Patients and procedures 

3 July 2006 tbs.pm/2110

Medical Photography does not consist of taking X Ray pictures of patients for diagnostic purposes. This work is undertaken by Radiographers who are a very specialised professional part of our health services, staffed by highly trained and competent staff. Medical photographers, also highly trained and of professional status, are responsible for taking still photographs, film, and videos of patients and procedures for diagnostic and record purposes. Many of the pictures taken are also used for student teaching, publication in professional books and literature, or parts of film and video inserted into larger productions. It’s a field in which Emrys Sparks, now retired, spent much of his working life.

An insight into Medical Photography & TV, 1966 to 1980

In 1958 I saw an advertisement in New Scientist for a junior photographic/film technician in a major London College, and decided to apply. I was offered an interview and, clutching my day return train ticket, went to London, somewhere I’d never been before!

I was so surprised to be offered the job, at some appalling low salary, but being green from ‘Hicksville’, Somerset, I had no idea of the cost of living in the metropolis, so I accepted.

Much to my parents’ chagrin I moved to London, and they expected me back after a week or so, but I loved every minute of it, and soon realised that there was another life outside living in the rural Somerset countryside. I’m not saying I was never at first lonely or broke (constantly!), but I made lots of friends, and found digs with a family a stone’s throw from the new BBC White City Studios and Lime Grove Studios in Shepherds Bush. I often used to peer inside the BBC Scanner vans, when they were parked outside the White City Stadium for greyhound racing, or athletics. To me it was another world of television technology.

I started my career at Imperial College London and loved the photographic work, in spite of only being the ‘ the boy’. I soon learned the business, and then started day release and evening classes at the Regents Street Poly (now the University of London) to gain professional qualifications. It took five long years of study, but finally I achieved a degree in Applied Scientific Photography and film production.

After Imperial, I spent a year making a medical film in the Middle East in ’65, and then returned to London, married, with a pregnant wife, homeless, and jobless. But we had managed to save a bit whilst abroad, and bought our first house.

A Temporary Job

I was offered a temporary job on a six-month contract at St Mary’s Hospital Medical School, Paddington, where Sir Alexander Fleming discovered Penicillin. I happily joined a team of medical photographers and artists, projectionists and AV technicians in a large medical illustration department, under the directorship of the late Dr. Peter Cardew, who was, at that time, the leading light in medical film production.

This ‘temporary job’ lasted nearly 30 years.

Medical Illustration was rapidly expanding in the mid 60’s, and there was plenty of scope for the highest quality photographic work for teaching and publication demanded by the medical staff. Up and down the country, medical illustration departments were being set up in major hospitals. Westminster and Charing Cross in London were two, Addenbrookes in Cambridge was another, and there were similar departments in Nottingham, Bristol, Newcastle, Aberdeen and many more.

There were four medical photographers in the St Mary’s department, who undertook most of the patient photography, either in a very well-equipped studio, where nearly all black and white pictures were taken on 4×5 cut film, using high intensity electronic flash. Colour was used on the wards, in operating theatres (also the post mortem room), or clinics with portable flash and 35mm. cameras. We used Kodachrome film for all our colour work, which although very slow, gave us the most accurate rendition of skin tones, the most important factor in medical photography.

There were also technicians undertaking flat copy, x-ray copying, darkroom processing, printing, slide duplication, secretarial and other ancillary work.

We built up a huge library of 35mm colour slides, which when I retired amounted to over 45,000 pictures. They were all closely cross-referenced, and our slide librarian could instantly access virtually any picture, without the aid in those days of a computer. The library has now, however, been computerised in the Wellcome Trust Photo Library.

These pictures were much sought after from medical book publishers and TV companies. The make-up department at BBC-TV, in addition, regularly came to choose gory pictures to mock up an accurate portrayal of accidents or wounds for use in TV dramas. There was also a valuable collection of early pictures of Sir Alexander Fleming in his laboratory.

Prize-winning films

We made sync. sound films, using an 16 mm Arriflex BL camera, and we edited and dubbed the 16mm. film within the department. I’m sure by today’s Health & Safety standards, working in an editing suite about 6 feet square with no ventilation, and the constant intoxicating fumes of film cement (Amyl Actetate – Pear Drops ), would now be totally unacceptable.

We made several prize-winning films, the major one with sync. sound being the story of a double leg amputee. This showed his progress and determination to walk again with the help of his Physiotherapist, both of whom had strong characters which came across in the film. We filmed them in the gym, at his house in Kent, having a pint in his local, talking to the local vicar (played by me – my 15 seconds claim to fame!) and finally ‘walking unaided into the sunset’. At its premier to other medical photographers and doctors it received a standing ovation, and was translated into several foreign languages.

Dr Peter Cardew also pioneered the filming of the larynx, by a clever arrangement of prisms and mirrors which allowed the doctor to see down the patient’s throat at the same time as we filmed the operation. The camera and lighting were all mounted on gimbals with counter weights, much like today’s SteadyCams…but remember this was the late 60’s, all equipment was extremely cumbersome and heavy, film stock slow and requiring huge amounts of high intensity light – but the results were quite outstanding, and again became a prize-winning production.

