Why POCUS?

Sweet sixteen – on reflection a defining age in more ways than one. I vividly recall my grade 10 science teacher taking me aside, counseling me to not pursue anything to do with physics. Apparently I ‘didn’t have the right thinking patterns’. As with most things that have defined my career over the following 35 years, this proved to be a red rag moment.

Six years later I was a science graduate – MRT, applied physics (with distinction). The world must have adjusted to my thinking patterns. Radiography was fun – the people, the patients – but ultrasound caught my attention. It presented challenges: I didn’t understand the pictures; patient interaction; skill development. I wanted to be part of that.

Diving in the deep end; university again, combined with a clinical placement apprenticeship style – some would call this a baptism of fire. I’d never worked harder in my life – the rhythm of the hospital, study, sleep – and loved it.

Studies finished and a comfortable city job awaited – but the challenge of rural Australia appealed. Tropical North Queensland allowed me to grow personally and professionally, granting me the space and independence to explore boundaries. The stories from that time – many amusing, some haunting – define me to this day.

New Zealand then beckoned – developing a love for obstetrics there again setting me on a new path. Corporate opportunities emerged and a passion for teaching sparked. Then senior management in Melbourne, with the non-clinical challenges that this presents.

But teaching was where my heart took me. I’d been a gym coach in a past life and loved the buzz of seeing students achieve what they’d previously thought impossible. I struck out solo.

Initially, it was sonographers, but a fateful day in 2006 changed everything. A senior ED physician wanted to learn to scan – a novelty as the term POCUS had yet to enter the lexicon. For months he’d fought for training time and eventually gained agreement. Although working a locum, I was nominated to assist – we were set to start. But bureaucracy intervened, firmly ending the plan within the first half-hour.

The physician was livid, I was baffled. What would he do? Where would he go to get trained? Having been told there was no place for ultrasound in the ED it was grade 10 all over again.

And so my passion for POCUS education was born. Nowhere in Australia could professionals outside traditional radiography could get focused training in bedside ultrasound – as it was called then. Ultrasound Training Solutions was born – first working out of a utility trailer, later in a ‘proper’ facility. As technology got better and clinical applications grew so too did the demand for training. The world had adjusted…again.

While the idea sounds simple and logical, there were critics. Many critics. At conferences I’d be accosted. “Why would a physician need to learn ultrasound?” “Only sonographers and radiologists were competent at imaging – anyone else was a cowboy”. “Training physicians isn’t safe – it’s dangerous.”

But my rebuttal is sharp – I owe my life to POCUS.

I was six weeks pregnant – at a meeting in Sydney – things seemed to be progressing fine. Until I collapsed. An overwhelming pain, followed by sleepiness and a warm comforting darkness. I remember the paramedic trying desperately to keep me awake. In and out of consciousness. It was a FAST scan performed in the ED that got me to theatre. More than anything, it’s this that continues to drive my passion for making sure everyone has the opportunity to learn ultrasound.

So why do I believe in POCUS?

POCUS is what medicine should be about. It puts the power of diagnosis in the hands of the people making life and death decisions. It allows patients to see what is happening to them, generating a conversation, knowledge, and trust. It brings together professionals from all disciplines from all around the world. It utilizes the best in technology to make medicine better.

Plus it really does prove that you shouldn’t always listen to grade 10 teachers.