Paediatric Compassionate Photography (PCP), Part 1 of 4: Definition & Purpose

Part 1: Definition and Purpose

PCP is documentary photography specializing in paediatric patients with serious illnesses potentially leading to poor outcomes. There are two types of PCP, differentiated by their proximity to potential death:

• photos taken weeks, or even months before potential death, as in a patient who is scheduled to undergo a high-risk procedure. There is less urgency for the photo session, scheduling is flexible, and the atmosphere is relatively relaxed. Location may be away from the patient’s bed, in a non-clinical setting such as a sun-lit playroom or in a garden.
• Photos taken immediately before and/or after the withdrawal of life support. Although the photo session may be scheduled anywhere from a few hours to days ahead, the actual shoot is subject to the patient’s condition on the advice of medical staff and parents' wishes.

PCP is not a record of a clinical procedure. Melding craft and art, the aim of PCP is to document the physical presence of patients with their families (craft), and to capture the emotion and the atmosphere of the moment (art) in images that will be, at the least, bearable, even pleasant to look at in the future.

The wide latitude afforded the photographer to interpret these finals moments come with the immense responsibility to render a poignant occasion worth remembering in photos.

In my estimation, PCP is 25% photo technique and 75% preparations to get to the point where parents/guardians are comfortable enough that photos may be taken.

The aim of the photographer is to capture the beauty  of the patient, with the love and support of family members. Through a combination of judicious framing angles, lighting, and selective focus and depth of field, the clinical setting can be minimized and attention focused squarely on  people. 

Here is a link to the principles of design in photography.

Paediatric Compassionate Photography (PCP), Part 2 of 4: Equipment

Part 2: Photo Equipment

In the hands of a capable shooter, any equipment will suffice. Ideally, any gear should be an extension of one’s mind, eyes, and fingers. Setting adjustments should come naturally and quickly, like a pianist not having to look down at the keys. As such, any gear that the photographer is comfortable with is suitable gear. However, there are some features that I consider to be must-haves:

1. silent shutter (a truly silent shutter, NOT just a quiet shutter),
2. Live View with a tilt or articulating electronic screen,
3. at least 2 fast primes: 24mmm, 50mm (f1.4, f2.8 minimum)
4. a mid-range zoom with a macro feature, e.g., Sony 24-105F4

A silent shutter is ideal, for obvious reasons. The moments of reflection that go along with the grieving process shouldn’t be interrupted by the click-clack of the shutter. A silent shutter, in combination with an articulating screen allows for shooting where the camera doesn't have to be brought to the photographer's eyes. People instinctively "get ready” for a photo to be taken when the photographer brings the camera to his eyes; shooting while the camera is at waist-level allows for natural “poses”. Grabbing shots when the subjects are unaware captures unguarded moments.

A 2-sec shot burst can cover a wide range of facial expressions; letting off a burst as if one is shooting a sporting event can be very upsetting.

I've been a Sony user for the last 12 years. My main body is a Sony A7III. Although the Sony menu is known as the most counterintuitive in the camera industry, I've managed to customize my settings to the point where I can change them as soon as I want to. I have gotten to the ideal situation where the camera is now a neural extension of my mind. Shooting in RAW+JPG mode means I have the best possible image available (RAW), as well as an image (JPG) I can quickly send to my phone to be quickly sent to whoever needs it right away. Face and Eye Focus is so precise that faces are always in focus if desired.

The Sony 24-105F4 is extremely sharp wide open, and the vast majority of my photos are at F4. The high dynamic range and low noise even at ISO12800 means that every lighting situation is covered. 

The fast F1.4 primes are nice to have for a really shallow depth of field. My primes are extremely sharp wide open as well, although the depth of field at F1.4 is so shallow I shoot at F2.2 just to make sure I don't miss my point of focus.

Finally, it is nice, but not essential, to have a small flash, to be used as fill-flash for outdoor shots.