Several of these early films also detected the early signs of throat cancer in the patients.

Moving into Television

In the late 70s we obtained cash to buy our first B/W TV cameras. Theytoo were large, heavy, and also required masses of light to produce a very poor image, but we thought they were wonderful. The first reel-to-reel video machines came on-stream soon afterwards, but they were very unreliable. They used three-quarter inch tape, which wrapped around a helical scanning drum, giving a tape-to-head speed of 200 inches per second. When working well, they produced quite good quality stable pictures, but they were also very prone to tape jams and clogged video heads. They were, however, the best available at the time in our price range.

We had no editing facilities, except by setting up two tape machines back to back and assemble-editing from one to the other. We had to allow time for both machines to come up to speed before hitting the edit button, or else there was a loss of sync., which meant going back two edits and trying again. We soon got used to making sure we had plenty of cut-aways when shooting so that we could drop them in to cover any bad edits. Yet all our very crude attempts were well received, and gradually the quality improved. I also spent several months learning professional TV production and editing techniques at various courses at the BBC training school

In the early 80’s we moved into colour. Again lighting was a problem, as the camera sensitivities were so low.

A New Facility

It was also about this time that a brand new building was planned, and we were allowed space for a full-size TV studio, with control room and sufficient funds to kit it out. We installed high-band video recorders, full video editing, a sound mixing desk, radio mics, good quality colour cameras, and computer graphics. The control room was linked with video and sound, with talk back, to several operating theatres and lecture theatres, so we could record or replay tapes without having to push heavy monitors and trolleys of equipment around the campus..

We thought we were in heaven.

We started to produce excellent teaching videos, filming operations and clinical procedures, and transferred a lot of our early colour 16mm film onto video. We had several full-time TV technicians and camera operators, and the studio was in constant demand, thus allowing our original stills studio to carry on without having to double up when it was required for TV, as it had done before the new department.

Another more pleasant aspect of our department was the photography of important visitors, recording the construction of the new buildings, awards ceremonies, prize givings and so on.

The private Lindo Wing of St Mary’s was the popular venue for the Royal births, and we also had a number of visits from members of the Royal Family. I had the honour to photograph HM The Queen Mother on at least eight occasions, also HM The Queen and Prince Philip, HRH Princess Margaret, HRH The Princess Royal, HRH Princess Diana, and several more; we also had visits from Margaret Thatcher, Elton John, and several other well-known celebrities.

Thus, medical photography was not all doom and gloom.

All Things Must Pass

By the mid-eighties Dr Peter Cardew had become semi-retired and I had taken over as Director of Medical Illustration, but also by this time everyone in the NHS and academia was being forced to become ‘cost conscious’, and so our work had to begin to be ‘cost effective’.

Up until then we had only made a small charge for each job, to cover the cost of materials, not including patient photography, but I had now to change from being a ‘hands on’ photographer to a being a ‘manager’ – a very different aspect of the job that I was not trained or prepared for. Labour and material costs had to be calculated, and time and motion studies undertaken.

The world we knew had changed forever.

Obituary

Dr Peter Cardew died on March 19, 2006.

Peter was born in Paris in 1917, and was the youngest, by 13 years, of four brothers. His father was Chaplain at St George’s Anglican Church in the centre of Paris. He was sent to school in Switzerland, and then gained entry to Westminster school, after which he entered Guy’s Medical School, and qualified in 1942. He immediately joined the 7th Hussars, and spent the war running a medical evacuation camp in Palermo. After the war he returned to work at Guy’s hospital, but was also very involved with the Ballet Rambert and photography

In 1949 he founded the Medical Photography Dept. at St. Mary’s Medical School, Paddington, where he stayed for 33 years, thus combining his knowledge of medicine and photography.

He had many talents and was a great lover of music, sailing, bridge, history literature, and of course photography. He was an accomplished piano and French horn player, and regularly played in a wind quartet with Warren Michell. One day he was incensed when in the middle of their practise in walked Eamonn Andrews, who thrust a mic at Warren, and whisked him away to the This Is Your Life studios. Warren, too, was very upset by this intrusion.

Peter was a great family man and used to take his four children in their Safari Land Rover, towing a boat he had built himself, to Southern Ireland for summer camping holidays.

He had a great sense of humour, and I am proud to have been able to work with him for nearly 20 years. I would also like to thank his family, and his wife Ann, for kindly allowing me to include this obituary.

Emrys R. Sparks May 2006

A Transdiffusion Presentation

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1 response to this article

David Kirk 12 September 2016 at 2:14 pm

Very interesting reading about Dr Cardew. I knew him and you Emrys briefly when iwas employed as a projectionist/technician at St Marys A V dept , my first job after leaving further ed college. hope you are enjoying retirement ,good luck fot the future David

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