Field Trip to Citi Neuro Hospital

Today, we went to Citi Neuro Hospital with everyone taking the Medical Image Analysis course. There were ten of us and we booked an SUV to the place. The air was super hot outside the campus, and the first thing I noticed about Hyderabad was how undulating the terrain was. Apart from small areas of the city, most of it is super uneven. The place we went to, Banjara Hills, is literally that, hilly. Some parts of the roads were like roller-coasters, steep and winding.

Banjara Hills as a residential area is pretty posh, and I definitely might have seen some A-list celebrity homes while I passed them. We went to the hospital and I took out my mask (haha). Everyone else had to buy masks. I wish I looked more closely at the patients (the hospital was CROWDED) because this wasn’t like a usual hospital, it was for neuro disorders, so I’m sure the patients would be remarkedly different. In general hospitals, people usually look pained, and in suffering. Anyways.

Dr. D. Ravi Varma who’s part of the board (and he probably owns the hospital) came out to receive us. The staff and the patients gave us a wide berth when they saw who we were with. He took us first to the X-ray room. It was kinda fancy, he showed us how the walls were super thick so that radiation wouldn’t leak outside, and then I saw that some walls had water seeping through them and I looked very suspiciously at that for a while. Because I was trying to think whether water would be affected by X-rays in any way. The X-ray machine was super sophisticated, it could move in two directions (say X-axis and Y-axis) and could rotate along one plane.

The room had provisions for a full body X-ray (where the patient has to lie down) and for a chest X-ray (where the patient has to stand, much like Roentgen’s wife in the original X-ray experiments). I didn’t really understand why the two are so different, even though he said something about magnification. The operator stands behind a lead frame? (the right word evades me at the moment) and the glass he sees through also has lead in it. There was a heavy (I tried it on, it is heavy) lead apron for pregnant women so that the foetus is not harmed.

Then we went to CT, the machine costs 1.2 crores, and they’re planning to replace it with a machine that costs 3 crores. CT was pretty uneventful, except that I saw a warning on the CT machine that warned technicians to not put their fingers in the machine. I mean, some idiot must have done that for the machine to come with that warning. Also, for angiography, they use iodine (which is super dense) in order to mark out blood flow. But the body only wants limited quantities of iodine, and injecting that much iodine is super bad. So they tie up iodine in a molecule called iodohex? me forgot :(

Then we went underground, which really puzzled me, because the hospital was like 5 stories high or something. Guess why? These MRI machines are so heavy, so heavy, that the roof would fall on your head if you placed it on standard slabs. Being a civil engineer, you could see how interested I was in all this. 6 tonnes, is how heavy the machine is. And the machine was a thing of beauty. Physics and engineering in perfect tango. We had to remove all metallic objects and we went inside. There were pictures of the beach inside in all directions to help claustrophobic patients. I asked how many claustrophobic patients he gets, and he said, VERY SURPRISINGLY TO ME, that almost all the patients he gets are claustrophobic.

We spent so much time with the MRI machine, Ingenia 3.0 Tesla by Philips. It has some 3 million miles of wire about 2 micron thick running with some huge current to generate the magnetic field. The current is sustained by ensuring superconductivity of the material, liquid Helium is sustained at 4K (-269 C) by using a heavy Carnot engine, that pumps so loudly that the room vibrates constantly (thud, chain click, thud, chain click). The patient is given a pair of pneumatic headphones (which are super awesome, they convert digital sound to pneumatic sound, and the inside of the wires have loads of cilia, which propagate the sound) so that they’re not affected by the magnet. I wish I asked if the patients could choose their own music.

I was fascinated by the warnings, and the backups, and the backups to the backups they had. One warning near the MRI machine showed a person being sucked into the machine because they got too close with their wheelchair, the drawing was hilarious. There were 3 separate buttons to turn off the magnet in case of such a situation. Apparently, turning of the magnet and turning it back on will cost, wait for it, drum roll, 2 crores. Self-explanatory no? THAT IS MORE THAN THE CT MACHINE.

Phew, once, they lost power supply to the machine because of some circuit breaker. An MCB, it didn’t break all the way and got stuck in the middle, and because of that, they didn’t get power from either the electricity board or their generator, and the machine turned off. Since then, they have installed a protocol where they have sensors that always tell them whether the board is giving them power or not. And if that protocol fails, the chief doctor (Ravi Varma in this case) has a direct line to the EB (electricity board) in charge with priority. All rather important stuff.

When I said underground, you should have thought of what I said earlier, that we were in Banjara Hills. The hospital has been built into a hill. Dug into rock, I wonder how stable the building really is. It has been 7 years, and I definitely did see some cracks in some corners. He then showed us how fast his computing machines were (they have state of the art GPUs to get instantaneous reconstructions in 3D, and in super high resolution), their data center, which gets filled by 1TB a year (that is unreal) because of all the high-quality images they store. That is that, I don’t think I’ve forgotten anything else. One funny thing that happened was one student asked him how long the generator runs, and he replied rather drily, “as long as we pour diesel into it”.

I found it cool, how well-versed he was with the physics, the engineering, the computation, the algorithms, and the logistics of his hospital. He’s a doctor, and he’s the first one I’ve seen that I would never guess was a doctor unless he told me.