On this week's journey, I think I'll let the pictures speak for themselves. Well, perhaps a bit of commentary to tie it all together.
The title card is from the Philly Airport. I had just enough time between flights to grab a bag full of food for the 4 hour trip out to Denver. I ate it all, and got a lot of work done on the plane. Sometimes I think I should install an airplane seat at my desk!
Let's backup a bit. The planning for this trip was interspersed with another time consuming project. I suspected there might be some last minute work to do before leaving town, so I packed my bag days in advance.
As predicted, the night before the flight, I had a request to help create a powerpoint presentation matching the design of the video graphics, and including some video clips from the edit. To avoid a late night in the office I decided to take the computer home and do the rendering at night while I did some other chores to prepare my wife for a few days alone:
Clean dishes to eat...
...a pasta casserole with vodka sauce, sun dried tomatoes, artichoke hearts and Kalamata olives.
Media Encoder seems to move slowly when a deadline is looming. The files finished at 11pm. I set the FTP upload going and went to bed. When I woke up at 3am, the files were ready and i could email my client.
No time for breakfast, gotta hit the road.
One nice thing about such an early flight is I can get to the airport in less than 45 minutes, security is a breeze and the terminal is deserted.
I have to admit I was a bit bleary eyed.
You know it is an early flight when the sun is just rising while making your connection.
I spent the flight primarily reviewing the detailed shot lists prepared by my colleague. being familiar with the shots and formulating questions for our contacts on the ground would be helpful in the meeting scheduled a few hours after landing.
Back in the Denver airport, underground to the choo-choo, luggage, pickup curbside by another co-worker already in town, and to the hospital for pre-production.
After a long flight, airport food, car ride, meeting and running on vapors, we all decided to get grocery store food and dine in our rooms. But we were not done yet. After getting the gear charging and self-nourishing, it was time for a final planning session, going shot by shot, deciding upon the schedule and division of labor. Teamwork is vital.
Next morning, get to hospital, change into scrub attire and get setup. Specifics of the shoot are, as in many cases, proprietary and not able to be discussed in detail. However it is the teamwork and the process that is important to talk about here.
Lunch break arrived around 1:30pm for me. The break room had one of those automated coffee machines - you select decaf or diesel, mocha or regular, small or large and hit GO!
Back to work. The afternoon was spent getting a lot of stills with the 7d and various action shots in and around the OR. Follow the shot list, work the system, get your shots, think on the fly, stay motivated, think creatively, give directions, explain things, show peole what you need and make your moves.
Finally at 5pm it is a wrap for the day. It's a weekend, people have plans. Our plans are to find a restaurant, eat, maybe see some daylight, and have another planning session to make sure we get what we need on the final day.
Here are a few interesting shots from the day.
Overall, despite the earlier hours, cheap coffee and dry air, a satisfying way to spend the weekend. The material captured over two days will help to complete several important projects over the coming weeks. For now, thanks for reading.
When preparing for a shoot, a trip or a trip to a shoot, one must visualize the known knows and anticipate the known unknowns. A little bit of planning plus confidence in your abilities and you are off to a good start.
Recently I have discovered Live Maps - a more detailed online mapping service - excellent when planning a driving route in unfamiliar territory. Normally Google maps with and without the satellite view is adequate. But sometimes it is hard to tell where highway exit and entrance ramps are - fairly important to have nailed down before getting in your rental car in a strange town. See the following examples of the same location to see the difference:
bird's eye view:
Is it real..or is it Microsoft? Hey, that's catchy.
Especially good feature for a close-up view of exact destination:
This week was a quick 24 hour trip to Toronto - just as much traffic as New York but more spread out. I flew out of LaGuardia in NY - a trip I can do with my eyes closed. No sign of any geese so that's a good start. An Air Canada mini jet makes for a quick 1 hour jaunt across Lake Ontario - wait for the tripod tube, and hit Canadian customs. When carrying commercial goods, even if they are not for sale, you need to declare your items to customs. There are two ways to do this: 1. Purchase and properly use a ATA Carnet, or 2. Get an invitation letter from your client and hope that is enough. I went with option 2 since all I had with me was my operating room tripod - I rented the rest of my gear locally. If carrying my own camera I would go to customs in the US before departing, get the Carnet stamped or whatever, and do the same in my destination country, then reverse the process for the return trip. Next time you have an international trip here you go: http://www.atacarnet.com/
Speaking of customs, I get a bit paranoid about losing my passport, so a trip like this calls for my travel pants. The Zippered pocket is roomy enough for wallet, passport, phone, pen and plane ticket.
