A CT-guided needle biopsy at Papworth hospital

Stepping into the Royal Papworth Hospital is like entering a modern cathedral to science. It is a vast circular complex of five stories dedicated to cardiothoracic medicine and surgery, equipped with the latest technological advances in nuclear medicine and imaging, and was only opened two years ago by the queen when it was given its royal status. They start dealing with day cases every half hour starting at 07:00 and my appointment time with the high priestess of CT-guided needle biopsies was at 08:00, so I had to be on the ward early and starved, so Edwin called round at 06:15 to take me in.

Because of Covid (isn't everything now), there was a guard on the door admitting only patients with an appointment letter, so no visitors or family to accompany we who were assembling. The vast entrance hall and inquiry desk are covered by a glass dome with corridors angled off, but all strangely silent and deserted, as only a small trickle of patients drifting through. In the day unit I stripped quickly to don a backless hospital gown and the priestess came through to explain the ritual and what I might experience like some initiation ceremony, driven by pain to drive the demons out. I was first on the list, but could hear through the thin curtain screens what torments awaited the other supplicants for better health. One, a bronchoscopy, for possible lung cancer; another, a stent for blocked arteries; a third was due a lung transplant. Papworth serves the whole UK as a specialist hospital, and the transplant woman had been driven up from Luton by her mother, who was forced to wait in the carpark for news before she could go home.

The procedure itself was simple, from my viewpoint. I had to lie prone for nearly an hour, one hand above my head the other by my side to rotate my shoulders slightly and lift a rib clear for the passage of the needle. I then had to lie absolutely still as the long needle was inserted between the ribs to reach the lesion, somewhere deep within the lower lobe. They repeatedly drove the bed with me on it into the heart of the huge doughnut-shaped scanner, then pulled me back calling out mysterious numbers to move the needle about as they probed to find the centre of this unwanted addition to my body. Then a series of loud clicks as the needle closed in the cells. Finally it was over, the needle withdrawn, a large pad pressed and taped against the wound, and I was wheeled back to the ward to lie still for another hour recovering, before I was allowed to sit quietly in the chair. It was all relatively painless.

Later, I was given a sandwich and cup of welcome tea, before being taken for a check X-ray which showed a small pneumothorax, where air had leaked through the puncture wound in the lung and tracked up to sit as a bubble above the lung. A repeat X-ray an hour later showed this bubble had grown, so they wouldn't let me go early until a final X-ray late afternoon suggested it had stabilised, and Edwin could come and fetch me. The specialist said she had obtained good specimens, but the results from the micropathology would not be available until next week, when the team would discuss them and my management. I think I can feel the partially collapsed lung pulling in my chest, but perhaps knowing it is there fires the imagination. Now it is no more than uncomfortable, but I have been told to avoid violent coughing, strenuous exercise, sexual intercourse and lifting for a few days. At least part of that injunction is easy to do.