American cinematographer (Jan-Dec 1941)

SURGICAL CINEMATOGRAPHY By FRED C. ELLS PULSATING, alive, a pink-gray human brain is exposed. An embedded tumor smokes and hisses under the electric cautery as it is being excised. Sterile-gowned nurses and assistant doctors, nerves tense, watch with narrowed eyes the surgeon's rubbergloved hands in delicate manipulation, as they maintain a steady balance between life and death. Above the sleeping patient, behind 5000 watts of white light, a purring 16mm. camera with unerring fidelity records every detail of motion and color of the sensational drama. That is a sequence that the layman in the past never saw. With a changing attitude on the part of the medical profession, however, surgical pictures of general interest are now being shown to the public in some localities. They are sure to excite an intense reaction, for even doctors whose lives are spent in the atmosphere of the operating room, gasp at the accuracy of modern color film, and the scalpel-sharp recording of the modern lens. But satisfactory results in the specialized field of surgical cinematography are not possible without a great deal of cooperative understanding. The technical requirements are so exacting that most attempts by enthusiastic amateurs, and even by professionals inexperienced in this work, are dismal failures as teaching media. Los Angeles surgeons count themselves fortunate in having available a surgical cinematographer, Billy Burke, whose surgical cinematography they consider unequalled in this country. But Mr. Burke has arrived at this eminence by over a decade of experimentation, and would be the first to admit that there are still many unsolved problems before him. In a series of interviews with Mr. Burke for The American Cinematographer, he points out a few of the pitfalls that beset the beginner in this field. First consider the stage on which the picture is to be shot. Hospital operating rooms run on a precision schedule. Patients and surgeons are assigned definite rooms at definite hours, and must not be kept waiting. Just sufficient time must be allowed between operations to clean up after one and prepare for the next. The cameraman must not interfere with this routine any more than he can possibly help. He must arrive at the hospital about an hour before the operation is scheduled, and get his equipment near the surgery. The equipment cases are seldom opened outside the hospital, lest they collect The keynote of the policy of THE AMERICAN CINEMATOGRAPHER is to bend every effort at all times to ensure complete technical accuracy and trustworthiness in the articles presented to its readers. To this end, when articles dealing with subjects with which neither the Editorial Staff nor the Advisory Editorial Board may be completely familiar are received, they are submitted before publication to the critical scrutiny of outstanding specialists in the field with which they are concerned. When this article was received, it was therefore submitted to the examination of one of America's foremost specialists in the exacting field of brain surgery, Dr. Rupert Rainey. His comment, coming as it does from an outstanding member of the conservative medical profession, is an unusual tribute to Mr. Ells' article and to Cinematographer Buike's achievements. He states "I have read and approved this article, and it is my opinion that it should be required reading for any operator of photographic equipment in a surgery." — The Editor dust. The camera, an Eastman CineKodak Special, with extra magazines, is carefully checked. That is, the cameragates must be free of emulsion particles, and the interior of the magazines scrupulously clean. Lenses are painstakingly polished. Fresh 100 foot-rolls of Type A Kodachrome are loaded. A professional-type tripod, solidly built, with a total possible height of 10 feet, is extended. Two lights, new No. 4 Photofloods, about 2,500 watts each, are screwed in their reflectors, which in turn are mounted in special fittings on the tripod, from which they may be turned on and off, and their position adjusted as necessary. Equipment must be so constructed as to preclude absolutely any possibility of accidentally falling into the sterile field, or of any dust or dirt jarring off into that area. Finally, all electrical connections are checked, that there may be no failure of lights and the ample ampei-age may be received over underloaded power lines. Cable-connections are taped, so they cannot be accidentally pulled apart. There must be no electric sparks in the operating room, for ether and other gases are highly explosive. All equipment taken into the operating room must be wiped with a clean towel wet in alcohol. All this must be accomplished without interfering with the routine of the busy surgery. That requires on the part of the cinematographer intimate knowledge of hospital practice, and the cooperation of the hospital staff. Any infraction of rules or any mishap, might force the hospital to bar further cinematography. In a surgery, the patient is always the first consideration. In the surgeons' dressing-room, the cinematographer removes his street clothing, washes up, and dons a sterile white gown, cap and mask. As soon as the patient is in position on the surgeryroom table, the tripod is moved into position and the camera mounted. Any portion of the apparatus near the sterile field must be draped with sterile towels. The cameraman mounts a small stepladder. He critically focuses on the field by a direct observation through the reflex finder. Surgeon and assistants place themselves in position. The stage is set. From this point, cooperation with the surgeon is all-important. He has already discussed the case with the cinematographer, who must have a clear idea of the action to expect and the consequent angle at which to shoot. Such discussions require a considerable knowledge of surgery, for surgeons have a vocabulary of their own — almost a separate dialect — and it is incomprehensible to the laity. At the same time, the camera has certain peculiarities, to which the surgeon must conform if the picture is to be successful. A surgeon who is familiar with motion picture technique, acquired by experience, is almost essential. Occasional quiet requests are exchanged. The area covered by the lens may not be over a foot square; often half that. The field must be left open as far as possible to the lens. The camera runs at 24 frames per second, but in so small a field the motion of the hands and instruments must be smooth and not too rapid. Otherwise the picture would falsely show what would appear to be nervousness on the part of the operator. Unnoticed, the surgeon's arm may move into the field. At a word from the cinematographer, it moves slowly out. Gloves become stained, or new gloves covered with powder are introduced. The surgeon is reminded to wash them off. Soiled towels in the field are replaced, and swabs and instruments removed promptly. For his part, the surgeon calls the shots. He knows what he wants. Much of surgery is routine, familiar to all 120 March, 1941 American Cinematographer