Patient X
by Jonathan Williamson

Reflection

This piece of photography aims to get across a point which I think is quite overlooked, and of which I have personal experience, however it was really highlighted as a universal problem when talking to Mrs Smith on a Home Visit.

Mrs Smith was diagnosed with bladder cancer three years ago. When her cancer returned the doctors tried a relatively new cancer drug, which was put directly into the bladder. Unfortunately Mrs Smith had a very bad reaction to this and the medication caused a lot of problems around the abdominal area. When the cancer returned yet again, she asked specifically to not have the drug again as she knew it had bad consequences. This decision was however over-ruled by the doctors just before surgery because they still felt the placement of the drug was necessary despite the information given about the patient’s the reaction. Mrs Smith is now in a period one month after surgery and is really ill due to the drug.

The first point my photo tries to highlight is, quite literally, the highlighting and focus of the photo. I used the depth of focus to make the stethoscope only in focus and blurred the edges of the photo to further draw attention to this. The editing of the colours in the photo, whilst providing a faded view which gives a curtain mood, also makes the red of the stethoscope stand out subtly over the others. The stethoscope was chosen because I feel it is a very prominent symbol of medicine. The focus of just the stethoscope and blurring of the edges represents how the traditional medical (less holistic) view is often used and how often the patient’s specific options are somewhat blurred. Mrs Smith’s case showed this when her knowledge of her own body’s reaction was over-ruled by the doctors’ because the drug’s effectiveness with other patients may have ‘medically’ made it worth pursuing. Along with the fact this was arguably the wrong decision, it makes the patient feel like ‘just another patient’ because they feel they haven’t been listened to, nor their opinions valued.

When talking to Mrs Smith, she said she felt “lost in the system”, as now she isn’t in hospital, she hasn’t been followed up and her problems are left un-diagnosed, with no course of action foreseeable. Mrs Smith also said she felt very un-informed afterwards about the future, which relates to the lack of holistic care that should ideally follow up surgery.

The patient in the picture is wearing a hospital wristband, named ‘Patient X’. I chose the wristband to be in the picture, as, along with the stethoscope symbolising medicine, the hospital wristband represents the patient’s identity. By writing ‘Patient X’, I tried to portray the lack of individual specific care and that they are just another patient ‘lost in the system’.

Mrs Smith found that the only reason she could cope with everything was due to her family, specifically her daughter, chasing up results and taking on the problem of care and her diagnosis. I think this is a prominent point as many ill patients don’t have the energy to handle their care and so it is very common that it is left up to family or friends. The arm reaching into the photo and resting on that of the patient’s, is quite an emotional gesture. From my experience, this gesture epitomises this essential social support. The photo itself represents the hazy experience of uncertainty, amongst the other issues I have described. I therefore used this arm to reach into the photo to show the external support. It is also a link out of the situation, which Mrs Smith said was essential.

Jonathan Williamson

Year One, G.P. Attachment, 2010

Comments

Sam Scotcher

02 March 2011 - 11:27:02
"Great piece of work - nice skills with the depth focusing on the stethoscope to show the traditional approach to medicine."

Tom Geddes

17 March 2011 - 13:11:10
"A great bit of photography, I think the soft focus on the patients wristband allowing you to just make out the "patient X" is a great way to further portray the vagueness and lack of individual specific care in the way many patients feel like they are being treated."

Trevor Thompson

19 March 2012 - 11:25:01
"It is very well judged - the balance of focus and out of focus. "

EK

19 March 2012 - 11:25:01
"I love this photograph because it clearly highlights the need for caring as well as medical attention. The focus on the stethoscope and not the patient is also very poignant."

Ellen

19 March 2012 - 11:25:01
"This is very clever as it highlights the traditional way many people think of medicince but then also the problems associated with this."

