Sunday, June 28, 2009

Reston Town Center, 6.28.09

Great day at the races, nice venue. Reston Town Center Grand Prix, a criterium hosted by Evolution Cycling Club, in Reston, Virginia. Keeper rate was high. Techniques seem to be falling into place, mid-season. Ready for Fitchburg next week, massive Massachusetts stage race and party. Had a little "freedom of the press" travail, since a road guard and cop kicked me out of a sweet spot in the most downhill corner, a strip of median grass I named "Crash Beach." A few good crash shots there, like this one, a flying junior and bike. But I didn't get the quite the angles or proximity I wanted, so I left. Anyway, nothing Pentagon Papers level. The Crash Beach shots were pretty good.

Shot mostly ISO 800 and 1/1,250 ... F-stop was more constrained, since it was overcast and sometimes drizzly. A lot of shots around F5.6. Most shots manual focus. Resulted in some pretty good snappers, like this one. Tight and pretty clear. Rich tone. In general, I'd pre-focus then capture folks in the peloton when they came through sharp and, mostly, had an interesting expression. Candids mostly at 1/320 second or less. Some interesting architectural features, dogs, kids, guys and gals.

During Cat 4 race, light turned bad, so picture quality (and keepers) turned down. Same for second half of women's 1/2/3 event. Album is published here, about 275 images, more than usual.

Thursday, June 25, 2009

Risk taking

Someone beloved to me said: "Dad, you're too close. You could get hurt." (Don't do that.) I've had crashes almost land on top of me. I'm careful to stay out of the way, to not contribute to crashes. Being close, though, helps grab the decisive moment. I'm not too much for complicated photographic technique, a bunch of flashes and $20K of gear (though my stuff isn't cheap). I think -- my photographic style is -- that the real value, the art, is catching the scene and the context. Recording something very human, pathos. Whether it's slum kids in Cairo, a dying man, or a cyclist on the edge.

Yep. I could get hurt. Here, I'm ambivalent. Because I was gravely injured by a drunk driver when I was 17, I have not had a pain free day in 32 years (excluding occasional, prescribed narcotic drop-offs). My father was a famous war correspondent (and occasional photographer), all the big ones from Vietnam forward. (Age 75, he was embedded with 1st Marines in Iraq,
Kuwait to Baghdad.) My great grandfather and namesake walked from Capetown to Cairo, taking pictures. Two or three times. He walked across Russia with a pushcart. India, Japan, more. I've marched with protestors in Mexico shooting film, and left my girlfriend (now wife) crying on the street while the brown-shirts arrested me photographing Basque rebels in Spain. (Both times my camera and pictures were confiscated or stolen.)

Alas, getting close, it's a bit risky. But -- for a mild-mannered computer nerd embedded in government -- it is vivifying. When I'm done, kaput, I hope it will be a good picture.

Tuesday, June 23, 2009

Tour of Washington County (Williamsport Criterium), 6.21.2009

Caught the last half of the last stage of the Tour of Washington County (Maryland), slipping into Williamsport after lunch Sunday to catch a bit of the top women's race and the Category 1/2/3 criterium. My son was riding top 5 in general classification coming into the crtierium. He finished third overall. Pretty awesome.

Light was good, bright, and I settled into a couple corner spots, shooting racers pretty close, often 5 to 15 feet away. Mostly used manual focus technique, with ISO 400 or 800 and 1/1000 or 1/1250 sec. shutter speed. As normal, shot candids at 1/320. Corner location afforded a couple crash shots, reproduced in blurred sequence here and here. Rest of gallery starts here.

Health to the fallen riders, and to guys who slurped brown splash that ran off farm fields during Saturday's wet road race.

