Part 33: A Breath of Air

I had to quit my job drawing blood at National Health Labs once classes began at UMBC in the fall.  The only hours the lab was able to offer me were during the daytime, which conflicted with my classes. I still did several night and weekend shifts at Pharmakinetics, doing draws for drug studies, but I needed a full-time job.

Bill Brown, my paramedic friend from New Hampshire, told me of an opening they had where he works, at the pulmonary function lab at St. Agnes Hospital.

A part of the respiratory therapy department, the lab does pulmonary function testing and runs blood gas analyses, he explained. “You get to do arterial sticks,” Bill said. “That’s a lot of fun.”

I don’t know anything about pulmonary function testing, I said, and I’ve never done an arterial stick.

“Don’t worry about it,” Bill said. “The machine does everything. All you have to do is follow directions. And arterial sticks aren’t that difficult. You’ll get the hang of it.”

Before I knew it, I got the job and was officially a pulmonary function technician.

The trickiest part of the job was maintaining the instruments for testing arterial blood. There were two machines, one that measured oxygen and carbon dioxide, and one that measured the pH, or acidity/alkalinity, of arterial blood.

At the core of each machine were membrane disks covered with a delicate cellophane-like material. Accurate tests relied on the integrity of these membranes, which tore easily during testing and had to be replaced several times each shift. Every time the membrane was replaced, we’d have to run reference samples through – high, low and normal values – to make sure the machine is operating properly. There was no room for error; when a doctor orders a blood gas test, it’s usually a life-or-death situation.

It seemed that about half of the job was spent maintaining the instruments and documenting results.

I’d watched doctors do arterial sticks, but never did one myself. Drawing blood from an artery is quite different than sticking a vein. But I got the hang of it, sure enough.

And just as Bill said, doing pulmonary function testing was a snap. The test is all automated, done by a desk-sized Hewlett Packard machine with a long tube attached. The patient breathed through a disposable mouthpiece. Prompts on a screen instructed each step: breathe all the way in, hold it, exhale as forcefully as possible. Working the evenings and night shifts, I rarely did pulmonary function tests.

There were also expensive fiberoptic bronchoscopy instruments to play with, which let you peer around corners and snoop behind cabinets.

But the coolest toy was the pulmonary function machine itself. I don’t know how many others on the staff were aware of it, but the heart of the machine was an HP computer running a standard UNIX operating system. Pressing the Control and Break keys on the keyboard interrupted the pulmonary function program and allowed access to the UNIX prompt.

The pulmonary function machine could be used as a personal computer, using standard UNIX commands. I recalled a handful of things from high school, when I first used an IBM 360 connected via slow-speed modem at Cornell University.

On the pulmonary function machine, I could change directories and list files, write and run programs in BASIC, and discovered that the HP computer even had familiar UNIX games–Lunar Lander, 3-D Tic-Tac-Toe, and ELIZA.

I spent many nights, when not maintaining instruments or running arterial blood tests, hacking the pulmonary function machine and playing Lunar Lander.