Even if we're not professional photographers, most of us at some point have fancied getting paid full-time to take photos. Weddings? Sports? Fine art? Press? Commercial? How about a medical photographer?
The route to becoming a pro is multifaceted. For many, it might have started after being asked to shoot a friend's wedding and then garnering a few gigs. That can lead into family and portraiture. For others, they get a job assisting a pro and then set up their own business in the same genre. One route to becoming a pro was as a press photographer (for example, Thomas O'Halloran); however, they are rapidly becoming a rare breed as newspapers cut back. Perhaps less well covered are some of the other niche areas, including medical photography. In order to find out more, I caught up with Mark Bartley, who is the clinical photography team leader in the Photography Department at Addenbrooke's Hospital, UK.
Addenbrooke's Hospital, located in Cambridge, sits on a large site to the south of the city where it acts as both a research and teaching hospital, as well as servicing the East of England region for general and specialist care. It has nearly 800,000 outpatient visits a year, well over 100,000 accident and emergency attendances, and over 5,000 births. Those figures are breathtaking in themselves, and not surprisingly, it takes nearly 10,000 staff to run the place. It's worth reminding ourselves that hospitals are amazing places. Most of us are born in one, many of us end our lifelong journeys there, and they are witness to the ordinary and not so ordinary trials and tribulations of our health.
So, what do hospitals need photographers for? And what is medical photography? Perhaps not surprisingly, the remit of the photography department meets a broad range of needs and so every day can be different. Mark explains:
[Clinical Photography] is centered around documenting a particular medical condition for either a record of how it looks so its progress can be tracked over time or for teaching material to train students
As the gallery below illustrates, the human body is remarkable for its complexity, and it's therefore not surprising that things go wrong. It also goes without saying that we tend to visit hospitals when we've got a problem. In these cases, it's important to track the progress of a condition in a patient in order to aid their treatment. Equally, the teaching hospital is concerned with documenting known conditions to aid the training of future doctors. Perhaps unwittingly then, clinical photography mirrors much of other areas of photography in that it is drawn to the unusual. The images are particularly eye-catching, because they help reveal the unknown, offering explanation. To put it more simply, clinical photographers can photograph any part of the body, inside or out, but the work often relates to those areas that are easy to look at, such as skin conditions or plastic surgery.
As Mark says: "it could be something as straightforward as photographing a mole to make sure it doesn't change or as interesting as being involved in documenting groundbreaking operations or studies to help find new cures for conditions."
Mark began his career as an accountant, but having literally seen the light, he subsequently studied for a degree in Photography, Video, and Digital Imaging at the University of Sunderland. By his own admission, he ruled out freelancing early on because of the job stability or rather, the lack of job stability!
"My plan was to get a job either at a hospital, with the police, or a newspaper/press organization. After a year looking for work, I was taken on as a trainee medical photographer at the Cardiff & Vale NHS Trust, where they put me through an MSc in Medical Illustration."
Of course, like any career, your really want to find your calling and enjoy the work you do. It may be because you like the creativeness of producing complex Photoshop imaginings, the frenzied semi-chaos of a wedding, or the buzz of being in a war zone. As Mark explains:
When I discovered medical photography existed, I did think it would be a pretty cool way to use my skills in a positive, helpful way, either by helping patients get a diagnosis or treatment or helping student doctors to learn from my images. I still find that aspect of it the most rewarding part
In addition to the patient work, the department also has a PR section for anything newsworthy, including famous people visiting, charity promotions, staff portraits or promotional materials, with an increasing amount of video production. Further specialist areas include work in the pathology laboratory photographing specimens (organs or parts of organs) and the ophthalmic section acquiring images inside of eyes. One particular area they work in is 3D facial imaging, specifically for patients with cleft lips and palates. As Mark says:
We tend to see these patients from day one of their lives right the [way] through to their early 20s as they require a lot of surgery whilst they grow and the 3D imagery provides consultants a way to track their progress through childhood
So, what sort of kit do they use? For the clinical work, they have several Nikon D800s with the Nikkor macro 105mm and 60mm lenses. For PR, there is a Canon 5D Mark II, including a couple of standard lighting studios. The ophthalmic section have some modified Nikon D90s, one for ultraviolet capture and another with a dermoscope.
Working in such a remarkable place, I asked Mark what was the most interesting aspect of the job:
[It's] working in operating theaters, having the chance to see top-class surgeons effectively putting broken humans back together again. [It] never ceases to amaze me — their ability and calmness under the extreme pressure of holding someone's life in their fingertips astounds me.
Often in photography, our work in producing an image is making the ordinary extraordinary. We take something that can be mundane or banal and through our creative envisioning, turn it into something new, unique, and interesting. However, Mark finds himself working in reverse, where the extraordinary becomes ordinary, the miraculous becomes everyday. As consumers of medical imagery, it's possible, with the proliferation of medical TV shows that we have become saturated with what is remarkable. It is therefore important to remind ourselves, as Mark says, that these are real people dealing with life and death every day.
So, what does the future hold? It's worth noting that the photography department sits outside of other medical techniques such as PET, radiography, or MRI, focusing on visual imaging. Mark reckons that as the cost of technology falls, thermal and 3D techniques may become more prominent. Video production has seen a steady increase in use, but it's a drive to cut costs that could see a dramatic increase as videoconferencing is deployed for virtual clinics, something that's already happening.
As ever, I finished the interview by asking Mark what his biggest stuff-up has been. When he was training, a student doctor brought him a microscope slide to photograph. The student was concerned as it was the only sample she had. "Can I bring it down when you have the time to photograph it and do all the handling of it?" As any skilled and conscientious photographer would, Mark replied:
Look, honestly, you don't need to worry, we handle these things all the time. We're always careful. I'm not going to break it, seriously. Leave it with me and I'll call you when you can pick it and the photo up.
It's not hard to imagine what happened next:
So, as I was cleaning it with a blower brush ready to photograph it, of course I knocked it out of my fingers and it smashed on the floor. No slide, no photo, no PhD illustration. I was mortified.
The best learn from their mistakes, and Mark hasn't broken one since. More seriously, a job that's worth investing your life in — a career – has to be something you value. Working across a broad range of areas, medical photography is both interesting technically, but also has immense value to the other professionals who are caring for the patient and obviously, to the patient themselves. It's made me pause and think about where I am now and where I want to get to with my career. It pays to think about the extraordinary every so often. As Ferris Bueller said: "Life moves pretty fast. If you don’t stop and look around once in awhile, you could miss it."
All images courtesy of Mark Bartley.