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BEST OF 2012, Allen Jones
Ashland, VA
Project: Documentation of the 20-hour procedure to separate conjoined twins Maria and Teresa Tapia for the Children’s Hospital of Richmond at Virginia Commonwealth University.

© Virginia Commonwealth University; photograph by Allen Jones

© Virginia Commonwealth University; photograph by Allen Jones


Health-care photography specialist Allen Jones pulled a marathon session documenting a complex 20-hour procedure to separate conjoined twins Maria and Teresa Tapia at the Virginia Commonwealth University Medical Center.

“I’ve been shooting health care for 30 years, and this was one of the most compelling, emotional and gratifying assignments I’ve ever had,” says Jones. “The commitment and compassion of the medical team and staff was contagious, and we all felt like we had a stake in the outcome. I photographed the entire procedure, stepping out of the operating room occasionally to process files, so they’d be ready for distribution once the surgery was over.”

ASMP: How long have you been in business?

Allen Jones: I’ve been a professional photographer for 30 years and have had my commercial business for the past 15 years.

ASMP: How long have you been an ASMP member?

AJ: I’ve been a member of ASMP’s Central Virginia chapter for eight years and an officer of the board for four years.

ASMP: What are your photographic specialties?

AJ: I specialize in editorial and advertising photography for the health-care industry as well as portraiture and landscape in my personal work.

ASMP: What do you consider your most valuable professional tool?

AJ: I would say it’s my reputation for delivering a creative, finished product on time.

ASMP: What piece (or pieces) of gear could you not do without?

AJ: Can’t do it without the camera.

ASMP: What is unique about your style/approach, or what sets you and your work apart from other photographers and their work?

AJ: I have been specializing in health-care photography for 30 years, and that gives me an insight rarely afforded to photographers who shoot health-care images only periodically. I understand physicians, patients and the health-care environment, whether it’s in a physician’s office, the operating room, a patient’s room or the emergency department. There is both skill and etiquette necessary to make a shot work.

ASMP: The Children’s Hospital of Richmond at Virginia Commonwealth University asked you to document the separation procedure for conjoined twins. How did you get this assignment? What made you the best photographer for this particular job?

AJ: In addition to my freelance business, I’m on the staff at VCU. I’ve been photographing in operating rooms for 30 years, and they called me because I am familiar with working in an operating room.

ASMP: The separation procedure took place over 20 hours. Did you photograph throughout the course of the entire procedure? If so, how did you stay alert and maintain focus?

AJ: Yes. I documented the entire procedure, stepping out of the OR from time to time to process the files so they would be ready for distribution when the surgery was over. It was exhausting, but interest in the project and a lot of caffeine kept everyone sharp.

ASMP: The twins were joined at the lower chest and abdomen and shared a liver, part of the biliary system, pancreas glands and part of the small intestine. Were there any moments when you had to look away, given the complexity and potentially graphic nature of the procedure, or are you used to such scenarios? Do you have any visualization or relaxation strategies when faced with particularly graphic scenes or when working in a stressful environment?

AJ: I’ve been doing this a long time, and I don’t have a problem photographing graphic materials. There is something about having the camera between yourself and the subject; it gives you enough distance to stay focused on the task at hand and hopefully make good images of graphic scenes.

ASMP: You mention that this was one of the most compelling, emotional and gratifying assignments you’ve had over the 30 years you’ve photographed in the health-care field. How often do you become emotionally invested in health-care situations you are photographing? Is part of the job to care, given the field, or do you often need to distance yourself from the patient or the outcome?

AJ: I don’t usually become emotionally invested in a health-care situation. This experience was unique in that we got to know the children and some of the family. The more typical scenario is that the patient is anonymous — I’m making the pictures, and I know what the procedure is, but not the patient. I think it is always important to be mindful of the patient’s dignity.

ASMP: Did the Tapia family request any of the photos you made of the procedure, or did you offer them any? Would the hospital be amenable to allowing the release of your photographs, or are there strict policies that cover such an exchange?

AJ: The hospital has strict policies on what is released, in deference to and respect for the family. The images were vetted and approved by hospital administration.

ASMP: What kind of equipment do you use while photographing complex procedures? Is it important to have quiet, unobtrusive gear? Can you use flash? Has your presence in photographing a procedure ever rattled a health-care worker in a way that affected his or her performance?

AJ: During an extensive procedure, there are a lot of medical personnel in the operating room (OR), so it’s important to be unobtrusive. Basically, you have to make good pictures but stay out of the way. Compared to the days of analog film, digital cameras make shooting in available light much easier. When we are doing an advertising shoot in the OR, I can selectively light with strobes. Generally in these circumstances, we have an opportunity to set up, and rarely are there real patient situations.

ASMP: Your health-care images are very clean and well lit, even in environmental settings that contain a lot of clinical equipment, which is likely very cluttered in reality. Please talk about the technical aspect of making this type of work. Can you share any tips for lighting or composing these kinds of scenes?

