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The
mammalian vascular system is like a double exposed photograph of
a many branched tree. One exposure is the arteries and the other
is the veins. These vessels supply every tissue of the body with
the cells which carry oxygen, the cells which battle infections
and the cells which repair injury. Without a continual supply of
these cells, the tissues lose their vital entropy and undergo
decay. Until diabetes and atherosclerosis have responded to
treatments based on diet, exercise or pharmaceuticals, these
diseases will continue to afflict patients who require the
skills of vascular surgeons.
An x-ray of the diseased arteries of the ankle and foot divide
the images of vascular surgeon Ignacio Rua, MD and assistant
Hugo Corrales, MD, as they create a new conduit for the flow of
blood from the upper leg to the foot. (2006) |
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Dame
Barbara Hepworth (1903-1975), is more noted for her abstract
sculptures than her paintings. She battled carcinoma of the
larynx for several years prior to dying in a fire in her studio.
She created six images of surgery in her Fenestration series,
all minimalist images with swirling smoky muted shades
(sfumato) of blue and grey with a sense of place dramatized by gloved
hands and
focused eyes above surgical masks. In her
painting,
Fenestration, The Microscope (1948), she
coarsely renders in pencil and oil the forms, textures and
motions of the surgical team as they use a binocular microscope
to perform an operation on the middle ear for otosclerosis. My
image of an eye surgeon and a microscope pays homage to her
perceptions and paintings of the operating theater.
Ophthalmologist, Alejandro Espaillat, MD, peers through the
surgical microscope while Stephanie Sanchez, ORT prepares his
instruments for the replacement of a cataract with an
intraocular lens. The image is roughly sketched as with a
pencil. The eyes and hands are detailed in focus and the
background is washed with muted blues and grays.(2006) |
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In
difficult times we look for a leader with a clear and certain
vision of a better future. We look for an Abraham Lincoln, a
Winston Churchill, a Jesus, a Moses. We look for a
leader who is able to put aside the demons of fear and
uncertainty and guide us along the path to recovery.
Often, for the seriously ill patient, the surgeon fulfills this
role. Surgeons demonstrate self confidence but know the
limitations of their skills and live with the knowledge that
once their surgical journey begins, there may be no turning
back.
A wizen long haired man dressed in a white robe points his outstretched arm to the left
as demonic snakes rise from the depths and a patient sleeps,
awaiting the insertion of an implanted defibrillator. This
is the second image in the Orozco series which merges a scene
from a modern operating room with the dramatic Orozco murals
(1932-1934),
"An Epic of American Civilization," at
Dartmouth
College Baker Library. (2006) |
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As the
theatre lights dim and the drama unfolds, the natural and
supernatural merge. Into this new reality come images and
behaviors which are denied in our daily lives. A stranger
experiences a similar sense of altered reality when first
entering the operating theatre. And yet there are times when
even the most experienced surgeons, anesthesiologists and nurses
witness an astonishing sight they have never seen before. This large mass adjacent to the hands of the surgeons suggests a
strange life form from a foreign galaxy If the mass is not
supernatural, then at least it must be a deadly malignancy.
Quite the contrary. The tumor is a large benign renal cyst which
increased to this extreme size because doctors believed the
patient’s renal failure and severe heart disease precluded surgical
intervention. The patient finally found a surgical team at
Jackson Memorial
Hospital willing to attempt this long and complex
operation. (2004) |
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The
surgical pathologist is an unsung member of the surgical team.
Working without surgical cap or mask and lacking the theatrical
lights of the operating rooms, the surgical pathologist is
usually found in casual attire stooped over a microscope, a
glass slide or a bloody specimen. The size of the surgical
specimen is sometimes barely visible and at other times consists
of a significant portion of a body cavity. As the surgical
pathologist works, the surgeon waits for answers to critical
questions. Is the tumor malignant? Is the disease best treated
by other medical specialists? Has the tumor been completely
removed? Are there more tumors elsewhere?
