Spending the weekend with Dr. Vasquez, and medical photography


For internet searches for medical photography – all of my images are free for your use, but please give proper credit for my work, ie. “Photo by K. Eckland”.  For commercial uses, contact me, (so that I can contact the subjects of my work).

Please note that patient privacy is protected – and patient permission is obtained prior to photographs.  For the most part – I photograph surgeons – not patients, or surgery.

Spent much of the weekend in the operating room with Dr. C. Vasquez, cardiac surgeon at two different facilities, and the differences couldn’t be more apparent – and perhaps not what one might expect.  Much of it comes from perspective; as a person behind the lens, I see the scene differently than others might.

harvesting the radial artery

In fact, this prompted me to write an article on the subject of medical photography, complete with a slide show to illustrate the effects of color on surgical photographs. I’ve also re-posted much of the article here (see below).  Once you see the photos from today, you’ll understand the article.

the beige operating room

The case today went beautifully, with the patient extubated in the operating room.

Dr. Vasquez, and Lupita, scrub nurse

While we were there – had an unexpected surprise! Dr. Gutierrez ‘Lalo’ showed up.  I have been trying to get him into the cardiac OR since he confessed his interest in cardiac surgery.  It was great to see him – and I like encouraging him in his educational goals.   (I kind of miss being a mentor, and preceptor to students..)

Lalo peeks over the curtain..

Dr. Gutierrez (Lalo) in the cardiac OR

Medical Photography

Medical photography is many ways is more art, and luck that skill – at least for people like me who never set out to be medical photographers in the first place.  It was a natural development prompted by dire necessity during the early days of interviewing surgeons and medical writing.  I am still learning, and hopefully improving.

But as I said before, much of it is luck, and timing, particularly in this field, where the subjects are always in motion and a slight movement of the hand tying the suture knot can result in either a breath-taking shot or an utter failure to capture the moment.

The most dramatic and vivid photographs often come at mundane moments, or unexpected situations.  In medical photography, where the subject matter combines with a dramatic interplay of color, light and shadow to illustrate some of life’s most pivotal moments such as birth, death and life-saving operations – it is surprising how important the background elements are.

Here in Mexicali, I have been taking photographs of different surgeons for several weeks at different facilities across the city.  But, almost unanimously, all of the photographs, regardless of subject at Hospital Almater are lackluster and uninspiring.  Contrast this with the glorious photos from the public facilities such as Hospital General de Mexicali, and Issstecali.

The culprit is immediately apparent, and it demonstrates how such carefully planned such as aesthetics and interior design can have unintended consequences.  The very studied, casual beigeness used to communicate upscale living in the more public parts of the hospital are destroying the esthetics of the operating room services they are selling.  Whereas, the older facilities, which have continued the use of traditional colored drapes and materials do not have the problem.

Historically, surgical drapes were green for a very specific reason.  As the complementary color to red, it was believed to be a method of combating eye fatigue for surgeons looking at the red, bloody surgical fields for hours at a time.  Over the years, operating room apparel and drapes evolved away from this soft green to a more vivid blue, know as ‘ceil’.  The reasons for this change are probably more related to manufacturing that medicine, and since that evolution, surgical drapes now come in a variety of colors – hence the color matching here, of the paint, the tile, the patients, the operating room and the surgeons itself.  Somewhere, an interior decorator is filled with gleeful satisfaction – but I can only muster up a groan; knowing I will be here again and that most of my photos will be unusable.

While the consequences of poor medical photographs may seem trivial to anyone but myself (and my interviewees) at this junction – it runs far deeper than that.  With the advent of the internet, and the complicated legalities of getty and other corporate images, small, independent photographers such as myself are gaining wider exposure than ever before.   Alas! – much of it is uncredited, but several of my more popular images are downloaded thousands of times per week, to grace slideshows, powerpoint presentations and other illustrations for discussions of anything from medicine and surgery to travel, technology and even risk assessment.  In an era of branding, and logo recognition, places like Hospital Almater are certainly missing out.

In  other news/ happenings: Upcoming elections!**

Finally found someone to talk to and explain some of the issues in Mexican politics – but he hates Quadri, and doesn’t really explain any of it except to say ‘He’s corrupt..”  (From my understanding, ‘corrupt’ is an understatement, and that all of the parties are corrupt – and it’s pretty well understood by everyone involved – so of course, if I hear something like that – please explain.. explain..)  It’s not like I am capable of voting anyway, but I’d sure like to hear perspectives..

It looks like I’m not the only one who is a little leary of pretty boy pena’s party’s dubious history.  His numbers have fallen in recent polls in advance of tonight’s televised debates.  (Let’s hope these debates are better than the last.)

My personal “favorite”, Quadri is still trailing in the dust, but it looks like Lopez has a chance to take the election from Pena (much like it was ‘taken’ from him in 2006 with his narrow defeat..  Lopez is a socialist which is hard for Americans like me to understand – but then again, it’s not my country, and the levels of inequity here are certainly wider than at home – so maybe someone like Lopez can bring some much needed support to the lower classes.

I mean, a lot of what we take for granted in the USA doesn’t exist here, like a decent free public school education.   (Okay – I know critics will argue about the value of an inner city education – but we still provide a free elementary & secondary school education to all our citizens.)  So socialism for the purpose of providing basic services in all areas of Mexico seems pretty reasonable.  (It would help if I could read some primary source stuff – without using translation software, so I would have a better idea of the specifics of AMLO’s ideas.)

