I am having an ultrasound done on my heart. It’s September. My father-in-law has walked my daughter off to school so that I can make my early morning appointment. I am lying shirtless on a cold table while a woman close to half my age smears a warm gel against my ribs, her eyes intent on her screen. I have been told that it is more routine than worrying—just due diligence, making sure.
An ultrasound probe is made up of a number of piezo electric crystals. These crystals expand when in contact with an electrical current and contract when that current is removed. If voltage is rapidly applied and removed, the crystals create ultrasound waves. These are sounds in frequencies that exceed 20,000 Hertz though the frequencies used in medical imaging are typically much higher, in a range from 2 to 20 million Hertz. The human ear is unable to distinguish ultrasound frequencies.
The rhythm of my heart stays the same as the tech moves the probe to different angles but the tones and the accents change. At one point I say that it sounds like a dj scratching a record. She laughs, says that she loves to know what different people hear in the machine tone. Everyone hears something different, that it is like an audio Rorschach test for her. “You must be really into music,” she says. I let out a little bit of air. I find myself wishing that I could have a recording of my own heartbeat, taken like this from so many different angles. A more full understanding of my own rhythm that I could remix in any way that I wanted.
When a piezo electric crystal is compressed, it creates a voltage. When ultrasound waves return after hitting an object, this sound compresses the crystal. This creates varying levels of voltage based on the intensity of the returning pulse. In this way, the same crystals that send this sound into our bodies can read the reply. A transmit and reply conversation happens instantly and repeatedly, a language that is translated with dizzying speeds by these crystals.
I am having an ultrasound done on my heart. She says “Take in a small breath. Now hold.” And she is clicking buttons, adjusting the transducer probe, listening, watching. It lasts long enough for the breath in my lungs to become stale, for the burning to start. “…And breathe,” she says. I come back to myself, feel the paper crinkle under me as I shift.
Air disrupts ultrasound waves, reflects them rather than allowing them to penetrate the body. Liquid, though, is a friend to these waves and so a thick liquid between the probe and the skin is the best way to get a good reading of what lies beneath. Hence the jelly lathered heavily onto the skin.
There is a certain cold intimacy to medical procedures. When I first removed my shirt, the tech asked “Oh, do you have dogs?” and I wasn’t sure why she had asked. It was only later, watching her hand guide the probe over my skin as I clumsily held my breath that I realized she had been looking at the scars on my arms, that she had imagined a dog jumping up on to me as I came home and leaving these marks behind. It is a safe thing to imagine, a peaceful sort of lingering wound.
When an ultrasound wave enters the body, one of three things happen to it: Attenuation, refraction, or reflection. Reflection is the purest response, the language that is compressed and read within the crystals – the body giving up its secrets. Refraction occurs when the wave travels between tissues in the body of different densities. Some of the waves bounce in indirect ways and continue to travel in their new trajectory. In attenuation, the wave is absorbed or otherwise lost within the tissues of the inner body and never returns.
Some days I forget that I was a cutter.
I like that I forget it now sometimes. It isn’t something that I ever thought would have faded to the background. It isn’t something that I ever thought that I would be able to talk about like this, in a surprised sort of past tense. But as I removed my shirt and laid back onto the paper covered table, I forgot that my scars were there. I forgot their heavy, insistent stories. I forgot that old need.
I forgot at first, too, to feel embarrassed. When she asked me about dogs, I merely smiled and said a confused sort of no, not yet remembering enough to be ashamed.
The biggest desire in an ultrasound reading is good resolution. At its simplest in this case, resolution means the ability to see two things as two things, rather than them blurring together into one image. In general, high frequencies create shorter wavelengths which give better resolution. The problem is that high frequencies tend to not penetrate as far into the body. Often some kind of compromise is needed between resolution and depth and the frequency is decided on in accordance to that compromise.
I am having an ultrasound done on my heart and it is a terrifying sort of familiarity, this act. I am bared, lying on the table. She presses against my ribs, my sternum. Though it isn’t true at all, it feels like my life is in her hands. I am tense, embarrassed of my body as it comes into the full focus of its nudity in her presence. I trace these jagged lines on my wrists and biceps with my eyes. There’s a history here that is only half visible to her though I feel like it is all suddenly out in the open.
In the end, the ultrasound technician is not supposed to give you any kind of results. Though they have been reading these waves and their responses for years, they are to leave the deciphering to the doctor who has referred you to their lab. As I am putting my shirt back on, she says “I am not supposed to tell you anything, but if I were you I wouldn’t be too worried. I think that things are probably going to be okay.” It is an unexpected, unasked kindness and I thank her as I cover myself, as I once again erase everything that has come between us.
–This story owes a great debt to the website howequipmentworks.com which taught me a great deal about the inner workings of an ultrasound machine.
C.C. Russell has published his poetry and prose in such journals as The Colorado Review and Whiskey Island. He has been nominated for the Pushcart Prize and for Best of the Net and is included in Best Microfiction 2020. He lives in Wyoming with a couple of humans and several cats. You can find more of his work at ccrussell.net.