The image shows surgical pathologist, William E. Smothermon, MD,
preparing to examine a pelvic leiomyosarcoma, the product of hours of
surgical exploration and resection. (2006) |
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Pictures
of surgery vary in style from primitive realism reminding us of
our corporeal mortality to images of modern technology offering
the promise of immortality. Jose Clemente Orozco (1883-1949),
the controversial Mexican muralist, believed that technology
does not solve social injustice, and he associated the
continued mechanization of society with a devaluation of human
life. His art portrays the political and economic reality of
these conflicts.
This image is based on the “Human Sacrifice” panel from “An Epic
of American Civilization” (1932-1934) mural at the Baker Library
at Dartmouth College. The image describes an Aztec priest removing the beating heart of a
human sacrifice. Superimposed are images of surgical lights and
a surgical procedure on the heart. At the speed of light these
images bridge centuries of cultural history and technological
progress.
This image first appeared in Dartmouth Medicine which may
be accessed through the Published Images page on this web site.
(2003) |
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To an outsider, a cardiac surgical
procedure appears to be a carefully choreographed dance. The
surgeon and the scrub nurse are continually on the stage
performing small movements of their arms and legs. The
circulating nurse traverses the corners, frequently going on
and off stage. With shiny containers and transparent tubes, the cardiopulmonary
bypass team is absent during the first and last acts but command
our attention as the middle act enfolds. The anesthesiologist is
very active during the first and last acts but remains still
during the majority of the performance, occasionally startling
into action responding to imperceptible cues.
The image is a glimpse at the first act of a coronary bypass
procedure with anesthesiologist, Julio E. Menendez, MD, watching
a video monitor as he positions an ultrasound probe in the
esophagus. The surgeons and the nurses seen in the background
are engaged in their part of the dance. (2005) |
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Viewers’ interpretation of this collage
range from the familiar to the exotic, from the comforting to
the frightening, from the sacred to the secular and from the
temporal to the eternal. Some viewers see this collage as an
allusion to a holiday wreath with a perimeter of green
surrounding the central red. Other viewers see the green
vegetation and the gloved hands of the surgeons as a biblical
allegory to the partaking of fruit from the tree of knowledge in
the Garden of Eden.
Just as the violin maker can not know all the melodies which
will flow from his musical instrument, the visual artist can not
know all the interpretations which will flow from his imagery.
This image of contrasting serenity, color and subject matter
leaves a great deal to the viewer’s imagination. (2004) |
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What appears as bizarre or ludicrous to an
adult may appear comical or cheerful to a child. Similarly, the
anatomy, physiology and pharmacology of a child differ from an
adult. Residents in anesthesia spend months learning how to
anesthetize adults before learning the skills to anesthetize
children. Residents may continue to develop this proficiency
during an optional year of fellowship.
A child undergoing anesthesia is a serious matter for the
parents and the surgical team. A playful costume at holiday time
contrasts with the seriousness of the scene as anesthesiologist,
Sarah P. Kafi, MD, completes the induction of general anesthesia
and positions the child for surgery. (2004) |
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The phrase “the man behind the mask” is
laden with meanings. These meanings range from a fabric mask
covering a physical deformity, as in the “Phantom of the Opera”,
to an emotional mask covering feelings of anger or insincerity.
But for the anesthesiologist the meanings of “the man behind the
mask” are less metaphorical. First, a surgical mask is worn by
the anesthesiologist to protect the patient from contagion.
Secondly, an anesthesia mask covers the nose and mouth of the
patient providing the interface between the patient’s airway and
the anesthesia breathing apparatus. The earliest anesthesia
apparatus consisted of a gauze anesthesia mask and a bottle of
ether or chloroform.
In this image we look through an anesthesia mask at the surgical
mask and eyes of anesthesiologist Francisco Izaguirre, MD as
he initiates the placement of the breathing tube into the
trachea. (2002) |
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Images of our modern world continually
intersect with images which evoke the primitive world. Flip
through the pages of a news magazine and see a picture of an
elemental particle traversing a cloud chamber adjacent to a
picture of strangely dressed men participating in a fraternity
hazing. View a photograph of a primitive village in which a bare
breasted native woman converses on a cellular phone.
Albert C. Barnes, M.D. (1872-1951), believing that aesthetic
traditions could bridge the modern and the primitive worlds,
mixed French Impressionist art with African art in “wall
ensembles” at the Barnes Foundation in Philadelphia,
Pennsylvania.