Now for the exciting part. 1 hour of flying + 3 hours of driving = not much fun.
First stop, downtown Toronto to Vistek, the Bexel equivalent of Canada. Picked up a HVR-V1U and a JVC 9" monitor.
Next stop hotel about 15 miles North of downtown. The maps made it look pretty easy. The maps did not however depict the wall-to-wall traffic in all directions. Oh well, good thing I left plenty of time in the schedule. One advantage of traffic congestion is the opportunity to drive around neighborhoods and check out the local architecture. Toronto as it turns out has some pretty classy areas, with lots of brick.
As usual, I choose a hotel with free coffee in the lobby, and within walking or short driving distance of shopping/dining. Since it was only 6pm, I had some time to kill and no laptop. I found a bookstore and then a wine bar/restaurant. Drumroll please...and here as expected, is one the famous Mike Cohen camera phone food pictures:
Now to the hospital for the shoot. 6:30am - a late start! Three patients on the schedule, huge operating room, helpful nurses - we like nurses! - life is good.
This I can do with my eyes closed - the "known knowns." Change into scrubs, setup the camera and monitor, get the right angle, ask questions, follow the action, drink coffee. This particular institution offered complimentary coffee, snacks and lunch for not only the staff but for the patients. Nice!
I reversed course - gear in car, drive back to Vistek, return the gear, browse the 3-levels of photography heaven...Turns out the EX1 and EX3 are a lot bigger in person, and very poorly balanced for hand held use.
I don't get too much time to visit B+H in NY, so any time I can browse such a showroom I'm a happy camper.
...then gas up the rental car, find the rental facility, van to the airport, and check-in. I generally book late flights home, not knowing the actual schedule until a few days before the shoot - too late to book tickets a reasonable rate. No worries. Air Canada has a pretty fair pricing system - $50 to change to an earlier flight to the same destination.
You actually go through US Customs at the Toronto airport - presumably there is such a volume of US bound passengers the NY airports would be overwhelmed. Thanks Canada, always thinking of us!
With an hour to wait I spent my remaining Monopoly money on food, got on my plane - this time an Airbus - read a little, slept a little - landed 3 hours earlier than originally planned - luggage, car, yadda, yadda yadda...
Home by 9:10pm as opposed to 12:30am. Very nice indeed.
Having had a shoot on Friday before Memorial Day Weekend, I shall now return to the office after a week to capture and edit and then continue planning the next shoots wherever that may be - one thing's for sure, it won't be anywhere near home!
In summary, adequate planning combined with actual feet on the ground experience makes the knowns confirmed and the unknowns into known knowns. You know what I'm saying?
Thanks for reading.
If I am waiting for a plane or waiting for the distance between Connecticut and California to shrink, I sometimes recall past experiences. This was supposed to be the goal of this blog, but the present seems a lot more interesting. So we'll take a break from the hustle and bustle and recall a few unique experiences. One can always learn from the past. I am somewhat methodical in my, er, methods, so I'll go sequentially...
My first solo shoot. Having accompanied several shooters on about a dozen trips both in the OR and other settings, it was time to be the lead guy on a trip. We were doing a video about the immune system. Driving on the New Jersey Turnpike was a new experience for me, but it is basically a very busy road which passes through some really polluted landscape. Interestingly, ballast from ships returning from WWII was dumped in the swamps near the Meadowlands.
Anyway, I arrived at my location in Southern New Jersey. Setup One was a hospital room. A child was about to receive an infusion of intravenous immunoglobulins - basically a treatment for immune diseases such as Kawasaki's Disease or Guillain-Barré Syndrome. As it turns out, this was rather uneventful - took about 30 seconds. Next setup was a laboratory, where I threw some orange light on the background and shot various angles of a lab technician mixing the IV solution. Slightly more interesting. Finally on the ride home I stopped for a tour of my dad's office in Edison. Most interesting of all!
Cincinnati. Growing up, the only thing most kids knew about Cincinnati was WKRP and Loni Anderson. As it turns out there is more to this town than meets the eye. My particular shoot was at, get this, a hospital! Seriously, it was the first Ob-Gyn surgery I had filmed and it was a doosie. People often ask me if I get queasy. Usually the answer is a resounding No. On this occasion, the answer was Yes. Since kids and moms read the blogs, I will just say that there was a lot of blood, and you the reader can use your imagination.
