a manufacturing engineer for Pall Corp., which manufactures a wide range of filters and filtration systems, including water filters, air filters, and biopharmaceutical filters. All kinds of vaccines and drugs are made using our products. I currently support production of our blood filter media. In addition to daily troubleshooting on the shop floor, I focus on continuous improvement projects, using lean and six sigma tools. (I was certified by Dartmouth Six Sigma.) We have used the lean concept of visual factory, in particular, to facilitate flow and increase productivity and throughput.
—Julie Matteini ’03 Th’05

SMOOTH MOVE: Bill Shields ’03 Th’04 is working on improvements to Stryker’s Trident Ceramic-on-Ceramic hip system, a titanium-and-ceramic press-fit hip system designed for young, active patients.  Image courtesy of Bill Shields.
SMOOTH MOVE: Bill Shields ’03 Th’04 is working on improvements to Stryker’s Trident Ceramic-on-Ceramic hip system, a titanium-and-ceramic press-fit hip system designed for young, active patients. Image courtesy of Bill Shields.

I work as a product development engineer for Stryker Orthopaedics. I design and develop new implants and instruments for total hip replacement surgeries. I spend most of my time working with orthopedic surgeons to develop new products and with our manufacturing engineers to figure out how to make them. Once we have a validated manufacturing process, I develop and perform tests that ensure the product’s function and strength. This testing is then submitted to the FDA or other regulatory agencies to obtain product approval. Working with orthopedic surgeons has been one of the most enjoyable aspects of my job, due to the highly collaborative environment. I have had the pleasure of collaborating with some of the country’s most innovative surgeons, which has resulted in some very exciting and beneficial products. There is nothing more rewarding than watching a surgeon I have worked with for a number of years use a new product we invented to help a patient.
—Bill Shields ’03 Th’04

Patrick McCarthy ’04 helped create 3-D models and a life-sized mock-up of Anshen + Allen's
Patrick McCarthy ’04 helped create 3-D models and a life-sized mock-up of Anshen + Allen's "Green Patient Room."

I’m a project coordinator at Anshen + Allen, an architectural firm in Boston that designs healthcare, academic, and research buildings. One of our showcase projects is the Green Patient Room, a healing environment that uses green materials and technologies, connects the indoors with the outdoors, and deinstitutionalizes the healthcare environment. I helped create 3-D models and a life-sized mock-up of the room that travels to different cities and trade shows to demonstrate what’s possible. Within the Green Patient Room, there is a menu of solutions and options that hospitals can customize to their particular settings. At Dartmouth, I majored in engineering and studio art. While working at Anshen + Allen, I have become LEED certified and I am currently in the process of becoming a certified architect.
—Patrick McCarthy ’04

I’m working on my Ph.D. in chemical engineering at Stanford. We try to produce proteins at high yield using an in-vitro system. We work with proteins that are difficult to produce in living cells due to improper folding, cell toxicity, etc. I have been working on lymphoma vaccines and novel cancer diagnostics. I have been trying to optimize our in-vitro (or cell-free) system to maximize yields of certain protein targets. The real-world applications are in patient-specific cancer vaccines (specifically for B-cell lymphoma) and for stem cells. For stem cells, the proteins we have tried to produce could help reprogram fibroblast cells (skin cells) into stem cells, which could circumvent the need to destroy an embryo in order to generate stem cells. The biggest challenges have been learning to develop my own projects and experiments without having specific protocols or mentors to follow. As with most things, critical thinking and persistence have probably helped the most.
—John Welsh ’04 Th’05

I’m working on my Ph.D. in biomedical engineering with a focus on tissue engineering. My thesis is on uncovering some key players in embryonic development and applying that knowledge to create steroid-producing tissue through several means: by directed differentiation of embryonic stem cells and induced pluripotent stem (iPS) cells, reprogramming of ES and iPS cells, and transdifferentiation of terminally differentiated cells. The goal of the project is to set the foundation for a cell-based therapy for individuals with steroid insufficiency resulting from either congenital defects or cancer. The research I did at Thayer really set a strong foundation of problem-solving skills, applying unique approaches, and examining a problem from a variety of angles. I hope to use my Ph.D. as a foundation for a career in academics.
—Jaime Mazilu ’05 Th’06

