Ola Tumor: Shooting High End Surgery

9 cm long, attached to the carotid artery in patient's neck

Ah, tumor, my old enemy. I didn't see you in such a pretty light when we first met. Now you look to me like a starfruit, a papaya overripe, an exotic tropical fruit selling for $5.99 a pound at Whole Foods. Detached like this, posing for my camera, the tumor inspires wonder rather than horror, and I have no sense of toxic radiation, not an inkling of spread; you are trapped in solitude, cut away from your host, a bauble to be admired as a fighter might regard a battlefield trophy.

This picture is nine frames, combined. It is bracketed in nine pictures separated by a stop each, so the light that carries the image ranges over nine stops. The process isn't elaborate to do, but can seem so to other people, so as I am shooting this I come to the attention of three surgeons who are discussing the operation, just concluded. What is he doing? asks one surgeon of another. "It's art, he's making art of the tumor," says the surgeon who removed it, and the others say "ahhhh" and tippy-toe around me. Professionals stay out of each other's way, and I am like the fellow cleaning the office windows: if a bookcase must be moved, the millionaire must stoop to it and push or lift so the $13-an-hour laborer can do his thing. I have disrupted the entire surgery with the needs of my camera, but the surgeons have needed me, and they make room, pushing and lifting until I am happy beneath the blazing light and they proceed like several Leonardos to cut into cancer's victim to save her life.

The tumor is 9 centimeters long, about four inches. But it's surprisingly fat, and relatively rare for its location, attached to the patient's carotid artery, a small grapefruit bulging in her neck. The carotid artery brings oxygen to your brain, pumping blood upwards from your heart. (The jugular brings the blood without oxygen back to the heart.) The cancer has grown onto her carotid, and the operation is potentially fraught with problems. If the surgeon makes a small mistake, the room will be showered instantly in the patient's blood, and a second operation to correct that mistake will break out, and my camera will be as if submerged. The surgeons want the procedure of removing the tumor caught on camera for a teaching opportunity. I go up to New York to shoot this removal, another strange step in my odd apprenticeship, a decade-long, with photography. And moreover, the surgeons want me because I am also teaching photography, and think I can bring another element to the operating table, of telling a story rather than simply recording a procedure. As they talk about this, I am reminded of advertising's new edict: Tell, don't sell.

And at 06:40 I am in operating theatre #3, setting up, beginning to realize the gravity of my situation. No Starbucks, no chai, no caffeine, and no food for more than 10 hours, and now I am hungry and dull. And the hour! This is when I go to bed. Four hours, five hours in surgery? I am offered coffee, but I've never drunk a drop of it and this causes mirth. I am feeling fainter. How many steps to each door, I calculate, in case I have to fall down? And the scrubs they have put me into, over my clothes, are making me warmer by the minute. The mask pinched over my nose is lending a new claustrophobia to my spinning mind; I try to concentrate on details, and shoot this and that around the empty battlefield. And then I think of the patient, incoming. They're going to cut her neck open and I'll be inches away from the knife. Yasus, which idiot put me here? A surgical nurse pops in and I almost say, okay, I made a mistake, get me out of here, and then I think, did I pee? Am I going to be here hot, sweating, hungry, thirsty, decaffeinated, and having to pee for four hours while the gaping yaw of the patient's open neck emits a unique smell beneath my nose and camera. I am reeling now in tiny panics, little waves that slap the vessel of my ambitions: I should be shooting flower petals flecked in dew, not some pulsing vein. And the tumor! There will be a tumor, my old friend, and now I am ready to pack up and retreat, and at that exact moment they bring the cancer patient in and hoist her from the gurney to the table, and she is not lively but she is alive and manages to smile at me and say thank you. She knows she's being filmed, she's signed the releases, and she is resigned to her fate because the grapefruit hanging onto her neck is making life a misery; dying now, in a small mistake, is better than the slow collapse she is experiencing on the outside. And, sweetheart, I have been there, resigned and lonely more than terrified when they separated me from the people I loved and said, "Time to go, Sean," and Sandra filmed me being wheeled through the doors to the operating theatre. What a pathetic sight, both times! Normally so loud and boisterous, reduced to a whimper. I lower my mask, and smile back at the patient. This small gesture, allowing her to see my smile, causes her to smile back and I give her a thumb's up and press Record.

My surgeon took out my tumor, another four-incher, but much narrower than the version in the picture, and saw six bulging lymph nodes that he didn't like. Radar, his sense of disorder, made him make six snips; five of them carried cancer. But on video before my first operation I instructed them all not to give me any information about their findings. N O N E. I wanted no statistical bracketing, and I found out about the lymph nodes 15 years after surgery. A death warrant I was never served. And more peculiarities: I went into the operation with a Walkman and a tape cassette, and an earring, and the nurses objected, and I stood up to walk out. The surgeon walked in, What's all the fuss? He won't take out his earring because it was molded together in his ear and it will break, and he wants to wear a Walkman during the surgery! Michael Choti, Johns Hopkins, oncological surgeon, wants to know what I have on the tape. I have flamenco, and my own voice telling my red blood cells to cooperate with the man with the knife, that he is our friend, hold onto our panic, and Choti says he loves flamenco and tells the nurses to chill and rules are made to be broken, and as they start to put me under the anesthesiologist volunteers to turn the cassette over when it reaches the 45 minute mark. I give her a thumb's up and she smiles. (Unbelievably, she finds me in my recovery room the next day and sits by my bed and asks me all sorts of questions about life and creativity before saying wondrously, Whatever you told your body to do during that operation worked out pretty good because when we cut you open we all stood there for a few seconds and then looked at each other and wondered why you weren't bleeding. Anesthesiologists  n e v e r  visit the patient!)

This tumor, in the picture, the toxic starfruit, pops out of the patient's neck and you can hear the oohs and ahhs when it does. The surgeon expertly and patiently cuts it away and asks me if I am okay and do I have a good angle. And when the tumor is detached, he places it on the patient's chest and slowly cuts into it, as he might into a baked potato. The surgeon wants to know how solid its core is, and the tumor melts as if ready to be diced onto a salad. They are yelling at the woman within an hour, slapping her awake, demanding that she say hello, come on, say hello, and when she manages a weak "hi" everyone grunts and walks out to the next operation. Later that night, she will reach up and touch her neck and smile in disbelief. The tumor is gone.

The surgeon takes an inkjet printout of the tumor to show her family. He turns to me at the door and says, "It is not as good a picture as yours, of course, but it's a picture and they will feel better when they see it, the family." We both laugh.