Read Katharine‘s paper via THIS LINK
What first interested you in scientific photography?
I have been interested in scientific photography since high school, when I would experiment with infrared film and often photograph skin, trees, plants, flowers, insects and mushrooms. Early on in college I was very interested in alternative processes and lighting; I remember convincing my dentist to let me keep a film X-ray of my teeth and making cyanotypes from it.
Medical photography was a natural career direction for me after college, when I got a part time job doing Mole Mapping for a dermatologist. I first became interested in polarized light a couple years later while working with a doctor who wanted photographs of the skin which were free of glare and specular highlights. I knew that polarizers could do this, but I couldn’t find a lot of information about how to go about incorporating polarized light into clinical photography.
When I eventually found a technique for modifying two flashes on a macro rig to photograph highly reflective amphibians, I used that technique and began making lots of polarized photographs and learning how to appropriately use the light to document the skin for dermatological purposes. The doctors I worked with appreciated the quality of photographs I was able to produce with polarized light, so I continued to refine the technique.
Tell us a bit about your background and education.
I come from a science and art background. I studied photography and biology in college and ended up with a degree in photography. I never felt a strong compulsion to produce lots of creative or “fine-art” photography; I often approached my work as a technical endeavor aimed at documentation. I think this general disregard for aesthetics made medical photography a good choice as a career. During college, I was lucky enough to have the opportunity to take holography courses. Dr. Harris Kagan, a physics professor at OSU ran this amazing holography lab with high-end optics and lasers. Learning about physics of light by making holograms definitely helped me later in my career when it came to understanding the principles of polarization.
Early in my career, I worked very closely with pediatric dermatologist, Dr. Kara Shah, and it was really because of her teaching skills that I ended up learning what dermatologists are looking for when it comes to subtle features and micro structures of the skin. Polarized light is especially important for dermatological photography because of its ability to enhance our view of either colors or textures. Presently, I work with all specialities -which is nice because it has helped me broaden my clinical photography skills.
As a Medical Photographer, what does your job entail?
I make photographs for doctors. Each specialty and medical condition requires unique types of images, and this entails technical proficiency with digital cameras and flashes, as well as some understanding of what doctors are looking for that visually describes the disease, anatomy or procedure being photographed.
Another important aspect of being a medical photographer is how we interact with patients. Often the people we photograph are sick, uncomfortable, nervous or upset. Sometimes they don’t want to have their photograph taken. Making them feel relaxed and respected during the process is crucial.
Finally, having knowledge of image data and databases, privacy laws, and how clinical photography supports research and medical education is helpful.
What tools or software do you use in your work?
I use a DSLR camera with macro lenses and flashes. This allows for photography at very close distances with good resolution. I prefer to use twin macro flashes which give me even, shadow-free lighting and a lot of control when used properly. Polarizers can be fitted onto most any handheld clinical photography system.
As for software, I like to work with Adobe Lightroom, which is a database built on SQL, making it ideal for file management and organization. Many photographers use Adobe Photoshop, but for clinical work, you don’t really do much post-production or editing. I also like Lightroom because it can support medical education and research through construction of clinical image databases. Images can be organized by keywording or metadata and recalled later for teaching, publications and other academic activities.
Can you briefly tell me about the project “Cross-polarised and parallel-polarised light: Viewing and photography for examination and documentation of biological materials in medicine and forensics“?
It started with me asking doctors, researchers and forensic experts if they used polarized light. Not very many did (in America, at least), and most didn’t have a clear understanding of what this type of light could do. I already knew how important polarized light was for clinical photography in dermatology, and after reading all of the literature I could find about the subject in other areas of medicine and forensics, I decided to compile the research I’d done into a review article. Although many specialities seemed to be using polarized light in some capacity, there was not a good comprehensive overview covering a variety of equipment, clinical and research applications for polarized light.
The real motivation for me to publish the review article came when I began to understand how well cross-polarized light worked for visualizing bruises on darker skin types. I had been working in a large pediatric hospital for several years, and was familiar with how child abuse screenings were conducted. I realized that there was an unmet need when it came to social workers and pediatricians being able to accurately see bruising on black children. This is a known health disparity for darker skin types who may have cutaneous findings that are simply difficult, if not impossible, to detect and document with traditional light sources. Beyond abuse and rape screenings, I hope the research promotes an increased interest from medical examiners, pathologists and forensic photographers.
Did you need to learn any new skills during the project?
I had to read a lot of technical papers, some of which were beyond my scope of interest. Much of the learning I did was just part of the research itself, understanding how other medical specialities function when it comes to examination and documentation of visually challenging anatomy and pathology. Polarized light has a lot of interesting applications outside of medicine, and some of these scientific and industrial uses would send me down a rabbit hole where I’d often find myself reading about invasive plant species or ice formation on jet planes or isotropic and anisotropic minerology for days on end. I always enjoyed the reading even when it was not medical literature.
What was most rewarding about the project?
Medical photography is extremely rewarding in general, because the images we make can help people, whether they are used for clinical purposes, research or medical education. Unlike commercial or creative photography, I know these images have the capacity to make a meaningful difference to someone’s healthcare or education. The most rewarding part of the project was helping doctors communicate more clearly and be able to show exactly what they were seeing to patients or to other doctors. If one patient or victim is helped by documenting their condition with polarized light, then that is the ultimate reward.
What are you working on right now?
The next step for the research is to refine a technique for visual color segmentation of cross-polarized photographs. Because cross-polarized images are able to capture information from beneath the surface of the skin, these subsurface features can then be enhanced, by selectively targeting certain colors. Sometimes this is achieved on the front end, by filtering the light using colored filters, or by using multispectral sensors, followed by image segmentation. I have found targeting and enhancing certain colors during post-production through a specific luminance adjustment can achieve separation of pigmented and vascular features.
I will be talking about the process at the Bio Communications Association (BCA) meeting in Savannah, GA in June of 2018.
Is there another project you would like the opportunity to undertake?
I would love work on developing a cross-polarized lighting method that is universal and inexpensive for rape and abuse screenings. Dark skinned victims are most vulnerable to not having their injuries clearly appreciated and appropriately documented, and I hope that I can someday help design a lighting solution to this medico-legal challenge.
I also have a strong interest in dermoscopy, confocal microscopy, spectral imaging, and other alternative light sources. I’m interested in working on projects utilizing various skin imaging technologies.
CONNECT and CHAT to Katharine about her work here: