Belgian radiologists speak of shock after terrorist attacks

2016 03 30 10 53 29 840 Belgium Triumphal Arch Lighter

A group of radiologists traveling to Munich on an industry visit have described their experiences when they got caught up in last week's bombings at Brussels Airport. None of them appear to have been seriously injured, but the impact was devastating, they said.

"I was not physically hurt, but the scratch on my soul will take a long time to heal," noted Dr. Rik Achten, professor and head of radiology at Ghent University Hospital in Belgium. "The chaos was complete ... it seemed endless. Pieces of ceiling came down with the suspension and glass, lots of glass ... This created a dense fog that smelt like gunpowder, and it contained a lot of material floating around. You could hardly see it."

The scratch on my soul will take a long time to heal, Dr. Rik Achten said. Images courtesy of the European Society of Radiology (ESR).The scratch on my soul will take a long time to heal, Dr. Rik Achten said. Images courtesy of the European Society of Radiology (ESR).

Achten, who is president elect of the European Society of MR in Medicine and Biology (ESMRMB), was having breakfast in the airport departure lounge when the two bombs exploded last Tuesday, and has provided a frank and detailed account of his experiences in an article in Dutch posted by on 24 March. He said he felt very dazed after the traumatic experience but was also deeply impressed by the work of the emergency services. Being a doctor, he could not walk away, he added.

According to another report in De Standaard newspaper, Achten -- who is a promoter of I-Brain, a local initiative to bring brain science to the general public -- helped look after severely injured victims, but also expressed frustration that he lacked the necessary equipment and emergency care expertise. He tried hard to remember the three basic rules he had learnt at medical school (ensure breathing, stop bleeding, and keep the heart going), and stayed with the injured until the emergency team arrived. He was then driven to safety and collected by his son, before returning to work on the same day.

Achten was one of several people heading to Munich to see an electronic medical record system as part of a trip organized by Agfa. Dr. Tom Mulkens, a radiologist from the Heilig Hartziekenhuis in Lier, was checking in at the airport when the first bomb exploded. The second bomb went off close by about 10 seconds later, and he was saved from potentially fatal injuries by the actions of a quick-thinking member of staff who pulled him behind the desk and held a suitcase over both their heads to protect them from debris.

Dr. Didier De Surgeloose, a radiologist from Ziekenhuis Netwerk Antwerpen (ZNA), a healthcare network in the Antwerp area, was also on the Agfa trip.

"I was very lucky to arrive early at the airport that morning, and had just passed the baggage control when the explosions occurred. It is a miracle that none of our group were seriously injured because the check-in was exactly in the part of the departure hall where it happened," he wrote in an email. "Normally I would have arrived at the airport by train but because I had the late shift at the MRI department the next day, I decided to take my car. And I was lucky not to bump into one of my colleagues at the airport, so I decided to move on."

One of his residents in radiology was also at the airport on that morning. He was part of a group of four friends departing on holiday and stood a few rows away from the first blast. He also returned safely with only minor hearing problems, according to De Surgeloose.

State of siege

"We are all in a state of utter shock," said Dr. Paul Parizel, president of the European Society of Radiology (ESR) and professor and chair of radiology at Antwerp University Hospital (UZA). "Belgium, our small country, is now in a state of siege, if not outright total war."

"It feels like we have woken up in a different country because a group of terrorists, many of whom grew up in our own country, do not adhere to the same liberal values that we have," Parizel told in an interview. He said he has drawn great comfort and reassurance from more than 50 messages of support received from colleagues from all over the world, including Brazil, Canada, China, Colombia, Kazakhstan, Russia, Singapore, South Africa, and the U.S.

Do the bombings make him feel more reluctant to travel?

"Absolutely they do," Parizel replied.

For practical reasons, due to the cancellation of flights to and from Brussels by several airline companies, he was forced to cancel his trip to the ESR offices in Vienna this Friday. Austrian Airlines contacted him with a proposal to re-route him via Liège Airport or Amsterdam International Airport, but the timings were not convenient. He thinks the recent terrorist attacks will force everybody to think more seriously about whether they really need to meet face-to-face when teleconferencing by means of services like GoToMeeting can be effective.

The medical services have coped remarkably well, Dr. Paul Parizel commented.The medical services have coped remarkably well, Dr. Paul Parizel commented.

"It is really scary, and it is food for thought," he noted. "A few days before the attacks, I was checking in for a flight to Athens in Brussels Airport next to the SN Brussels airline counter, exactly where one of the bombs exploded. On the previous Saturday, I had a meeting at the Royal Academy of Medicine of Belgium, and I drove through the street where the subway bombing incident happened. And just Monday evening, I was in Brussels for a meeting at the Ministry of Health, and I took the train and got out at Brussels South ('Midi') station."

Over the past week, staff at Antwerp University Hospital has treated 36 bomb victims, including a young man whose left leg was very badly injured by so-called "nail bombs" containing metal shrapnel and glass fragments. He was in the airport with his teachers and classmates from school, because the group was leaving for a study visit to Rome, a classic trip for high-school students around Easter time. Around 150 young people, around 17 years old, were in the airport when the bombs exploded, including the sons and daughters of three professors at Antwerp University, according to Parizel.

Another man was rushed from the CT scanner room to the operating theater for amputation of his foot, and more casualties came from the subway station attack, he continued. Many of the patients have suffered from tinnitus, and have had several treatment sessions involving cortisone injections and hyperbaric oxygen therapy.

"By and large, the medical services have coped remarkably well," Parizel said. "The triage system has worked, and patients were distributed quickly to between eight and 10 hospitals, including hospitals in Brussels, Leuven, Mechelen, and Antwerp, among others."

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