I am the information security manager for Dartmouth-Hitchcock Medical Center. My responsibility is to make sure the organization is compliant with the HIPAA security rule by building an information security program that attempts to identify all of the IT security risks to the organization and recommend and oversee the implementation of measures to mitigate those risks. Information security is a complex and rapidly changing field; hospitals are highly regulated complex organizations. When you combine the two domains, it can quickly be overwhelming. To someone outside the field, you may not be aware just how many automated processes are handling much of the work inside a hospital. For example, when you visit your doctor and get your blood drawn, the sample is placed into a machine that performs millions of tests and automatically routes the results back into your electronic medical record. Tracking available beds, dispensing medications, generating laboratory results, and conducting radiology exams are just some of the myriad processes that are automated within a hospital. Protecting those computer systems requires full-time staff who are dedicated to the effort. The trend toward greater inter-operability and communication between hospitals will greatly aid the provision of health care but can also introduce vulnerabilities. If properly mitigated, the risk is worth the reward.
—Doug Madory Th’06

I am a management consultant with L.E.K. Consulting, and I recently worked on a growth strategy for a leading medical devices company, outlining strategies for becoming a global leader in its blood collection systems division.
—Mayank Agrawal Th’08

Kevin Olds ’07 developed a prototype automated therapeutic hypothermia machine, used to control an animal’s body temperature (such as this rat’s) while studying how hypothermia can be applied to the treatment of cardiac arrest.
Kevin Olds ’07 developed a prototype automated therapeutic hypothermia machine, used to control an animal’s body temperature (such as this rat’s) while studying how hypothermia can be applied to the treatment of cardiac arrest.

I am doing my Ph.D. in biomedical engineering at the Johns Hopkins School of Medicine, though I am still a rotation student and haven’t started thesis work yet. As part of a class project and in conjunction with one of the research groups in the B.M.E. department, we just finished a prototype automated therapeutic hypothermia machine for use in animal experiments. The lab is studying how therapeutic hypothermia can be applied to the treatment of cardiac arrest. At Thayer I worked primarily on projects involving robotics and electronics. I became interested in biomedical engineering largely because I was thinking about the future; the main fields robotics is used in are military, industry, consumer products, and medicine. I chose to go into medical robotics since this seemed like a noble cause and an area with a huge potential for expansion.
—Kevin Olds ’07 Th’08

Engineer at Work: The Life of a Medical Physicist

If you’re lucky, you’ll go through your whole life without encountering a medical physicist. If you’re a cancer patient, you might come across one but not realize it. Few people know that medical physicists play a crucial part in the design and accurate delivery of radiation therapy.

Christina Skourou Th'06. Photograph courtesy of Christina Skourou.
Christina Skourou Th'06. Photograph courtesy of Christina Skourou.

One procedure I handle is the intravenous delivery of glass microspheres containing Ytrium-90, used to treat liver cancer. The microspheres are infused into the liver via a catheter inserted into the femoral artery through a small incision in the leg and guided to the hepatic artery by fluoroscopy. I spend mornings in the “hot lab,” where the exact dose for the patient is calculated and measured. In the operating room, I set up the delivery device and, with the assistance of a physician, ensure delivery of the total dose. I use a Geiger-Müller device or scintillator to monitor the delivery of radiation and survey areas and personnel that may have come into contact with the radioelements. Afterward I collect all contaminated material and return it to the hot lab for proper disposal.

I also manage the delivery of high-energy photons or electrons for external beam therapy. About 100 patients are treated daily at DHMC on one of four linear accelerators. One procedure that uses these accelerators is stereotactic radiosurgery (SRS), in which high doses of radiation are precisely deposited in the brain via carefully oriented external beams. SRS is given to eradicate brain tumors. Working with a radiation oncologist and neurosurgeon, the medical physicist is responsible for localizing the target, designing the plan to treat the lesion and miss normal structures, and delivering the treatment. The day of treatment, a light aluminum alloy frame is fixed to the patient’s skull with plastic pins. This frame is visible in the imaging equipment and is used to give an exact set of coordinates for the target. Aided by specialized software, the physicist uses the image set and advanced algorithms to plan delivery of the desired dose to the patient’s lesion by manipulating beam orientation, intensity, and size. A long series of tests and dry runs ensures that the radiation will be produced and delivered as planned. When the patient is finally brought in for the procedure, all the checks are repeated with the patient in position. Only then is radiation delivered.

Whether or not patients are aware of us, we medical physicists are there: checking, verifying, double-checking, measuring, adjusting, and improving every step of the treatment — and proud to be engineers.

—Christina Skourou Th’06, Department of Radiation Oncology, Dartmouth-Hitchcock Medical Center

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