AJ: For advertising images, I scout the location and get everyone on board to allow me to set the stage for the photograph. That often entails making the environment free of clutter. I try to utilize the existing light and supplement it with my lighting when and where it is needed. When I’m shooting live surgeries and am unable to control the environment, I have to watch and wait for those clean compositions. Surgeries generally last a while, so you have the option of waiting for the right moment to make the photograph. ORs are usually four white walls, a white ceiling and a white floor, so the light is even and flat and easy to color balance. When the room lights are turned off so the surgeon can see the flat screens for robotic surgery, the light gets very dramatic. That’s when you have to wait for the right combination of light and composition.

ASMP: Do you do much postproduction work on your health-care images? If so, please describe the types of adjustments generally needed and how long this takes. Do you do the postproduction work yourself, or does anyone else handle this?

AJ: Yes, I do postproduction work on some of my images. How much depends on the client and what their needs are. Depending on the complexity of the retouching, I may do it or have a more accomplished specialist do it. I often push up the color saturation to enhance the drama of the image and work on the contrast, especially in available-light images where the lighting is tricky.

ASMP: How did you first get involved in photographing health care? What continues to draw you to this specialty throughout the past 30 years? Have advancements in technology made your job easier or more difficult, or are there aspects of both?

AJ: When I went to the university as a staff photographer, one of my responsibilities was to document surgeries in the OR on analog chrome film for surgeons to use as a record and a teaching aid. You could spend the entire day and night, going from one OR to the next, photographing various specimens and procedures. With the advent of digital, many physicians and residents began to photograph the routine day-to-day procedures themselves, and my role became one of documenting the more important surgeries or making more creative images for editorial or advertising, which I have always thrived on. The digital camera’s ability to record in low light has been a major benefit for me. During live surgery, the use of flash is sometimes acceptable, sometimes not. I can make good digital images in situations that in the past, I would have had to pass over if I couldn’t use flash. With analog, there was an accepted wait time. Now the client expects the finished image much sooner.

ASMP: Do health-care photographers such as you need any medical training? What is helpful knowledge to have, and/or what skills/training outside photography have you pursued in order to better your skill set in photographing for the health-care field?

AJ: It’s really experience, rapport with physicians and medical teams. They have to trust that you have their best interest and the best interest of the patient and the institution in mind when you are photographing. You have to understand the orchestration of the setting you are in — the OR, the ER — and know when to make your photograph while navigating the workings of the environment.

ASMP: How often, if ever, are you asked not to make specific pictures while capturing health-care imagery? Are there sensitive situations or moments that you’ve learned to be aware of?

AJ: There are times when I am asked not to record certain pictures. Often on assignment, the client’s need will dictate the type of image you make. I think you always have to be sensitive and respectful of the patient. You need to make a strong image and not exploit the patient to get that image. It’s sometimes a difficult line to walk, and there is sometimes the temptation to cross that line.

ASMP: In photographing health care, do you ever find yourself caught between the desires or demands of marketing and PR personnel and the doctors or medical personnel responsible for treating patients? If so, how do you respond to this?

AJ: While everyone wants to put the best face possible on the physicians and the institutions, the doctors and the marketing teams are often approaching the image selection from different perspectives. The perfect image for a surgeon may be too graphic for what the marketing person wants to portray. I sometimes find that what I would see as the most compelling images are not what ends up on the cover of an annual report. There is often a collision of opinions. Sometimes you are happy that someone else makes the call; other times you fight for what you think is the best image, and sometimes you prevail. Every assignment can be different.

ASMP: Malpractice claims and suits are at an all-time high. Do you, as a photographer, need any special insurance coverage in order to protect yourself in this regard?

AJ: The burden, if you will, generally falls to the institution or hospital you are shooting for. But with that said, I go to great lengths to ensure that documents have been signed and that I personally have a photo release form. Today with Health Insurance Portability and Accountability Act (HIPAA) laws, it’s more important than ever, and of course, you always want to respect and protect the rights of patients. They are ultimately the most important part of the equation.

ASMP: Do you need to get model releases from patients you photograph in the field of health care, or does the hospital take care of those details for you beforehand?

AJ: The hospital generally takes care of that, but I do like to have a release for my own records, and I look at all images as possible elements for my Web site, and a release and permission ahead of time will make that process easier.

ASMP: Your Web site includes a section on motion, featuring a multimedia slide show on the “Mission of Mercy” project. Did you capture the audio for this piece yourself, or did you work with a colleague or assistant?

AJ: I’ve done a few of these, and I generally partner with a videographer, and we collaborate. The combination of the videographer’s years of experience coupled with my experience in stills has allowed me to produce the pieces faster and at a higher quality right out of the gate.

ASMP: Based on your experiences creating this multimedia piece, please share your thoughts on the future of visual media in its widest sense as well as the relationships between various components.

