Creatively Photographing in a Hospital OR

As a commercial photographer you have to create images that draw attention, that may even surprise. And you typically have to pull this off within a short time frame, and with less than full control over a shooting situation.

I was recently asked to go on location to a hospital in east El Paso to photograph the newest DaVinci Xi surgical system in their OR. My client on this assignment was The Hospitals of Providence, the largest hospital provider in El Paso TX. I’ve been photographing assignments for Providence for some time and was excited to accept this challenging job! The photo was to be used on a “peel off” cover on El Paso’s The City magazine, so it would serve both advertising and editorial purposes at once.

As soon as I knew of this assignment I began working out in my mind what the photo might look like. As I’ve been photographing in OR’s for ten years I had experience with this. A color scheme was essential for a dynamic image, and I imagined a mix of cool and warm tones. I began researching images of DaVinci systems so I knew what to expect with our “subject”! With portrait photography one is most concerned with pose, expression, and good lighting. In fact these same image aspects also applied to photographing this special subject, replacing “expression” with the positioning of the device’s surgical arms.

Once my assistant and I arrived at the location (very early on a Monday morning!), I began my usual process of introducing myself to staff and security. Our contact on this assignment was a Marketing Director for Providence. No matter how well you prepare for an assignment there will always be the unexpected. It’s critical to doing this type of work that you keep your focus on the getting the job done, and remain fully professional at all times. So… it turned out we had much less time to execute the photograph than we’d thought. A bit of worry did set in, realizing the challenges of pulling off a technical photograph like this.

So, we proceeded with our equipment to surgical area of the hospital, an area that definitely requires a special level of security and permission to gain access to. Once that was cleared we were introduced to the department manager and a process of preparation began. There would be three of us entering the OR: me, my assistant, and the Marketing Director. Fortunately we also had a helpful young guy who works as a tech every day in this OR. The rest of us had to wear white “bunny suits” over our clothes, our heads, and our feet. Getting these on is a challenge, but once dressed you tend to forget about them. My assistant and I then began assembling the equipment we would be using: four lights each with a color gel, light stands, power chords, a large accessory bag, and my camera bag (two Nikon bodies, numerous lenses, flash triggering systems, and dozens of additional pieces of equipment).

Once we moved our equipment into the OR I stood back and surveyed the room for the first time. It turned out that the DaVinci system had been in use for a few weeks. Working OR’s, while they are kept very clean, still become a bit cluttered and are typically far from “picture perfect” ready. Fortunately, we had our tech to assist us in rearranging the room a bit. All of us were reluctant to touch anything, so we relied on him to physically move things.

Having had so much experience working on location I immediately began issuing commands (sorry about that!) as to where to place this or that. Dynamic, strong photographs require that we draw attention to the subject, and avoid distractions. There was quite a bit in need of repositioning, but some things could not be moved due to power chords that couldn’t be unplugged, or were permanently in position.

My color scheme would be a blue tone for the room overall, set off by a strong warm tone tending toward magenta. Additional warm tones would be added by two large circular surgical lights. There would be no opportunity to shoot a variant of our color scheme as we had no more than 30 minutes to complete our work.

Creatively, without adding color to the room our photo would have lacked interest. Of course, one could create a very strong B&W shot, but the client and magazine required a color image. The dull monochromatic colors of operating rooms simply do not work.

While I had worked out ahead of time what colors I wanted to use and my equipment there is always a scramble to fine tune these choices to the reality in front of you. I can say I don’t think I’ve ever had to pull of a shot as complex as this in such a short time. The outstanding help from my assistant, as well as the full support of hospital staff was essential. Fortunately our subject never complained!

Once our lighting was in place we proceeded to “styling” the DaVinci system. Because we truly were in a working OR with several surgeons outside in the hallway waiting for us to finish, it was not possible to add the actual surgical tool attachments to the device arms. This was, of course, something I had wanted to do. The various scalpels, stitching, and holding attachments would have been a great finishing look for this photo. But location photography on a deadline is the art of the possible.

We decided to position the unit’s arms in something of an arc shape, and the camera was positioned a bit lower than head height directly facing it. Despite the final image it was not my goal to make the surgical system look threatening. My goal was to make a medical device have a dynamic look, and I hope we achieved that.

Setting up in the OR took 20 minutes before we were ready for the first shot. That shot looked just about right with just a bit of tweaking, so I proceeded to photograph… till I was told we needed to pack up and leave. At that moment the photographer realizes: yes, the moment has come, we’ve concluded our work, there is no more time, so… we turned off our lights and begin breakdown. Within five minutes we were out of the room and back in the hallway where we’d begun.

I began post-production that night as the client needed a finished file very quickly.

After an assignment I often obsess a bit on what I’ve done, or didn’t do. After this assignment there were several things I kept thinking about. I won’t list them, but it’s part of being a perfectionist that wishing I’d done this or that is simply part of the game, as they say.

I decided on a fairly straightforward approach to the file post-production on this shot. I didn’t want to make dramatic alterations to things, so it was mostly a matter of adjusting contrast and color, and selectively drawing further attention to areas of the image. All post production was accomplished with Adobe Lightroom Classic, from basic assignment editing to retouching of completed files.

When I saw the finished cover of the magazine (all handled expertly by the team at The City magazine) I confess I was pleased. It was a strong cover and image and achieved the goals of the magazine and The Hospitals of Providence. This was the first time the magazine had used a “peel off” cover. The cover pulls off by lifting a corner and can be saved as an advertisement. The response was overwhelmingly positive and I was gratified to have been part of the process.

Location assignments, whether editorial, advertising, or corporate should always be looked forward to with enthusiasm and excitement. It’s important to plan as well as possible, and have a great team to work with. Thanks to my assistant, the staff at Providence East, and the marketing team with Providence. It is a privilege to work on a project that communicates important information to the public, and that is what great advertising always does!