Saturday, June 20, 2009

G10 (first outing), 6.20.09

I like to take pictures and I like to ride bikes. I need to ride to help keep my body (such as it is) from falling apart. I'm going to Bend in a few weeks (as Soigneur and father), a land of great rides and visual splendor. But my photography kit -- a Canon 5D and a passel of lenses -- isn't bike-suitable. It doesn't go in a jersey pocket. I have a little old Nikon Coolpix point and shoot. It's serviceable, but with 3 Mb pixels and all, it didn't feel up to snuff. I test rode the Coolpix last weekend out in Poolesville and up and down Sugarloaf. The shots were pretty mediocre. So I traded in a summer's worth of kitchen points today and pulled down a Canon G10, a 15 Mb pixel gizmo that also shoots RAW. Everyone raves about it. $450 at Best Buy. (I lusted after the Leica Dlux 4, but at about $700 ... I couldn't walk that plank ...)

Today I did a quick walkabout with the G10, from Rosslyn across Key Bridge into Georgetown. My initial reaction to the work is not astounding. Obviously, I still have a lot to learn to optimize the shots (I need to re-read the instruction manual, for starters) ... but I was concerned that even with 15 Mb pixels some of the shots came out sort of grainy, a moire wash. Also, as I knew, the gizmo isn't much for action shots, taking more than a second to cycle through a capture. On the other hand, the color seems spot on and it can grab pretty sharp detail. I'll keep practicing and I'm pretty confident by the time I'm rolling about the Three Sisters or Crater, in Oregon, the shots will be snazzy.

Friday, June 12, 2009

EMT Training

This was my second rotation at the Inova Fairfax Emergency Department. My prior study at Inova consisted of about 12 case observations, ranging from care for patients with significant hypertension, respiratory difficulty, wound care, substance abuse, cancer-related medical disability, syncope, and psychogenic issues; as well as procedures such as male patient personal care, cleaning medical equipment, electrocardiograms, ultrasound, and computerized axial tomography (CAT). My preceptor gave me high marks, but apologized that the round was “not very exciting.”

For my second study, I arrived at 6:40 AM, and was assigned to ER triage. The initial observed cases included leg joint swelling, abdominal pain (suspected early pregnancy), severed finger (construction accident), severe hypertension (BP 294/179) with acute abdomen, and a cancer patient with tachycardia (P 200). At about 9:00, we were notified of incoming code yellow and code blue vehicular trauma patients, transported by ambulance and air, respectively.

My preceptor assigned me to stand in a doorway between the two large ER patient care bays. Patient 1, the code yellow, arrived first, and was transferred to an ER bed in bay 1. S/he was alert, responsive and in severe pain. ER staff performed a rapid trauma assessment and identified probable pelvic fractures and lower abdominal injuries. The patient received x-rays in the bay, and was to advance to CAT scan. Cervical spine immobilization and backboard techniques were used throughout patient care.

Patient 2, code blue, arrived and was transferred to a ER bed in bay 2. Patient 2 received a Glasgow Coma Scale rating of 4 at the accident scene and 3 in the ER. (GCS scores range from 3 to 15, with 3 being most severe.) Prior to arrival, the patient was intubated by EMT personnel. The unresponsive patient was catheterized, given intravenous fluids and medications. Rapid trauma assessment indicated no obvious trauma beyond ecchymosis (bruising) and swelling about the left eye, and slowly reactive pupils. I helped transport the patient to CAT scan. I considerately asked a few questions. A medical resident, previously an EMT-paramedic, instructed me to ‘follow [and observe] this patient all day.’ Imaging showed approximately 2 cm midline deviation of the cerebrum. This indicated cerebral hemorrhaging and swelling. The patient and trauma team returned to the ER bay and further medications were administered. The patient received various assessments, including deep foot stimulation, for which s/he was unresponsive. The patient showed seizure activity in the arms. Subsequently, we took the patient to the Trauma Intensive Care Unit (TICU). The patient was evaluated by a neurosurgeon. An intracranial pressure (ICP) monitor was inserted by drilling a hole in the patient’s skull above the right ventricle and inserting a fiber optic measurement device. Patient position was managed, from Trendellenberg (feet elevated) to reverse Trendellenberg to observe ICP. ICP ranged as high as 85; normal is less than 15 mm Hg. Medications, including mannitol (an osmotic diuretic to reduce intraocular and intracranial pressures), were administered. The patient appeared to be roused, moving all four limbs, and a doctor worked to evoke a patient response by loudly calling the patient’s name, asking the patient to show two fingers, slapping the patient’s chest and squeezing the patient’s hand and arm. The patient did not respond to the stimulation.

