AUDIOTAPED INTERVIEW OF VERNON FICKEN, Ph.D.
January 27, 2005

MS. BIRDLENE LAVALOIS: I've been chosen to interview Dr. Vernon Ficken. It's January 27th, a beautiful day. We are in Dr. Ficken's home.

Dr. Ficken, how did you first become involved with the Southwestern Chapter?

DR. FICKEN: I was a technologist in the mid to late '60s working at the University of Oklahoma. My supervisor, Larry Wilke, and the Department of Radiology encouraged technologist participation in Chapter meetings. 

One of the early meetings I went to was in New Orleans. My wife and I went by train. I spoke with a prominent physician about rectilinear liver scanning. Being involved in the Southwestern Chapter was a wonderful experience that grew on me. 

MS. LAVALOIS: So when did you become president of the Technologist Section? 

DR. FICKEN: I became president in 1973 when the Southwestern Chapter began its formal organization of the Technologist Section. The Southwestern Chapter had a technologist section operating a little before the National Chapter. 

MS. LAVALOIS: What are some of the highlights that you've seen over the years? 

DR. FICKEN: I'm very proud that I was a nuclear medicine technologist many years before I became a physicist. I am also proud of having the opportunity to work with my colleagues to form the Southwestern Chapter technologists section. I had a lot of help from wonderful people like Theda Driscoll, Bill Lobby, Al Garza who worked at M.D. Anderson. A lot of good things came from organizing the Technologist Section.  Focusing on topics that dealt with training technologists was important to me. 

As I grew in the field, I became a member of the Board of Trustees for about six or seven years. Then I became Treasurer. Following that, I was elected President in 1990. Being involved in the Chapter, serving as an elected officer, and volunteering or giving a paper now and then gave the opportunity to meet wonderful people and exchange ideas about issues relevant to the Chapter. That’s what makes it so strong.

In terms of what happened during my presidency, there were tough times and good times. One of the tough times was when the Treasurer resigned. We were fortunate enough to have Richard Campeau help and step in as Treasurer. Also during that time, we got the state of New Mexico as part of our Chapter; the members there of course wanted it. Grabbing a whole state is a rare event as far as the National SNM goes. 

Also important to mention is the passing of Dr. Winfield Evans, the physicist at St. Anthony Hospital, whom I knew very well. During the process of his passing and my presidency, we established the Winfield Evans Memorial Lecture which is now called the Winfield Evans Lecture. 

MS. LAVALOIS: What do you see as some of the disappointments? 

DR. FICKEN: One has to do with a meeting held in Oklahoma City when I was President or President-Elect at the time. We had a good turnout but had problems with finances. The Chapter wound up losing money that year. It was a good meeting but we lost money, and I’ve always hated that. 

MS. LAVALOIS: Who was the most memorable person you came in contact with? 

DR. FICKEN: There are so many wonderful hard working people in the Chapter, but I think it would have to be Dr. Thomas Haynie. What a wonderful leader—nice to work with and skilled in managing people and organizations.  His knowledge of medicine and nuclear medicine is terrific. In terms of leadership, I bet most people look up to him today as the Chapter leader. 

MS. LAVALOIS: Dr. Ficken, how long were you a nuclear medicine technologist before becoming a physicist? 

DR. FICKEN: It's interesting to try and divide that line. I started in nuclear medicine technology in 1963. I received my first master's degree in 1970 but did not give up my registry in nuclear medicine technology. I think it was well into my second master's degree before I had the nerve to say, “Well, I'm not going to be a registered nuclear technologist anymore.”

But I remained the Technical Director of Nuclear Medicine at the University of Oklahoma Health Science Center until my retirement in 1992. I got a Ph.D. in 1984. So somewhere between 1973 and 1984, I made the transition. I’ve always missed being a technologist because of the gratification I got from taking care of patients and knowing that I did the best job I could on every case. The science and technology of nuclear medicine is always interesting.

MS. LAVALOIS: Yes. Yes, it is. 

DR. FICKEN: So maybe I'm still a nuclear medicine technologist. 

MS. LAVALOIS: I think you are because you feel the same as I do. And what do you feel about mandating continuing education?

DR. FICKEN: As a physicist, I have to have continuing education in order to keep a license. Because of their important role, I don't think any less should be required of nuclear medicine technologists. Physicians, scientists and technologists should all participate in continuing education.

