The Opposite of Fashion

September 20, 2010 § 2 Comments

Hidradenitis suppurativa of the axilla. Photo from

A career in fashion photography seems to be the dream of a lot of young photographers these days. In medical photography however, you won’t find much glamour or glitz, but a lot of real people with real problems.

A patient came up from the skin ward for some pre-treatment photos. An experimental and potentially dangerous treatment, he told me, for the skin disease hidradenitis suppurativa. This non-contagious disease causes chronic abscesses and cysts in the sweat and sebaceous glands of the skin. Frequent inflammation and infections often results in wounds that don’t heal well. This guy was willing to try an experimental IV drug treatment to stop this thing. Even though one of the reported side-effects was cardiac arrest.

One of his affected areas was his buttocks.  In order to expose an pilonidal cyst in his natal cleft the patient had to spread his buttocks with his hands. A potentially humiliating pose for any person, but a lot of people with chronic diseases are admirably little embarrassed about their bodies. So this guy matter-of-factly turned his back to me saying “I guess I’ll have to stand like this if you’re gonna get a decent shot”. I just said “yes” and started adjusting the light a little, when he said: “I’m sorry. This isn’t exactly the most delicate of views.”

I admit I almost let out a laugh. He hit the nail on the head, all right. “I guess you’re right,” I said. “But then again, we didn’t sign up to shoot fashion.”

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