My first day in radiotherapy physics: reflections of a medical physicist

NHSIn 2010 Karen Goldstone was awarded the MBE for her services to healthcare. Here she reflects on the primitive tools used for radiotherapy patient outlines back in the 1970s and remembers the wise advice she was given on her first day as a radiotherapy physicist.


I started work in the NHS as a Hospital Physicist in 1970. Prior to that I did the MSc in radiation Physics based at Middlesex Hospital. When doing a placement in nuclear medicine, computer tapes had to be taken to University College about a fifteen minute walk to the other side of Tottenham Court Road and fetched the next day hopefully having run successfully.

In my first post I expected to be doing mainly diagnostic radiology physics but discovered that that was rather a luxury field and so most of my time was spent doing radiotherapy physics. Those were the days when patient outlines were taken using a strip of lead or a flexicurve and planning was done using tracing paper and coloured pencils or biros. There was no computer planning of course and we only had one calculator with a paper roll print out so slide rules were in constant use. The main piece of advice I remember receiving on my first day was that if I discovered I had made a mistake I should own up to it straight away and not seek to cover it up – very wise words.

When not doing radiotherapy physics many hours were spent reading out film densities produced using our homemade “Ardran Cassette” in order to check kVp. This was the beginning of setting up a quality control programme for X-ray units. Another time-consuming activity was sealing lithium borate powder into plastic capsules in order to measure dose to radiologists, carrying out various procedures under fluoroscopic control, and subsequently reading the doses received.

Although diagnostic radiology physics was not seen as important it was an exciting time and I was fortunate enough to hear Godfrey Hounsfield give the 1972 MacRobert Award lecture on “Computerised Transverse Axial Tomography” – an invention that has revolutionised diagnostic imaging.

I started my second post in 1974 in a smaller department but with responsibilities in other, far-flung, hospitals. Here I was the radiotherapy physicist (the only one) and also covered diagnostic radiology and radiation protection, but because it was a smaller department and staff had to be versatile I also did some nuclear medicine and even once some ultrasound.

In the peripheral hospitals in my patch one was still using wet developing, one using just a fluorescent screen for fluoroscopic procedures and one an image intensifier viewed not via a camera but via a mirror arrangement.

How times have changed!

About Karen Goldstone MBE

I worked for forty years in the NHS, in radiotherapy physics, diagnostic X-ray physics and all aspects of radiation protection. In 1983 I set up the East Anglian Regional Radiation Protection Service (EARRPS) based at Addenbrooke’s Hospital in Cambridge, and ran it for almost 30 years. I was both a Radiation Protection Adviser and Laser Protection Adviser. I gave physics lectures to radiologists and was a physics examiner for FRCR both in the UK and Malaysia. With colleagues in EARRPS and Cambridge University I ran a number of Radiation Protection Supervisor courses and gave countless IRMER courses to reluctant clinical staff. I was exceedingly surprised to be awarded the MBE in 2010 for services to healthcare.

Since retiring I have taken up rowing and become a Level 2 rowing coach; I have given two courses on Radiation and Health to the University of the Third Age in Cambridge and am otherwise kept busy with my garden, allotment, grandchildren and church activities. I am still involved on one or two committees for medical physics and radiological protection.


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