Around this time we started going to Philadelphia a lot to work with two different world-renowned surgeons. One was another Ob-Gyn surgeon specializing in reconstructive surgery. Again, without going into too much detail, he is a specialist in fixing problems with incontinence and other problems in that region. But the best part about this surgeon was his personality. He had some funny stories to tell about his patients. Knowing there are some comedians here on the COW, see what you can do to setup the punch line "I need you to water my lawn!" During one operation, this surgeon said, "This ovary is really calcified. Mike, you gotta feel this." So I dutifully put on some gloves and was handed the excised organ in question. It was indeed the most calcified ovary I had felt (up to that point anyway.)
The week after my honeymoon, I was off to South Bend, Indiana. You get off the plane and there in the airport is a shiny new Hummer - the big Ah-nold version. South Bend is home to AM General and of course the University of Notre Dame. This particular project was about Cryosurgery. Not quite as cool as it sounds. There is an opportunity for a Mr. Freeze joke here, but I have already mentioned the Governator once, so I will let it go. Basically, for two days we were setup in a local doctor's office with a camera. Each patient that came in had some form of wart to be removed. Technically, not all growths on one's face or neck are warts. There are plantar warts, moles, skin tags, and other exciting appendages. Amazingly, a liquid nitrogen spray freezes the little devil and after a few treatments it will fall off. Hasta la vista, baby. We also did a video about using the cryo spray gun, venting the excess liquid nitrogen, and learned how to make a fun fruit punch for Halloween parties!
LA. Although I visited LA once during college on a family vacation, this was my first trip sans-Griswalds. We were shooting hernia surgery. The surgeon asked that we shoot with two cameras. May I remind you this was 1997. Video cameras and operating room tripods weighed in at about 90 pounds each at the time. So my colleague Mike and I took some fly by night airline out to LAX and checked into the Riot Hyatt on Sunset Blvd - the hotel where Led Zep was known to tear it up back in the 70's. We hit Hollywood Blvd, went to the Ripley's museum and stuck our hands in the various imprints on the Walk of Fame. Thinking back, this is a good way to pick up an unwanted souveneir. Should be called the Walk of E. Coli. Anyway, the next day we arrived at the hospital setup our two hulking towers of stainless steel and BNC cables, cameras (HL35(?)) tube camera with dockable MII deck on one side, HL55 2/3" CDD camera with portable BetaSP deck on the other. Lock and load! This video remains a top seller, if hernia surgery is your cup of tea. It is one of the most common surgeries performed in the world, so it is the cup of tea of a lot of people.
Detroit. Cue KISS music. I visited the Motor City a few times this year, just the luck of the draw I guess. For the first trip, I stayed at the Omni Hotel, a glass structure reminiscent of the Bonaventure Hotel in LA - a hotel I always wanted to visit since seeing the 1980 Michael J. Fox classic "Midnight Madness." This futureworld was complete with a Ford display, monorail and a direct link to GreekTown for all the lamb chops and souvlaki you can eat. The next morning I arrived at the hospital for a planned C-Section. The doctors had determined that the full-term baby had gastroschisis - a disorder in which the intestines have herniated through the umbilicus during development and stayed there. Having never seen a baby being delivered, this was very exciting. What was not exciting was seeing the baby rushed to another OR, while I had to break down my gear and move it all to the other OR before they did the surgery without me. No worries, I think one of the surgeons helped carry the tripod (the big 70 pound one) One of these days I will post a picture of the beast. For now here is a cartoon.
Once in the OR, the surgeons reduced the bowel back into the baby's abdomen and used some mesh to reinforce the skin until it grew large enough to accommodate the contents. In other words, the baby grew inside the womb with some of the bowel outside of the abdomen, so there was not enough room to put it all back where it belonged.
The New Millenium. High tech was upon us. We had recently started using the Media 100 XR for most of our projects, but we kept two online edit bays up and running. Since LVD SCSI drives were very expensive ($3500 for 9 gigs) the long form projects remained on 1" tape.
One particular long project was the creation of a 25 tape video library. A surgeon has previously recorded about 50 DVCPRO tapes worth of live cases. So it seemed we were starting out with good material. However, the switcher feeding the DVCPRO deck was not synced to anything, so every time there was a cut there was a loss of picture sync. Oddly the audio continued. So first we had to dupe off the tapes to a new reel, in order to be able to use the source tapes for online editing. Once that was sorted out, we sat with the surgeon for a few days editing all the cases down to length, then a few weeks later recording hours of narration for final editing.
