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Observations Medicine and the Media

Picture imperfect

BMJ 2008; 337 doi: (Published 17 September 2008) Cite this as: BMJ 2008;337:a1659

Rapid Response:

Spot the Difference

I congratulate Dr Manoj Padman on being the right doctor and the right time. Idling a week-end away at a Children’s hospital less busy than my own, Dr Padman noticed in that fountain of truth, The Sunday Times, a photograph of a child in Zimbabwe whose legs would not have been broken as we were told in the caption, by Mugabe’s thugs, but seemed instead to be in the middle of treatment for pes equino- varus. No-one suggests that Mugabe, his thugs or the child did not exist because the plasters were wrong.

I hesitate to ask if this has been done before and whether the last event was attended by a full page BMJ fol-de-rol because I know the answer is yes, and not a million miles away from Tavistock Square, either. In 2001, a photograph of Dr Van Velsen, pathologist at Alder Hey Hospital appeared, in the BMJ. Dr David Thomas emailed in from Oz to ask ; “The photograph accompanying the news article regarding the Alder Hey report on organ retention and falsified records, is a falsification itself - it consists of at least two superimposed images. Why falsify photographs to make a good image, or was the irony intentional? “ (1)

The BMJ's pictures editor, Jan Croot responded, with no fanfare at all: “It was not an irony, and it wasn't intended to fool people into thinking it was real. It was a way of making two images relevant to each other and that would be uncompromised by splicing, would take up less space, and appear more interesting than they would have done separately.” Ms Croot has not joined the US Treasury.

One gets a full page spread and the earlier gets buried in the
electronic version of the BMJ. So why, may we ask, is there a difference
in treatment ? Surely, surely not we all ask ourselves again, because Dr
Van Velsen was subject to GMC proceedings and is clearly a bad man. He was
struck off after an undefended petition, and is clearly worse than Mr
Mugabe – last liberation leader in the African continent . As a BBC
announcer portentously refers to him hushed tones, even when it comes to
11m% inflation, perhaps he is in some way blameless. An alternative is
that after the Raj Persaud case, Dr Padman thinks that falsification in
print merits some dire punishment – a view shared by the GMC but no-one
else. Dr Persaud was referred, let us recollect, by the Church of
Scientology – laughably this apparently shows the GMC is not susceptible
to outside pressure.

But anyway as we ponder all that, I can point out that it has been a
good week for forged photos and varying treatment. The Sunday Times
carried a full page on a retrospective on Robert Capa. His most famous
photo is the soldier of the Spanish Civil War being shot on camera. Later
the original roll of film was shown to have later shots of the man eating
his lunch. The retrospective will rehabilitate Capa by stating that the
original roll, wasn’t, but instead was a edited copy, out of chronological

Dorothea Lange’s photograph of the Oklahoma Sharecropper by great
contrast, does seem to have been of a mother of seven without employment.

Cecil Beaton’s photograph of a bomb victim Eileen Dunn 1940, a
doleful gamine with huge goo-goo eyes, unleashed floods treacly prose.
Here is a spoonful: “His photos of children can be terribly moving. His
wartime image of bomb victim Eileen Dunne (1940) shows her ‘enthroned’ in
a hospital bed, holding her doll, meeting the eye of the camera with her
own huge, wondering, beautiful eyes.” (2). Here is another: “He took
pictures of bomb damage and its victims, pilots in training, children
evacuees and his unforgettable portrait of the 3 year old blitz victim
Eileen Dunne (1940) in a hospital bed in the North of England was
particularly poignant at that time. (3) A few years ago, a medic pointed
out that Eileen has a classical mastoid dressing, implying of course that
Eileen might have been around when there was bombing but wasn’t a victim.
Anyone now re-reading the prose quoted above, would be unable to laugh
because he was gagging.

As the century moves on, restaged film becomes common place.
Reporters don’t like having their heads shot off, so a lot of the trench
warfare shots of the First World War were staged. Incredibly when they
were played in cinemas, men on leave would shout – “yes yes it is just
like that!” even when people in different brigades’ uniform were going
over the top, showing a certain licence which escaped attention at the

Years before the BBC liberated Kabul on radio, Allenby replayed his
march into Jerusalem, showing a diminutive Lawrence in the background, and
Gen Allenby walking amongst the liberated peoples. The 1918 film had a
message and had to be done right. Allenby wished to walk amongst the
liberated people in contrast to the Kaiser who had previously visited and
rode (in a car).

Flag ceremonies get replayed as well. The marines at Iwo Jima
hoisting Old Glory weren’t shot by Japanese snipers because there were any
by the time it was re-shot. Also the Red Army occupying the Reichstag in
1945 was a re-take and is therefore visually perfect.

But let us consider seriously if this was a modern phenomenon,
typical only to disgraceful dishonest medics which the GMC is nobly
trying to stamp out and rid this disgraceful cancer from our midst. And we
find all sorts of examples where a picture is worth a thousand lies.

In 1618, the Thirty Years War broke out after the Imperial
ambassadors had been thrown out of the windows of the Hradcany Castle in
Prague. The cartoons show them being thrown out of the long drop, whereas
in fact they were thrown out of the short drop probably (Protestant) or
possibly (Roman Catholic) onto a dung heap. (4)

Earlier still, The woodcut 1563 of the burning for heresy of Hugh
Latimer (5) in the ditch outside Oxford wall 1556 which is now a part in
Broad St., seems to be historical. There is an X which marks the spot in
Broad St and the view of the tower in which he spent his last days is now
obscured by buildings but is still there. Bonner birching a Protestant
(6) in the same book, Foxe’s Book of Martyrs has caused more comment, as
Bonner looks as though he is enjoying it and the Protestant has no
breeches. This may contrast the pious celibacy of the imprisoned and
tortured Protestants with the profligate unmarried Marian priesthood. At
the time 1569, Bonner commented of the woodcut, “a vengeance on the foole,
how could be get my picture drawn so right?’ Wiki comments of Foxe,
“Although the work is more accurate when dealing with events during Foxe's
time, it is generally not a correct or impartial account of the period,
and includes occasional "wilful falsification of evidence."

Clearly there has been an industry of falsification, but in previous
times, far less finger pointing. Book burning was reserved for heresy and
not falsification. Is the intention to deceive ? Certainly the altered
image elicits different emotions than the original and is intended to do
so. I suggest that it is commonplace in history and not particularly
heinous and has had not long term effect. I further suggest that the
reason it got a page spread in the BMJ was because of previous GMC
interest in Dr Persaud’s case which history will quickly show to a
monumental waste of the GMC’s time and our money.

Oliver Dearlove FRCA





4. Note a .



Conflicts of interest: I provided some of the Wiki comment on Latimer
and The Defenestration of Prague 1618 which was then later modified. These
are not the views of anyone else, my employer, College of which I am
Treasurer and certainly not the regulator

Competing interests:
as script

Competing interests: No competing interests

29 September 2008
Oliver R Dearlove
Consultant Anaesthetist
Royal Manchester Children's Hospital