I did ask my friend about the student demonstrations for Yo Soy 132.  I guess as an American growing up after the 1960’s – we tend to not too make much of a big deal over student demonstrators – after all – we have the ‘Occupy’ movements going on right now in our own/ other countries – but he was telling me that this is pretty uncommon in Mexico.

** No, I’m not really into politics but I feel like it’s important to try and understand as much as possible about the places (countries) where I am residing.

Great day in thoracic surgery and oops!


Oops! probably shouldn’t be part of any blog about thoracic surgery – but I say – “Oops!” because as I look over some of my writing – I see that I have definitely fallen into old habits (of writing reviews).  But I won’t fight my natural tendencies – and just maybe, when we get done – there will be another ‘Hidden Gem’ for my loyal fans..

Long, wonderful day in thoracic surgery – which started at the Hospital de la Familia, a private facility on the outskirts of Mexicali by the ‘new’ border crossing.. It’s way out on Avenue Maduro (after it changes names a couple of times) in an industrial area.  But – like most of the private facilities I’ve seen so far in Mexicali – its sparkling, and gleaming with marble floors, and plenty of privacy for the patients..  Don’t worry – I’ll be writing more about this, and the other private hospitals in Mexicali soon..

Hospital de la Familia

While I was there – I got to see Dr. Octavio Campa again.  He’s an anesthesiologist – and a pretty darn good one (and if you’ve read the previous books, you know I won’t hesitate to mention when anesthesia isn’t up to par, either.)  This picture* should show you exactly why I am so fond of him – as you’ll note, he pays very close attention to his patients, and their hemodynamic status.

Dr. Campa – Anesthesiologist

This is my second time in the operating room with Dr. Campa – and both times he has consistently shown excellence in his care of the patient.  (He’s pretty skilled with a double lumen tube, which helps.)

Dr. Octavio Campa Mendoza  MD

Anesthesiologist

(if you want to contact him to schedule anesthesia for your surgery – email me.)

Dr. Campa was born and raised in San Luis, Mexico. In fact, along with Dr. Gabriel Ramos – he’s known Dr. Ochoa for most of his life.  After completing his medical education, he did a three-year residency in Anaesthesia, and has been practicing for seven years.

Prior to starting the case, he started a thoracic epidural for post-operative pain control – using a nice combination of Fentanyl and bipivicaine, so this should be fairly comfortable for the patient when (s)he wakes up.   A lot of anesthesiologists don’t like performing thoracic epidurals (it’s an extra hassle, and takes more skill than a standard lumbar epidural) but I am sure the patient will appreciate the extra effort.

He was attentive during the case – and the patient’s vital signs stayed within acceptable ranges during the entire case – good oxygenation, no tachycardia, and no hypotension at all during the case.  He didn’t delegate any of his responsibilities to anyone else – he administered all the drugs, and stayed by the patient’s side during the entire case.  (Like, I said before – if you’ve read the books, you know that this is not always the situation.)

Recommended.

Dr. Vasquez, the cardiac surgeon joined us in the operating room today.  It was nice to see him.  I posted a picture of him in his surgical regalia so everyone will be able to recognize him when I interview him next week.

Dr. Vasquez (left) and Dr. Ochoa at the end of another successful case.

I can’t (and won’t) tell you much about the individual cases but I did get some great photos to share today.. (It’s too bad – because I always meet the most interesting people – disguised as ‘patients.’  But it wouldn’t be fair to them.)

* I don’t believe in ‘staged’ operating room photos – what you see is what you get – sometimes the photos aren’t perfect, because I take them while people are working – but I don’t want to add any artificiality to the scene.  Of course – the casual, between cases photos are a little different.

a more casual photo now that the case is over.. Dr. Vasquez, Dr. Campa and Dr. Ochoa

I promised everyone more photos – so don’t worry – I still have a lot more to share.  This is one of my favorite ones of Dr. Ochoa – he’s notoriously hard to get ‘good’ photos of – because he’s always in action, so to speak – so a lot of the operating room photos don’t always capture him well.

Dr. Ochoa, writing orders

After the first case – we headed over to Mexicali General – where I was able to get some more pictures of my friends.. However, this photo below – is probably my favorite that I’ve taken in Mexicali so far.. (Which is surprising because: a. it’s not a surgery photo and b. I had to set aside some of my ego to even post it.)

But then again – no one is going to look good in a photo next to Carmen – she’s a stunningly beautiful woman – even after an evening in the operating room.  Carmen is one of the circulating room nurses at Mexicali General – and she’s pretty awesome – in addition to having these amazing expressive eyes that peep out from behind the surgical mask.  I really enjoy talking to Carmen – because at the end of the day – whether I am taking on the role of medical writer, photographer or student – I am a nurse, and I always enjoy talking to other nurses and hearing about their work, and lives. (I know there is a great book there – a compilation of nursing stories from around the world – but try getting a nurse to slow down for five minutes for an interview..)

with Carmen, a circulating nurse at Mexicali General

Of course, I couldn’t end my post without more pictures of my two favorite people; Lalo and Jose Luis..

I like standing next to Jose Luis – besides being a fabulous guy – doesn’t it make me look thin??

For the last photo today – I’ve got a great, dramatic action photo of Lalo.. You can’t really see – but he’s throwing sutures in this picture – and I just think it will be a great photo for him to have when he’s a practicing cardiac surgeon someday.

Dr. Gutierrez, throwing sutures during a VATS case