ICP remained high. Medical staff inserted main line IV routes for high-volume administration of medications in the patient’s chest and arm(s). I maintained traction on the patient's right arm, to help manage swelling caused by the new line. Doctors indicated that surgery was required. We took the patient for a further CAT scan in order to image the current positioning of the brain. The patient was taken to an operating room (OR). Because I was not wearing surgical garb, I remained in an outer hallway. The patient was prepped for surgery, head shaved and orientation lines marked on the patient’s head (with lines indicating a left-superior cranial incision arc, from the top of the head to above the left ear). My preceptor returned from the OR and saw that I was outfitted in surgical garb — hat, mask, shirt, pants and booties. I put on gloves in the OR. There were approximately 12 medical personal in the OR, including the neurosurgeon and resident. I stood out of the way, about six to twelve feet from the patient, observing medical procedure and asking infrequent questions. The surgeon cut a rounded triangular skin and tissue flap (approx. 10x15 cm.) from the patient’s left superior cranium, and lifted this flap back to expose the skull (cauterizing vessels/tissues in the process). The surgeon drilled approximately six burr holes on the perimeter of the exposed skull area. (This procedure is termed craniotomy.) When the surgeon(s) subsequently pierced the dura mater beneath the skull, cerebrospinal fluid and blood gushed from the opening(s). The burr holes were connected by the surgical drilling/cutting instrument and the patient’s skull segment removed. (This procedure is termed craniectomy.) Incisions were made into the dura mater. Upon broad opening of the dura mater, the brain herniated about 2-3 centimeters from the plane of the skull. This was dramatic. It looked like patient’s brain leapt from its container. Several medical staff commented: “Did you see that? ... That’s not good.”

Surgeons reattached the patient’s skin and tissue flap and conducted various closing and wound care activities. I accompanied the patient back to TICU. The patient’s ICP was reduced, but s/he remained in critical condition. At 3:30 pm, I excused myself, returned my surgical garb, met with my initial preceptor (in ER triage), obtained signoff, and returned home.

[material redacted]

Sunday, June 7, 2009

Ride Sally Ride, 6.06.2009

Rode bike out to nice criterium in Sterling, Virginia, hosted by Whole Wheel Velo Club.  (Carolyn drove and brought camera gear ... I drove home, she rode ... symmetry.)  Arrived about noon, in time to catch some master's racing and my son Avery's Cat 4 event along with Cat 3, Women's and 1/2/3 events.  Good light, hazy then a little bright later in the day.  Shot many shots, all manual focus but sometimes using 3-4 shots per second bursts.  Posted 150+ here.

Hung out in basically same place all day, catching riders from 6-20 feet away.  Nice tight corner, might have been better with wide angle, but seemed to do okay with lens at about 100-135 mm focal length (using 70-200 F4L).   A fellow I met at at Crystal City, also working with Canon 5D, used his ISO and shutter speed cranked way up (e.g., ISO 1600+ w/1/3200 shutter), so I tried amping these settings a bit.  Basically, I didn't like the results.  High ISO resulted in loss of fine-grained detail, and increased depth of field so much that backgrounds came into focus and proved distracting.  (In many shots, you can see my friends chillin' in lawn chairs under their canopy or other noise, like building roof antennae and telephone wires.)  Lesson learned.

During my only saunter of the day, a junior crashed after high-speed corner following downhill chute.  Fearing it was my own (I asked, "red and white?" and the official said "yes," making it likely one of the kids I work with ...), I ran to the crash.  It was a high octane junior from another team.  An EMT was on scene, so I put on blue gloves and took C-spine (held his head to immobilize the patient's cervical spine).  The youth's helmet had been blown apart on the left side, so we feared head injury; 6-8 cm laceration on left face, possible jaw/orbital injury.  Hip abrasion and injury.  Transferred C-spine to crew when ambulance arrived.  I've seen a lot of injury, but this one made me nauseous.  Maybe because it was a youth like my own, or empty stomach.