This haunting image shows otolaryngologist, Paul Kleidermacher,
MD, with his head light and optical loops set against the blue
sky of a high mountain lake. In a dream-like panorama, we can
imagine an angulated medical headdress morphing into a tribal
mask suspended above a landscape we once saw while on vacation.
(2004) |
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The
surgeon begins an abdominal procedure by placing a large
surgical retractor over the patient’s abdomen and anchoring it
to the side of the bed. Additional devices attach to the sides
of the retractor to push aside abdominal contents to maximize
the visual exposure of the organs and tissues. But even with
this stretching and pushing, the surgical disease may only be
identified and removed by using the tactile sensations of the
fingers. The hands of the surgeon become extensions of his eyes
traveling in the less accessible corners of the body beyond the
reach of light.
Like a found object in the artwork of Marcel Duchamp
(1887-1968), the Bookwalter Retractor, which normally exposes
the abdominal contents to surgical inspection, surrounds the
surgeon, Joe U. Levi, MD, as he removes part of the liver from a
patient with metastatic cancer. (2003) |
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Sir Isaac
Newton (1642-1727) noted that all objects are drawn toward the
center of the earth. The fruit from the trees, the water from
the mountains and the birds from the sky all fall to the earth
governed by the laws of gravity. Gravity also weighs on every
tissue and organ of our bodies. Plastic surgeons have responded
to a culture which values youthful appearances by providing
treatments to conceal the effect of gravity on wrinkled and
loose tissues. But some tissues
such as the breasts may in adolescence grow so large that their
heaviness causes discomfort to the spine that labors to hold them erect.
This image shows two plastic surgeons, Seth R. Thaller, MD and
Alberto S. Gallerani, MD, as they remove a large portion of
both breasts prior to recreating the contours of the breasts in a
smaller size and weight. (2003) |
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The story
of surgical care is told not only by bright lights, masked faces
and gloved hands. The story is also described by the hopes and
dreams of the patient. Will I be free of pain? Will I live
a long life? Will I be beautiful? Will I be loved?
In the foreground we see three faces of anesthesiologists,
Stephan A. Klumpp, MD, Stacy J. Bax, MD and Peter A. Chin, MD gazing at
the video monitor. The anesthesiologist in the center
manipulates the endoscope and guides a breathing tube into the
motionless child. Later, the surgeon will place a tube to drain
the excess fluid inside the brain into the abdomen.
This tense and medically complex foreground contrasts with the
serene background of a public park where a mother watches her
child descend a slide. (2004) |
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Operating rooms require a manager to
supervise the flow of surgical cases through the daily schedule.
Surgical procedures have uncertain durations; therefore, the
surgical schedule undergoes modification throughout the day.
Cancellations and emergencies require additional changes. The
reassignment of staff is constrained by their skill levels and
personalities. The manager coordinates these activities and
provides the
staff with bathroom, lunch and coffee relief.
An effective manager is perceived as supportive of the unique
needs of the various groups of physicians, nurses and staff
without favoring one group’s special interests over another. And
the manager certainly must strive to avoid conflict. The manager
needs to coax all the fish to swim in the same direction,
unbothered by cats lurking nearby.
The design of some suites of operating rooms includes a highly
visible, windowed administrative office which is affectionately
called “the fishbowl”. The image shows a glistening school of
herring in an aquarium as Janet L. Randolph, RN pensively
studies the yellow and red highlighted surgical schedule. (2002) |
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If cancer
had a face, what would it look like? Would it have a geometric
elegance like the spiral staircase of the translocation on the
DNA molecules? Would the face be framed by absent hair? Would
strands of hair be neatly combed or reach wildly beyond the
margins of canvas?
Would the tired lines of the face softly blend from one tone to
another or abruptly change with contrasting colors? Would the
reflections in the eyes be the colors of winter’s grays or
autumn’s browns?
Who would paint the portrait of cancer? What style would we
choose? Would we commission an expressionist like Vincent Van
Gogh, Edvard Munch or Francis Bacon? A cubist like Pablo
Picasso? A surrealist like Salvador Dali? Perhaps the portrait
of cancer transcends artistic style and remains to be painted.