Sam

19 March 2012 - 11:25:01
"When I first saw the photograph I was able to place my own meaning on it which is very important for this kind of work. To me the stethoscope on the bed gave two interpretations: the doctor breaking down the professional barrier between themselves and the patient to show true compassion, signified by the skin to skin contact where the hand is the doctor's, or the opposite where the doctor is giving up on the patient because they are a difficult case. As you say in your reflection I also felt the patient being in an unfocussed area of the picture was poignant and very cleverly portrayed the feeling of being lost in the system. The armband that displays "patient x" in my head links back to my personal interpretation of the stethoscope, and can work in both scenarios described, in that if the patient is just another patient, "patient x", can one truly display empathy when you break the down the professional barrier or would you give up on a case that is hard because you don't see them as a person, merely another case of a disease? A fantastic piece of photography, well done."

Simi Ninan

19 March 2012 - 11:25:01
"I found this photo to be extremely touching. It made me think back to the time when I was hospitalized for a minor surgery, and yet how vulnerable I felt in the hospital gown and how my parents were a constant support for me, being my advocate. I love how the stethoscope is on focus. For me, it showed how this can be used as a form of barrier between the doctor; A source of protection from becoming emotionally attached to the patient. Another aspect of this photo I found interesting was how even when the 'patient' in 'patient X ' has been blurred, my first thought was that it read 'patient X'. This showed, how we make assumptions quickly without truly taking time to individualize patients. It shows how most of the time we are in 'autopilot'mode. A brilliant peace of photography tackling many aspects of whole person care. Well done!"

Ella Smith

25 October 2017 - 21:36:15
"I believe this photo to be hugely effective. It emphasises the importance of always treating the patient rather than their disease. I found the use of 'patient X' to be particularly touching, as my before my great grandfather's passing he too described himself as feeling 'nameless', especially when being treated by a huge number and variety of health care professionals. The use of the stethoscope in the foreground really made me question if there is such a thing as 'too much medicine' and if sometimes medicine can actually be a barrier in a patient's recovery rather than an aid. As gestured by the supporting arm, sometimes all a patient needs is an understanding and caring presence. This is another essential thing to consider when using shared-decision making, which is not always used by doctors as shown by the scenario above. This image has showed me that doctors must strive to consider all aspects of an individual and that often medicine overlooks and undermines the way patient's feel and think. Outstanding piece of work."

Chelsea Wu

04 November 2018 - 09:22:53
"The composition of this photo is highly effective at portraying the artists intention. My interpretation of this is… The stethoscope represents the clinical side to a Mrs Smith whilst the hands represents Mrs Smith as a whole, including her feelings, relationships (with the person holding her) etc. The stethoscope being so much more in focus than the hands stress that in the NHS today, a patient is defined by their illness and not by who they actually are. Some are even forced to loose who they are as their decisions are taken away from them – like Mrs Smith who has been labelled ‘Patient X’, a nameless person on a sheet of paper stressing the unimportance of her own beliefs and autonomy to the clinicians treating her."

Alex Price

04 November 2018 - 09:24:13
"The photo conveys a sense of depersonalisation- the patient is merely just another patient and the doctor is just doing another job. To me it emphasises the fact that patients should be treated as individuals and listened to, rather than medics thinking 'the doctor knows best' and dismissing any patient views that do not conform to their own. Patients should be given the information necessary, they should be supported in making decisions and they should be treated as a human rather than the symptoms of their disease. The focus on the stethoscope acts as a metaphor for there being a barrier between the patient and doctor: perhaps the doctor acting as superior with lack of shared-decision making and patient-centred care. Good patient care envelops the practice of medicine and this picture shows how, often, this is disregarded. Amazing piece of work that really does tell a story."

amy

04 November 2018 - 22:12:39
"The photograph really appealed to me initially because of the selective colour and choice of focus and the background on the image really helps to explain the purpose. "

Imogen

05 November 2018 - 07:19:39
"This photo depicts the lack of individuality that some patients may feel during their treatment, due to the doctor perhaps being under pressure and rushed, and hence dismissing their personal wishes. The focus on the stethoscope suggests a lack of connection between the doctor and patient, which is also emphasised by the wristband labeling her as 'patient X'. "