Image of Surgery - November 2011

The elapsed time that is recorded on the anesthesia record is measured in regular intervals by clocks and computers. In contrast to this recorded time is the elapsed time of the anesthetized patient which is subjective and may even appear to stop.  From birth onward we experience few gaps in consciousness and few interruptions in the memory of passing time. Even when we sleep there is an experience of elapsed time; one dream follows another into a more or less coherent night's sleep. Only under anesthesia is this continuity of consciousness broken and with it comes the cessation of the experience of elapsed time. The patient remembers the nurse who starts the intravenous and perhaps the physician or nurse who injects a small dose of drug into the IV. But after that there is nothingness until the patient awakens in the recovery room.
This is a picture of Simon Angeli, MD and Christine Dinh, MD using a surgical microscope to perform a lateral temporal bone dissection as part of a radical head and neck operation, a procedure which has many steps with multiple doctors and nurses contributing to its success. From beginning to end of the surgical procedure, the clock on the wall measured an elapsed time of 14 hours. The patient, however, experienced the passage of only a few moments. (2011)

Image of Surgery - October 2011

The digital media offer a plasticity never previously experienced by photographers. One can start with a photograph and transform its appearance into a sketch, a cartoon, a serigraph, an abstraction or even a painting on canvas.  The tools are relatively simple and the results are limited only by the imagination of the photographer.

These transformations break down the aesthetic barriers between figure and background, representation and abstraction, pixels and paint. They demand as much from the post-processing of the image as from the image acquisition by the camera and the arrangement of lighting. We greatly admire the portraiture of Rembrandt both for its technical virtuosity and its interpretative sensitivity. These same standards can be applied to our appreciation of digital portraiture.

The image shows neurosurgeon Louis Pagan, MD performing spine surgery. But added to the photograph is a textured vignette simulating a painting on canvas. Perhaps we have transformed a photograph into portraiture.  Or maybe the transformation is only a distraction and has degraded an otherwise iconic image of a surgeon at work?  You are the judge. (2011)

Image of Surgery - September 2011

There are several types of images of robotic surgery. One type shows a surgeon at a computer console watching a video monitor display of a body cavity while using his hands and feet like an organ virtuoso to control the devices. This image conveys a feeling of a virtual world populated with pixels and bits rather than a surgical world of bones and blood.  It suggests science fiction possibilities where we could walk through a device resembling an airport security scanner and emerge with our appendix removed from our abdomen or wrinkles removed from our face.

A second realm of images of robotic surgery focuses on the sleek and mysterious robotic machine pod. Several manipulators extend from a pedestal base, resembling the multiple serpentine arms of an Indian goddess or a broad shouldered cartoon transformer soldier ready to do battle.

Then there is the real image of robotic surgery which not only includes the aforementioned imagery but also the hours of preparation which necessarily precede the robotic cardiac surgery: the induction of anesthesia, the collapse of one lung, the insertion of monitoring devices and the careful and precise placement of retractors, video cameras and manipulators. We see in sketchy outline Drs de Cannière and Medina as they prepare a patient for robot assisted mitral valve replacement. (2011)