(2004) |
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From the
perspective of the kidneys the body seems like a giant swimming
pool. The kidneys function like a pool maintenance man,
balancing the chemicals and acidity of the body fluids. When
both kidneys fail, toxic constituents of the blood rise to
levels which impair all the metabolic processes of the body;
particularly the ability of the brain to process information and
the ability of the muscles to do the brain’s bidding.
Renal dialysis removes the offending chemicals for a few days at
which time the treatment is repeated. Renal transplantation
offers the opportunity of a life without frequent dialysis by
replacing a diseased kidney with one from a live or recently
deceased donor. The mastery of this complex surgical and
immunologic treatment is one of the triumphs of modern medicine.
The image shows transplant surgeon, George W. Burke III, MD
and transplant fellow, Hector G. Illanes, MD, replacing a
diseased kidney. The harsh light of the surgical foreground
contrasts with the serene nighttime illumination of one of the
grandest swimming pools in the world, the pool at the Biltmore
Hotel in Coral Gables, Florida. (2004) |
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The
triptych is an art form popular during the Italian Renaissance.
By honoring the icons of the Catholic Church, displaying the
mysteries of the trinity and framing the altar, the three panel
composition became one of the highest forms of Renaissance art
surviving to modern times.
This triptych shows oncologic surgeon, Adrian Legaspi, MD, and
surgical assistant, Lara Mitchell, PAC, gazing down at the contents
of the upper abdomen framed by the reflections of surgical
retractors. The image of the abdomen is repeated in narrow
transformations on the gowns of the surgeon and his
assistant.
Humility acquired by age and experience
replaces the vanity gleaned during years of apprenticeships.
We gradually realize that the diseases of our patients will one day become
the diseases of ourselves and our loved ones. (2002) |
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Like an insect trapped in a ball of amber, the
surgeon appears frozen for
eternity in the light from the surgical lamp. Like an insect
attracted to these rays of light, the surgeon's eyes and hands pursue
the light as it explores the cavities of the body. At the
conclusion of the operation, when the dimming theatrical light
extinguishes our view of the leading actor, the surgeon, now
estranged from this heavenly light, returns to a life measured
by appointments and earthly chores.
Within the perimeter of the amber light, we see two views of
Beethoven Brown, MD as he performs an operation on the heart.
(2003) |
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Physicians use their senses and humanity as they search for the
diseases which burden their patients. Sight, sound, smell,
touch culture and language comprise the essentials of physical
diagnosis. But the disease may have a weak voice and remain
undiscovered using these skills.
Nevertheless, that which cannot be seen or cannot be felt does
not hide from the diagnostic techniques of x-ray, magnetic
resonance and ultrasound. The absorption and reflection of
invisible waves of radiation compel the body to reveal its
hidden burdens.
The light transmitted through the chest X-ray from the view box
illuminates the face of a woman. The X-ray and the woman
alternate between positive and negative as Anique M. Bryan, MD
studies the X-ray, seeking out the unseen. (2004) |
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Like the
clouds in the sky which we seldom pause to appreciate, the scrub
nurse is present during every operation and is essential to the
success of the surgery. Also known as surgical tech or
instrument nurse, a good scrub nurse knows every step of the
surgery and knows which instruments to give to the surgeon
without being asked.
No wonder that surgeons carefully train and cultivate the right
scrub nurse to assist them. By stripping away the walls of the
operating room except for the high windows to the scrub room, we
see a view of the world popularized by
Rene Magritte
(1898-1967), the Belgian surrealist painter. The serene clouds
in boundless blue sky contrast with the anxious and constrained
space of the operating theatre.
This image shows Teresa Santos, RN, sitting behind her
instruments. Her arms crossed as if in meditation, she waits for
the anesthesiologist to complete the first phase of the
operation. (2003) |
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Fragments
of memory, like reflections from the shards of a broken mirror,
appear before our eyes. We see disjointed faces, lights, and
colors. And yet we easily recognize the enfolding surgical
story. Does the mind record images like photographic film or
does the mind disassemble an image by a complex algorithm and
reassemble the image when needed for recall? In what way does
anesthesia impair this recording and playback of memory?
