The History of Ultrasound

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Dr. Arthur Fougner: "Hi, I'm Art Fougner an obstetrician-gynecologist in New York whose practice now is limited to ultrasound."

Dr. Eric Blackwell: "And I'm Eric Blackwell. I'm one of the Co-Chairs of the History of Ultrasound project for OBGYN.net along with Joan Baker and with a lot of help from our advisor, Terry DuBose."

Dr. Arthur Fougner: "I'd like to ask you, Eric, how did you get started on this History of Ultrasound project?"

Dr. Eric Blackwell: "I was there for part of it - you do notice the grey in this beard here. I started training back in the mid-seventies and ventured into ultrasound; I was the first ultrasound 'fellow' out of the Bowman Gray School of Medicine. I've done nothing but ultrasound since the beginning which makes me a very odd bird in the field so I've known a lot of people including some of the true pioneers like Joe Holmes and those people just in passing. I got to thinking about the stuff I have, I have slides and material that I thought I'd like to put it together, and Terry DuBose gave me the opportunity to get some of that on the web. I've put up some things already; pictures from the early days and people that I couldn't identify, for example, and already by e-mail have gotten wonderful feedback. It's an opportunity to do what Terry calls 'poly-biography' - which means history by the many of the many events where's there's no end to how much input and linkage, and the Internet's just the perfect tool for the job so that's kind of how I got in the back door."

Dr. Arthur Fougner: "I first came across ultrasound also back in the seventies, interestingly enough, at Bellevue. We had one of those old Siemens Vidoson, you know the big Tyrannosaurus rex attached to a gel bag, and we called that real-time back then. I knew the folks at NYU and they'd carry around their Aeroflex B-scan transducers in their pockets, just screw them right on, move the gantry back and forth, and at the end kind of like a little swoosh as the signature."

Dr. Eric Blackwell: "Did you know Dr. Fred Winsberg at all?"

Dr. Arthur Fougner: "No, Dr. Winsberg I didn't know."

Dr. Eric Blackwell: "He was a wonderful teacher and a real pioneer but he used to carry his own transducer for cardiac work wherever he went. He'd go into somebody else's lab and he'd pull out his transducer and screw it in and get to work because he'd finally found the one with the perfect characteristics."

Dr. Arthur Fougner: "It looks like ultrasound has sure come a long way from looking for a shift of the midline echo on neuro patients."

Dr. Eric Blackwell: "Did you ever do that?"

Dr. Arthur Fougner: "Actually, in medical school on rounds we used to look at these pictures and say - oh, the line is slightly deviated to one side."

Dr. Eric Blackwell: "That's what I started doing. I was a neurology resident and my mentor, Dr. Bill McKinney was a neurologist and he's the one that started the Center for Ultrasound at Bowman Gray so I started out doing midline echo before we had CT. We literally had one piece of equipment and it was kept in a broom closet. You'd go open the broom closet, haul it out, go down to the ER at two in the morning, and try to figure out if there was a midline shift. Then the next step was we got a wonderful piece of equipment from Merrill Spencer and Jack Reid for looking at carotid and that's what actually got me into the field, and it's just continued to grow and grow since then. And the things we've looked at around here just in the last few days, the little Terason unit that plugs into a personal computer and the new unit that Kretz has for Medison that's the size of a large textbook, things just keep improving and changing and there's more choices out there for us to use."

Dr. Arthur Fougner: "I'm convinced that what we're going to end up doing certainly in OB is instead of handing patients a little picture of their baby, we're going to hand them a little computer disk, they're going to put it into their DVD player, and on their coffee table will be a little dancing hologram from Ally McBeal."

Dr. Eric Blackwell: "Absolutely, it's inevitable. I think the technology is there; it's probably going to happen. I have to ask more specifically how did you get into the ultrasound end of things because apparently you were keeping an eye on it from the early days?"

Dr. Arthur Fougner: "I got into it when I was a young attending just out of residency at Albert Einstein. I'd remembered actually how much fun I had playing with the first ADR unit that they brought onto the labor floor at Bellevue to demonstrate. I just simply started getting my hands on it every chance I got and went down to the ultrasound lab in the radiology department. Actually, I pushed for the hospital to get one up to OB and started doing it and that's how I got it pretty much like most people. There was no certification or formal training program, you just went in and started doing it and went to the hard knocks school."

Dr. Eric Blackwell: "One thing that always really interested me about the field was in the early days you really could come in to it from any background. There was a lady named Henrietta Givens at Bowman Gray, and Henrietta was our patient transporter. She started kind of looking at what was going on when she'd bring these people down to the lab and then asked if she could watch. Then she asked if she could be in the training program and then she became Head of the Cardiac Ultrasound Unit."

Dr. Arthur Fougner: "Excellent."

Dr. Eric Blackwell: "She died there last June, it was a sad loss to us. But it was really a wide-open thing where all you had to have was the enthusiasm and some support from a mentor of some kind. Were there any people that really stand out in your memory as people you looked to for advice or mentoring in ultrasound - your pioneers?"

Dr. Arthur Fougner: "Actually the person I respected the most was a fellow by the name of Oberlander who is now at Saint Lukes Roosevelt. He has nothing to do with ultrasound interestingly enough but this guy was the most experienced obstetrician I ever met in my life. He is an Israeli and he went to South Africa and worked for years in the black hospital in Johannesburg and then came to the Bronx. He was scared to death but he sat through the OB-GYN boards anyway, passed, and now is a big name in diabetes and pregnancy. This guy said - you should get involved with this, you should do this, and so that was my mentor basically."

Dr. Eric Blackwell: "And I take it you've not regretted it?"

Dr. Arthur Fougner: "I've not regretted it a single bit. Thanks a lot, that was fun."

Dr. Eric Blackwell: "Yes, good to meet you."