Cradle to Grave

A few blogs ago I mentioned that I'm in the medical profession. I'm going to pick up on that thread and talk a bit about an experience that relates my day job to my cemetery photography. Totally unlike me, I know. I tend to jump all over the place with these stories, simply because I have the attention span of a gnat.

Sometime in the early 2000s I had an exhibit of my work in a cafe, one of my first public hangings, as it were. The image above was one of the fifteen pieces in the show. I call it "Possessed of the Means," a relatively simple composition, yet it seems to have innate power. A woman phoned me asking to buy it. Obviously I like when people buy my work--it fills me with a sense of awe that people are willing to part with their hard-earned cash in exchange for something I've created. What I'm never prepared for, however, are the stories. People often feel obliged to tell me why they're buying my work.

Sometimes the stories are amusing, like the woman who bought the photograph at right--she emailed me afterwords to tell me she loved it so much she's having it tattooed onto her back! People are always respectful of the work, but very often the stories are quite unsettling. The woman who bought "Possessed of the Means"  hit me with a story that left me speechless. But first, a little background on what I do for a living, to show that my interests actually run from cradle to grave.

I work at a hospital where I (among other things) prepare and prime heart-lung bypass machines for newborn babies. This special kind of bypass called "ECMO" came into being in the 1970s, reaching accepted status as a viable therapy (for certain respiratory ailments) in the late 1980s. ECMO stands for Extracorporeal Membrane Oxygenation, which simply implies an artificial lung, pump, and plastic tubing system outside the body. Vascular access is attained on both the venous and arterial systems (through the neck), blood is siphoned out, oxygenated, then re-infused into the patient.

ECMO is not structurally different from adult heart-lung bypass, whose purpose is to bypass the heart and lungs for a few hours while some surgery is being done, usually on the heart itself. The main difference being that with certain babies with respiratory failure, ECMO is actually the therapy itself. Bypassing the organs for a week or so allows them to heal themselves! Our hospital was the lucky 13th ECMO center in the world, in 1988. Since then, we've saved over 500 babies, achieving a survival rate of about 95%. These are neonates who would've died without ECMO.

Back in 1988, a hospital couldn't actually buy an "ECMO Machine" - they didn't exist. Such things only became commercially available in the mid-1990s after ECMO became more than an "experimental" procedure (and insurance companies would pay for it). It was up to us biomedical engineers to build the devices that would provide the therapy. We built several over the years, often treating three babies at once. We eventually purchased sophisticated new commercially-available ECMO systems, scrapping most of our handmade systems. At one point, the Franklin Institute (in Philadelphia) asked to borrow one for a year-long exhibit on medical innovation. It was quite an honor, as the first heart-lung machine was designed and used at the hospital where I work decades ago by Dr. John and Mary Gibbon.

I never see the patient when I'm working, what with the surgical drapes. My team sets up the bypass system, primes it with blood, assists the surgeon in connection to the patient, then leaves. Nurses manage the case for the duration. I only get called if there's a major problem.  I also don't see the ECMO 'graduates', survivors at 5 or so years of age when their happy parents bring them back for a visit.  My eyes would leak all over the place. There's a reason I didn't train to do direct patient care, and instead became a biomedical engineer: I'd rather work with machines--machines don't cry. I really don't handle emotionally-charged situations very well, especially when they involve children.

So, back to selling my art. After this particular show came down, I made arrangements to meet the buyer and give her the framed "Possessed of the Means" piece she wanted. It was a happy enough occasion, I thought--I was getting a few hundred dollars and she was getting artwork that she desired. We sat at a table in the cafe and she immediately told me that when she originally called me, she listened to the pre-recorded message on my work answering machine, and asked what I had to do with ECMO. I figured she was curious so I began to give her the layman's description of what ECMO is. She stopped me fairly quickly and said, "I know what it is. My twelve-day-old son died on ECMO. The angel in your photograph reminds me of the one on his grave."

What do you say in a situation like that? Selfishly, I hoped her son hadn't been treated at the hospital where I work, but I was at a loss for words. All I could think to do was express my condolences and told her simply that I was glad she found meaning in my work.