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Medical Photography

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Here’s a subtle way to slip in the fact that my day job is brain surgery. As in, I am not a photographer but really the neurosurgeon. But, beginning in high school, I was a photographer first! Medical teaching was often done with a Kodak Carousel slide projector. Hence, there was a need to get visual aid materials. I started medical photography with a Nikon film camera. I shot slide film with a very limited exposure latitude. Print film does not go into a projector. Sometimes we would be able to catch frames from the operating microscope via an adapter.

This was all before digital and fairly primitive. The lighting in the operating room is highly specular due to the operating spotlights and headlights. The general room lighting is incandescent mixed with fluorescent. It’s easy to overexpose or to have heavy shadows in the slide frame. It’s not much help to bring in flash but I experimented briefly with a ring flash. I lusted after the Nikon Medical macro lens with ring flash built-in. It cost around $2000 and was bulky and heavy. I never got around to getting it.

Digital has made it all so much easier. For a long time, I carried my heavy Nikon digital DSLR camera and got some fine operative shots. I just didn’t care to have the camera in the operating room where I might forget to take it home. Then, I got a Canon G11 last year. It has a macro setting, auto white balance, and is small and compact. This has made it easier. Even my OR nurses can shoot with it. I still shoot several frames at a time because one will always be out of focus.

As for capturing radiographic images, I use ‘Grab’ on the Mac. Most of the hospitals now use image systems loaded to the internet and screen saving is great. For x-ray film, I simply take a shot of the x-ray frame of interest. No names are allowed for privacy.

Oh, in this example, I show a patient with a brain tumor. Not wishing to be subtle, this patient has a very large meningioma, a benign tumor, which was removed in its entirety. The tumor literally took up one quarter of the brain space and grew in a very eloquent critical area of the left hemisphere.  Afterwards you can see the brain has collapsed. It’s a happy ending and the brain later expanded again. The patient has returned to his baseline neurological function.

The MRI scan shows the tumor in saggital, coronal, and axial planes. The images are reversed left and right per radiology protocol. The surgical images show the brain tumor, its removal and then the collapsed brain after removal.

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