Damadian, Lauterbur, Mansfield, and a Prize With Two Names on It
A History of the MRI
They put the needle in between the vertebrae of his lower back and let the oil run in.
The oil is iodine in a poppy-seed base, heavier than spinal fluid, so it sinks, and the table is tilted to send it where the radiologist wants. On the film it is a white column running down the spine. Where the column narrows, something is pressing on the cord.
They try to get it back out through the same needle, and mostly they cannot.
What stayed behind sat against the membrane that wraps the cord and, in some people, set it inflaming. The membrane thickens. The nerve roots inside clump like wet rope and scar in place. The name is adhesive arachnoiditis and there is no undoing it. The pain runs down both legs and does not stop, and the man with a bad back at forty has a worse one at seventy.
Nobody knows how often; the figures in the literature were taken under different definitions across four decades. The one with a denominator behind it came from The Lancet in 1956: of 119 patients followed about three years, 43 still had symptoms. Removal had been attempted in six of the 119. It was hard to get out, so it was left in.
Britain took Myodil off the market in 1987. In 1995 Glaxo settled with 426 plaintiffs for seven million pounds, about sixteen thousand each, admitting nothing.
That was how you looked at a spine.
Raymond Damadian was a physician at a Brooklyn medical school with a question about cancer. In June 1970 he put rat tissue in a magnet and found the signal from a tumour behaved differently from the signal from muscle. He published in Science in March 1971.
The paper is careful and it is small. Six normal tissues from the rat and two malignant tumours, whose relaxation times sat plainly outside the normal range. He read that as water in tumour tissue moving more freely. He also ran two benign specimens, and those looked like muscle, the obvious objection answered before anyone raised it. On two specimens.
The word in the paper is discriminating. Not a picture. A signal that differed, and a proposal to use it.
Eighteen months later Paul Lauterbur wrote in a notebook at Stony Brook that if you made the magnetic field deliberately uneven — strong at one end, weak at the other — a proton’s frequency would report its position. Position becomes pitch. Take enough views from enough angles and you can compute what is inside — the arithmetic the CT people were running on X-rays. He cited Damadian’s paper in the entry and had it witnessed. Nature rejected the manuscript. He appealed, revised, and it ran in 1973.
At Nottingham, Peter Mansfield solved the part nobody else was working on: time. His group learned to excite one chosen slice in 1974, and in 1977 published echo-planar imaging, which pulls a whole slice out of a single excitation. Minutes became a fraction of a second. In 1976 they had already made the first picture of live human anatomy: a cross-section of the finger of Andrew Maudsley, his graduate student.
Damadian built a machine. He and his students wound the magnet by hand and called it Indomitable.
It ran at five hundredths of a tesla. He climbed into the receiver coil himself first and nothing came back; he was too heavy for it. Larry Minkoff, who was thinner, sat down inside instead.
On 3 July 1977 they took 106 readings from his chest over most of five hours and drew the result in coloured pencil before the computer had it. Damadian’s notebook says FANTASTIC SUCCESS.
Then it went the way these things go. His company in 1978, the first sale in 1980, American approval in 1984, Medicare paying from 1985. By 1990 the United States had more than two thousand machines, running sixty-six hours a week.
No radiation. That promise was kept and has never been broken.
The bill came from somewhere else. The machine resolves what is there, and most of what is there is ordinary damage that was never going to announce itself. Scan two thousand people who feel well and about seven in a hundred have had a small stroke they never noticed. Scan the knees of the middle-aged and you find torn meniscus everywhere — and of those carrying a tear, sixty-one per cent had felt no pain, no aching and no stiffness in the previous month. A Norwegian register study of 48,212 knee scans found between fifty-eight and eighty-five per cent had no relevant examination or diagnosis in the six months either side.
Its own societies have said so for twenty years. When the American colleges ran a campaign against low-value back imaging, the measured effect two and a half years on was a four per cent reduction.
So the answer looks obvious, and this is where it stops being obvious.
Where scanning is rationed to hold the cost down, the waiting becomes the illness. The Canadian median for an MRI in 2024 was sixteen weeks; on Prince Edward Island, a year. In England this past January, 369,273 people were on the list, a quarter of them past six weeks. Cauda equina syndrome is the bundle of nerves at the base of the cord being compressed, and it gives you hours — the British standard is a scan within four. One hospital audited its own emergency scans and met that standard three times in ten; in one investigated case the wait was four days. The health service paid sixty-eight million pounds over two years on cauda equina claims, about eight hundred and ten thousand where the diagnosis came late. That is what a bladder is worth in a courtroom.
Most of the world is not in this argument at all. Rich countries average twenty-seven machines per million people. Among low-income countries the median is seven-hundredths of one. Of thirty-five African countries reporting, eleven reported none. Of every modality medicine has invented, MRI is where the gap runs widest.
The prize came in 2003, to Lauterbur and Mansfield. Damadian’s name was absent. The rules permit three; the committee named two, so nothing forced the choice. His company bought full-page advertisements under an upside-down Nobel medal — The Shameful Wrong That Must Be Righted — with a coupon at the bottom to mail in.
I have read the 1971 paper. It does not describe a picture, and the patent he was granted in 1974 claims detection, not reconstruction. Lauterbur solved a problem Damadian had not addressed. And Lauterbur said in 1986 that it was Damadian’s paper that first turned medicine’s head toward magnetic resonance at all. Both are true, neither cancels the other, and I do not think the record settles which one the prize was for.
Then, three months after the ceremony, The Lancet observed that using field gradients to locate a signal in space had been done by Robert Gabillard and by Herman Carr in 1952, and never acknowledged by Lauterbur. The man accused of taking another’s credit stood accused of taking another’s credit.
The committee’s reasoning is sealed until 2053. Damadian outlived both laureates and died in 2022 with the question exactly where it had been.
What endures is a picture of the inside of a living person made out of water and a magnet, with nothing left behind. No oil sits in anybody’s spine for fifty years. The argument now is only who gets one, how soon, and whether they needed it.
It cannot be undone, and most of us would not undo it. That is the bargain medicine made.
The next machines would not be content to look. They would go in — through an opening the width of a pencil — and the first patients would pay for the surgeons’ education.
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Charles C. Jett is an author, civic educator, and Professional Certified Coach based in Chicago. A graduate of the U.S. Naval Academy (Class of 1964) and Harvard Business School, he served during the Cold War aboard the nuclear submarine USS Ray (SSN 653), where his tactical innovations helped inspire Tom Clancy’s Jack Ryan character. He is the author of six books, including Super Nuke!, hosts four podcasts, and writes across his Critical Skills Blog platform on history, leadership, and the health of the American republic. In his writing he employs AI tools in a limited, supporting role for research, occasional image creation, and editing, while the prose and judgment remain entirely his own. He and his wife, Dr. Nancy Church, live and co-host the Chicago Salons at Water Tower Residences.
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