While we were in fact in the 21st Century, the world had not yet caught on to this fact. We went to Baltimore to document a conference, basically consisting of 2 days of slide lectures. In 2001 Bill Gates had not yet convinced the whole world to start using PowerPoint. Thus, as each speaker presented his slides, we had a guy in the back of the auditorium scanning the carousel of the previous speaker.
However because it took 60 seconds per slide scanned, it became a bottleneck. Well, the conference ended, we managed to return all slides to their rightful owners, and we journeyed back home to begin editing the slides into the video. Each lecture became a 400x300 Sorenson Quicktime file to be integrated into an Authorware CD-ROM. Seemed so high tech at the time!
End of BCE - Before Computerized Era
2002 - The Computerized Era - in other words, the time by which everything was digital, and the 1" machines died. It was a long time coming. With that I will sign off for now. The fact that I can recall such details from BCE is pretty incredible since I don't recall what I had for breakfast today. I will pick up this trail in a future post tentatively entitled "Tales of a Fourth Grade Editor."
Thanks for reading. Sorry about the graphic story....Ah yes, it was eggs!
Mother's Day weekend 2009 - sorry Mom, I will see you soon! Duty calls.
Two weeks ago, or whenever my last blog post was, er, posted, I did a site survey and client meeting in advance of this past weekend's trip. After months of editing on a new crop of videos, we made a detailed list of pickup shots needed to complete these videos, and shots to cover some new scripts recently green-lit for production.
As usual, the locations for our projects are far from home. But thanks to modern air travel, it is mostly easy. i say mostly because modern air travel has a few problems:
Faster than driving, probably safer. But I like to know what I am flying before I book my ticket. Airbus A320 or 737 - good. MD80 or Turboprop commuter plane - not so good. Mini-Jet such as the Dash 8 or Embraer 90 are good choices for short flights. Preferentially I pick an aisle seat behind the trailing edge of the wing on the right side - supposed to be the safest spot on the plane.
I listen to the safety lecture and reach under my seat to see if there really is a life vest. You never know.
Lost luggage is ok if all you are missing is your electric razor and iPod charger. Lost luggage is a big problem when it includes tripods and DVCPRO tapes. Last time I checked, my neighborhood big box store was out of stock on DVCPRO tapes. Thus, it is a good idea to arrive early enough in the day to give your airline time to locate and deliver your luggage.
Luckily on this trip, we all got all of our bags.
Carry On Luggage.
A shoot like this has a lot of luggage. There have been debates on the Business and Marketing forum about Shipping vs Checking gear. We always check our gear, but sometimes I think otherwise. Checked bags cost a lot each way, meanwhile carry-on restrictions are getting...restrictive.
While I have stayed in many spectacular hotels over the years (Fontainebleau Miami, Ritz Carlton New Orleans, Sir Francis Drake San Francisco, and of course the grandiose Washington Hospital Center Guesthouse) the more you pay, the less you get. Let me explain. Luxury hotels give you plush bedding and nice toiletries, but you also get the privilege of buying a cup of coffee whenever you feel like it and the $19.95 breakfast buffet in the morning. Oddly, table service at fancy hotels is especially slow.
On the flip side, budget hotels designed around business travelers, such as Hampton Inns and Holiday Inn Express, the less you pay the more you get.
Free coffee and tea 'round the clock in the lobby and in many cases a free breakfast buffet for all guests.
Free in-room and in-lobby wi-fi is a rarity in a fancy hotel(wired/expensive), but at the previously mentioned variety of hotel, it is expected. A nice business center featuring comfy chairs, computers and free printing is another bonus of the budget hotel. Certainly there are super-budget hotels like La Quinta or Super 8, but I have seen free buffets and wi-fi and pretty low prices.
When booking a hotel, with or without a car, it is important to scope out restaurant choices ahead of time. In an effort to save costs, finding decent dining within walking distance of your hotel is a good idea. A nice meal plus round trip cab fare is less nice. On this particular trip, we picked a Hampton Inn on the edge of downtown Denver, just a few blocks from the 16th St Promenade, similar to the 3rd St Promenade in Santa Monica.