AJ: I think multimedia is very much with us now and here to stay. It is and will continue to permeate all media. As with much of new media, everyone can “do it” to some extent because the technology is user-friendly, but that doesn’t mean they can do it very well. I think we need to embrace it and get good at it, or at the very least, we need to understand its potential.

ASMP: The bio on your Web site includes a short video interview, in which you discuss your career and your interest in photography. Did you hire a videographer to work with in producing this, or is it self-produced? What made you choose to portray yourself visually instead of only in words?

AJ: I thought with the new technology and so many things moving toward motion, it was only logical to work this into my Web site, which is a promotional piece. I am a little old-school, and I still feel like the work should speak for itself, without us as photographers telling everyone how great we are. However, the world has changed, and I thought the video piece would give potential clients a chance to see a bit of your personality and decide if you are the kind of person they want to work with. I worked with a videographer to put the piece together.

ASMP: You work with both analog and digital technologies. Under what circumstances do you prefer to work with analog film? In an ideal world (without demands of clients and the marketplace), do you have a preference for one medium over the other, or is this a function of the project?

AJ: For my commercial work, virtually everything is digital. It’s faster and more versatile. For my personal work, I like to work with large-format, 4x5 film. It slows me down and makes me more deliberate with my compositions. It is an entirely different way of photographing and capturing the image. I like both. I think it’s a question of using the most appropriate tool for the job.

ASMP: One of your personal projects, “Return to Normandy,” focuses on historical World War II sites. Please tell us what motivated you to seek out this subject. What did you aim to show through your photographs? How long did you research this project before you began photographing?

AJ: My father was a World War II veteran. And because of him, I have always been interested in WWII. When I had the opportunity to go to Normandy, I did extensive research in advance of my trip, particularly on the D-day invasion. When I got there, I had a good feel for the history and geography of the area. I made numerous trips to Normandy, and it was a long-term project. I was fascinated with what was left after 60 years and what those ruins represented and said about our culture.

ASMP: Fine art prints are available for purchase on your Web site. World War II veterans and their families receive a discount on “Return to Normandy” prints, a generous gesture on your part. Talk a bit about the community-building aspect of photography. Do you believe this medium is capable of uniting us to some extent?

AJ: I have tremendous respect for our veterans and their families and the sacrifices that they made and make today. While I was working on the project, I met a lot of veterans and heard amazing stories that only a few people have heard. I realized that the project brought back many memories for the veterans who saw it and sparked an interest within their own families to discover what amazing lives their grandfathers and grandmothers lived. So I do believe that the medium always has and always will educate and from time to time unite us.

ASMP: “Return to Normandy” was exhibited for a couple of years, and you met several veterans in the process. What was their response to your photographs? Did the images strike an emotional chord with them, even after all these years? Describe one memorable exchange you had with a veteran.

AJ: The exhibition was shown at museums around the United States, including the opening of the National D-day Museum in New Orleans.

While working on this project, just before I left on my second trip to Normandy, I was photographing an assignment for a story about treatments for patients with congenital heart defects. I had photographed a grandmother and granddaughter for the story. I was about to move a bench back to its original spot when the grandfather, Mr. Dowdy, offered to help me move the bench. As we moved it, he asked me to slow down, stating that he didn’t move as fast as he used to due to a war wound. I asked him where he got wounded, and he said that it was in Normandy during the D-day invasion.

I told him that I was leaving the next day to work on this project and asked him if he had ever gone back. He then told me a very emotional story of how he and his brother had been stationed in England preparing for the invasion. They made plans to meet back in London when they got their leave after the invasion. He was severely wounded, and while he was recovering in England, he repeatedly wrote to his brother, but all his letters were returned as undeliverable. Eventually, he learned that his brother had been killed in action. Mr. Dowdy returned to the States to continue his recovery and learned that his brother’s wife was pregnant with twins who would never know their father. He married her, and they raised the twin girls. He credited his wife with persuading him to return to Normandy to find closure on the events, which had occurred some 60 years before.

At the first opening of the exhibition, I asked Mr. and Mrs. Dowdy to attend as my guests and asked him if he would mind if I told his story. Many veterans and the families of veterans from Bedford, Virginia, which figured prominently in the film Saving Private Ryan attended the opening. At the end of the talk, I don’t think there was a dry eye in the house. It was a very moving experience.

ASMP: Do you have any dedicated staff or assistance in getting future jobs and someone dealing with client relations, ongoing print sales, opening the mail or other business matters while you’re off working on a project?

AJ: Other than assistants and retouchers, which I hire on an as-needed basis, I am a one-person operation.

ASMP: Is there a philosophy you follow that enables you to allocate working time to the projects that fuel your spirit without neglecting the ones that pay the bills?

AJ: It’s often difficult to balance the work you do for your livelihood and time for your personal work. There is always something you should be doing business-wise, which cuts into the time and energy needed for personal work. For me, it’s about persistence and realizing that your personal projects will get finished but maybe not as quickly as you would prefer. It’s important because, for a lot of photographers, it’s the personal projects that made us want to do this in the first place.