The image shows the fragments of otolaryngologist, Horacio P.
Groisman, MD and surgical assistant, Esperanza Gomez, MD, as
they remove a cancerous lesion from the side of the nose. (2002) |
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Some say the image resembles the mythical Minotaur,
part man and part beast. Others liken
the image to Ganesh , the Hindu elephant-headed god of
wisdom and learning. In both cases the body of the
ophthalmologist appears joined to a primordial head constructed
from the branching optics of the surgical microscope. As
the intense
light measured by candle power penetrates the fluids of the eye, the clouded lens
is replaced with a transparent piece of plastic. (2005) |
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Although
the surgeon gets the top billing, a great performance
requires a skillful supporting cast. The
circulating nurse circulates within the operating room and the
adjacent surgical supply areas, obtaining those items which are
required for the surgery but cannot be selected before the surgery
begins. While wheeling the patient to the operating room from the preoperative
area, the circulating nurse calms the patient's anxiety with
reassuring words. Once the patient has undergone anesthesia, the circulating nurse
prepares the surgical site by scrubbing the area with antiseptic
solution.
The picture shows circulating nurse, Lauren K. Schwan, RN,
scrubbing the left leg of a patient undergoing a below the knee
amputation. Enclosing a darkened foot, a transparent plastic bag
reveals the gangrenous area which needs to be removed to
preserve the life of the patient. The accompanying image shows
the leg after the diseased tissues have been removed but before
the skin is closed to form the stump which can accommodate a
prosthetic leg. (2002) |
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Since the
beginning of time, breathing has been acknowledged as an
essential attribute of human life. In Hebrew the word neshamah
has the dual meaning of breathing and soul. The ancient people
understood that when breathing stops, the soul departs the body.
The association of breathing with life impacts the practice of
anesthesiology. Nearly every drug that produces unconsciousness
impairs breathing. Furthermore, a separate class of drugs, the
muscle relaxants, produces the flaccid conditions required for
the surgical entry into the body cavities. The patient’s
breathing is taken away during the initiation of general
anesthesia and then returned at the end of the surgical
procedure.
Just as the auscultation of the heart sounds is a defining skill
of a cardiologist, intubation of the trachea is a defining skill
of an anesthesiologist. By placing a breathing tube through the
mouth, between the vocal cords and into the trachea, the
anesthesiologist transforms a human capable of breathing and
making sounds into a silent flaccid mass of vital organs. The
tension and physical effort of this procedure is captured in
this picture as anesthesiologist, Christopher J. Gallagher MD,
and resident, Ali M. Elamin, MD, intubate the trachea of a
patient about to undergo lung surgery. (2004) |
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Quilts
hold a special fascination for many doctors and nurses. The
basic skills of cutting and sewing are shared by the surgeon and
the quilt maker. Technology has replaced the hand sewn quilt with
a computer controlled machine sewn quilt and the hand sewn bowel anastomosis with a surgically stapled bowel anastomosis. But in
both cases the final placement of the intricate parts remains as
much an art as a skill. The replication of shapes and
recognition of colors rotated in two dimensions requires the
special perceptual skills of both the surgeon and the quilt maker.
As more surgical procedures are performed through endoscopes,
more of the surgeon’s three dimensional view of the inside of
the body appears like a two dimensional quilt.
This image shows a patchwork of yellow gloved hands of
orthopedic surgeon Walid Mananymneh, MD and surgical resident
Howard S. Richter, M.D. as they complete an above the knee
amputation. (2000) |
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Some
artists see our world with new eyes. Yet we readily understand
their unique and bizarre transformation of the visual
experience. One such artist was Vincent Van Gogh (1853-1890).
We immediately recognize his paintings of later years by their
vivid primary colors and untamed brush strokes. And even as Van
Gogh descended into lunacy, he rendered on canvas a vision of
the world which is highly valued.
