Medical Images: A fun and challenging advertising photography niche.

Way back in my advertising agency days we serviced a handful of medical clients.  A big hospital and a couple of medical device manufacturers. They weren't very much fun but they were reliable and straightforward. But in the "old days" medical practices in general didn't do much advertising and doctors did none at all because of various laws and "codes of ethics."  All of that has changed. Doctors, especially in specialties, are competing head-to-head with other practices and, in some cases, even against luxury goods.  Think: Elective plastic surgery.

But the genie is out of the bottle for most hospitals, radiology practices and other specialties like oral surgery and dermatology. The more affluent the market the more competitive the marketplace. While the referral is still a major part of the mix brand advertising to the general consumer is the growing trend.  The profession, in general, is not going to go back to an era when it was considered unseemly to do direct advertising and brand marketing.

Back in 2002, long into my current career as a photographer,  we did a campaign for a local hospital that specializes exclusively in cardiology. The image above is one from that campaign and was shot with a Nikon DH2.  The graininess comes from a SnapSeed post processing effect ("structure").  We set up and lit a number of shots of people at work over two days of principal photography but the majority of shots were done with available light and fast lenses.

During the same shoot we did a few outdoor shots and, as in the case below, we used a Kodak DCS 760 C which is a six megapixel camera and, at the time, the highest res digital camera we could buy for less than $8,000. I looked at the file as I reduced it for this blog insertion and it stands up remarkably well across a big screen.  No noise at ISO 100, just good, crisp, saturated files.

In the shot above we used a model for our "patient" but the rest of  the team was legit. We were up on the roof with a loaned helicopter when the call came in that another medical helicopter was inbound with a real emergency.  We were rushed off the roof with all of our gear and we waited in the elevator lobby while the first crew revved up the helicopter we'd been shooting and took off to make space for the one incoming. We watched a group of emergency medicine people charge through to the roof to receive the patient and get him into the hospital ER. We never found out what the final resolution was because the HIPA laws protecting patient privacy were already in place at the time.

One of my favorite medical shots in the one just above. We were photographing a radiologist in an office little bigger than a closet in the basement of a local hospital. I added portable flashes (SB-800's outfitted with radio slaves) at very low power to light the walls behind the monitors and to backlight the (real) radiologist but the main light came from the glow of the screen she's facing. It was shot with a Fuji S5 and an old, used Sigma 24-70mm f2.8.  I used the lens at f4.  It's really sharp.  And the camera (advertising to the contrary) was really only a six megapixel camera.

Consumers have a choice now and we're seeing practices evolve and upgrade their clinics and consumer facing spaces. If for no other reason than the nicer waiting rooms, exam rooms and front desks lessen the angst of going in to a strange office for a series of tests that may result in unhappy tidings for the "customer/patient." We shot the lobby above with a Nikon D2X and whatever cool Nikon lens we had that did wide angle at the time. I'm gong to guess it was my 12-24mm zoom.

Earlier this year we also shot extensively in a San Antonio hospital. When working in busy ER's and around expensive diagnostic equipment you need to practice working fast and staying well out of everyone's way. Shoot no faces that aren't model released and you can't really, legally get a release that will stand up to a legal challenge from someone under physical and mental duress; meaning: no real patients. Shot with a Canon 5Dmk2 and a 20mm Canon lens.  Nice, smooth and color rich.  

I like medical gear and I like close up stuff. Several diagnostic tests require the injections of radioactive materials into the bloodstream. This syringe (above) is largely encased in a lead protector to minimize radiation exposure.  I'd love to say I used some very impressive camera and lens but on that day I was shooting with an Olympus e300 and a 14-54 mm lens.  A couple of flashes bounced off the ceiling. Art directors still like this one years later. At some point all the gear is good enough. 

The image above relies on a clean, high ISO to work.  You've got to use high shutter speeds to freeze action and you have to have the action so the poses and gestures are authentic.  We have some that we did with motion blur but I think this one works best in the application we had in mind.  Canon 5D mk2 with 24-105mm L lens.  One nemesis of photography in hospitals is the ubiquity of white sheets and white blankets and white coats. They demand good exposure technique and/or really, really good sensor latitude. The newest rev of Lightroom 4.0 helps a great deal with highlight recovery but I think a real photographer should learn how to do good exposure in the camera, just in case you have to shoot fast and send the image directly to a customer or a magazine.  Isn't that why they invented Raw+jpeg?

The nurse and baby were photographed in a section of the hospital that works with premature babies. We didn't add light we added f-stop. I opted to shoot a series in this area with a Canon 1DSmk2 and the Zeiss 85mm 1.4 ZE.  Made sense to me.  ISO 400. You have to get the written permission of the parent and you have to be a good, no pressure salesman because the nurses are busy, they are not paid to be there for you, and if they agree to be part of the shot they do so because you were able to communicate your empathy and gratitude. No other way to do it right.  

Surgery. The makers of medical instruments, artificial knees, hips, pace makers, and much more really seem to like photographs of surgery. I'm not comfortable with blood and exposed guts and all the other stuff that goes with possible mortality and operating rooms.  When we shoot "surgery" we find a willing volunteer from the surgical staff or from our own entourage to be a surgical model.  It's important to make sure that the scene looks authentic because people who work in these environments can also be an audience for the final use of the images. 

In both the image above and below we used no other lighting but the surgical lamps and the standard lighting in the room.  We could have made it more dramatic by turning off everything but the surgical spots and plunging the background into darkness but it's not really authentic and people are getting smarter and smarter about phony shots.  One exception is in a Cath Lab (catheter lab) where the room lights are turned down so doctors can "read" the video images on the flat screen monitors which give them the real time view they need of a patient's veins and arteries.

The image just above was done recently for a radiology practice. We used a Sony a77 and the 16-50mm kit lens (which is wonderfully sharp and corrects perfectly in Lightroom 4.0). The scene was lit with a combination of existing room light and two of the small, battery powered Fotodiox 312AS LED panels.  These are the panels with controls for changing color temperatures.

I like making images for this industry.  The majority of the people I meet are highly skilled and very committed to what they do. If you are affluent in America, and live in the right cities, you really do have access to the very best medical care on the face of the earth. And the interaction of patients and professionals along with state of the art imaging technology means that there's lots of great material to photograph.  

The best working methodology of photographers working in the medical world:  "Go in smart, work fast, be discreet, be honest, stay out of the way, show people in the best light."  Bottom line? The patient is always more important than the guy who showed up to do advertising images.

I would add that these situations call for minimalism with gear.  Recently I've been shooting with fast lenses and small LED panels that can be quickly and effectively repositioned, the brightness is controlled by one dial and the color temperature by another dial.  All without power cords or extension cords.  Tailor made for moving quick.

It's fun for me to look at the images over time. To see what difference (if any) the changing equipment makes a difference in the way I work and the images I get.