One of the problems is that it's costly for technologists to pay for travel, hotel, meals and then have an expensive registration fee to get continuing education credits. I know the Chapter has tried to maintain a substantially lower price for technologists. The truth is that there are many more technologists attending Southwestern Chapter meetings than physicians and scientists. It makes sense that if there are many more technologists attending than physicians and scientists, there certainly ought to be a break for the technologist participants in the meetings. I know this philosophy will continue indefinitely, and I think it's necessary. 

Some days you feel like you're doing the same thing. You're trying to get the best study and without continuing education, you'll never know if there’s a better way to do the study that you've been doing every day. And you know, it doesn't have to be the high-tech answer. It's the little things like how you stand by the patient, what position you use to inject the patient or how to immobilize the patient. All those little things that somebody else has spent time thinking about that you haven't quite figured out yourself. There's the answer. 

MS. LAVALOIS: And it could make your study better. 

DR. FICKEN: Yes, and your life easier. 

MS. LAVALOIS: One example is giving ice water to clear the liver. There are still people that don't know that tip because they haven't attended some of the meetings, but it works. What do you consider unique and special about the Southwestern Chapter? 

DR. FICKEN: It's people working together and having a free exchange of ideas and information. That may be its biggest strength. Of course there is the political aspect.  If regulatory or reimbursement issues became seriously adverse to the practice of nuclear medicine, I think you would see the Chapter say, “Hey, we're not going to do it that way. We're going to protest this. We're going to get this changed.” We’ve done such things successfully in the past and that's a very important part of what the Chapter can do for its members. 

MS. LAVALOIS: What do you see as the direction of nuclear medicine? There have been doomsayers in the past, but obviously it's still around because I've been here for 12 years. 

DR. FICKEN: Going back to the mid '70s, for example, CT became important in the diagnosis of certain neurological problems—particularly in a patient's brain. In the fall of 1976, at the University of Oklahoma, we were doing about 20 nuclear brain scans a day. When CT started, we dropped off to two or three scans a day. We thought the world had come to an end and that there wouldn't be nuclear medicine. That was pretty nearsighted on our part because all of medicine is subject to change.

And, thank goodness, it was change for the better. CT is much better for imaging the head than what we were doing. 

It has been a continuous evolution for nuclear medicine. Nuclear cardiology came along not too long after we lost brain scans and just overwhelmed the practice of nuclear medicine as a whole. Now we have PET scanning which has become very important and seems to be increasing just as rapidly. 

I'm certain there will be changes and improvements in what we do in nuclear medicine. Some tests will go by the wayside and new ones will come along. 

Tracer elements on molecules is a concept that is not going away. I think we're going to have it forever. 

MS. LAVALOIS: When you were a nuclear medicine technologist, did you ever foresee nuclear medicine becoming mobile? 

DR. FICKEN: I had a long time to think about it before we had our first mobile camera which was about 1979 at the University of Oklahoma. We certainly weren't the first ones to have such a device. What prompted it at our facility was nuclear cardiology. Although the doctors wanted it for that purpose, we were figuring out other things we could do with mobile nuclear medicine. At that time, it was just like the main nuclear medicine department going to the patient’s bedside. 

We probably had brain death studies and nuclear cardiology as the primary procedures. We also did lung scans. Personally, I hated brain death studies more than anything else because I don't think I ever saw a brain death study on an old person. It was always on a young person and every time you saw one, you came away with this bad feeling and the question, “Why did that have to happen to that person?”

Over time it became obviously necessary to deliver mobile nuclear cardiology and mobile nuclear medicine to areas where it was not practical to have a full-size nuclear medicine department. It became a need. I bet there's not a single community in Oklahoma that doesn't have access to nuclear cardiology that once had a hospital or significant clinic. I think they're all covered. 

MS. LAVALOIS: What about upright imaging? 

DR. FICKEN: I remember a talk by Ralph Blumhardt, another wonderful leader in nuclear medicine, on SPECT scans of the patient in a chair. I got the impression he didn't think it was going to go very far. Of course, today we are doing a great deal of nuclear cardiology scans in the chair. I think that what Dr. Blumhardt had available to work with was different from the equipment we have today which is quite improved. I haven’t talked to Dr. Blumhardt about this but I bet he has a different view today.