Two Van Gogh paintings inspired this surgical image. The frontal
view of a man with a wide brimmed hat in
Portrait of Armand
Roulin (1888) is replaced by a surgeon wearing magnifying
lenses. The ghostly stars in
Starry Night Over The Rhone
(1888) are replaced by blurred clusters of surgical lights. The
dark blue sky joins the two allusions together as vascular
surgeon, Ignacio Rua, MD, focusing on the surgical repair,
holds the forceps in his left hand and the electrocautery stylus
in his right. The illuminations from the starry sky echo the
bright reflections from the surgical glasses. (2002) |
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Just as
the tracks of an animal on fresh fallen snow show us where the
animal has been, the surgical sponges tell us the story of a
complex surgical journey. The color of the sponges, red for
blood, green for bile, and brown for bowel are signposts
along the surgical path. The quantity of sponges and their
redness with blood suggest the difficulty of the procedure.The tree-like structures are constructed from sheets of plastic
pockets. Dry white sponges change to
red after soaking up blood from the surgical
field. The wet sponges are placed into the horizontal pockets of
the plastic sheets, five sponges per sheet. These vertical
sheets of five sponges are hung from a pole to facilitate
counting at the end of the procedure thereby reducing the likelihood of leaving
a sponge in the patient. The trees of sponges grow as the hours
of surgery pass. The red life force of blood contrasts with the gray senescence
of the winter landscape. Neither the sponges nor the winter
sky discloses whether we are viewing the beginning or the end of
a new day, as the surgical transplant team replaces the failed
liver with a better one. (2004) |
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Costumes
have been a part of folk medicine since the beginning of time.
Shamans, sorcerers and witches donned bizarre headdress and
masks which transformed them from ordinary people into powerful
healers. As apprentices, they mastered the costumes, gestures
and words, which established their authenticity
and promoted public confidence in their treatments. Our modern day surgical costumes are bland by comparison and
treatments are seldom performed with incantations. Within the
operating theatre any magical benefit from costuming
is overshadowed by requirements for hygiene and cleanliness. At
holiday time this organizational sterility is relaxed to permit
individual expressions of humor and humanity.
The image shows Maria C.
Gonzalez, RN inserting an intravenous catheter in the hand
of an anesthetized child. The conventional face mask and gown
contrast with the playful cap and antlers. Francisco A. Ong, RN
watches Maria’s experienced hands perform the procedure. (2003) |
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Surgical treatment for diseases of the urinary system are
recorded at the time of Hippocrates (460-370 BCE) who segregated
"stone cutters" (urologists) from other medical practitioners. In
modern times urologists continue to treat kidney and bladder
stones but also treat prostatic hypertrophy, urinary
incontinence and erectile dysfunction. These latter maladies are
household words thanks to the television advertisements which
advocate particular drug therapies. Since the urinary tract is
an integral part of the male and female organs of reproduction,
the urologist continually balances the needs of medical
diagnosis with the needs of patients for modesty. This same
balance is sought in medical advertisements and medical
photography.
This image is reminiscent of the sculpture,
Fountain (1917), by Marcel Duchamp (1887-1968),
regarded as one of most influential works of art in the
20th century. Duchamp championed the artistic school of
Dadaism which created layers of meaning by juxtaposing incongruous
objects.
The picture shows urologist, Manuel Camacho, MD, framed
by blue plastic drapes covering raised knees. The procedure does
not require a surgical mask and we see his eyes and face focused
on the video screen which displays the textures of the urinary
bladder. The
urinals define the surgical specialty and suggest the symptoms
which may have caused the patient to seek medical attention.
(2002) |
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The
colorful background shows the gothic stained glass windows of
Saint Chappelle in Paris. These famous relics of the medieval
world assert the divine sovereignty of the Catholic monarchs
of France by linking their monarchy through the Davidic Covenant
to the patriarchs of the Torah, to the kings of Judea, and to Jesus. While some surgeons may claim divine sovereignty of the
operating room, others perform their leading role in the
surgical team with sincere humility. If the surgery succeeds, the patient may
attribute the cure to the divine powers of the surgeon. If the
surgery fails, the patient may have little recourse than
spiritual sustenance derived from prayer.
Among the many similarities between surgeons and priests are
their costumes. The cap of the surgeon looks like the skull cap
of a priest and the yarmulka of the rabbi. The loose fit gown of
the surgeon resembles the robe of the clergy. The position of
the surgeon’s arms and hands as he prepares for the surgery
resembles the clergy during the priestly benediction.
