Radiology History: Evolving Role of the Technologist, First Fifty Years

Published in Radiology Update - 2020

The word community has always been closely associated with the Radiology Department at Johns Hopkins and is perhaps most evident in the close relationship between radiologists and technical staff members.

The fundamental nature of this key relationship was established more than 100 years ago when W. Ross Mitchell became the first technical staff member in the division, hired by pioneering physician Frederick H. Baetjer, the head of the X-ray division at Johns Hopkins. William Halsted, professor of surgery had selected Baetjer to direct the X-ray division in the Department of Surgery. Since those days, the division became a department in 1946 and has grown into an organization of expert staff of radiologists, technologists, nurses, and support staff to bring essential, often life-saving imaging and therapy services to patients.

Mitchell had a background as a photographer and became adept at the myriad technical requirements of early use X-ray methods — mixing chemicals, developing glass plates and conditioning X-ray tubes.

“The first X-ray plate I developed was from a gastrointestinal series. When I put it in the tray of developer and started to gently rock it back and forth, I wondered what the doctors could make out of all those shadows which began to appear,” Mitchell recalled in a 1969 interview with Rosemary Longo, a 1965 graduate of the Johns Hopkins School of Radiologic Technology.

At the time, Mitchell was one of only three non-physicians in the division; the others were a secretary and an orderly. In the early years, nurses began to learn the skills that Mitchell had honed—how to operate the equipment effectively and safely, the intricacies of chemically processing X-ray plates initially, then film, and the fine art of patient positioning for imaging with safety.

In 1939, technologist training became more formalized with the launch of a distinct program by chief radiologist John Pierson. The division added new roles to support increasing exam volumes and needs for prompt image availability in the operating rooms. The role of technologists and other support staff was so fundamental to the smooth functioning of the department that renowned radiologist Russell Morgan, former chairman of the department (1946-1970) and then dean of the Johns Hopkins University School of Medicine (1970-1975), once described clerk/ darkroom technician Peggy Sutton as the most important person in the department. That expression of the importance of the team has only grown with the advent of new imaging and therapeutic applications in recent decades.