Craniotomy involves a surgeon removing a piece of the skull to access the brain for brain surgery. They may perform craniotomy for several reasons, including: removing a brain tumor, repairing an aneurysm, removing a blood clot, treating epilepsy, implanting stimulator devices, repairing skull fractures, or fixing a tear in the membrane lining the brain.
The see-through drape, made of clear, lightweight plastic, provides better vision for the operating physician and guards against the risk of surgical site infection. Using plastic adhesive drapes to protect the wound from organisms that may be present on the surrounding skin during surgery is one strategy used to prevent surgical site infection.
Pneumoencephalography (abbreviated as PEG; sometimes called an ‘air study’) is an old invasive technique that involved the draining of the majority of the cerebrospinal fluid (CSF) from around the brain through a lumbar puncture. The CSF was replaced with air, oxygen, or helium to enable the structure of the brain to be more defined on an x-ray image.
A subdural puncture (commonly referred to as a subdural “tap”) is used to drain blood or fluid in the membranes (dura) between the skull and brain. This is done when there is too much fluid in the cranium, causing hydrocephalus or symptoms of increased intracranial pressure.
Ventriculography is a procedure where a patient's spinal fluid is removed from the brain and replaced by air, making a tumor more visible in x-ray scans. Air is much more permeable to X-ray than is bone. Thus the air shadow offers a marked contrast to that cast on the roentgenogram by the skull. (The roentgenogram is named after German physicist Wilhelm Conrad Röntgen, who discovered X-rays in 1895. ) Ventriculography lets doctors see the brain's structure and any deformations that would indicate the location of a tumor.
Mitchell Payne began a project in Jan. 1971 that would be an examination of the characteristics of the staff and patients of a large, modern hospital. He planned to photograph two hospitals, but eventually restricted his essay to one neurosurgeon, Dr. Duke*, a resident physician associated with Strong Memorial Hospital. Payne felt that his early photographs in this series were too sentimental, and later began to document aspects of the impersonal nature of the doctor patient relationship.
Focus Gallery (San Francisco, Calif.) exhibited these photographs as Hospital Pictures in Mar. 1972. This essay was published as "Neurosurgeons in Action" in the July 1973 issue of Physician's World. The Center for Creative Photography (Tucson, Ariz.) exhibited the photographs in 1977.
Mitchell Payne was born on March 31, 1944 in Shawnee Mission, Kan. Payne died August 19, 1977 from a gunshot wound. He was thirty three.
(Unknown. Mitchell Payne archive. Appendix A. [http://www.azarchivesonline.org/xtf/view?docId=ead/ccp/AzU-CCP_AG49.xml])
*I have written azarchivesonline to inform them that this collection of photographs (from Payne's graduate thesis) is in fact a photodocumentary following the artists brother, Dr. Nettleton Payne, as evidenced in his thesis, The Patient as Object. "Dr. Duke" is almost certainly a pseudonym for Nettleton Payne. Though Payne does not mention his brother in his early notes, or in his submission to Neurosurgeons in Action for whatever reasons, in the thesis statement for The Patient as Object he does mention him, implying the connection. His reasons for this initial concealment are unknown.
Photos in order of appearance:
Banner photo
ANDREAS FEININGER 1906 - 1999
The Doctor, 1955
Date: 1955
Accession #: 81.30.49
Medium: Gelatin silver print
Dimensions: 13 1/8 x 10 5/8 in.
Description: [silhouette of man with lighted mirror on head]
Photos in presentation
The Mitchell Payne photo collection can be found in the digital archives of the Center for Creative Photography, Part of The University of Arizona. Payne Collection: http://ccp-emuseum.catnet.arizona.edu/view/objects/asimages/search@?t:state:flow=adfe0ec7-7d9e-4bee-9a61-fcfe9037c18f
MITCHELL PAYNE 1944 - 1977
Self Portrait
Date: 1970-1972
Accession #: 81.204.83
Medium: Gelatin silver print
Dimensions: Image: 5 5/16 × 7 15/16 in.
Description: [two men sitting on gurney in hallway, side view, hand on thigh, biting lip]
MITCHELL PAYNE 1944 - 1977
Hurrying to X-ray for cerebral augiography
Date: 1970-1972
Accession #: 81.204.139
Medium: Gelatin silver print
Description: [man in scrubs holding double doors open, woman on gurney]
MITCHELL PAYNE 1944 - 1977
man in head brace, Rochester? N.Y. hospital
Date: 1970-1972
Accession #: 81.204.115
Medium: Gelatin silver print
Dimensions: 5 9/16 × 8 3/16 in.
Description: [back of shaved head and shoulders, surgical implements taped to head]
MITCHELL PAYNE 1944 - 1977
Operating on a dehumanized patient
Date: 1970-1972
Accession #: 81.204.166
Medium: Gelatin silver print
Dimensions: 7 7/8 × 5 11/16 in.
Description: [draped medical sheet taking up 3/4 of image, two people in scrubs standing next to it]
MITCHELL PAYNE 1944 - 1977
Opening the skull for the removal of a brain tumor
Date: 1970-1972
Accession #: 81.204.148
Medium: Gelatin silver print
Dimensions: 8 1/8 × 5 1/2 in.
Description: [hands in motion using hand crank drill with another hand holding skin away from back of head]
MITCHELL PAYNE 1944 - 1977
Moving an obese anesthetized patient from the operating table to the patient's bed
Date: 1970-1972
Accession #: 81.204.153
Medium: Gelatin silver print
Dimensions: 5 13/16 × 8 11/16 in.
Description: [people in scrubs surrounding patient with exposed breasts on table]
MITCHELL PAYNE 1944 - 1977
Patient's head draped behind self-adherent plastic in preparation for craniotomy
Date: 1970-1972
Accession #: 81.204.150
Medium: Gelatin silver print
Dimensions: 5 11/16 × 8 3/8 in.
Description: [back of shaved head covered by plastic sheet]
MITCHELL PAYNE 1944 - 1977
untitled
Date: 1970-1972
Accession #: 81.204.45
Medium: Gelatin silver print
Dimensions: 5 1/2 × 9 7/16 in
Description:
[close up of patient under plastic cover, with ventilator, two gloved hands.
MITCHELL PAYNE 1944 - 1977
Pneumoencephalography in progress
Date: 1970-1972
Accession #: 81.204.147
Medium: Gelatin silver print
Dimensions:8 1/4 × 5 1/2 in.
Description: [baby being held up by two hands, device over face, person in scrubs in background]
MITCHELL PAYNE 1944 - 1977
untitled
Date: 1970-1972
Accession #: 81.204.54
Medium: Gelatin silver print
Dimensions: 5 1/2 × 7 13/16 in.
Description: [man holding baby's head steady while doctor inserts needle, doctor holding vial in other hand]
Payne, Mitchell, "The Patient as Object" (1971). Thesis. Rochester Institute of Technology. https://scholarworks.rit.edu/cgi/viewcontent.cgi?referer=https://www.google.com/&httpsredir=1&article=4579&context=theses
Yardumian, Aram. “The Death of the Hero-Surgeon: Mitchell Payne's The Patient as Object.” 2010. http://web.fu-berlin.de/phin/phin52/p52t4.htm