The foreground of the image shows an oncologic surgeon, Daniel
Weingrad, MD, performing surgery on a breast. After he removes
the malignant tumor, a plastic surgeon will restore the breast
to a normal appearance. (2002) |
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Cancer is one
of the most feared diseases. Like an alien force, cancer
transforms the miraculous life forces into instruments of
disfigurement and death. In contrast to degenerative
diseases which sap our strength in imperceptible increments, cancer
bursts forth into our personal reality from out of
nowhere. The diagnosis of cancer is a defining time in our
lives when our wishful assumptions of immortality vanish
forever. The patient is a young woman whose two year old child was in the
care of grandparents. She was crying before surgery with little
hope of being saved from a shortened life and unable to accept
well meaning reassurances from her doctors and nurses.
Small cancers can be fatal, yet the tumor in this image is so
large that we immediately sense great danger. Perhaps this
intuitive fear originates during childhood when we learn to fear
large objects which we do not understand. The background view shows the
tumor contained within the abdomen as the surgeons carefully
separate the tumor from the surrounding vital structures. The
foreground view shows the tumor removed from the abdomen with gynecologic oncologist, Giselle Ghurani, MD,
holding the
large red mass. Assisting surgeon, Matt Pearson, MD, looks on with
astonishment. Despite the complete
resection of the tumor, the patient succumbed to her sarcoma
several months later.(2004) |
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Although
residents of Miami Beach are continually exposed to the images
of art deco, they do not expect to see these icons of the 1920’s
paired with their 21st century ophthalmologist. This
futuristic image brings together two ancient visual themes. The
first is the fascination with glass as it
transmits, bends and reflects all light that shines upon it. The
second is the pathos of blindness with its limitless nuance that
has stirred poets and inspired legends. The image shows
the surgeon encapsulated within a reflecting sphere, perched on
the top of a golden glowing pedestal, suggesting both a position
of prestige and a sense of isolation. The eye is illuminated by
the surgical microscope as the surgeon prepares to remove the
clouded cataract, insert an intraocular lens, and restore sight. The composition of this image was suggested by the surgeon in
the image, Louis R. Keilson, MD. (2004) |
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Andy
Warhol (1928-1987) brought together art, photography and graphic
design in an irresistible visual package. Like images from the
faceted vision of an insect, Warhol’s repetitive serial images
are immediately recognizable. His large scale works include a
range of subjects from portraits of the rich and famous to
portraits of soup cans. His serial technique is frequently
imitated and easily adapted to digital design. This image began with a photograph of a neurosurgeon at work. The elements of
cap, mask, face and magnifying glasses were extracted from the
picture and assigned a unique color. The image was then serially
reproduced into a 4 by 4 matrix. Although
hidden by the glasses, the eyes of the surgeon appear red and
seem to extend diabolically from the glasses. Warhol died
following complications of gall bladder surgery. Perhaps for his
last image he would have created this portrait of a
surgeon. (1999) |
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The
cover and the feature article in the Spring 2004 issue of Dartmouth Medicine exhibit the photographic images of Alfred
Feingold, M.D. and are available
on line (go to Publications). The cover image shows three surgeons
engaged in the correction of vascular insufficiency of the leg.
The team is illuminated by the daylight from a portico window
found elsewhere at the Dartmouth-Hitchcock Medical Center. The
juxtaposition of these two images, one deep within the most
private area of the hospital and the other from a public area,
emphasizes the unique status of the surgeon in the medical
world. The portico window resembles a spider web, an additional characterization of the complexity of surgical
care. (2003) |
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The retinal surgeon, Jay
H. Levy, MD, lives in a
Lilliputian world of intense light and color: pupil black,
sclera white, iris blue, retina red. His surgical vision is
enhanced by a powerful microscope. The dexterity of his fingers
is transformed by tiny instruments as he opens a path of light
through the vitreous humor to repair the retina. The loss of
blood, measured by most surgeons in liters, is measured in
drops. With the room lights dim, the surgeon blends into
the dark background, the precise movements of his fingers and
instruments intermittently catching the stray light from the
microscope. (2000) |
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