In other words, closed to traffic, decent selection of restaurants, and a smattering of street performers and homeless guys begging for coin. We actually saw a robbery in progress at a 7-Eleven with police in hot pursuit. Better than Southland, that's for sure. Only problem with walking to dinner, after a 12 hour shooting day on your feet, is walking BACK from dinner. Well, the beer helps you fall asleep in advance of the next day's 6:30am call time!
On the flip side, some downtown areas are pretty scant when it comes to restaurants. A recent trip to Phoenix for a convention produced limited options for dining without a cab ride. In all fairness to Phoenix, I have had some very good meals east and west of downtown - no offense. Sometimes after a day standing up at a convention center, the last thing you want to do is travel far to get some grub. Room service, hotel dining, or a local dive is sometimes a better choice.
People make fun of me, but if I get a good looking meal (hopefully good tasting) I snap a photo on my handy phone cam.
The Shoot Itself.
We have a unique location - a hospital.
Depending upon the shotlist, we may be in the OR, patient holding areas or central supply. A helpful crew of volunteers, use of supplies and the ability to start and stop with the exception of surgery (I have occasionally asked a surgeon to pause what he is doing for a tape change) are all important elements. Also important is of course knowledge of your capabilities. Look at a setup, know where to park the cameras, and know if when you stop tape you have what you need.
Another part of being prepared is being prepared for anything. It is a long walk back to the office for a missing piece of kit, so on these trips we take everything. Thus the trusty blue Porta Brace bag is packed to the gills with extra mics, XLR cables, AC cords, camera power supplies, blank tapes, a portable mixer and the trusty wireless kit. Just make sure you keep track of the wireless transmitter before someone goes to the bathroom or worse - home.
Safety is also important when you have smooth tile floors, lots of cables and lots of people wearing floppy shoe covers and face shields.
Monitoring what you get and occasionally checking playback is good peace of mind.
With the shoot complete, a celebratory meal, and a brief night of sleep, it is time to wake up early for the flight home. I am well past the age of taking a red-eye home. Although LAX at midnight is a nice trip back to 1960. Sometimes my eyes play tricks on me.
Return the rental car, check luggage and stock up on pre-packaged sandwiches and bottled water for the flight home.
Call the valet parking hotline, take the shuttle bus, pack my gear in the car and drive home.
Next day return to the office, fire up the Falcon and check voicemail.
After a shoot like this, we have a lot of tapes to digitize.
But before that, just like looking at your double prints after a pre-digital vacation, you check the tapes and see if you actually got anything on tape.
Good stuff. The AJ-D700 is still a great camera after all these years. And the V1U speaks for itself.
In summary, as discussed ad infinitum on this blog, travel is wrought with details and potential problems. But with careful planning, teamwork and a little bit of luck - and a good night's sleep, free coffee and good meals - you can look back and smile. Thanks for looking back with me on this one. It was fun.
As a kid, I had two dream possessions: Batman's utility belt and a Stormtrooper utility belt. Basically the same thing - a belt with useful gadgets. Turns out the Stormtrooper belt was an extension of the Jedi utility belt, but let's not get too geeky.
Fast forward to the present. I recently spent a week on travel, with essentially 5 different video shoots. When I pack my gear for travel, I try to keep as lightweight as possible, but I also try to take everything I could possibly need. In a word: gadgets.
On this trip, a blue Porta-Brace bag was my gadget bag. I packed it tight with gadgets large and small, including some I have not yet had a chance to use.
XLR cables. You can never have too many audio cables - either to use individually or to link together for longer runs. On this trip, I spent 3 days in an auditorium take a feed from the house sound mixer, so longer runs were not needed. However I also did an impromptu 2-camera shoot with 4 live mics.
Field audio mixer. I picked up a low-cost Azden mixer a while ago, knowing I would need it eventually. For the aforementioned panel discussion, I thought about taking a AC powered Boehringer mixer, but no matter what I did with it, I was getting a noisy signal into the PD-170. I posted on the Audio Professionals forum here on the COW, and got some great feedback, but I could not solve the problem. The original plan was to have a moderator and 4 panelists. Thus I needed my 4-input mixer going into 1 XLR channel on the camera, with a 5th mic going into the 2nd XLR on the camera. With the Boehringer problems, I was relegated to the Azden 3-input mixer, leaving me with 1 more mic than XLR inputs.
We will call this the Hot Dog Bun Problem.
It is well-known that hot dogs and hot dog buns come in different sized packages. 8 hot dogs vs 6 hot dog buns. Thus you always have too many or too few of one required food component. Same goes for the mics.
