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A Healing Lens: Doctors and students explore patient experience through photography

Theresa Hildago, a nurse practitioner, attends to Belen, a patient.
Theresa Hildago, a nurse practitioner, attends to Belen, a patient.

After completing his residency, the young pediatrician Dr. John Moses shed his white coat and spent eight years making house calls with a camera.

With a grant from the Lyndhurst Foundation, which also funds the Center for Documentary Studies, Moses split his time between Duke Medical Center and the homes of 25 teenage parents in Durham and surrounding rural counties. He would walk up to the door with a medium format Hasselblad camera to spend an hour or two hanging out, talking and shooting several roles of film. On return visits he would bring photos to show to his subjects.

These close personal interactions, accumulating to dozens of house visits between 1986 and 1994, resulted in a book titled “Youngest Parents” and a newfound clinical perspective on the motivations, fears and hopes of pregnant teens. The experience also led Moses, Trinity ’78 and currently a full-time, primary care pediatrician and an assistant clinical professor at the Duke Medical Center, to teach documentary photography for medicine at his alma mater.

“The arts can tap into important aspects of medicine that are hard to examine any other way,” Moses said. “The presence of arts in medicine reminds us—us being the doctors and patients—that we are complicated, vulnerable, sensitive human beings that need more than just the prescription or the operation or the expertly done procedure.”

Although he majored in zoology, Moses studied documentary photography as a Duke undergraduate. Projects like photographing a camp of migrant farm workers in eastern North Carolina prompted him to pick up his camera again after medical school. He now teaches “DOCST 104S: Medicine and Documentary Photography” at the CDS.

Moses’ photos are focused on documenting the patient experience and using what he discovers to improve medical care. In his class, students pursue projects that visually document areas of medicine, ranging from topics such as brain surgery to the treatment of gunshot victims. The documentary format, by humanely rendering the patient experience, is especially suited to effective medical service, Moses said.

“When we go to the doctor we need more than just shots, we need a compassionate, educated, human being across from us,” he said. “I’d like to think that [the arts] can help good doctors become maybe a bit better and remain good compassionate clinicians.”

Documentary medicine is expanding beyond the realm of his class. Moses helped, for example, to launch a monthly medical interest group focused on documenting medicine, and similarly, fellow Duke documentarian Liisa Ogburn now directs the Duke Innovation Fellowship—a documentary medicine program that is funded through the graduate medical education department and the CDS.

The innovation fellowship recently completed its first year with five residents from five departments, each documenting an area of medical interest to them with the help of a mentor photographer. The second class expanded to 12 students.

The interest from beyond the resident community has prompted her and Moses to launch an intensive four-day workshop on documenting the patient experience next May, Ogburn said.

“[The documentary process] forces them to slow down in a way they are not typically allowed or forced to do in their traditional training,” she said. “And they’re excited. Most of them came with the impulse to have these rich patient interactions. The way we train physicians, there isn’t time for that.”

Dr. Andrew Parker, a third-year Duke Emergency Medicine resident and member of the inaugural class of Duke Innovation Fellows, spends his workdays treating patients who come to the Duke emergency room, but for the last year, he has been coming in to the ER on his own time to hang around with a camera—sometimes a sophisticated lens with extensive lighting equipment, but at other times just an iPhone.

For his fellowship project, Parker photographed ER “frequent flyers”—patients who visit the emergency room often. Parker said documentary photography communicates a medical issue more effectively than traditional medical approaches.

“It really puts a face on the issues at hand. It turns a topic that’s really amorphous into a narrative,” Parker said. “People remember stories, they remember faces—they capture the humanity of a person’s illness.”

Parker’s year-long series of interviews and photographic portraits of repeat ER visitors have prompted action among the ER staff.

“We had data on frequent flyers, but we weren’t doing something about it,” he said. “But you do a documentary project and all of the sudden there’s a new committee, like ‘Hey, let’s fix this.’”

The photography project now sits as the first item on Parker’s curriculum vitae. In spite of skepticism he heard from some colleagues that the project would distract him from his career, Parker said recruiters at health care institutions like Kaiser Permanente have expressed particular interest in that qualification.

“My experience on the interview trail is with that on the top of your CV people are like, ‘Whoa, what is this? This is the kind of innovation were looking for,’” he said.

Junior Namrata Kodali wants to be a physician. In addition to her pre-med studies, her interest in photography as a hobby drove her to take Moses’ class. She developed a project focused on interviewing the family members of gun violence victims in Durham and discussing the circumstances of the homicides that claimed their loved ones and the impact of pervasive violence in their lives.

“It’s important that they are heard, and showcasing their images and their portraits is sort of crucial for their healing process and moving on with their lives,” Kodali said. “It’s important for people to talk.”

For her own class project, junior Talia Glodjo arrives at 6:45 a.m., dons a surgical “bunny suit” and stays at least an arm’s length away from all sterilized instruments. She documents the work of renowned neurosurgeon Dr. Allan Friedman, neurosurgeon in chief who has treated the late Sen. Ted Kennedy and former Duke professor and author Reynolds Price. Glodjo said she aims to explore the mystique that surrounds the practice of brain surgery.

“There’s this idea that being a neurosurgeon takes something indescribable, something more than being a [general practitioner],” she said. “I want to shed light on what it’s really like.“

Glodjo said she initially felt awkward photographing in the operating room but ultimately found the environment to be surprisingly calm and candid.

“Everyone in there is so professional, and they have their routine and I was obviously the odd man out,” she said. “I had to get used to getting up in the action, so to speak, instead of just passively clicking my camera. I had to photograph Dr. Friedman when he’s… completely in his element.”


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