My solution was sitting right in front of me. My 2nd camera for the panel discussion shoot was a VX-2000 - our much-loved original 3-CCD DV camera. The VX has 1 mini audio input, which takes either Line or Mic level. However XLR mics can be plugged into the VX via an adapter, but with inconsistent results.
We have a Sennheiser wireless mic kit, which has both an XLR and a mini output. Mini plug into the VX - crystal clear signal. Problem solved. When the actual shoot date arrived, one of the participants was not available, so I was down to 4 participants - all mics went into the PD-170 without incident. Sometimes serendipity prevails.
Speaking of the wireless mics, the kit also came with an XLR transmitter, which can be attached to any input - a hand mic, such as for news stand-up reporting, an XLR or in this case, an audio mixer. For the last day of the conference, I wanted to move the tripod elsewhere in the auditorium to avoid the inevitable heads in the way. However all of the XLR cables were engaged in the panel discussion setup (I setup at 7am for the 12pm shoot). Also, I had the levels and setup with the PD-170 all perfect, so I took the VX to document the conference.
I grabbed the trusty, yet never actually used before, XLR wireless transmitter, plugged it into the output of the house mixer, and voila - the most crystal clear audio feed into the VX I have ever heard.
Another problem solved by taking my bag of gadgets with me. You never know what you might need and when you might need it. But if you know what you might need at some point in time, and you have those things available, when you do need them, you can calmly reach into your bag of tricks and make the magic happen.
Thanks for reading.
Although lampooned recently on SNL, Macgyver was once a 80's tv show and it is now a noun, verb and adjective. To "Macgyver" something is to improvise, to use Yankee ingenuity to get the job done.
In video production, there is a lot of thinking on one's feet. Sometimes it is simple, sometimes more complex. A bag full of tools and gadgets can make or break a shoot.
Someone started to call the common clothespin a C-47. Apparently Warner Brothers stored clothespins in a bin marked C-47 - or a fancier name was needed to make it sound like something other than a clothespin. Whatever the reason, you can do a lot more than just clip gels and diffusion to a light. You can fasten a piece of cardboard or paper to any number of materials, to create a makeshift teleprompter, flag or bounce card. You can keep cables, headphone wires or other parapharnelia neat. And should you pack too few socks in your carry-on bag, you can do laundry in your hotel sink and hope it dries by morning.
The Ponytail Holder
I sometimes get strange looks when I buy a pack of these at the drug store, but there is nothing cheaper for holding a coil of audio or video cable wrapped tight. Actually you should see the strange look I once got when buying some nylon stockings - I was trying to soften the image of a wrinkly interview subject! You can also use them to secure cables to a tripod leg, utility cart or to keep cables together. The slightly less cheap multi-colored Velcro® strips available at your local home center are good also.
These doohickies, though seldom used unless you are in an office with a drop ceiling, are a great way to secure a light without a stand.
A solid utility cart
For years we used a pair of stainless steel and aluminium carts. These were well balanced and held our 70+ pound OR tripod. This tripod was a beast, originally designed to support a 16mm camera back in the 70's - we used it up until 2003 with our D700, now it is in the basement with the large Anvil cases and the lost ark of the covenant.
Now we use a pair of Rock-n-Roller carts. These things are lightweight and so far indestructible. We got one in 2000 and it still has its original parts, and you can move a VW Bug with it.
Gadgets in the OR
In the OR, when shooting surgery, we use a combination of our own gadgets, plus we get to see the latest gizmos used by surgeons. There are some amazing devices, all of which should make you quite optimistic about surgery.
When opening up an abdomen for surgery, you need to keep the small intestine, omentum or colon out of harm's way. There are some pretty cool choices. The Army-Navy retractor is very useful, compact and has two sized blades for retracting smaller structures. Malleable retractors are basically flat pieces of metal with rounded edges, and are bendable (malleable in medical-ese) so they can be shaped around a particular structure. Self-retaining devices, such as the Wheatlander have the handle like a pair of scissors but the business end looks like two serving forks with the tines bent outward. You squeeze the handle and the tines extend and lock into place, keeping a smaller incision wide open - hands-free (very useful in hernia and axillary surgery). The Thompson retractor, and others like it, use a large ring with ridges, mounted to a vertical support, over the incision. Then several retractor blades are attached to the ring with spring-loaded clips, widening the operative field, also hands-free. From a video point of view, the fewer hands the better!
Most people know the term "cautery" or "cauterize." Cauterization is using heat to seal tissue, as is often done in the eyes or nose. However the electrosurgery device, usually called the Bovie, uses electrical current to cut or coagulate tissue, such as blood vessels or other connective tissues. You can basically cut anything with it. There is a grounding pad placed on the patient's thigh, which takes the excess current and gets rid of it. Another form of energy is ultrasonic energy. A cutting blade vibrates at an extraordinary frequency, cutting or coagulating tissue in the process. Kreskin would be impressed.
Many people who have had surgery are familiar with Skin Staplers, an alternative to skin stitches. In ancient Egypt doctors would use the pincers on an insect to close wounds - for real! However another type of stapler is the surgical stapler. This is hard to explain, but it is a device which uses several rows of staples and a blade to both divide and join structures, depending upon how it is used. These are used to cut bowel and to join segments of bowel together, and for other uses, such as in obesity surgery.
No, this is not the device that turned Bruce Banner into the Hulk. In some types of surgery, notably breast cancer surgery, a radiation-detecting probe is used to find the extent of the spread of cancer. Let me explain. Prior to surgery, the patient is injected with technetium sulfur colloid, a specially designed radioisotope designed to adhere to cancer cells in the lymphatic system. A pre-operative scan shows lymph nodes which have captured the material. Then during surgery, the surgeon moves the probe over the patient's axilla (armpit) and monitors the radiation level detected. A higher number indicates a large take-up of the cancer-adhering material, and that lymph node is removed. They keep at this until the radiation level decreases. The last lymph node detected that is removed indicates the extent of cancer spread, and prevents the need, in some patients, for a complete lymph node dissection at the time of breast cancer lumpectomy. A similar technique uses a blue dye in the same manner. This is about as close to Dr Crusher's medical tricorder as you can get.
Some years ago I helped produce a monthly course on this procedure. We had two OR's wired up with remote control pan-tilt cameras, wireless mics and a video conferencing touch screen control panel, connected by fiber to a conference room in another building. I would sit in the control room, operating the cameras and switching sources (and sometimes recording the non-synchronized switched feed to DVCPRO), while my colleague in the OR would manually move the camera booms, wire up the surgeon for sound, and communicate with me via wireless land-line telephone headsets. We did this two days a month for 6 months in a row at a hospital in Tampa. Fun stuff. Lots of troubleshooting.
Let's say a patient has metastatic cancer. This means cancer originated in another organ, but cancer that spreads tends to go to specific organs, such as the liver. If a patient has tumors inside the liver, detectable using ultrasound, you have limited choices - remove a portion of the liver, or destroy the tumor from the inside. There exists a metal probe, inserted into the tumor guided by ultrasound. Once in place, 5 thin metal tines are extended out to the edges of the tumor. Then an RF signal at a certain frequency is fed into these tines, to destroy the tissue surrounding the tumor, thus cutting it off from its blood supply, and saving the patient from a major operation.
Patients having surgery in the brain or sinuses often have a mass or other offending material that needs to be removed. In the case of a mass inside the brain, you can't go removing large pieces of brain. In the case of the sinus, surgeons use a video endoscope either up the nose or through the room of the mouth along with suction and cutting devices to remove mass quantities of goobers. In either case, how do surgeons know where they are going?
A system of radio frequency receivers is placed near the patient's head, while a transmitter is attached to the tip of the endoscope. By triangulating the position in X-Y-Z space, and synchronizing this 3D position with a 3D reconstruction of the brain or sinus created by a CAT Scan machine, the surgeon gets a real-time 3D roadmap of the surgical field. Motion capture systems work on a similar concept.
Thinking on One's Feet
Troubleshooting your own video system is pretty straightforward. Troubleshooting someone else's system can be a problem. In an OR, the cables are often hidden in conduits, the ceiling or are simply not labeled.
Thinking on your feet can also relate to finding yourself in unexpected circumstances, such as, oh I don't know, being approached by security guards while shooting the exterior of a hospital - hypothetically, or so I have heard :)
Many of the thinking on your feet experiences seem brilliant at the time, but they are not memorable. You do what you gotta do to get the job done.
Truth be told, I used to carry a Swiss Army knife and a roll of duct tape in my leather jacket at all times. Even on airplanes pre-2001. Now most of my multi-tools are property of TSA, but a roll of gaffer's tape still has 1001 uses, but that is a whole blog post of its own.
As always, thanks for reading.